Will You Stay or Go Away?

I was visiting with some recent EMT-B graduates who were coming back to take an ACLS for EMT-Bs class when one student asked how long I'd been in EMS. When I said "36 years," he looked at me like I was from the time of the pyramids as he queried, "How'd you manage to survive EMS for that long?"

His question still rang in my head as I went home after the class, and I decided to put together a short list of what I thought had helped me stay in the field of prehospital medicine for three-and-a-half decades.

Listed below are my top 10 ways to increase your longevity in EMS and your job satisfaction.

1. Continue to read and learn

In most parts of the country, you can get certified with a score between 70% and 80%. While that may get you out working on the streets, it is important to ask yourself just exactly what 20% to 30% of medicine you DON'T need to know to be competent in prehospital care. Whatever areas you were short in that resulted in that 85% passing score, seek out opportunities to learn what wasn't learned the first go-round. Never stop being curious about medicine.

2. Hope for the best; plan for the worst

This particular piece of philosophy was imparted to me by Dr. Jim Adams, an incredibly talented ED doc from South Chicago. Jim felt that no matter how dismal a given call might look, or how unlikely survival might be, once EMS is on scene, we still represent the possibility of success. Even if we only bring a 5% chance of survival, that is still better than O%.

On every call, we should routinely be optimistic, even when confronted with disaster. At the same time, we should be physically and emotionally prepared for the worst to happen, so if it does go down bad, it doesn't take you down with it.

3. Accept life's unfairness

At some point in your career, you will run a call where a drunk driver drifted over the center line or lost control of his vehicle, hitting and killing an innocent family while he walked away from the crash. That family did nothing wrong. They were just in the wrong place at the wrong time, and, because of that, their lives were wiped out in the blink of an eye by an irresponsible drunk. There is no way to understand the fairness of what happened, because it isn't fair and never will be. If life was fair, no good people would ever die young—just the bad ones.

4. Like what you do and do what you like

I got my first job when I was 16 and have worked at a number of jobs over the course of my life. Nothing I have ever done has provided me with the job satisfaction EMS has. Simply put, I've been paid to work for 36 years at something I truly enjoy. While I know I won't get rich or famous in EMS, there is truly no other field I can imagine working in that would provide me the level of job satisfaction I am blessed to have.

5. Know in your heart that your job is important

While saving lives is often what people associate with EMS, in truth it is a fraction of what we do on a daily basis. Providing comfort to the little old guy who thinks he's going to die from the big one, connecting the abused wife with law enforcement and social services support, and the bazillion other things we do along with trying to save lives make a huge difference in the quality of people's lives.

6. Get and STAY in good physical shape

It's a simple fact. If you get and stay in good shape, the likelihood that you will suffer an injury is reduced. If you do get hurt, you're likely to have lesser injuries and recover faster. This is without question one of the single most important things you can do to increase longevity on the physical side of the job.

7. Build relationships and a strong support network

We are in the people business, so it only makes sense that we need people in our professional lives whom we know and trust. By building relationships and a strong support network, you will deal better with the tragedies you encounter.

8. Expect to be humbled by the complexities of medicine

The more I learn in medicine, the more I realize how little I know, especially given the incredible depth and breadth of medicine as a whole. No matter how hard you train, and no matter how far you take your education, medicine will still humble you on a routine basis. Don't take it personally; take it professionally. It's going to happen, like it or not.

9. Cultivate a positive attitude

Go out of your way to cultivate and maintain a positive attitude. It will roll off you onto your patients and coworkers and will make your job much more satisfying. A 24-hour shift when you are in a bad mood seems to last a week. That same 24-hour shift when you have a positive attitude flies by in the blink of an eye.

10. Maintain personal and professional balance

Go out of your way to cultivate friendships outside EMS. Make time to do nonmedical things. Take up a hobby or pastime that broadens your horizons. Having everything in your life tagged with the Star of Life is not a good idea, nor will it ever be. Work to have a life outside of EMS so you'll be refreshed and energized when you do your medicine.

I hope this list is helpful for those of you who want to increase your longevity and job satisfaction. I'd love to hear your thoughts.

Until next month…

Mike Smith, BS, MICP, is director of clinical education and lead instructor for the Emergency Medical & Health Services program at Tacoma Community College in Tacoma, WA, and a member of the EMS World editorial advisory board.