Original Contribution

When Rosie Met Sheila: Women in EMS Part 6: A Visit Down Under

Tracey Loscar, BA, NRP

02/10/2011

"Don't worry about the world coming to an end today. It is already tomorrow in Australia." --Charles M. Schulz

When the idea of writing a series about Women in EMS was discussed, one of the things I set out to do (and have hopefully succeeded) was to walk the line between complaint and observation. I, along with thousands of other women, entered the field to do the work--usually understanding that we would be the underdogs in a male-dominated field. There's no misperception here, no sense of entitlement, no searching for reparations for grievances real or imagined. Could conditions and situations be better and more supportive for women? Sure. I would never say that isn't the case. George Bernard Shaw said that the reasonable man will adapt himself to the world, and that holds true for reasonable women as well. I am absolutely not saying that we should allow ourselves to be victimized just for the right to do the same job as someone else. I am saying that across the country, for the last few decades, a sisterhood of providers have gritted their teeth and gone back to work shift after shift to build for us a standing in a career that would otherwise not exist.

So who's to say that it's any different anywhere else in the world?

If you know me, you know that I love gadgets and social media. I have found that Facebook (when its powers are used correctly) can be an exceptional tool for networking on both personal and professional levels. It is easily one of the 16 different ways people have to contact me, and for me it is informative and entertaining. It's also one of the ways I get ideas or different perspectives, as the base of my friends list is a cross-section of providers (past and present) from all areas of the world and types of care. This month's piece is a direct result of the power of social media from a small post I have on a dusty group for Women in EMS.

The View from Australia

From a single post to an e-mail exchange, I found a bunch of lovely ladies south of the equator who face the exact same challenges we do, only with another flavor. Here we find Associate Professor Tina Ivanov, an intensive care paramedic and education manager in Melbourne (where it is currently 75 degrees and sunny, while I'm here, looking out over the frozen tundra of my yard where my dogs keep falling through the icy crust into a foot of snow beneath).

Tina recently created and registered the Australasian Council of Women in EMS (ACWEMS), a new organization offering a two-fold role. They not only want to support women in EMS, but want to provide advocacy for improving women's experiences as patients as well. It's ambitious and has been tough going for them, but they believe it's absolutely worth the effort. Tough as nails those Aussies are...

It's down here, on an island so big it's a continent, that Rosie meets her match. For my time in the ghetto, Sheila's got hers in the bush. My "office" has rats and guns; hers has roos and impossible terrain. I deal with a bouquet of hepatitis varieties and the culture of HIV and other delicious pathogens; she has the most toxic species of plants, insects and animals in her backyard. Above all else, she is proof positive that gender is an identifier, not a barrier. Let's talk to "Sheila," shall we?

How were you treated when you first entered the field? Did you ever feel that your gender was focused on?

Tina: I'd grown up being told women can do anything, so when I entered the ambulance I was blown away by the fact a chauvinistic attitude actually existed. On day #1, I was told to my face that the only reason I was there was to meet a government quota. "Good men missed out on this job because of you." So I knew from that moment on I would have to prove my worthiness. I worked in Victoria, where only a few women had been employed, so we were trail-blazers in one sense. One thing we all learned early on was that as long as we could lift ‘the heavy end' and we knew our stuff, we were pretty much accepted as one of the boys. Though having quick wit and thick skin certainly aided survival around the branch.

Interestingly, it was more often the patients who commented on my gender than my colleagues. The number of times I was asked if the boys "let me drive" or I was congratulated for being able to reverse the "big truck" without help from the men was ridiculous. It was a rare occasion when women were crewed together when I started, and I remember one of the few nights working with another female paramedic. The Communications Centre offered to send back-up to the late-night jobs to ensure we were safe. We declined of course. We went to one job where the woman who had called us to help her husband was quite shocked when she saw two women arrive. She immediately called 000 (Aussie version of 9-1-1) and asked the dispatcher to "send the men." She then berated us for attempting to do "man's work" and asked us to explain how the hell we would be able to lift her sick husband. My answer: "Hey hubby, can you walk to the truck?" To which he promptly stood up and made his way straight to my stretcher in the back of my shiny white ambulance. Why lift when you can walk?

