not assertive enough? advice please

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brandnewemt

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Hi all,

I just finished my EMT-B course a month ago. When going on calls, my biggest issue seems to be that I'm not being assertive enough. The problem is, I'm worried about overstepping and pissing off those who have been doing this much longer than I have. I'm confident in what I've learned, yet I find myself fumbling around at the simplest things. Does anyone have any advice on how to overcome this? I'm only 3 calls in, but I'd like to resolve this issue ASAP.

Thanks!
 
Are you responding with another EMT? With a medic? Why do you feel you're not being assertive enough? I suggest that you tell your partner you want to lead some calls. You can't do it unless you do it.
 
I'd say ask the folks you're working with - tell them "I'd like to step up on some of these calls but I don't want to step on toes".

Some folks will be fine with this, and some won't. At least you've laid it out for them. A good mentor will encourage new folks to step out of their comfort zone.
 
Its a fine line between being assertive and being aggressive and its a wise person that knows the difference. If in doubt, be assertive by asking questions. Don't blow your cool, try not to fumble too much and always review what you did to see whether there would be changes to the process next time. If you see a difference between the waqy you were taugt versus what you see in the field, don't be afraid to ask why there is a difference and/or why your partner chooses that specific method.
 
brandnewemt said:
Hi all,

I just finished my EMT-B course a month ago. When going on calls, my biggest issue seems to be that I'm not being assertive enough. The problem is, I'm worried about overstepping and pissing off those who have been doing this much longer than I have. I'm confident in what I've learned, yet I find myself fumbling around at the simplest things. Does anyone have any advice on how to overcome this? I'm only 3 calls in, but I'd like to resolve this issue ASAP.

Thanks!
Click to expand...

Are you being told you are not assertive enough or is it how you feel?

If you are being told, tell those people to "F*** off" and ask them if that is better.

If it is a self assessment, I can tell you that confidence comes with comfort. I'd be more worried after 3 calls if you thought you were an expert than you being afraid.

You are still very new at this, give yourself some time to get all of the stuff in your head into an order of importance and action.

Very few patients are actually textbook as you learned them. If it feels like you can't figure them out right now, you are probably where you should be. It gets better with more patients.

Also, something not often expressed in medicine is that we become better providers from the sum of our experiences. That includes close calls and mistakes.

In my not always humble opinion, a provider who is once bitten and forever shy is a far bigger diservice to future patients than one who is bitten but tries again.
 
brandnewemt said:
Hi all,

I just finished my EMT-B course a month ago. When going on calls, my biggest issue seems to be that I'm not being assertive enough. The problem is, I'm worried about overstepping and pissing off those who have been doing this much longer than I have. I'm confident in what I've learned, yet I find myself fumbling around at the simplest things. Does anyone have any advice on how to overcome this? I'm only 3 calls in, but I'd like to resolve this issue ASAP.

Thanks!
Click to expand...

Hi Brandnewemt~ I'm a newbie as well. I have gone on 4 calls so far since finishing my basic class. I'm still pretty nervous but eager to learn. I feel confident about my "textbook" knowledge, but I'm overwhelmed by it at the same time. I feel like I have so much info in my head that when I'm on a call, I try to dial in to what's going on, but I forget the stupidest stuff, stuff that I KNOW is in my brain but somehow I don't recall it in the moment.

For the rest of the forum, please tell me that, with experience, all this information swirrling around in my head will fall into order...Did or does anyone else feel the same way when starting out?
 
swampwolf said:
Hi Brandnewemt~ I'm a newbie as well. I have gone on 4 calls so far since finishing my basic class. I'm still pretty nervous but eager to learn. I feel confident about my "textbook" knowledge, but I'm overwhelmed by it at the same time. I feel like I have so much info in my head that when I'm on a call, I try to dial in to what's going on, but I forget the stupidest stuff, stuff that I KNOW is in my brain but somehow I don't recall it in the moment.

For the rest of the forum, please tell me that, with experience, all this information swirrling around in my head will fall into order...Did or does anyone else feel the same way when starting out?
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If you are lucky, you will have a teacher or mentor who instructs and guides you how book knowledge applies to the "real world."

You will then become a competent and confident provider.

If things don't go so well, you will learn what to do, but always be at a loss for why.

That leads to ignorance and arrogance.

It is much easier to be calm and collective when you are proactive rather than the constant uncertainty of being reactive.

But as I said to the OP, at this stage in the game, you sound like you are right where is expected.
 
Communicate with your coworker. That is how division of labor and coordination of action are initially devised. If your mentor/coworker won't communicate, at any point working on ambulances, it's time to ask to talk to your supervisor.
If you are on orientation they ought to have a full crew with you riding extra and doing stuff as directed and observed. If you are on orientation and expected to act as a full half of a team, then your company either has problems, or you really impressed them. If you are off orientation, then you and your coworker need to talk, with you as the mentee, and (s)he as the mentor.
 
Last edited by a moderator:
swampwolf said:
Hi Brandnewemt~ I'm a newbie as well. I have gone on 4 calls so far since finishing my basic class. I'm still pretty nervous but eager to learn. I feel confident about my "textbook" knowledge, but I'm overwhelmed by it at the same time. I feel like I have so much info in my head that when I'm on a call, I try to dial in to what's going on, but I forget the stupidest stuff, stuff that I KNOW is in my brain but somehow I don't recall it in the moment.

For the rest of the forum, please tell me that, with experience, all this information swirrling around in my head will fall into order...Did or does anyone else feel the same way when starting out?
Click to expand...

