Skip to main content

Recovering Loss of Revenue from “not at fault” Accidents

When your units get hit by a third party and the vehicle is out of service, are you getting Loss of Revenue for the downtime while the unit is being repaired? Whether you answered yes or no to that question, reading this article will be the one of the most lucrative uses of your time this year.

A call comes in and your dispatcher does a perfect job of answering and scheduling the run. The EMT’s jump into the clean, fueled, and well stocked ambulance responding to the call. Then from out of nowhere, a car turns directly into the ambulance’s path rolling through a stop sign. Now what? You have two paramedics stranded on the side of the road who will be spending the next few hours on paperwork and drug testing. In addition, all the drugs and small equipment need to be removed or secured. Hopefully you have another unit to dispatch or your competitor may have already been called.

What happens next is key to getting maximum recovery for your losses caused by the accident.

Key items that help maximize your recovery from accidents:

  1. Educate and equip fleet drivers with the tools necessary to collect key accident information at the scene and relay it. This includes a description of the accident, clear color pictures of the accident scene, the damaged vehicles, and third-party driver’s license and insurance information.
  2. Gather as many witnesses as possible and statements from both drivers.
  3. On board videos are great, but if not, having a smart phone video of the damage and intersection can be very helpful if the liability is in question.
  4. Get an accurate and thorough estimate. Be aware that, for the most part, insurance companies are motivated to pay out the least amount possible to get the claim settled. Their adjusters are typically not trained accurately determine the damage to specialty vehicles or the equipment they may contain. Using a TPA with strong experience with commercial fleets is critical.

We are surprised how many firms don’t realize or understand what they are entitled to recover because of an accident where their driver was not at fault. Essentially, the law supports that the owner is entitled to the use of their “chattel” and compensation pursuant to the same. Here is an interesting titbit. Chattel is originally a Latin and old French term referring to moveable personal property. A good term to throw out at the next risk managers meeting to impress everyone. With that said, what you are entitled to and what shows up in your mailbox are two drastically different things. Insurance companies are motivated to pay the least amount possible and delay that payment as long as possible.

Most people assume that insurance companies make money when they generate more in premiums than they pay out in losses and expenses, but for the most part that’s not true. Most insurers are happy to break even on their underwriting and make their money by investing the premiums and keeping the investment returns.

What am I entitled to from a “not at fault” accident? There are a lot of factors influencing this, but essentially you are entitled to your physical damage, diminution of value, and loss of use/revenue. How much you are entitled to are the subjective negotiations that firms like ours engage in hundreds of times each day. Driver liability, statute of limitations and minimum policy limits vary from state to state. Typically, the state where the accident happens will be the applicable laws and regulations.

If I have a spare unit to take the place of the damaged vehicle, am I still entitled to Loss of Revenue? The short answer is yes, but getting the carrier to ink the check is another matter. There are real costs of having a spare unit which is why the law supports the loss of the use as a recoverable item. Acquisition cost, maintenance, licensing, certification, insurance, and storage are all costs incurred by having a spare unit.

Pursuing Loss Recovery

The following are steps fleets can take to help maximize recovery:

  1. Pursue all possible recoveries. There is often potential recovery from the third-party drivers in the form of an umbrella policy, company policy, or personal assets. Driver liability, statute of limitations and minimum policy limits vary from state to state. The key is to know which accidents offer what potential in which states, and then to pursue recovery using the latest industry tools as quickly as possible.
  2. Follow insurance industry documentation standards. The required forms need to be properly completed and submitted to the third-party driver’s insurance carrier. Knowing insurance industry regulations, standards, and the law are key to move the carriers to action. Technically, a carrier can wait 30 days after receiving a demand before taking action on the claim.
  3. A key component to Loss of Revenue is accurate records showing the income the unit generated prior to the accident. This is the hardest to recover and gets the most pushback from the insurance companies. Putting the data in a format that meets the insurance company’s needs varies by company.
  4. Even after the carrier has agreed to pay, be prepared to make a lot of follow-up calls and emails to get your claim paid. A common tactic used by carriers is to drag out the claim hoping you will either give up or accept less. Essentially wearing you down.

The second key recovery component is Diminution of Value (DV), or Loss of Market Value the vehicle suffers even after it is repaired. Age of the vehicle, miles, condition, and other factors determine this amount. Without a strong recovery plan or Third Party Administrator (TPA), we see significant diminution of value left on the table. The key here is strong data which supports your valuation utilizing use multiple sources and have extensive experience and a successful track record for recovering DV.

Getting accurate value when a vehicle is a total loss. The term “Total Loss” is an insurance term lacking legal definition. Carriers have often used title branding laws to determine if a vehicle is a “Total Loss”. While each state has different criteria for “branding” titles, vehicles can, and have been, paid as total losses with damage percentages well below the title branding statutes. Carriers often tout statements such as “Federal Guidelines” or “State Statutes” when attempting to settle claims. More accurately, legal entitlements are based upon what is called the Restatement of Torts, and defined by case law in each state. Typically, property and casualty insurance adjusters don’t understand these laws and again are motived to pay out the minimum possible. Engaging a firm that specializes in commercial fleet claims can provide an arm’s length transaction necessary to be pro-active on the front side in setting the claim up properly, which usually results in a higher recovery.

So how do you win at the recovery game? Well unfortunately you are in a game where the opponent is highly motivated to not pay or pay the least possible, has their own set of rules on how much you should get, and make most of their profit on dragging out a payment when they finally do decide to pay.

There are essentially three routes you can pursue.

  1. Handle the claims yourself. Unless you have extensive knowledge in the law and insurance industry, plus have ample time to talk to the voicemails of insurance carriers, this option may not be ideal.
  2. Let your insurance company handle the claim. They will pay your Physical Damage, but rarely does the policy have coverage for Loss of Revenue and Diminution of Value.
  3. Hire a TPA (Third Party Administer) to handle the claims for you. Select a firm with a long track record, experience with specialty vehicles, adequate technology, a strong legal department, and specializes in Loss of Revenue recovery. Make sure their fees are performance based and they only win if you do. They can recover Loss of Revenue, Diminution of Value (inherent and repair related) and other costs typically not recovered.

Few fleets have the number of trained personnel in each of these areas to adopt these best practices. If the fleet’s resources are already stretched to capacity, consider outsourcing to a TPA. The chances are the partnership will yield state-of-the-art best practices and more than pay for itself.

I hope you found this article helpful, don’t hesitate to contact me with any questions or to learn more.

Brian J. Ludlow is Executive Vice President for Alternative Claims Management. He is an entrepreneur and consultant to the insurance, financial, and transportation industries. Brian specializes in disruptive technologies. His firm has transformed the accident claims recovery process.

bludlow@AltClaim.com | 231-330-0515

Family Liaisons Following EMS Line of Duty Deaths

I was just a kid when I started in EMS. 23 years old, hungry for adventure, and ready for everything the world of EMS was prepared to give me. Car accidents, gunshot wounds, stabbings, intoxicated shenanigans, elderly falls, fist fights, medical emergencies, strokes, and cardiac arrest were all on my list of expected possibilities. One of the scenarios I had not thought of, and nobody presented to me throughout school and orientation, was the possibility of clocking in for shift and not going home. I do not recall line of duty deaths being a discussion point in the paramedic curriculum, job interview, or orientation process. I had experienced the unexpected loss of a younger sibling due to a motor vehicle crash before I started my journey in EMS, but the fact that life is short and unpredictable did not connect with the fact that I was knowingly and willingly walking myself into unknown and potentially dangerous situations with each response. Even after the UW Med Flight crash happened early in my career, and in my service area, we simply did not talk about our own potential for death as a direct result of our profession.

