House MD

I'm not a griper, but I was watching an episode of House, MD, my all-time favorite show on the "Idiot Box" and found the opportunity to bring up an issue.

The main character is quoted in one episode as saying:

"Dr. Gregory House: [to EMT guy who has just tried to give directions] If you wanted to be a doctor, maybe you should have buckled down a little more in high school."

this quote coming as EMS is wheeling a patient into the ED and saying something to the order of "he lost three units of blood en route, he needs a transfusion stat." Not that I would never say something as canned as that, but the response is still slightly off, don't you think?

Another episode has an EMT announcing to a crowded restaurant,"someone call for a wagon to Princeton-Plainsboro [Hospital]?" (Anyone ever arrive on scene and ask if someone requested a [meat]wagon, or even use our EMS slang: bus, truck, rig...?) The actor saying that last line is listed in the credits as the ever-dreaded: "Ambulance Driver."

This line of thought brings about the age-old topics of debate: (1) How do we rid ourselves of the title "Ambulance Driver" and (2) How do we cope with our profession (applicable to the professionals*) and care (applicable to the volunteers, professionals, and everyone else) being portrayed in such a manner, in such public view. We are all highly trained, and albeit paramedics much more so than us simple EMTs, but we all take great pride in our work, and I think we all take just a little offense when we see ourselves placed in a lesser role in life, given less respect than we deserve.

The term 'ambulance driver' probably, and you old timers would know better than I would, came from the point in history when the people who worked on ambulances were just that, 'ambulance drivers.' That casting can easily be seen when one watches such classic TV shows as 'Emergency!'. Those proud L.A. paramedics Johnny and Roy (who, Lord only knows how and why, can perform a trench rescue in nothing but their station blues and not get the slightest speck of dirt on them) would hop into the back of the ambulance just as it was about to be driven off by the... driver. Need I remind anyone that this was 1972. When was the EMT program established? Answer: 1973 with the federal EMS Systems Act. By the way, who was given authority for the development of the EMS curricula and development: why of course, the Department of Health and Human Services! Wait, but then why does it say Department of Transportation on the third page of your EMT-Basic text? Oh, now I remember.

According the Wikipedia, the first organized police department occured in 1667, the first organized fire department happened in Rome (that's Italy! not New York!) in the Year AD 6! EMS, the third branch of the emergency services could not even begin to be considered until the advent of CPR in the 1950's and 1960's. Being more than three hundred years older than the other 'uniformed' services, has its disadvantages: No NFPA, no PBA. I attended a lecture this past weekend about the safety of ambulances by Nadine Levick at the National Collegiate EMS Foundation's Annual Conference (I'll post about the conference itself.... later). Did you know that ambulances are only one of two types of vehicles on the road today that are exempt from federal safety standards. This ain't a good thing. If you dig around her website there are some spectacular images of what happens when an ambulance gets into an accident.

Essentially, no one is looking out for us prehospital care professionals, us EMTs, paramedics, etc. We have no strong unions (my friend works for a commercial outfit: their union, the teamsters. Another transportation related group). No lobbyists. The NFPA exists solely for the protection of firefighters. When they come out with a new regulation regarding building construction, it almost automatically becomes part of a municipality's local codes. How about a similar organization for EMS? Nope. Nonexistant. If you work here in New York City for FDNY as an EMT or paramedic, you are allowed to take the test and then accept a promotion to become a firefighter (No more EMS work). That's right, the career ladder clearly shows that firefighter is above EMS. Frustrating huh?

So all of this brings us around to our initial question. (1) How do we rid ourselves of the 'ambulance driver' stigma? and (2) how do we appear more professional than we are often portrayed?

The answer to both questions, I believe, are simple and obvious. We work hard. We provide excellent patient care, and we act as the professionals that we are. Through this, we as an industry, and as individuals working as EMTs and paramedics can open the eyes of the public as we touch them through our care every day and earn the respect that we deserve.

Griping fine. (My entire Italian lexicon put to good use)




*Professionals - Do ye volunteers consider yourselves as professionals or merely as workers? Or is professional applicable only to the career guys? Another side issue that could turn into a post, but probably never will.