Do you help off duty?

[AnthonyM83]

He basically, no he did, called me an idiot for wearing a uniform that the school TELLS ME I HAVE TO. What was I supposed to do. March into my class, say, "hey I want my money back, some guy on an internet board said we are all idiots, and your wrong!!!

We really should have an FAQ for people who have been offended by Dust.

I think the most common cause for tension from people with Dust comes from thinking they are specifically being targeted by him. That they are specifically being told they're idiots or whackers or being played by the system. Almost everything Dust comments on is ABOUT the system as a whole.

For example, if he talks about how worthless basics are...It's not like he's a medic on a high horse and thinks only medics are good enough to help and anyone who isn't at that level is a washout retard.

Rather, he's saying in the overall EMS system, having the level of EMT-Basic is a bad idea (other than as first responders). Not because there's not basics who surpass their level of training and try to get educated, but because that specific cert level with that specific training and scope isn't really helpful to having a good EMS system.

Or something close to that...

In your case, he's criticizing programs that get their students to buy into that mentality. You can either become curious about what he's saying and seeing if you can get a bigger picture understanding of what's going on or just resist it, as a newbie knowing you're right. Every now and then he explains this.

Our EMT class was pretty down to earth, so when I came on this site and Dust told me for the first time that EMTs didn't have enough depth of understanding, it clicked right away. (Well, actually, I think my reply, was we didn't need education because we were just technicians following basic algorithms...point is our class had already seen the training level of EMT-B for what it was)

[AnthonyM83]

Customer service is for Starbucks, Wal-Mart, and Medicaid factories. I don't have customers. I have patients. I do what is in their best interest, not what makes them happy. Capital driven medicine is one of the best ways to start doing some real damage to patients. People now believe they need a medicine because the TV told them so, not their doctor.

Working for a private ambulance company, I'm definitely in the customer service field. We're all about the customer. This doesn't mean bad medicine, it just means we're there FOR them, not just TO treat them. We don't really do anything extra...we just try to leave a good impression on them as an ambulance company. It's not like we're trying to get repeat customers either since who transports them is based on where they are when they call 911.

[Richard B the EMT]

Looks like a new debate just started, although I have heard of this one before, outside of EMT City.

Is a patient a "patient", a "customer", or a "client"? If anyone wishes to pursue this, start a new string, don't hijack this one.

[Bigfireguy]

Honestly I think some of you have seriously missed the point. (Maybe you should consider yourselves part of the problem rather than the solution.)

If you are serving a community, you can bet your butt you have customers, and they are paying customers too. Not that you don't have patients, but not nessarily at the same time. And before you freak out, please note that the "Customer Service" ideology is being driven primarily in the Fire Service end of things, not that it doesn't carry over to EMS only agencies. But the basis of it is that you are there as a member of the community, and you are expected to serve that community. Every resident and visitor to your community is a customer especially when they aren't your patient. I feel it is totally unacceptable for an unassigned (not on a run) unit, fire or EMS, to ever pass a vehicle that has stopped in an unusual place. i.e. out of gas, stalled, fender bender, or just plain lost. You are capable of helping that person with almost any of their problems, and at least can assist to get them out of harms way if not back on their way. That is customer service. And taking attitudes like that can make or break a public service agency when it comes time for bond elections or tax increases to support pay raises, new facilities, or new apparatus. And that kind of response doesn't cost us anything but a little personal effort, and a moment of our employer's time. It certainly doesn't decrease our ability to care for our patients. I would challenge you that it ultimately improves our ability to provide care for our patients. And that ideology isn't about "Capital Driven Medicine," although it does have an effect on the economics of our services. The question is do you want a positive effect or a negative one.

As far as getting hurt, I didn't say it didn't happen, I said it doesn't happen as much as some (like those who state that they won't render aid off duty) would have you believe it does. And I didn't say we shouldn't protect ourselves, we should be trained to do this to the point that is second nature to us. Don't do anything you wouldn't do if you were on-duty, so be prepared. And if you aren't willing to be prepared, I would suggest you find a new career. People with that kind of attitude are killing our profession. I believe we have an obligation to protect not only those persons involved but the 13 inexperienced wannabes as well. Who better to help control the incident prior to the regular responders' arrival, us or the 13 "heroes?"

