101 Things We Should Teach Every New EMT

1) You aren’t required to know everything.dc fire and ems by ep jhu via flickr

2) You are required to know the foundational knowledge and skills of your job. No excuses.

3) Always be nice. It’s a force multiplier.

4) There is no greater act of trust than being handed a sick child.

5) Earn that trust.

6) Don’t ever lie to your patient. If something is awkward to say, learn to say it without lying.

7) Read Thom Dick’s, People Care. Then read it again.

8) You can fake competence with the public, but not with your coworkers.

9) Own your mistakes. We all make them, but only the best of us own them.

10) Only when you’ve learned to own your mistakes will you be able to learn from them.

11) Experience is relative.

12) Proper use of a BVM is hard and takes practice.

13) OPAs and NPAs make using a BVM less hard.

14) Master the physical assessment. Nobody in the field of medicine should be able to hold a candlestick to your physical assessment skills.

15) Keep your head about you. If you fail at that, you’ll likely fail at everything else.

16) There is a huge difference between not knowing and not caring. Care about the things you don’t yet know.

17) Train like someone’s life depends on it.

18) Drive like nobody’s life depends on it.

19) Pet the dog. (Even when you’re wearing gloves.)

20) Have someone to talk to when the world crashes down.

21) Let human tragedy enhance your appreciation for all that you have.

22) Check the oil.

23) Protect your back. It will quite possibly be the sole determining factor in the length of your career.

24) Say please and thank you even when it’s a matter of life or death.

25) Wipe your feet at the door.

26) When you see someone who is really good at a particular skill say, “Teach me how you do that.”

27) Nobody can give you your happiness or job satisfaction. It is yours and yours alone. And you have to choose it.

28) We can’t be prepared for everything.

29) We can be prepared for almost everything.

30) Check out your rig. It’s more meaningful that just confirming that everything is still there.

31) Tell your patients that it was a pleasure to meet them and an honor to be of service.

32) Mean it.

33) Keep a journal.

34) Make it HIPAA compliant.

35) Thank the police officer that hangs out on your scene for no good reason.

36) Recognize that he or she probably wasn’t hanging out for no good reason.

37) Interview for a job at least once every year, even if you don’t want the job.

38) Iron your uniform.

39) Maintain the illusion of control. Nobody needs to know that you weren’t prepared for what just happened.

40) Apologize when you make a mistake. Do it immediately.

41) Your patient is not named honey, babe, sweetie, darling, bud, pal, man or hey. Use your patient’s name when speaking to them. Sir and Ma’am are acceptable alternatives.

training rig by EMS Shane in Portland via Flickr42) Forgive yourself for your mistakes.

43) Forgive your coworkers for their quirks.

44) Exercise. Even when it isn’t convenient.

45) Sometimes it’s OK to eat the junk at the QuickyMart.

46) It’s not OK to always eat the junk at the QuickyMart.

47) Don’t take anything that a patient says in anger personally.

48) Don’t take anything that a patient says when they are drunk personally.

49) Don’t ever convince yourself that you can always tell the difference between a fake seizure and a real seizure.

50) Think about what you would do if this was your last shift working in EMS. Do that stuff.

51) Carry your weight.

52) Carry your patient.

53) If firefighters ever do #51 or # 52 for you, say thank you. (And mean it.)

54) Being punched, kicked, choked or spit on while on duty is no different than being punched, kicked, choked or spit on while you’re sitting in church or in a restaurant. Insist that law enforcement and your employer follow up with appropriate action.

55) Wave at little kids. Treat them like gold. They will remember you for a long time.

56) Hold the radio mike away from your mouth.

57) There is never any reason to yell on the radio….ever.

58) When a patient says, “I feel like I’m going to die.” believe them.

59) Very sick people rarely care which hospital you’re driving toward.

60) Very sick people rarely pack a bag before you arrive.

61) Sometimes, very sick people pack a bag and demand a specific hospital. Don’t be caught off guard.

62) Bring yourself to work. There is something that you were meant to contribute to this profession. You’ll never be able to do that if you behave like a cog.

63) Clean the pram.

64) Clean your stethoscope.

