Something I had tucked away that I dust off from time to time, how some of you may feel sometimes.
Dear Manager (or Chief)-
I have been in emergency services a long time, beginning many years ago as a volunteer firefighter, culminating as a full time career firefighter and paramedic. Throughout my career, I have seen different services with different problems. Usually, all of those problem result from having to put people into a system. It is a proven fact that any time you introduce people into a system, there will inevitably be problems.
I spent 4 long years walking college halls learning the skills necessary to be a professional engineer, which gives me an interesting look at how systems integrate and operate. You could say that I see every patient as a complex network of interlocking systems that require specific conditions to operate. I also see how our system operates, and despite my best efforts and the efforts of many others to introduce effective and more efficient processes and procedures to that system to make it both user friendly and operator friendly, we have been rebuffed at every turn by those that see the thinking man as a hindrance to their desired plan, and their egos.
I have offered many suggestions from myself and others that would fix our in-service education and training programs, but because the desire of a certain few to keep their little fiefdoms in order to secure their future of never returning to field work again, they have gone unheeded. Somehow, what I suggested years ago is now a suddenly needed idea. Those that desire to hold on to their power, choose to ignore the problem and shovel the responsibility upon field providers to get the necessary training and education on their off days, which defeats the purpose of “in-service training” doesn’t it?
We’ve recently had logistical issues on items that require strict control, and the knee-jerk response has been to implement yet another step in the daily examination of those items, and change the forms that crews use, and change the packaging of those to “tamper resistant.” I hate to say it, but anyone looking to steal those items could easily defeat the new system, just as easily as the new system. You will never eliminate the problem, and the future of the present system is such that those controlled items will end up in the hands of far off supervisors that will never make the scene in time to utilize them and deny patients those necessary items. What has transpired to fix the system will ultimately hurt patient care. I made a clinical decision based on how difficult it was to utilize those items just the other day, when it may have made a difference, the risk of being accused of something and subject to investigation because I did the right things is not a worthwhile risk. Once again in this case as well, solutions were suggested in the proper form to the proper people and those ideas went unheeded because of the egos of a few or keeping it simple was too simple, even though it accomplished all the tasks and met the necessary requirements.
Everything that has been suggested as fixes has been sent to a committee, and I have learned that the value of “committees” in this organization is where good ideas go to die. Most of these “ideas” though aren’t new ideas, more than likely they are the solutions found by other organizations that worked. The idea that we need to “field test” all new equipment is purely ridiculous, and often the equipment that is field tested is too expensive, heavy, fragile, or cumbersome to actually use. This leads to a considerable strain on personnel when we are constantly trying new things that will never be implemented just to once again satisfy someone’s desire to pad the stats or the resumes.
I read in a book of essays on leadership by Christopher Kolanda that such an organization that doesn’t value to reward or elevate it’s best examples and brightest minds to serve as an example to others, will find that those people will leave as soon as the opportunity presents itself. I find myself, a hold out to the idea that eventually things will improve, looking down the long line of things to come and deciding that perhaps I need to leave as well.