Are You A BLS Paramedic?


As most of you may know, I have an almost 25 year history in EMS. I have spent most of my “career” learning and doing EMS activities and working to become a better medic than I was yesterday. You could say I’m an EMS geek! I have been in EMS management; responsible for making sure goals and objectives are met. In the past I have been responsible for setting up training’s and making sure that the EMS providers kept their certifications current. Pretty much anything EMS related was in my “wheel house” so I feel I have a broad view of EMS and how it should operate.

That being said, I have always been fascinated by the individuals that spent time obtaining their EMS certification to come out of school and not use it. The Registry process is a grueling one and it stresses most people to the max. I often wonder what their goal was when they started their training. Examining behaviors is a hobby of mine so I have the mother-load of examples to look at in any department.

That leads me to today’s topic. Are you a BLS Paramedic? I’m sure some of you are trying to figure out what I actually mean by that. When I ask that question, I am looking to those folks that do not do the ALS skills that could make a difference in the outcome of their patients and those folks that differ their patients to their lower certification partner because they can just “tell” that the patient isn’t in distress simply by looking at them. It’s a form of complacency and it fascinates me.

“Complacency is just a factory word for laziness” – Chief Rick Lasky

Don’t get me wrong, I have downgraded my share of patients. I can assure you however that there was little doubt that they were BLS or simply needed a ride. If there was even the slightest disturbance in my gut, I took the patient and had my partner drive. I won’t sit here and say that I haven’t made a mistake either. I have had a few patients that, by all accounts, were not sick at all but ended up causing me to stop the rig and switch with my partner and complete the run. I am not above mistakes and will never claim to be. But as I said, I am fascinated by the ability of some providers to downgrade almost

I think the part that I am fascinated with is that you as an EMS provider have put yourself through the training. You sat through the countless hours in the classroom. You did all of those hours in the hospitals and you did all of that ride time to complete the practical requirements. I don’t get why you wouldn’t want to practice what you learned. I get that some had to obtain the cert to secure a full-time job but even those people still have a responsibility to do that very job to the best of their ability. I can also understand that you come out of school armed with these new skills that scare the shit out of you or skills that you haven’t quite wrapped your head around but why not practice to get better?

I hear some of the arguments. “I didn’t want to do EMS but I had to” or “It’s not my fault that my department makes me do EMS” or “I don’t like it but it’s part of my job description so I guess I have to”. Well you knew your department did EMS when you applied so why are you irritated by it? What makes you so special that you think you can have an attitude about it? As a Chief, I paid people to do a job, the entire job, so I expected them to do it. I had no sympathy for how much you have been on the medic. I rode the medic as a Chief. I also still work in another department as a street medic. It’s your job! Most likely, the EMS revenue is propping up your departments budget anyway!

My overall point is this; don’t take your lack of understanding, fear, laziness or complacency out on your patient. I can assure you, most or the time, they don’t give two shits what your problems are with your job, your administration or your life. They expect you to be present, alert and aware of what they need and expect you to take care of their situation with professionalism and compassion.

So the next time you downgrade the chest pain or whatever it may be, think of your mother, father, gran gran or papaw sitting on that cot, asking for help. Take care of them!

Treat the patient, not your shitty attitude!


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