65) Your patient’s are going to lie to you. Assume they are telling you the truth until you have strong evidence of the contrary.

66) Disregard #65 if it has anything to do with your personal safety. Trust nobody in this regard.

67) If it feels like a stupid thing to do, it probably is.moreofthedriver by Rob! via flickr

68) You are always on camera.

69) If you need save-the-baby type “hero moments” to sustain you emotionally as a caregiver you will likely become frustrated and eventually leave.

70) Emergency services was never about you.

71) The sooner you figure out #69 and #70, the sooner the rest of us can get on with our jobs.

72) People always remember how you made them feel.

73) People rarely sue individuals who made them feel safe, well cared for and respected.

74) You represent our profession and the internet has a long, long memory.

75) Don’t worry too much about whether or not people respect you.

76) Worry about being really good at what you do.

77) When you first meet a patient, come to their level, look them in the eyes and smile. Make it your habit.

78) Never lie about the vital signs. If the patients vital signs change dramatically from the back of the rig to the E.R. bed, you want everyone to believe you.

79) Calm down. It’s not your emergency.

80) Stand still. There is an enormous difference between dramatic but senseless action and correct action. Stop, think and then move with a purpose.

untitled by ben roffer via flickr81) Knowing when to leave a scene is a vital skill that you must constantly hone.

82) The fastest way to leave a scene should always be in your field of awareness.

83) Scene safety is not a five second consideration as you enter the scene. It takes constant vigilance.

84) Punitive medicine is never acceptable. Choose the right needle size based on the patients clinical needs.

85) Know what’s happening in your partner’s life. Ask them about it after you return from your days off.

86) If your partner has a wife and kids, know their names.

87) No matter how hard you think you worked for them, your knowledge and skills are not yours. They were gifted to you. The best way to say thank you is to give them away.

88) Learn from the bad calls. Then let them go.

89) When you’re lifting a patient and they try to reach out and grab something, say, “We’ve got you.”

90) Request the right of way.

91) Let your days off be your days off. Fight for balance.

92) Have a hobby that has nothing to do with emergency services.

93) Have a mentor who knows nothing about emergency services.

94) Wait until the call is over. Once the patient is safe at the hospital and you’re back on the road, there will be plenty of time to laugh until you can’t breathe.

95) Tell the good stories.

96) You never know when you might be running your last call. Cherish the small things.

97) You can never truly know the full extent of your influence.

98) If you’re going to tell your friends and acquaintances what you do for a living, you’ll need to embrace the idea that you’re always on duty.

99) Be willing to bend the rules to take good care of people. Don’t be afraid to defend the decisions you make on the patients behalf.

100) Service is at the heart of everything we do. The farther away from that concept you drift, the more you are likely to become lost.

101) There is no shame in wanting to make the world a better place.

Comments

  1. This is fantastic. I haven’t been in EMS for very long, but I have been in long enough to appreciate the truths within this list. This is the kind of heartfelt honesty that is vital to being a good EMT. This is also a refreshing approach to precepting new EMTs, as apposed to the “eat your young” mentality that many EMTs treat their students/trainees with.

  2. Bravo!

    ????

  3. I love this! 19 years in and I still try to remember these.

  4. Anonymous says:

    You all have so much to live up to, I am so proud of you! Thank you!!!

  5. Vince Parker says:

    25 years in EMS 20 years teaching and I really appreciate this. Will use this first day of class.
    Thanks

  6. Jim Manning says:

    I am going to print this out and put it in my locker at the station. A good reminder for all of us.

  7. Hal Curtiss says:

    This list is a brilliant “wisdom” list! It is a foundation document of our commitment to patient care. Thankfully, and I mean thankfully, as a new EMS responder I have mentors and team leaders who embody and thus are imparting these principles and truths to me. It is a transfer of excellence and I deeply appreciate both their skill and there wisdom.

  8. Learn Sick/Not Sick…it is a game changer. !!!

  9. Funny how people give their years of service. That tosses out #70 already!

  10. I left Fire / EMS in 2005 due to injury and havenever regretted a moment of the 28 years I spent there. The 101 pointers still hold true and will for many years to come. Thank you for sharing them. They should be a key part of EMT development.

