How to be an EMS manager*

If I were an EMS manager**, this is what I would say to the crews:

  1. Let’s not sweat the small stuff. I don’t care what you wear as long as you are in the basic uniform, properly identified and don’t look like a dipshit. I know how hot and how cold and how wet it can get.
  2. I don’t care where you cover your post or what route you take as long as you’re on scene in a timely fashion. But drive safely.
  3. I do care that you show up to work early like responsible adults so you don’t fuck the crews you’re relieving. I do care that you show up to work, period, as scheduled even if there is a bitchin’ party happening somewhere so you don’t fuck the crews who are responsible enough to come to work (or not cool enough to be invited). I do care that you do not call in sick after failing to get vacation approved. I do care that you do your time and take your turn working weekends and shitty shifts like everyone else.
  4. On the other hand, I do not want you at work if you’re sick. It’s unfair to everyone. Sick leave is for sick employees. Take care of yourself first, then you can properly take care of others.
  5. The dispatchers will try to accommodate your requests to get food and coffee as reasonably as they can so you don’t show up on a call hungry or, worse, grumpy. They will arrange to get you off on time. But please don’t forget the unscheduled nature of this work.
  6. I do very much care that you are nice to patients and their families. But I do not want the assholes walking all over you either, and I will back you as long as you handle it with appropriate firmness.
  7. I also do care that you do the right thing for your patients. DON’T BE LAZY. Laziness means sloppiness, and sloppiness means bad outcomes. I don’t want to hear about you talking someone out of a transport just because you don’t want to get off late.
  8. I want you to realize that everyone can learn something from everyone, anytime.

And this is what I would say to the local EMS authority:

  1. Cardiac arrest aside, response priorities and response time requirements are completely stupid – both in theory and in practice. “I don’t feel good” is Code 3 because someone said yes to the absurdly leading question, “Are you short of breath?” Fuck off. If there is a better example of things like MPDS making everything more complicated than they have to be, I don’t know what it is.
  2. Let my crews refuse transports and make someone else – anyone else – take the psych calls.
  3. If my crews want to walk the guy who wants a sandwich or the voluntary psych patient into the ED, the nurses do NOT get to say anything to my crews. They are not the ones unnecessarily lifting people who can walk.
*Reality suspended
**Again, reality suspended.

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