Years later, after many more line of duty deaths and even more reports of violence against EMS and healthcare workers, this topic weighs heavy on my mind. In my time as Staff Development Manager for a service, I pushed for the DT4EMS courses to train our medics on how to recognize potential dangers, escape those situations, and defend themselves if they are unable to escape.  We all know the ‘scene safe/BSI’ tagline and list of what things might make a scene unsafe is not enough. As the Rescue Task Force (RTF) formed, I watched as some were excited for the opportunity to be involved and others started to question their willingness to respond to so many unknown situations as their young families were beginning to grow. I started asking myself if EMS agencies are doing enough in terms of preparing themselves and their employees for the possibility of a line of duty death.

The Line of Duty Death Handbook, published in part by the AAA, is a great tool to start building policies, protocols and personnel records. The handbook guides you through the importance of having employees fill out emergency contact and next of kin forms, and keeping them updated, as well as assigning family liaisons and how to manage coverage for funeral services. As I reviewed this, I started thinking about the assignment of a family liaison—a member of your agency who knew the individual well and will be the primary contact for everything the family needs once the notification has been made. What type of person should be assigned this role, and what kind of training should they have? I sat down with KC Schuler, MDiv and board member for the Fox Valley Critical Incident Stress Management group to discuss.

What are some considerations services should make when putting together their line of duty death policy/procedure?

I think the first significant consideration should be conducting pre-incident training. I mean, are you starting the conversation about critical incident stress exposure all the way up to, and including, the possibility that they may never go home to their family, at orientation? During onboarding? So many of the EMTs and Paramedics coming in are young, and this may be their first job. In my experience, they can be somewhat blind to the possibilities. Early education and creating a culture of support—including letting them know you have their back (and their family’s back) in every potential scenario is important. The second consideration, I think, is to determine what scope you define as a line of duty death. The on-shift motor vehicle crash or incident resulting in death while on the clock is apparent, but what about suicide? If someone is having significant job-related stress and commits suicide, will that be looked at as a line of duty death, or not? This is something all organizations need to consider before such an event happens.

S: What type of actions would you recommend take place, or are discussed, as part of the orientation process?

KC: This is a great time for employees to fill out the emergency contact and next of kin form—this also provides an opening to discuss the possibility of death and the importance of filling out the form accurately and keeping it up to date. They are the best ones to tell you who you should notify in such a situation; guessing in the event of a death is not ideal. A portion of orientation and annual training should also be spent on mental health, including awareness, recognition of post-traumatic stress symptoms in themselves and their peers, and available support resources. Trained peer support and EAP can be very valuable in the management of work and home related stressors. Again, being intentional to build and sustain an organizational culture of support prior to an unfortunate tragedy like a line of duty death will help all those involved.

S: The Line of Duty Death Handbook talks about assigning a family liaison—a person who becomes the 24/7 primary contact for the family once notification has been made. This person should be available, in person and via phone, and dedicated to the family whether it is household chores such as mowing the lawn and grocery shopping, to communicating with out of town family members and arranging hotels. Who should be considered for such an assignment, and what might the service do to prepare these individuals?

KC: This is a high-intensity assignment, and this role should not be assigned to shifts in the beginning either. Being a family liaison is a big responsibility, and it is not a responsibility that should shift from person to person; ideally, the family will have one liaison for the duration. Trust is a significant factor—the family must trust the individual they are assigned, so that individual must be able to build that trust or recognize early if it is not a good match. Services should consider the following in their selection of a family liaison:

  1. Someone who is specially trained in being a family liaison. The nature of this position is demanding and can significantly interfere with the liaison’s personal life and responsibilities of emotionally supporting another. They need to be able to have clear boundaries, open lines of communication to leadership, and have a stellar support system in place as well. The International Critical Incident Stress Foundation does offer a 2-day LODD course.
  2. Preferably, the family liaison would not have any other roles (such as being an honor guard member) as they will likely have other duties and responsibilities throughout the process and at the funeral itself. The liaison duties need to be 100% dedicated to the family.
  3. Gender sensitivity—If the deceased is a male, you may want to assign a female liaison to the spouse as there can be a lot of strong emotions during this time and unhealthy attachments can form. You should consider gender identity and sexual preference in assigning a liaison as well.

Training and preparation of individuals for family liaison assignment should happen before an event like this ever occurs.

S: If I am a service director looking to send a few people to train for this, what type of people should I look for?

KC: If I had to provide a list of characteristics for liaison selection, it would probably include someone who:

  1. Does not gossip and respects confidentiality.
  2. Can make things happen—someone who is comfortable making, and either has the authority to make decisions on behalf of the service, or has direct contact with someone who can.
  3. Has a great support system of their own.
  4. Understands and respects boundaries—can set limits where appropriate and necessary.
  5. Is comfortable speaking, but also understands and can recognize the importance of silence, or when not to respond.

S: When it comes to families, there are a lot of dynamics a liaison might have to contend with such as divided families or family members that do not get along. If more than one individual is involved in a LODD, such as two members killed in a car accident, there may also be dynamics between those two families that need to be considered. What are your recommendations for addressing those type situations, where either a single family or multiple families may be at odds?

KC: If there is more than one family involved (i.e., two employees) you will want to assign each family a liaison, and those liaisons will need to be in close communication with each other and the organization leadership. One thing agencies may wish to consider is holding family support or family networking events throughout the year, before an event like this happens. I mean, beyond the Christmas parties and summer picnics where all families are invited—events that allow family members of your employees to get together, build relationships, and form a support system between families who understand the dynamic of supporting someone in EMS. If families are meeting for the first time as the result of a fatal accident, the dynamic will likely be much different (and more difficult) than if they are afforded a place to get to know each other and form bonds before such an event would happen. It is a lot easier to blame a stranger than a friend; it is easier to share pain and experience with someone you share a bond.

If there is pre-incident conflict within a family, such as animosity between divorced parents or an ex-spouse, these situations become more difficult to manage. Training will help the liaison better navigate and handle these situations.

S: You mentioned before, the importance of knowing the resources in your area—what would you say to those services who might plan to reach out to their local CISM or hospital for a family liaison or other support in this situation?

KC: As I mentioned before, EAP is a valuable resource but likely not the best as a stand-alone support in the event of LODD, and it certainly would not be able to function as a family liaison. Many hospitals may have pastoral care staff, such as myself; however, many would not have the capacity to operate as a family liaison or the awareness, authority, and connections to make decisions on behalf of your service. So, neither of these options would not be the best plan in my opinion. CISM teams can help in debriefings, but again, that is different than functioning as a family liaison. Some of your staff members that are trained as CISM peer counselors, however, may be excellent candidates for continued training in LODD and more specifically, as family liaisons.

S: You also mentioned how the family liaison should be taken off shift responsibility and assignments while they are functioning as the family liaison. What time frame should a service expect, and could the director or administrative staff function as the liaison to reduce scheduling disruptions?

KC: The time frame will be variable and unique to each situation; this is part of the importance of a service’s selection and training of these individuals. They need to determine when the family needs the high-intensity liaison, when to move to periodic support, and when to transition out to periodic or then eventual annual check-ins. They need to do this without creating a co-dependence.

A director or administrative staff would not be the ideal candidate for the family liaison assignment. The director will be busy dealing with many other operational details and would not be able to devote the time or attention to the family during the high-intensity phase. Ideally, the liaison will be someone the fallen individual knew, worked alongside, and had a good relationship with; someone who can share some stories with the family. The liaison’s ability to do this goes back to the importance of fostering the family/spousal support network as well.

There are many ways in which services can prepare for a line of duty death. Option one is to bury your head in the sand and pretend it will never happen to you. This, we know, is a lie; a lie to ourselves, our employees and their families. Option two is to address the potential with eyes wide open and full support starting in orientation and stretching through the selection of qualified employees for advanced training. Even if I am lucky enough never to experience a LODD personally, I would rather work for an organization adopting option two every time.

