Lame excuses

My employer runs a paramedic program. When I say that the company runs a paramedic program, what I want you to take away from that is that the company supplies a physical location for a paramedic program, and students to fill the chairs.

But, they attached the words “EMS Academy” to it, so maybe it is sorta-kinda-official.

Whatever. It’s a moot point.

My employer runs a paramedic program.

Being one of the company’s Field Training Officers, I get to see the aftermath of the paramedic program, when the newly graduated paramedics spend several shifts riding with me. Some of them aren’t prepared, but most are.

I was having a talk with another FTO, Tony, while at the hospital a few days ago. This must have been early in a shift, because I actually cared about the topic.

Tony mentioned that he rarely sees the same paramedic student more than twice, and that each student does¬†at least twenty rides at our company. He thought it would be wise for a student in our paramedic program to be ‘assigned’ to an FTO for the duration of their preceptor rides.

While we’re on the subject…our program is putting paramedic students on ambulances for their preceptor rides after three months of school. They don’t know how to read a monitor, and they aren’t allowed to perform any ALS interventions. What the hell is the point of riding for twelve hours on an ambulance if you can’t do anything?


Tony¬†made a good point. After ten rides or so, there should be a pretty good rapport between an FTO and a student. They should be able to communicate openly with each other, so the student can get the most out of their classroom time, and their ambulance time. After twenty rides, any bad habits should be corrected, and the FTO can feel confident in his evaluation of the student. Alongside the FTO’s confidence in his evaluation, the course director can feel confident in the evaluations he gets from the FTO.

But instead, the students just ride whenever, and wherever. Rarely more than once with the same paramedic, or even with an FTO.

So Tony and I brought it up to the director of the program.

“Assign each student to an individual FTO. We have twenty-five students, and eighteen FTOs. Surely we can come up with a list of seven competent medics to fill the roster of needed FTOs. Once a student is assigned to an FTO, that student does all of their rides with that FTO. It only makes sense.”

We got a reply:

“Well, that would just be too hard, and we don’t want to make it any harder on the students.”

This is why I don’t care.

Lame-ass excuses.


  1. Right on. It’s unfortunate that the bar for EMS education and training is being set by standards of convenience and thriftiness rather than striving towards producing effective providers. I feel that this is one of the biggest reasons that EMS isn’t being treated with the same respect as nursing by the medical community.

  2. Flash Larry says:

    “Harder on the students” sounds like a red herring to me. If you tell people what will be expected when they start the program, they’ll accept it. “You will be assigned to ride with a specific FTO when you start your field assessments and you’ll have to make arrangements to do your rides when he is working.” That’s neither hard nor excessive.

    It seems to me that he thinks it will be harder on him.

    Or maybe he’s just not that smart.

  3. Jesus that’s depressing. I’ll second the other commenter’s points on why we as a profession don’t get respect. And add that this is a pretty common cultural issue in the Midwest (at least in the “Chicagoland/Northwest Indiana are) too. We can’t fail anyone because we don’t want to make them feel bad and we “need” higher pass rates. We can’t be too hard on the students because they’re sensitive and we don’t want them, you know, prepared to make life altering decisions on people and/or get the hell out because the kind of calls that lead to those decisions don’t get made every day. I just signed up to be a preceptor for a hospital’s paramedic program, I’m simultaneously excited and terrified that I might be “the asshole” given the comments I’ve received when I’ve been the one failing most of the students at practical exams. I fail them because I don’t think we should be giving passes to people who can’t be bothered to memorize a skill sheet in order to get their license. And I’m the asshole.

  4. So, until we have people running these programs, “managing” us, and handling the billing that are actually professionals and have the knowledge and experience to do something more than make the ambulance folks defraud Medicare to make sure they get paid none of this will change. All too often the “managers” in this business have very little past a high school education, much less some sort of business education. And heaven forbid someone with a bachelors or masters comes in. We all know how the uneducated “managers” get all worked up and try to get rid of that person as soon as possible.

  5. Flash Larry says:

    One of my old teachers said, “If they ask a question, they deserve an answer.”

    If they ask for an assessment, and give you the parameters of what is expected, then they deserve an answer.

    They will either learn to ignore what you write, use what you write, or will stop asking. That’s not your issue.

    I wasn’t sent in this world to be nice.

  6. J Froscher says:

    On the student side I am glad my instructors were hard asses it may be stressful in class and some days I didn’t like them but it definitely prepares you for the even more stressful situations out in the field. My instructor always said manage your emotions and follow your script. As long as you know you script out there I feel I have been able to provide great care to my patients. So thank you to all preceptors and instructors that still push and make students do what they are suppose to or fail them if they don’t. We have people’s lives in our hands it’s not a desk job.

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