“I’m Only An EMT Basic”

I’m so sick of hearing this phrase. If I could banish any phrase from the EMS lexicon this would most certainly be the one. I heard it today when I posted a question on Twitter, “How much do you really know about ACE inhibitors?” I asked.  The first reader reply, “Not much since I’m only an EMT Basic.” Ouch. I get stomach pains when I hear that.

I want to make a bonfire out of all the worthless phrases in our vocabulary and throw, “I’m only a …” right on top.

Since when was an understanding of out patients medications an advanced skill? Since when is medical knowledge of any kind an advanced skill?

Somewhere along the way we started giving EMT Basics the idea that anything that isn’t contained in their EMT textbook is somehow beyond them. It’s patronizing. “Here you go little EMT dude, here’s the basics. Don’t move on to anything more complicated, you could hurt yourself.” That’s just ridiculous.

Someone should have put that EMT textbook in that students hands and said, “Here it is, the most important 70% of EMS knowledge. Here’s the stuff that’s so damn important we need everyone to master it. There will be plenty of time later to jump into all the other stuff. Let’s get the essentials down first.” Instead, we have a bunch of EMT’s out there with the world of medical knowledge at their fingertips and they’re afraid it’s somehow beyond them. Bagh!

“I had one EMT tell me that lung sounds were not in her scope of practice. I’m serious. She was worried someone might charge her with malpractice if she placed a stethoscope on someone’s chest and asked them to breath deep. I’m not making that up…lung sounds.

As if basic patient assessment somehow fell outside of the basic EMT procedures. I tried to explain that basic patient assessment WAS the EMT scope of practice. No self respecting EMT should feel outclassed by a paramedic when it come to head-to-toe patient assessment, vital signs, lung sounds, neurological assessment and the use of OPA’s, NPA’s and a BVM. These things are the EMT’s bread and butter. They are your domain.

Own them.

Don’t ever let anyone try to tell you a basic patient assessment is beyond your scope of practice. Don’t ever let anyone tell you an area of medical knowledge is beyond your understanding. Don’t let anyone put you in a box. Your knowledge and skills are too important for that.

What do you think?: Have you ever been told something basic was outside your scope or beyond your understanding. have you ever done it to yourself?

Read more good stuff:

EMT Basic Skills Are Not Basic

The Rise of The EMT

Five Things Sports Can Teach You About Being A Good EMT

What Makes A Great Partner?

6 Reasons Why You Should Be a Better EMT

Comments

  1. Medic 322 says:

    I have said it. It seems that many providers do not have a good understanding. Of the different levels of pre-hospital providers. Some Er nurses will ask. How come No saline lock or how come no fluids hanging. How come this patient is not intubated. Ahh well we are just basics. Part of this interaction is the reason I am knee deep in Emt-I school. It has already made me a better basic. Regards

  2. I’m going to agree with 322. The only times those words ever passed over my lips before I was a medic was to explain why certain skills and treatments were omitted.

    When I was a Basic, however, I had a desire to learn, so when something would come up that I didnt know, I would ask. I’d ask a Medic to go over an EKG with me that was abnormal, or I’d ask about certain meds and treatments vs others.

    Once you have that desire to learn, you need to hold onto it. I couldnt imagine doing a job like this, and watching someone doing something without myself knowing why they did it. That patient belongs to ALL of us at a scene, not just the highest level provider.

  3. Those words have come out of my mouth as well. And I totally agree, that we should continue to try and learn as much as we can (I am like Scott and am always asking questions) However, part of the reason SOME EMTs say they are “only” and EMT is because there are those that look at us that way. I have been treated in a condescending (sp?) manner from RNs and Paramedics….even firefighters and cops. Last year I got my EMT-I certification and during one of my EMS rotations, the paramadics I was paired up acted like I did not have a clue. By this time I had been an EMT for 10 yrs! So, I most deffinately had a clue and then some! Maybe because I had worked in an ER and not on an ambulance or because I was working at a doctors office and not in the field….anyhow we were transporting a pt with chest pain and I took his bp and it was elevating. I told the 2 others this and they looked at me like “yeah whatever” and pretty much scooted me out of the way and one of them said, “let me listen” …sure enough it was elevated by quite a bit. Now before everyone says “well you were just a student and they have to make sure you know what you are doing and couldn’t just take your word for it” I totally get that! I am now in a position where I train people all the time and know how the process works. BUT it was the manner and tone that irked me. These 2 were both condescending the whole 12 hours I was with them and I could NOT wait to be done with the shift! So, my point in all this is…no we should not say we are “just” anything but also to those out there who have more training than we do…remember: You were here at one time too, help those that are learning from you don’t treat them like they are not worth your time! There are a lot of arrogant people in our field (c’mon admit it! You know there are!) and there is no place for that, it will get you in trouble one day, guaranteed! And then to those that it is just a lazy thing and don’t want to do anymore than you have to…Why on earth did you get into this field? We are out there to save people’s lives! That is NOT a lazy occupation!!

