Practical EMS

Mindsets to avoid burnout – Julie humanizes the patient and understands that whatever difficult things we are dealing with are temporary and have gratitude

We must constantly recognize possible anchor bias and avoid cynicism to appropriately treat our patients

We talk about our interactions with EMS

Both Julie and I remember working in EMS and the value that EMS brings in their report because they often see a lot of things we don’t ge...

Started out her medical career as an EKG tech and in EMS as an EMT for one of the first ambulance companies in the area

She saw the disconnect between the provider that people wanted to become and who they became, and she didn’t want that to be true for herself

She became an attending in 1991 and now has close to 40 years in emergency medicine

She became a physician when it was predominantly a male field

Julie talks about some of the t...

Brian talks about his experience being on the “other side” of the bedside with his wife’s cancer treatment

He really appreciated the extra time that the doctors spent with him and his wife to explain things – repetition is very helpful for your patients to really hear you

Brian talks about balancing fatherhood and being a husband with our emergency medicine schedules and the challenges of being in a physician couple 

You have to figur...

We talk about setting the right mindset, culture and tone as a leader of the department and especially in smaller facilities

You don’t have to be perfect, but you can avoid the little negative comments and criticisms

Being a good example goes a long way

As a Christian we are supposed to act like Christ would

We have a lot of metrics we have to worry about as clinicians but, as Christians, we need to worry about the metric of mercy

Under...

Has been an attending physician since 2019

Brian volunteered when he was a teenager in the ER and the staff that got him involved really drew him toward emergency medicine in med school

Brian worked in the ED as an EMT as well

He talks about early mentors and the impact they have, including helping him get loans for medical school

We need to remember to be like that mentor that encouraged us when we were new and pay it forward to the n...

Advice for the new EMT, paramedic, nurse, physician who is also a believer

Build your faith in the easier times so your faith doesn’t shake when times are hard

You have more reason than anyone on the planet who doesn’t believe to strive to do this job better every day, you are held to a higher standard

Adam still finds joy in emergency medicine, doing hard things, interacting with many different humans, seeking an answer, the intellec...

Faith and burnout

Adam talks about how he tends to spend his spare time reading the Bible, going to church, spending time in prayer and how this develops character and is better than pursuing time wasting activities or the easy dopamine dump that does not add to sustainability or self-improvement

We are designed to do hard things – mental or physical – including pursuing Jesus – this builds stamina, character and makes you better in ...

Former paramedic and has been an ER physician for 7-8 years

He pursued emergency medicine after his experience as a paramedic because he feels it is more in line with his personality 

We talk about how emergency medicine checks a lot of exciting boxes that we enjoy

Adam talks about his burnout symptoms as well as how he course-corrects

He talks about symptoms like lacking as much compassion/empathy as he should have. So he corrects by ...

Give the escalating patients some room, you don’t have to be within arm’s reach

I talk about what a bad code blue looks like and what a good code blue looks like and how this translates to running a good code grey

Assign roles, we don’t have to surround every aggressive patient with a ton of people

Don’t join in the fight or flight mindset that the patient may be operating in

We talk about who should be lead in these situations and how...

Josh has 20 years in Public Safety

Currently doing crisis prevention instruction

We often don’t get any education in med school or PA school in how to communicate well with patients or how to de-escalate their behavior

Code greys are the behavior health emergency response; someone has some concern that a patient is escalating to potentially violent behavior and a team will respond

Staff safety is priority

We are there to provide excelle...

Lucas gives his pitch for why it is still worth it to be a physician - it’s one of the best jobs in the world but you have to have the ability to adapt to change over time

Being a physician still allows you a rewarding, stable and consistent job. A comfortable lifestyle. Job portability

As a PA, this can be even better because you can switch between specialties

Our variable schedule in the ED has its cons but it has a lot of pros as w...

Longevity in a tough field is something you need to consider as well as the right mindsets that keep you there – be intentional about being grateful

Lucas gives some advice in doing triage shifts and focusing on the good people you have the privilege to interact with and trying to be intentional about not focusing on the mean, angry patient

Intentionality behind the things that improve your well-being are more important to prioritize...

ER physician for 15 years

He talks about this path into med school and emergency medicine as his first choice

He likes the challenge, lack of predictability and wide scope of problems we must solve. We have the honor to accept patients when no one else will

Lucas talks about how the term emergency medicine is almost becoming antiquated when we are doing acute, undifferentiated care

Some of the care is emergencies, but not all. And that...

Leave work on time
•David’s story: a skilled, compassionate paramedic who deeply connected with patients, especially during psychiatric crises.
oStruggled to separate work from life.
oRelied on alcohol as a coping mechanism, which ultimately cost him his life.
•Core lesson: In emergency medicine, you must leave work at work—emotionally and physically—otherwise burnout and unhealthy coping are inevitable.
•Health...

Introduction

• My first experience with a cardiac arrest as a new EMT → exhilarating, confirmed calling to emergency medicine.
• Early struggles: dropped out of college, lacked discipline, but EMT training provided a direction and purpose.
• Spent years balancing work as EMT/paramedic with school → long path to becoming a PA.
• Lessons from emergency medicine shaped clinical skills and mindset.
• Concept of standards:
  • Standards = benchmark...

Advice for new EKG techs:

Trust your knowledge and build your confidence over time, stay calm and take deep breaths when you start to get busy

Stay humble, ask for help

No one comes out of school knowing everything, you need to know your limits

Regardless of your role, don’t be afraid to advocate for the patient

Providers need to remember to project an approachable demeaner so that everyone has a level of comfort bringing things to thei...

We talk about stat vs routine EKG orders as well as metrics that they are always working to hit on time

When EKG’s are not done on time the source of the problem needs to be found, sometimes it is the providers’ fault for not realizing the EKG order had not been placed 

We talk about how we should communicate between provider and EKG tech and how much info we like to get as providers

I talk about how providers need to become good at t...

Welcome to the show Sean and Cheyenne, EKG tech experience and scribe experience

Sean talks about certifications and expectations that go beyond merely obtaining an EKG as well as the stress testing role

Cheyenne talks about the role that scribes play in the ED

Scribing for providers is often used as a role to gain patient experience for medical school or PA school

They talk about how they got into scribing and EKG technician work and ...

I’d like to welcome to the show Dr. David M. Berry, MD, he is a growing voice in the recovery and addiction space, an area that we deal with a ton across EMS and the emergency departments. He is an Emergency Medicine physician with over two decades of experience.

 You can reach him at dberrymd@hotmail.com

Burnout and moral injury – how do we avoid these in dealing with the addicted and psychiatric patients? We can’t control most fac...