“It is a curious thing, the death of a loved one. We all know that our time in this world is limited and that eventually all of us will end up underneath some sheet, never to wake up. And yet it is always a surprise when it happens to someone we know. It is like walking up the stairs to your bedroom in the dark, and thinking there is one more stair than there is. Your foot falls down, through the air, and there is a sickly moment of dark surprise as you try and readjust the way you thought of things.”

― Lemony Snicket, Horseradish

8 Ways You Can Support Millennials in Your Workplace

Millennials… am I right?

That seems to be the most popular punch line when I am sitting around a table with colleagues discussing organizational change or current challenges in EMS, particularly staffing and development. I recently attended a conference focused on leadership in EMS and if there was a session without mention of the dreaded millennial and how awful they are, I missed it. To be honest, it’s getting old and my ability to filter my exasperation is wearing thin, especially as we are now seeing offers of multi-day trainings for how to work with millennials. The entire concept seems quite strange to me… were there classes offered to the Boomers on how to get along with the Generation Xers?

The words I usually hear associated with the generation at hand are entitled, needy, whiney, lazy, untalented and impatient. I don’t believe anyone I know well or have worked with over the years would describe me with any of these terms (ok… maybe impatient from time to time), although I am in the generational age range for millennials. In fact, I am willing to bet many of you work with people who are within the age range for millennials, yet you would not immediately lump them into the group you find so difficult. According to the PEW Research Center, millennials were initially described as those being born after 1981 are now defined as those born between 1977 and 1992.

While I am not attempting to climb up and be a representative for the entire millennial generation, I do believe this simple list addresses many of the issues I have heard, from both sides of the generational gap, over the past few years.

  1. Stop complaining about millennials.
    Generally, please stop using the word millennials to begrudgingly sum up every challenging situation or conversation you’ve had involving someone younger than you. Specifically, please stop complaining about millennials to me… a millennial. I realize you think my entire generation is made up of needy children who cannot be bothered to show up for work, but is that how you would describe me? I will admit the above description does fit some of my generational cohorts, if you can admit there is a certain irony in constantly complaining (whining) about a generation of whiners.
  2. Get to know me.
    Time is precious, and you don’t have enough of it. Staffing shortages, schedule changes, contract demands, and personnel issues take up so much of your time it can be easy to overlook the simple things that really make a difference in an organization. Something as small as a conversation can drastically change how I feel about, and in, an organization; it helps me learn about the culture of the organization, how I should approach leadership with any issues that come up in the future and how long I’ll stick around. Leadership taking the time to have a conversation, even 15 minutes, will set the foundation for the relationship I will have with the individual(s) as well as the organization.Seriously, take time out of your day to get to know me as a person instead of an employee number. This can start in the interview or orientation process, and continue while I’m on shift. Most EMS organizations have shift supervisors that are also working on the truck and, in many cases, orienting new employees during their first 60 days; take the time to have a conversation about expectations (from both sides), communication preferences and styles, and personal and professional goals. Onboarding someone to your organization is about more than protocol compliance and radio reports.
  3. Stop talking to me about money.
    Yes – money is important, and I expect a reasonable level of compensation for the work I am doing. I want to be able to support myself, my family and my lifestyle but I’m about more than that. By and large, I am value driven; I want to know that what we are doing is making a difference somehow, and that my values are mirrored in the organization I work for. To clarify, money is NOT the primary motivator and when you lecture me about finances (the way my father would), I shut down and know that you do not understand me.PS: Organizations that take the extra time to lay out and explain complete compensation including benefits, insurance costs, etc. and offer resources for budget planning are absolutely adding value to all employees, not just millennials.
  4. Share your vision, so I know the path and the timeline
    I might seem impatient…but my whole life I’ve been told to set goals and reach them. Go to college and get a respectable job. DO better. BE better. Nobody ever told me to be PATIENT. Share the vision of the organization. Share your vision for me (specifically) within the organization, and ask what my vision is. Work with me so I can understand my potential career path and a realistic timeline, so I can be an active participant in my development and, together, we can manage my expectations.
  5. Realize that when I ask you “why” I’m not challenging you.
    I legitimately want to understand why I’m doing what I’m doing. The things we do during downtime, on scene and in the back of the ambulance are all part of a process, not the entire process. Understanding where my “place” in the process is and what happens next helps clarify the importance of specific tasks, particularly those that need to be completed in a certain order or timeframe. It is important for leadership to go beyond the “because I said so” reasoning. I remember being told once, long ago, that I should never tell anyone something I can’t show them. That message stuck with me and I have come to expect the same from others, particularly those handing out orders. Help me see the why and I will gladly complete the task… maybe I’ll even find a way to do it more efficiently.
  6. Stop telling me “Good Job”. It’s a cop out – you know it and I know it. Just stop.
    Recognizing effort is always better than recognizing completion. EMS is a high-stress, mentally demanding industry that can feel somewhat all-consuming. When I take on a project that means extra time away from my family or squeezing more work into my already busy shifts, learning and exercising new skill sets or successfully coordinating the work of others, an “Atta Boy!” just doesn’t cut it. Also, I know I’m not perfect, so when performing my annual review, a blanket “you’re doing a great job…” tells me you’re really not putting the effort into giving me an honest review and you’re not invested in my continued improvement.
  7. Don’t be my punchline.
    This is a simple one… I expect you to practice what you preach. For example, if you implement (and enforce) an organizational policy that says employees cannot call in late or sick via text message, do not cancel a meeting or let me know you will be late via text message. Require a minimum of a 4-hour notice for a sick call? No problem, until you cancel our meeting at the last minute, or even worse, after it has already started, you’re not there and I have to call you. Please do not talk to me about the importance of dedication and doing the right thing even when no one is watching and let me see you leave early when your boss is out of town or hear you complain about meetings that go past 5pm. Coaching me on the importance of follow up? Please, please make sure you set the example of what good follow up looks like, because if you’re enforcing rules that you clearly believe you are exempt from and failing to provide the example, you lose a lot of credibility.
  8. Get Social
    It’s a social world, and we’re proud of what we do and where we work. For many being an EMT or paramedic isn’t just a job, it’s their identity; take the opportunity to post your new hire photos and bios on your social media accounts and tag the employees in the celebrations so their friends and family can share in their pride and success.

 

Build Your Future with a Career in EMS

The U.S. Bureau of Labor Statistics expects career opportunities for EMTs and Paramedics to grow another 15 percent by 2026, far outpacing most other professions… With EMS agencies hungry for skilled providers, there has never been a better time to chart your career path in mobile healthcare.

This week, an editorial from AAA President Mark Postma was featured in a special Media Planet section on healthcare careers. Read the full article►

Time to handle 911 call demands with Paramedics

When discussing this new and growing field of pre-hospital care, there seems to be two unique paths that services are following. The first is the hospital-owned or contracted service, where community providers seek ways to decrease readmission rates for CHF, COPD, Pneumonia, Sepsis, MI and other chronic illnesses.

When a patient discharged with one of these targeted conditions is readmitted within a 30 day window, “hospitals face penalties of up to 3 percent of Medicare payments in 2018” (Gluck, 2017, para. 10). That is a lot of money. Consider, “Lee Health, Southwest Florida’s largest hospital operator, which is expected to lose $3.4 million in payments” (Gluck, 2017, para. 2). This model represents the if, or, and type of service, meaning if we can do it for less and there are providers willing to do this type of medicine, then we can save the expensive penalties from CMC.

The other model of community paramedicine is 911 abuse reduction. For years EMS has conditioned the public to call 911 for any emergency. But today, what we consider an emergency is far from the public’s perception of an emergency. “EMS has experienced a 37% increase in 911 calls since 2008.” (White, 2016, para. 6) Yet have we increased staffing proportionally to meet the demand? Afraid not since “only 50% of EMS services in 2008 were fully staffed, and more than 63% had a volunteer component as part of their staffing level” (“Critical Staffing Shortages,” 2015, para. 2).

