I have been a full-time paramedic for over twenty years and a part-time hospital EMS coordinator for over six years. Over the years my ideas of who the best paramedic is have changed markedly. I used to think the best paramedic was the one with the swagger, the one without fear, who never hesitated to act, who never allowed doubt to enter the equation. And while I still admire many aspects of that paramedic archetype, from both my vantage of twenty plus years on the street and the newer position of someone who can actually match up what happens on the street (or at least as described in the prehospital run form) and what happens to the same patient in the hospital, I have learned that many paramedics I thought were never wrong, can actually be wrong quite often, and that some of the paramedics who I thought were rather dull, have actually pleasantly surprised me time and again.
So here is my new ideal medic(s):
A great medic will call a STEMI Alert even if he is not certain the patient is having a STEMI. He will never hesitate to call for backup on a call (he is not afraid of being seen as weak or unsure) if he thinks it might benefit the patient. A great medic doesn’t always get the tube, sometimes she doesn’t even try. She’ll reach for the combi-tube if she thinks it will protect the airway sooner. While he tries to gauge the moment he enters a scene whether the patient is sick or not, he doesn’t lock in his impression. She is not afraid of saying she is uncertain. He gives the benefit of the doubt to the patient. She would rather medicate a drug seeker than deny someone in pain. He considers before acting. Sometimes he is afraid, but he won’t let his fear keep him from doing what needs to be done. But he always recognizes that sometimes, the best course is the conservative one. She understands the meaning of the phrase, ‘It depends’ And if he is criticized or if a nurse or a bystander says something offensive to him, he doesn’t feel the need to put them in their place. She talks to her patients as people, explains what she is doing, what she thinks might be going on, she guides them through what is happening. Sometimes he just makes small talk. At the hospital, he seeks follow-up — even and, in particular– when he thinks he may have been wrong about a patient. She tries to learn from each call. She does her job. He puts the patient first.
So here’s to you, my ideal medics out there. You know who you are. People notice. Carry on!