Declaring Independence
The status quo has changed.
Surely, we’ve all heard that from one healthcare organization in some form. “Here at Jimmy’s House of Medicine our brand of medicine is different” and we’ve all heard the classic trope of “We’re not co-workers, we’re family.” I can say for the duration of my career I’ve heard my various employers parrot the same empty rhetoric about how the way they do things is “moving medicine forward” or extending another platitude that their system or service is superior to the other by using some tired wordplay like “Moving at the speed of life.” We use these recruiting tools to bring people into our hospital systems, and then we expose them to the same exhausting, short-staffed, long-hours, toxic work environments that we’ve all gotten used to. Then a new generation of employees come in, and the cycle perpetuates. We often talk about the need for things to change, but then we never act on it. I submit that this lack of change is often due to a systemic lack of will. That is, organizations writ large are fearful of change so they elect to do nothing and offer non-answers as solutions. Of course, this is done while saying the organization will always do whatever it can to stay current.
The thing is, this time it’s different. We’ve all lived through a collective trauma that has affected all of us in ways known and unknown. How many providers are this much closer to leaving EMS because of the pandemic than there were in 2019? How many supervisors are tired of making calls to their employees that they have to stay home because they’ve tested positive for a virus that was effectively unavoidable in their workplace? And for the love of all that is holy, how many “Heroes work here” signs did we all have to endure? Coming out of this pandemic, there are going to dozens, hundreds of messages to healthcare workers thanking them for all their work and sacrifice. Leaderships across all healthcare fields will crow from their 5thfloor offices that the efforts of the staff of the hospital is what got us all through the first plague of the 21stcentury. They’ll offer how essential we are, and we’ll all hear lots of messages like “We couldn’t do it without you” and “Staff are the backbone of this hospital system” and to them, I say this:
Start Acting like it.
lol i got a bonus while you had re-use N95s
Across the globe, paramedics are grossly underpaid, while hospital systems made billions in profits during 2021. Some of them even broke profit records. It must be said that all of this is happening while some paramedics have had to resort to living in their cars. Is it not exhausting to show up to a workplace where you are constantly reminded how important you personally are to the organization while simultaneously being told to re-wear your N-95 mask (still.)?
Providers are just as exhausted as the general public is with the emotional toll that Covid-19 has wrought upon us. Anecdotally, I’ve seen providers stop wearing masks. Not because of some vague ill-conceived political notion, but because they just can’t anymore. Their emotional canister is full, and they have simply run out of cares to give.
Record profits. During a pandemic. While providers are continuously asked to enter people’s homes and pretend as if we are still operating under business as usual conditions. Times have changed because they must. EMS workers must no longer accept simple lip service for the work that is done. Year after year we are asked to sacrifice a little more, to wait a little longer for things to get better.
“Please pick up more shifts, we’re short staffed.”
Maybe if we get some new blood in here, they can really make a difference. That tends to be the thought process when evaluating a management team. Any sports fan can tell you that from time to time you have to shake up leadership in order to move the organization forward. But in EMS we choose not to take that route. We allow for providers to fail their way upward through the system and we work very hard to ensure that the most ambitious among us move onto different careers. We do not encourage upward mobility or growth, instead encouraging providers to continue to take the same alphabet soup courses (which aren’t even based on current data anymore) and expect to turn out high level providers.
Dear reader I offer this to you. We have an opportunity. We have a chance to fix an EMS system that we watched break before our very eyes. We can take the lessons that this pandemic has taught us an apply them to our everyday care. We can address flaws or cracks in a system that stopped working when the public needed us the most. This is a chance to make EMS all that it promises to be in the grand halls of conference rooms in big hotels. All of the sweeping statements we scream from the rooftops about the difference we can make in patient’s live if we only had the funding. We know that our hospitals have the funding, what is needed now is a rapid IV bolus of will to make the system we care about so much into the shining beacon that it can be.
We are all responsible for what happens to our EMS systems moving forward from here. Providers and systems should see this chance as a clarion call to build up their employees and their response operation to better serve those that sacrificed so much during our darkest times in recent memory, and to better serve the public that so often applauds what they cannot understand. Happy workers will invariably lead to a happier work environment. We can take this opportunity to make people want to come to work again and help them to remember why they loved the job in the first place. Who knows? Maybe we can even help the paramedic shortage and recruit some people?
Ah, but I dream.
Ed Bauter is the host of The Overrun podcast and managing partner of Overrun Productions, LLC. These opinions do not necessarily reflect that of his employer. Change the system, but don’t get fired over it.
