About apathy

Just for those of you who asked, I will post my thoughts on the state of apathy. I might even use a big word. Just bear with me.

 

Everybody just wants to complain. Whine, moan, bitch, and complain. But they don’t want to do a thing about it.

We want more drugs, more procedures, more leeway to determine who does and does not need to go to a hospital. But we don’t accept the responsibility that comes with it. We don’t go to lectures at the teaching hospitals offered to the medical staff. We don’t read. We don’t write. We don’t further our profession.

No. We come to work for our checks and we bitch all the way to the bank.

And I’m tired of it.

I know other paramedics don’t go to medical staff lectures. I know this because I do, and invariably, I am the only paramedic in the room. Hell, I’m the only guy in the room that doesn’t have MD or DO behind his name.

I know this because I have been going regularly. Some of the doctors at Big Teaching Hospital know me by name. Because I am involved. I take notes. I ask questions. Good questions, too. Questions that other medics should be asking, but they can’t because they are too busy planning their next vacation or playing the newest video game or planning their next drinking binge with their buddies.

Call me self-righteous all you want. But don’t call me lazy. And you sure as hell better not call me apathetic.

Why wouldn’t we go to the same continuing education programs that physicians do? For crying out loud, the word Paramedic means a person who is trained to work in an auxiliary capacity to a physician.  

I know other medics don’t read. I know this because of the looks I get when I reference medical research. “There was an article in the BMJ a few months ago that…” “What the hell is the BMJ?” is the response I get. “Why would I read a medical journal?”

We don’t further our profession because we don’t care about our profession. Perform your own experiment at your service: ask your coworkers what their plans are for EMS 2.0. Let’s see what the response is.

But nobody cares. NOBODY CARES.

Sure, there are those of you who are regular readers of EMS bloggers. You care. Those with the blogs care. But the rest of EMS doesn’t. I can wade through my almost 1,000 comments posted to my blog since I started roughly 14 months ago and bet that there are fewer than 50 contributors The same people are commenting over and over again.

I’m no prolific blogger by any stretch of the imagination. But when I review my stats, the two posts that have the most views are posts entitled I don’t like people and A letter to a stethoscope thiefThat’s what interests the vast majority of blog readers: sophomoric musings on why people generally suck and an asshole that stole my stethoscope. (Well, mine at least.)

But when I try to get people involved, to actually take ownership of EMS, and to play a more proactive role, I am met with a lugubrious apathy that irritates me to my very core.

I was met with this during our protocol-writing meetings. “It’s not fair that some paramedics would be able to use drugs that other paramedics can’t” was the paraphrased response I heard when we were discussing carrying some antihypertensives. “Life ain’t fair, buddy. You want to use the fancy stuff, go to the fancy classes.” was my response.

Andrew Grove, who rose to be CEO of Intel, wrote a book called Only the Paranoid Survive in which he gives leadership advice to people that work in any industry. Andrew Grove knows how to be successful. He says that there are:

“…moments in any business in which massive change occurs, when all the rules of business shift fast, furiously and forever. He calls these moments “strategic inflection points (SIP)” and he has lived through several. They are not always easy to spot – but you can’t hide from them.”

These strategic inflection points can make or break a business. I believe we are in the midst of what Mr. Grove would refer to as an SIP. Community Paramedicine, Critical Care Transport, expanded scope, changing educational requirements. Those that aren’t prepared to change and adapt are doomed to suffer terrible losses, the same that Intel suffered for three years before realizing they had to change their business model to compete with the Japanese.

Those in our profession who are not willing to change, who are okay with the prevailing apathy, are about to get, run over by a train. And when they get knocked out and wake up to a bright light, it’s not a paramedic checking their pupils; it’s that train coming right back for them.

So, if you aren’t ready to change, if you aren’t ready to make this the true profession that it should be, if you aren’t ready to learn, to take responsibility, to take ownership, to be proactive, then leave.

