Is EMS designed to attract dramatic people?

[VentMonkey]

@OREMT excellent post! Thank you for sharing. This is the kind of post I feel ALL newcomers should read. And, no, it wasn't too long.

If you want to become a paramedic, believe me when I say you will do great, but if nursing piques your interest that's cool, too.

A humbled provider is a wise one, regardless of their "field time". I know paramedics with twice as much "experience" as me who don't possess the insight you've just shared, so thanks.

 

[OREMT]

Thanks, @VentMonkey. I always like reading threads from experienced folks on here, so thanks for that too.

 

[NomadicMedic]

<slow clap>

Well said @OREMT. Well said and well done.

 

[DesertMedic66]

As a newbie I can't say I've got much wisdom to offer, but I'd like to share an early EMT experience that ultimately made me much wiser. Sorry if this post is too long.

I am a brand new EMT, just certified last August. I found A&P fascinating, was interested in healthcare, and wanted to work outside, so I started down this path in the hopes of becoming a career paramedic. I can't say I was ever really drawn to the gore and promises of "heroism," at least not at first. But as my EMT class progressed, and as I heard more and more war stories from veteran medics, I really started thinking, "Hey, this is kind of a badass job." When we did practice scenarios in class, we often pretended to be responding to extreme situations - lots of GSW's, serious MVA's, and tricky "scene safety" scenarios involving drug houses and nightclubs. Though much of this was tempered by conversations with actual EMT's in the field about transferring dialysis patients and running syncope calls, I nonetheless found myself feeling more and more like a future action hero when I went to class.

When it came time for me to do the first of my few required "clinical experience" shifts in the local emergency department, I was foolishly hoping for a cardiac arrest to come into the trauma bay. You can't do much in the hospital as an EMT student, but you can do chest compressions, and I wanted my chance to play the hero. By this point, I knew many of the medics working that night and as they brought in patients I kept jokingly asking them to bring me a cardiac arrest (just so you know, I'm cringing as I write this.) Codes are "good calls," and I wanted to see a "good call." At around 5:00 AM a guy in cardiac arrest following three gunshot wounds to the chest came in, and I had my chance. In between my compressions the trauma doc tried needle decompression; it was all very bloody, and the doc called his death within a few short minutes. I felt stupidly satisfied that I had seen a "good trauma."

No sooner had I taken my gloves off than I heard another arrest coming in, this time to a pediatric bay. A mother had woken up to find her 6 year old son in cardiac arrest in bed. I rushed to the bay, but it became instantly clear that this was no place for an EMT student to get "hands-on" experience, so I just watched the situation unfold. They worked the kid for maybe 10 minutes before they had to call it. As I watched, I didn't see any "heroes" defending this boy from the reaper. Rather, I saw a highly skilled team of professionals working together and doing their job. There was no bravado, no magic, and no drama, save the real-world drama of comforting a grieving parent.

I cannot tell you how instantaneously I realized what a supreme a**hole I had been for hoping someone would go into cardiac arrest, just so that I could feel like a big deal. That man whose gore I thought provided a "cool experience" had a family too. This, more than most anything from my EMT class, was my real learning experience. After that I realized that yes, there is drama in the field of EMS. There is in fact plenty of real world drama - enough to make it so that there should be no room for dramatic EMS providers, no room for self-centered, wannabe heroes.

I think EMT education has a lot to do with how this job is perceived by newbies and by the public. It can be a dangerous job, so EMT classes (or at least mine) seem to overemphasize the danger, to the point where one assumes that you must be some sort of action hero to do the work. I think this mentality can be reversed through more actual experience in the field, more opportunities to see what the day-to-day job is really like. I also think EMT classes should have students spend more "experience" hours in places that care for the elderly (be it nursing homes or acute care in the hospital), because EMT's spend far more time responding to elderly patients with chronic conditions than severe traumas.