The article references increasing wages to help compensate for the decrease in trained providers by attracting more professionals to the field. With the CMC limiting payments and the major insurance companies following suit, doubtful this will be an option in the near future.

To reduce calls and increase levels of service, we can try to reeducate the public to what is a true emergency, but that is a long and slow process. For example, Philadelphia has started the trend and placed several billboards up around neighborhoods that contribute an ordinarily high amount of non-emergent 911 calls. Will this work? Time will tell but I would believe not enough to affect the volume of calls.

What about enlisting Community Paramedics in these situations? I believe this is a viable solution with nurses triaging the low acuity calls in the 911 center. Dispatching Community Paramedics armed with not only the usual equipment, but also the knowledge base to connect these patients with primary care physicians, social workers, and the programs that are available to them. This will help people receive the long-term care they deserve.

Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.

References
* Critical Staffing Shortages (2015)
* Gluck, F. (2017, February 7th, 2017). Lee Health will lose $3.4 million in Medicare payments because of readmission rates. USA Today
* White, D. (2016, February 16th, 2016). Community paramedic? program intended to reduce 911 calls. Manatee Technical College

Protecting EMS and What That Means

I have been seeing a lot of chatter on social media and reading quite a bit about ambulance services issuing ballistic vests and providers being allowed to arm themselves. Looking at the available data, consider the following:

  • 67% (95% CI = 63.7%–69.5%) of respondents reported that either they or their partner had been cursed at or threatened by a patient;
  • 45% (95% CI = 42.4%–48.3%) had been punched, slapped, or scratched and 41% (95% CI = 37.9%–43.7%) were spat upon;
  • Four percent (95% CI = 2.8%–5.0%) of the respondents reported that they or their partner had even been stabbed or involved in an attempted stabbing; and
  • 4% (95% CI = 2.5%–4.8%) reported being shot or involved in a shooting attempt by a patient.” (Oliver & Levine, 2014, para. 22).

When looking at the survey results, specifically the low percentages of violent activities, it would appear that such protections are not needed. However, I cannot support the notion that a provider feels that where they work this protection is essential to them. I think a closer, more current look with a larger sample will create a better perspective. This study is relatively small and would be better served if the questions were more focused.

When it comes to “arming EMS Providers” I do think we are far from that. To arm EMS Providers would certainly require specific training, educational classes, and buy in from legislators.

Consider what happens if I defend myself. Am I now obligated to treat the person I’ve harmed? Would I, should I, be held to the same standard of trying to deescalate a situation as the police? With the absence of training and ambiguity of the legal system, I do not think arming EMS providers at this point is the answer.

To me, we need better education, better perceptions from the general public, and most of all a unified EMS front at the national level that is tasked with moving our industry toward the 22nd century.

______

Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.

References

Oliver, A., & Levine, R. (2014). Workplace Violence: A Survey of Nationally Registered Emergency Medical Services Professionals

 

Discovering the Meaning of EMS Week

Being in EMS since 1990 I can certainly tell you I have seen numerous EMS Week celebrations come and go. Did you know EMS week owes its founding to the American College of Emergency Physicians? In 1974, ACEP asked former President Gerald R. Ford to declare November 3-10 as National Emergency Medical Services Week. Since then, ACEP has moved the annual observance numerous times, finally landing on the third week in May. This move provided a distinction between EMS and Fire Prevention week.

EMS has always been a part of my life, from the EMT-M class I took in January 1990 to becoming an RN in 2008.  I have done almost everything in EMS a person could do, volunteer EMT, Paramedic, Critical Care Education, ED RN and now vice president of EMS Education at OnCourse Learning.

Let’s discuss ideally what EMS providers actually want most for EMS Week. This year, let’s dismiss all of the usual tchotchkes, mugs, t-shirts, hot dogs, pens and flash lights. I can honestly say after 25+ years, I’ve gotten it all and am a bit tired of it. The ED sponsored pizza, while a very kind gesture, always seems to go uneaten for a variety of reasons.

Let’s face it, we know we are under paid and over worked. Although I am always grateful for the sentiment people have for us as a profession during EMS week I’d prefer recognition more frequently, even every day. Don’t get me wrong, I’m not being ungrateful, the hot dogs and pens are appreciated. But let’s focus on what matters most for pre-hospital professionals – better pay, working conditions, and meaningful education.

Which brings me to the area I can influence most. Not the everyday education, you know card certs PHTLS, ITLS, APLS, PEPP, and EVDT etc. I want something more. I want continuing education that excites me. That embraces my desire to improve EMS and helps us all to change and improve the care we deliver to our patients. To change the protocols that guide us in the care we provide. Basically, what I am asking for is a seat at the table, minus the pens and hots dogs. Let’s start with a better educational foundation, a voice in the care we provide and deliver better care to those who rely on us to care for their loved ones.

About the Author
Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME.  Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.

How to Stand Out Using Low-Cost Recruitment, Retention Strategies

Scrolling through Facebook, I regularly notice EMS providers seeking feedback from friends and colleagues. Someone will post, “Hey, I’m moving to this city. Does anybody know some good ambulance services that are hiring?” Plenty of people will respond, “This is a pretty good place.” Others share warnings such as, “Don’t work for Provider X.” Word of mouth can be valuable for any EMS. What current and former employees say about their positive work experience is a major benefit to recruitment and retention. In order to ensure a top-notch service to customers and to attract top-tier employees, recruitment and retention must be at the top of the to-do list. This is important for both public and private EMS departments. With negative word of mouth, unless somebody is desperate to get a job, “Provider X” in the example above won’t receive a second look from applicants. While some services use salary as a major recruitment and retention tool, it’s not the only way to stand out. There are various low-cost strategies to employ when it comes to recruiting and retaining employees.

Moving on up

Opportunities for advancement are one attractive benefit. In a fire service, providers often begin their tenure as a fire service paramedic. They can take a test to become a paramedic lieutenant. If a space opens up, a person can test to be a paramedic captain or eventually paramedic chief. In private ambulance services, the organizational structure is often different. Provide an infrastructure for improvement is of the utmost importance. For many professionals, that upward mobility is gained through education. Offering more knowledge benefits both parties and has an impact across the continuum of care. The advanced education benefit allows providers to offer better care and to communicate better with colleagues in other healthcare disciplines about a patient’s care. This builds loyalty among employees toward a service that continues to invest in their skills.

Some organizations may avoid providing education while on the clock. Advanced planning ensures coverage while expanding the team’s skills. Work with your team to determine the most convenient time and day for the provider and the EMS to obtain educational opportunities.

Learning curve

An EMS department can offer a number of educational opportunities — starting with all the necessary courses to maintain certification — to expand a provider’s knowledge.
Some of the options include the following:

  • Tuition reimbursement for college
  • Flight paramedic, critical care or tactical paramedic certifications
  • Critical care continuing education

These certifications make providers, and the service they work for, stand out above the crowd. Think of the added benefit of saying, “All of my paramedics are critical care paramedics.”

To recruit or to retain

So what comes first – recruitment or retention? That depends on the needs of an individual service. If a service, for example, is 10 people short, filling those spots is paramount. If there aren’t any open spots, concentration turns to keeping the providers you have satisfied and offering the best service possible. These providers are valuable because they are most familiar with your area, contracts and how your service does business. Whether recruitment or retention is the goal, the following perks may help candidates choose your organization over competitors:

  • Free uniforms
  • Recognition awards, dinners, picnics and other company events
  • Colleague referral programs
  • Discounts for services and products, such as gym memberships, travel, etc.
  • Tax breaks for EMS volunteer hours (in some states)

While some services rely on a quick increase in salary as their only tactic, recruitment and retention is impacted by much more. Finding and incorporating multiple ways to value your providers and their contributions is the most beneficial path to follow.

