Want to become more awesome in 2012? Here are 17 places you can start:
Most organizations have a policy in place that states that oncoming EMS crews should complete a thorough checkout process. The reality is that very few of us check out our rig at the beginning of each shift with the proper attention that the task deserves. We know we should, but we get caught up. The signs of an incomplete rig checker are subtle but recognizable. If you open your cabinet or kit on a call and note (for the first time) that you are low or absent a needed supply, you’re not checking out your rig well enough. If you need to look in two or three paces to find what you are looking for, you aren’t checking out your rig well enough.
When you complete a detailed rig inventory, you aren’t just confirming that everything that is supposed to be there is still there. You are hard-wiring into your brain the exact location of everything that you might need. Once you’ve done this over and over again, you’ll find that you are able to collect necessary equipment in a fraction of the time. When you can grab equipment without even looking, your patient care efficiency will go way up. You’ll become a better caregiver. So grab that list and open those cabinets.
2) Look -Up Every Prescription Medication That You Don’t Recognize
The patient’s medication list is a wealth of information about their medical history. It contains vital information about possible causes of the their current condition. It hides details about how the patient will respond to acute medical conditions and it gives clues to how they will respond to your subsequent treatments. If you don’t understand what those medicines are and what they do…you’ll miss all of it.
If you’re caring for folks and you don’t understand the medications on their med list, you might as well wear a blindfold. You’re missing that much.
In today’s information age, there’s no excuse to not have some sort of medication reference in your phone or in your pocket or in your work bag. Carry it and use it. Every time you sit down to write a trip report and you write a medication down that you aren’t completely familiar with, look it up…right then. Don’t wait till later. Just pull out your reference and learn the medication. Google it if you need to. Once you start this habit, you’ll be surprised by how quickly you start to understand these lists in a much more detailed way.
3) Stand Up and Claim Your Mistakes
This can be one of the hardest new habits to learn. Partly because we’re all so afraid of admitting that we made an error. Winston Churchill once said that success was the ability to go from mistake to mistake without losing our enthusiasm. It’s absolutely true in medicine. We can’t grow as patient care providers without making errors. In 2012 commit to avoiding errors whenever possible and owning every error that you make. Be brave. Be fearless. (But don’t be reckless.)
4) Learn Every Patients Name and Use It for the Duration of Your Care
In all but a few rare exceptions, asking your patient’s name is an excellent first step in your patient assessment. Airway, breathing, circulation and a large majority of the cranial nerves can be assessed by simply taking your patient by the wrist and asking their name.
Once they say their name, the next step is a little harder. Remember their name. This takes a conscious effort at first. Once you get in the habit, it’s easier. Now that you remember their name, use it. I think you’ll find that your patient rapport increases dramatically (almost effortlessly) once you stop calling your patient honey, sweetie, dear, sirs, ma’am, pal, friend or partner, and start calling them by their name.
5) Learn Your Protocols
I mean better than you already do. When I was an EMT-Basic, I all but ignored my county protocols. I figured protocols were things that paramedics needed to worry about. Once I became a paramedic and started reading my protocols I realized that I should have read most of them back when I was an EMT.
Your protocols are the rule book. I’m not an advocate of always following the rules, but before you can break the rules properly, you need to know the rules. Learn them. Know them. Then you can start refining your care around them.
6) Pay Attention to Research
I already mentioned that this was the information age. There’s really no excuse to be ignorant of current research in EMS. If you don’t know where to start, start with the research section of EMS World. Then check out the news and features at EMS1. Keep an eye on podcasts like The EMS Educast and The Research Podcast. When you’re ready for the big leagues, check out Rogue Medic’s blog. (Wear your seatbelt.)
Half a dozen things you’re doing right now will change in the next five years. Want to know which six things are going to be obsolete? Start paying attention to research.
7) Develop a Specialty
Think of the most talented, well respected EMS practitioner you know. I’ll bet I know something about them, even though I’ve never met them. I’ll bet that they’ve taken their knowledge in at least one area of medicine far beyond the expectations of their job. Think I’m wrong? Ask them.
Sooner or later, every EMS caregiver who’s eager to learn and improve will find some area of medicine that interests them to a degree that they seek out more information. Once they tap into the subject they’re compelled to keep going. They become specialists.
It could be cardiology and it could be limb splinting. It could be airway management and it could be extrication. The subject isn’t that important, the idea that your knowledge does not need to be limited by your scope of practice is critical. Find an area of medicine that fascinates you and dive in. Don’t worry about whether or not the information is applicable to your patient care. Learn for the sake of learning.
Before you know it, you’ll be a specialist.
8.) Use the Information in This Blog (Or Stop Reading It)
Yes, you read that correctly. This might be the only time you’ve ever heard a blogger tell you to stop reading his or her blog, but I’m serious. If you’ve been reading my blog for a while and you still haven’t encountered anything that you can take to work and use to your benefit, stop reading.
I’m not writing this stuff for my own information. I’m writing it for you. If you don’t actually use any of it in practice, then it’s worthless. You can stop reading…I won’t take it personally.
If you aren’t using and applying the information you see here your wasting our time. Find those useful little gems that resonate with you and go to work and actually try to be a better EMT. Or find someone else’s blog to read who might be more useful to you.
There are so many awesome podcasts out there in our field. If you have an iPod or an MP3 player or any other device that plays digital audio, you have no excuse to not listen. Download a few and see what you like. Make that down time useful.
