I am seriously considering giving up teaching AHA courses. I am a CPR instructor, ACLS, PALS…you name it and I am giving it up. I am going to let it lapse. Sell the manikins. Take down the website.
“Why?” you ask.
Because I just can’t complete with dishonest people, and I can no longer stomach lazy students. These are two bold statements, so I will take a moment to explore both.
Full disclosure: I make money from teaching AHA courses. Let’s get that out of the way right now. However, I make money from teaching AHA courses in the same way that healthcare workers make money from sick people. I have to make a living. I chose to do something good for humanity with that time I spend making a buck. So I teach people how to save lives. But just like any organization, even non-profits and hospitals, if the money is not there I have to shut the doors. There have been a couple of instances as of late where I have had to make a choice between continuing with a course that was actually going to lose money, or simply canceling the course. Guess what I chose.
Let’s start with the dishonest people. If you are a healthcare worker, you have probably gotten one of those clandestine CPR cards. You know the ones I am talking about. One day you go to work and an administrator tells you, “Hey, the database says your CPR card is out of date.” You check your wallet and have your “oh crap I can’t work” moment. At this point you either call that “guy you know” or sometimes even the administrator will take you to the office and make a card for you. The person handing you the card says something like, “Hey, you were at that class last week, right? Yeah, here it is…your name is on this roster…you attended this course, right?” And you walk out of the office with your freshly printed CPR card, and all is right with the world. Or is it?
Personally, I think it is ridiculous for certain kinds of healthcare workers to have to take CPR every two years. That is not the AHA’s fault. It is the laws of the state you live in, or the organization for which you work. They made that mandate. Not the AHA. Take a look on your card, it says “Recommended Renewal Date.” That’s just what that is: a recommendation. If your card goes out of date on June 30th of 2009, do you somehow magically forget how to do chest compressions on July 1st? But someone has to keep standards, so we just blindly follow what the AHA recommends. But there it is. A standard. In writing. So, being the stupidly honest guy that I am, I follow it. To the letter. To a fault.
I have always been one of those people who is anal retentive about teaching. I know full well that a group of paramedics do not need to be taught CPR. So I modify the class a bit to make it interesting. I am sure that the black helicopters with the AHA logo on the side are about to swoop down and take me out for modifying their precious class, but that is exactly what I do. If the class seems to be an experienced bunch, I will put the video away for a second and give a deep lecture on why the AHA made so many changes in 2005. I will talk about perfusion pressures, thoracic pressure, and introduce some of these new adjuncts like the ResQPod. In other words, no one leaves my class without learning something. I will make the class and the experience worth your time and money.
Problem is, no one wants that. No one, and I mean no one wants a good class. They want a card. They want it in their wallet. They want it yesterday. And, by the way, how dare I try to actually teach them something.
Case in point: a PALS class I taught last year. An administrator at a local hospital called me with a proposal. “Hey Buck, I have a friend who is a very experienced nurse who needs PALS yesterday. She needs it as a prerequisite to a graduate program. I know you don’t do private classes, but this would be easy as she is a pedi-nurse. She is super professional, and a good student. I would consider it a personal favor and she will make it worth your time.” I said I would do it for $450, she agreed, and she met me at the fire station. She wanted to sign the roster right away, and was a bit pushy about it. I said, “Hang on, we have all day. I am going to fill it out during the first video.” She got pretty tense, but I pressed on and started filling out paperwork. There were only two of us in the classroom, but we watched videos, we had skills stations, I gave mini lectures on technique. Finally, she just had enough and snapped, “Look! I have to be somewhere with my family. I thought I was just going to get a card and leave. What is the hold up here?”
At that point I got nasty and said, “First of all, how dishonest do you think I am? Did you really think I could be bribed into forging paperwork for $450? I am not that kind of person. You hired me for a full day’s work, and that’s what you are getting.” We had a knock-down, drag out argument that ended in her completing the course while pissed off, and me telling her to calm down every five minutes.
After the class she called our mutual friend and had the gall to actually complain about me. She wasn’t just griping to her friend, she wanted to file a formal complaint and wanted to know what form to fill out. My friend actually had to explain what was wrong with this. In the end my friend said, “Yeah, you do that. Come on down here and fill out a written complaint stating that he actually tried to teach you something, and you just wanted to bribe him for a card. Let’s send that up the chain and see who wins that battle.”