A Novel Approach to Beginning an Injury Prevention Program

As leaders none of us discounts the importance of fitness and wellness programs for first responders. However from my personal experience I have not seen many leader let alone a coach / personal trainer at the departments I teach at across the country. Instead I see fitness minded first responders, cross fit™ coaches or more often than not a PT academy instructor that gets pushed into the position of coach. This often leads departments with a struggle to design, implementation and buy gain in from crews.

The misdirected pursuit of strength and fitness

What I have seen more times than I can count are that these ‘instructors’ who mean well are pulling from a tool box of outdated and often dangerous exercises hoping to improve employee fitness. There is often no scientifically accurate planning as they do not have the knowledge base to pull from, instead we see ineffective warm up’s, a complete lack of self-care and mobility training coupled with exercises that harm more than they heal.
On top of that we also see departments building a “box” because it’s cost effective and popular. Just my opinion here but I often wonder if the lack of buy in, follow through and behavior change stems from a litany of psychological junk stemming from high school PE through the academy. Are we demotivating responders from exercising by programming them that fitness always has to be hard to be effective?

The unreported prevalence of Pain

“When anomalously surveyed over a 6 month period 57% of EMT’s and paramedics have sustained some type of soft tissue injury that they did not report.” (1) I have repeated this study (unscientifically) in every class I teach and I am seeing this number edging close to 70% of the class, every class. If we have an unreported injury rate above 50% that leads me to believe that pain is a serious demotivator to participation in and follow through with wellness and fitness programs.

Shift work and Stress

The literature is full of studies about the dangers of shift work, chronic stress activation, hormone disruption and the effects on the body. (3,4) As a former Paramedic I can clearly recall the sleep disturbances, stress responses and fatigue so profound that the last thing I wanted to do was train. This is where we often see the drop off; chronic fatigue, stress and pain acting as a demotivating factor to even the most fit of responders. No one wants to train hard after their 4th 12 hour shift in a row, and if you have been on the street those 12’s often turn into 14’s by the time you clock out.
Add to that stress eating, fatigue eating, (2) substance abuse including alcohol (the dirty little secret that no one will talk about) and coaches we have the perfect recipe for exactly what departments are dealing with; a total lack of participation and buy in.

Remove the Barrier

One of the tools that have worked extremely well is the use of a simple practice (pressure less) tennis ball. We spend time teaching responders not only on the how but the why of trigger point massage. Instead of just telling them to massage and trigger point the piriformis we teach them that a tight Piriformis can cause knee pain and it can also cause low back pain. A tight pectoralis minor can contribute to upper crossed pattern which can lead to headaches, neck pain and even rotator cuff disorders. Focus on the calves, hip flexor, lats as well as the afore mentioned. By following this approach we can empower responders to not only treat their symptoms but to apply self-care techniques that can benefit them throughout their career, pain is not normal it’s a symptom so treat it. A final benefit is that this is a very easy and inexpensive home technique that responders can do pre or post shift without the fear of being razzed by their peers; which is a rite of passage and coping mechanism in first responders.

KISS

Movement matters and as the saying goes move well and move often. However in fire and EMS how do you teach responders to lift a 400 lb. patient out of a bath tub, that’s wet, naked and has stopped breathing? As coaches we know that strength will reduce the rate and severity of overexertion soft tissue injury but in many cases the spinal loads responders sustain are more than 5x the NIOSH recommended limit. (5) One PEARL that I personally like because it’s simple, effective and ties into a safety culture is to follow theses 4 steps.

1. Feet flat: To ensure proper balance, firing patterns and stability make sure the feet are always flat and when possible shoulder width apart.
2. Hips hinged: Make sure the hips are hinged to spare the spine; ensure that your crews know the difference between a squat and a hinge.
3. Sternum up: Keeping a neutral spine is of the utmost importance, I like to teach the crews that “if your sternum points into your body you lose, keep your chest up!”
4. Head up: Always lift, move, push, pull and carry with the head up. This holds especially true for confined spaces and awkward lift situations.

Its human nature to make things overly complicated and to fall prey to fads, gimmicks and crowd think; as leaders we need to keep one eye on the science and the other eye on the crews. Fatigue, stress, dehydration, repetitive motion disorders and disease are sadly the norm in most departments; with many responders surviving on overtime shifts to make ends meet further compounding the issue. Keep is simple, actionable and just help them to feel better as it’s all possible from there.


(1) FEASIBILITY FOR AN EMS WORKFORCE SAFETY AND HEALTH SURVEILLANCE SYSTEM,
DEPARTMENT OF TRANSPORTATION NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, TECHNICAL SUMMARY, CONTRACTOR Bedford Research; The Pacific Institute for Research and Evaluation REPORT DATE February 2007
(2) http://www.health.harvard.edu/newsletter_article/why-stress-causes-people-to-overeat
(3) Stress hormones may increase cardiovascular risks for shift workers
October 3, 2011, The Endocrine Society. Appl Ergon. 1996 Feb;27(1):9-16.Costa G.
(4) http://www.ncbi.nlm.nih.gov/pubmed?term=MartinGill%20C%5BAuthor%5D&cauthor=true&cauthor_uid=22023164
(5) Efficacy of the revised NIOSH lifting equation to predict risk of low-back pain associated with manual lifting: a one-year prospective study.Hum Factors 2014 Feb;56(1):73-85 Ming-Lun Lu, Thomas R Waters, Edward Krieg, Dwight Werren

Mental Health Support: Getting Help for Depression

Many of us struggle to tell the difference between depression and sadness because the primary symptom of depression is pervasive sadness. But it’s important to know that there is a significant difference. Sadness is a normal emotion that is usually triggered by a hurtful, challenging, or disappointing experience, event, or situation. We tend to feel sad about something. When that something changes or when we adjust or accept it, our emotional hurt tends to fade. With depression it’s not the same.

Depression is a mental illness that affects our thoughts, feelings, and behaviors in a pervasive manner. We feel sad about everything. With depression, sometimes that sadness is present despite the fact that, from the outside looking in, everything is going well. Depression doesn’t require a specific event, situation, or experience as a trigger. Depression infiltrates all aspects of our lives making everything less enjoyable and less important. Depression can be debilitating and significantly impact our daily life function.

The most common symptoms include a persistent sad, anxious, or empty mood; feelings of hopelessness or pessimism; feelings of guilt, worthlessness, or helplessness; a loss of interest or pleasure in hobbies and once enjoyable activities; sleeping difficulties, including trouble falling asleep or staying asleep or even excessive sleeping; eating difficulties, including eating too much or too little; fatigue, a lack of energy; thoughts of death or suicide, or suicide attempts; a change in your mood, irritability or restlessness; difficulty concentrating, remembering, or making decisions; persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

Steps to take if you think you might be depressed: Some research suggests that the longer you wait or try to handle it on your own, the worse it can become. You can start by seeing your general practitioner, a therapist, or any doctor whose care you might be under. They can assess your need and help support connection to the appropriate resource if that’s needed. Other suggestions include increasing your activity or engaging in anything that brings you pleasure or joy. You can also talk to a trusted friend or relative and try definitely to stay active.

If you’re concerned about a loved one who seems depressed: It can be very difficult and challenging to live with someone that might be depressed. If you are concerned about a loved one, please try to take immediate action. Stay engaged with them and encourage them to see a medical professional. And if you suspect that they might be of danger to themselves or another, make sure to dial 911.

It’s important for people who are suffering to know that they are not alone and that they don’t have to suffer. So if they don’t want to seek help, try to keep them encouraged. Check on them and express your concerns and the benefits of getting help. Hopefully your persistence can support them to taking some next steps. Being concerned about a loved one who may be suffering from depression is very difficult. While you are encouraging and supporting your loved one and trying to help them
take the next steps, it’s important for you to know that there are many resources available. Explore your employee assistance program or meet with a therapist and talk with someone to help you navigate helping them.

