Talking to a five year old about EMS...what to say?

            Hypothetical situation…you are asked to speak at a school to a group of approximately five year old kids about EMS for public safety awareness week (or whatever you want to call it). You are standing in front of about 15 kids expecting you to tell them some crazy cool stuff about driving ambulances with lights and sirens…so what do you say? You could start by telling them that, in all honesty, (especially if you are working for a private Ambulance Company) we do not use the sirens and lights all that often. In fact, kids we transport grandma or grandpa from point A-B and take discharges from hospitals home, etc. You could tell them that our job as an EMT is a thankless one, involving long, sleepless hours with little compensation. You could tell them about all those times you were harassed by patients, spit on, attacked, yelled/screamed at, treated like an idiot…You could tell them all these things and more. I like to think differently. I am one of those crazy optimistic people who think things can only get better. I happen to have a wonderful girlfriend who thinks the same way and she happens to be a pretty awesome teacher for young kids in pre-K education. She as proved to be an inspiration, with little pay or thanks for her job, she keeps a smile on her face even in the most tough of situations. Her positive attitude and passion for this age group has propelled me to think that maybe being an EMT is not all that bad, especially when every kid wants to be in a cool looking vehicle with lights and sirens (and guess what…I live that dream everyday!). I believe Sir Ernest Shackleton put it just right when he said, “Men and women wanted for hazardous journey. Small wages. Bitter cold. Long months of complete darkness. Constant danger. Safe return doubtful. Honour and recognition in case of success.” This is a hard job with constant danger and no recognition; however, there is success and with that success happiness knowing that what you have done has impacted someone’s life regardless of whether or not it was a routine transport to or from dialysis. We make an impact on all of our patients and they make an impact on us. In this job you are constantly learning, constantly meeting new people, constantly being put into situations that are challenging and dangerous. We are the few, the proud, the EMT.

            So, what do you say to the five year olds looking up at you with great expectations? You tell them the truth…this is a hard job and driving an ambulance can be fun, but I get to help people every day and that is what makes it worth every minute of my time I invest in this job. I get to help grandma and grandpa cross the street, I get to bring joy to people who may rarely have contact with the outside world, I get to save people who, without me, could get hurt and have no one to help them. I am not a superhero, I am not a hero in general, I am just a regular guy who wakes up every morning, makes a cup of coffee and goes to work. What I am, is an EMT, and this is my life. I have no secret identity, I do not hide from the world until needed…no…I stand proud to serve my community in rain, sleet, hail, blizzard, you name it, and for all that I do not expect thanks, nor medals, nor compensation, I do not stand at the top of a building with a big S on my shirt nor a picture of a bat…no…I  have served my community, I have possibly saved lives, possibly made someone happy for a brief moment, but my sense of accomplishment is making it home at the end of the day knowing I did all these great things while also getting the opportunity to see and spend time with the ones I love. So for all you kids out there, or those who are kids at heart, remember, as tough as our job may be, as little thanks as we may get, we do an important job and we are heroes, or, at least to those kids we are.