Go get a job doing something else. Do everyone a favor.

And if you are a manager, and you are the resistant force to this change, step aside and let a true leader take over. Managers manage, and anyone can do that. It’s not hard to babysit employees and to slap their wrists when they do something wrong. It is a whole different story when it comes to being a leader. Leaders have vision, and they know how to accomplish their vision.

Rudy Giuliani was by most accounts, a great mayor. Mayor Giuliani recognized that he did not know how to solve problems, but he had a vision for the way things should be. He used his vision to select people who shared his vision to fill his positions of leadership. And he accomplished his goals as a Republican in an overwhelming Democratic city. I am not from New York, and if you want to disagree with me on Mayor Giuliani’s politics, do it somewhere else, not here.

This is my career. This is what I want to do. It is not a ‘stepping stone’ nor am I in a ‘holding pattern until something better comes along.’ This is what I do.

And frankly, I am tired of the same old lazy, apathetic losers standing in the way of our progress.

Change, get out of the way, or get out. Period.

A grand quote from the aforementioned Mr. Grove:

“Your career is your business, and you are its CEO”

Would you fire yourself? A lot of EMTs and Paramedics should.

Comments

  1. Flash Larry says:

    All in all, brilliant! Impassioned. Sometimes you need to preach a little to get the point across.

  2. Awesome post! Sadly, I’ve seen this all too often. I was on the ground floor of a new statewide paramedic association some years ago. We actually had people that went to legislative meetings, were involved in statewide EMS strategic policies, etc. The initial groundswell, we had over a third of the state’s paramedics as members.

    But it was always the same people who were expected to do all the work. As a statewide organization, the board made a point of moving the quarterly meetings to various parts of the state. Much of the board did not volunteer to be nominated for reelection after showing up for a quarterly meeting and a) the agency/person who secured a facility for the meeting didn’t even bother to show up…the folks the had to drive 4 hours; they were there. The guy that lived down the block? Nope.

    Sadly, I wound up the last president of that fine group. I’d been elected vice president and the president left. I was also the last dues-paying member.

    Apathy will kill this profession if we’re not careful…and most of our people are NOT being careful.

  3. Angie LaFrance says:

    AMEN! Great post and right on target!

  4. Thank You for the inspiration. I do read your ( and others) blog but rarely comment. Instead I soak them in, learn from them, then try to pass the lessons on. So count me among your numbers. Anyway, recently I had the opportunity to crack the door of change open. There were many behind me to get me there but then I turned arounfd and they were gone. They wanted change but wanted someone else to bring it. They don’t understand that it’s a process not an election.

    There are many threats to the future of EMS, lack of accountability, Fire companies controling our funds, image, and infighting, not to mention breaking the hold the “back in the day” boys have on many our services, but apathy, that is the common denominator. I preach against it everyday, in every aspect of the job, to young and to old. Lately I’ve felt like I’m swinging at wind mills, glad to find out others can see them too.

  5. John Gruber says:

    Thanks for the article. I am three months into school to become a paramedic and have been reading blogs and want to expand my professional reading. I was wondering if you could please point me in the direction of some of the EMS and medical journals I should begin reading as my career starts? Thanks.

    • John; continue reading the blogs. But stay focused on your schoolwork. It is easy to get distracted with all the information out there.

      When you do read an article by, say, Rogue Medic, pay attention to the article that he (usually) cites at the end. Look for references which are more like arrows, pointing you towards what you should read next.

      Good luck with school.

      • John Gruber says:

        Thanks for the reminder and the tip. Guess, I need to build the house before I decide on different kinds of furniture. Just got finished with my first quarter conference and I have an A+.

  6. If you took a poll of EMS providers as to what the biggest threats to our prodession are, “I don’t know” and “I don’t care” would be tied for first.

  7. Great post! I myself enjoy reading your blogs though I believe this may be the first time actually commenting on one. I’ve been quietly following you for some time now and for what ever reason, I just felt the need to share.

