In this episode of EMS One-Stop, Sophie Fuller — better known across social media as Paramedic Sophie — joins host Rob Lawrence for a candid, energizing conversation about what it really feels like to work in EMS right now: pride, the pressure, the burnout, and the culture issues that too many providers have been taught to silently absorb.

Sophie is a critical care ground paramedic, flight paramedic, educator and president of the Tennessee Association of EMS Providers (TAEMSP), and she brings a provider-first lens to everything from leadership visibility, to mental health and pay equity.

Together, Rob and Sophie dig into why Sophie started creating content in the first place (hint: burnout and the need to connect), how social media can be used as a force for good, and what “healthy” EMS culture should look like in practice. Sophie shares practical advice for crews and leaders alike:

• Be human

• Say the uncomfortable thing

• Stop normalizing harm

• Build systems that “care back” for the people doing the work

• “We're just working in systems that haven't yet learned how to care back for the provider.” — Sophie Fuller

• “Management by walking about. Don't be stuck in the office. Don't say my door is always open because that relies on people coming in to see you. Get out and go and see them.” — Rob Lawrence

• “We love this job and that distracts us from the fact that it's also hurting us.” — Sophie Fuller

• “Just because it's normal doesn't mean it's healthy.” — Sophie Fuller

• “We confuse trauma with tradition.” — Sophie Fuller

Additional resources:

• Follow Paramedic Sophie on:

  • YouTube

  • Tik Tok

• “The Next Shift : A mentorship workbook for EMTs and Paramedics” | E-Book, by Sophie Fuller

• “To Err is Human: Building a Safer Health System” - PubMed

01:00 – Rob introduces Sophie Fuller (“Paramedic Sophie”) and frames the influencer vs. “effluencer” concept

02:14 – Sophie’s origin story: graphic design → hospital tech → EMT → volunteer fire → paramedic → critical care → flight

06:16 – TAEMSP: why Tennessee needed a provider-level association and the shift toward legislative advocacy

08:05 – Why she started with social media: two full-time 911 jobs, low pay, burnout and the need for an outlet/connection

09:32 – Defining EMS burnout: the “jar on the shelf” and cumulative strain that becomes chronic fatigue

13:26 – Sophie’s guidance to providers: vulnerability, telling the truth and not letting naysayers silence needed conversations

16:00 – Sophie’s message to leadership: don’t be the “Wizard of Oz” — show up, communicate and stay connected to crews

20:26 – EMS culture: self-sacrifice, silence, “earning your place through suffering,” and confusing trauma with tradition

23:10 – Sophie’s book “The Next Shift”: a field guide to “learn, lead and last” in EMS

26:03 – Mistakes and “just culture”: reporting, mentoring, anonymous reporting systems, and learning vs. blame

32:08 – Closing challenge: stop normalizing harm; speak up for culture and patient care

33:14 – Where to find Sophie online and how large her platform has become

Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode.

In this episode of EMS One-Stop, Rob Lawrence is joined by his own Medical Director, Dr. Maia Dorsett, to unpack the 2025 NEMSQA Measures Report — a deep dive into trauma-focused quality measures built largely from NEMSIS data.

Dr. Dorsett frames the discussion around the central aim of quality improvement:

• Are we doing a good job?
• Are we delivering the best possible care?
• How do we get better?

From pediatric vital signs to traumatic brain injury (TBI) fundamentals, she walks listeners through what the report reveals, what it can’t reliably measure yet, and why some of the “sexy” procedures are too rare to serve as useful system-wide metrics.

The conversation highlights a recurring theme: fundamentals matter most. Dr. Dorsett explains how measures like complete vital signs and avoiding secondary brain injury in TBI (hypoxia, hypotension, hyperventilation) can drive meaningful outcomes — even during relatively short prehospital intervals.

She also points out where current measurement approaches unintentionally create documentation burden for clinicians, arguing that systems should do more of the “figuring out” (like trauma center designation and prenotification capture) without requiring extra clicks.

The episode closes with a call to action: anyone can join NEMSQA, contribute to the work, and help shape what EMS quality measurement becomes next.

Memorable quotes from Dr. Maia Dorsett

“I think the most fundamental question in quality improvement is, are we doing a good job?”

“I think part of the value of this report is specifically looking at those things and saying what should we be measuring using NEMSIS data or how should things be integrated into that database so that the answers are there rather than needing to be documented on each individual case?”

“If there's one thing that you're going to take away from this trauma report is that, the sexy stuff is important, but it happens rarely. And if you want to improve care in your system, it's about the fundamentals of good care.”