Tracey: I think the only comparison I can make to walking into work back then was when I had to walk through a maximum security prison filled with men who hadn't seen "outside" women in a decade or two…sort of a cross between an oddity and an entrée. There weren't a lot of women doing professional EMS. You saw more of them dispatching. It was almost as if we "belonged" in the kitchen, behind the scenes.

Every time I had to ask for help moving a patient or had an issue getting somewhere, it was tough to live down. Twenty years ago, my female partner and I had to call for help on three separate occasions (legitimate lifts I will have you know). To this day, the guys who worked the rescue truck that night still bring it up. It's like they have to remind me that I'm not invincible.

The nursing profession has historically been female dominated. Have you ever been encouraged to leave EMS and enter nursing with your gender as a factor?

Tina: No chance! As much as I highly respect my nursing colleagues and think they do a great job, to be stuck in a hospital with doctors telling me what to do would drive me insane. This is probably where some differences between the north and south become obvious. We have a greater shift of nurses becoming paramedics than the other way around. The conditions in ambulances are slightly better than nursing, but it does depend on what you prefer from your career. The main difference is the autonomy. Paramedics in Australia work from clinical guidelines applied based on clinical judgment. There is no consulting, no radioing in and no doctor on board. We assess, we decide, we treat. Many nurses see the challenge of field work and autonomy in decision-making as a huge carrot to leave the four-walls of hospital.

Tracey: My mother was an emergency room nurse for 30 years, and when I entered the field she was appalled. She never wanted me to become a nurse, but felt it was more appropriate than what I had chosen. I've heard off and on, "Why don't you just become a nurse?" However, I think that today it's a different slant. It's more a matter of increased pay and alternate job opportunities than whether I belong in the field versus the hospital based on my gender. Personally, I don't want to be a nurse --I don't think I'm wired correctly for it.

What is something you know because of your job that isn't found in other places that do EMS?

Tina: Anyone from Oz would have to say we are probably the most well-versed on managing the whole gamut of envenomation. Whether you are on land or in water, the biters, stingers and suckers all have potentially devastating effects on the body. You do bandage a snake bite; you don't bandage a red-back spider bite. As for those box jellyfish, who would've thought vinegar could be such a lifesaver? It's a shame vinegar is only good for one type of animal emergency. It does nothing for Jumping Jacks. The one thing I always get asked is how many shark bites I've had to manage. Happy to say, only one so far, and it wasn't my own.

(Tracey: I had no idea what a "Jumping Jack" was either. Apparently, it's a big, jumping, carnivorous, venomous ant. Go ahead, Google it. I dare you. My neighborhood vermin seem so much nicer now.)

Tracey: During the 90s, I could spot someone who was HIV-positive from the doorway. It has been a unique experience working in our field during the recognition, advancement and treatment of a previously unrecognized disease. I can tell you more about asthma, seizures and street drugs than you'd ever want to know. We've had major gang franchises in place for a long time now; not that we've needed them. The inner city with its host of problems spurred by abject poverty and poor socioeconomic status has been stabbing and shooting each other since long before they put on uniforms to do it. I once got to shortcut a horrible line in Houston customs because I could answer a trivia question about knife wounds for the officer who was reviewing our paperwork. I have a street knowledge of ballistics that puts me quite out of place with the other soccer moms.

When has being a woman been an advantage as a paramedic?

Tina: I'm happy to say it's always an advantage from the way I see it, but I do have one story that cracks me up. We got called to a workplace one morning around 5 for someone who was "generally unwell." When we arrived, one bloke was confused, uncoordinated, diaphoretic and just a little agitated. His mate didn't know much about him so was not sure why he was behaving this way, but said it wasn't like him. The bloke was probably hypoglycemic, but he wouldn't let us assess him or do a BGL. It doesn't happen often, but he took a shine to me, and yep, in his mixed-up world tried to hit on me. So as he tried his best pick-up lines on me, we shared a Bundy and Coke (minus the Bundy of course, despite it being a great Aussie rum) and slowly his skin dried up, his coordination returned, and it turned out I wasn't as pretty as his hypoglycemic mind thought. Considering he wanted to punch on with my partner, it certainly was advantageous being a woman that morning.