    I work as an EMT with a private ambulance company somewhere in the mid- northern states, we are a pretty big company working on the line of two states, so being duel certified is a must. Though like working in any private ambulance company, the vast majority of calls are nothing more than your typical chuck runs, our bread and butter as most would say. We are >60,000 runs in one boarder state, >20,000 in the other, and my company it seems is ran and operated by only “apathetic” souls. I had been given the impression that since we are only handed a few emergent calls a week, depending on which side of the river you are on, either nobody really cares about anything, or they know to much with only 6-months on the job. It’s apparent that there’s no need to better ones self, no intuitive to further your education, patients I feel are treated just ‘ok’ and lately I’ve taken a different approach to addressing the issue. One I’m not so proud of but it does demonstrate another point of why I feel as if our “managers” need to also be replaced.

    I’ve been working with a lot of different types of personalities over the the past few months, I know I’m not perfect by any stretch of the imagination but a lot of my fellow (BLS) co-workers have this ideology that they are and will be nothing more than ‘just’ an EMT, a quality I find quite degrading, though I have adopted this saying that if you’re only going to be ‘just’ an EMT, at least try to be the best damn EMT you can be! Unfortunate, it’s apparent words mean nothing except for the few.

    I understand that to our local city’s ran EMS company, majority of them look down on us and we are seen nothing more than a glorified taxi driver. I know that’s not truly the case, we do more than transport granny to dialysis, again we are the primary 911 service just an arms length across the river, but unfortunately, that’s how we are looked upon on this side. I’ve always tried encouraging my co-workers to participate in EMS related activities, take a look into some seminars, sign up for CEUs with different hospitals expand your horizons, we’re not just a taxi even though it may feel that way some days. I tend to bring magazines in like JEMS which only seems to have accumulated a bit of dust in our library (a table by the time clock which is attended to be used for additional EMS related martial). I have thrown out EMS related scenarios between calls with my partners in which majority have no interest to participate in. I try so hard to encourage my fellow co-workers to participate in different continuing education courses. Just recently, our company hosted a PHTLS course with 15 spots open, only five individuals showed up, only four from our place of work.

    I haven’t been here long, some would say I’m still new to this world, but with such display of .. whatever, I have started to resent some of my fellow brothers and sisters and I’ve become a little hostile over the past few months. How I’ve interacted with my co-workers, is surely a turn-a-round from how I used to. I’ve been seen lately as the “a-hole”. My remarks are sharp and a bit downgrading to some, a characteristic trait I am not so proud of, one I was actually truly unaware of until just this past week. It was only brought up to my attention when I was scheduled to work with my good buddy Nick whom I haven’t worked with in a while. On our trip back to HQ after a long days of work, he had asked if he knew why lately I’ve been rotating from person to person instead of one single partner like before. I honestly had no idea, just thought since my normal partner no longer works here, it’s just works out this way. My buddy shares the same views I do and will never hold anything back, he tells it how it is but never in a way by putting people down, a characteristic I wish I had because for the past few months, I’ve been doing the exact opposite. He furthered on telling me that through hear-say, supply has received a few complaints about my demeanor and have decided to rotate me around with different people instead of having someone work with the a-hole so many shifts in a row. It really hit home, and to be honest because looking back, I really have been a jerk. I haven’t always been, but it’s apparent now.

    How he found out though was nothing less than annoying. I show up to that supply window day in and day out, never once did any supervisor pull me aside and bring up this issue, never once was anything mentioned to me about anything, It was all kept quite until I left the supply window and my name was mentioned in which Nick overheard .. Apparently another co-worker had mentioned that I’ve been acting like a jerk lately and asked if they could work with someone else. It’s a little bothersome that this said co-worker never addressed the situation directly to me though it’s understandable. I find it more so malicious that the issue was never addressed to me at all period after months of gathering my supplies from the supply window. Instead of a “higher-upper” pulling me aside and addressing the issue, they decided to rotate me around a few months, all while I continued to show no remorse for an action I was unaware impacted people in such a way. It doesn’t surprise me that this particular supervisor stayed quite, his reputation is also not well liked. How he still holds his position is still mind-boggling to most of us honestly, but that’s a whole other story.

