Unseen Observer: Putting Practice into Practice

     EMS Reruns is an advice column designed to address dilemmas you may have experienced in EMS that you did not know how to handle. But it offers you a luxury you don't have on scene: plenty of time to think. 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. We don't know everything, but we do know a lot of smart people. If we need to, we'll contact just the right experts and share their advice with you. E-mail ideas to Nancy.Perry@cygnusb2b.com.

     It's 4 in the afternoon and you've had a full day--seven calls, including a code, two transports to trauma centers and a refusal that's already generated a complaint against you. You're only halfway through your paperwork. You haven't had lunch and didn't have time to finish your morning coffee, and you never saw today's duty schedule. Another crew informs you that you're supposed to be at your station for training from 6 p.m. until the cows come home. It's skills night, they say, and you groan. Any good EMT can snooze through a lecture, but that ain't easy when you're doing skills.

     Your medical director expects you to demonstrate your competency in five areas every year, and there's no way out of this. You catch yourself praying for calls, and that makes you wonder if you've lost your mind.

     Q. Even on your best days, skills review is a drag-especially in busy systems like yours, where crews get plenty of practice. How do you get your energy up for these things, anyway?

     A. Even if your medical director weren't insisting on annual checks, the National Registry includes them as part of your recert process every two years. They'll never be convenient, they'll never be fun and they'll never go away. If you're a seasoned caregiver, you know they're just part of your practice.

     More than that, professionalism isn't an award you receive; it's a choice you make. If you hate being treated like an amateur, then don't be one. As an example, try the following technique. It's simple, and it applies to every aspect of public service. Imagine there's a resident of your service area in the room, silent and invisible. (Remember, they own your certificates.) Imagine them watching you go through your skills. Will they see a professional doing his best and taking the process seriously, or will they see an amateur, slackin'? If you're not doing your best, imagine trying to explain to them why that is.

     Q. Last time you went through skills, it was clear the instructor didn't really take his role very seriously. He'd also had a busy day, and he was obviously not well prepared. Perhaps to compensate, he acted more like your pal than a teacher, and suggested you "imagine" the presence of equipment he hadn't provided for you. It's the same guy tonight. How are you supposed to take this seriously, if even the instructor doesn't?

     A. Instructors aren't perfect any more than EMTs are, and very often they teach in addition to their full-time duty schedules. Sometimes they're assigned to teach with little or no advance notice. It's damn near impossible to provide a good learning experience under those circumstances. If your agency isn't serious about education, chances are you know it. In that case, tonight is not going to be any better than last year was.

     Q. Sure enough, you see no evidence that anyone has done any planning for tonight's event. Everybody's just going through the motions, and most people are fooling around. You feel like you're wasting your time, and you want to lecture them or something. What can you say?

     A. You can stand up and preach if you want to, but if your coworkers are as tired as you are they'll probably just tune you out--or throw you a blanket party and beat the snot out of you. About the best you can do is muster enough fluxie to take your own skills as seriously as you can. Examples out-influence lectures, any day.

     Chances are, your colleagues silently wish things were different themselves. Every one of us would like to be affiliated with an agency that deserves our respect. That doesn't happen by magic, and it doesn't happen overnight. It happens because somebody cares enough to do something. Tomorrow, you can act the part of a professional and approach your medical director about fixing the system.

     If he's reading this piece, maybe he has an unseen observer, too.