July 23rd, 2012 § Comments § permalink

I ran my first EMS call in 1974 as an explorer scout. When we arrived on the scene of the car crash, the lead paramedic handed me three flares and told me to set them up down around the corner. When I walked down there, it was dark and I had no idea how to light the flares. I tried everything to get them lit, but I didn’t have a flashlight, there was no light, and I’d never lit a flare before. My biggest fear wasn’t approaching traffic, my biggest fear was not looking stupid. So, of course, I didn’t walk back and ask for help, I just figured it out and got them lit.

20 years later, in 1995, I was working as the EMS operations manager of a large, suburban fire district. I was serving on various committees, task forces, and advisory roles. I left that rewarding an successful career to pursue other avenues, but in 2010, partly due to the economic downturn, I found myself unemployed. It seemed the easiest way to find employment and keep our house was to regain my paramedic license and find EMS employment. Six months later I was employed by a large corporate ambulance transport agency.

At first it was quite challenging. Much had changed, yet much remained the same. Essentially I’d been out of the field for 20 years, though I still ran calls and did a lot of teaching in the 90s, I was mostly a desk jockey. And though I worked for a non-transport agency,  my previous experience included both air and ground EMS. The hardest part about returning was the pace. I soon learned how busy system status EMS takes it’s toll on medics and EMTs.

After getting through FTEP and settling into the role, I had a period of joy. It was really fun being back into the career I always loved. It was great to run calls again, solve problems, and take care of people with needs. But that joy quickly wore off. EMS is different now.

When I first worked in EMS, prior to the implementation of the 9-1-1 system, the ambulance company I worked for ran without first responder support. My partner and I were often the only ones on scene, and the calls seemed to go much smoother. We were able to establish rapport with our patients, comfort family members, and reduce the chaos and confusion we found. After EMD was implemented and communities decided to send firefighters as EMS first responders, things started to get more complicated on scenes.

There were attempts in the 1980s and 90s to streamline our EMS systems by awarding ambulance serve contracts and eliminating the duplication of agencies, but from what I can tell, far too few communities have accomplished this. To me, this is one of the most disappointing aspects of our current systems.

About six months ago I found myself working the graveyard shift on a system status ambulance. The county I worked in had no quarters and we covered thousands of square miles with just a few rigs. We spent the night moving from post to post. Sometimes we would be at a post for hours, sometimes we never sat still. This began to take its toll on me. I began to realize that this shift, combined with the claustrophobia of the ambulance cab, was killing me – and killing my family.

I’m convinced that system status is taking an abnormally high toll on EMS workers. The stressors of the job, considered one of the more stressful careers in the US, and the long hours, are killing our paramedics and EMTs. It’s a shame really. People come into EMS excited and with high hopes of making a difference. But after about 5-10 years, they grow demoralized and depressed. I’ve never worked with so many discouraged people in my life as I have in the last two years.

I worked hard to stay healthy, keep a positive focus, and improve the lives of my coworkers. But I’m afraid the task is too big. There are several agencies and communities around the country who do EMS really well. They not only offer quality patient care, but they treat their employees well. Other communities have not been so quick to adapt. Sure, paramedics are being paid much better than in the early 80s – back then I made $4.10 an hour and I was working one of the busiest ambulances in the country.

Somehow, our society has forgotten to take care of its EMTs and paramedics. Unless they find employment in a well-funded public agency, I would not recommend people seek EMS as a lifelong career. This pains me to say, as I love my coworkers and the job, but I don’t see changes happening anytime soon.

Last week, after a two month break, I resigned my position. I’m too old for this, and I’m not a good fit. I’m not a bad paramedic, but I wasn’t getting enough sleep. After reading this article (Life in high gear takes toll), I realized I was taking too big of a risk. If I mess up on a drug administration, which according to David Marx, happens one out of 700 times, it is my career and livelihood on the line. I know my employer wouldn’t stand behind me.

The sleep deprivation, the pressure to make scene times, the lack of quarters, and the lack of focus on quality patient care have made me realize I need to move on. I don’t know where I’m going next, but I feel peace. I would gladly work at an agency that cared about their employees, put customer service and patient care needs above the desire to make a profit, and used their resources to improve the local system.

Just like when I was a 15 year old kid, I just want to make a difference by caring for people in need. I’m not in it for the money – I gave up that pipe dream a long time ago. I just want to serve my patients and their families. It is my hope that paramedics, EMTs, physicians, nurses, and system leaders will continue to improve our fledgling profession. There is still great potential, but it won’t be cheap. It will take a great influx of energy, desire, and vision.


A Plan, A Direction, A Vision

June 20th, 2012 § Comments § permalink

My original idea for this particular blog was to document my development as a Dad. Long before my Darling Daughter (now 7!) was born, I began to read books, listen to podcasts, and seek mentors on how I could be a good great father. Of course this created a lot of opportunity for introspection and growth. And since I tend to learn more when I’m writing, my goal was to write down those thoughts and learning opportunities.