Depression is the most treatable of all mental illnesses. There are various kinds of therapies that work. Treatment such as psychotherapy, support groups, and medication management are the most common treatments for depression. Don’t give up, find support. If you think you might be depressed, see a professional as soon as possible.
Call LifeWorks at 888-267-8126 or visit www.lifeworks.com (username: theaaa; password: lifeworks).

Maintaining Compliance Within an EMS Service

Maintaining compliance within an EMS service can be a daunting task, especially given the number of regulations that we must follow.

One way to look at EMS is if a trucking company married a hospital.

There are rules and regulations to abide by for an entire fleet of vehicles, from safe operation guidelines all the way down to the use and color of lights. Then there are requirements for a group of healthcare providers, which include necessary certifications such as CPR and knowledge of pertinent life-saving skills.

Not only does maintaining compliance keep vehicles and equipment running smoothly, but it can offer employees valuable peace of mind and keep everyone focused on the same goals of providing the best care possible.

I like to consider compliance an investment in common sense.

Employees know what is expected of them at all times, and they know what type of support their employer will provide to keep their skills sharp. In turn, an EMS service gains from being in good standing with regulators and from an engaged, confident workforce.

The benefits of a strong culture of compliance are immense. An organization that lives and breathes compliance can help ensure a smooth-running operation that features top-notch communication and quality providers who offer excellent care.

Journey to Compliance

These six key ways ensure compliance will serve as a roadmap to a strong culture in your organization:

  1. Start from the top: Backing from leadership ensures a strong culture of compliance. For certification and education compliance to stick, it starts with the attitudes of upper management, such as the board of directors, chiefs, officers, and day-to-day operations staff. Leaders must actively support all compliance efforts, including regular compliance-related reports, approving policies and having a general knowledge of the rules that govern EMS providers. Without the right tone from the top, an EMS service’s compliance efforts are usually undermined and ultimately fail. This results in issues with governing bodies, payers, scheduling and staffing.
  2. Commit to resources: Having the right personnel and systems in place are both vital to creating a strong compliance culture. The organization’s compliance staff should have experience in directing compliance efforts and supporting the evaluation of compliance-related risks. When it comes to certifications and education, compliance is always black and white. Knowing how to evaluate and respond to operational issues is important to maintaining compliance and successfully operating an EMS service. Systems that provide information to assist the service in complying with its obligations are a necessity.
  3. Have the write stuff: Developing written policies and procedures for compliance programs and internal controls is essential to adequately address regulatory requirements and an EMS service’s specific risks. Having these policies and procedures in writing sets the expectation of what is required of both managers and employees. Assessing risks before drafting these programs will help identify key areas where controls are needed. A compliance program should include how a service’s policies can be implemented from an operational perspective. This will include internal controls and standard operating procedures.
  4. Provide education: Providing the training for your EMS employees gives them peace of mind that they will be in compliance and acknowledges that the service values them.
  5. Test the system: Subjecting procedures to an independent review and audit ensures the compliance system is working correctly. This review provides an evaluation of where the EMS service’s compliance efforts stand. It also offers an opportunity to correct deficiencies before an outside regulatory audit is performed.
  6. Communicate more: Communication is vital to all organizations, but it can be the most difficult piece of the puzzle to achieve. With compliance-related responsibilities, sharing information is very helpful and, in some cases, required. Communicating expectations within EMS training programs is imperative. Reporting compliance efforts and noting any deficiencies should be a part of a communication strategy, especially if your state has an active medical director and/or board of EMS.

Lifeworks: Overload at Work

You aren’t alone if you often feel overloaded at work. More than two-thirds of US workers suffer from work overload, according to Kelton Research/Cornerstone. Overload can increase your stress and make you feel out of control even if you enjoy your job.

Stress and overload can also affect your productivity, work relationships, and performance. If you are working longer hours or feel overwhelmed by all that you have to do, you may be experiencing overload at work. If the fast pace that was once challenging starts instead to leave you feeling drained, that may be a sign of overload. Learning to cope with your workload can reduce your stress and help you stay productive and valuable to your organization.

Gaining understanding and control of your workload

Here are ways to gain control of your workload:

  • Realize that you can reduce overload. There may be parts of your job that you can’t control, such as seasonal variations in workload. But you can control how you prepare for the peak season. Focus on what you can change, not what you can’t.
  • Know your limits. Some people thrive on a heavy workload, while others feel stressed by small increases in their responsibilities. If you’re assigned a project that you know will be very challenging, start looking for help and for solutions before you feel overwhelmed by a task.
  • Review your responsibilities. Has your job changed recently? If you have greater responsibility, you may still be adjusting to new demands.
  • Decide if your workload is likely to ease. Is some of your overload caused by a temporary situation, such as a co-worker on leave? It may help to know there’s relief in sight.
  • Talk about the workload. Rather than complaining to co-workers, talk with a mentor or trusted friend who understands and sympathizes with the pressures you face.
  • Explore solutions to personal concerns that are contributing to your stress. If you have a partner, get his or her ideas on this. Could you hire a house-cleaning service or could your partner take over some of your household chores for a while? If you’re caring for an aging parent, consider using short-term respite care for occasional relief.
  • Consider meeting with your manager or human resources (HR). Your manager or HR may suggest ways to handle the situation or tell you about helpful resources.

Other ways to reduce overload

  • Cut back on other commitments until your workload eases. When you’re overloaded, a good rule of thumb is to drop one old commitment when you take on a new one.
  • Set aside time each day to do something you enjoy. This will help you avoid becoming burned out at work. Make time for friends, family, relaxation, exercise, or spiritual activities that have meaning for you.
  • Focus on leaving work on time. If you tend to work late, start with leaving on time just one or two days a week. A little less time at work may lead to increased focus, energy, and productivity when you’re there.
  • Take vacations. Getting away provides more than a way to relax and unwind. It also gives you psychological distance from your workplace helping you to recharge and return to your job with a new outlook. Employees who don’t take vacations because of work pressures feel even more overworked. And yet, many Americans have days of paid vacation left over at the end of the year.

We all want to feel challenged and excited about our work, and we want to know that it’s manageable and under control. With the right tools and support, you can achieve this goal.

Call LifeWorks at 888-267-8126 or visit www.lifeworks.com (username: theaaa; password: lifeworks).

What is Reddit? (And Why EMS Leaders Should Care)

If you were asked to name the top 10 most popular websites in the United States today, I’m willing to bet that you could guess most of them: they are, in descending order of Alexa page view rankings, Google, YouTube, Facebook, Amazon, Yahoo, Wikipedia, Twitter, Reddit, Ebay, and LinkedIn.

“Wait,” you may be asking, “what is ‘Reddit,’ and how can it be in the top 10 most popular American websites if I’ve never even heard of it?”

As a self-appointed cultural ambassador for the millennial-heavy EMS workforce, I’d love to give you a basic introduction. Seasoned Redditors, feel free to skip this post. But those new to Reddit, or even social media in general, please hang in there—it is increasingly important for ambulance executives of all age groups and technology skill levels to “get” what is going on in influential online communities.

What is Reddit?

Reddit describes itself as “the front page of the internet.” What does that mean?

Reddit (usually styled lowercase as “reddit,” but I’m capping for clarity) is an online community platform allowing users to anonymously share, comment, and vote on links, images, personal stories and more in topic-specific “subreddits.” A user’s self-selected subreddits are merged into a personalized feed, which is often very different than the generic Reddit Front Page generated from the posts voted best across the whole site.

Wildly popular with millennials, Reddit is one of the most engaged and active digital communities in history. Reddit communities’ collective taste-making influence drives modern pop culture and politics in unprecedented ways, and the popularity and sway of the site is only growing.

I am sticking mostly to practicalities in this post, but highly recommend reading a little bit about the history of Reddit (2014 Mashable article, 2016 WSJ CEO interview), if you have a moment. The Wikipedia entry also gives a great overview.

Why should EMS leaders care?