  4. FireMedic41 says:

    When I took over as EMS Coordinator at our combination FD, I was sick of this exact statement. It was driving me crazy hearing that someeone couldn’t do something because they were an EMT-B. At the same time I had Paramedics that wouldn’t trust in the skills of the EMT-B’s. It was about as dysfunctional as I could imagine, so I coined a phrase, a mantra as it were, that we all were going to live by. “It’s not ALS, and it’s not BLS, it’s EMS!” Certainly there are different cases that require different levels of care, but the phrase was intended to curb the attitudes and ingrained belief system.
    It’s worked though. Our EMT-B’s were instrumental in getting the King Airway approved in our side of the metro area a few years back, and were one of the first to use them down here. We’ve trained them well and they’re doing albuterol and narcan. A majority of them are taking the advanced EKG classes that we are offering, and while they can’t interpret officially, they always feel more involved when our medics ask them what they see. There is now inspiration and excitement amongst those ranks. It really wasn’t always their fault either. I think ALS providers, nurses, and docs have played a role in minimizing the EMT-B. For the nurses and docs parts, they minimize based on the skill set. For the ALS providers we minimized on skill set, rig duties, seniority, etc. It’s up to us to promote our BLS counterparts, and help them be the best at what they do. When we see and treat them as equals with a different skill set, then we’ll be getting somewhere.

  5. One of my personal theories is to always think two levels above my job. When I worked in business I would think about what my direct supervisor worried about, and then think about what his boss was concerned with. I apply the same theory in prehospital care. If I am operating within a BLS scope of practice than I think about what an ALS provider and a receiving ER physician would be concerned with.
    There is never a justifiable reason to close doors on knowledge.

  6. I just joined my local first aid squad. I’ve completed CPR for Healthcare Providers, and I guess will be completing further first aid and other practical training in the future. Until I go to EMT school, I guess I’m technically not an “EMT”. What would you call me? A first responder?

  7. I always correct EMT-basics when they say “Im only an EMT”. I was an EMT-B once and hated it when I was looked down upon because of it. So I am sure to tell the basics I work with, be proud to be an EMT, own up to it, a good or bad EMT can make or break an ALS provider…

  8. junebug1979 says:

    I am a EMT-B in the middle of my medic class…My theory is we all were EMT-B at some point. I agree with WV medic girl I hate it when people call me just a “basic” If basic are treated that way then why would anyone want to be a medic? A medic is only as good as their EMT partner. (we run a EMT-B with a medic partner)

  9. Brittany says:

    When I was taking my EMT course in July of 2009, my instructor almost smacked half of the class at least once for asking the same question. “Are we really allowed to do that?” Yes, you are allowed to do that, it’s why I’m telling it to you. The man even showed up how to hook up and read a heart monitor. Not in my scope of practice, sure, but do I now know how to do it in event of dire emergency? Yes, I do. It amazes me how so many EMT-Basic’s think that their learning ends when they’re license is in their hands. My Dad(a former paramedic) always reminds me of one thing;

    “The day you stop learning in fire or EMS, is the day that you should stop doing it all together.” And boy does it hold true.

  10. My response is longer than your post, so I wrote my own post. Notice the imaginative title.

    “I’m Only An EMT Basic”

  11. Chaps, I think we have a case for starting a movement to get the name of EMT-B changed to inspire more confidence in everyone!

    EMT Primary or EMT Core for example would be much better.

    Or even EMT-DI (for Damn Indispensible) 🙂

  12. Silverman780 says:

    In response to Theo, in Oregon they are changing the titles:

    First Responder is going to be Emergency Medical Responder

    EMT-B will now be known as just “Emergency Medical Technician”

    EMT-I will be Advanced Emergency Medical Technician

    Paramedics

  13. “Here it is, the most important 70% of EMS knowledge. Here’s the stuff that’s so damn important we need everyone to master it. There will be plenty of time later to jump into all the other stuff. Let’s get the essentials down first.”

    Here in lies the problem. From what I’ve seen, the EMS textbooks for EMTs don’t even contain 50% of what students need to know. Much of what is contained is wrong, or based on outdated education. I could, and have, drone on and on about how the 1994 curriculum dumbed down EMT education, but won’t.

    Suffice it to say that EMS has wasted much of the last 15 or so years by concentrating on ALS education and ignoring BLS education. Decontenting BLS education has not only given us less capable EMTs, it’s made it harder to produce good paramedics.

    It’s time to rethink not only BLS education, but how we structure EMS systems in general and what we expect from EMS.

  14. JDVista163 says:

    As a fairly new EMT-B in an area where the medic can be coming from near half an hour away normal traffic, My instructor made a strong point in remembering we are NOT medic dependent. The entire reason I decided to become an EMT was because I was a firefighter in a combination department who was tired of sitting around at EMS scenes feeling like I didn’t know anything, or couldn’t do anything.

    I just received my card late last July, and I’ve taken every chance I get to learn things from the Medics I work with. I even found this little corner of the internet looking up information related to a short lesson a Medic gave me recently, And I spent a short time working with an ALS staffed Agency who’s paramedics taught me the crash course of assisting in just about everything such as setting up and Reading EKGs and helping with IVs. But when the time came for me to make the call to GO rather than waste precious time waiting for a medic, all my training came together and my patient was on the way to the ER where she needed to be.

