What would you bet your life on?
In 1996 I took a job about 40 minutes south of San Jose, California with a small mom-and-pop ambulance company. The service was named after the owner and had been serving a mostly rural area of northern California for a couple of decades before I arrived in town. They were, without a doubt, the worst ambulance company I ever served under.
The owner ran the place like a dictator. I started work the day after my interview on a dirty ambulance wearing an old uniform that was two sizes too large. My partner was the grumpy silent type. The station conditions were deplorable and the policies and procedures were down-right unethical. (As an example, the owner would frequently order crews to respond to scenes, after they had been canceled enroute, so that they could gather billing information from the caller.)
I worked at the service for about three weeks, then I left. I knew that nothing about that service matched with who I was as a paramedic and nothing I could do would ever change the two decades of tradition and old guard thinking that had brought them to where they were. Unlike my uniforms previous owner, I washed my threadbare shirt before I handed it back in. Then I hit the road and I didn’t look back.
I could have wasted years in that joint.
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It’s the week before the final exam and my EMT class is feeling the pressure. The two-hundred question final looms large on the horizon and, in less than a week, the students will need to perform five randomly selected skills stations perfectly. This is the task that has most of the students really feeling the heat.
So we do what we do every class. We practice and practice and practice. So
there we were, gathered around in groups, practicing our National Registry skills sheets. That’s when Joey asked me the question that absolutely floored me. It floored me and annoyed me, but really didn’t surprise me. I’ve heard the question asked before in many different ways.
Joey finished up his medical scenario and I was giving him some feedback on his performance. He looked down at the fictional patient’s medication list that I had provided him and he shrugged his shoulders. “We don’t really have to know what all these mean right?”
I told him I didn’t understand. He mulled the thought over in his head and took another stab at it. “I mean…we need to write these down and report them to the doctor, but it isn’t important for us to know what they all do. (Pause.) As EMT’s. (Pause.) Right?”
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Call it a curiosity. I wanted to know how the EMT Spot readers would finish the sentence, “Behind every great EMT…” So I asked.
I asked on twitter. I asked on Facebook. I even asked right here at the blog. And the answers poured in. Your responses represented the full spectrum of personalities that inhabit our workplace. There were poignant responses, cynical responses and a bunch of funny ones. The responses made me smile and frown and think.
Within this list of answers you’ll find feedback from 30+ year EMS veterans and newbies just getting their EMS feet wet. Everyone is represented. And the responses are telling.
I’m rather proud of how this little experiment turned out. I hope you find these responses as enjoyable and thought provoking as I did. Thanks for all your contributions. Aside from categorizing these contributions, I’ve made no further editorial additions. This post will become part of the guest posts category, because it was written by you.
Complete the sentence, “Behind every great EMT…”
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OK, I can’t keep this to myself any longer. It’s time for the big
announcement. With the final draft still in the mail from my editorial team and the final design still lacking a few details, it would probably be best to just keep this under wraps for a few more weeks, but I can’t wait.
My first E-book is scheduled for release on January 21st, one week from today. The e-book will be free and it will be available right here at The Spot.
The Book is called The Non-Conformists Guide to EMS Success. This book is the culmination of two decades of EMS experiences, mistakes, failures, trials, and errors that lead to my ultimate success. My goal was to write something that would be useful to EMTs at any stage in their career. And I didn’t hold anything back. This is my road map to finding true success and fulfilment in EMS work.
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Circus elephants present a containment problem. It’s hard to keep a big elephant cage around wherever you go. So when baby circus elephants are trained, they are staked down to a pole with a chain. The young elephants pull and struggle against the chain for a while and then learn the limitations of the situation.
Soon the elephant can be staked down with a wooden stick. The elephant could easily break the confinement but it doesn’t try. It’s already learned what it can and can’t do. To add further insult to the awesome, unrecognized power of the beast, by adulthood many of the elephants can be training to pull up their own stake and move it on command and then remain in the spot that they re-staked themselves too.
