3.27.2016

What It Takes - EMT Edition

I thought this was a really interesting thing to write about -- so often I find myself stewing over whether I have what it takes to do this or do that, I suppose I'm a chronic pre-analyzer, but there are a few things I think I know how to do pretty well and those are important things to write about.  I like the idea so much I may even make this a series.

To Be A Good EMT
I just want to stress, there's a huge difference between "EMT" and "Good EMT."  When I say "good" I don't mean "most lives saved" or "most cool sexy firefighter."  Like any other job, there are a million personal reasons why people take the path toward emergency medicine, and there are a million different attitudes and abilities that those people bring to their profession.  I've seen the full spectrum, which is astonishing to me considering I've only been an EMT for four years.  But I still like to think I know a few things, and here's my thoughts on those common traits the good ones have.


 
 
An Innate Duty to Act - All EMTs are legally bound to act (specifics of this vary by state) which means yep, we are obligated by law to take necessary action to prevent harm to another person/people, and beyond that, to use our scope of practice to assist in any way appropriate.  Again, state laws vary on what exactly that scope of practice is, and what an EMT, paramedic, or so on "must" do.  And that is all well and fine, and every EMT has a duty to act, but good EMTs have an innate duty to act....meaning, a natural moral obligation to go above and beyond, to step forward and help others in a crisis situation the way the general public cannot. That is likely how and why we started down the path in the first place.  We didn't want to be the person screaming and panicking when somebody else dropped in cardiac arrest, right?  We wanted to be able to do more.  I think that good EMTs were the people stepping in, assessing damage, and calming down others before they ever realized there was a career just made for that kind of thing.

Mind to Intuition - This is one that I struggle with a lot, despite valuing and deeply believing in the power of intuition.  It is rapid human observation and nothing more--intuition means that our brains process input and give us feedback at an astoundingly rapid rate, and unfortunately that information often gets twisted and ignored by our lesser rational mind.  Intuition can tell an EMT many important things: is the scene safe? is this patient going to decline (or come at me with a knife)?  Am I picking up on other symptoms that they aren't telling me about?  The list goes on.  I'm not saying we should ignore our main reasoning brain--more on that next--but I'm saying, a good EMT knows to listen and follow body language, environmental, and contextual clues that only intuition can tap into, quickly and efficiently. 

Know Your Shit - It's gotta be said, unfortunately, because somehow there exist idiots in every field.  A good EMT has to know a plethora of terminology, anatomy, signs, symptoms, drug interactions, interventions, and so on.  This is where you have to really struggle, because emergency medical personnel don't have the luxury of pulling out notes or researching on our patients before we get there.  We get there and are expected to know what to look for, how to respond, and to do it quickly, effectively, and without being dicks.  A level head is a must, but you have to keep all the shit in your head, because a level head that doesn't know how to sling and swathe or put on a c-collar or what are the contraindications of nitroglycerin...and so on, is completely useless.  There are plenty of jobs you can fake the in-depth knowledge of your trade, but emergency medicine is not one of them.

Know Your Limits - I think in this field in particular there's a lot of "Nah I'm okay."  "I got this."  No, stop it.  A good EMT asks for help when he needs it and knows his limits, and vocalizes that.  The field is getting a little better about things like therapy, and talking and support, but we have a long way to go.  A big part of this is making sure you have a good support network and team, and ensuring that you communicate your needs to them.  There's pretty much no job that isn't made better with clearer communication, but it definitely assists the EMT world.  We are humans too...we can't do everything without batting an eye.  And having empathy toward our fellow workers is a must as well--know their limits and don't push them to do more than they can.  Another caveat to add here--most good EMTs will have "EMS humor" (which I think can be encompassed as "medical humor" because any doctor or nurse I've ever met has it as well) a very dark, grisly black sense of humor that helps EMTs cope and makes other people stare in abject horror if they overhear.  Keep that humor! Sign of a good EMT!



A Good Attitude - This is basic, or at least it should be. When I refer to having a "customer service attitude" some fellow EMTs might get a little miffed; in a life or death situation who gives a crap about formalities? Well, I do.  Call me southern, or old fashioned, but I have a lot of empathy for my patients.  I'm not there because they feel swell or because their day is going right.  And yes, some are over-dramatic, or some are just plain obnoxious, but we're all human.  I am very aware that a lot of our patients don't have even basic medical training, so when symptoms appear or they are in an accident or whatever, their emotions immediately go off into an unpleasant area and they are scared, confused, angry, in denial, in panic mode....just any wild card emotion, sometimes quite a few at a time.  To navigate through those, again, you need a good service attitude and a lot of empathy.  I get really irritated when I see EMTs or paramedics get exasperated with patients.  What's wrong with you????  Go be a pharmacist if you want to make fun of medication lists.  I'm not talking about group venting after a call -- I think that's completely normal for us to do.  But when you're on scene and helping that person, have a helper's attitude.  Even if they puke on you.  Do you think puking is fun for them?  Rant over.  Help your patients. And be kind.  Show a little empathy.  That's all. 

If any of my readers are interested in writing about what it takes to do their job or hobby or passion, I'd love to read it.  

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