On a day like today…

So many short years later, Father Judge’s last homily is a reminder and a blessing to all of us on the job. I found it last night once again and wanted to share it, as I often find this homily to be a balm for the various wounds life and this job can visit on us. I hope you find his words to be as well. The emphasis in color is mine.

“Good morning, everyone.

May the grace of God the Father, peace of God the Son, and the fellowship of the Holy Spirit be with you all.

We come to this house this morning to celebrate renewal, rejuvenation, new life.  We come to thank God for the blessings over all the years – the good work that’s been done here and especially the last few days.  We can never thank God enough for the reality of the lives we have.  So, standing in His presence this morning, and truly this is a chapel, let us pause for a moment, perhaps close our eyes, and thank God for some special blessings in our individual lives.

Let us pray.

Thank you Lord for life.  Thank you for love.  Thank you for goodness.  Thank you for work.  Thank you for family.  Thank you for friends.  Thank you for every gift because we know that every gift comes from you, and without you, we have and are nothing.  So, as we celebrate this day in thanksgiving to you, keep our hearts and minds open. Let us enjoy each other’s company, and most of all, let us be conscious of Your presence in our lives and in a special way in the lives of all those who have gone before us.  And Father we make our prayer, as always, in Jesus’ name who lives with You forever and ever.

That’s the way it is.  Good days.  And bad days.  Up days.  Down days.  Sad days.  Happy days.  But never a boring day on this job.  You do what God has called you to do.  You show up.  You put one foot in front of another.  You get on the rig and you go out and you do the job – which is a mystery.  And a surprise.  You have no idea when you get on that rig.  No matter how big the call.  No matter how small.  You have no idea what God is calling you to.  But he needs you.  He needs me.  He needs all of us.  

The retirees – He needs your prayers.  He needs your stopping by occasionally to give strength and support and to tell the stories of the old days.  We need the house and to those of you that are working now, keep going.  Keep supporting each other.  Be kind to each other.  Love each other.  Work together and do what you did the other night and the weeks and the months and the years before and from this house, God’s blessings go forth in this community.  It’s fantastic!

What great people.  We love the job.  We all do.  What a blessing that is.  A difficult, difficult job and God calls you to it.  And then He gives you a love for it so that a difficult job will be well done.  Isn’t He a wonderful God?  Isn’t He good to you?  To each one of you?  And to me!  Turn to Him each day.  Put your faith and your trust and your hope and your life in His hands, and He’ll take care of you and you’ll have a good life.

And this house will be a great, great blessing to this neighborhood and to this city.

Amen.”

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Fr. Michael Judge

Chaplan FDNY

EOW 09/11/01

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National EMS Memorial Events 2017

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The National EMS Memorial Foundation is a non-profit organization to honor the commitment, service, and sacrifice of our nation’s EMS providers that have died in the line of duty and those who continue to serve. The foundation also endeavors to establish a physical national memorial in our Nation’s capital or surrounding area, similar to those already established for police and fire. In addition to this mission, NEMSMF holds several events to honor our brothers and sisters who have made the ultimate sacrifice, and died in the line of duty.

Saturday, May 13, 2017 10:00 to 11:00

National EMS Memorial Bike Ride East Coast Send Off – Boston City Hall, Boston, MA

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In conjunction with the National EMS Memorial Bike Ride held by the Muddy Angels, NEMSMF will participate in the send off ceremony for the East Coast route of the National EMS Memorial Bike Ride. The events will include the first Reading of the Names for 2017.

There should be other events on the route- check the schedule if you are local to the route.

Friday, May 19, 2017 to Sunday, May 21, 2017

National EMS Memorial Service Weekend of Honor – Washington, DC

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The Weekend of Honor is comprised of multiple events to honor the EMS providers that have given the ultimate sacrifice and to provide support their loved ones, EMS providers, family and friends are welcome.  Some of the events include: Welcoming the EMS Memorial Bike Riders to DC, Dealing with Our Loss for survivors, National EMS Memorial Service, and Family Breakfast. If you are unable to make it to the event, there is a link to a live streaming of the memorial service at the link above.