Tracey: "If Mama ain't happy...ain't nobody happy." Regardless of any suggestion that women are the weaker sex, or that they are prone to victimization, everyone has a mother. Used correctly, our gender is a powerful tool toward providing not only comprehensive, but compassionate care. I think patients are more apt to trust and go along with women when they're apprehensive, and we certainly have a leg up when it comes to dealing with children. Face it, if you can get a free drink in a bar with a flip of the hair, why can't you learn to use your powers for good and convince some frightened old man to go with you to the hospital, even when he doesn't want to (but desperately needs it)?

What is the most un-womanly thing you've had to do or deal with on the job?

Tina: Other than wearing men's overalls because they didn't make female ones? And in case you didn't realize, there is nowhere to carry your lipstick in those things! I've been so indoctrinated to being one of the boys that it's hard to know what is un-womanly anymore. Certainly having to drag a dead cow off the road so we could actually get to a patient off a motorbike was what I would consider "man's work."

Tracey: I am often the one who is in the wrong place at the wrong time, and that resulted in a long streak of spending way too much time rummaging around in male patients' junk. And I'm not referring to stuff they'd collected over the years. It's more like having to boldly go where it really isn't fair to go, at least not without buying me dinner first. Most of the cases were trauma, shootings and the like--where the source of the bleeding had to be found. Considering the clientele, you retrieve the most interesting objects, from little bags full of assorted goodies to a .22 caliber pistol.

What do you think is the biggest barrier facing women in EMS today?

Tina: For women in Oz it's role-modeling. We have so many young, intelligent women entering the service; about 50% of new recruits are female. Yet, they have few role-models in senior positions to learn from and aspire to. Less than 10% of senior operational positions are held by women. So our young women are not part of the right clubs, they are overlooked for opportunities, and they are not round the right tables to help influence decisions. No wonder they get disgruntled early in their careers and leave. There's no network for them, and they don't have a voice.

The other key issue is even though we are legally required to support pregnant women and parents in the workplace, we do not have family-friendly rosters. If our women decide to start a family, they often feel they must choose between being a paramedic and being a mom. Most wouldn't dare speak up about it, 'cause we all know that the only way to get by as a chick in an ambulance is to fit in, be one of the boys, and boys don't have babies!

Tracey: Well that's a toss-up between "we are the barrier" and "the fire department." For the former it's quite simply that, as a group, we demonstrate the same weak spot found in other facets of EMS--we're independent, and getting us to function with unified purpose is difficult. Plus, we are even more judgmental of other women in the field than others were of us.

When I say the fire department, I mean it on a few levels. As a profession, they demonstrate the type of universal fraternity that EMS (and subsequently women in EMS) should embrace and practice. A result of this is that if they do not like or want something it can be very hard to overcome. It remains the ultimate boy's club. Women have made the fewest strides in the fire service over the last few decades compared to huge in-roads in police or EMS. For multiple reasons, there are an increasing number of areas where the fire service either begins doing EMS or takes over the local department. This trend has the potential to make a future for women in EMS more difficult than it is now. That's all I will say about that for now.

What kind of advice do you have for women entering the field?

Tina: Bring it on! Absolutely know your stuff and be able to do your job. But at the end of the day, be exactly who you are. We bring a new way of doing things and a balance to the boy's club. It's not about fitting in; it's about changing the culture to an even better way of doing business. But do remember one thing--there's no crying in the ambulance.

Tracey: Nobody owes you anything because you're a girl, except maybe a fair shot to prove that you can do the job. So put your big girl panties on and prove it. Learn your craft, learn how to lift, drive safely and stand up for your patients when nobody else will.

"The Job" is universal. Ultimately, it isn't gender, department or hemisphere that matter--so long as you wear those boots (or overalls) proudly and know that you did the work to earn them.

Until next time, this is Rosie & Sheila signing off!

Tracey A. Loscar, NREMT-P, is the training supervisor in charge of QA at University Hospital EMS in Newark, NJ. She is also a featured speaker at the 2011 EMS World Expo, scheduled for August 31-September 2 in Las Vegas, NV. For more information, visit www.emsworldexpo.com. Contact Tracey at taloscar@gmail.com.

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