Additional resources

• NEMSQA 2025 Report Release
• EMS One-Stop: Leading through momentum: Dr. Douglas Kupas on steering NAEMSP

Episode timeline

00:31 – Rob welcomes listeners; introduces the 2025 NEMSQA measures discussion and notes prior episode with Dr. Jeff Jarvis

01:10 – Dr. Dorsett joins; holiday surge discussion and flu impact on EDs and admissions

03:08 – Dr. Dorsett explains her role as co-chair of NEMSQA’s Measure Analysis and Research Committee; trauma focus of the 2025 report; pain measures not included due to active research

05:00 – NEMSIS scale and opportunity: extracting meaningful measures from a massive national dataset

05:35 – Dr. Dorsett on what NEMSIS measures well vs. what it shouldn’t force clinicians to document (system should determine trauma center status)

07:46 – “HALO procedures” table: why rare interventions shouldn’t become national quality measures

10:17 – Trauma 08: complete vital signs; pediatric gap (adults ~93% vs pediatrics ~85% in discussion)

14:22 – TBI measures: preventing secondary brain injury; why fundamentals outperform “sexy” fixes; correction rates for hypotension/hypoxia discussed

21:39 – Trauma 04: trauma triage criteria and transport to trauma centers; why national measure looks low; documentation field limitations

24:17 – State collaboration comparison: using state trauma center designation data shifts performance dramatically (often 75–90%+ in examples)

26:55 – Trauma 14: hospital prenotification; importance and measurement challenges (multiple modalities, inconsistent capture)

30:01 – Rob raises operational/policy concerns about trauma alerts and incentives; Dr. Dorsett adds nuance about local criteria variation

33:22 – Closing: Dr. Dorsett’s “fundamentals matter” takeaway; impact at scale

34:44 – Dr. Dorsett plugs joining NEMSQA as an individual/agency; committees are open

35:31 – NAEMSP Tampa preview; Dr. Dorsett: “The people” are why she goes — leaves energized with new ideas

Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode.

Dr. Douglas Kupas joins Rob Lawrence to kick off EMS One-Stop in 2026, reflecting on his first year as President of NAEMSP — a year he describes as fast-moving, complex and occasionally “whack-a-mole,” with emerging issues demanding real-time leadership while long-term priorities still had to move forward.

He shares what he’s learned about the presidency, the value of NAEMSP’s leadership “bench strength,” and why advocacy and coalition-building across national EMS organizations has become more coordinated, more strategic and more essential.

The conversation then turns to what’s immediately ahead: the NAEMSP Annual Meeting in Tampa (late January), including pre-conference courses, the flagship Medical Director’s Course, and a packed scientific program. Kupas highlights a keynote focused on transforming battlefield trauma care; major research programming through oral abstracts and hundreds of posters; and high-impact sessions spanning clinical care, operations, legal issues, and international perspectives — reinforcing why the Tampa meeting remains a must-attend event for anyone serious about the science and future of EMS.

00:00 – Rob tees up NAEMSP Annual Meeting growth as a “good problem to have” 00:50 – Welcome/Happy New Year 2026; Dr. Kupas introduced as first guest of the year 01:45 – Year one as NAEMSP president: what’s surprised Dr. Kupas, pace of work, governance “bench strength” 04:26 – NEMSAC termination: what happened, what NAEMSP hopes comes next 07:02 – Building the pipeline: medical student/resident interest group, travel support ideas 08:47 – “Hot off the press:” NAEMSP accepted into WHO Acute Care Action Network 10:08 – Advocacy “hunting as a pack:” overlapping national orgs, EMS on the Hill coordination 12:40 – Why Hill visits work: stories, staffers and why first-timers matter 16:48 – “White hat” advocacy and patient-centered priorities; ED wall time as a key issue 20:07 – Tampa preview: “It’s not just for docs,” NAEMSP membership structure 22:11 – Pre-cons overview: Medical Director’s Course, QI workshop, MIH, ventilation, blood, TECC 23:55 – Keynote: Dr. Frank Butler and special intro by Dr. Bob Mabry; Grand Rounds obstetric focus 27:45 – Major legal session format and why legal content draws a crowd 29:28 – Space constraints and future planning: small convention centers; San Diego “buyout” scale 31:49 – Research explosion: oral abstracts, posters, receptions; better ways to access abstracts 34:39 – “Meat of the conference:” operations, clinical topics, international speakers/learning 36:49 – Closing question: Bill details

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