Sunday, May, 21, 2017 13:00

14th Annual EMS Day at Citi Field with the Mets – Queens, NY

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An afternoon of fun with the NY Mets as they take on the Los Angeles Angels. Special pricing and packages for EMS providers available. Proceeds from this event benefit EMT Yadira Arroyo’s family and NEMSMF.

Please share with your brothers and sisters. In the next few weeks I will be posting more information on NCEMSF and federal legislation related to the building of a physical EMS memorial in the Nation’s capital.

What goes through a medic’s mind?

Ginger Locke is infatuated with the minds of medics.

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She is a paramedic educator, researcher, author, blogger, and social media maven (please see awesome memes below). She has recently transformed her written word blog into a multimedia paradise featuring her new podcast, Medic Mindset, where she interviews medics delving into what makes them tick. She was inspired by her medic students questions as they became newly minted medics and wanted to help others know what to expect from their profession by interviewing working medics that share their honest perceptions and experiences. Clinical, operational, and personal topics are all present. Click above to access her blog and listen for yourself.

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The most recent episode features Fiona Thomas from The Code Green Campaign. The Code Green Campaign provides awareness of EMS provider mental health and suicide via shared stories, collects anonymous reports to track EMS suicides (in concert with Firefighter Behavioral Health Alliance), and provides education for the EMS community. Their site also has a section with mental health providers and programs that specialize in treating first responders.

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Fiona shares the origins of Code Green, personal inspirations, and her ever changing career evolution. She also shares her clinical experiences as a paramedic, what challenges her clinically, and how she personally deals with stress and mitigating the effects of work. She also has some interesting non-EMS related jobs.

She discusses the cathartic effect journaling produces for her and it’s role in helping her release stress. Fiona pulls from her non-EMS life experience, sharing that “words matter,” not just the written word, but the actions our verbiage denotes and images they inspire and communicate.

Fiona gives some sage advice to her younger self (and the rest of us) to “just stick it out.” As EMS providers, and perhaps my personal experiences, we tend to give up when things get hard (professional or personal).

She continues by advising us to “listen to your patient.” We all know patients will tell you when they are going to die, vomit, or have a baby. But, what about the patients who aren’t in the throes of an emergency- listen to their stories or what they are telling you they need, even if it’s not in your clinical arsenal

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I’m not going to spoil the ENTIRE episode for you – you’ll have to listen yourself!

If you aspire to be a student of the profession and stay abreast of current topics in EMS, make it your business to follow Ginger and Medic Mindset.

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Social Suicide

This blog post is a part of  the second “What If We’re Wrong Blog-a-thon.” You can find the other posts here. The premise of this event is to play the devil’s advocate and argue the opposite view on a topic we normally cover.

In my lecture, “Selfie Sabotage” I discuss how to use social media to your advantage as a tool to promote your EMS career and increase your professional prospects. My personal experience using social media as an EMS provider has been a positive one; I have been able to advance my exposure in the industry over the past three years promoting my writing and making key connections with other EMS leaders using social media applications. Most others with an eye on improving their career prospects and the inclination or appropriate training have minimal issues with using these applications professionally or difficulty keeping their personal life out of their professional one… but we all know at least one story about a professional meltdown with social media as the weapon of choice.

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Social media use is not a right. Unfortunately, most use it with abandon and no method of policing themselves or ability to pause before posting something controversial. There are reasons agencies place restrictions on their employees use of these applications; yes, you may “say” what you like, but there are always repercussions in real and virtual life.

 

  • “It’s on the internet, so it must be true.” I am a fan of curation in addition to producing content, however many social media users do not check the sources behind information, whether articles or photographs, that they share with their followers. The next people don’t check their sources and share and so on until a lie becomes the “truth.” Obviously, there are entertainment spoof sites like The Onion and Gomerblog, which most understand are tongue in cheek and not real news. Outside that, what do you look like to other providers and prospective employers when you share inaccurate information on a clinical level? What if you take a “clinical” article as gospel and it’s wrong? Could that be detrimental to patients in your care? It’s up to the reader to vet their sources and sadly most don’t.