EMS Round Table Discussion

Yesterday, I went to observe a mock call session at another college with a fellow EMT from my squad. Needless to say, the mock call session was incredibly well done with details ranging from bystanders who were given specific details of what to say and what not to say on-scene (simulating the fact that some bystanders know more than others which further helps the responding EMT identify who would have more information on a scene), to fake blood and clothes for the EMTs to cut off the patient (Awesome!). This whole session got me thinking about how to effectively train/educate the EMTs/FRs at my school and I came up with an idea. Mind you, this idea came to me during a US Foreign Policy class round table discussion and made it very hard for me to concentrate for the rest of the class. The idea popped into my head because I observed how my professor set up our class discussion and our class in general. At the beginning of the week, my professor provides the class with a lecture outlining the particulars of the weeks topic (this week he lectured about Operation Ajax and the rise of fundamentalist Iran). Then, during the week, the class does the assigned readings and on Friday we all come together to discuss, in a round table setting, our thoughts on the readings and the topic. It works amazingly well and makes me very excited to go to his classes.
So, I combined what I observed in the mock calls at the other school and what I like so much about my foreign policy class and came up with this idea of practical with discussion, or, as I like to call it, the EMS round table discussion. We would offer a series of mock call sessions for our EMTs/FRs to practice physically arriving, assessing, and packaging on-scene (getting our EMTs/FRs comfortable with on-scene protocols and on-scene communication with patient, team members, and supporting units). On top of this series of mock call sessions, we would also provide a round table discussion on calls. The class would be arranged in a round table discussion format so as to facilitate equal and responsive dialogue. The class would be given a call with all the details for them to see on a white board/computer screen (no hidden vitals or anything like that, I want them to see everything about the patient). Then the class would discuss how they would approach this scene. The discussion would involve what safety precautions would need to be in place (i.e. Police, Fire, Hazmat, etc.) and what precautions the individual responders would need to take (i.e. Gloves, masks, etc.). The discussion would go on like this; presenting issues of what tools should be on-scene and what we could use for improvisation if those tools are not available. Questions of how the patient should be addressed, who should be performing what duties on scene, how should we be allocating resources, etc. etc. In this format, the class members can not only discuss and develop new ideas to approaching scenes, but also challenge each other on ways to handle a scene.
By integrating a series of mock calls and round table discussions, the EMTs/FRs are getting both training and education. The mock calls act as a training/educating forum with responders practicing their skills on-scene (training), then discussing what could be done better or differently (education). This is what happened at the other college. The round tables act as, primarily, an educational tool, with EMTs/FRs discussing multiple facets of handling calls (the reason why this would not have a training component is due to the fact that I believe that training revolves around more hands on skills and repetition of those skills as opposed to discussion and learning what those skills mean in relation to training, which I define as education).
Think of this idea in terms of potty training. At a young age, our parents put us on the toilet and expected us to practice the skill of using this strange device when we needed to use the bathroom. The training portion of this is the physical act of our parents placing us on the toilet and having us practice flushing, etc. This is training because we are being taught a skill and we practice it over and over again, but we aren’t told why we are doing this. That is where education comes in. Our parents do not just plop us on the toilet without explanation (or at least, good parents do not just do this) and expect us to know why we are doing this. Our parents explain that the toilet is important for hygiene, social acceptance, and public sanitation (this might be complicated for a young child to truly comprehend, but at least they know where it all goes right?) In any case, the training involves us repeating the steps of our bathroom follies and education is the reinforcement of that training with the understanding of WHY we do this, WHEN we do this, and HOW we do this.
So, like in potty training, we need to provide the training portion of the education of an EMT/FR and the educational portion. By providing EMTs/FRs with excitement in what their doing and an explanation as to why they are doing what they are doing, you can get a better quality EMT/FR. So, with all this said, I hope to implement this scheme of alternating between having a mock call session one week and having a round table discussion the next, giving our EMTs/FRs confidence on scene and an expanding knowledge of what all this crazy EMS stuff means.

EMS: An Urban Study

Dear Readers,

Over the next several weeks, I hope to share with you more than just insights on my personal views of EMS. For next few weeks leading up to Thanksgiving, I will be neck deep in research studying the development of Urban EMS for my US Urban History final research paper. During this time, I hope to share, in several installments, my findings. So, with that, keep your eyes open for some cool stuff!

