I read it all the time: “They need to pay us better.”
But do they need to increase EMS pay? Have you taken the time to look at some of the individuals who work in the EMS industry? In your local agency? Across the board, there is a lack of professionalism in our industry.
I spent several years working in the field before moving to the administrative side of the house. I spent a year working in clinical investigations, which is basically the EMS version of internal affairs. It was an eye-opening experience to say the least.
Clinical issues are common
Some healthcare providers seemed to be pretty good practitioners when I encountered them in hospitals. Then I started reading some of their patient care reports.
Some of the clinical issues I encountered were:
- Starting 14g and 16g IVs in a patient’s hand simply because the patient was drunk or a homeless frequent flyer.
- Sedating with Etomidate and intubating a patient because the person was an aggressive psychiatric patient. Forgoing attempts to physically restrain the patient and ignoring chemical sedation protocol.
- Posting protected health information on social media websites.
- Failing to follow spinal immobilization protocol for patients with distracting injuries.
- Failing to complete patient refusals.
Waiting too long to meet education requirements
Another issue is the lack of personal responsibility. Before moving on from the private agency I worked for, I was responsible for the staff’s continuing medical education (CME).
We instituted mandatory quarterly training. Two quarters a year had asynchronous online education, and the other two quarters involved in-class synchronous training. Regardless of the manner in which class was held, we continuously had 20 to 30 team members who did not compete their training by the deadline, and this was paid training.
We were forced to implement disciplinary action — starting at suspension — to fix the problem. If a team member failed to attend a make-up training session, that person was separated from the organization. Suspension and separation over mandatory training should never have to happen.
Still, I see the procrastination. We are coming into our busy season at Distance CME. We see a slow, steady climb in enrollment and attendance starting in roughly October and peaking in March.
Starting in October is great because EMS professionals have six months to complete the 48-hour refresher training. That is an average of eight hours per month of CME in two-hour increments to complete all the requirements by the March 31 deadline.
In March, we see a huge spike in attendance and have paramedic refresher classes with well over 100 students per session. When the final week before the deadline hits, potential students are frantically trying to figure out how to complete the training over the course of that week.
Last year, we had some customers complain to our customer service team because they were not going to be able to complete 48 hours of training during the final 24 hours before the deadline. Seriously.
Professionalism and accountability matter in EMS pay
I’m admittedly not very good at the math, but I am pretty sure 48 hours of refresher courses would require two days, and even that isn’t realistic. You really need four or five days to get through the training, and at least three if you hit the cycle just right.
Some members of our profession cannot manage to complete 48 hours of training over a two-year period, but then want to argue that they deserve better EMS pay.
Before we start demanding better EMS pay, shouldn’t we step up our game in regards to professionalism and accountability?