  11. I hope i have taught my Students this, and I pray I have done this in the Field. Many thanks from an Old Dog about the new information!

  12. Ronnie Hogue says:

    I have been in the field since 1988, I have always done my best for patients and coworkers but always remember GOD has the final answer no matter how good we are and I pray every day for his guidance and strength to face it all. Be safe above all.

  13. Wayne Galbraith says:

    Great advice. I will pass this on to my son. The 101 items of wisdom will be good guidance as he begins his career as a paramedic. Mine is done and I recognize the truth in them after 30 + years working as a paramedic.

  14. Dennis J. Aitken says:

    Very well said. I haven’t been in EMS in a long time as I am in my 60s but these are words of wisdom and experience.

  15. Kevin Humphrey says:

    31 years on the street and this is the best list I have seen. The only one missing is to make sure everyone goes home safely at the end of the shift…always.

    Stay safe!

  16. Amanda Stewart says:

    I just became an EMT last spring, all that is stated above is exactly what our instructor taught us. I hope I can do what other great EMT’s out there do and be able to do it safely and to the best of my ability.

  17. anthony adams says:

    Been in EMS a long time. Absolutely one of the best!

  18. Anonymous says:

    I would add”See the light”, turn on lights as you enter a residence, day or night! Dont get caught trying to run to the pt, there things that can hurt you in the dark!

  19. Becky Null says:

    Always have a clean ambulance, inside and out.

  20. Russell Cowliing says:

    Always ask your patient if they have any questions.

    Great list!!!!!!

  21. Jeff Teeters says:

    Great read! As a new EMT (February), it’s good to see this kind of thing so that I can continue to make myself better. That People Care book, though? Every copy I’ve found is RIDICULOUSLY expensive. Anybody know where a cheaper copy can be found?

  22. Paul Gallagher says:

    #8 should be reversed, rule number 1 should be to treat patients like you would want to be treated. Rule number 2 is to act as if every call is being filmed by your local news crew.

  23. Penny Godwin says:

    WHERE WAS THIS LIST BACK ON THE DAY!!! COULD HAVE PASSED IT AROUND TO OFFUCERS AND WNLISTED ALIKE !!!!! :-/ JUST SAYING!!!!!……

  24. @Jeff Teeters: http://www.emergencystuff.com/category-s/1822.htm

    17.95 plus shipping; less if you kindle, etc.

  25. And I will add a couple more after my 30 yearts in the biz then shut up (okay I never shut up..)
    1. …………..YES, WE DO DIAGNOSE!
    2. And you CAN get emotionally involved. The best care caregivers do. Or just be nothing more than a “technician” your whole career. The trade-off? Studies show the caring are the best caregivers but the careers are shorter as it takes a toll on that type of person.

    I freakin hate that saying people (even EMT’s) say all the time that “EMTs don’t diagnose” …..we’ll just because you don’t sign the hospital admission slip doesn’t mean you don’t diagnose. You damn well better be able to have at least a clue you have a triple A versus gastric reflux. Or a true CVA vs a Bells Palsy. You better know what an MI is. How about an appendicitis? Have a clue or they may die. We could go on forever, but yes you diagnose all the time. You’re not, my friends and colleagues, a robot – so don’t act like one.

  26. It doesn’t matter if the lights on the ambulance and the lights on a fire truck are the same color. never drive the ambulance like a fire truck, especially with your partner in back trying to take care of a patient.

    Listen to the conversation of your partner and the patient in back while you are driving. If the patient is complaining about the road condition, that is a nice way of saying your driving needs improvement.

  27. annoysmous says:

    Good list to remeber. Thank you all emt &paramedics for all you do

  28. Also; make sure you look at a map or record an address carefully; sometimes there is the same road name w/ different extensions (“road”, “street”, “ave”, etc). I learned this this the hard way recently.

  29. 102: Never let someone between you and the door.
    103: Humility

  30. Never ever sit on a old persons chair.
    It’s sometimes soaked in urine!!!

  31. Also, if the patient is of undetermined gender/sex or is a guy wearing a dress, or a woman with a beard – treat them with respect! It is not your place to judge them on their life choices.

