Sunday, March 6, 2011

The 5/20 and 20/5 Rule

We've all heard the old nomenclature given to the newbie cohorts that have been riding a rig for about 26 seconds, yet seem to have seen it all. These young bucks have done it all and saved 'em all. Just ask them. They're always willing to tell you all about their awesome exploits and war stories.... all three of them.

As a profession, we commonly refer to this collectively as the "5/20 Rule".  5 years in service, 20 years experience.

Now, I'm not going to bore everyone with examples of these heroes amongst us because we all know who they are and we all know their stories. Chances are, some of us were these guys and girls at one time or another. ....then we grew up.

Instead, I'm going to present to you another group of cohorts we all know and love. I refer to them as "...abiding by the 20/5 rule..." and once you smell what The Grinder is cookin', you'll follow along.

How many of you know a Paramedic or EMT who has been around since the beginning of time who just doesn't want to learn anything new? They've been doing the same old thing for 20 odd years and, dang it, it's worked just fine for this long. Why change? I know that personally I encounter 20/5'ers on a near daily basis. Actually, one of them asked me where we keep the Bretylium in the stock room.

I replied with " the coffin next to your Paramedic book...".

Thus, the "20/5 rule" is born. Paramedic Moses has been working shifts for 20 plus years and still operates out of the same 5 page Paramedic book they gave him in 1827. They've been doing the same thing for so long, their practices have went out of standard and have been re-adopted. (see: tourniquet application).

Both schools of practice are detrimental to morale and professionalism within their respective services. You can't be a true professional if you're not up to date on the newest skills and studies. Co-workers eventually get tired of the new guy with the big britches. Something has to give....

So, which one of these is worse for the cause? ...the old dog who refuses to learn new tricks or the new kid on the block with a dose of reality headed their way? What are some ways that you can help quell the effect that these negative schools of practice?

ADD Side note: As I write this, I'm sitting in a suburban firehouse with 3 of the whitest guys in the history of white guys watching Katt Williams on Netflix. One of these things is not like the other!

Wednesday, March 2, 2011

My Beef With Fire-Based EMS or "This ain't 1976 anymore!"

If you've been following me on Twitter or have known me long enough, you know I'm a fairly opinionated dude. I know that sometimes my opinion may seem wrong, far-fetched or biased in some way. Well, all three of those observations may be fitting for this next subject.

Shortly after the submittal and released of the new EMS White Paper, one of the first entities to pipe up and respond with ideas was...... Yep..... You guessed it.... The IAFF and IAFC. Wait... what?!

Yes, the International Association of FIRE FIGHTERS and the International Association of FIRE CHIEFS. NEMSA woke up, scratched it's ass, had a cup of coffee, smoked two Pall Malls and retorted in an untimely manner, as usual.

Let me make this clear before we go any further - I have NO beef with Firefighters, Chiefs, Recruits, Training Officers, Fire Prevention Officers, Hydrant Testers, Extinguisher-refiller-guys or anyone else even loosely affiliated with fire suppression.


Emergency Medical Services has been in need of a makeover professionally for a LOOOONG time, and this White Paper may be just the thing to light the proverbial fire under some asses. We need to develop an identity for ourselves, whether it be "Public Safety" or "Allied Health" or "Not Just a Meatwagon Anymore", something has to give. The IAFF and IAFC are doing the smart thing... They jumped right in and showed everyone how awesome fire-based EMS can be. Let me translate some of their lines for you, baby birds.

They say: "It's cost effective!"

- Translates to "We need EMS's revenue!"

They say: "We have a large base of EMTs and Paramedics to pull from within our fire departments!"

- Translates to "We have a whole bunch of guys who want to be firemen first and medical providers second for the extra cash."

They say: "Our fire trucks usually beat the ambulances on scene and render first response care anyways!"

- Translates to "Our fire engines don't get used enough to justify their being, so we make medical runs to boost our numbers." (and OBVIOUSLY your city needs more ambulances!)

I'm sure there are plenty of well-organized and medically driven fire-based EMS services around the nation, and I mean no discredit to any of them by saying all of these things. However, it's time for EMS to have a voice for itself. Do I blame the IAFF and IAFC for jumping into the discussion quickly to state their case? Absolutely not. It's the smart thing for THEIR organizations who would be hit the hardest should EMS break out of it's shell.

NEMSA has very little lobbying clout when it comes to big wig politicians in comparison to IAFF. The problem is, the soft-spoken and oft drowned out voice that EMS does have from time to time is so broken up, divided and unorganized that no one voice can be heard. That's why the time to organize and SCREAM "EMS IS..........." is NOW!

Pre-hospital medical care is at a dire and dangerous crossroad right now... Which way do you think we should go?

First Grind - "EMS Anchors"

Recently, there has been much discussion in the EMS Twitter and blog landscape on the idea of colleagues who are holding EMS back from evolving as a profession, or as Mr. Ted Setla so affectionately refers to them as "EMS Anchors". We all know these folks and if you've worked in an EMS service for longer than a few minutes, you have a pretty good idea as to who they are. They can be the old warhorses that have been around since Jesus cardioverted Lazarus or even someone who is new to the profession but is all about complacency. These are the people who are holding us back from moving forward, and they must be destoyed.

Ok, not really. That's a bit much.

Bitter and careless, these monkeys on the proverbial back of progress are keeping all of us from bringing EMS to the forefront and allowing us to develop and sense of individuality as a profession. They come to work disshelved, unshaved and unprofessional looking. They complain about everything possible. They just don't care. In this line of work, it's not the way to be.

These are the people who are undoubtably going to be the 'anchor' (ah ha!) that slows, if not completely hinders EMS to move forward. So, what can we do?

Comment away and let's discuss!

Thursday, February 24, 2011

Upcoming Posts

I've been working on a few posts that I'll (hopefully) be finishing up and putting up over the next few days.

Some of these include topics like the prevalence of EMS Anchors, professional obstacles created by fire-based EMS services and "The Grinder's 5/20 and 20/5 Rule of Attitude".

It should be fun. Stay tuned.

Sunday, February 13, 2011


Hi kids. Did you miss me? Yeah, didn't think so.

Anyways, over the past few weeks, I've been thinking about the blog. Everyday, I read many excellent posts from so many amazing writers and it makes me almost feel guilty for some of the things that I have written and have been working on posting.

Alot of the stuff I read is very informative, well thought out and well-researched.

My blog and it's drafts have been me writing knee-jerk reactions to situations I've been in or issues that I've encountered without much thought into how it would be perceived. When I first started this thing, I told a friend of mine (@MsParamedic) that I wanted it to be fun, sarcastic and mildly educational. I wanted people to find what I posted to be somewhat relevant and something that they could relate to.

Guess what? It kinda worked.

The bad part of me accomplishing this is simple... Some people took me the wrong way.

The whole "Apathetic Medic" thing immediately labeled the blog as a "I don't give a damn about my job, my career, my profession or my patients" kind of deal. This is 110% whole-heartedly NOT the case and is also 110% TOTALLY my fault for presenting it to you folks, the readers, as such.


I've beat my head into the wall for a few hours and a not so bad idea fell out. How about "The EMS Grind"? Not so much the "What Really Grinds My Gears" short stint segment that Peter Griffin had on Family Guy, but more of 'post and discuss' kind of forum, speaking about all kinds of different topics that concerns the modern EMS provider.

Hey... I kind of like it.

Regardless, with this kind of style and thinking process, I believe it will enable me to be more open as a writer on subjects and not appear to be so much of a bitter burn-out.

In closing, look for more medically related posts coming in the near future. Don't give up on me just yet.

- Grinder