Once I got my first EMT job working a wheelchair van I believe I saw much more of what the prehospital environment is like in real life, though I still have a hell of a lot to learn. Now that I've gotten over my whacker phase, I hope to keep maturing into a healthcare provider. Funny thing is, I found I really like the patient interactions I have on the wheelchair van, and many times when I've mentioned that to other EMS folks, they'll say, "Maybe you should think about nursing school..."

Are you sure you are new? Based off of that post I would have said the opposite.

I teach the medical skills for a local EMT class and I always avoid doing what you said your EMT class was like. I do not tell war stories because they normally serve no other purpose than "I am a badass". The majority of the medical calls that I give the students are the normal calls we get and sometimes strange calls we get. Every semester I will mix in a handful of critical calls just to see how they do (I record all the calls and review them with the students later).

Why lie to students and tell them they get to wear a cape and save lives everyday with a hot chick on your shoulder.

 

[VentMonkey]

@DesertMedic66 how receptive do your students seem to be to your approach?

Clearly, it isn't a "standard" approach taken by most EMT instructors I have heard about, regardless of the region.

I've had way more misguided new trainees from anywhere, and everywhere than anything. I'm going to go ahead and say his post reflects a little bit of life experience as well. We all know most EMT students don't have that.

Since they don't what is it you think would help ensure they'll abide by your realistic and practical scenarios, and not get sucked into the "EMS bug"?

 

[DesertMedic66]

@DesertMedic66 how receptive do your students seem to be to your approach?

Clearly, it isn't a "standard" approach taken by most EMT instructors I have heard about, regardless of the region.

I've had way more misguided new trainees from anywhere, and everywhere than anything. I'm going to go ahead and say his post reflects a little bit of life experience as well. We all know most EMT students don't have that.

Since they don't what is it you think would help ensure they'll abide by your realistic and practical scenarios, and not get sucked into the "EMS bug"?

I haven't had any complaints and usually get great reviews after the class is done. I try to really make the students think (once they have their basic assessment down) and will usually relate the scenarios to the info they had in lecture earlier in the day to help reinforce those topics but I keep it varied. So the first call will be a chest pain, second will be an infant full arrest, third will be a trauma (students have a hard time when they are in the medical station and they have a trauma patient) and that last patient may be an organophosphate poisoning.

 

[EpiEMS]

War stories...oy. I was lucky in having an EMT instructor who avoided them. The only personal stories he told were ones that were illustrative of a difficult differential or, I realize this now, bad system design. Maybe that comes from his background (trained public school teacher).

You know, there's something to be said for having teachers that are trained in teaching - not to disparage those of us who are not professional educators (by training), but maybe there is something we are missing?

 

[NomadicMedic]

In the NAEMT instructor course, they specifically note that if your class seems inattentive to "relate a personal experience"

Perhaps to some that means "tell all the war stories".

 

[EpiEMS]

In the NAEMT instructor course, they specifically note that if your class seems inattentive to "relate a personal experience"

I have to wonder if that is really best practice for adult learners. I don't think a personal experience necessarily makes for a good teaching tool, you know what I mean?

 

[VentMonkey]

I have to wonder if that is really best practice for adult learners. I don't think a personal experience necessarily makes for a good teaching tool, you know what I mean?

Right, and here are the two very pertinent key words to this conundrum.

 

[SandpitMedic]

Interesting view for a newcomer.
I like it. Once again, barriers.

Formal education. Associates degree minimum. Extended clinical internships.

Those will go a long way in helping people succeed in this field, and see it for what it really is. A more well rounded education to prepare students.

Everyone is excited when they are new, and there is nothing wrong with that. When I had my first job, I was excited to be collecting carts and bagging groceries, and earning my own money. You know what though, cleaning the bathrooms every night really sucked!

Being excited is a normal emotion. Being a whacker is not.

 

[SandpitMedic]

I like that we have reached the point in this conversation in which we've narrowed down some reasons why we perceive EMS to attract "dramatic" people.

The training process.
The educators themselves.
The "wow" factor.

Good stuff. What do we do to start the evolution? We have some information and ideas... how do we implement them and share them beyond EMTlife.com ?