    I’ve seen the apathy attitudes of my co-workers and instead of continuing to encourage, I decided to, unnoticeably on my part, belittle them. I’m working on rekindling relationships with my partners, I never wanted to be “that guy”. I will continue to do my best but I’ve also realized that the only person I should be focusing on now is me. I will not be “just” an EMT .. I’ll start with my attitude, hopefully I can gain back the worthy relationships I once had with some of my previous co-workers. Hopefully things turn around … hopefully my my actions I can encourage a few into looking into how one could better one’s self. Hopefully. Hopefully.

    • Flash Larry says:

      Mr. Taylor,

      Sounds like you’re doing a productive thing by making some changes in what you call your demeanor but which I call you actions. How you feel about something is one thing, how you act about it is another. I have often said that if I said what I actually think (about many things), that I would have few friends and few people who would even speak to me. But I don’t say what I think – well, at least some of the time.

      Changing the ethos of a large organization like yours is virtually impossible. You’re responsibility is yourself – to make yourself the best that you can be. I gather that you’re an EMT as opposed to a Paramedic (however that’s all titled in your jurisdiction). Well, nothing says that you can’t increase your knowledge base beyond EMT. So start reading other literature. JEMS is ok, but Annals of Emergency Medicine and other such are better and you will be reading above your level, which will pull you up.

      Don’t talk, demonstrate. Teach by example. Do your checklists every day without fail. If partners don’t do them, YOU do them. Don’t criticize, just say, “I’ll take care of it.” Set a standard for yourself and adhere to it so that people come to see that you will do things the right way every time both with patient care and patient relations. Explain things to partners who don’t know why you’re doing what you’re doing. Become someone who knows what he’s doing, and knows why, and does it and is willing to explain to the interested.

      I’m not a perfect person with respect to this. I commented on someone behaving in an arrogant manner once and my wife cocked her head at me and said, “You’re criticizing someone ELSE for being arrogant. I remember how you used to be and it was doubtless far worse.” “Used to be” is the most important part of that sentence to me.

      So yes, you can change and become an example and a teacher. It’s a challenge. The quality of your service and the quality of your co-workers is immaterial to who you are and who you can be.

      Just for the record, based on what you say about how “Nick” learned about your situation, your management is unprofessional and incompetent. They have no business discussing personnel matters openly.

      Good luck as you move ahead.

  8. Skip Kirkwood says:

    Great commentary – thanks for putting it down. Center of the bulls-eye.

    Now – how do we change it. I’ve got eight years left before I retire, and I’d like to be part of jump-starting our “profession” and, to steal a phrase from the Army, help it to “Be All That It Can Be.”

    Skip

  9. Brian LaCroix says:

    Wow. Way to call like you see it – well said.

    I especially appreciate your call for leaders to lead. And to do so with vision. I often think about a phrase that emerged from the task force who analyzed the attacks of 9-11. They called it “a failure of imagination”. EMS, like so many noble endeavors, could use an inject of both commitment and creativity.

    Thanks for the blog post. Spot on!

    Brian

  10. Ive had these conversations with many a EMT and Medic.

    “Did you see the RAMPART study?”…blank stares

    “I was reading that JAMA study”….”whats a JAMA?”

    “whats Harrison’s Practice”

    Head, meet wall

    Most people say that this stuff is too advanced for the EMT to be concerned with and that I am wasting my time. I reply that i can feel comfortable telling people whats going on inside their body beyond “You have boo boo, you bleed, i stop it” Just the other day i had a medic ask me why my patient wasnt on oxygen and my reply was simply “Its not indicated based on their presentation.”

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