Solutions for the Future: Change is in Order

Welcome to my first installment in a series of guest editorials. My goal for these articles is to shake up and change the EMS establishment for the better. To do this, I need your help. Here’s one way you can participate: Drop me a line and let me know how you would change EMS as a career field. No area is sacred and all your ideas and opinions count. You can reach me at Docbeaker@aol.com. Put “Solutions for the Future” in the subject line.

First of all, we need to agree on one thing. In order for EMS to survive and prosper as a viable career, it needs to change. If you don’t agree with this, you’re wrong. If you’re happy doing a job that not only saves lives, but also puts yours at risk for minimum wage, then open your eyes and look at your bank statement.

My EMS crew ate at a well-known waffle joint the other night at 1 a.m. I looked at a help-wanted flyer displayed in the dining area and was amazed at both the differences and similarities between the jobs of a paramedic and a waffle waitress. Her pay scale averages from $6–$12 an hour including tips. The average paramedic salary in my county hovers around $11. The waffle joint offers full medical, dental and life insurance benefits, stock options and two weeks of paid vacation annually, beginning the first year of employment. You can get all that for slinging hash browns.

In EMS, you perform a very dangerous, technically skilled job that most people can’t even stomach. By the time salary and benefits are added up, you do this for about the same wage as the waffle gal.

But how can you, as an individual, contribute to widespread lasting change? Before I begin, let me preface my comments with a note of caution. What I’m going to talk about does not concern small insignificant troubles and gripes. When I mention problems in EMS, I’m talking about the big stuff; the items that, if not changed, will make you switch into a different career. Don’t complain to me if there are no good restaurants in your coverage area. Just pack your lunch. And always think twice before bringing up any issues with a superior: Is it really a problem or just an inconvenience? With that qualification, let’s start the ride.

Speak Up

First of all, the medic on the ground needs to make himself heard. Quit griping to your coworkers and your family. The argument has nowhere to go from there and people will start avoiding you. It’s unfortunate, but most of the time, presenting a valid fact-oriented case to a superior won’t help either. Still, if you’ve thought it through carefully, you might give your supervisor the benefit of the doubt and take your complaint to him or her first. You never know, he might be one of those rare ones who is a true leader, rather than just a boss. The alternative, stepping outside the chain of command, as a rule, will burn bridges.

Here’s the right way to do it: Present a concise, well-thought-out list of complaints in writing, with possible solutions, and have your boss read it in your presence. If he wants to help, you’ve made an excellent ally. If he doesn’t want to help, don’t pester him, but request that he pass your concerns and comments up through his chain of command. This way, if you get into trouble for any further actions, you did not technically violate chain of command. Your supervisor dropped the ball. Thank him for his time, leave the office and plan your next step.

At some point, you will need to step outside your agency with your lists of problems and solutions. Start an e-mail, letter writing and phone campaign to elected officials from the town council all the way to the state governor. Expand your campaign to private organizations as well. Nearly all areas in the United States have Better Business Bureaus, unions and business councils. If you’re worried about losing your job because you’re causing a stink, have a family member pen all of your letters. If you can get fired for a letter your wife wrote, all the more reason to speak up.

Get your voice in the public by writing letters to the editors of reputable publications. You can write letters in all your area newspapers. In a best-case scenario, a reporter or editor will pick up on the letter and interview you. Another good outlet for letters to the editor is a national EMS journal like this one. Field personnel and supervisors in all sectors of EMS read this magazine. Many of them may even agree with you and offer to help.

Join the Crowd

Second, to enact change, I recommend you join an association or other professional group. This is the best way to present a large voice that will rattle cages in state capitals and Washington, DC. Find a group that best represents your particular interests and goals. There are groups for specific jobs, such as flight medics, EMS educators and tactical medics. There are also groups that represent EMS in general. Find one you like, join up and offer to help in any way you can. Most of the groups will have action committees that need volunteers or other areas where you can jump right in.

Most individual states have their own state associations. In South Carolina, there is both a large and a smaller grassroots state association. Sometimes if you want to shake the trees, you’ll have more luck with the small organizations.

Stand Up for Yourself

A third way to force change is to quit giving in. This is where you need to really stick your neck out and show some intestinal fortitude—and this is where you may make the most obvious individual changes. For example, in the hospital, refuse to turn over a patient until a nurse takes a report from you. When doctors and nurses treat you like a street bum, invite them to come and ride a shift with you. So far, no one’s taken me up on that offer.

When anything happens that you don’t agree with—on a scene, in the hospital or in the station—write an incident report. You know the drill: If you don’t write it, it didn’t happen. Incident reports are not meant to enact immediate change, but they build a case of written complaints that could help you in the future.

No More Freebies

If I haven’t already made everyone mad, I’m sure I’ll take some flak for this last suggestion, but here goes anyway. Quit giving it away.

Think about it. As long as you and everyone else is willing to do a job for free on the nights and weekends, why should anyone pay a decent wage for others to do the same job? Volunteers are the ball and chain of the EMS profession in many areas. As long as a Basic EMT fresh out of high school is willing to jump on a fire truck or ambulance for free, why should a county government pay a trained and experienced EMS veteran $10 an hour to do it? To most services, a warm body with a certification card is all they are looking for.

I look forward to hearing from you on this and other ideas. Future topics will include:

• Should EMS be part of the fire service?
• What about paramedics working in hospitals and doctors’ offices?
• Just what is the problem with ED nurses?

Until next time, I leave you with a slogan to ponder: EMS: Saving others’ lives at the expense of our own.