This is EXACTLY how I feel! It make me feel much better that others feel the same way. it seems like there are so many people who get their EMT card and want/expect to take charge right off the bat. To me, the ability to lead a call should be something that's earned, not expected...
 
Relax a little. You will learn through experience what horses (versus zebras) to expect and what to do, and especially how to assess a patient. There is NO replacement for real patients with a variety of repeating problems to teach you patient assessment and care, and every day has the chance to toss you a curve.
Once you get by this initial stage, they will trust you more (maybe too much at first:cool:) and you will feel the pressure lift if you are not beating yourself up. That will never end if you don't end it.
 
brandnewemt said:
it seems like there are so many people who get their EMT card and want/expect to take charge right off the bat.
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With the exception of some rather reputable field training programs in a handful of very reputable agencies, you likely will be expected to take charge in short order.

Depending on your area or agency, you might just show up and be the highest trained provider on sceen. (If not in your circumstance, remember that somebody somewhere is facing this with the same training and experience as you.)

There is no classroom exercise that prepares you for the moment everyone looks to you to take direction from. It is scary and seldom goes perfectly.

But you cannot be in charge a second time until you have been in charge the first. Relax. You will make mistakes. (Now you don't have to worry about if you will.) Nobody is perfect, those claiming such are fools or liars. Learn and move on.

brandnewemt said:
To me, the ability to lead a call should be something that's earned, not expected...
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:rofl:

Sorry, don't know if you know what you signed up for. Emergency medicine and service is known for giving people enough rope to hang themselves prior to being thrown to the wolves.

The experienced people are also known to eat their own young.

But we made it and so can you.

Don't worry about what cannot be changed.
 
I always recommend to anyone entering into a new field or role to keep a journal for the first year. After you get the hang of things, what was once really exciting becomes a common occurrence. Gradually you may even become bored of things that almost gave you a heart attack in the early days. What's truly humbling is your recorded attitude when your first "regular customer" passes away. Its a riot when you go back and read about these constantly new occurrences, your fears and attitudes. I recommend that to all healthcare providers regardless of their role.
 
Roger that tederator!
 
Always remember it's their emergency, not yours.

We're all human, if you intend to stay in this field you will make your fair share of mistakes. We all have our stories.

If you find yourself too anxious on calls to remember your duties just remember your basics. Don't get tunnel visioned... Distended abdomen, flail chest, cardiac or stroke like symptoms, it doesn't matter. Keep your ABC's in mind, trend your vitals, treat what you can but most importantly never lose site of what is REALLY important.

Keep this in mind and you will go far. For now relax, take in what you can.
 
I can't speak to your partner(s), but personally I'd rather a rookie step on my toes, so to speak, than be a wallflower on calls. You should work out beforehand who will take the lead on a particular call. Once you have done your primary survey and vitals, if your are not 100% sure how to carry on communicate with your partner, recap briefy your findings, then suggest what you think the next course of action should be, even if youre not totally sure.

The most important thing is to try and base the decision on the information you have. My biggest peeve with EMT partners is when they look to me to make decisions for them. That said, I step in if he is doing something out of line, or if interventions are out of his scope. Otherwise, I want my partner to be able to make independent decisions as for his scope will allow.
 
I'm a student still and have trouble being assertive no one in my family is assertive. I've also had calls where im leading and I walk I forget everything I learned. Anyone ever have that issue?
 
xrsm002 said:
I'm a student still and have trouble being assertive no one in my family is assertive. I've also had calls where im leading and I walk I forget everything I learned. Anyone ever have that issue?
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You'll learn to develop a "work face." Plenty of mousy people in this job who know how to turn it on when they make patient contact.

As far as assertiveness, just remember that your degree of confidence reflects your level of actual competence. You don't want to learn to waltz around acting confident before you actually know what you're doing, because you're sending out a message that you don't need any help and you've "got this"; if you actually don't, then you're going to hurt somebody. If you've got a pretty good handle on the work and you're still timid, that's one thing, but if you're still figuring things out and you look that way, there is absolutely nothing wrong with that. Like a "Student Driver" sign on your roof, it's a useful and important signal to those around you.
 
brandnewemt said:
Hi all,

I just finished my EMT-B course a month ago. When going on calls, my biggest issue seems to be that I'm not being assertive enough. The problem is, I'm worried about overstepping and pissing off those who have been doing this much longer than I have. I'm confident in what I've learned, yet I find myself fumbling around at the simplest things. Does anyone have any advice on how to overcome this? I'm only 3 calls in, but I'd like to resolve this issue ASAP.

Thanks!
Click to expand...

Here at the station I usually have a set group of people that I work with. We all have a rule that we will take turns scribing/taking lead/doing vitals. That way no one over steps the boundary of another person. You aren't going to get anywhere if you don't ask if you can take lead, they're just going to assume you aren't confident or comfortable and keep taking lead. Either that or they're just going to throw you in one day and tell you to do it. Don't be afraid, the only way you get any attention to the problem is if you speak up about it. And definitely don't go hijacking the other person's scene.
 
Be assertive. Who cares if you piss someone off? It's your patient, your responsibility.

I am shy as hell outside of work, however once the uniform comes on, I have a job to do and I do it, and anyone who gets in my way preventing me from doing the job I'm paid and educated to do will get theirs.




Be respectful, but don't be afraid to hurt feelings if it's called for.
 
OP how'd it go?:mellow:
 
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