not assertive enough? advice please

Are you basing this conclusion that your not assertive enough on EMT school clinicals, or are you currently working as an EMT?

EMT school is to learn. I was horrible early on in clinicals simply because I had no clue what was going on. Because I had no clue I wisely attempted to stay back and observe. Towards the very end of class I was more assertive because I actually kind of had a clue what I was doing.

I would worry more about the people who are assertive and overconfident but DONT know what theyre doing, and there are a lot of them in EMS.

We had one guy in my EMT class who would jump right in on calls during ride alongs, and acted like he had been doing this all his life. Problem was whenever we did scenarios and practical stations or were just asked questions, this guy never had any clue what he was doing and always got the minimum passing score on tests, just enough to not fail, before finally failing the final exam. This despite the fact he was supposedly this star student on clinicals.

I also see a first responder on many calls who because hes been a first responder for many years, thinks he knows everything. In fact he has no medical training or education beyond first responder, and consistently will say things that are flat out wrong, and does these haphhazard patient assessments that focus in on some hunch he has to the neglect of everything else.

Ill welcome someone who is self conscious and questions themselves over an overconfident knowitall idiot any day.
 
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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@ Swamp wolf I am in the sane boat as you I am able to recall it out in the lab verbally but I get on the truck on a call and all the stuff I learned in class leaves my head, then I forget to do the simplest things.
 
xrsm002 said:
@ Swamp wolf I am in the sane boat as you I am able to recall it out in the lab verbally but I get on the truck on a call and all the stuff I learned in class leaves my head, then I forget to do the simplest things.
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This is awfully common for new folks. The sheer volume of stuff you have to remember becomes overwhelming, then in the fuss you forget stuff that you actually do know. The trouble is that often the folks with experience forget how much there is to remember, because it's all second nature to them now, so they go around slapping their head: "How could numbnuts forget to tie his shoes?"

Eventually everyone seems to hit a tipping point where you know most of the basic steps, suddenly you realize that you know it, and you start to relax. Some scenario-type work and other drills can help you hammer in some of it so there's less active thinking and more automatic execution.

For now, just start each scene with a deep breath.
 
@Brandon OtoWhat about folks who just graduated the class portion of medic school and have been on the truck for over 200 hrs!!
 
xrsm002 said:
@Brandon OtoWhat about folks who just graduated the class portion of medic school and have been on the truck for over 200 hrs!!
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Eh... that's not so long. Particularly for a new medic, because you've got so much more to think about. Did you have BLS experience prior?

I usually find it takes at least six months (full-time) before people start to get into a real groove, know how to handle most situations, and feel comfortable thinking on the fly. Maybe a little less in very busy systems, but again, that's for BLS.
 
xrsm002 said:
@Brandon OtoWhat about folks who just graduated the class portion of medic school and have been on the truck for over 200 hrs!!
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Total hours is a poor measurement and indicator.

Number of patient contacts along with severity is a much better indicator.
 
My preceptors don't think I'm assertive enough but I move slow due to the fact I have some PTSD according to my therapist. I am debating if I should tell my preceptors or clinical coordinator this, therapist says no, but I know this is what's causing me to freeze up.
 
xrsm002 said:
My preceptors don't think I'm assertive enough but I move slow due to the fact I have some PTSD according to my therapist. I am debating if I should tell my preceptors or clinical coordinator this, therapist says no, but I know this is what's causing me to freeze up.
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The plot thickens...

One day people will understand it is better to move slow and be right than to move quickly and be wrong.
 
xrsm002 said:
My preceptors don't think I'm assertive enough but I move slow due to the fact I have some PTSD according to my therapist. I am debating if I should tell my preceptors or clinical coordinator this, therapist says no, but I know this is what's causing me to freeze up.
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I would say no unless it gets to the point where you may end up terminated as a result. Just keep grinding along. Everyone goes through this same process to a greater or lesser extent, and frankly I think some of the slower learners end up being the best providers in the end.
 
These are my 2 cents.


