"Ya wanna hear about dumb?"

Recently I called out a local ambulance service for reporting a “blood pressure” that was obtained during chest compressions while performing CPR (obviously a pressure generated by CPR itself). It’s generated a lot of laughter as well as some angry responses from EMTs - but not anger at the EMT; they were angry with me. So please, allow me to elaborate.

I have no doubt that in every EMS service there are many excellent medics. Additionally, it has been demonstrated that every ambulance service has some goofballs working there too. Excellent medics know who they are. The goofballs do not. And the problem is not with the ambulance services, but rather that no one ever tells the individual(s) that they are a goofball.

Now certainly, even the best EMS professionals make mistakes. I’m not referring to that. I am talking about the ones who should never have been allowed to continue in the EMS profession. We EMTs are quick to call ourselves heroes and give ourselves little awards for whatever and declare how generally awesome we are as a group. But as soon as the awards ceremony is over and we’re back in the ambulance with our partner or hanging out on the ER ramp with others, out come the stories that start with “You wanna hear about dumb? Lemme tell ya about this one person I was working with…”

So let’s just clear the air here - yes, even you know that there are some incompetent folks at your service, at my service, and at that other service. So what have YOU done about it? As a group, we have struggled for years to get others to view EMS as a “real” profession. Then we hear about a story like this, and it sets all of us back to square one in the eyes of others. Suddenly all the learning, training, refreshers, ACLS, BTLS, in-services and accomplishments fly out the window and we’re back to being “ambulance drivers.” And the worst part is no one says anything. We allow an incompetent coworker to destroy the reputation that we’ve worked so hard at trying to achieve. At best, the offending EMT might be sent to remediation. No one learns from remediation. If they don’t get it by now, more of the same won’t help.

So what to do? More awards? Hardly. Does anyone remember as a kid when there were “winners” and “losers”? What did that teach you? That you either strove for excellence as a winner or got out of the game when you consistently went home in shame as a loser. Now, however, all the little kids get an award just for showing up. I won’t go into how that does kids a disservice, because I’m talking about EMTs. But the “award for showing up” is something that EMS cannot afford to allow. It has no place in the real world, and YOU, dear EMT, have the power to make it stop.

If you see or hear someone doing something like reporting a “blood pressure” on a patient in full cardiac arrest, don’t get angry at the person who calls them out on it. Instead, get angry at the person who just knocked out your years of hard work from under you. You need to call them out on it too, else such incompetence is viewed as the standard by which all EMTs practice. Tell them that they are acting like an idiot when they demonstrate it. Yes, I’m talking about good ol’ fashioned shaming. It delivers more results than any hero’s banquet. Ask any of the EMTs that I have personally trained if I was afraid of shaming them for idiotic behavior. I guarantee you they’ll say no, and I’m proud to say that most of them turned out to be not just good medics, but excellent medics. And if anyone is wondering, I’ve had my own share of shame and embarrassment from others. It works.

So yes, please hang out with your coworkers for a drink; demonstrate the camaraderie that makes EMS a great group of people. But when it comes down to incompetence or idiocy professionally, don’t let that guy turn you back into an ambulance driver. I want you to be an excellent EMT. So be one.