Humor was never the problem. Anyone who knows me on a personal level knows that I love to laugh. I love pranks. I am kind of a huge nerd. I love the fact that Young Frankenstein has so many applicable quotes at work while talking to my partner. One of my favorite movies is Nacho Libre. My humor isn’t always refined or well thought out. I tell jokes that fall flat, but I keep telling the same ones because they amuse me. Yet, there is a side of me that knows when to turn off the gag reel. Humor is not the problem.
I have been mulling over how to approach this subject for some time, never finding the right words to say or the right ideas to put together. Today, I feel like I finally have a little clarity. Before I start to write my main body of thought, I want to make an important statement that I want there to be no confusion on. I am a hypocrite. I am not an idealistic person that is sitting in my glass house while throwing stones at everyone else’s. For the last four years I have worked in a high-volume EMS service and have felt the scorching effect of compassion fatigue and burnout. I have said things to my friends, family, and myself that make me cringe to this day. This is a personal topic for me, so allow me to editorialize instead of bringing you a clinical blog.
Social media is perhaps the greatest gift that has been introduced to modern day education, but it is a double-edged sword. If you remember in Episode 6: Social Media and EMS, Stephen and I raved about a lot of the applications that are available to EMS providers now, as well as some of our favorite blogs, chat rooms, and podcasts that we follow. When used in this manner, social media strengthens the medic’s knowledge base by allowing a platform for them to exchange ideas with other providers. So what’s the downside?
Look through any popular blog on Facebook that has anything to do with prehospital care… Not only will you see many unfounded personal opinions, but then you begin to notice the grade school name calling and playground antics. I observed a post in one of these forums. A newer EMT student was questioning the decision making process of the medics that were treating his brother for chest pain. The student provided a list of information for the crew, and was genuinely asking why the crew didn’t listen to him. Some responses were thoughtful, and tried to explain that the majority of providers just want to get a good baseline for themselves before taking bystander reports at face value. Others resorted to this… “Sounds like little girl got her feelings hurt because her first call didn’t go as planned and they weren’t hanging on her every word as an expert“. All of us started somewhere, and I can guarantee you weren’t a rockstar on your first day. There have been entire social media accounts dedicated strictly to mocking newer or inexperienced medics. This helps no one. It shames emerging providers for asking questions, and at the end of the day, the patient is the one who suffers.
NOT EVERYONE DEALS WITH TRAUMA THE SAME WAY
Before I continue my tirade, let me stop and point out the positive strides that are being made in this arena. I can’t stop applauding the efforts of the Code Green Campaign for very publicly opening up the dialogue of PTSD and first responder suicide. It is a problem. In a study conducted in 2012, 4,022 medics in the United States were polled asking if they had ever contemplated suicide or had ever attempted it. 1,383 (37%) pollers stated that they contemplated suicide, while 225 (6.6%) stated that they had attempted suicide in the past. Both of these rates are exponentially higher than the national average… Before telling someone to “get over it” or “it’s part of the job”, take a moment and think about your worst day and the help you wished you would have had. Don’t be so quick to invalidate someone else’s experiences. We don’t know what triggers other have. We are all just “one bad day” away from making a life-altering choice without the proper support group. There is no way to tell where on this spectrum someone is.
In the spring of 2015, a Russian paramedic took to social media posting some horrendous selfies of her flipping off deceased patients, as well as referring to MVC victims as a reason for hating her job. Granted, this is one isolated incident. The public doesn’t care. The minute the seed is planted that we don’t care about our patients, we lose credibility in the public’s eye. As animosity grows, it is my genuine opinion that we will continue to see violence towards first responders as a whole rise. We are not responsible for others’ actions, but we can quit throwing fuel on the already out of control fire that is violence on prehospital professionals by openly condemning and separating ourselves from these actions.
Yes, the location was intentionally blurred out as to not to continue to affiliate this hospital with this nurse’s bad choices. What message are we sending by doing this? We don’t care about our patients. This job is about what makes me feel good. Social media has added significant complexity to our jobs, but responding to it like this is killing our profession’s integrity.
Since I have entered the field, I have never once been able to select who calls 911 and who doesn’t. I will admit that I have experienced great frustration witnessing a patient that has just woken up from an opiate overdose decide to go back home and shoot up again. My job is not to judge this patient’s life choices, but to treat their condition, regardless of what they do fifteen minutes after I leave. Opiate addiction and overdose in the region I work in is a gigantic problem, but our response should still be one of patient advocacy. Refusing to give a medication because of a punitive reason is despicable, and it happens. It is a breach of duty. Addiction for many is not a choice. Take a second to stop reading this post, and read this article that highlights what happens to your body throughout the cycle of addiction. Education about these issues is the only way we can move beyond this mindset. Conversely, providing interventions that are invasive and not necessary isn’t just being an asshole to your patient. It’s abuse. We have all heard the stories about medics cramming an NPA in someone’s nare because they were “faking it”, or starting a 14g IV on a belligerent intoxicated patient for no other reason other than they were being annoying. The more we glorify these posts, the more we desensitize ourselves to what is really happening here. We are betraying the oath we took when we became medics. It is time to stop acting like this humor is cute, amusing, or worst of all acceptable practice. It’s time to start encouraging our brothers and sisters in the field to vent in ways that are therapeutic and constructive, instead of spewing out hateful blanket statements. So, as I am ending my day-consuming rant about the state of personal conduct and social media, I will implore my friends and colleagues (including myself) to take a step back and ask yourselves three questions. 1. Is what I am about to post in line with my core beliefs? 2. Is what I am about to post going to help someone else or hinder them? 3. Is what I am about to post in line with the oath I took when I became an EMT? “The fault, dear Brutus, is not in our stars, but in ourselves, that we are underlings.” – Shakespeare, Julius Caesar
Every once in a while, when I feel burned out and cynical, I like to stop and take a look back at what I enlisted to do, and the reason I did it. Here’s a copy of that reminder. I’ll find something else to get on my soapbox about next week, but I promise, it will at least be something clinical. If you have any gripes, concerns, or comments about this post, you know where to find me.