I think about the circus elephant staking itself down often. Mostly when I hear my colleagues and friends talk about the obstacles that prevent them from recognizing their goals. You know what I’m talking about. All that stuff we’re waiting for before we can start really moving toward our vision for our life.
When I look at the awesome human potential that we carry around within us and then I consider the little, insignificant things we chose to see as barriers, I think about the elephant.
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From Your Computer
As you might imagine, I’m a big fan of E-learning. I also have a soft spot for the social media craze. But there are still a few things that you just can’t learn staring at a computer screen. OK, there are a LOT of things you can’t learn staring at a computer screen. Here are ten:
1.) You can’t learn pattern recognition.
If you’ve ever wondered about how experienced EMTs and medics can figure out exactly what’s wrong with the patient two steps inside the front door, it’s not magic. It’s pattern recognition. When you’ve seen what CHF looks like a hundred times, you can pick out the pattern almost instantaneously. Watch a hundred people have cardiac chest pain and you’ll be able to see it from across the room. But it doesn’t matter how many times you read those chapters in your books. You need to see it.
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I get a bunch of E-mails from people just starting their EMT education who want advice on how to excel in their programs. “How should I prepare? What books do you recommend?” The questions vary but their is always the familiar flavor of enthusiasm and the same basic question, “How do I do this well?”
Success in this field is fairly predictable. Use the right recipe and you’ll get there. I think the hierarchy of EMS success looks like this:
1.) Attitude
2.) Motivation
3.) Tolerance for repetition
4.) Goal orientation
5.) Strategy and tactics
6.) Performance
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In the span of a generation, NASA has lost two spacecraft and 14 pilots in the collective disasters of the space shuttles Challenger and Columbia. Can you tell me why? Trust me, it’s worth exploring.
The space buffs in the crowed might recall that faulty O-rings in the Challenger’s solid rocket boosters failed and allowed supper heated gasses to escape. The result was a catastrophic explosion and a sullen announcement from my school principal in the middle of sophomore science class. In his quiet monotone, we learned that the mighty Challenger, moments before, had been destroyed and the crew was lost.
Our teacher didn’t know quite what to say, and in the silence that followed, my sixteen year old world got a little smaller.
More of you might recall that Challenger’s sister ship, Columbia, burned up on reentry returning from a mission in 2003. The Columbia’s heat tiles were damaged when a piece of foam insulation dislodged during takeoff and struck the tiles on the wing. Those tiles later failed under the heat of reentry and the craft burned up over the mid-west. Interesting right? But what does all this have to do with EMS? Follow me on this next part.
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I’m going to ask you to try something out for me. And then come back and tell me what you did and how it went. I want you to go to your next shift with this idea:
Be Remarkable
That’s it.
What would it look like? How would you do it? Those are valid questions. They also might be resistance to the idea of being remarkable.
You may have grown accustomed to the idea of laying low, going with the crowd and being rather unremarkable. Here are some ideas.
1.) When little kids and grown adults are inspired by you, you’re remarkable.
2.) When you walk on to a scene and the energy you bring with you changes the mood for the better, you’re remarkable.
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Did you get the IV?
Sometimes it seems like your performance on the whole call can be reduced to the success or failure of the IV start. Rarely does the successful treatment of the patient hinge on a successful IV placement but sometimes it can certainly feel that way.
The best way to ensure that you’re ready when that make or break it IV start does come your way is to start a lot of them when the pressure is not on. If you wait until game day to practice, you’re a whole lot more likely to fail.
The single biggest factor that separates the IV virtuoso from the weekend hacker is practice and experience, so when the patient could use an IV, jump in there. The patient’s a kid. … Get in there. The patient is a frail, elderly woman on Coumadin. … Get in there. IVs are nothing to fear. Start practicing these six IV start tips. Before you know it, you’ll be an IV starting superstar.
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