Do your time first, hero

I can remember the day I first started in EMS like it was yesterday. It was a brisk November morning about 15 years ago. I was really excited to save lives and be a hero and get on the news, and all that. I had a fancy stethoscope that I bought at the College’s bookstore (for like $10! What a deal!) around my neck, a neat black glove pouch on my belt, and a nice trauma shear/bandage scissor combo that I had in my right leg pocket.

I was a hero.

I was also too young to buy alcohol, so cut me some slack, okay?

As I strode into the station, I admired the sharp creases that I had spent countless minutes and an immeasurable amount of starch ironing into my patches. Then I saw him: my new partner.

He was about six-three, and easily weighed three hundred pounds. And it wasn’t necessarily “fat” pounds, either. This guy was built like a defensive end. And his face was mean, too.

“Damnit. Another new kid! They always put me with the new kids.” were the first words out of his mouth. He sounded, in a word, angry.

“Hi, I’m C” I introduced myself in an effort to break some ice.

“I don’t care who you are, or what you think. Keep your mouth shut and do what I say, and you will do just fine.” was his reply.

While his reply was gruff, I listened to it, and heeded his advice. I kept my mouth shut, and I did what he said, and we got along great. He taught me a lot, and I am grateful for his tutelage. I didn’t get my feelings hurt, and I wasn’t offended by his manner. I was really okay with it. He was the veteran, and I was the rookie, so I knew he could teach me a thing or two, perhaps even three.

But nowadays you can’t get away with that. You have to treat the kids with the “kid gloves.” You have to be all tactful and mindful of the self-esteem of the new kids. Especially when they are kids.

Saying something like “I’ve been doing this since you were in Kindergarten, and we need to do things a certain way” can’t be said. Because the new kid runs to the supervisors and tattles on you, saying “he was really mean to me and hurt my feelings, and I need to cry about it a little bit, but he needs to get in trouble!”

There is a lot that the new people could learn from those that have been around for a long time. It’s just too bad that I have to be concerned with someone’s feelings. Especially when I have been in EMS since they were in Kindergarten.


  1. Yes, I find that in EMS, the best way to get my point across is to be gruff and rude to people.

  2. Beginning a new job can be daunting, no need to make the day worse for someone starting out as a Paramedic.
    Personally, I opt for the friendly and supportive approach, turning the pressure on if that doesn’t deliver. In my experience many people deliver better results in a more friendly and reduced pressure environment.

    Maybe your first tutor had some bad experiences with students in the past, but you reminded him how rewarding it can be. Theres a soft core in all of us somewhere…

    @Patrick: Being gruff and rude to people will get the point across that you are a gruff and rude, and therefore generally unlikes, colleague. If that’s what you want….

  3. Personally, I don’t see that “spoiled” mentality as much as it’s complained about.

    Also, it’s one thing to be gruff and unfriendly, it’s quite another to be “that asshole medic”; the one who really believes that EMT stands for Every Menial Task and refuses to help wash the rig, restock the rig, clean the back after a call, and otherwise treats his partner as a servant and not a subordinate or partner.

  4. Flash Larry says:

    I have precepted quite a few young medics over the years. There’s precepting and there’s precepting. Some precepting is really a “ride-along” where the person is just finding out what it’s like. For the new EMT is can all be a little daunting – as it was for me – and I’m always supportive and providing guidance where I can, leading them step by step from observing to talking to me about what they’re thinking and telling them what I’m thinking in re patient care. I always tell the patients that I have a student and I’ve never had a patient have a problem with that. Then from there I move the student into taking blood pressures and doing more up unto what they’ve been trained to do.

    With paramedic preception, I expect the person to know what he or she is doing and to demonstrate readiness to direct and manage patient care. I’m not necessarily a teacher – other than talking about things outside the scope of their training – because these people need to know what they’re doing before I plan to pass them out of preception. I do like to tell them what I expect at the beginning.

    But CCC is right that people today are much, much less amenable to instruction and correction. When I was young, I knew I didn’t know anything and listened to everything my field preceptors and partners and anyone else that I respected said. I was willing, anxious, to be corrected and to have my understanding expanded.

    I don’t see that so much these days.

