Advice for New EMT's

A few weeks ago I received an email asking for some advice…

“My question to you is…what do you expect from an EMT fresh out of the box?”

I’m honored, first of all, that you’d choose to write me to ask your questions. Being the researcher that I am, I went to the experts in my life. I asked coworkers, former coworkers, fellow bloggers. I got quite the response. Some of the following advice is common sense, a lot of it has been gleaned from experiences we’ve been through.

I’d like to thank Fat Fireman, Medic Matthew, Bernice, @jisbellemtp, Pulse And A Patch and Crzegrl for their input. If anyone else has anything to add, please don’t hesitate to leave a comment.

**********

Be prepared to work. Every day.

Be on time, which means at least 15 minutes early. Showing up thirty seconds before you’re scheduled, and sitting down with your coffee, or stand around with your hands in your pockets is going to impress no one.

Pack some food. While there are definitely days where you can camp out and graze at the local pizza joint, there are also days where there is no guaranteed meal break. Those days will almost always be the days you failed to pack a lunch.

Wear a watch with a second hand. Carry extra pens. Carry scratch paper. Buy a stethoscope that you can actually hear with. (The Littman Lightweight II SE is what I have. Best $50.00 I’ve ever spent.)

Take pride in your appearance. Come to work in a clean, ironed uniform. Shine your boots. Remember that you are representing not just yourself, but EMS crews everywhere. Not to sound dramatic about it, but these people are my tribe, and I take that seriously. Many of them have put in more years than you’ve been alive trying to advance this “job” into a respected profession.

Your reputation is by far the most important tool you can have on your belt. Admit when you are wrong and learn from your mistakes.

Leave your drama at home. Everyone is guilty of bringing problems at home to work from time to time, we’re human. Don’t make a habit out of it. Believe me when I say that patients and your partner don’t want to hear you screaming at your significant other on the phone.

***********

Learn Thy Truck.

Participate in the rig check. Ask questions. Get acquainted with the layout of the truck so that you know where everything is. Having to tear apart the cabinets in back to find restraints while a little old lady or a psychotic drunk is pummeling you is not fun.

Familiarize yourself with how your stretcher operates. For some reason they didn’t teach us in school how to raise and lower it with help or on our own. They didn’t teach us how to put it away by ourselves. Ten minutes of getting to know your stretcher (How YOU doin?) will save you from at worst, dropping the cot with a patient on it (and blowing your partner’s back out) and at best humiliating yourself in the ambulance bay when those around you figure out that you can’t put the stretcher away by yourself.

Learn what the buttons do on the console in the front of the truck. Learn how to turn the lights on and off, how the siren operates. Know how to turn on the power to the back of the truck. Learn where the battery switch is (if your truck has one).

Familiarize yourself with the radio. Have your coworkers show you how to change the channel and adjust the volume. Learn what’s expected when communicating with dispatch and the ER’s.

**********

“Fake it till you make it” does not apply when it comes to equipment or skills.

If there is a piece of equipment that you don’t know how to use, don’t touch it.
If I ask you to do something and you don’t know how to do it, tell me.
If you are in the back with a patient and there is something the patient needs that you don’t know how to do, tell me immediately. It’s okay, really. We were all there at some point to some extent.

Under no circumstances do you ever fabricate a vital sign reading. If you can’t hear it or feel it, there may be a reason.

**********

Practice your basic skills. Then practice them again. And again… And again….

BLS skills are the foundation of everything ALS stands for. BVM ventilations can be just as effective as dropping an ET. There’s never been an IV or fancy electrical tool that has saved a patient whose ABCs were not being managed effectively.

Many trucks have monitors on them that will take a BP for you. All initial BP’s should be done manually. Many monitors can prove to be at the very least occasionally inaccurate, and at the most way the hell off.

Listen to everyone’s chest. Breath sounds, at the beginning, can be very confusing. The more breath sounds you hear that are normal, the better. This way when you hear something that is off, it’ll stick out.

**********

Know when to speak up and when to shut up.

If you have a legitimate concern… speak up.
If you have a question… ask. And listen to the answer.
If you have no idea what you are talking about… sit down, shut up and observe.
It’s okay to be confident, but don’t be cocky. Karma will bite you in the butt faster than you can say fresh meat. (AMEN, Bernice!)

Watch what you say in front of a patient and/or their family. Patients are people first. Nothing will piss me off more than if you talk about your patient to myself/a nurse/anyone else like they aren’t there.

Stay off of your cell phone when we’re with a patient. No phone calls, no texting.

**********

Know your Role.

Many of us come into this job with thoughts of saving the world. We want to help people at their worst moments. We want to be Superman, and fly in with our ambulance and save the day, rescue a bus filled with Nun’s and discover the cure for cancer, all in one shift.

That’s not the way it goes.

You’re not going to save the world.

Many of us get stuck on transfer trucks doing the dialysis shuffle or running bariatric patients to their podiatrist appointments. There is little that is glamorous about this job, but that doesn’t make your role any less important than that of someone working on a first-in primary 911 truck. These are still people who depend on you.

If you are on a 911 truck, realize that you are going to get called at ridiculous hours for even more ridiculous reasons. People are going to abuse the system. You’re going to be called to transport people with popped pimples, drug seekers, and people who just (quite literally) want a ride across town. Accept that it’s going to happen, and move on.

**********

Realize that it’s okay to be emotional.

You are going to see a lot as an EMT, even if you’re not on a dedicated 911 truck. You’re going to become attached to patients. You are going to develop relationships with these people. And a lot of them are going to die. You are going to read their names and see their faces in the obituaries. You’re going to learn more about their lives.

You will probably have particular runs that will wake you up at night in a cold sweat.

Caring about your patients is okay. Crying is okay. Asking for help is okay. Needing help dealing with these runs does not make you weak.

Needing help dealing with these runs does not make you weak.

Yes, I typed it twice. On purpose.

If you find yourself having problems sleeping, or sleeping more than normal, or drinking more than normal, or just in general feeling bad about anything… Find your partner or a coworker to talk to.

**********

Remember to breath.

Starting any new job can be stressful. This one is no different. There is a lot to learn, and relearn. You’ll be tossed into situations you couldn’t even begin to imagine.

If you find yourself getting overwhelmed, take a second to breath. My EMT instructor once told us to check our own pulse first, as long as we could find one we’d be okay. He knew his stuff. I still find myself unconsciously checking my pulse when I’m in a situation that is outside of my realm of experience.

Keep your head up, and your eyes open. You’ll get through it, reader. Keep us posted on your progress!