EMS WEEK 2020: Aftermath
This week is EMS Week. The idea is to recognize and thank the clinicians in the prehospital and mobile health profession who do a very unique job under challenging circumstances, any day, anytime, anywhere.
Usually, if you’re in EMS; this means some type of free meal, water bottle, bag, or other gift that symbolizes their respective agencies, hospitals, and healthcare systems thanking them for their service.
It’s been going on for quite a while; but the last few months have put a real perspective on recognizing and honoring those who choose to go into the job, often with less pay, benefits, and protections than those who enter other emergency services professions.
Since the entry of COVID-19, EMS has noticed a difference. People wave. They clap and give us thumbs up signs as we pass. Signs entering ambulance bays around the US, and the world for that matter; point out in no uncertain terms that “HEROES WORK HERE”.
We’ve been (rightly, by the way) more visibly recognized for the important, unique work we do. A nation of people living in apprehension over an adversary they cannot see or defend, gives its thanks to those who suit up and go to meet the challenge at the source; for people they’ve never met.
The effort has not been without cost. According to EMS1, at least 25 EMS clinicians and support staff have been confirmed dead from the effects of COVID-19. As with most sacrifices, they probably had no idea that they would be the ones who would fall. And for many of them, their families and friends will have to pick up the pieces and move on without the security of other line of duty deaths’ families. It’s a sobering thought.
We’re going to come to the end of this.
The cheers and applause will fade. The free coffee and food will stop. People will stop going out on their balconies to clap at shift changes. Memories are short. As it has been in the past; the public, the media, and our leadership will forget.
“Thank you for your service” is to me, an empty phrase for people to use when they don’t know what to say. Or don’t know what it means. Or don’t understand the costs. We say it to military members because for the vast majority of us, we have not the first idea of what it means to make that kind of oath and sacrifice. We say it to cops and firefighters because we as a society have no idea why someone would willingly run to danger while others run away from it.
It’s sobering when you think that on September 11, 2001, the firefighters and police officers who moved toward the World Trade Center had no illusions about their chances to tell the story to their grandchildren. Much like the soldiers in the first wave of landing craft at Omaha Beach on June 6, 1944; they willingly went to their fate not for their welfare; but for the greater good.
And they were right. 9/11 was a horrific tragedy, but also the greatest rescue operation in the history of the fire service. Those aren’t my words. If my memory is correct, the comedian Denis Leary; who established a foundation to support firefighter causes said it. And he was 100% right.
Omaha Beach was horrific for those who endured it; but from their sacrifice was the spark that helped to liberate a continent and dethrone a demonic ideology.
You can visit the monuments to these sacrifices in New York, Shanksville, and Normandy.
And now, it’s happening to our colleagues.
What will be their monument? How do their memories get honored?
How should we really be thanked for our service?
I don’t want statues, walls, or obelisks. I don’t want parades, or ginned-up “holidays” that only promote retail sales in the end. And I sure don’t need more water bottles, golf umbrellas, or other tchotkes.
What I want are tangible things that recognize what my brothers and sisters in EMS have done and continue to do in the face of unseen threats that could possibly end them at any time.
And there will be no easy way out mentally or physically. for the thousands of EMS and medical personnel of all areas who get through this.. Those that live after being sick from COVID-19 face an uncertain future of potential damage to their bodies that we’re still trying to understand.
Others will do so with the memories of this sunken into their heads and hearts, and the deaths of patients and colleagues alike soaked on their memories
Whether they want to, or not.
The horror of September 11th goes far beyond that day. As an example, there was one FBI agent who was killed in the line of duty on 9/11. Since then, 15 more have died from their exposure to the toxic aftermath. This continues to play out among the other emergency services that responded that day. We have lost almost as many to cancer from being at that toxic site, as we did on the day the towers fell.
And what I find especially chilling, is that while there is a running count of those who have died from cancer following 9/11; the research surrounding the mental health of 9/11 responders is a lot more murky.
Mark my words, we will lose some of our brothers and sisters from the memories that haunt them far longer than the virus itself. I’ve seen it before. Most of us who were in uniform during that time know at least one person who completed suicide as a result of that day.
