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"Trauma Junkies" and Street Work

Occupational Behavior of Paramedics and Emergency Medical Technicians

C. EDDIE PALMER

Paramedics and emergency medical technicians develop a need for role validation associated with ambulance runs that call forth advanced lifesaving, rescue, and medical skills. Metaphorically, this need turns paramedics into "trauma junkies," because answering calls involving multiple casualties, physical trauma, and fast-paced action becomes the "real" work of emergency medical services personnel. Calls evoking less sophistication of response behavior are devalued. Within an occupational milieu of excitement, danger, and public attention, paramedics perform a variety of roles constituting street work similar to that documented for police officers. Playing the roles of authority figure, lifesaver, information specialist, partner, grief manager, and counselor, paramedics are immersed in a work world replete with teamwork demands, conflicts with medical and nonmedical personnel, vaguely defined legal standards, and occupational uncertainty due to the newness of their medical niche.

Journal of Contemporary Ethnography, Vol. 12, No. 2, 162-183 (1983)

DOI: 10.1177/0098303983012002003

© 1983 SAGE Publications

What does this mean to you and how does it apply, or not?

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Ethnography (ἔθνος ethnos = people and γράφειν graphein = writing) is the genre of writing that presents varying degrees of qualitative and quantitative descriptions of human social phenomena, based on fieldwork. Ethnography presents the results of a holistic research method founded on the idea that a system's properties cannot necessarily be accurately understood independently of each other. The genre has both formal and historical connections to travel writing and colonial office reports. Several academic traditions, in particular the constructivist and relativist paradigms, employ ethnographic research as a crucial research method. Many cultural anthropologists consider ethnography the essence of the discipline.

http://en.wikipedia.org/wiki/Ethnography

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  • 3 weeks later...

I've always been a self described Trauma Junkie or Adreniline Junkie, but I'm much better now. :roll:

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"Trauma Junkies" and Street Work

Occupational Behavior of Paramedics and Emergency Medical Technicians

C. EDDIE PALMER

Paramedics and emergency medical technicians develop a need for role validation associated with ambulance runs that call forth advanced lifesaving, rescue, and medical skills. Metaphorically, this need turns paramedics into "trauma junkies," because answering calls involving multiple casualties, physical trauma, and fast-paced action becomes the "real" work of emergency medical services personnel. Calls evoking less sophistication of response behavior are devalued. What does this mean to you and how does it apply, or not?

I think this is a problem that people fail to consider when they choose this proffesion. I believe some people choose this career because they are self proclaimed "Adrenaline junkies". The problem starts when they realize the adrenaline surges soon wear off and if you have no interest in patient care you get bored. The media portrays EMS as a fast paced, heart pounding career that is recognized as heroic. That just is not the case!

I don't really need an MVA every few days to validate me as an EMT, i am in the business of patient care, I do not need heart pounding action to remind me why I do what i do.

Personally I enjoy solving the riddle of why grandma feels "off" today, just as much as running a code, or transporting a multiple system trauma patient.

It is important for people new to this business to realize adrenaline rushes end, and you are not a hero. That medal is left to the firefighter who pulls 1 person from a fire once in his 35 year career.

People put themselves in this place. it is not the "Old peoples" fault for calling us when they aren't in dire need of us. It is the EMT(P)s fault for not expecting to do non-emerg runs for the majority of his/her career.

If you are an "Adrenaline Junkie" (which is the same as a "Trauma Junkie" as far as I am concerned), you are better off being a parachute testing technician than an Emergency Medical technician.

That's my thoughts!! :)

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I think it depends on the provider.

Think about your younger paramedics and EMT's... many will be in debt from school, just learning to establish their adult identity, hopeful, looking for that sense of place that validates them.

They think, "I can make a difference here" but as they get into the field, they realize that many of the older providers really don't value the 3am granny runs, and just want to talk about the blood guts and glory calls. Is it any surprise that they will then come to only value the "hairy" calls?

Now, this isn't true for everyone who's a younger EMS provider... some of them learn to see the bigger picture and thus enjoy more aspects of their job. These are the guys that don't burn out after 4 years.

Then there's your mix of older providers. Many of them are jaded because OH MY GOD SHARLA it's the 5th drunk tonight. Can't we just go home? (Sorry... I think I must have been watching too much Scrubs lately!) What I'm trying to get at is that dealing with the elements of society that we do on a daily basis wears at many people. Some people take the time to process how they react to it, others choose to create the jaded facade to shield themselves with. That in turn affects how they interact with coworkers...