 

  • Misrepresentation is rampant on the internet – and not just for online dating. It’s easy to slip past embellishment in a virtual environment; the virtual nature implies privacy and anonymity, but could not be further from the truth. I have been a witness to many conversations in chat groups or comment threads where one provider knows another and calls them to the carpet on the fib related to their stated experience or certification. I have also witnessed others researching a provider purporting to be someone their not and revealing the true status or level of their certification or employment. Not exactly the best way to be noticed.

 

  • It’s much easier to put your foot in your mouth with the insulation of the internet. That ranges from outlandish tweets to insensitive memes to inadvertent missteps. The results are wide ranging: insulting patients, offending your coworkers or peers, breaking agency protocols leading to your dismissal (and possible blackballing from emergency services), to causing safety concerns for yourself, your partners, and other emergency agencies in your area.

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Many EMS providers, and people at large, place too much faith in the content they find online. Just yesterday a friend posted an article that was an absolute lie, many people knew it was inaccurate and informed him; others commented and took it blindly as the truth. Posting on any social media site requires the same mindset as face to face interaction. If you are not willing to invest the time to pause before you post when you are unsure or ranting then you should limit your social media use. These missteps makes EMS look foolish as a whole.  If you don’t have anything nice to say – just don’t say anything at all.

Like No One is Watching

Sometimes you don’t even notice the people watching.

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I mean, we’re all busy right? So many tasks to complete in a certain number of hours and only a certain number of hours in a day, can leave everything in a little bit of a blur. Constant working and feeling like you never get anywhere can leave you really frustrated and focused on all the bad things going on; even like your work was worth it.

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I recently left an agency where I had a leadership role. The past year or so, I felt stagnant and voiceless; a few months ago, I decided as soon as I finished my agreed upon term, I was going to resign. I felt it was better not to “waste” any more of my time. So, for the last few weeks I have been prepping my replacements, giving them information, who to ask for what, how to avoid regular road bumps of people’s personalities. Yesterday, I turned over my keys to my replacement and punched out for the last time. Just before I did, something unexpected happened.

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People came up to me one at a time in the last few hours and said: Thank you. Thank you for doing a good job, working hard, helping out. Finally, my partner came up, I could see on his face he was about to say something mushy. He went on to wish me good luck and that we’d probably see each other at the hospitals and then…

“…thank you for teaching me.”

Wow. Just wow. I am so humbled on so many levels; mostly that someone thinks anything I had to say helped them become a better healer, to use their hands, head, and heart to take care of others. This whole time I didn’t think anyone was watching, using the work I was putting in. I thought maybe the whole thing was a waste of time.

It was me looking in the wrong place.

I was looking for acknowledgment from those who would never be moved. I was so zeroed in on their obstinance that I couldn’t see the people who did matter: the people I was leading and teaching by example.

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Some days I am so mad with EMS and all our shenanigans and tantrums and prima donna antics that I could just spit. I wonder if anything will ever change with just the minority of forward thinkers ready to depart from the ideas of yesteryear. But then, every so often, you find out someone WAS watching. What will you be teaching them?

It seems appropriate at this time to say thank you to all the people I watched when I was a new guy and watch today to learn how to be a better provider, leader, and human being. Every day I realize there are even more than I thought, when I remember an appropriate story or anecdote related to a present situation. Yes, that even includes folks I don’t care for very much because they left a sour taste in my mouth. I thank all of you, thank you for letting me watch and learn, thank you for sharing that part of yourself.

EMS Compass: The Missing Link in EMS

Hardly a week goes by without hearing about providers feeling left out in the planning of the futures of their agencies and the future of EMS in general. It’s true, some providers will never be happy, that is the nature of humans at large and it is present in any profession. Yet, not everyone is jaded, and many do have a point of not having had a voice in the coming change and development of EMS as we grow up. That is, until now.

The EMS Compass initiative is being led by The National Association of EMS Officials (NASEMSO) and financed by The National Highway Traffic Safety Administration (NHTSA) to develop EMS performance measures over the next few years. Part of their plan is to invite all stakeholders (providers, managers, agencies, government) to participate via direct suggestion during the Call for Measures this month, informational and public meetings, and transparent communication via direct access to key players.

