Your Image IS Your Signature

For the past few weeks there has been an image circulating around social media. 

I am not going to clip it and show it again here because it has already had far too much exposure via Facebook alone. If you are in EMS you may already have a minds eye picture of it in your head just from what I have written so far. It is the back view of an EMS professional from about shoulders down, uniform shirt in disarray and not tucked. The boots are untied and the fabric of the uniform slacks is bunched up around the open boot tops. The individual is facing the front fender of an ambulance. 

Obviously there have been many comments posted with many different opinions. It is also true that we do not know the context behind the picture. Maybe it was before shift start. Maybe it was after a messy call. Maybe it was even while washing the ambulance in the picture. I won't debate that there may be some kind of reason for the uniform condition that we are unaware of in the moment that the image was snapped.

What bothers me really is not the image itself.

What bothers me is the comments.

Someone points out that the uniform condition does not instill confidence. Another immediately points out that the uniform condition is not and indicator of their ability to deliver care. Yet another is offended, saying that the state of the uniform does not decrease their medical skill performance.

And the war was on.

Hundreds and hundreds of argumentative comments. More of them trying to justify the state of the subjects uniform with some type of social media warrior response that would lead you to believe that they were defending an individual sentenced to the death penalty for having a sloppy uniform.

This is where I get worried really quick. Let's assume the subject is mid-shift. Why can we assume that? We have all seen it. Heck, I've even done it in the past. I used to think my comfort was more important to the delivery of my care than my appearance (I should say here that comfort seems to be of extreme importance up to the point where someone wants to add ten tons of tactical gear to the uniform... then comfort suddenly disappears as a necessity). So what changed in me to make me change my mind?

I grew up.

One of my up line managers from "back in the day" was fond of saying, "perception is a person's reality." I have found that to be very true. If you find that statement too general... just refer back to any social media diatribe. Look at an argument on gun violence, how to impact the opioid crisis, what to do about social security or any other social issue. People do not change their minds easily. 

People also thrive off first impressions. 

Look at any story told. It starts with the first impression of the third person viewpoint. Perception, defined as reality, sets the stage for the entire environment of an occurrence.

What does this have to do with the sloppy uniform?

The reality that your patients (and your patient's families, law enforcement, fire personnel and ER physicians) form of you happens in the first ten seconds as you get out of the ambulance or walk into THEIR environment. Why did  I capitalize the possessive in the last sentence? Their world does not belong to us. We do not get to define what they think of us. What starts out wrong stays wrong. Is that not a primary EMS mantra?

Your image is YOUR signature.

We are quick to point out the dirty clothes of the homeless or serial inebriate, or the condition of a home we enter. We discuss scents and unsanitary conditions. But it's perfectly alright to have a sloppy uniform because... we work hard... we see bad stuff... we sweat through the summer and try to stay warm in the winter... we are too tired to spend one more minute on our uniform than it takes to pull it out of a pile of laundry. The uniform may simply have become another task in your mind that can be discarded... As the military folks say... learn to "embrace the suck."

The boots lose their shine (and yes, I meant that to sound like more than just the shine on the actual boots).

Maybe in the real EMS world you are capable of putting a sixteen gauge catheter in an external jugular vein efficiently , and when clinically warranted. Maybe your critical thinking and cognitive knowledge are at the peak of current practice. 

But you failed to paint the picture. Look in the mirror. If you

fail to instill confidence, you may end up not getting the chance to do those skills. Maybe your lack of concern about your appearance generates questions about your abilities and knowledge. Maybe the words of your lips are right and just but they will not be heard because the leather worn off the tips of your boots tells a different story of what you may or may not be capable of. Sloppy is not visually attractive or conducive to instilling confidence in others.

I am not perfect. I have been there. There are things I cannot do today, but I can always learn.

Do you want to succeed? Be good at what you do. That is a "given" so to speak. Then learn how to make it visual and audible.

Learn and practice laundry skills.
Get the wrinkles out of your shirt. An iron is not hard to use and the process can be relaxing.
Find a veteran and learn how to polish and protect your boots.
Exchange comfort for appearance.
Grooming is not an option (kudos to Justin Spath for using that phrase a lot).
Keep your rig and equipment clean. Sloppy here is dangerous. 
Tame your tongue. If you are argumentative in healthcare, you will not survive. Keep doing it and see where it gets you. Learn civil discourse and practice it. Just because someone else is rude does not give you license to retort. Especially when you cannot change it. It just creates angst.
Stop taking (and creating) shortcuts to get out of the parts of work you do not like. Do your job with pride and become an icon that others will look to as an example.
Call out what does not fit. Do it politely and with concern. Help others succeed.
Stop creating (or spreading) drama. Stop eating each other alive. Primum non nocere applies to your fellow workers as well, across agency lines.
Be competent. You know what your cognitive and psycho-motor weaknesses are... find an expert and take steps to improve instead of covering these things up. Stop making excuses.
Be on time. Be on time for work. Do not be a creator of delays.

If you want EMS to be recognized as a professional career, start here. You can have all the degrees in the world, but if you cannot tie your shoes to work a shift, you are part of the problem, not the solution.

Like I said. Look in the mirror. Are you relaying what you are truly capable of doing? Do you look and act like you are capable of mitigating the emergency and providing a good outcome when you walk into the worst moment of someone's life?

So, if you think that photo floating around is justifiable, you need to work on your reliance on excuses.

We all have issues. We can all improve. 

Pick a starting point and get going.