Going from EMT to Paramedic: What I learned I had been doing wrong

Paramedics can sometimes get a bad rap from their EMT counterparts. Many EMTs have been in the business many years and feel they can impart wisdom on the new Paramedic. In some instances this is very true. However after being an EMT for several years, I finally saw how frustrating some common EMT habits are to Paramedics. Here are some of the things I never thought about, but now I know are so very important.

1. Learn to drive!
Seriously! Your driving is so important in so many ways. As an EMT I always tried very hard to be as smooth as possible with hip fractures and c-spine patients, but other than that I didn't notice much. I had a paramedic or two say something to me. Here is what I never realized. EVERYTHING the paramedic is trying to do is harder when you do not drive smooth. Drawing up meds, writing my chart, checking the drip rate on an IV, even opening up a 4x4 is tough when you are being tossed around. Easy on the brakes son, and drive through the corners.

And the code three patient is always a tough one in this aspect. Yes, I want to get this patient to hospital as quick as I can but these patients usually need the most intervention as well and I cannot do it if I am hanging on for dear life. You want your paramedic to find you indispensable??  Make them wonder if you are really driving code!


2. Stop complaining about the charts you write.
On those rare days when you write more BLS charts than I do, I really don't want to hear about it. We both know it is rare and even if you write ten charts to my one, my one is more in depth, detailed and more likely to get me fired or sued. Often late at night it would be me and the other car's medic up doing charts while our EMTs slept. How many mornings do paramedics get off late finishing paperwork? How many times to does the EMT go grab a water and donut out of the breakroom while the medic works on his chart at the ED? I really don't want to hear about your one day of five charts.

3.Your enthusiasm is obnoxious!
I really am not trying to be mean here but chill out. Several things happen with the overeager EMT. First and foremost, I miss stuff. While I am trying to sort something out, read an EKG or look over a med list, my EMT is asking questions. If it is an EMT I work with often and we work well together this is not a problem. But occasionally I get some EMT that finds out important details and does not pass them on. I either repeat the questions later to the annoyance of the patient or the EMT pops up with the info as we transfer the patient at the ED making me look like an idiot.

Also, you may love trauma, but that does not give you the right to charge in there and take over the scene.
You may love cardiac but if you question what I see on my EKG I will lose my cool.

Because here is the deal. As an EMT I loved to look at an rhythm strip and tell my paramedic I thought the patient had this or that. I thought I was really helpful when I told them that "If it was me I would give them Drug A". But as an EMT I there was NEVER the consequences to think about. Anything that happens to that patient is on my head, not yours.

If I ask for your opinion, then by all means speak up.

4. Never, ever, question me in front of the patient.
This seems like a no brainer but often many EMTs do not even realize they do it. When you ask simple questions like, "oh you are giving 4mgs? I always thought the right dose was 5mgs" it seems like innocuous conversation to you. To the patient, it makes it seem like one of the two of you don't know what they are doing. It can set the whole call up for disaster.
I, and most medics I know, will be more than happy to discuss any aspects of the call AFTER the fact and in private. Unless you genuinely fear I am about to kill someone, mention it later.

5. The things you do when you think no one is paying attention makes the patient uncomfortable.

This is one I did not realize right away when I became a medic. Little things like listening to music in the front, rolling down your window to talk to someone outside, or even talking to fire outside for a minute before we leave all give the impression to the patient that they are not the most important thing going on right now. And every patient, yes even the ones we don't like or don't think should have called and ambulance, should feel important. It is called customer service.

For that matter leave our conversations  for when we are alone. Real things my EMTs have said in front of patients.
*I think I want Mexican for lunch
*My girlfriend is such a bitch. She just called me to tell me ...
*Oh man. Medic 2 is so lucky. They are going on a gunshot while we are stuck on this.
*Yea! See that car behind us? I would totally flip them off if we were not in the ambulance!
and my personal favorite.... "Skadoosh! Have you seen Kung Foo Panda? It was awesome!"

So to sum up, I am sorry to all my Paramedic partners for the above infractions I have committed. It is hard to want to be in the game and be excited about what you and not realizing you may be in the way. You may be tired of getting blood pressures and putting on oxygen but those things are important! EMTs are important, and having a good relationship with your partner makes life so much easier!

Stay safe my friends!!