Administration and Leadership, Operations, Patient Care, Training

30 Life Lessons: JEMS Editorial Board Members Offer Words of Wisdom

Issue 3 and Volume 35.

Lead boldly—with kindness and a deep respect for others! This brings out the best in your organization and all you serve.
—Jay Fitch, PhD, President & Founding Partner, Fitch & Associates

The lesson of my life has been how much this giving profession actually gives back to us. You never have to hate that ambulance of yours, when you consider that everybody you meet there reminds you how lucky you are—to be breathing without effort, and living without fear or pain. Never forget the daily privilege of being there when people are born and when they die—private times, when no one else would be welcome, but you are so personally invited.
—Thom Dick, EMT-P, Quality Care Coordinator, Platte Valley Ambulance

Irrespective of your level of certification, type of agency you work for or area served, you’re here to provide the best care to each and every patient you contact. In a sense, they are your family and should be treated as such. —Chad Brocato, DHS, REMT-P, Assistant Chief of Operations, Deerfield Beach Fire-Rescue & Adjunct Professor of Anatomy & Physiology, Kaplan University

Learn to recognize all the non-medical issues that may influence your medical decision-making, such as too many runs, 4 a.m. calls for “nonsense,” annoying patients or families, or personal issues. Then work hard to set those aside, and make your patient-care decisions based on the medical concerns. A decision made in the best medical interest of the patient is the right way to go.
—Kathleen Schrank, MD, FACEP, FACP, Professor of Medicine and Chief, Division of Emergency Medicine, University of Miami School of Medicine; Medical Director, City of Miami Fire Rescue; & Medical Director, Village of Key Biscayne Fire Rescue

Share your dreams and visions of the future with those individuals (achievers) positioned to understand and move you toward your success. They will assist you greatly in your personal and professional achievements. You will find there are many individuals (maintainers) willing to tell you what you can’t accomplish. It’s of utmost importance to remember that most of these individuals are very successful at their mission of keeping you and others from achieving success.
—Walt A. Stoy, PhD, EMT-P, CCEMTP, Professor & Director, Emergency Medicine, University of Pittsburgh & Director, Office of Education, Center for Emergency Medicine

When assessing and treating patients, always remember that technical expertise in your skills is the basic expectation of the patient and people watching you work (all of whom are your customers). The public doesn’t want a minimally competent technician; they expect your EMS expertise and best care. Do whatever you have to do to be able to provide that highest level of care, consistently. It’s the mission of the true professional (paid or volunteer). After you can do that, adding an optimistic, genuinely caring, communicative manner will often be greatly appreciated and make your calls run that much smoother.
—Richard Vance, EMT-P, Captain, Carlsbad Fire Department

Keep it simple. Always go back to the basics when you’re not sure what’s going on. You can always come up with more esoteric answers after ensuring that the ABCs are intact.
—Adam D. Fox, DPM, DO , Clinical Assistant Professor of Surgery, Division of Traumatology & Surgical Critical Care, University of PennsylvaniaZ

If there’s anything I wish I had known then, it’s this: Be a good listener. This one single character trait is the secret of success of those I most respect. As a provider, the ability to actively listen to your patients will reward you with unique insight into their lives and a better understanding of their needs. As a colleague, a good listener is your partner’s best friend because they know you respect their opinion before giving them advice. As an employee, the ability to listen first before criticizing the actions of management gives you the opportunity to measure your response and decide which issues are really worth fighting. And finally, as a husband or wife, a good listener puts their spouse’s concerns above theirs and help keep you from bringing too much of the “job” home with you, when the purpose of being home is to get away from the job.
—Keith Wesley, MD, FACEP, Minnesota State EMS Medical Director & Medical Director, HealthEast Medical Transportation

As EMS providers, we need to continue to learn medicine and search for better methods to achieve better outcomes, even if it’s at the most basic level. As mentors, we need to be able to teach and explain our craft so it can be understood at the most basic level.
—Gregory R. Frailey, DO, FACOEP, EMT-P, Medical Director, Prehospital Services, Susquehanna Health & Tactical Physician, Williamsport Bureau of Police Special Response Team

My lesson and direction came from Fess Parker, the actor, playing Davy Crockett on TV. He taught us a motto and it has been my guide: “Be sure you’re right, and then go ahead.”
—Katherine H. West, BSN, MED, CIC, Infection Control Consultant, Infection Control/Emerging Concepts Inc.

Treat all patients in the EMS setting as if they were your mother, father, sister, brother, son, daughter or spouse. And after you have treated them in exemplary fashion, make sure to document this outstanding care on your run report without leaving out any pertinent and important details. —David P. Keseg, MD, Medical Director, Columbus Fire Department & Clinical Instructor, Ohio State University

Don’t come to work each day expecting to save a life. Come to work expecting to provide care, to ease suffering and to provide comfort to those in need. It’s often those things we do in EMS that are impossible to quantify that have the greatest impact upon our patients and their families. —Marc Eckstein, MD, MPH, FACEP, Director of Prehospital Care, Los Angeles County/USC Medical Center; Medical Director, Los Angeles Fire Department; & Associate Professor, Emergency Medicine, University of Southern California

My advice would be twofold: First, EMS providers are obligated to always perform their best in patient assessment and advocacy, providing therein the optimal response to those in need with the resources that we bring to bear. Second, always explain a tachycardia.
—Ray Fowler, MD, FACEP, Associate Professor, University of Texas Southwestern SOM; Chief of EMS, University of Texas Southwestern Medical Center; & Chief of Medical Operations, Dallas Metropolitan Area BioTel (EMS) System

Caring for patients in the EMS environment is like riding a motorcycle: The moment you get comfortable and think you’ve seen everything, you become dangerous!
—David Persse, MD, EMT-P, Physician Director, City of Houston Emergency Medical Services; Public Health Authority, City of Houston Department of Health & Human Services; Associate Professor, Emergency Medicine, University of Texas Health Science Center—Houston

Doing what you know is best in adverse situations, or any situation, can be challenging and sometimes downright unpopular. But in the end, it’s what’s right and results in the respect of yourself.
—Jerry Overton, MPA, CEO/President, Road Safety International Inc.

