I tend more towards confident myself. ATCEMS's hiring policies present confident, assertive personnel with a challenge: bite our tongues for years while accepting the Kool-Aid in a system similar in all regards to every other "high-performance" EMS system, making lower-middle-class wages in an expensive area, and betting on better-than-average long-term benefits being enough to accept hard limits on our work and professional development.
Take me for instance. I have been a paramedic for six years now. I do not know it all, but I know quite a bit, and more importantly, I know I can handle myself and manage a call. I know the workflow, how to work with people, how to delegate and manage, and how to perform. I'm the man, the chief, the leader. Certainly I also know how to help, assist and advise, but I find myself wanting to lead and do and manage, because my place is (to me) that leader's role. I want things to be done the right way, my way, and I am not bashful or ashamed of it. When partnered or assisting likeminded folk, it is smooth and harmonious- work is being done by two well-trained, likeminded teammates- but those partnerships in places I work in are of my design, because I am the leader of the team and my way goes. I am the paramedic, and I like it that way. Certainly I can and do pick up information, knowledge, techniques and tricks from everyone, but I don't have revelations from peers or need to be precepted or mentored to be functional, competent and confident in any EMS system. Even crazy ones like Presidio would come fairly quickly to me, because I have the confidence and knowledge of how to work and learn already. Systems like ATCEMS, particularly ones with Lots Of Good Hospitals and Protocol Bibles and Limited Prehospital Care, are the kiddy pool of EMS and take about as much practice as learning to wade for me to be confortable, competent and excellent at. Put me in Houston, or Las Vegas at AMR or MedicWest, in Denver, in Albuquerque or Fort Worth or OKC or Austin or San Antonio (Fire EMS or Acadian) or Pafford or Hall or AMR or anywhere where English is spoken and I can hit the ground running. Tell me how I get paid, tell me the door and radio codes, tell me where your protocols are and what QI expects and I can work well. I know how to be a paramedic.
That's confidence. You call it cocky, but that's because you associate that confidence with what you have always been told is "cocky", dangerous and unstable. It's anathma to the leadership at most "high-performance" systems, because that confidence leads to more than just clinical assertiveness- it leads to a desire to improve our lots in life the easy way, the aggressive way, the American way. It breeds questions, challenges and expectations that can never be met, so it is labeled as recklessness, cowboy, unstable, bad and undesIrable.
Austin-Travis County doesn't want that attitude. They'd rather take someone and train them by repetition until thet only know how to work the ATC way. That's not wrong, but their entire approach relies on deprogramming the habits and attitudes of the Rest of the World and replacing them with the sanctioned, approved thoughts of ATC. New guys who know little or nothing but ATC do well, because they are "the best" and they know it; they can master their systems and promote and perpetuate the myth, legend and mentality and measure themselves with their chosen yardstick to be the best- but they need more than just local new talent to staff and replace, so they reach out and target everyone else's new folks too, in the hopes of getting them before they are set in their ways. Sometimes it works, and they get Chewy20s and other new paramedics and EMTs, lured by the different locale, the promise of Texas-style bigger and better, the organizational structure and the retirement and the illusion of job security. It's tempting, and admittedly objectively better than a lot of other places offer. Me in 2012, fresh out of the Army, patch and pulse and eyes wide open, would have been perfect for ATC- but I went elsewhere. The ATC recruiters don't just get new people though. They get (and sometimes hire) people of all sorts of backgrounds, as they see fit. Sometimes they get experienced people who fit in, who can play the game and bite their tongues or just don't mind the Kool-Aid- but sometimes they get people with initiative, with drive and desire. People like me, who question and eventually get frustrated and stagnant. People like Ryan.
The reason ATC has so many morale problems is because they are stagnating. In the early years of the millenium or the 90's, they might have been legitimately cutting-edge, but they really aren't any more. The rest of the world has caught up to ATC and surpassed it, so now ATC is just another high-performance urban EMS system.