Interestingly, life handed us a couple of curve-balls and I focused on not striking out, instead of growing and sharing. Our Colorado Springs Project was failing, we had to move, my position in Oregon wasn’t a good fit, then came the health problems, unemployment, and sudden career change. Whew…  Life grew very interesting over the past six years.

For health and family reasons, I decided to take an unpaid sabbatical. I’ve been away from work for over a month now. I have recharged, re-balanced, and relaxed. We have experienced some recreation, recuperation, and refocusing.  This has been a positive experience, albeit challenging. Our current lifestyle – night shifts, long hours, long commute, and financial pressures – was killing me, and killing my family. It was the right thing to take this past month away from work.

Sometimes finding one’s direction is about passion, sometimes it is about opportunity, and sometimes it is about needs.

One thing I’ve been able to do is reassess my priorities. Leaving the Common Ground family was really difficult. More than a project, much more than a mere church, these people were our extended family. And right when we needed them the most, we moved cross-country into a church that didn’t know how to be a church. We found ourselves alone and struggling during a very difficult time.

This blog became my outlet – and hence, it lost its original focus. As I’ve shared with my Wonderful Wife, this space became a place for me to whine, rant, and complain. Oh sure, there were some deep insights, but watched my loyal readership slip away. In addition, as my life turned away from church leadership and towards emergency medical services (my first career from 30 years ago), I began to doubt my direction. Pretty soon, my writing became more sporadic, less frequent, and very unfocused.

A few months ago I began writing posts on three different self-managed blogs. I created an EMS blog for EMS-related topics. There is a spiritual growth blog for topics related to being a disciple of Christ. And there is this blog, which has remained somewhat autobiographical and random. I then created Facebook and Twitter accounts for these three topics and over the past month, I’ve been curating topics into these threads. It is interesting to see what generates the most attention.

In reality, what I’ve been trying to do over the past few years, is to figure out who I want to be and what I want to do, when I grow up. I love being a team-building leader. I loved being a part of raising up Common Ground. I miss being a part of that kind of community. But here I found myself, ensconced in EMS. So, I tried moving into leadership and management – but I found I wasn’t welcome there.  Now what? Maybe consulting?

For me, management and leadership comes easy – but that doesn’t mean it is easy.

Yeah, I believe that being a leadership consultant is something for which I have passion and talent. A few doors have opened in that arena, but not very wide. It is very confusing to be in a dark, windowless room, forced to work a mindless job, teased with opportunities, but never seeing the true light of day.

Sometimes finding one’s direction is about passion, sometimes it is about opportunity, and sometimes it is about needs. When all three of these align, like they did in Colorado Springs for us, the choices are simple. When only one or two of these line up, the risk of making a good, or bad, choice increases exponentially.

Here’s what I know right now:

  • As long as I continue to work in my same position, at the same hours, with the same commute, for the same low wages, I will die and bring my family with me.
  • I have a passion for empowering people, leading life-changing projects, and making a difference in the lives of individuals and communities.
  • I am too much of a free-thinker, too independent, and too outspoken to be embraced my most corporate entities. In other words, I do not make a good employee and I am too much of a threat to the stability of other people’s careers.
  • I have an entrepreneurial spirit that is evidenced through many branches of my ancestral family tree. This spirit does not sit still very long.
  • Of my three life passions, the doors are virtually closed on two out of the three –
    • Denominational Employment. Even if I wanted to work for the church, I’m pretty sure I’m not welcome. There may be leaders out there who would hire me, but the people in the pews are not very open to this idea. And, yeah, there is really only one denomination whose values and beliefs I align with – so working for another denomination would be a real integrity stretch that I couldn’t overcome.
    • Emergency Medical Services. From the age of 15 I was immersed in emergency services. I was there at the beginning of the paramedic revolution and I’ve had a very diversified career. I know I have much to offer yet, but the price to pay is probably more than I’m willing to put down. There are some unspoken opportunities out there, I could do a better job of networking, soliciting, and promoting – but I realize I really don’t have the passion like I used to. Mostly, because I’m not longer intrigued by the bureaucratic challenges and political realities.
    • Leadership. Now this is where it gets complicated. In our society and culture, we like to move people up through the ranks, and we like to know they have the basic skills and knowledge related to the particular industry/employer. For instance, using the examples above, we want our denominational leaders to be theologians and we want our EMS leaders to be paramedics. Hospital administrators are almost always doctors, and the manager at McDonald’s almost always came up through the ranks. This occurs even when leadership and administrative skills are more important than the industry skill.

Over the course of the past 20 years, I have walked into a variety of situations and assumed leadership roles with virtually no experience in the particular industry I managed. I’ve supervised a deli staff, managed an IT department at a mid-sized university, managed employees at a dry cleaner, grocery store, and wholesale food distributorship. I’ve managed commercial lease properties, led government task forces, and managed a municipal water district. I was foreman of a pipeline construction crew and president of the graduate school student body. I’ve managed paramedics, laborers, secretaries, and volunteers.