You can hear some of the most lucid thinkers in EMS talk about the latest issues that affect you and your industry if you simply tune in. I recommend The EMS Garage, The EMS Educast, The EMS Leadership Podcast, EMS Office Hours, and Confessions of An EMS Newbie. They’re all awesome.
You can learn a bunch from regularly listening to any one of them. In the age of MP3 Players, Ipods and smart phones, there are no longer any excuses for wasting your time in your car listening to commercials on the radio. Pick a podcast you like and start listening. You won’t believe how much good information you’ll have packed into your brain by next year.
10) Start Teaching Something
It’s time. If you already teach a class, such as Red Cross First Aid or AHA CPR, great. You can skip this one. But if you haven’t taken the time to give back to the community by teaching the EMS information you already know, 2012 is your year.
It’s hard to describe how much teaching can expand your knowledge and experience. Once you know that other people are going to learn vital skills based on your knowledge you will feel compelled, like you never have been before, to dial in your own knowledge.
Teaching opportunities are everywhere. Hopefully you can find a way to teach your specialty to other people. Educators like Mike Smith and Tom Dick have built their careers on finding something they are passionate about, becoming the leading authority on the topic and then teaching it to other people.
Maybe in 2013 I’ll see you on the speakers list for EMS World or EMS Today.
11) Bring Yourself to Work
You might be thinking, “Steve, I’m required to show up at work.” True. That’s not what I mean. I mean that this year is the year for you to find that unique contribution that only you can make to the world of EMS. When you begin your career, you mostly copy the styles and techniques of your preferred instructors. You do what you can to be like them.
Now it’s time to break that mold and ask yourself what your style is going to be. What are your techniques? How can you make this job uniquely your own. What can you do to make the people you work with think to themselves, “Wow, I’ve never seen anyone do it like that before.”
There is a unique something that you were meant to bring to the world of prehospital emergency care. No one can tell you what it is. You have to figure it out on your own. When you find it, don’t tell anyone…just show them.
12) Start Doing Full Head-to-Toe Patient Assessments
I know you’ve been faking it. I know this because most EMT’s fake it. Regardless of how good or talented they are, most EMTs don’t have a good, smooth, thorough head-to-toe assessment that they can perform with confidence in front of other people.
And the really sad thing is that it isn’t that hard to do. You just have to start doing it. Do it and then do it again and then do it again. As you practice detailed head-to-toe assessments again and again you will quickly reach a level of proficiency that far exceeds that of the vast majority of your colleagues.
More importantly, you’ll become a better caregiver to your patients. Commit right now to making 2012 the year when you quit faking it and start doing solid patient assessments
13) Learn a Thorough Neurological Assessment And Do It Whenever It’s Appropriate
You can add this one to your new-found head-to-toe assessment when the need arises. A neurological assessment is how we figure out if the patient’s body is talking to the patient’s brain correctly. Just like a physical assessment, it starts and the head and ends at the feet. A good neurological assessment includes motor, sensory and cognitive assessments. If your assessment includes questions like, “Can you feel me touching here?” or “Squeeze my hand.” or “Where are you right now?”, you’re already doing some neurological assessments.
Once you have a systematic, head-to-toe, neurological assessment, do it on every potential spinal injury, stroke, overdose, poisoning and head injury patient. (That’s a good start.) I’ve never seen two caregivers who use the exact same neurological assessment. Develop your own. It will get better over time. Do it often. It will help define you as a quality caregiver in 2012.
14) Find One Glaring Mistake or Outdated Treatment in Your Protocols and Vow to Violate It
I know this one is going to be a little controversial. I’m not telling you to give inappropriate care to your patient. I’m also not giving you a license to not know your protocols. (See number five.) But I can guarantee, beyond doubt, that there are some things in your protocols that are out of date, useless and possibly harmful to your patients. Find one of those things and commit to not doing it in 2012. Make sure to write a variance report when you’re done.
15) Stop Eating Roadside Junk Food
It’s killing you. Just stop. This year, start bringing your food in a little cooler. As an industry tasked with protecting the health and safety of others, we are ridiculously fat and out of shape. Don’t be the next post-difficult-call-cardiac-arrest story in the national news. Drop the trans-fat and eat an apple.
16) Stop Having Tantrums On Your Way To Calls
Yes, you do. We all do it. The dispatch happens and we immediately start rationalizing why this shouldn’t be our call. “Isn’t Medic 36 closer to this? Are they still out at the hospital. Those guys spend way too long at the hospital. This nursing home calls for the dumbest reasons. Why can’t PD transport their own drunks?” When we’d rather be doing something else, there’s always a reason why we shouldn’t have to run the call we’ve been assigned.
Just decide to commit yourself to the call from the moment that you are dispatched. You can’t feel good about the job you do if every time you get assigned a call you go into angry / frustrated mode. You’d be surprised how much energy you can expend with these habitual negative tantrums. Let go of it. Shrug it off like a heavy weight. If the job is worth doing then decide to just do it. You’ll be amazed at how much better you feel.
So that’s it. There’s your recipe for how to have an awesome 2012. We’re just far enough into 2012 to have abandoned all of those ridiculous resolutions that we committed to on January 1st. Now you can make some real worthwhile commitments. Pick a few and get started.
“Wait!” you say… “You promised us 17 ways to become awesome.” Indeed I did. You’ll have to wait until next time to get the 17th tidbit. It’s just good enough to warrant its own post. …And you can find it right here.