Response to AD on pay...

On the topic of pay, we are at 0% in the industry.  I am a Union man so I always feel there is not enough pay.  The problem is how do you judge what is right and fair with pay?

I work full-time in an industry that has nothing to do with EMS.  I can lay a sewer pipe to grade and repair or install water lines all day long.  My experience includes everything from being the laborer to the equipment operator and now spend my working hours inspecting or investigating problems.  It is a skilled labor job and I can go make $60k-$70K almost anywhere I want to go.  In my area an experienced Paramedic can expect wages in the area of $35K-$60K depending on whether you work for the small county service or larger Fire Based service.  Big difference is: I would be paid, at my current salary as a Medic, about $45K a year to work half the days I work now.  I think that puts me in the middle.  I want more, everyone does and should but, how do you justify that.

A lot of the people I know in EMS and at my full time job say we are paid way to little for "saving lives".  Lose the hero complex be honest with yourself and everyone else, when was the last time you actually saved a life?  99% of what we do in EMS is for patient comfort.  I may not be a popular person for saying that but, we see very few patients with true life threatening illnesses or injuries and the ones we do benefit far more from rapid transport and BLS care than anything in our ALS toolbox.  In my opinion the argument for more pay of "we save lives" works about as well as trying to eat a soup sandwich.

For every experienced Medic that is employed the local Paramedic Factory, read Community College, is turning out 10 green, never stepped foot in an ambulance except for clinicals, Paramedics.  These people want a job so bad that they will work for half of what an experienced Medic will work for.  The seat of the truck or lazy boy never cools off between employees and that is what is actually driving down the pay right now.  We are not the only industry experiencing that problem, Nursing has the same issue locally.

The larger issue with pay is the attitude it causes.  Maybe we should ask our patients what we should be paid.  Were they treated with respect and did we make them feel better or did their Paramedic or EMT treat them poorly because of they felt it was a waste of time to do this transfer or run.  The 25% Mr. Grayson refers to can be like a drink of sour milk.  Their attitude leaves a bad taste in the mouth of our patients and managers which reflects on the other 75%.  As one of the guys I respect and look up to, Elite Series Bass Fisherman Kevin VanDam, says "It's all about the attitude."  You have to change the culture if you want more pay and the culture cannot change until the attitude of entitlement changes.  Paramedics and EMTs exist for the patients they have not the paycheck they want.

Favorite day of the year...

For those of you that live up north here you can understand.  Tomorrow officially starts my marathon run of Bass Fishing Tournaments.  I have fished a couple this year, earlier than I ever have but, tomorrow morning at 0430 I leave for the first club tourny and I have a tournament planned for every weekend until the last week of October.  So, to my wife, I'll see you again in October for a couple of weeks between fishing and deer season.  To my employer, now you know why I saved those sick days...

I love this time of the year and as the King of Bass Fishing, Kevin VanDam, says "It's all about the attitude."

Healing begins...

I remember the day vividly.  Heat, dust, that smell in the air, the taste of the fucking place.  I was in the middle of the Sunni Triangle and had just finished another mass casualty incident, not the drill type.  A suicide bomber had blown up a DFAC near Mosul and it was the breaking point for me.  That was the day my ability to have compassion died.  That was the day empathy left me.  That was the day that I told God to go fuck himself.  That day I became a robot...No emotion on the outside, empty being on the inside.  If I lost one more patient I was going to die myself.  I turned from compassion and empathy to hate and rage in order to survive.  I had reached the point of emotionally losing it so I forgot how to care and started treating slabs of meat, not Brothers and Sisters that shared the uniform with me.

I shared this with a counselor at the VA a few weeks after my blow up at work.  It was the day my emotional self began to heal.  I had forgotten how to feel emotions and be a human being.  By looking at and talking about the breaking point I had experienced it allowed me to begin to tear down the wall I had put up inside.  I cried.  I sobbed.  I cried some more.  I am sure the Counselor contemplated committing me that day.  I took the cap off of the bottle and began letting out years of emotions in a healthy and controlled environment.

I eventually had to go through two years of therapy to get where I am today.  I am still not the same person I was before but, I have a good understanding of what it takes to stay sane and emotionally stable to be an effective clinician.  I still have the bad days, days that will be forever engrained in memory.  I still have dreams and nightmares, they are like that horrible 50 Cent song set on repeat on the CD player, and there is no escape from them.

We all have had that one scene or one call that stung deep and threatened to unravel us.  That is OK and normal.  It is what we do with that experience that will determine who we are as clinicians and how effective we are at treating our patients.  Everyone is different and there is no one fix to emotional scares.  There is however a fix for each of us that will allow us to cope.  Take it from a badass Soldier, talk to someone, see a professional, or whatever is needed.  We are all human and it is not a sign of weakness to say you need help.

Emotion Part 1 - My Story

I have often wondered what emotions other Medics feel.  I also often wonder what emotions other Emergency Professionals feel are appropriate to have on scene and after.  How does everyone deal with it, and not the textbook answers...First my story.

One hindrance of being a Military Medic in a combat zone is the inability to process and deal with emotions.  God knows I bottled up over a years worth of seeing brothers and sisters in uniform fucked up on a daily basis.  Seeing the innocents of war, children, torn to pieces both physically and emotionally.  The emotions must be bottled up because you have to be the rock, that one person that can work in added pressure of trying to save a life on top of trying to staying alive.  Any weakness you show can have a huge blow to the confidence your patient has in you.  It can also make you combat ineffective since it can be a distraction.

Sure I had a couple of moments; watching a First Seargent and a Seargent Major shed tears over the loss of a soldier in front of the medical personnel.  The two NCOs in a unit that are supposed to be the emotionless baddasses that do nothing but kick ass and get the mission done.  Watching a mother read a letter that her son sent home the day he died, read on Mothers Day, one week after he was your patient and despite everything you did he died.  Those two incidents offered me a few minutes out of over a year to lose control of that emotionless facade and break down in private.  Maybe five minutes each time.  In retrospect I managed to stuff a career of emotions into 14 months and allowed myself to shed some tears for maybe 10 minutes.  Also, in retrospect it was not a good plan.

Fast forward 2 years, back home and back to the job I left, barely holding it together.  I had gotten divorced because my ex-wife did not know me anymore, I was close to the unemployment line, and pissed off at anyone that did not serve their country.  Seamed like all I wanted to do was beat someone, I could not sleep, I could not allow myself to have emotions, or release what was bottled up.  I was scared that if I allowed any of the emotions to come out they would all come out, anger and rage included.  I was scared of myself and the monster I had bottled up inside.

It all came to a head on a job site when the cap was loosened on the bottle and a little pressure was vented.  I made some decisions out of rage and the resulting actions could have seriously injured someone.  A coworker was trying to push me over that edge and almost succeeded, I ended up having a choice of getting professional help or collecting unemployment.  I was fortunate that my employer was very Veteran friendly, they pushed me to do what I was too proud to do on my own:  Talk to someone...

Part 2 -The Process of healing begins.

My night so far...

Patient tells me they did not do any drugs...

Found K2 packaging all over the house, the house he completely destroyed.  That was prior to going outside in a pair of boxers and tearing shit up.  But, no drugs...Oh yeah, they tore up the ER after the Versed I gave them wore off...but, they did no drugs...

Next patient calls because they cannot sleep...

30+ ambulance runs on them in 2 months on top of an unknown number of other trips to the ER not by ambulance...

Some days I wonder why we do it...Maybe I'll get a legitimate patient I can feel some compassion for before the morning, just maybe...