Large swaths of your staff are routinely participating in Reddit communities, likely many times per week. For all that we hear about generational conflict in EMS organizations, wouldn’t it be great to gain some firsthand insight into the candid thoughts of EMTs and Paramedics across the country? Of course this only works if leaders approach Reddit (and the subs and threads of varying merit within) with an open mind—because of its inherently populist and anonymous nature, there is an ever-changing mix of valuable and abhorrent content that sometimes takes a little time to sort through.

Additionally, more and more people are electing to get their news, pop culture, and entertainment first through Reddit or other social media, instead of mainstream news sources. EMS leaders relying solely on information from TV newscasts or even the websites of traditional print journalism outlets are missing the backchannel dialogue and meta commentary that is shaping the way our industry is perceived.

Can Reddit participation help with EMS advocacy?

Many ambulance execs are unfamiliar with the fact that top politicians as diverse as President Obama and Gary Johnson choose to interact directly with Redditors, personally fielding user questions in the r/IamA sub. Reddit’s political commentary subs are also famed for the sometimes prescient, sometimes wacky user analysis of current affairs and election hoopla. Start with r/politics, the largest sub, to get a feel for the Reddit politosphere, then find your niche in some of the more targeted subs below. Not seeing your interest? Search the site for hundreds of other options ranging from radical to reactionary—or start your own.

How can I get started on Reddit?

We all have that kooky relative who doesn’t “get” Facebook, and so posts inappropriate rants or the equivalent of text voice mails on our walls. Don’t be “that guy” (or gal) on Reddit—although most people are nice, not everyone is patient, and some users may report your post to moderators for removal. Also, it is just good manners to follow the norms of any community in which you participate, be it face-to-face or online. Here are some easy steps to ensure that you become a valued contributor to the Reddit community.

  1. Create an account. Note: Do not use a variation of your real name or company name in your username. This is not Facebook, or even Twitter. It is crucial that unless you are a world leader (u/PresidentObama), celebrity (u/GovSchwarzenegger, u/williamshatner), or other very public figure (u/thisisbillgates, u/ColChrisHadfield) that you keep your personal information as private as possible for your own safety.
  2. Curate your subs.
    • Login to reddit, then visit your subscription page to remove yourself from any default subs that don’t interest you. For me, this meant immediately axing everything related to sports (sorry, I mean, “Go Sox!“).
    • Next, find and subscribe to many subs that interest you. There are thousands of subreddits for everything from r/cooking to r/gardening to r/motorcyles to r/parenting to r/books, and that is just scratching the surface. Typically large, general-interest subs will list more niche subs in their sidebars to make them easy to find.
  3. Lurk and get used to voting. Read your feed, or peruse a specific sub in-depth, upvoting posts and comments based on quality, not your level of agreement with the poster’s opinion. Typically, it is best to lurk (read without posting) for a month or two before you leap into the fray to get a sense for how each community interacts.
  4. Start posting and commenting. Now that you have some context for the types of conversations going on in your favorite subs, you’re ready to start submitting new posts and commenting on the posts of others, in addition to voting. It is really important to read Reddit’s content rules and Reddiquette guidelines, as well as the sidebar rules for your particular sub, before posting. Also, it is pretty much universally forbidden to share with the group any personally identifying information, even about yourself. Don’t get overwhelmed—most of the rules are common sense, and the time investment will pay off when you experience the thrill of sharing ideas and news with like-minded people from around the world.

Are there EMS-specific subs?

There are many EMS-focused subreddits, ranging from the (mostly) serious to the ridiculous. Here are just a few:

  • r/EMS – by far the largest, with 21k subscribers as of today. Diverse mix of jokes, personal stories, protocol questions, opinions on employers, and more.
  • r/RealEMS (2k subscribers) and r/TalesFromEMS aka r/TFEMS (3k subscribers) smaller subs focused on the perceived “real” side of EMS.
  • r/911Dispatchers – (2k subscribers) – Sub targeting dispatch professionals.
  • r/EMScringepics, r/LookImAFireFighter, etc – smaller subreddits where some popular EMS sartorial choices are mocked. Very definitely Not Nice, but may strike your funny bone if you have a certain sense of humor.
  • r/firefighting (11k subscribers) – sub serving firefighters, but often touches on EMS topics

Hint: Sort by “TOP” then choose a timeframe to catch up on the best (or at least most popular) posts in a particular sub.

My service is mentioned on Reddit in a negative manner. Should I respond?

If someone posts something negative on Reddit (or Facebook, or Twitter, etc, etc) about the organization to which you’ve dedicated so much time and love, it can be very tempting to fire off your side of the story in response. However, it is almost always inadvisable to go in “guns blazing” on an anonymous message board, particularly if you aren’t very familiar with the norms for the specific sub in which you would respond.

If you really feel you must set the record straight, I suggest asking three other sensible Redditors and your attorney to review before posting, to make sure that you don’t accidentally open your organization up to a lawsuit or media nightmare. You may also want to create a separate “throwaway” username before replying, as anything you’ve previously commented or posted under your usual username is publicly visible. No matter how innocuous your past activity may be, it can and will be used against you in the court of public opinion (see: Ken Bone Reddit controversy).

My service is mentioned on Reddit in a positive manner. Should I respond?

In this case, it is a hard maybe. The tricky thing is that you want your organization to avoid being perceived as “Big Brother,” particularly in response to anything (good or bad) that might have been posted by one of your own employees. Given Reddit’s higher level focus on anonymity than, say, Facebook, even a “thanks so much, so glad to be your favorite employer!” reply can seem creepy or intrusive, depending on context. It may be best to just privately enjoy the knowledge that thousands are reading your unsolicited praises (and likely looking for job openings at your service).

If there are no HIPAA or human resources concerns involved, you can enlist the help of seasoned Redditors in crafting a response that is right in tone for your service.

Can I market my ambulance service on Reddit?

Commercial self-promotion of any kind is very much frowned upon by the Reddit community. Viral marketing, or any post planting or vote manipulation that can be perceived as viral marketing, even more so. For a glimpse at the level of energy around this issue, please see r/HailCorporate, or consider the vitriol directed at users who create alternate “sockpuppet” accounts to upvote their own posts. Any kind of advertising outside of appropriate subs that specifically allow it (or actual Reddit ads) is risky at best, and may completely backfire.

Can I post job listings to Reddit?

Read the sidebar rules of the subreddit you’re considering posting in to see if commercial offers are permitted (for example, counter-intuitively, r/jobs forbids job postings). Your may wish to consider posting to one of the subs dedicated to job seekers, including r/jobopenings, r/youngjobs, and r/jobbit, or your closest local job sub.

Another thing to consider is buying an ad on the Reddit site, then running it in EMS-specific subs, particularly if you’re open to paying relocation for medics from other areas, or if you are willing to train individuals coming from other industries.

Note: recruitment is not yet a primary Reddit focus, so you may or may not have much luck at this point. However, as  more people join Reddit and rely on it new and different ways, this is likely to change.

