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. I am an aspiring EMT and I will keep this list close to me during my classes, when I’ve started working in the field, and around for me to pass on to another. Thank you for writing this.

  2. Great Anna. I’m glad you liked it. You’re welcome.

  3. Thank you. As dd of our local volunteer corp I am posting this in the bay and will be handing it out at our next meeting.

  4. Gerry Murphy says:

    I train new EMTs and Paramedics for a busy Metro service. I tell them “Tips from the Trenches” every morning. I gathered these tips from the amazing people I work with. I’m very proud to say most of the above tips have been mentioned. But still, some haven’t. Thanks for this incredible list!

    Gerry

  5. Absolutely amazing…this is a list that should be drilled into every new practitioners head. Well done

  6. Ashlee Godbold says:

    I just got accepted to college where I will be taking my EMT course in the spring. Im learning its not so much of a career choice as it is a passion. Im glad I found this to read it helped a lot, and I may just print it off and keep it with me.

  7. Edwin Martinez says:

    Going on 29 years as an EMT ( now a -P) and I can attest to the need to follow all these. Thanks!!

  8. I’ve been in EMS for 24 year. Full time Paramedic Firefighter. I have precepted many students and feel this list is the most accurate true to life lack of bullshit I’ve ever read. Well done, I’ll post this and keep it around for student and coworker education. Thanks for this, God Bless, stay safe
    Mike

  9. kiwimedic says:

    An excellent and valuable list. The most valuable advice from my mentor is a little like #79. They will live or die in spite of you, not because of you. Calm down and do what you can with what you have. That made life as a new medic much less stressful.

  10. tania hajjar says:

    11yrs in and agree with all this list says! But it also applies to medics.

  11. Skip Kirkwood says:

    It’s been 41 years since I got my first EMT card. There is much wisdom in this list. Than you to whomever wrote and posted it for all of us to share.

  12. J Brockel says:

    Thank you, author, for the amazing guidance, I love and agree with every detail. I am keeping this list close, very close.

  13. D.Stanley says:

    18 yrs as a medic. Humility is key. The more we learn, the more we discover what we do not know. Recognizing this keeps all of us in a space that encourages growth and hopefully absent of attitude.

  14. You nailed it! I thoroughly enjoyed this; it should be required reading within EMS curriculum. Great job!

  15. Mike Weller says:

    Junior EMT here. This list is just great. I’ll keep it with me all the time.

  16. You posted these as EMS tips, however a majority of these tips can be related to nursing. I am an RN and clinical nursing instructor and I will use these tips in my practice also.

    Thanks for sharing.

  17. Nick Pastore says:

    Of all the crap and silly (if not stupid) lists written about EMS I have seen, this one makes up for all of them. Fantastic job!! This should be printed on small laminated cards and carried as a piece of personal equipment by every EMT and medic on the job. Well done.

  18. John Bruno says:

    Very well done.
    Regarding lying:
    Don’t tell the patient you know the disease they have if you never heard of it. –
    -Ask what it is,
    -Read up on it
    And ask again when you forget again.

  19. Can I add one?
    Sometimes what you see when you close your eyes at night is horrifying. It doesn’t make you weak. It makes you human.

  20. I am currently finishing my last month of in class theory, and then I begin my placement with a full-time crew, and I believe reading this will help me become the best possible paramedic I can be. Thank you for taking the time to write and share this encouraging list. I will be sure to pass this on to my fellow classmates.

  21. EXCELLENT read- made me smile! Thanks!

  22. Gary Silver says:

    If it is wet and sticky and on the floor and it ain’t yours; leave it alone
    Air goes in and out blood goes round and round if this changes FIX IT
    Always remember your rig was built by the lowest bidder

  23. Jeff Beinke says:

    The rules above are very good and even some life-lessons included. As an instructor of many years for all levels of EMS I always start my initial classes with the following simple “rules”:
    1. All bleeding stops, eventually.
    2. No one lives forever.
    3. If in doubt of Rule number 2, do CPR.
    4. If you drop the baby, pick it up; they are slippery when they come out!
    Recently added:
    5. If it is wet, warm and not yours – do not touch it!