  32. Anonymous says:

    58 is completely false. The amount of people who swear with conviction that they are going to die and simply have a migraine or a cold is exponentially higher than the amount of people you will see who say they are dying and actually are

  33. Anonymous says:

    Bla bla bla bla bla,sheep

  34. I’ve been an EMT (or paramedic, went up the ranks) for 20 years, instructor for seven, and I love this. I think it is missing something about respect for the geriatric patient and remember that the frequent flyer will eventually be having “the big one” and you don’t want to be the guy that just assumed, signed them off and went back to the station, only to return an hour later for a CPR call (or had another bus at that address doing CPR).

  35. Jeff Teeters,

    Check bookbyte.com. Many online marketplace has title in used (like new condition) for more reasonable cost. Happy Reading!

  36. Awesome article.

  37. Curt Orde says:

    I begin each new EMT class with the 101. By the end of the semester, most students understand how, what and why of each these gems. Thank you.

  38. anonymous says:

    There’s a thin line between confidence & cockiness… know the line & don’t cross it. Dead is dead…you can’t fix dead…though we try. Know when to let go, have compassion for the family… families can handle death a hell of alot better than a 20 yr vegetable. Just cuz you can do an intervention… doesn’t mean you should, every pt doesn’t need an IV. I’ve been doing this 18 yrs & still counting, at times I’ve struggled with my own compassion but I always go back to…. what if it was my loved one on that stretcher… our pt’s are ALWAYS somebody’s loved one who deserves our competence & compassion. Just cuz we don’t think a call may be an ambulance needing emergency at 2am with 5 cars in the driveway all following you to the hospital…doesn’t mean it’s not an emergency in their eyes, remember general public is ignorant of what is actually a medical ambulance needing emergency. You never know who knows who that’s going on your stretcher, it may very well be your supervisors mother, be safe, treat every pt & their family with the respect & dignity you would want for your family & yourself. This is a great list, I believe it should be in the EMT curriculum or at least in every agency’s field guide. Thank you

  39. This is a great list that applies to just about any profession. I like it.

  40. Always try to use the restroom when you have a chance.

  41. 52 should read “Don’t carry your patient (unless they can’t walk)” Ties in with 23.

  42. DRBellard1486 says:

    As a 10 year EMS Professional, this list is by far one of the best I’ve encountered. I encourage all EMS Personnel to provide new employees with this list.

  43. rescuelou says:

    Hey there I’m so rich with wisdom on EMS world. I’m new at the field 1.5 years to be exact. Their are days where I feel like I don’t know enough and I panic. Sometimes when it comes to my volunteer place I don’t feel like going but after reading your list made me realize that I’m human and it’s ok to step back and watch.i love the fact that I am an EMT. I makes me feel good and one day I would like to become a medic.

  44. Anonymous says:

    As a patient who was taken by ambulance, I remember how very nice and professional they treated me. Also how neat they were. The next day when I was in the hospital one even came to check on me. I was very impressed with her caring…also I have a son who is a paramedic. I know how he cares about his patients. It has to be very stressful but he never lets it get him down. My family has been involved in in saving lives over many decades. I am very proud of them.

  45. MedicKrex says:

    Such a great list. I’ve seen it and others like it numerous times and still find myself reading them every time they pop up. Been in EMS for 5 years and there is still nothing better than the older man or woman who grabs my arm on the way out of their room to tell me how sweet I am and thank me for helping them… When I rendered no further care than to hold their hand from the scene to the ED.

  46. * A good physical exam will find most weapons.
    * Behavior has meaning. Seek the meaning in bad behavior.
    Four years a lifeguard, nine years a paramedic/firefighter, twenty eight years a physician and these are the only things I can think of to add to your excellent list. Well done.

  47. Even with my 25 years as an EMT, this is an excellent reminder that should be regularly revied during training!

  48. Glenn Stevens says:

    Always keep a sense of humor and be able to laugh at yourself…

  49. I visit daily a few websites and websites to read content, except this weblog presents quality based content.

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