Wednesday, June 29, 2011

Your First Day

It’s your first day here. You might be a new volunteer, a paramedic student, or a fresh hire. This may be your first time in an ambulance or maybe you worked ten years for a service in another state. You might be nervous or you could have so much confidence you had trouble fitting your head through the doorway. No matter who you are, this is my advice:

Show up early for your shift. By early, I don’t mean ring the bell at five AM for a six AM shift. Be here fifteen minutes early.

Come to work in clean clothes. I don’t care if your boots are spit-shined or not – mine aren’t -- just don’t have your shirt untucked, your shoe laces untied, or dirt under your fingernails. First impressions can be wrong, but they can be hard to overcome and they rarely turn out to be wrong.

Tell me your name and look me in the eye when you shake my hand the first time. Like I said first impressions count.

Years ago when I was an intern in Washington, D.C. working for a United States Senator, one of my first jobs was to do a massive collation project – the copiers back then didn’t always do it for you so you had to do it by hand, spreading the copies out on tables. I introduced myself to the lady in charge of the project and she said don’t even bother to tell me your name. I have seen so many interns come and go, I don’t even bother to learn their names anymore. That was so rude of her, but the point is true for many jobs – new people come and go, and for people who have been one place a long time, they may not pay a lot of attention to you unless you catch their eye in a good way or a bad way, and they may not learn your name until you have been around awhile. I outlasted her by over a decade, and yes, I remember her name.

Unless someone asks, don’t tell or elaborate on your experience. If they do ask, stick to the facts. If they don’t, show them your experience through your actions. We had a guy come through here a number of years back who boasted of how when he worked in Maryland, they did a shooting every morning before breakfast. If there was a shooting every morning, it was likely his coworkers firing shots at his car to keep him away as he quickly proved to be worthless. You may have some good stories and you may be able to back them up, but my experience has always been the more someone talks, the less they have behind it.

If you work with me, I will ask you about your experience. I don't care if this is your first time in an ambulance or if you have been doing it longer than I have. What you tell me won't make me like you more or less. I just want to know your comfort level and what to expect once we walk on a scene.

I tend to believe people, so when their brash talking doesn’t bear out, it’s worse than if they had never spoken.

Strong and silent works well in EMS when you are new. It works well if you’ve been around twenty years, too.

Now keep this in mind. The seasoned person they put you with may be a jerk. Or they could just be a nice person having a bad day. EMSers are often sleep deprived and many are under stress. You are not the center of their world. You want to get yourself off on the right foot, you need to study who you are assigned to as well as you would study a patient with psychiatric illness. Is it safe to ask this person questions? Am I talking too much? Do they just want to be left alone? You need some interpersonal skills to figure this stuff out.

When I was going through my ride time, I rode with some awesome paramedics and I rode with some real losers, some certified head cases. I rode with a female EMT-I who was a supervisor partnered with a new and very timid paramedic. The EMT-I , not only wouldn’t let me touch the patient, she wouldn’t let the medic touch the patient, and did the medic’s job, including giving medications while the medic sat next to her on the bench. When she wasn't telling the medic what to do, she was bitching to her about her husband. I still feel sorry for that man. I was scheduled to work two more shifts with this pair. I said nothing to either of them, but made certain to take myself off those shifts.

I worked with another medic when I was a student who was wound way too tight. We had been called for a seizure, the medic seeing the patient, shouted "Not you again!" and started swearing at him and basically told him to take-off in expletives. "You'r e not getting another F--ing ride from me!"

I had one chance at an IV that day – I missed it. The madman then knocked me out of the way. He proceeded to sink the IV, then removing the needle from the catheter, stabbed the needle into the bench seat, and then went about taping the line. I was offered no further attempts. Later in the shift the medic got in a shouting match with a supervisor because a doctor had complained he hadn’t c-spined a near-drowning we did. Maybe my trying to hand him a collar on that call had accentuated his reaction because after that he had nothing to say to me. At the end of the shift, I didn’t even bother to give him my evaluation form. I figured I needed at least an additional 12 hours of run time to unlearn what I had seen in those 12 hours.

Don’t let a poisonous person, poison you. Keep your mouth shut, don’t get in their way (unless they are about to kill someone), and see if you can’t tactfully find a way to ride with someone else the next time.

If you are asked to do skills on your first day under someone’s watch, be truthful. Don’t make up a blood pressure. Don’t do something you don’t know how to do or are uncomfortable doing. Don’t be afraid to step aside.

Keep your eyes open, think before you speak. The rule no question is a bad question only applies if you judge the person you are asking the question of to be a balanced and open individual. Never ask a stupid person any question unless you already know the right answer.

And the number one rule for you to follow is: Trash No One.

You might fit in quicker by talking smack along with everyone else, but just because you and another EMT are talking smack about someone else, doesn’t mean the EMT you think is your friend now won’t be talking smack about you as soon as you walk out of the room. Putting someone else down is no way to hold yourself up.

Be above the fray. Act professionally. And you will outlast lessor people.