I have to agree that many people don't realize that EMS is not going to be difficult emergency runs for most of your day. A lot of people come into the field, old or young, thinking that it's going to be just like 3rd watch or Rescue Me... and then they experience a severe let-down when they realize that much of it is NOT going to be the adrenaline run.

Thus, the fleeting and rare adrenaline run is the validation... it's the intermittent reinforcement thing. The one or two calls that meet that expectation reinforce that this is "what EMS is all about" for those providers; since it's the most "fun", it becomes the most important kind of call.

I like all of it. :) That's how you can tell I'm a younster...

Wendy

CO EMT-B

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Being a "Trauma/Adrenaline Junkie" doesn't necessarily mean that you want a steady diet of the guts and gore. You have to accept that the non-emergency runs and transfers and nursing home calls, etc. are part of the job too. It all goes hand-in-hand. I don't ever re-call chomping on the bit because of a dry spell of MVA's or Code's. One thing I had to explain (to my mother of all people) is that you are not wanting for someone to be seriously injured or ill, you are just more than ready to perform your duties to the best of your ability. Those incidents are going to happen whether you want them to or not. And that the more serious the situation, the higher standard of care you are ready to perform. Granted, there are some out there that after the "new" is worn off or the novelty of it all has diminished, get bored with it or loses interest. Those are the one's that are willing to hang it up after only a few years. One status I heard was that the average legnth of service for a professional in EMS was three years. I have no idea what that figure would be today. But as for me, after more than 16 yrs. I was still up to the challenge. But it took a medical disability to side line me. It was discussed about me going into strictly instructing, but that I will admit I don't think I could due to not having the time, the patience, and good old fashion burn out.

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Ethnography (ἔθνος ethnos = people and γράφειν graphein = writing) is the genre of writing that presents varying degrees of qualitative and quantitative descriptions of human social phenomena, based on fieldwork. Ethnography presents the results of a holistic research method founded on the idea that a system's properties cannot necessarily be accurately understood independently of each other. The genre has both formal and historical connections to travel writing and colonial office reports. Several academic traditions, in particular the constructivist and relativist paradigms, employ ethnographic research as a crucial research method. Many cultural anthropologists consider ethnography the essence of the discipline.

http://en.wikipedia.org/wiki/Ethnography

The Great and All powerful Spenac.......... wikipedia rules!! :wink:

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"Trauma Junkies" and Street Work

Occupational Behavior of Paramedics and Emergency Medical Technicians

C. EDDIE PALMER

Paramedics and emergency medical technicians develop a need for role validation associated with ambulance runs that call forth advanced lifesaving, rescue, and medical skills. Metaphorically, this need turns paramedics into "trauma junkies," because answering calls involving multiple casualties, physical trauma, and fast-paced action becomes the "real" work of emergency medical services personnel. Calls evoking less sophistication of response behavior are devalued. Within an occupational milieu of excitement, danger, and public attention, paramedics perform a variety of roles constituting street work similar to that documented for police officers. Playing the roles of authority figure, lifesaver, information specialist, partner, grief manager, and counselor, paramedics are immersed in a work world replete with teamwork demands, conflicts with medical and nonmedical personnel, vaguely defined legal standards, and occupational uncertainty due to the newness of their medical niche.

Journal of Contemporary Ethnography, Vol. 12, No. 2, 162-183 (1983)

DOI: 10.1177/0098303983012002003

© 1983 SAGE Publications

What does this mean to you and how does it apply, or not?

I think it is from 1983..1983 :shock: ..probably not too valid an argument today...twenty four years later and the changes in the education and expectations of paramedics has changed a bit. Trauma was the focus then. I believe that medical focus has overshadowed the trauma junkie mentality today and hopefully made strides toward a more rounded professional..IMHO

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Working for an interfacility transport company, I rarely dealt with trauma calls besides the LOLFDGB (little old lady fall down, go boom) calls (yes, Grandma Jane who fell 30 minutes ago, exhibited no change in activity, isn't complaining about pain, and is now happily sitting in the dinning room eating dinner probably doesn't need to go to the hospital, but you call, we haul).

The flip side was that we had a fair amount of nursing home -> ER calls besides the normal routine of dialysis, doctor's office, hospital discharge calls. My old company also had a rather robust CCT program utilizing RNs and RTs as needed for interfacility transports. I can see an argument that many of our providers became "medical junkies." It wasn't about that biker that went down and got messed up. Instead, it was about walking into a nursing home room and seeing a patient barely responsive to pain (alert/talking yesterday) with a blood pressure of 60/20.

I believe, to some extent, all emergency providers enjoy the adrenaline rush. The problem is that some providers forget that there's more to this then that 1 in a 100 major trauma or major medical problem.

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