Why do we do what we do? - Ed Bauter

Why do we do what we do? - Ed Bauter

                                                    Why do we do what we do? 

                                                    Ed Bauter NRP, CCP-C, FP-C

For years now whenever I begin teaching a class, I begin with the same question and phrase it as a joke. I’ll ask the class “Why are you here? Why do you want to be an EMT? Don’t tell me that you want to help people, because I presume that you’re not a sociopath.” It’s a question that typically gets the same responses: 

·     “I want to advance my career” 

·     “I needed a job” 

·     “I joined a squad and they asked me to go through the program.”

·     “I’m pre-med/nursing/PA and thought this would help.”

·     “I’m a firefighter/Police officer and my job wanted me to be here.”

            Now, none of these answers are wrong, or somehow ignoble, however we don’t see a lot of answers that are perhaps the answers we may want to see. Rare is it that someone will answer with “I really love the idea of working in medicine and helping my community” which is kind of the answer I’ve been yearning to hear. But I wonder whenever I see an incoming class if this is a problem that we created for ourselves. 

            In a previous podcast we discussed career mobility. What we found was that there is truly very little opportunity for someone to work as an EMT or as a paramedic for the length of a career without needing a second job or changing careers entirely. We tend to bring people into the industry, train them for the equivalent of five weeks, and then send them on their way hoping that they’ll find whatever vague destiny awaits them. You see this romanticized in movies when a character is placed on a sheet of ice or a small boat and sent away from their village to live a better life. In the movies, of course, this tactic works well. But this career, this profession, is not the movies. 

            So, the question then becomes, how do we train people to do well in their job, and secondly how do we retain these people? In March 2018[1]a study showed that 60% of those surveyed who left EMS, left to pursue further education, where 54% left for a different career entirely. Now, these numbers do not necessarily reflect nationwide numbers in the US, and they certainly do not represent international numbers. But, let’s work with these numbers for a moment. I tend to think that the 60% who left to pursue further education were likely going to leave the industry anyway. These are the people mentioned above that started in EMS so that they could have a leg up on their competitors to get into a medical, nursing, or PA program. I believe that the population that we can retain better is the 54% that left for a different career. But how do we do that 

            To be clear, the percentage of providers that leave EMS is low. In general, the number seem to be around 4%[2]. However, it should be considered that when this study went out in 2017, the response rate to the survey sent to providers was 10%. So, it is possible that these numbers are artificially low. That being said we still must find a way to retain these 54% that leave to pursue other interests. I tend to think that these providers fall into the second and third group that I mentioned above. Those that need a job, and are not necessarily looking for a career may leave when the next available opportunity arises. Who can blame them? Someone who is simply looking for a way to make ends meet lands a job with an average salary of $33,380 per year[3]and is able to find something that provides for them or their families better. But what about those who were introduced to EMS through a friend or a volunteer program? These valued providers leave the industry too. How do we hold onto them? 

            I’m of the mind that these candidates are the ones that we are more likely to cultivate and keep in the EMS field. The ones that were exposed to the excitement at an early age, or early in their development as an EMT. These are the people that we can show the value of EMS and pre-hospital medicine too and they can grow into phenomenal providers given the right circumstances and training. 

            None of that, however answers the initial question of why do we do what we do? We know that what we do is important. We know that it makes a difference in our communities, and we know that we can have a direct, tangible, and positive effect on people’s lives. But why do we do it? Why do we expose ourselves to high attrition, sometimes poor working conditions, low pay, long hours, et cetera? 

            Simply put, I think the people that enter EMS and stay in EMS for the long haul do it for the people. The co-workers we meet and become like a second family. The inter-agency comradery that you see daily. The interactions with the community whether on an assignment, or on a standby at an event. These seem to be the common threads for longevity in EMS. I worry though, as time moves on and society evolves, that we will eventually see a regression of these types of providers. Stagnant wages and long hours lead to burn out, and while the job outlook for EMTs is positive, there is a generation that started before us that will soon be retiring. 

            Some of us got lucky. When I entered EMS, I had a support structure that was second to none. I was fortunate to have someone that I could always refer to, bounce questions off of, and have healthy debates about the practice just a phone call away. My father began his EMS career two years before I was born, and was always able and willing to have the difficult discussions and talk about the frustrations of the industry with me. My first partner, like my father, started his career in the 1970’s. Whenever we had a difficult patient, or a very sick patient, he was able to talk me through the call. This made me the provider that I’ve become, and I cannot thank them enough for that. But I am absolutely and outlier to these scenarios. We have a generation of EMTs and Paramedics who will be retiring soon. Who will pick up their flag when they fall and continue to educate new and rising providers? When the careers of my father and my partner started, working in EMS offered a career path, and now it tends to offer an entry-level job to many people. I worry that we focus sometimes on making “riding in an ambulance” seem cool, as opposed to teaching it as a passion and a calling. That is not to mention the comradery we see every day. This may be our biggest hurdle. 

            Those that stay in EMS tend to stay in EMS because of an intangible love for the profession. It’s difficult to place, and it sounds kind of hokey to describe. But those that catch “the bug” tend to be in for life. We stay we because we want to. We stay because we’ve finally found a calling that we may not have known that we had. The trick now, is to help others find that calling. 

 

[1]https://www.ems1.com/paramedic-chief/articles/381889048-Research-analysis-Addressing-attrition-of-EMS-professionals/

[2]https://www.tandfonline.com/doi/full/10.1080/10903127.2017.1339749

[3]https://www.bls.gov/ooh/healthcare/emts-and-paramedics.htm

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