  24. Melissa Perry says:

    I have something to add. If you feel you seen it all and done it all, you should probably look for a new career. No case is the same and you should always be learning.

  25. Steve Whitehead says:

    Thanks for putting it up Diane. That’s great. Gerry, I’m glad I managed to sneak a few new tips in. Bernie, I appreciate the enthusiasm. No need to drill (ouch). Somtimes leasons take time. But they influence eventually.

  26. Steve Whitehead says:

    Ashlee – Good luck!
    Edwin – Thanks.
    Mike I appreciate you posting it up. Really. I hope others enjoy it too.
    Kiwimedic – It’s also one of the toughest things to learn.

  27. Steve Whitehead says:

    Tonia – Good point. there are really none of these that I haven’t carried into paramedic practice.
    Skip! – I wrote it… And you’re awesome. 41 years and you are still in the game. You’re an amazing influence and I appreciate you in EMS and all the advocacy work you do.
    J Brockel – You’re welcome sir.
    D Stanley Humility is key. I agree. It’s key to all of it. Especially to the “Experience is reletive” observiation.
    John F – Thanks. It’s nice of you to say that.

  28. Steve Whitehead says:

    Mike – Glad to contribute something worthwhile. Thanks for spreading it.
    Wanda – That’s awesome. I’m glad you think RNs will get something out of it. good luck with your teaching.
    Nick – I’m glad I could redeem some of the other lists. Thank you for saying that.
    John B. Thanks for your addition.
    Jill – One? You can add three or four! but this one is plenty good. Thank you.

  29. Steve Whitehead says:

    Nicholas – I’m glad you found it worthwhile.
    Brenda – Thank you.
    Gary S. – All good advice for sure.
    Jeff B. – Classics one and all. Thank you guys for making the list even better.
    Mellissa P. – Some folks do indeed need to move on. (And some need encouragement to do so.) But some folks need to be reenergized. The job takes a toll for sure. Hopefully we can lift each other up too. Thanks for your comment.

  30. Matt Watkins says:

    I am a long time paramedic and EMS educator. I’ve heard and said many of these things, but I’ve never seen so many truths conveyed so succinctly and in one list. This will become required reading for my new students. Nicely done.

  31. So often I read these “Number of things about EMS” which are filled with mostly funny stuff. This one however is dead on, and though geared toward EMS, these concepts are applicable to most anything. Bravo!! Excellent list!! This should be the very first handout given in both EMT classes and Paramedic school. Been out of the field for a while, been an ICU RN for years now, but EMS will always reman a big part of me.

  32. Barbara Wright says:

    Started in 1985, retired my EMT-P card a year and a half ago. Learned this along the way: Sometimes we need closure after hard calls. Do not be afraid to go to the hospital or to the funeral. We fight death; we cannot defeat it. That was done by someone else.
    This list gets right to the heart of our profession and passion. Thank you!

  33. Steve- Thanks for publishing this list. I’ve been in EMS for over 15 years and the day that “I know everything” will be the day to retire my certification. The 101 tips was a good refresher and always will be. I can only hope my brothers and sisters whether the “ink is still wet” on their cards or whether they are “seasoned” will read and re-read and commit to the 101 tips .They are spot on.
    Best Regards

  34. Mike FP-C says:

    This is a great list. The only thing I would insert as #2 would be “You don’t know everything. There is always more to learn.”

  35. I work in the service of others in a different respect. This list will be valuable to me not only as a reminder but as lessons I missed along the way..
    I recently had a Horrid experience involving EMTS and wow 6 members Bombarded my peaceful and tranquil home and turned it into a nightmare event.. #69 and #79 were dismissed..I ask myself WHY?? He died peacefully and what seemed like an hr later the EMTS were still trying to revive him #81
    The room was left in a state of disaster and disrepair..I DONT GET IT> 8months later after of shody restoration people I was able to use the room again.
    I am Grateful for the service they were attempting but by missing out on a few of these steps it turned the atmosphere into one filled with Negetive Energy.. Be respectful to all..even those who have already made their Transistion into the Unknown.

    as a closing note..Remember to Breathe..
    Blessing to all of You

  36. #102: Proofread your article before you publish it: #4 *there, #17 *someone’s, #41 *patient’s, #47 and #48 *personally, #85 *partner’s

  37. #103: Remember, mistakes will be made but that’s okay because you’ll always have over zealous people like Paul to correct your every little mistake, call you out in public and generally be arrogant. Remember, these people typically have a very shallow breadth of knowledge and therefore tend to miss the point all together.

