Top 10 Habits that Will Make You a Great EMT
Be On Time
There’s nothing more appropriate to start off with than something that applies to every job, being on time. We have all heard that first impressions are everything, you only have one so make it count. Your first impression is an example to your peers, your bosses, and others that you are reliable and respect other people’s time. You don’t want to be the last one walking into orientation and you don’t want to show up to your 0700 shift and learn that the person you are relieving is now on a call you were supposed to be on because the call toned out at 0701 and you showed up at 0710, not even fully dressed. Regardless of any other factors that play into your daily life, be on time to every meeting, shift, and all other events. If you happen to be late to shift due to the good ole car trouble, make sure to call or text someone before you are going to be late. Follow whatever policies your employer or school has in place for this situation.
Be Respectful
Everyone has a role in the community and everyone has a role in this field. Maintaining respect for others, your environment, and yourself is necessary to everyone. It is evident when someone does not respect themselves and it makes it difficult for others to respect them. Simple things such as lack of body hygiene (yes, I have to mention this), constant self-deprecating humor (we all have a dark side to us but we know when it’s taken too far), and lack of consistent positive attitude are all behaviors that are indicative that one does not respect themselves. Even such, all crew members should respect their patients, coworkers, and chain of command. Everyone has their personal opinions and ideas and there are appropriate times to place them on the table for discussion but I emphasize the appropriate timing. Whether you grew up respecting your parents (as we hope you did) or not, know that if you do not respect others or your environment, you will get “chewed out”. The good ole chew out can be very necessary to build character and most of us have had one before. Lack of progression after confronting any negative behavior is where there lies a problem. If this goes uncorrected, maybe this is not the place for you.
Understand Chain of Command and Respect It
It cannot be stressed enough, understand your chain of command! This concept does come from the paramilitary structure most agencies follow, some more than others. It is imperative to attempt to solve any problems at the lowest level possible. Those of you that have fire department interviews under your belt may have noticed one of the common questions is how to confront another individual about a problem, either within the station or on a call, in a non-confrontational way, prior to seeking help from higher chain of command (e.g. captains, chiefs). For example, if you are an EMT and you have a problem with something your partner did that is reasonable (patient care, safety, etc.) then the ideal way to confront the issue is to talk to your partner directly. Perception can be everything and it is important to voice your concerns. If you don’t feel comfortable after the conversation with your partner, then the next step would be to talk to a direct supervisor. Depending on your agency, this could be a captain, FTO, or an actual acting supervisor. If not solved at the next direct level, it should go up the chain of command accordingly. You should never jump a level in the chain of command, even if you don’t have confidence that they may help. You should always manage to follow policy and command, then continue further. The longer you spend in this career, you will find leadership is not always efficient. If you are truly concerned about something and no one in your chain of command has taken it seriously, you do have the option to go to HR or some other resource available but note they will always ask if you have attempted to correct the issue yourself at the lowest level. You will see this in annual training every year and may even have classes on it. Also understand, it should not be used for personality conflicts. As long as you’re in this field, you will have to work in groups and problem solve as such. Correcting problems via chain of command should be on the basis of concern.
Have a Good Attitude
This should be a given but unfortunately we have seen, it is not. We can be overworked and underpaid, completely burnt out but this attitude is not attractive. Some of the very green guys and gals may find this attitude of burnt seasoning as attractive, almost the right of passage and begin to act this way in the beginning of their career and let me tell you, it’s easy to spot a mile away. We see the individuals who start working in a busy 911 system, straight from IFT (interfacility BLS transports) and lose compassion right away after running plenty of urban camper calls. Being in a toxic environment does no good for someone who truly wants to stay in this field (and yes, those environments do exist especially in private ambulance companies). We also see it in the more experienced individuals who may have had a few bad experiences. They lose respect for the service in general. We have heard plenty of people say “I don’t care, I’m not going to be a firefighter” and that’s where it all goes wrong. Everyone has a role, we are a job built on community. You don’t have to want to be a firefighter to respect a firehouse. If you are in-house with fire, it is your job to participate, to help do station duties such as clean and restock, as well as participate in activities. If you are not in-house with fire, you should still strive to respect your environment, clean the station, restock, etc. If you feel you are losing patience, as it will happen eventually, it is time to take a break. Don’t pick up overtime, spend time with family and/or friends, and enjoy your life. If you are in a toxic environment and/or feel stagnant, come up with a game plan to leave and further your career or change industries. At the end of it all, you choose to be here, no one is forcing you to be.
Be Inquisitive
Stay curious and pay attention! Even if you’re doing your first ride along ever, if you can’t do anything hands on (there should be plenty of opportunity to) then watch and pay attention to what’s being said and what’s being done. There are always new ideas popping up everywhere which is truly something so exciting about this field. You can never know enough, be the sponge that soaks it all up. Can it be overwhelming at times? Of course and you must pace yourself because there is always more to learn. This is something for the newer generation to embrace and the seasoned generation to support. Even if there are reliable ways to do things, we can always be open to fresh ideas. Although, you don’t want to be reinventing the wheel, there are always upgrades that can be made to that wheel to make it faster, stronger, and more efficient. Use your downtime to broaden your horizons. This applies to everyone but especially the new guys and gals. When I was a green teenager, fresh out of school and on my IFT unit, my partner asked if I knew how to use a traction splint. I, having only had a brief explanation of it in class with no hands on experience, hesitated. We were “posting” at the park and he said “Let’s take it out and play with it.”. Our unit was stocked with a Hare Traction Splint and with all the parts, it can be confusing. My very patient partner took it out and we went over it. My partner not only wanted to have a competent partner but also took the leadership role to ensure I understood the equipment more. If you are new you should always have a question about something.
