Stuff I Wish They`d Taught Me in Class Part 12: How To Be a Better EMT

For three or four years I functioned as a paramedic. I had all my little para-tools constantly within reach in my ambulance. There was nothing I couldn't fix. My stubbed toe patient who was laughing and giggling one moment, then suddenly lapsed into cardiac arrest (true story!) was easily fixed by quick application of high-flow energy by defibrillator and a round of CPR. Every patient received my best care...my best ALS care.

Sure, I didn't do an IV or put the monitor on everyone. If they didn't need it, they didn't get it, but the tools were there. I had unknowingly given myself a safety net: If BLS couldn't fix it, ALS could. If ALS couldn't fix it, there was a hospital around the corner with medical professionals in a higher pay grade who could.

I worked with my net, feeling like I could conquer anything. The nine little letters on my patch meant that any and every problem could be solved just by rummaging through my little blue bag and pulling out the appropriate drug.

Then, I got thrust into the world of BLS.

I've been running with a service as a paramedic in an EMT's uniform. For the last year, I've been strictly a BLS provider: no drugs, no monitor, not even an IV. My safety net is gone.

I didn't realize how much I relied on having my bag 'o tricks safely nestled by my side until I rummaged through my bag recently looking for a nebulizer to do a breathing treatment and the realization that I didn't have one, and even if I did I couldn't use it, zapped me upside my head like a ninja with a 2x4. Sure, we all know how to use a manual blood pressure cuff and pulse ox, but now take the paramedic mind that's thinking 30 steps ahead and only give him enough tools to provide the basics until the real paramedics arrive.

It has been a harrowing but wonderful experience. I have honed my skills as an EMT in ways I didn't know I could. I now feel comfortable treating borderline patients without giving them an IV with a saline lock or putting them on a monitor just to be on the safe side. I've also learned how to better interact with my fellow BLS providers. There's nothing like having a medic pull up on scene and talk down to you like you know nothing...to hear, "You're just an EMT, what do you know?" I have never felt so rejected in my EMS career. I used to think, if I ever had to be an EMT again, I'd quit the field immediately, or my favorite, I didn't go through 18months of medic class hell to do basic crap.

I know there are probably a lot of EMTs ready to throw things at their computer monitors after hearing that. Unfortunately, I fell into that train of thought that ALS is the solution to everything, and I was wrong. I've learned so much just being an EMT and have become more comfortable in my own skills.

I've had to think outside the medic box, and some days it still terrifies me. I still feel trepidation showing up first to a chest pain call and not knowing if the patient is having a heart attack, but I trust my basic skills more, knowing that ALS is just around the corner and I can keep the patient alive until they show up.

I've also learned how to better communicate with my patients rather than being so lost in thought about what I’m doing.Sure, I used to chat with my patients, but I'm sure it wasn't the best conversation ever. I've had to fully immerse myself in communicating with my patients, because there's nothing more to be concerned about on a stable patient, and unstable patients still get my full verbal attention: You're going to be just fine. We are getting you to the hospital quickly and safely. And..."The paramedics will be here soon."

All in all, I've learned more than a book could ever have taught me. The unbridled joy of holding someone's hand, coaching them through their worries and fears as we get to the hospital, and knowing I did more than any drug could is a wonderful experience that every provider should have. I have a much greater respect for all the EMTs I've worked with in the past and those I’ll work with in the future.

Shao Trommashere completed paramedic class in 2007 after working as an EMT since 2002 in the Northeast corner of the United States. She also has a blog called Looking Through A Pair of Pink Handled Trauma Shears.