I'm just back from reading Chris Kaiser's "rant' over on Life Under the Lights. I responded there, but thought it would be good to bring it here, too. I touched on this topic a while back. So, I'm giving you a reading assignment: Go to Chris's blog, read his 'rant', then come back and tell me your thoughts. I've experienced lots of petty crap in my professional life, whether Fire, EMS or Military. There's always some napoleonic little bastard (Roach, I'm looking right at you, pal. You know who you are.) that wants to rule with an iron fist, but lacks the basics of leadership and charisma to motivate people without fear. We all hate those people. Likewise, I'm sure we feel equally as strong about people who want to be in charge just because it strokes their egos, and have little regard for the overall welfare of the organization or the customers we exist to serve in the first place. So, below is the rant I left on Chris's blog. Not that it solves any problems, but at least MY pressure-relief valve has operated for a little bit;
I came out 'here' from California. That means I came from an all-paid, professional (don't even go there, I'm not debating that term here) EMS system with Paramedics on every ambulance on 9-1-1 response. I learned EMS as an EMT, Firefighter and Paramedic, and I learned that if you don't value the patient FIRST, you're not going to be around very long.
That said, 'out here' is the East Coast, Jersey to be exact. I was horrified to learn that a vast majority of this state (the nation's most populous per square mile) is covered by VOLUNTEER EMS. Now, that's not necessarily a bad thing, if properly managed. Volunteers can, and do, provide excellent EMS in many places. I didn't work in one of those places. I worked fire-based EMS on a military installation, surrounded by volunteer EMS squads. All of their little fiefdoms and petty kingdoms fought, both internally and amongst each other. No one went to calls- too many petty arguments over who was senior, who's doing what to whom, which squad is better, whose area a call is in... and many many more BS little things.
We, the full-time, staffed Fire-based EMS crew, sat in the station and listened. We listened as calls for dyspnea, chest pain, unconscious subjects, vehicle accidents with injuries, trauma, and yes, total crap calls too, went unanswered. I distinctly remember listening to the dispatch as this call went out:
"Attention *town first aid, respond to * care center for a person choking"
no response
TWO MINUTES PASS
"Attention *town first aid, respond to * care center for a person choking, second request"
no response
ANOTHER TWO MINUTES PASS
"Attention *town first aid, third request, respond to * care center, CPR in progress, requesting mutual aid"
I didn't hear the outcome of that call, but it's blatantly obvious to those of us in the business. That patient died. Not because there was no ambulance available, not because other calls had taken the volunteers away from their town. Because no one bothered to respond. The petty bullshit ran all the potential responders away long before this call came in, and too many egos were involved. This is a town that has significant tax basis for a full-time, paid EMS division. They get well over a thousand calls a year. There are major roadways going through town, a very large industrial area with numerous high-risk processes, a number of convalescent/care facilities, a very busy rehab hospital... they have the need for staffed EMS. So, why not go paid? Because someone would have to give up control of their little piece of the kingdom, and that means they wouldn't be the "big boss" anymore. That simple. They don't want to let go of control.
I know, I know. Why doesn't the public do something? They don't know, don't care, don't want to bother with it, don't want to pay more taxes, don't think it's necessary because THEY don't need the EMS right then and there. AND, NJ has a law preventing litigation against the volunteers. AND, the state "First Aid Council", an all-volunteer group that... well, I don't really know what they do besides prevent forward-thinking and progressive EMS from coming into NJ. It goes on and on and on... what it boils down to is exactly what your rant is based on- a lack of concern for patient care as the primary reason for existence.
So, all that to say, "I agree with you, I feel your pain, and I hope everything gets better soon." I don't see that happening here in Jersey. Too many people have to keep their little kingdoms, have to exercise power because they can, are afraid of change because it's "change".
Stay safe, take care of each other, and take care of the job. In that order.
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So, there it is. I'd really like to hear your thoughts on the subject. I'm bound by my limited experiences in life, and everyone has a slightly different perspective to offer. That's how we learn and grow, something I would think all of us need to continue doing.
As some friends of mine would say, "Y'all c'mon back now, Y'hear?"
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