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It’s Come to This


Just more evidence that I really am Too Old To Work, To Young To Retire. I was talking to a co-worker whom I get along with very well. He has a wit that is both drier and sharper than mine, although not by a whole lot. We were lamenting the sad state of affairs with our latest crop of new EMTs. For the most part, these are minimally experienced BLS personnel, in fact some of them have never worked on an ambulance. The learning curve, as they say, is steep. That curve is not made any less steep by management’s proclivity to take a “They’ll straighten out sooner or later” attitude and pass off people who should be gently shown the virtues of other career fields, while the exit door is held open for them.

My friend related this sad tale of a few days ago. The quotes are my best recollection of the exchange, but are probably not 100% accurate. Despite that, I think you’ll get the drift of how this went.

My friend’s ALS unit was called to one of our city’s too numerous to count homeless shelters by a BLS crew that had been dispatched previously for some sort of none to serious medical malady. On said BLS unit was an experienced EMT and his trainee. At this point in his training period the FNG* should be pretty much ready to work on his own as he is near the end of his training period.

The BLS crew had been on scene for a couple of minutes when they called for the ALS unit. When the ALS unit arrived a few minutes later, they had a not unreasonable expectation that the patient and crew would either be in the BLS ambulance or on their way out. So, the waited. And waited. And then waited some more. After about five minutes, the BLS crew came out with the patient on the stretcher. No oxygen, no straps, no, well, no anything that made my friend think that this was an acute patient.

The FNG pointed hopefully to the back of the ALS unit, but the paramedics pointed pointedly at the BLS unit.

Once everyone was aboard, my friend asked the FNG what was going on. The FNG gave a classic deer in the headlights look at my friend and then looked pleadingly at his partner/training officer. Who was staring at the ceiling of the ambulance. My friend asked again, a little bit less warm and fuzzily than he had the first time, and the trainee stammered that the patient was cold and clammy and that the medical staff of the shelter had given the patient multiple tubes of Glucose paste. He also helpfully offered that the clinic staff had given him a form which he hadn’t read, but was hopeful would be his salvation. My friend was having none of it.

Medic: “What’s going on?”

FNG: “The staff gave him glucose paste.”

Medic: “So, what’s that mean?”

FNG: “Uh, I think he’s hypoglycemic.”

Medic: “Is he a diabetic?”

FNG: “I don’t know, but it might be on the form.”

Medic: “I’m not asking the form, I’m asking you. Did you do a blood glucose?”

FNG: “No, the staff gave him Glucose though.”

Medic: “I don’t care what the staff did, I want to know what you did. Did you check his BP or pulse?”

FNG: “No, he had on too many layers of clothes.”

Medic: “I don’t suppose you considered taking off a few layers or even trying to palp a pressure by putting the cuff over the clothes. You know, something to give us even a bit of a clue as to what his pressure might be.”

FNG: (Blank look, followed by pleading look at his training officer who was now counting the number of 4x3s on the shelf. )

Medic: “Why isn’t the patient on Oxygen?”

FNG: “We heard you arrive and wanted to get him out to you.”

Medic: “We were here for five full minutes before you came out, you couldn’t manage to get a set of vitals, blood glucose, or put oxygen on in all that time? What were you doing?”

FNG: “Uh, uh, we were getting the form from the staff.”

(Pause in conversation while the paramedic rolls his eyes towards heaven and prays for patience. )

Medic: “Do you think you can drive us to the hospital, since you clearly aren’t doing anything else of value?”

FNG: “Yeah.”

Later on while he was writing his report, my friend’s partner came out and told him that the FNG was inside, crying. That’s right, crying. A putatively grown man, crying because an experienced paramedic asked him some very straightforward questions. My friend avers that he never raised his voice above normal conversational volume. Knowing my friend, I’d guess that maybe a hint of sarcasm crept into his voice, but just a hint, no more.

This is what it’s come to, EMTs crying when they are asked a few simple questions by a paramedic. We’re doomed I tell you, doomed.

I offered to give my friend a stack of my cache of McDonalds applications, but he’s afraid of the effect it might have on some of these FNGs. I have to agree with him on that one. Besides, one of them might get a nasty paper cut and go out on disability.

For those of you wondering, the patient did in fact turn out to have the none to serious illness that the original dispatch was for.

* I’ll leave it to the reader to engage in the intellectual exercise to figure out what this acronym stands for. I’m confident that my field is not the only one that uses this terminology.

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After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it? I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs. I still write about EMS, but I'm adding more and more non EMS subject matter. Thanks for visiting.


  1. The case I told you about of the paramedic providing the wrong treatment and adding V Tach to the underlying life threatening pulmonary edema, had a similar focus. There was a complaint filed because the doctor had the medic crying for almost killing a patient. It was fortunate that the patient survived as long as he did, in spite of the medic’s attempts to kill the patient.The doctor is a tiny woman, who was 7 or 8 months pregnant at the time. I have never seen her raise her voice to anyone. One of the least intimidating people possible.Next thing you know, these medics will be opening up the rear ambulance doors and threatening to jump – without putting the step down. This scenario could escalate.Not that I’ve never been yelled at for doing something stupid, maybe once or twice. Not that I’ve never cried on a call, but my tears have been for the patient or family, not for me.

  2. Nuts. I’ve never made a grown man cry. My professional life has come up short. But now, at least, I have a goal to strive towards.

  3. I have made grown men cry. The quality (or lack thereof) of EMTs and paramedics coming out of the puppy mills is scary.But God forbid we hurt their feelings by correcting them.

  4. Shameful! He IS required to pass a field exam isn’t he? Any chance he’ll be looking for work in a different field? Lord have mercy!

  5. Field exam? Yeah, sure he is. The problem is that it’s totally subjective and the dictates of diversity and inclusiveness mean that only the very worst trainees get shown the door. Herbie, you are so right. As with the public schools it’s all about being nice to them. Training officers aren’t supposed to raise their voices or, goodness forbid, utter a harsh word.

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