Leaders don't necessarily need a title.
Leaders don’t necessarily need a title.

What is a performance measure?

Performance measures are common in other industries and have been used in medical practice, but not traditionally in EMS. Performance measures enable providers, management, and government agencies to track and improve performance to benefit patients and communities. Some of these measures will be clinical in nature, but operations, safety, and business/ financial aspects are also included as all of these are needed for well rounded agencies and further development of a well rounded industry.

Performance measures don’t have to be complex or convoluted. In actuality they are quite succinct. For example it is widely accepted that patients with cardiac chest pain should take an aspirin. The performance measure for that event would read: All patients who have chest pain of a cardiac nature should receive aspirin. This would then be documented via charting we already complete and reviewed later for quantification. Many things we already do such as standards for STEMI, TXA for Stroke patients, or even trauma protocols were founded in related medical professions performance measures.

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Why bother?

-We will be contributing to the development of these standards for our profession, who better to do so? Historically, government at large has not been the best at recognizing what we do and our level of importance (please see “Ambulance Extenders”)

-We already contribute data via NEMSIS for data collection in the EMS industry, this process contributes to data collection and provides information for where we currently stand so we can continue to improve and move forward

-The measures are evidence based. We are Emergency MEDICAL Services and should be practicing medicine in the way that other medical professions do, with evidence not today’s whimsical idea on how to get “cool toys”.

-Provides means of measuring long term performance in our industry so when the next generation of providers arrive, they can build on the foundation we have laid.

-Currently, if your agency bills, you are paid for service whether the patient is treated well clinically and will have an improved outcome or pleased with how they were treated, Medicare will pay for the transport. In the future, in conjunction with The Affordable Care Act (ACA or Obamacare) we will be paid for the outcome: clinically accurate care, patient satisfaction, etc. Hospitals have been preparing for this for the past few years, we should not be naive to think the government will not try to limit our payments.

-Medicare is encouraging other insurance companies to follow suit on requiring a higher standard of care for payment for EMS services.

-Can lead to better provider compensation, improved provider safety and health, and better recognition of the job we do and love.

Obviously, the above is a very simplified over view of what EMS Compass is and will achieve. I have included links below for your information. There is a great webinar you can access on demand that explains how the process works and the history of data collection in EMS. I also included links to the Call for Measures that is live until the end of May, so get your measures in. I also included links to some other blogs and podcasts that have been talking about EMS Compass recently.

Until a standard is set industry wide, EMS as an profession will flounder. EMS needs to define acceptable standards of care on an industry wide level, the lowest common denominator can no longer be our standard if we are to grow into the industry we desire. Much of what is described above are things we already do, we are just organizing and tracking it now. We must to take ownership of our profession before someone else, who has no idea what we really do, tells us how to do it. You can be a part of the future of EMS on a larger level than you ever imagined by contributing to the call for measures by May 31, 2015.

The EMS Compass Site (you can access the Call for Measures and informational webinar here)

The EMS Garage – The EMS Compass

Inside EMS Podcast – How the EMS Compass Initiative will create industry standards

Medic SBK- EMS In The New Decade – The EMS Compass

A Day in the Life of EMS

Ah, EMS Week, full of granola bars, bat-belt chachkis, and music videos.

No, not a typo, my EMS Week 2014 included the great opportunity to be involved in Lt. Farooq Muhammad’s latest and much awaited EMS rap video: A Day in the Life of EMS!

Everyone involved in the making of this video embodied the true spirit of EMS. Even though some of us (patients) were not a part of their agency, we were welcomed and we all worked together to get the job done. Farooq’s videos resonate with EMS responders because under all the lights, sirens, and cool uniforms, the real qualities of EMS: teamwork, professionalism, and family, are illuminated. I was reminded of why this job is the best in the world while watching some of the other scenes being filmed. I became inspired to continue to learn and become a better provider in spite of the daily struggles with EMS nonsense that weigh most of us down.