    • Flash Larry says:

      Let me add one more thing. A ride-along is a very revealing event for the perceptive preceptor. The behavior of the student during the ride along is predictive of how he or she will handle the job later on. If you have a student who is just there to get through the ride, not interested or at least not pro-active or aggressive about working with a patient, not asking questions, not thinking or trying to figure out what is going on with someone, not asking you why you do what you do – then this is the kind of EMT you may end up with: someone who will just get in the truck, take a blood pressure, and take the person to the hospital. Or will be partnered with a paramedic and will have to be told everything to do and will resent it.

      I’m looking for the EMT who is all the opposite. Who is ready to jump in, asks what he can do, is eager to learn and do stuff.

      Three stories

      On my second ride along at LPHEMS (Large Public Hospital and you get the rest), I showed up only to be told that they left early to catch a critical call. A guy had jumped off of a balcony of a burning house and broke both of his legs (bilat open tib-fibs). They returned and greeted me in the ambulance bay and said they’d be right back. The ambulance was a mess. I got some towels and cleanser and disinfectant and started to work and was just finishing cleaning walls, floors, bench seat, all the trash was disposed of.. equipment was replaced, when they came back. They stared at me. “What are you doing.” “Cleaning the ambulance.” “Why?” “Because it needed it.” The “Why?” was because no one had TOLD me to clean the ambulance and I was being self -directed in seeing and responding to the need. They had never had that happen before. They basically gave me full freedom to do what I wanted the rest of the shift.

      Story two: my son grew up around all this EMS stuff. He was a pediatric model in trauma classes and assisted me in setting up testing stations for ACLS classes from the time he was 8. At 13, I took him for ride along on New Years Eve in the big city. It wasn’t that bad of a night except for one call. There had been a fight at a bar and our patient had been propelled over the railing of a third story balcony and fell onto concrete. His injuries were serious and he was unconscious and unresponsive. I was down on the ground assessing him (unresponsive, breathing normally, good pulses, no bleeding, intoxicated) and looked up to tell my partner what we needed to get this patient packaged and to the ambulance. Everything was there that we needed. My 13-year old son was standing there. “Dad, I knew what you would need.” He had not been to an EMT class and wasn’t being precepted. If a 13-year old can do it…

      Story three: a student came to ride along with me for EMT preception – his first ambulance trip ever. 18 years old. Enjoyed the trauma calls but was equally as interested in the medical calls, even the minor ones. Questioned me about diagnostics, assessment, decisions and treatment protocols that I was using. Questions way beyond the usual EMT level. I thought to myself, “This one is going to be good.” I followed him through his EMT school, his paramedic school and on and mentored him as much as fate would allow. He in fact did turn out to be one the five best paramedics that I’ve ever known, maybe one of the three best. He’s better than I am, actually. Makes a (figurative) Dad proud.

  5. Playing devils advocate for a moment: we want more people to question the status quo, to be critical of current procedures. Or we could keep strapping people to spine boards and think adrenaline is the gold standard drug in cardiac arrest, no questions asked.

    Maybe the more we know, the more we question…

  6. Flash Larry says:

    Florian, that seems to be a bit of a non sequitur but on the other hand, someone who walks through the door and immediately thinks that he is able to critique someone with years of experience is a more than a stretch.

    If someone is studying and learning – well, put it this way: professional disagreements and discussions should be handled professionally.

  7. It’s all about being kinder and gentler. We had a staff meeting at my new job and it was suggested by the boss that we word our comments on QI reviews a bit more gently as the newer generation wasn’t used to harsh criticism. One of the other guys suggested that it was a result of the “Everybody gets a trophy” mentality.

    I probably left field work just in time. It was only a matter of time before someone complained about something I said or did and I was forced to leave.

  8. I followed a link to your blog from the Happy Medic, got this far, and figured I would pass along a link to you, a YouTube video of Millennials in the workplace… sounds exactly like what you were talking about (also, the later post where you hurt the new guy’s fee-fees)…

    Adding you to the list of daily reads.

    • Holy. Cow. That was awesome.

      Thanks for reading. Most of my readers are trickle-downs from the better, more prolific writers.

      Glad you are here.

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