Glossary

  • Default sub—Default subreddits are subs considered to have the right mix of popularity and quality to be automatically included in new users’ subreddit subscriptions. You can remove default subreddits that you are not interested in following on your subscription page after you create a login.
  • KarmaWhen a post or comment is submitted, other users can vote it up or down. “Karma,” divided into post karma and comment karma, is a loose indicator of the quality of a thread. You can track your own karma on your profile page, but it has no monetary or other value. In theory, voting is supposed to be based on the quality and relevance of the post or comment, but this doesn’t always play out perfectly. Some users have high overall karma scores because they post very relevant articles or incredibly insightful posts, others because they draw sketches or write poems related to posts, and still others because they are known for submitting posts or comments that the community finds funny.
  • NSFL—an initialism for “Not Safe for Life.” This is used in the title of a post to indicate offensive content that shows or makes reference to gore, death, serious injury, the abuse of animals or people, etc. I would very strongly suggest that even the most hardened EMS folks stay away from most of these posts and the comments sections about them—NSFL posts do not bring out the best in humanity.
  • NSFW—an initialism for “Not Safe for Work.” This is used in the title of a post to potentially sensitive content involving any kind of nudity or sex. Depending on context and the subreddit in which it is posted, this flag can be used for posts covering everything from a news photo of the Janet Jackson Super Bowl wardrobe malfunction to actual pornography. Use your best judgment.
  • OP—like most other internet forums, on Reddit “OP” refers to “original poster,” and is a generic term used in comments to refer to the creator of the thread you’re currently reading.
  • MemeMost folks have probably heard of memes (pron. “meems”, not “meh-mehs,” “me-mes,” etc), or may even have shared some around the office or on Facebook. Reddit has a variety of inside jokes and memes specific to the community. If someone replies to a post with something that seems like a total non-sequitur, but others seem to find it funny, you may want to Google for inside jokes or check Know Your Meme for answers. Be forewarned: while some are funny or insightful, many memes and Reddit inside jokes are crass, prejudiced, or just stupid.
  • Reddiquette—Reddit’s own set of community manners. Read it here before posting!
  • Sub / Subreddit—Although originally not officially recognized, “sub” or “subreddit” are now almost universally used terms refers to self-moderated community centered around a particular topic. Here are just a few examples of the tens of thousands of subs you can choose to subscribe to, depending on your interests.

 

Have questions about Reddiquette or other social media platforms? Please don’t hesitate to reach out at ariordan@ambulance.org. Please feel free to share your own tips in the comments section below. We would love to hear about your ambulance service’s online successes and foibles.

LifeWorks: Helping AAA Member Employees Make Life Work Better

Enhance employee health and engagement by making sure your workforce is aware of the LifeWorks Employee Assistance and Wellness Program. The LifeWorks program is centered around helping your employees achieve work-life balance, improving their productivity and well-being.

We all face challenges in life. From finding answers to parenting questions or managing personal finances, to getting help with a relationship or taking care of health issues, LifeWorks offers around the clock fast, free, confidential help.

AAA understands that your people are your most valuable asset. Make sure your employees are aware of this resource for fast, confidential help with family, work, money, health and work-life balance issues. Share AAA’s EAP with your team.

Share Lifeworks with Your Team Today!

Download a copy of this flyer to share with your employees: AAA 2016 LifeWorks Information Flyer

Most of us find our jobs stressful at times. Often these feelings are temporary, but sometimes negative emotions linger and may begin to affect your job performance, your relations with others, or even your health and well-being. Learning to manage challenging emotions at work takes effort, but the payoff is big. When we deal with problems before they overwhelm us, we can contribute more to our team and gain a greater sense of control and effectiveness — both at work and outside of work. You can take steps to become more aware of your emotions and to manage them more effectively. If you are feeling stressed at work, the following tips can help you cope:

  • Recognize your emotions in their early stages, before they feel out of control. By reviewing your day’s activities and the feelings they caused, you may discover the source of difficult feelings at work. But it may take practice to recognize your real feelings. There’s a strong body of research that shows the ability to be recognize and name your feelings will protect you from having outbursts in the future and will improve your relationships. Ask trusted friends and mentors for help learning to recognize and name your feelings.
  • Learn to express your emotions in healthy ways. Have strategies for dealing with difficult feelings in ways appropriate for work.
  • Think about how you managed a problem in the past. If an event at work — like a conflict with a co-worker or an unusually stressful workload — is triggering an emotional challenge, consider how you overcame a similar problem in the past. What worked? What didn’t?
  • Write it down. This can be especially helpful if a problem is keeping you awake at night. If you are having an ongoing conflict with a co-worker, you might write: “Every time we talk, even about unimportant things, we end up arguing. Maybe I did something to offend him once but don’t know it. Maybe ask him out for lunch and find out.” This can help you come up with strategies and keep the problem from distracting you.
  • Build your emotional resilience.Pay attention to your physical and mental well-being. Eat well, get enough sleep, and exercise regularly. All of these will help you find the energy you need to meet emotional challenges. This will help to keep you emotionally resilient and to feel more in control of your emotions and your life.
  • Use your vacation time.Taking time off helps to buffer job stress, research has found. A vacation can also allow you to pull back and gain a fresh perspective on work stress and possible ways to ease it.
  • Maintain support systems outside of work.Talking about your concerns with close friends or your partner can reduce your anxiety and help you keep problems in perspective. Choose someone you trust who knows you well enough to give you honest feedback.
  • Cultivate interests outside of work, including activities with good friends. Remember, not all satisfaction comes from work accomplishments.

For support and more ideas on managing stress and other emotions at work, get in touch with LifeWorks—call to speak with a caring, professional consultant anytime, 24/7. LifeWorks is completely confidential and it’s provided to you at no cost. You can also go to www.lifeworks.com to explore our online resources—short videos, podcasts, and a wide range of articles including:

Call LifeWorks at 888-267-8126 or visit www.lifeworks.com (username: theaaa; password: lifeworks)

Acadian’s High School Champions Program Leads the Way

Founded in 1971 in with just eight staff and two vehicles, Acadian Ambulance has grown over the years to more than 4000 employees with a fleet of 400 ground ambulances, helicopters, fixed-wing airplanes, and van and bus transports. Their territory has expanded from Lafayette Parish, Louisiana, to stations spanning large swaths of Louisiana, Texas, and Mississippi.

How does such a large and varied service feed their talent pipeline? In addition to many other strategies, Acadian is leading the industry in its efforts to engage young adults in EMS through its High School Champions program, a division of their National EMS Academy.

Porter Taylor, Acadian's Director of Operations
Porter Taylor, Acadian’s Director of Operations

To learn more about the ins-and-outs of the program, AAA caught up with Porter Taylor, Acadian’s Director of Operations. Taylor has been in EMS for 29 years, since he joined Acadian Ambulance as a college sophomore. “I love making a difference in people’s lives. When I was working on a unit it was the patient, and now, almost 30 years later, it is the employees that I love helping.”

Establishing High School Champions was not a linear path. Initially, Acadian would send medics to career fairs and school functions to introduce the field and promote its National EMS Academy (NEMSA) as an opportunity after graduation. “There are a lot of technical grants out there, and a critical staffing need for EMS in general. We wanted to create an avenue for educating students about the benefits of becoming EMTs to support our staffing needs long term,” said Taylor.

Although these medic visits were effective, Acadian wanted to expand the fledgling program’s scope and reach. He began visiting area high schools and meeting with school boards and directors more than a year ago to build relationships and explore opportunities. The partnerships he built added another facet to the High School Champion initiative wherein Acadian continues to promote NEMSA, coupled with an effort to get the schools to incorporate an EMT program as an elective prior to graduation. “[I wanted] to introduce them to our company and our support of this technical career path. My goal was to let the teachers and technical program directors know that Acadian has jobs for their students upon the successful completion of the program. Once students turn 18, Acadian will be able to offer them a rewarding  position with good pay and benefits and with continuing education opportunities.”

Acadian Operations Manager Justin Cox was instrumental in the implementation at Livonia High School, a recent addition to the program. In concert with his professional know-how, Cox had a personal connection to the school—his thirteen year old daughter attends Livonia.

Collaborating with the administration, Acadian now works with schools like Livonia to introduce EMS career paths at the end of high school, a time when students are making key choices about their futures. Students can start the EMT training program as an elective prior to graduation and take the national certification exam upon turning 18. Students spend 2-3 hours 3 days a week, during their junior and senior years preparing. “It is a joy to work on this program,” said Taylor, “It is a privilege to help young people make a career choice that is full of rewards.”

Does your service have a great program that is making a difference in your area? Let us know in the comments section below, or email ariordan@ambulance.org.

Stay In Touch!

By signing up, you agree to the AAA Privacy Policy & Terms of Use