  38. Steve-
    From all of these peoples’ posts – the consistent thing is that what you say here is gleaned from experience. You can tell everyone these things, but it is only those that have the correct “EMS Blood Type” that will:
    1. Figure these out on their own, because they are ingrained in us;
    2. Live and love by (most of) these rules before they get into EMS.

    Well written, stay safe.

  39. Allison Smith says:

    As a Paramedic who is preparing to retire after 30 years of service, this is as true advice as anyone could ever give. I wil pass this along to all my students as I transition into the role of educator.

  40. Steve Whitehead says:

    Matt – I’m glad to hear that you think it will be useful. As EMS educators, our goal is to always pass on something useful. Thanks for passing this on.
    John – Thanks. I did want this one to be different. I’m glad that you noticed ad found it more meaningful.
    Barbara – Good advice. Thank you. Happy retirement.
    Mike – I agree. It’s one of the best things about medicine. There will always be more to learn. Thanks.
    Connie – I’m sorry that happened to you. I’m glad you are healing.
    Paul – Ha! That should be lesson number 1 in 101 rules about blogging. Love to write. Hate to proofread. Thank you for actually listing the errors instead of just moving on. I appreciate your help and I made all of the corrections you suggested. Except that I didn’t understand your meaning with #47 and. Now don’t start checking the spelling in my comments or I’m really in trouble.
    Matthew – I do count on folks like Paul. I’m good at being a paramedic. Paul’s good at spelling and grammar. He helped the piece. I can live with that. I’m glad you liked the list. 😉
    Kevin – It’s true. You can only really learn by experience. And those that aren’t interested in learning will most likely not take the time to read it. But for those who are interested, it’s helpful to have a guide to point the way. Thank you.
    Allison – Thank you. I hope it starts many great conversations.

  41. Jonathon January says:

    Ok, I’m a newbie…. I mean new newbie. Not even close to the EMT level yet. In fact, I’m taking my EMR Nation Reg’ test this coming Friday {scared to death}…

    That all being stated I got almost all of these except #63. Whats a pram?

    Thanks in advance.

  42. Great list!! If you were to expand it, I think
    A) never underestimate the power of humility
    B) if you want to become a medic, the best way to become one is to become an awesome EMT first. Nothing beats the basic assessment and basic skills. If you can’t perform rockstar compressions, it won’t matter that you can intubated.
    *just a few extras from my humble experiences.

  43. Don’t be too proud to accept a no from someone in Law Enforcement, Fire or EMS. They have a reason. (Experienced last Friday on Interstate 5)

  44. Dawn E. Pelazza says:

    What a gift you have given to all of us in healthcare. I will read and share this again and again. Thank you and God bless.

  45. Anonymous says:

    When the chest pain patient says he been
    Chest pains all day, and its now 3am, don’t
    Ask him while he waited until now to call

  46. Brian Moody says:

    BLS before ALS

  47. Anonymous says:

    Best advice ever!!!!

  48. 90% of what a paramedic does only requires BLS skills. But it’s understanding the underlying pathophysiology of the disease or injury which allows that paramedic to tailor treatment to that specific patient situation.

    Transport IS a theraputic modality!

  49. Cassie J says:

    I am currently in an EMT-B class and one of my fellow students posted this on Facebook. Thank u for posting this! I am going to print out a copy and keep it in my book. I’ll remember these as I continue my career as a paramedic. They r very insightful! Thanks again!!

  50. Cassie J says:

    I meant one of my fellow classmates not students haha!! Sorry about that.