If, in moving through your life, you find yourself lost...go back to the last place where you knew who you were, and what you were doing, and start from there. Bernice Johnson Reagon.

05 April 2013

The View From Under The Bus

Over on Facebook, on the page Paramedics on Facebook, there is an entry by an old boss of mine, Chief Skip Kirkwood. Now, there are a few things that Chief Kirkwood and I disagree on, but there are a few we agree wholeheartedly on. And this is one of them.

Chief Kirkwood asks the question, basically, why do we in EMS suffer from a lack of camaraderie, brotherhood/sisterhood, sense of family, or whatever you want to call it?

Basically, it is this- Why do we as EMS providers seem to be so willing to throw our co-workers under the buss at the drop of a hat?

I’ve seen it. Someone makes a mistake or a call goes bad and the crap starts flying. I’ve seen careers and reputations hurt by it. Really good people suffering long term at the hands of other, for all practical purposes, good people. Why?

I wish I knew.

When I was serving in the United States Army, we had folks that struggled. Maybe they were not too good with push-ups, they couldn’t hit the broad side of a barn at two feet with an M-16, they had trouble starting IVs, or just had some problem with some task or another. Did we throw them under the bus? Did we initiate a blanket party as depicted in “Full Metal Jacket”?

No. Not just ‘no’, but ‘heck no’. We helped them. During my Army career I can remember running in the rain, doing push-ups in the rain, letting fellow medics practice IVs on my arms, studying flash cards of obscure military facts, along with dozens of my fellow soldiers and NCOs…whatever it took to help my fellow soldiers overcome their obstacles.

And guess what? Never once did we fail.

During my fire service career, we had folks who had a hard time pulling attack lines, getting into an SCBA in less than five minutes, crawling around in turn-outs and SCBA, trouble with friction loss calculations, setting up and climbing ladders…you name it. And me and my fellow firefighters did what needed to be done- we helped them out. To use the quote from “Apollo 13”- failure was not an option.

I see this phenomenon in military and fire service all of the time- people helping people. In the Army, we did not throw people under the bus. In the fire service, we did not throw people under the bus, either.

But EMS? You make a mistake, a call goes bad, or a call goes like you think it should not have gone, and word travels faster than you can say “uh oh”.

Now don’t misunderstand me. The military and fire service are full of Monday-morning-quarterbacks who will second guess what other people do. All you have to do is look on the internet at any one of the thousands of blogs and forums out there. But it is always ‘someone else’. It is not the co-workers or fellow soldiers/Marines/sailors/airmen of the person who slipped up or had a bad moment.

EMS people? For whatever reason we will cast you to the wolves. Handle a call in a way that goes south? What your chain-of-command does to you is nothing compared to what your co-workers will do. And what is worse is something that I have seen in EMS that is, well, unique- command staff members that will throw someone under the bus, as well. Those are the ones that will tell their subordinates about the trials and tribulations of a fellow subordinate.

So what is it about EMS that grows this behavior?



Christopher said...

I chalk it up to some combination of a feeling like we need to cast ourselves as stereotypical Type A badasses (e.g. "only a select few can make it in this job") and a sense of dread that somebody's mistake will cause you to lose your autonomy or procedural skills (e.g. "Rick can't get his tubes so now they're taking away intubation").

Probably doesn't help that most folks are used to scare stories of losing their certification if they make a single mistake, compounded by other paramedics, nurses, and doctors.

Dan said...

When I was in the Army I was married to a woman from the Air Force, and witnessed similar behavior. The USAF detachment at our base was well-known for its culture of back-stabbing each other for the flimsiest of reasons, something not seen among the Army and Marine troops. And if you think about their differing roles in combat it makes sense: in the Army or USMC you rely on your buddies to have your back in a foxhole. I'll bet it's the same in fire service as well. Trusting someone with your life causes some pretty strong bonds.

BH said...

The military and fire service train that, with exceptionally few exceptions, you never do ANYTHING by yourself. Nobody clears a building by himself, nobody pulls a hose and attacks the fire by themselves.

We train EMS providers from the first day of Basic school that "You are the only EMT onscene." "You are the only ALS provider onscene." If a second person is needed for a skill station (spine boarding, traction splinting, etc), we tell the student that their partner needs explicit instructions or they won't do anything. We train them to think about scene safety in terms of "me first."

It creates a mentality that there IS, in fact, an "I" in team. I firmly believe this eventually leads to treatment of peers such as you describe.

BH said...

The fire service trains to never ever ever do anything alone. Everything gets done as a team, down to meal cooking, truck checks, station chores, everything.

EMS, from the first day of Basic school, trains you as if you're alone. Every skill station is accomplished by one person with essentially no help. We're trained to check our trucks under the theory of "don't trust anyone". The most common vehicle staffing configuration is two people with different levels of training.

We did it to ourselves.

BH said...

Aaaaad I didn't read the comments first. Feel free to not post either of these. I'll take a lap.