Don't get me wrong, I don't think we need to be driving our own personal rescue units. But having gloves & glasses and a basic 1st aid kit, and maybe even an old blanket, will usually cover about 99% of the incidents you stop at. At least long enough for help to arrive. And I'd be willing to bet (based on experience) that 9 times out of 10 just being there to calm folks down and take "control" is all that is required. But it can make a huge difference to the majority of the "common folk" involved. It may just be another 1 of a million accidents we've been to, but for most people, its their first or maybe their worst.

And be nice to those wannabes too. They will learn a lot from what they see you do. But what is it you want them to learn? That you & your agency are a bunch of jerks, or that you are totally unbelievably cool professionals that they want to be like someday. Someday we will be old and weary and those wannabes could be caring for us. Pay back could be a B**ch!

[Timmy]

Just an interesting law I came across in Northern Territory, Australia:

"In the NT it is a criminal offence, punishable by up to 7 years imprisonment for a person, who is able to provide "rescue, resuscitation, medical treatment, firstaid or succour of anykind" to "callously" fail to provide that treatment or assistance when it is required.

This obligation is not a general obligation to assist anyone in need. It is it is limited to cases where the person in need is suffering from a potential or actual life threatening injury" It must be shown that anyone committing this offence was physically and mentally capable of rendering assistance, they where sufficiently close enough to provide assistance and that they knew the person was in need of assistance" Criminal code (NT) s 155

[medfish]

lots of people there keep going.......few people stop and help.........................had a ed MD drop a tube the other day at auto accident we drove up on.........no one else was there......helped out.......but if their was a crowd he said he would have kept going.......food for taught................medfish

[AnthonyM83]

If you are serving a community, you can bet your butt you have customers, and they are paying customers too. Not that you don't have patients, but not nessarily at the same time. And before you freak out, please note that the "Customer Service" ideology is being driven primarily in the Fire Service end of things, not that it doesn't carry over to EMS only agencies. But the basis of it is that you are there as a member of the community, and you are expected to serve that community. Every resident and visitor to your community is a customer especially when they aren't your patient. I feel it is totally unacceptable for an unassigned (not on a run) unit, fire or EMS, to ever pass a vehicle that has stopped in an unusual place. i.e. out of gas, stalled, fender bender, or just plain lost.

We would need many many more resources to have that ability, including enough personnel that they wouldn't become burnt out by stopping to help stalled cars (and give rides?) when they signed up to be a medical professional. I've been the guy with the flat tire on a very dangerous windy road and had ambulances pass me by before becoming an EMT. I felt that hope that they'd help because they were 'helping people'. I've also felt bad for passing disabled vehicles.

But great majority of shifts, we're running NON-STOP, literally, non-stop either call to call or move-ups to other areas with depleted ambulance coverage from 7AM to 8PM (and later on many many days), often without food. So if I do have a second of downtime, I'm just tired out. Not burnt out with the job, but either busy going somewhere or just pooped out. EMS doesn't usually have all these resources to stop at over a dozen cars a day (per ambulance) and then give rides to gas station or call people for them etc etc. Though, that would definitely make for a good inviting community...but we need someone to give us those resources.

[snoopy911]

i only stop if there isnt anyone on scene yet. ie: ems is on its way or hasnt been seen yet. usually ill back off when they get there unless they need me.

[firedoc5]

i only stop if there isnt anyone on scene yet. ie: ems is on its way or hasnt been seen yet. usually ill back off when they get there unless they need me.

For the most part, that's usually what I try to do.

[snoop2468a]

However, it does wear out for many. Burnout can also happen with time. There are many articles on burnout. It is important to share your concerns with your EMS supervisors - if you have a call that is bothering you.

Stopping at incidents when off duty should be personally decided - if you can be prepared/scene safety/and have the time for the full duration of the call. There are of course many other conditions/concerns. Note: If your vehicle is advertised with lightbars and other insignias - you may have a predeciding factor. After about my first five years of EMS Lic plates, etc - I decided not to "advertise". However, if there was an appearance of life threatening situation with no EMS units on the scene of an incident, I would always choose it as an obligation morally to stop and assist.