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FDNY EMS Lt. Farooq Muhammad is one of the EMS 10 Innovator Awardees for 2013 for his work on videos promoting high quality EMS. You can see his other videos on his YouTube channel.

Dedicated For Life

“Not everyone wants a medal for their uniform, but everybody likes to hear ‘Thank You’.”

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Once again it is EMS Week – a week to recognize EMS providers, get free food, and maybe educate the public about EMS and what we do. I recently had the opportunity to be part of a podcast about EMS Week hosted by Medic SBK. One of the questions he posed in the interview was, “What part of EMS Week is something we should be doing ALL year?” There were many great ideas that came up in our conversation that I was going to highlight here, but this morning when I was thinking about this blog post, I saw the photo below.

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We, as providers, don’t appreciate each other ALL year. We pick at each other, catch attitude, stab each other in the back at the drop of a hat, but hardly anyone says, “Hey man, you’ve been doing great job. Thank you for giving your all.” How can we expect other healthcare professionals, our bosses, and the general public to appreciate what we do, when we don’t expect it of ourselves?

Being dedicated for life is more than a tag line for a campaign. The things we see and experience take residence within us and resonate far beyond retirement. Most of us are so busy keeping on our game face on and pushing down anything that looks like emotion, that we can’t begin to recognize the lack of general wellness in EMS as a whole. Sometimes, I wonder if we forget that we are human.

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I challenge you all to say “Thank you” at least once a week to a fellow EMS provider. Really appreciate them and let them know you mean it. If you need to write a note because you get tongue-tied or shy then do it! Let them know you are thankful for ALL their sacrifice: the holidays, the birthday parties, the vacations, the lost sleep, the cold food, the fights with family, and even their mental sacrifice.

I want to thank you all for your service and every sacrifice, no matter how small, to care for other people, most of which are strangers. You truly give your ALL, every part of you, and I am grateful that there are strong men and women out there to help us when we fall ill or are injured. Not everyone can do this job. You are a rare breed, and are to be treasured. I am honored to get to work with you and be a part of your life.

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What Are You “Saying”

While getting my nails done a few weeks ago my manicurist had CNN on the television, Donald Rumsfeld was talking about the United States response to one of the many violent events occurring in the world today. It struck me how eloquent this man was under pressure. I wondered how could this translate into my own deportment and why don’t EMS providers sound like this?

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Merriam Webster’s dictionary defines eloquence as: discourse marked by force and persuasiveness; the art or power of using such discourse, or the quality of forceful or persuasive expressiveness. These are all requisite to be even moderately successful health care providers and advocates for our patients. How can we convince a truly sick patient that they NEED to be in the hospital to curtail serious or deadly consequences if we don’t have the method to communicate this to them? How do we demonstrate our professionalism and passion to other related professions, healthcare providers, and politicians that also play a hand in advancing or restraining the future of EMS if we are not able to communicate well? Presentation is as important in EMS as it is in the business or entertainment setting. Good presentation is not just about tucking your shirt in and wearing new boots if you open your mouth ruin the illusion.

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It’s not as difficult as it seems to “sound smart.” There are a few ways we can all start to improve our vocabulary.