    My Fire and EMS department has been running EMS since the early years, and at one point EVERYTHING was “basic” the objective was still the same, get the patient to the hospital, and do the best you can. There are some things, Intubation, IV’s and such I cant do because I am “basic” but its no excuse to slack off what I can do.

  15. For JDVista163: Outstanding. I like your style.

  16. but what if I am just an EMT Basic?
    😉

  17. 9 ECHO 1 says:

    I have heard this statement. I hate it. It’s a cop out at best. And, like Rogue, I had to post on my site about EXPECTATIONS. Yours was a good post, BTW.

  18. Steve Whitehead says:

    I’m really happy and impressed by the volume and quality of posts on this topic. It’s even inspired several more pieces both here and around the blogsphere.

    @ Scott and Medic 322, It’s hard not to say it as a reflex when scope issues come up. But you could use the same response paramedics do, “It’s outside of my scope.” No apologies.

    @Kim We do run into arrogant people in our (and every other) field. But we choose to be who we are because of who we are, not because of who they are. I like the reminder that if and when we advance to paramedic, we should remember our roots. (Lest we forget how to treat the patient.)

    @FireMedic41 There will always be people who try to minimize us, but they can’t take anything away from us that we don’t give away voluntarily. (Oh, that could be a post.)

    @Beaver Medic, I like your theory.

    @Anon, I’d call you on your way to a great career and leave it at that.

    @WV MedicGirl Good for you girl.

    @junebug Everyone needs someone to watch their back. Nobody does this job perfectly. Hopefully you’ll watch your partners back. (Yes even the arrogant ones.)

    @Brittney I have similar experiences as an instructor. It’s one of the things that inspires me to write these posts.

  19. Steve Whitehead says:

    @Rogue Medic Loved your post. And it inspired another post from me. Thanks brother.

    @Theo Primary…I like it.

    @Silverman Hummm. I liked primary and secondary better.

    @totwtytr, thanks for coming by. I’m right with you on the EMT textbooks. It’s gotten so hard to find a good one. I really like the book we’re using right now. Our last one was horrible and we tossed it after one rotation.

    I’m not certain we’re getting worse EMTs. I think were getting good EMTs in spite of their textbook and curriculum, not because of it.

    @JDVista Now there’s a system where you can really learn the power of good BLS. I know some EMTs who’d like to come ride along with you.

    @Joe God love you brother. I know I do. Thanks for coming by the site and messing with my comment box. You should comment more often.

    @9 Echo 1 great post. I left you a comment as well. I like your list. I think it would serve new EMTs (and some old ones) well.

  20. I am really good that I happened across this website today. I m looking into taking the EMT Basic course this summer. These words I shall here when I m taking that course. This is what I really want to do. I think my only question is after I get my basic, where to go from there. I ll keep reading the site. Thank you this is great stuff, and encouraging to me 😀

  21. I meant glad. ^^ I got so excited I forgot to spell check

  22. Steve,

    Great post! As an EMT-B for nearly 14 years, I cringe every time I hear someone say this, especially the new blood coming into the profession. From my perspective, there are several causes for this line: 1) the “dumbing down” of basic EMT curriculum in various states, 2) the tendency of EMS providers to forget their roots, and last but certainly not least, 3) the tendency of advanced providers to strip “Medic” out of Emergency Medical Technician and feel the need to correct any EMT-Basic who says they’re a medic.

    It all starts with personal responsibility and accountability. If you want to play the game, step up to the plate. Read, learn, ask questions, repeat. Find a provider who’s willing to serve as a mentor and push yourself to learn. Don’t look at continuing ed classes as a punishment but as an opportunity. The more you learn, the better you will be, no matter what your level.

  23. I am deciding on wether to enroll in the EMT – basic course at my college, so I decided to do a little web surfing on the subject and landed here on my first try. I browsed around to the other articles here, and came back to this one. Thanks for your motivating words. I don’t think I’ll be happy being ” only an EMT – Basic”, and will learn all I can and ask a lot of questions while I’m there! This course is an elective Im taking while I wait for my nursing classes to start. I want to copy and frame your red words (from a differetn article) about being a good EMT will make me a good Nurse. Sounds like a proud line of work, and I am definately more sure about my decision after reading through this website. Nice Job to all of the EMT basics out there, and to you for a great website.

Trackbacks

  1. […] stole the title of this from Steve Whitehead. He wrote “I’m Only An EMT Basic” at The EMT Spot. I agree with all of what he wrote, and I do mean all, but here is the part that […]

  2. […] That being said, I wasn’t terribly excited when he posted a comment on my post “I’m Only An EMT Basic” announcing that his comments on the piece could be found over at Rogue Medic […]

  3. […] “I’m Only An EMT Basic” […]

  4. […] I’m Only An EMT Basic […]

  5. […] a post commenting on my post commenting on his post, Steve Whitehead writes some very nice things about me. I am […]