To this day I refuse all requests for private courses no matter how much money is dangled in front of me. And boy do they dangle. And boy do they get pushy. I had a doctor call me last year and offer over $1000 for a private ACLS class. This offer was the culmination of a 15 minute begging and pleading session in which I had explained several times that I could not help him. His group had placed him on suspension until he got his card, so he started to rant and rave at me. I finally cut him off and said, “Sir have a nice day,” and hung up on him. He immediately called back and started screaming at the top of his lungs, threatening to turn me in. At this point I unleashed, “Really!? Turn me into who? The ACLS cops? I hear they play hardball, man. I’m quaking in my boots! Oh lord, don’t send me to the AHA dungeon! I won’t make it down there! Hey, let me ask you a question. Do you yell at the clerk who has to close the store? Do you yell at the Starbucks that is out of your hazelnut coffee? Do you yell at the mechanic that doesn’t have a part for your car in stock? Listen up. My store is closed. We’re all out of ACLS. You’ll have to try the place down the road.” After that he came unglued and started screaming at me that he was going to tell everyone he knows to never take one of my courses. To which I said, “If your friends are anything like you, please, please, tell every single one of them never to call me. If all your friends are pushy, entitled, overly-demanding, elitist schmucks like you, then I don’t want to teach them either. Now if you have anything else to say about this you are just going to have to talk to the dial tone you are about to hear. Now go unfuck yourself, and don’t call me back.” Click.
I have to admit, that felt awful good, but this is probably the reason why I never really made any money teaching AHA courses. I am simply too honest. To this day, I have never had any repeat business from a CPR class. I never got one of those coveted nursing home contracts. Several other instructors have told me why several times: “You actually, teach this shit? That’s your problem. If you actually do hold a real class, just put the video on, let them talk on the phone or leave the room, or whatever the hell they want to do. Walk ‘em through the written test, and give ‘em their card. You have got to give up all this high falutin’ nonsense about actually wanting to teach them something.”
And yet I run calls in nursing homes where the nurses are trying to squeeze the bag on the non-rebreather like it’s a BVM. I get nurses who yell at me to shock asystole. I see whole crews of people doing CPR on someone who is telling them to stop. All of these providers have cards in their pocket.
Yep. You know it. I know it. That’s the world we live in.
“What about the laziness?” you ask. I recently set up a PALS class for six doctors. I reserved a room. I hand delivered the books. I hired another instructor to help. I did all the paperwork. I changed my schedule to accommodate them. I probably spent about five or six hours on the project. I had sent them an invoice for $1500, but they had not yet paid it. At 9:30pm on the night before class, one of the doctors called me up and actually told me that three or four students were cancelling because it was going to be pretty outside, and they wanted to have a day off. She wanted to know if I could still do the class for a reduced cost for the people that wanted to attend, and then do a makeup day for the other doctors later.
I let a long period of silence go by. Then I said, “So let me get this straight. It’s going to be pretty outside tomorrow. And most of you want to play hooky. So you want me to work two days for the same price that we had originally agreed for one day’s worth of work. Is that actually what you are asking me?”
There was another long silence. She decided to go for broke and simply said, “Yes, I guess that’s what I am asking you.”
“No.”
“Would you reconsider?”
“No. If this is how little respect you have for me, we are done. Either pay for the books and keep them, or have them packaged up and waiting for me to pick them up in your office by the end of the week.”
At which point she started to get testy with me, and I just hung up on her. Not wanting to be thrown into the AHA dungeon, I didn’t engage her anymore. I just ignored the next five phone calls she made and sent them to voice mail.
So that’s it. Somewhere a few months back there was a straw that broke something and I stopped trying to put classes together. Every request is met by an immediate we don’t have any ____________ classes scheduled in the near future. Sorry we couldn’t help you. You might want to call _______________. He may be able to help.
I haven’t modified my website yet, but you know what? I think I have just a few minutes left in my day after I post this. Now what is the password to that website again?
Buck, I to have ran into this issue when i teach HAZWOPER classes which you would think they would all want to pay attention in a hazmat class. I guess it is good to know the same problems exist as i will be taking the class to become and instructor in december. Also as a side note i to have wanted to go off on those that just want to bribe me for a card but i have been known to kick people out of the class without a refund.
Nice rant Buck.
By the way, before you close up shop, could you hook me up with a CPR card?
Mines about to expire.
I’d like the short class.
I can pay.
Steve
And yet I run calls in nursing homes where the nurses are trying to squeeze the bag on the non-rebreather like it’s a BVM.
That is actually something that I have taught for people who show up for the routine peg tube transfer and find the sudden cardiac arrest patient or the respiratory distress patient. Now, with the evidence that ventilation is bad, I would discourage this for the arrest.
I have never been the ACLS coordinator at any of the places I taught, but I did give in once and talked one into allowing me to do a private PALS class for an EMS service. Things went smoothly during the class, but everything else was a huge headache. I could not apologize enough to the coordinator, who was only guilty of being a nice guy.
I love the rant.
I have always taught ACLS as tailored to the students. Some places have not invited me back to teach again. And yet, my ego and integrity survived.
