provided by: 
EMS Reruns addresses dilemmas in EMS. If you think of an example like the one that follows, send it to us. If we choose to publish your dilemma, we'll pay you $50. E-mail ideas to Nancy.Perry@cygnusb2b.com.
You're returning from an MVA with a load of paperwork to do, and you notice your boss' car parked at your station. Sure enough, she backs you into the bay and comes to your window. She wants to chat. She greets you and your partner, then takes your partner's place behind the wheel and closes the door. She seems cordial, not too serious, but she clearly means business.
There's a complaint from the local ED. It's nothing serious, but this is about your sixth one in the past year or so, and they've all been about your attitude. Your boss is concerned, because you seem to be slipping. You've been on duty for four hours, the weather's nice and you haven't been busy. But the windshield is streaked and your equipment is obviously not clean. She points that out, she says, because this doesn't seem to be up to your usual standards. Your performance has always been really good, your equipment spotless, your documentation thorough and your medicine top-notch.
You've been a paramedic in your system for 10 years. You're comfortable with your skills, you like most of your co-workers and first responders, the equipment is safe and the protocols make it easy enough for you to take good care of folks. But lately you feel a little tired. Tired of washing the rig, filing the reports, renewing the certs, wearing the uniform and even putting up with some of those whiny patients and their demanding families. Tired of your agency's policies, and maybe even a little tired of some of your peeps. Fact is, you've become one of those EMTs you've complained about in the past.
Q. I know, something's wrong. I've stopped growing. I used to love EMS, but some days it doesn't seem like fun anymore. I feel like I'm just going through the motions. Nobody does this forever, right?
A. You're right about the fact that EMS is harder than it once was, but don't give up. Lots of good folks are trying hard to fix EMS through NAEMT, NASEMSO, NAEMSE, NAEMSP, NAEMSMD, NAEMSD and the Registry (not to mention some wonderful smaller groups like EPIC Medics and others). This will never stop being work, but it's not like anybody is trying to get rich. EMS will always deserve your devotion, and that 10 years of yours brought you wisdom and understanding that would be such a loss if you were to walk away.
Q. I'm not much for politics. I'm more of a worker bee, and besides, I don't trust organizations. I work for a little service that can't afford to send me all over the country to attend meetings. I'm just one paramedic, and I have kids to raise. I can't even remember the names of some of those organizations, and I never heard of a couple of them. How could I possibly make a difference?
A. Those sound like my own words, so long ago. I think the reason why the fire organizations like IAFF and IAFC are so powerful today and the EMS ones are so weak is that those fire folks got involved in their organizations 30 years ago and people like me didn't think it was important. I regret that so much. But the fire organizations are made up of worker bees, too. And our organizations can become anything we want them to be. Every movement begins with a single voice.
Q. So what, I should just join all those groups and start sending them money?
A. Consider NAEMT for sure. But you can do better than joining them all. Locate their websites, and spend a few months or a year learning about them, who they are and what they're doing. There's a whole world of activity out there on behalf of EMSers that most of us aren't aware of. Some of it will interest you, and some of it won't. Latch onto one organization whose work interests you, and get involved. It's much better to be a productive member of one group than a silent dues-payer to several.
Q. OK, but what does that have to do with the way I feel about my career?
If this were easy, anybody could do it. And after 10 years, you've had enough students in your ambulance to realize that most people simply can't do it. You can. You may need a vacation, a change of partners, a change of stations or even a sabbatical. But the life of a paramedic is just like a relationship; it requires routine maintenance. Think about all the people you've met on that stretcher of yours who weren't as lucky as you are. Most folks never get those kinds of reminders, and you've had thousands. Loving what you do is a treasure, and it's worth some trouble.
Come to think of it, so are you. Hope this helps.
Thom Dick has been involved in EMS for 37 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of EMS Magazine's editorial advisory board. Reach him at boxcar_414@yahoo.com.
author: By Thom Dick