So, what do I want?
How about never being put in the position again of having to improvise or do without protective equipment by a structure that values “just in time” delivery and regards stockpiling and using equipment as not fiscally sound.
And if that’s possible, how about we stop putting critical health care infrastructure into the hands of businesspeople who have zero clinical background? Let physicians decide what’s right for hospitals and medical centers on a clinical basis first. Then, let the “suits” figure out how to make it work. Not the other way around.
How about a work environment that puts clinician AND patient safety first? This means no penalty for using sick time, not allowing clinicians to come to work sick, and not tying bonuses or pay raises to the use of that sick time. All of these are tactics to minimize expenses and maximize profit, as well as minimize staffing to meet earnings targets.
That includes physical AND mental health maintenance for clinicians. That includes paying clinicians a wage that deters them from working ridiculous amounts of jobs or overtime to make ends meet. That includes taking units out of service after stressful or “hot” calls; not throwing them into the mix because other calls are pending. It means actually putting an investment into your people and recognizing their value, instead of a line item in your cost center.
How about not using “response time” as a metric, and start using outcomes and science as measures of how well an EMS agency is doing? I can bring a dozen random people in a dump truck to a call; I can’t guarantee they know what the hell they’re doing. And that’s wrong. Nor does it improve ED throughput, ICU stay, acuity, or a half-dozen other measurements. And that’s what really matters.
How about regulatory agencies that worry less about how many rolls of tape are in a unit, and worry more about the things that we know matter? Such as, “When was the last time your vehicle was actually cleaned and disinfected?” “When was the last time it was maintained?” “What condition is your protective equipment in?” And the all-important, “How can we ensure that clinicians wearing our patches and carrying our cards can actually do the job to the scope of practice they supposedly own”?
How about medical directors who are actually board-certified in EMS, who understand the role of EMS clinicians, and who are not afraid to give them the responsibility of their scope of practice? As an example, advanced airway management has been beaten to death; but stop expecting success when you tie a clinician’s hand behind their back. If you trust paramedics to intubate, then for God’s sake give them the proper tools that are evidence based to work! That means RSI, cricothyrotomy, and the training and oversight to do it RIGHT.
If you think the most valuable thing your EMS does is start IVs, please, get out of medical direction. Kelly Brackett retired, and maybe you should, too.
While we’re at it, how about we stop giving a voice to the loud minority of poor clinicians who refuse to stay current, stick to doing the minimums, and gloat about it at shift change? Why do we expose our students and trainees to a toxic mindset and then wonder why they don’t move forward? Why do we tolerate their garbage? We know it hurts our profession; we just don’t want to confront it. Because it’s not popular, and it’s easier to go along and get along.
But if we truly want paramedicine to flourish, then we need to identify those who do not meet the standard and move them along. Just like every other profession.
How about public education given the same priority in EMS that is given to law enforcement and fire? No one knows what we do, because no one can explain it. And stop throwing, “But, HIPAA”. We don’t need to give out names and addresses, (unless they’re OK with it). We just need to share our world a little bit. We need public information officers to take an active role in selling our profession.
Austin-Travis County EMS in Texas is one of the organizations that do a good job of this; let’s follow their lead. Or better yet; why don’t we recognize the agencies in our profession that get something right, and use them as examples of what we should be doing on a large scale!
And finally, when one of our own falls in the line of duty, whatever the nature of the call or service level; can we please, PLEASE guarantee that their family will not go into poverty, lose healthcare, or suffer because they chose to work EMS? It’s more than a group life insurance policy. It is security for families who already sacrifice a fair amount and are asked to make a bigger sacrifice. Police and fire get it. Why don’t we?
EMS Week is here. Again, spare me the trinkets, free hot dogs, and idle platitudes. Give my brothers and sisters what they deserve. Give them what they’ve EARNED.
If you’re reading this, and nodding your head; we’re the ones to start the movement. Now is the time.
Let’s do it for the profession. Let’s do it for the kids waving on the corner and wishing they were us, someday. Most importantly, let’s honor the memory of our fallen colleagues, and build a legacy they will be proud of.
