Monday, March 28, 2011

If I didn't know now what I didn't know then.

Some other folks online have been discussing whose responsibility it is to be sure that EMTs and/or medics are well trained.

It's a complex issue.  Or maybe it's simple.  Depends on how you look at it.

Here's how I'm looking at it today.

First, it's my responsibility to take my job seriously.  Along with that, I need to take training seriously.
I can do that, no problem.
If anything, I err on the side of taking it too seriously. Ask anyone who knows me.

But there are a couple of things working against me.

The first, and most challenging, is that the agency I volunteer for does not provide training for EMTs.
I think it used to. For a while, I assumed it still would.  
I got over that a while back.  Why, and how, I'll leave for another time.
For now, the important part is that there isn't any training.
Not for quite a while now.
Unless I do it myself.

Which I can do- but more about that later.

I first realized the seriousness of the situation when I discovered, by chance, that there were regional requirements for practicing as an EMT here that I simply hadn't ever heard of.  The place where I took my EMT-B class assumed that our agencies would clue us in on any regional requirements. The class I took was held in a different region from where I live.  There were students from all over the place.  Leaving the region-specific things to the different agencies makes a lot of sense.

If they, in fact, actually cover it.
Mine didn't.
And we didn't know enough to know there was something they were supposed to be telling us that they weren't.
We certainly didn't know that our agency's EMS director didn't tell us these things because he didn't know them.
That only became clear later.

So we've had to do a fair amount of scrambling to get information, and to get caught up.
I don't mind doing it myself, I just wish that I had known that we needed to.
It is also interesting to note that the region didn't notice that we hadn't done any of the "required" things until much later, when it got called to their attention by a particular event.  Nothing bad. Just that they found out we weren't doing these things when, and in the same way, that WE found out that we weren't.  Since then, they've paid more attention, which is good.  We're all on more or less the same page now.  Much better.

So here's my question.
While I'm willing to take responsibility for keeping myself up to date, and I'm willing to put a lot of effort into seeking out the training that isn't available here, it seems to me that the agency should bear SOME responsibility for facilitating, if not providing, some basic information and training.  The question is how much should they be responsible for, and how much should I be responsible for?  Do they really have no obligation at all?  Or what?

The officers sometimes tell us to "ask for" whatever training we want, but everything I've asked for hasn't ever happened.  I don't know why that is, exactly, but I have some ideas.  I'm willing to bet that if you asked them about training, they'd say we never ask for anything.  Which is getting to be true, after years of being ignored.  We don't bother anymore.  So each month, there is a week's training that is supposed to be "EMS training" but usually ends up being truck checks or a work night, or, if they decide to do some "training" it's someone who has no qualifications to teach, and who is no longer an EMT,  standing up and rambling on about something they come up with on the fly and don't have any up-to-date training on, themselves.  If we're lucky, they'll find someone's old powerpoint presentation and read the slides.  That's the best it gets- at least there is SOME plan- and that is rare. If we're REALLY lucky, we'll get a call in the middle of it and get to leave.

Is it like this in most places?  Is this just the way it is?  Is EMS itself in THAT much trouble?
I sincerely hope not.

There is a lot more to how things are here, but I don't want to go on and on about it.

I want to know what "good" looks like, and where it exists.
What does it look like at an agency where things work well?  How do they attract, train, and keep good people? How do they make sure there is sufficient coverage?  
What does the typical volunteer agency look like, if there is such a thing? 
Where is this one, on a scale from "negligent" to "optimal"?  And how can we move in the right direction?

My interest is partly academic, but also, I am very concerned about the results of a lack of training.
The public has NO idea how things are.  None.  They assume that if they call 911, a trained, qualified person will come help them.

It is not always the case.

And it gets very, very personal.
I know that there are times that if I am the one who needs help, there isn't going to be anyone. I'm out of luck, and too far from an AED or anyone who can do CPR.
There are a lot of other people in town in the same boat, who have no idea.  At least I know.

There are people who have a HUGE problem with me even discussing this.  They don't want to hear it.  They think it's just badmouthing the dept or even worse, emergency services as a whole.  Causing trouble.

But if it never gets discussed, how is it ever going to change?  If we can't be honest about the problem, how can we ever find a solution?

It often feels like a case of the Emperor's New Clothes around here.

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