Strive to be the best EMS professional you can be. Review every patient encounter and ask yourself if there’s any way you could have provided better care if faced with that same situation in the future—through more learning, better assessment or practicing your skills.
—Jeffrey P. Salomone, MD, FACS, NREMT-P, Associate Professor of Surgery, Emory University School of Medicine; Deputy Chief of Surgery, Grady Memorial Hospital; & Assistant Medical Director, Grady EMS

My biggest lesson is that there are multiple correct answers to most every problem. When I began my career, there was one way to do things—mine. Perhaps that was my experience level or lack of confidence working against me. As I grew in my career, I learned to leverage other people’s ideas to build better solutions on the street and in the office.
—Allen Johnson, MPA, LP, Chief Administrative Officer & EMS Director, Montgomery County Hospital District

Having a bad attitude or treating patients in a less than professional manner does not shorten your shift or reduce your call volume. And a bad attitude at work is likely to follow you home and spill over into your personal life. So, be selfless, make decisions based on family and have a great attitude. Every day, every shift is a choice.
—Criss Brainard, Deputy Chief, San Diego Fire-Rescue Department and President, San Diego Medical Services Enterprises

Regardless of a patient’s appearance or how poorly they may treat you, always strive to treat each and every patient as if they were your own family member. After all, everyone is somebody’s baby. If you practice this mantra with all of your patient encounters, you will be able to sleep each night with peace in your heart and be able to unequivocally look yourself in the eye in the mirror each morning without a glimmer of guilt or remorse. —Carol Cunningham, MD, State Medical Director, Ohio Department of Public Safety, Division of EMS; & EMS Medical Director & Emergency Physician, Lake Health

Never stop asking, “What else could this be?”
—W. Ann Maggiore, JD, NREMT-P, Associate Attorney, Butt, Thornton & Baehr PC; & Clinical Instructor, University of New Mexico, School of Medicine

The “emergency” in emergency medical services is really a very small part of the job. When you feel under-utilized or frustrated for those not-so-emergent calls, think about how much you enjoyed the circus. Being in EMS is like having a free ticket to the circus: You get to marvel at the oddities and uniqueness of the human condition.
—Bruce Evans, MPA, EMT-P, Assistant Chief, North Las Vegas Fire Department

Keep your passion for EMS alive through quality continuing education. And be proud of the difference you make in your patients and their families, every day!
—Linda M. Abrahamson, BA, RN, EMT-P, EMS Education Coordinator, Silver Cross Hospital; Board of Directors, National Association of EMS Educators; & Chair, Advanced Medical Life Support, National Association of EMTs

Never stop thinking about new ways of doing things that can better serve your patient and your community. JEMS has always been at the forefront of presenting new ideas and innovations to EMS providers.
—Stephen R. Wirth, Esq., Attorney, Page, Wolfberg & Wirth LLC; & Legal Commissioner & Chair, Panel of Commissioners, Commission on Accreditation of Ambulance Services (CAAS)

Integrity in EMS is doing the right thing for the patient even when nobody is looking.
—Bryan E. Bledsoe, DO, FACEP, EMT-P, EMS Textbook Author & Emergency Physician Faculty, University of Nevada

Whether it’s policy-making, destination decision, judgment calls or direct patient interactions, we should always care for (not treat or manage, but care for) those we serve, as eagerly and as compassionately as we would want for one of our own family members.
—Paul E. Pepe, MD, MPH, MACP, FACEP, FCCM, Professor of Surgery, University of Texas Southwestern Medical Center; Head, Emergency Services, Parkland Health & Hospital System; & Head, EMS Medical Direction Team, Dallas Area Biotel (EMS) System

Take every opportunity to learn. Take every opportunity to teach.
—Charlie Eisele, BS, NREMT-P, Flight Paramedic, State Trooper, EMS Instructor

Our job is to serve, regardless of whether it looks like an emergency or not.
—Corey M. Slovis, MD, FACP, FACEP, FAAEM, Professor & Chair, Emergency Medicine, Vanderbilt University Medical Center; Professor, Medicine, Vanderbilt University Medical Center; Medical Director, Metro Nashville Fire Department; & Medical Director, Nashville International Airport

It may seem like “no good deed goes unpunished,” but never stop doing good deeds!
—Edward T. Dickinson, MD, NREMT-P, FACEP, Associate Professor & Director of EMS Field Operations, Department of Emergency Medicine, University of Pennsylvania; Medical Director, Berwyn Fire Company, Malvern Fire Company & Haverford Township Paramedics; & Medical Editor, JEMS

Remember that for many conditions, kids are just little adults. It all starts with the ABCs, no matter the size of the patient.
—Mark Meredith, MD, Assistant Professor, Emergency Medicine and Pediatrics, Vanderbilt Medical Center & Assistant EMS Medical Director for Pediatric Care, Nashville Fire Department

t’s a small field. Be nice and respectful of everyone you come into contact with. You never know where a person is going to show up in your future. If you’re nice, respectful and courteous to everyone, you have no worries about meeting again.
—James J. Augustine, MD, Medical Advisor, Washington Township Fire Department; Director of Clinical Operations, EMP Management; & Clinical Associate Professor, Department of Emergency Medicine, Wright State University