Epiphany

Working on a college campus is, dare I say it, an adventure. From ETOH calls to severe trauma, our little squad has seen quite a number of incidents. We have responded to emergencies on and off campus, providing first response to MVAs and other injuries on the main street just off campus. And how cool is it now that we have a squad that has nearly doubled in size in a matter of a week? Most of these fresh first responders are surprisingly eager to learn more and as the weeks go on, more and more are interested in taking our EMT-Basic class. I remember when I was helping to teach the CPR class, that most of these same first responders did not raise a hand when asked about advancing to EMT certification. What does that say about the squad? We are getting better, we are attracting better people, and we are moving towards a higher quality of care. We are now, for the first time in our university EMS's history, getting a vehicle, nothing fancy and without emergency lights, but its a start. This way, we can get backboards and essential equipment to a scene faster and without sacrificing man power to do so. I firmly believe that our fellow students will begin realizing, if they haven't already, that there has been a positive, and noticeable, change in the way we handle emergency situations on campus. This change in confidence does not come from uniforms, being an all EMT service, or anything of that sort. We are a first responder group that has consistently proven ourselves on challenging scenes with one to multiple patients. We have earned the respect of the ambulance service that transports for us and we have earned the respect from those in the city around us. We have gained the confidence because we know we are good and we know we can do better.

Moral of the story: Training/Education, building trust, and building teamwork are ingredients in creating an amazing efficient, positive, and motivated group.

We volunteer thousands of hours per year in service to our school and we do so without one complaint. This is to all the EMT-Basics and First Responders that make up one of the best EMS squads on a college campus.

The Campus EMT/First Responder

I have been doing a lot of thinking recently regarding my position on my school's EMS squad. My official title is Training Liaison/Assistant although unofficially I am the Training Officer. My role is unofficial for a number of reasons that I would rather not delve into at this time, but this situation has raised an interesting point for me. One of the reasons I was told that the Training Officer position cannot be official at this time is that there is no one to replace me, that I am apparently the most qualified person for the job. Now, I pride myself on being able to teach people on my squad because teaching is not an easy job, it is thankless and takes a lot of effort and not every person can do it. Its a skill, a passion, and a desire. I see these traits in many people I work with on the squad. I see people capable and willing to educate new members. So why not make it an official position to train/educate people for our squad? Our goal is to go from a First Responder squad to an EMT squad and that takes a lot of hard work and requires a well trained, well educated, highly motivated group of volunteers and that is exactly what we should be working for. By offering regular classes on subjects ranging from vital signs to full out assessments and trainings where students are put to the test with rigorous practicals individual members will become increasingly comfortable with their skills and being placed in tough situations.

At the end of the day, this is a position that should be considered for all squads. Training/Education is no easy thing and it is hardly something one would want to throw out the window as not being important enough. Even if the trainings and classes are repetitive the most important part is that people feel more comfortable when they have seen themselves succeed repeatedly and once one has the basics down, it is easier to move on. So my answer to whether or not the Training Officer position should become permanent is simple...YES! and there are people who can do it and do it well.

Doesn't it feel good?

I was thinking over some of the calls I have had this year and was wondering exactly what is it that drives me to want to be in this field of work. To be honest, I still can't answer the question fully; however, what I have found is that being absent from EMS made the heart grow fonder. Over the course of my 6 month stay in Israel, I thought and did more with EMS than I thought possible. I began blogging about EMS, I began researching about EMS, I listened to podcasts about EMS, I practically lived and breathed EMS without actually stepping foot inside an ambulance (unless you count my brief stint with MDA). Coming back to the US, I have continued this obsession and am now on track to being a CPR instructor, getting my EMD, becoming a WEMT, and am now planning on Paramedic school. I am teaching, on a regular basis, new recruits to my College EMS squad, helping them feel comfortable on scene and being that go to guy that people can go to with even the weirdest of questions. Moral of the story: I am hooked and I love EMS. This is not love because of the money (or lack thereof) that exists in EMS, nor is because of the benefits (also questionable) in EMS; rather, my love for EMS stems from helping people. Seeing the smiles on the faces of patients whom I have helped, getting satisfaction from knowing that even my brief interaction with a patient has brightened their day, and lastly, feeling pride in what it is that I do on a daily basis. Yes, there are those days where work is frustrating and patients make you want to scream, but that doesn't matter in the long run. In the grand scheme of things, the good patients that make you feel worth something inside are what really count. Even for those bad patients, yes even them, we have done something for them whether they realize it or not, so feel pride in what you do each day, wake up with a smile, and do the best job you can do.