Me during the first few weeks of emt course. I was clueless, felt stupid, whenever I would get questioned by the teacher, my head would go blank, and I was nervous all the time thinking my teacher would ask me. I realized I needed to study hard, In case I would get asked by the teacher. In the weeks to follow, I was on top of the game, I was not the smartest in the book, but I was EMT smart. I was participating in the hands on skills, in the scenarios I was first to volunteer, and I was helping my other two friends in their skills. I would come up with scenarios and helped me and them finally get it. We all three did really good in the last tests, in the final, and passed the skills test like a breeze. I gained the confidence to not be nervous when my teacher asked me things. He worked at the hospital we did our clinicals, so he was constantly checking on us.

I got a job as an emt a month after getting the ambulance license, nremt, county card, etc. And my FTO treated us like scum, questioned every little thing we did wrong. Our orientation consisted of an 8 hr shift, with FTO and EMT. That was it. My first few shifts were with newbies. Our FTO's advice, do not kill anyone.

Imagine how a new EMT can feel in that situation, now add or I must say subtract, having at least an experienced EMT with you. Well it was rough, but after a month or so. I do not know how many calls exactly I finally got it. I am quiet person, not shy, just serious. My partner was a girl who thought she knew it all. Until my last shift there I saved her from running over a pedestrian because she was texting while driving. For a second I thought, maybe I should have let her run him over, it would have been on her, as it was my last day working there. However I felt bad for the pedestrian. Ms. Know it all said thanks. She probably learned her lesson, she was rude to us new EMTs.

So just remember you need a huge thick coat of skin for this job, or it wont work. You will get nice people, burn outs, know it alls, d bags.
 
I'm a pretty solid Beta who tends to defer to whoever is present and more qualified than I am. When I was new at EMS this meant pretty much everyone. As I became more confident in what I knew I also became more confident taking charge and suddenly people were looking to me for leadership. I now find there are fewer and fewer situations where there's anyone for me to defer to. Now I've started medic school and once again I've tumbled right back down to the bottom of the hill where I find myself once again looking to others for my cues.

Once you feel more confident in your skills and knowledge base you'll be fine. In the mean time as someone suggested just try and fake it.

One note though. Being assertive doesn't mean being an :censored:. often people who are trying to act tough take their examples from characters like House.

Be confident but be kind, both to your patient and to your co workers. Pulling the whole sarcastic :censored: routine only works on shows like House where you have time to get to know the warm fuzzy side of the character over the course of a few seasons. We only have a few minutes to an hour with our patients. If you act like a jerk that's all they will remember you for.

Also one more thing I want to point out. If you're a female it's even harder to manage the assertive but not a jerk thing. This has to do with the fact that society views assertive men as "strong" and assertive women as either insecure or outright :censored:s. This is a double standard that I don't agree with but it is a double standard that isn't going to change anytime soon. Women that manage to walk this line have my utmost admiration.
 
Well that's one thing I do have I show compassion for the ones I treat whether it be a frequent flyer or a rich person I try to treat them all like I'd want my family to be treated, kinda angers me when I see experienced providers yelling at the patients, or just talking down to them.
 
I have also been told by other people preceptors I am very easy to get along with.
 
I think assertiveness, or at least healthy assertiveness, is a fine balance between natural confidence, experience and the understanding of need. You turn it on and off.

If I think you really need to listen to me, and your health is in peril, then I'll assert. If you're getting too far off-topic and I need more specific info, then I'll assert.

But a lot of the time, assertion is unnecessary or even counterproductive. We need to be active listeners more than anything else. Don't be shy is saying hello or asking questions, and if you're unsure, double-check stuff. It's silly, but if I'm floundering, I'll reauscultate, or take a BP again or something. Get more information, build pt confidence, buy time to think.

We don't always make snap decisions, because deciding too quickly/early isn't always a good idea.

So don't stress. You'll get better over time as you've seen and done more.
 
I have the opposite problem... I had someone call me "arrogant and cocky" at work the other day. Me? never :rolleyes:
 
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