Be Disciplined
You don’t have to have grown up in a disciplined household to become a disciplined person. Some people learn this through the military, some in a fire house, some just adopt this behavior to better themselves. How does this apply to EMS? When motivation lacks, discipline stays consistent. If you are a not an individual who likes routine, as many of us don’t considering the job we took, it is important to get one. There are time a call will come, you run it, and you can return to where you left off beforehand. Preparing the night before (making sure your uniforms are ready, your backpack/purse/lunches are packed, and laundry is done) makes it that much easier to go to your shift in the morning, or vice-versa if you’re a night shifter. When you get to work, you can bring your things in, clock-in, and go straight to your rig check. Rig checks are so important whether you’re checking the oxygen levels, the intubation kit on the airway bag, or the chainsaw on the engine. You need to ensure equipment works. If the IV tray isn’t topped off or the rig does not look squared away, it won’t make or break a call, most likely, but it is not a good reflection on how you respect your work environment. When you are new and stay in-quarters, wake up at the appropriate time and retire to your room at the appropriate time, following station etiquette. When you work EMS, you are not a probationary firefighter and don’t need to fully act as such but you should show that you are appreciative of your spot. There will always be exceptions, especially those sleepless nights but always try to do the best of your abilities. Know that, for the most part, people will always have something to say but as long as you truly are doing your best, that’s what matters because hard work shows.
Stay Self-Motivated
The last thing you want to do is hold your partner’s hand. Don’t get me wrong, there’s nothing wrong with a little direction in the beginning, or even a lot, but you need to be self-motivated and self-directed in this field. When it comes to working on scene, if you are not the lead EMT or Medic, you should be watching and evaluating what needs to be done. If you don’t know and no one has directed you, then you can ask at the appropriate time. If you’re working BLS, get the blood pressure or blood sugar. If you are working ALS, get the patient on monitor. Is there a stair chair or backboard/scoop stretcher needed? Ask and grab. If you’re an EMT working ALS and don’t know what your medic wants next or don’t know how to do something, say something! Even if you were not trained, it is your responsibility to be competent in your skills therefore, you need to find the right time to be inquisitive and train. A lot of this field is managing your time and priorities effectively. When you get back to station, does something need to be done? Clean up is done, the rig is washed, but the dishwasher needs to be emptied or there’s EMS packages that need to be put away. Not working at a station? Ensure everything is topped off and squared away. Once you become complacent or stagnant, you are behind the ball and need to get back on track. Sometimes that means leaving your unit/station for another, sometimes that means making more personal changes. Do what you have to do to be self-motivated.
Communicate Effectively
Of all things you should learn how to do in any field but especially this one, learn to communicate effectively! If you lack good communication skills, work on it. Some people who get into this field are not the best communicators when they start off. If you have never worked customer service, hospitality, or other like industry, you may find it hard to be a “people person” but the more you work on it (and work in general), you will get there. From the words of someone in my first BLS IFT orientation (who has now become an MD), “you used to be the quietest person I have ever met and now you are so outgoing”. Understand there are a lot of factors in communication. There is body language which can tell a lot about a patient or peer, whether they feel comfortable being open or are closed off for some reason. You may not get good answers from your patients but evaluate how you’re asking your assessment questions. As usual, you should always maintain a respectful and professional attitude but you will not use the same language or terminology with a 6 year old that you do with a 60 year old (given there’s no significant developmental delay). Someone who is from an urban area with a lower socioeconomic class may not appreciate the references or terminology you would use with someone of the rural area. Correlation is not causation and we should never assume someone isn't educated based off their socioeconomic class but it is important to observe how someone feels comfortable speaking and the terminology they best understand. Also, learning proper radio etiquette and terminology for your agency/dispatch is paramount. You never want to be “that guy”. Look, listen, and copy.
Read People and Situations and Act Accordingly
Analyzing people and situations is almost a gift and cannot necessarily be taught. Your instructor or FTO may teach you to watch out for Levine’s sign, signifying cardiac chest pain. They point out a person complaining of shortness of breath, hyperventilating, and complaining of hand cramping (carpopedal spasms) is most likely experiencing anxiety. You do your full work up to dot your i’s and cross your t’s but this person is having an anxiety attack and most likely needs calming and reassuring measures. They may also point out that the your frequent flier is breathing deep and slow and balling up his fists, and you need to stay back but stay ready. What can’t be taught is interpretation. Unfortunately, sometimes individuals you respond to can be offended with things you say or your behavior. How you intend for something to be said does not mean that the individual you’re working with will interpret it as such. Working in an extremely culturally diverse community, we always did our best to respect customs the best we could. This may mean using a female crew member to place a 12-lead EKG on a modest female patient. If there is no female crew member, do your best to respect culture. Just because you do not understand customs, does not mean you should disregard them. In an emergency setting, you always do the work that needs to be done while doing your best to respect others’ views and beliefs.
Know Your Policies and Protocols
These days they don’t hand out employee manuals anymore, they tell you to log online so you can download and read them there or they hand you a flash drive and say study up. Some states and counties don’t even have hard copy written protocol books to be bought, yet it is your responsibility to know them. That is the unfortunate reality of today. Think about it like this, you need to know your medication parameters to pass an EMT program and be competent in your skills and medication administration to pass a paramedic program therefore, there is no excuse in not keeping up to date on protocols. It is drilled into us in school, if this does not hold up in court, don’t do it. Same goes once you’re out of school. Protocols vary form county to county and state to state just as some states don’t even have reciprocity. Know these are simply a part of the job you chose and will save you in the long run.