  1. Stop using profanity. Cursing does not illustrate your point, shock, make you seem important, or benefit you in any way. It really just agitates people and that doesn’t really work positively most times.
  2. Be aware of your tone and volume. How you speak may be more important than what you are actually saying. I used to work in an area with an excellent provider, but the care he gave was often missed by everyone on scene because his tone was harsh and the volume of his voice was much too loud. Many patients were disturbed and several asked for him to “stop yelling at me.” It doesn’t matter if you are the best provider in the department if your care is marred by your tongue.
  3. Use appropriate (and correct) terminology. If you want to be treated like a medical professional, you should sound like one. Honestly, you should also write your documentation like one. If you don’t remember medical terms from your days of EMT school, bust out your book and study or take a course on medical terminology. This small investment of time and money will go a long way in increasing your stature with other medical providers.
  4. Think before you speak. Many times our vocabulary faux pas is not related to the words we misuse, but because we don’t police our tongues and end up offending people. This can lead to more than disciplinary action, inciting violence on scene and placing you and your partner in danger.
  5. Listen to understand, not to respond. When you are speaking with patients or their families listen to what they have to say so you can understand what the true problem is, not just your perception. Then you can respond appropriately and sound professional. Sometimes people speak to us because we are the only ones they trust to listen without passing judgment. We in turn are often entrusted with their life experiences and they end up imparting a gift to us.
  6. Read. Reading might seem incongruous with improving your speaking abilities yet how do you learn new words and ideas without reading? Read things you wouldn’t normally read. Read from all topics, not just related to EMS although you should try to keep up with current events within our field.
  7. Look the part. I attended a seminar at a prestigious university where a speaking coach was discussing how to have your message heard. The very first thing she talked about was visual presentation. People make their decision about whether or not you are worth listening to within milliseconds. That may not seem “fair”, but it is what we have to work with when attempting to deliver our message and treat our patients.

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The list above is not exhaustive, but it’s a good place to start. It won’t be easy, but changing your vocabulary and way of speaking is possible with mindfulness and persistence. Don’t give up if it feels like the change is long in coming, it takes 3 weeks to make a habit. Changing how you speak won’t only improve your professional life, but can transform your entire life for the better.

EMS Day on the Hill 2014

1972281_10152289199047290_1229167034_nLast week I had the awesome experience of attending the 5th Annual EMS Day on the Hill sponsored by the National Association of Emergency Medical Technicians in Washington D.C. EMS Day on the Hill is an opportunity to educate our representatives at the federal level of government about EMS and the challenges we face on a daily basis as providers and managers. 190 EMS providers from various services and of all different certification levels attended and completed 242 meetings with federal legislators or their staff this year.

Before you get excited or think, “I don’t know anything about politics.” The NAEMT people have taken care of all of that. About a week before the event, they sent me an email with a basic schedule and information on the bills that are currently in progress. The evening before we went to Capitol Hill, they held a briefing reviewing information on the current bills, the atmosphere in Washington, and other recent events that might affect conversations the next day during our meetings. Along with our delegation meeting schedules, NAEMT provided us with briefing sheets on the bills at hand and any other pertinent information like phone numbers to people at the event if we needed help and a map to get around Capitol Hill. They also made packets for us to leave with representatives or their staff for their review after our scheduled meetings. We were seated by state delegations and after the briefing there was a networking event so we could get to know the other members of our delegations and discuss our plans for the next day. Everyone was friendly and happy to answer any questions.

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Group Photo of 2014 Attendees

The next morning, my delegation met in the hotel lobby and migrated to our first meeting. Our delegation was a mix of veterans and novices to lobbying. Those that had participated before lead the way at the first few meetings until the rest of us were comfortable to take part as well. The staff that we met with were all attentive and interested in what we had to present. One staffer even let us know that she learned something new from us about EMS and how we provide service and the challenges we face in doing so. Many were aware of the changing climate of EMS and how the Affordable Care Act might affect us in the future. The bills NAEMT presented during these meetings were: The Field EMS Bill and Medical Preparedness Allowable Use Act. We also promoted The EMS Caucus.

While going to Capitol Hill and participating in our nation’s government and being able to walk through the halls of history that make our country great was exciting, meeting fellow providers that believe and continue to work toward the future of our profession was even more amazing. My hope for the future of EMS was renewed via these conversations and I gained new insights into possible solutions for recurring issues that affect our profession. There is momentum and direction at the top, the rest of EMS needs to unite and place the power of our voices and votes behind this movement if we are ever going to progress and become a true profession.

I learned many things in the few days I spent in Washington, chief among them that I still have much more to learn. EMS providers need to put aside certifications, department affiliations, and petty differences if we are going to advance as a whole profession. Others see our division and don’t take us seriously because of it. Lobbying for EMS is not just one day a year. Speak to and educate your local and state officials about what we do and what our needs are, the squeaky wheel gets the grease. If you have the opportunity to attend EMS Day on the Hill next year or at any time in the future, jump on it! You will be glad you did!