The requirement for a pulse and a card includes all of the alphabet soup cards. This is not an evaluation of competence.
Anesthesiologists are horrible at intubating mannequins. ACLS requires that I evaluate the ability to intubate, for those with intubation in their scope of practice. This is silly. It is the duty of the director of the anesthesia department to evaluate competence, including the ability to intubate. Does it make any sense for an ACLS instructor to be evaluating the ability of anesthesiologists to intubate?
AHA card requirements are just another way that hands-off medical directors keep themselves ignorant of the damage they authorize.
Ok, NOW I understand why I am arguing with you about the Code 3 interview; you are my husband in another body…I have listened to him have the identical conversations and experiences teaching ACLS and PALS, and I am glad guys like you are out there handling it like you are.
I also read your background as to what you are trying to do with the Code 3. Admirable, if the people who weren’t going to trek to your mike weren’t heavily weighted toward the Star of My Own Show variety. Maybe you can search for the stories; the ones who need to tell it the most are often the ones who aren’t clamoring for the mike on karaoke night. Good luck!
Maybe I’m just an oddball, but if I’m taking a class I WANT the instructor to teach me something I didn’t know. Otherwise it’s a waste of both my time and theirs!
Not that my opinion counts for anything, but I do applaud you for maintaining your integrity in the face of so much dimwittery.
So, YOU’RE the guy I keep getting calls about. Thank you for being what all CPR Center Coordinators dream of – someone who actually WANTS to teach and makes sure their students get the tools. I will take you name off my referal list, reluctantly. Please reconsider for the few that will benefit from your skill.
very nice rant… I have to agree 100% with you. Not much repeat business out there when you actually try to do what is right. Trying to actually teach someone something… what a concept. Sad that it is such a strange concept to most people.
Wow, excellent article! It sounds like not having the courses and losing money is actually kinda worth it for the entertainment value of watching all the pissed-off bribers!
So let me get this straight. The only people who give a crap about learning this stuff happen to teach it, so the people who need to know the information don’t give a crap. Knowledge is power my ass. Hell, healthcare reform shouldn’t be about who gets care, it should be about who gives it.
I feel your pain, Buck.
If it’s not the lazy students, it’s the AHA criteria for selecting new instructors: “As long as you’ve got a brainstem and an index finger to press the PLAY button, you too can teach ACLS!”
I’m lucky in that I’ve gained a clientele who expects just what you try to do in your classes – more than what AHA requires. They’re tired of quickie, cookie-cutter, bare minimum courses, and the keep coming back to mine.
Come on down to Louisiana. We need good AHA instructors and EMS instructors.
*sigh* Not a good thing to read when I’m already irritated with people’s complete lack of caring for, well, *anything*.
I’ve been fortunate to have some terrific instructors, and I’m fortunate to have a few classmates who care as much as I do. But I know that it’s a rarity and I’ve seen it in the field.
And it sucks.
Please don’t quit. We need you.
The post that will not die! Since you all are having a go at it again, I will give you an update. I wasn’t kidding. I let BLS lapse. PALS instructor lapses next month. I will be ACLS and paramedic instructor till sometime in 2010. Negotiating now to sell my education company, and I accepted a job at an organ, tissue, and eye donor center. I still have my rural EMS job, and I still love doing the EduCast. I still teach the odd class as well. But I am pursuing a different career track and should be going back to school after my wife is done with her degree in about 18 months.
I wasn’t kidding. This post was serious. Dead serious. There comes a point where you start looking at your paycheck and start realizing that you are actually getting PAID LESS TO TEACH than if you simply took an hourly job. I make more money at my entry level position at a donor bank than I do on an ambulance or teaching. When it is time to clock out I simply go home and play with my daughter instead of making a thousand phone calls, doing lesson plans, grading papers, and writing tests off the clock. Its freaking madness.
I do like teaching, but I nearly bankrupted my family doing it. It just shouldn’t be that hard. Bottom line: I have zero stress, work less, and make more money. The only thing that kept me going was this whole one-man-mission to make EMS care better…it was nuts. No one really cares about quality. The void I created was filled instantly. I had trouble getting out of the way fast enough.
What I plan on doing is this right here. I have 15 years of stories and experience to share. You will be reading it right here. It is fun to look back, and I will be writing my memoirs one post at a time. When I get settled into my new job, Copy Code Three will start up again. That’s where I will record other people’s stories. This is where you will read my stories. And of course the podcasting with Chris and the gang will continue. I also do online classes with Greg over at EMSBootCamp, so I get my fill now and then. I am not dead. I have just reinvented myself. I am happier. My daughter is happier. My wife is happier. And somehow, people still manage to get those little AHA cards without me around.