Your partner likes to talk. He talks incessantly. Talks about patients, talks about his love life, and talks about his truck. He talks about dispatchers, partners and people he’s never even met. He talks politics and he talks religion. He even talks when you try to talk. He just never shuts up, and that’s not all—the sound of his voice kind of ... well, gets on your nerves.
Your 10-year-old ambulance has 300,000 miles on it, and you know for a fact the odometer hasn’t worked in more than a year. The paint looks pathetic. The chrome is wearing away. The logos are peeling. The windshield is cracked, the electrical system’s full of spooks, the obsolete light bar is plum dingy and the rear bumper looks like it’s been through a demolition derby. Your agency’s approach to PM is Postpone for Months.
Your ops chief asked you to stay over yesterday, and you said you couldn’t. But when you got home, there was a message on your cell phone. He wants to talk to you first thing this morning about a complaint. One of your last calls involved a motor home that rolled on the highway, and you triaged the driver black. His wife, now immersed in her grief process, is demanding you face her and explain why you didn’t even try to resuscitate him.
You’re so poor you can’t afford to pay attention, even though you’ve been working lots of overtime lately. But this morning, money troubles or no money troubles, you just can’t stand the thought of putting on that uniform. Your agency doesn’t recognize mental health days, so your only option is to call out sick. There’s a penalty for doing that when you’re not sick, and you work in a small town. You can hide at home, but if somebody calls from work you’re supposed to sound sick. That’s dishonest. What do you do?
This is a tough business, Life-Saver. When it’s easy, it’s real easy. But when it’s hard, it’s the hardest thing anybody can imagine. Working extra shifts (even for another agency) makes it even harder. Nobody does their best medicine when they report for work already tired of hearing about other people’s problems. You have bigger challenges than just this shift.
To begin with, agencies that don’t take care of their equipment are clearly saying something about how little they value their people. They can’t help it. Safety isn’t just something an agency achieves with a lot of hoopla whenever something bad happens. It results when they honestly value their people—and when they teach people to value themselves. The selection and maintenance of an agency’s equipment are eloquent communicators in that regard. You’re risking your own safety when you sign up with an agency whose leadership doesn’t get that.
As for calling out, I know that’s not easy—especially when working for a little outfit. Call out, and you know your friends are going to have to carry your load for you. You know each and every one of them well. And, you know they all need their time off just as much as you need yours. By calling out, you’re dumping your load on their shoulders.
But the immediate issue is immutable: If you can’t handle a shift, you can’t handle a shift. You’re not a machine. EMTs are chosen because they’re human; maybe more human than anybody. Needing to call out is a judgment only you can make, and we’ve all had to make it. I’m sure this will upset some readers, but I think sometimes we need to call out. And I think your agency’s staffing formula is partly your responsibility, but only partly. Staffing is an agency responsibility, and it needs to take into account the nature of an EMT’s work.
I also understand staffing is a lot more difficult for volunteer agencies. But the nature and importance of our work doesn’t make exceptions on the basis of how we’re funded. It is what it is.
Circumstances change from day to day depending on your physical health, the weather, your call load and the nature and distribution of your calls. Obviously, some of those things are outside your control. Your benefit to your system (and to your friends) depends on your personal balance. And sometimes, maintaining that means being somewhere else.