I began my career in EMS as a small town volunteer. I knew very little about EMS as a profession. I had a brand new state certification, a National Registry patch and a completed orientation packet for my local service agency.
I was eager to learn how to become one of the confident, capable providers who made up the volunteer crew. My entire EMS world consisted of my classmates, my instructor and the EMTs who ran the ambulance corps.
I knew nothing about the history of EMS, had never met our medical director, was unaware of the existence of a state office of EMS and didn't know what was meant by EMS CE. My state only required National Registry testing for initial certification. Retaining membership simply required renewing by check every year.
I knew that the state EMS office, usually said with dread or disdain as "THE STATE," required us to meet staffing, clinical and equipment standards and if we screwed up, we would get in trouble with "THE STATE."
In a silo
Like most of the ambulance corps membership, I had a full-time job, a young family, a social life and little interest in being involved in EMS other than what was required of me, which was signing up for shifts, attendance at in-service training and regular monthly meetings.
I lacked confidence, constantly asked questions looking for help with both understanding and skills practice. My peers tried to help by telling me that I was unlikely to kill anybody and that many of the scenarios I worried about rarely happened. Well meaning, but not helpful.
The culture of volunteer EMS has traditionally been insular. Information, collaboration and sharing of resources is not only limited, but often viewed as suspect. Volunteer agencies share the same goals, experiences and difficulties nationwide, but are often resistant to change and new ideas, especially from outsiders. In large companies this happens with departments, which are referred to as corporate silos.
It didn’t occur to me that I could — or should — go outside of my agency for additional education or experience. Like a lot of volunteers, I was a victim of the silo effect [1]. .
Rethink performance metrics
The only thing I knew about EMS outside of my town was that we were better than pretty much all the other agencies in the area because we did not pass calls. We always got a crew to respond in our service area. This was our number one priority.
At the time, I never even questioned why the fact that we actually showed up for 911 calls was considered a big deal. Our concept of success was based on only two things: not failing at our most basic responsibility to show up and not getting in trouble with the state EMS office.
Understanding that showing up is not a measure of excellence came later in my career.
You don’t know what you don’t know
A few times a year, flyers were posted about free education opportunities at nearby hospitals, usually a lecture by an emergency medicine doctor or a hospital-based paramedic. There was also a poster for the annual state EMS conference, a weekend event with a substantial registration fee.
At the time, we earned points for showing up for calls that could be reimbursed for uniform equipment. I didn’t need boots and I had a top of the line sparky gear bag already so I asked if I could use my points to attend. I quickly heard the usual excuses for staying home:
"People only go to those things to get drunk and screw around, like any convention."
"There is nothing there for regular EMTs."
"Nurses and paramedics go because they need education credits. It’s way over your head."
Eventually, a paramedic friend dragged me to one of the free continuing education offerings at our local hospital. It was on stroke assessment and a new initiative for stroke alerts.
I realized then that I had no idea exactly how much I did not know and how much I should know about prehospital care.
It’s not what you think
Many EMTs, especially volunteers, have had little exposure to dynamic learning experiences. Buy-in for mandated continuing education has been limited as it is often viewed as a necessary evil with questionable relevance or value. Death by PowerPoint and war stories, both ineffective educational methodologies for assessing or improving competency, had become the expectation.
Leave the conference a better EMT
I had been an EMT for almost eight years when I attended my first EMS conference. I had subscriptions to several EMS trade publications and had discovered and become a regularly reader of "Life Under the Lights" by Chris Kaiser, "Street Watch: Notes of a Paramedic" by Peter Canning, "Rescuing Providence" by Michael Morse, "A Day in the Life of an Ambulance Driver" by Kelly Grayson, and some other EMS blogs. I was excited to find out that some of the familiar names from articles I had been reading by Ray Barishansky, Allison Bloom, Jason Dush, Rommie Duckworth, Kelly Grayson and Tracey Loscar would be teaching at the conference and chose their classes to attend.
I particularly remember a class I attended by accidently going to the wrong room. I accidentally found myself in an ALS review on triads. During the presentation, I learned about the trauma triad of death and airway management techniques which immediately changed the way I practiced.
I also had the opportunity to meet people from the state EMS office. I was pleasantly surprised to find that most of them were human.
That evening group of EMTs who had arrived as strangers gathered by the pool, at the bar and in the restaurant. Debates, discussions, gossip and of course some shenanigans continued into the late night.
I had forgotten how much fun my EMT class had been and the camaraderie that had developed. Here it was again on a much bigger scale. The energy was palpable. My EMS world was no longer limited to my hometown.
I left my first conference a very different EMT. I was hooked. Since then, time and money permitting, I never miss an educational opportunity.
Education is not always painful
Leave the silo, get out of the bubble and give a regional, state or national conference a try. Network with other EMTs, share ideas and experiences, collect business cards, see the newest EMS products and attend classes for CE credit that look interesting and challenging.
As an added bonus you will leave with enough pens, notepads, koozies, hand sanitizers and carabiners to last until next year’s conference.
And it will be painless.
Have you attended a regional, statewide or national EMS conference" Why or why not"
Share your answers in the comments.
References
1. The Silo Effect: The Peril of Expertise and the Promise of Breaking Down Barriers by Gillian Tett, Simon &Schuster Sept. 2015
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