For me, management and leadership comes easy – but that doesn’t mean it is easy. The learning curve is usually steep, but asking questions, soliciting advice and input, and staying humble allows me to let other show me the paths to take. This builds stronger decision making, empowers the workforce, and enables the organization to move forward in unity. Sometimes, having an expert in the field will weaken this process because the “expert” doesn’t feel the need to build consensus.

So, now what?

  • I still believe I am called to lead a faith community.
  • I still believe in putting my family before my career.
  • I still am passionate about a few things.

When we get to a place where planting a church comes out of our vision, and not out of our anger and frustration with the way we’ve been treated, I believe we will be in the right place to start another Common Ground like experience and community. But not before that. However, I believe we are very close to that time. I have a lot of spiritual recovery yet to cover though.

I’ve already lost one job because I refused to put my family second to my employment, and I feel like my current situation is equally at risk. That’s OK though. God carried us through the first one – which isn’t over yet – I know he’ll carry us through the next one. Even if we have to live in a 600 square foot, run down space, I know we can choose to be happy – regardless of income or comforts.

The one thing I am passionate about is helping other men discover their identity and clarify their vision. I am passionate about great parenting. I am passionate about being a good husband. And I am passionate about a quality relationship with God. All of this came into clear focus on Father’s Day of all days. As I was donning my Daddytude t-shirt, I realized – this is my passion. And, this, is the direction I’m going from here forward.

Killing Us Softly

June 14th, 2012 § Comments § permalink

It’s no secret that sleep deprivation is a killer. Too little sleep is linked with depression, obesity, diabetes, and heart disease. We are lifesavers, but we are killing ourselves while we save others. Whether working in a system that requires overtime, working overtime to make up for low pay, or working in a busy system that requires 24, 48, or longer shifts – your life is ebbing away.

Is it worth it?

I see older coworkers who are barely able to put one foot in front of the other. They are depressed, broken, sick, and tired. Back issues, arthritis, obesity, and other burnout symptoms are rampant. It saddens me to see this.

What good does it do for us to save the whole world, but lose the lives of ourselves and our families?

When we were young we had visions of saving the world. We didn’t care about long hours and poor working conditions, we were pioneers in the exciting world of EMS and we were willing to do whatever it took to save people. My first full-time EMS job paid $4.10/hr. I worked 48/48s, and we ran 32 calls a shift. We learned to sleep and eat whenever – fortunately, most of the hospitals fed us well, and we ran our tails off. I was 21 years old and literally, living the dream! That first year, I made $6000 total.

That first EMS job cost me my marriage. I was either working or sleeping – that didn’t work well.

For the next 15 years, I got one of those elusive fire-medic positions. My pay tripled, my hours were cut by a third, and our call volume was only 10% of the big city ambulance gig. At first I was bored, but I now see how that saved my life.

I left EMS 16 years ago and completed by degree and began to work on post-graduate education. I got remarried, found a new career, and we have a couple of kids. Unfortunately, when the economy tanked, I lost my job – along with about 40 million other people. I figured that the best way to keep my house and feed my family, was to go back into EMS. So, I got re-licensed and found a job as an ambulance jockey.

It was fun to come back. I really never wanted to leave – and I always missed the challenges of transport – something many fire medics don’t get to do.

But a month ago, I had to take a medical leave. I didn’t hurt myself. I don’t have a medical condition. I am just exhausted. Because I have no seniority, I’ve been working nights. Because we had a house in the country, I’ve been commuting three hours – round-trip. It was killing me, killing my family, and destroying our quality of life.

We decided long ago that we had to move, but because we were now upside down on our mortgage, we couldn’t sell the house. Because our income is 30% less than my previous career, we were barely surviving. We drive very old cars, rarely eat out, and don’t take vacations – other than an occasional camping trip. Although we are not in debt, financially, we are in debt emotionally, physically, and medically.

Many of my younger colleagues are so eager to get the adrenaline rush they don’t see the path they’re on.

For the past few years we avoided house repairs, car maintenance, and medical/dental check ups. The co-pays are too expensive and we didn’t want to go into debt. Our lives are literally falling apart around us.

Being older, wiser, and with a few more trips around the infield, I can see this happening. The sad thing is, many of my coworkers didn’t see the job changing around them. And now they’re trapped. Many of my younger colleagues are so eager to get the adrenaline rush we all used to live on, they don’t see the path they’re on.

Something has to change – at least in the for-profit EMS world.

But even the non-profit sector has some self examination to do. Recently, I applied for a management position at a non-profit, hospital-based system. The crews work 48/96s – and apparently, this is causing some big issues. Safety and crew health are being negatively affected, but without hiring additional personnel, they can’t really change the system.

As a profession, we need to look at the issues, address the problems, and create positive solutions. What good does it do for us to save the whole world, but lose the lives of ourselves and our families?

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