I was ecstatic and astonished to be addressed that way at our 1995 commencement ceremony. The only other time I had heard those two words spoken consecutively was earlier in the semester, after I had euthanized yet another mannequin. My exasperated instructor ƒ a recent graduate himself ƒ asked, ÂDo you want to be a paramedic, Rubin?_ Gamely, I had answered ˙yesÓ and then wondered if the Navy might still be interested in me.
Even as I was accepting my certificate, I felt that I should go home and study something. Ten months of preoccupation with text books and test scores had earned me an upgraded card, but left me uncertain about my future as a medic. Did I know enough to treat real patients? Would anyone pay me to do that?
˙Life After Medic SchoolÓ was a mystery. I had learned how to become a medic, but not how to be a medic.
If this sounds familiar, read on. The goal of this article is to make your transition from student to paramedic a little easier.
Finding a Job
Most students begin their job search while still in school. Preceptors at practical rotation sites are prime sources of leads, so it_s never too early to impress. Treat every supervised patient encounter and every conversation with an instructor as part of a semester-long job interview.
Assume that you have 10 minutes to make a favorable impression when you first meet a prospective employer. Grooming, attire, professional bearing and communication skills are important elements of that initial evaluation. It can_t hurt to be competent, too.
If you impressed an employer while you were a student, the formal interview is more of an opportunity to lose a job than to get one. Here are a few things to not do:
˙Never bad-mouth anybody,Ó advises Eric Niegelberg, director of Stony Brook (N.Y.) University Hospital_s Emergency Department and EMS Division. ˙EMS is a very small field, and we tend to know everybody. The candidate who complains about their instructor, preceptor or partner is bound to put their foot in their mouth.Ó
The way you dress says more about your judgment than about your appearance. If the most conservative business attire that you own isn_t predominately dark gray, dark blue or black, you need to go shopping.
Leave the fancy jewelry at home. When selecting a fragrance, less is more. Hair and makeup should be as business-like as your outfit. Yes, you have a right to express your individuality, just as your employer has a right to choose someone else.
Most employers will ask for a resume. Yours shouldn_t be more than one page. Focus on EMS education, certification and experience. It_s safe to omit any summer jobs involving fast food, newspapers or lawn care.
Extra-curricular activities can enhance a resume. ˙Sometimes seeing that a person excelled in sports, or is an Eagle Scout, adds something to that candidate_s overall fit for the position,Ó Niegelberg notes.
A resume is another opportunity to display your communication skills, but don_t overdo it with self-indulgent prose about epiphanies or five-year plans. A good model is a well-written patient care report ƒ succinct, relevant and informative. Bring several copies of your resume to the interview, even if you already sent one.
Being a Good Employee
Good students don_t necessarily make good employees. Students rarely are unsupervised and, therefore, are less likely to determine the outcome of prehospital patient encounters. Communication, teamwork and risk management are particularly important in a professional setting. Most EMS courses don_t focus on such life lessons.
Paul Werfel, director of Stony Brook University_s paramedic program and a JEMS columnist, lists ˙managing time as studentsÓ and ˙punctualityÓ as predictors of success as employees. ˙Honesty, sincerity and integrityÓ are highest on Niegelberg_s list. An informal survey of other EMS employers elicited such characteristics as reliability, maturity, communication and a desire to make the boss ˙look good.Ó
That last trait isn_t as one-sided as it sounds: There_s an implied contract be-tween manager and employee that encourages them to look after each other. An employee who helps the boss meet their goals, with a minimum of inconvenience and risk, will be considered a valuable asset.
Know the chain of command at your workplace. Try to solve problems at the lowest level. Ask for help when you need it, but remember that you_re being paid to know your scope of practice and to deliver your standard of care. Take responsibility for your actions, and you_ll easily mature as an employee and as a medic.„
Becoming a Better Medic
An inscription on one of the gates leading into Harvard Yard reads ˙Enter to grow in wisdom.Ó It_s hard to imagine a more appropriate prologue to an EMS career.
Scott Falley, a recent graduate of the North Shore University Hospital paramedic program in New York, says that making the transition from the classroom to the streets is about adaptation. ˙You have to differentiate between the academic world and the real world. The book may say ÂDo A, then B, then C,_ but, in the real world, you have to improvise and adapt.Ó
New medics should seek mentors to ease the transition from student to profes-sional. ˙An ideal role model is as interested in the student_s well-being as [their] own,Ó says Werfel. ˙Honesty and candor are more important than just telling students what they want to hear.Ó
˙Staying currentÓ is a term that represents the dual challenge of learning new things and remembering what you_ve already learned. Cardiology, pharmacology and pediatrics are examples of topics meriting frequent review. ˙Be a sponge,Ó advises Nikki Puccio, a recent addition to Stony Brook_s paramedic staff. ˙You actually have more free time as an employee than as a student. Use some of it to broaden your knowledge.Ó
In addition, interpersonal skills ƒ such as empathy, consideration and respect ƒ are often more valuable to patients than medical expertise. Listening to a patient, making eye contact and responding sympathetically, instead of behaving in a patronizing or superficial manner, can accomplish more than any of the medications in your drug box.
Some paramedics boast that they wouldn_t be able to tolerate a ˙nine-to-fiveÓ job. Many enjoy a sense of autonomy in an ambulance-based workplace. But our mobile ˙officesÓ must be staffed 24/7, and the odd and often irregular hours of EMS can jeopardize our health.
According to a University of Chicago study, sleep deprivation can lead to weight gain, insulin resistance and other metabolic disturbances. ˙Rotating shifts can mess up your life,Ó warns Paramedic Rob Lambert of Suffolk County (N.Y.) Medical Control. He and partner Joe Iannuzzi, a paramedic for 10 years, agree with the experts that a balanced diet and exercise reduce the life-altering impact of overnight shifts. ˙Getting away from EMS is important, too,Ó adds Iannuzzi, who favors a movie on a day off.
Paramedics take risks; our profession demands a willingness to do so. But risk awareness, rather than risk aversion, is the proper mindset. Such dangers as bloodborne pathogens, ambulance accidents, unsafe scenes and combative patients, can be minimized by following safe practices. It_s easier to prevent such untoward events than to address them after they occur. Unfortunately, many of us have a sense of invulnerability that lasts only until our first exposure or injury. ˙It_s a challenge not to get careless,Ó warns Falley.
Planning a Future
EMS is about patient care. It_s unrealistic to contemplate long-term employment as a paramedic without accumulating hands-on experience during at least the first few years. Thereafter, if the challenge and stimulation of ˙street medicineÓ don_t offer long-term job satisfaction, consider other routes within the profession:
Study: Pursue a bachelor_s or master_s degree. Your major matters less than the letters ˙BSÓ or ˙BAÓ after your name. An MBA (business) or MPH (public health) are both good choices for graduate programs, particularly if you_re interested in a management position.
Enlist: Would you like to add central lines, suturing and chest tubes to your skill set? Consider military service. It_s a good way to develop confidence and discipline while enjoying an expanded scope of practice. Many employers give preferential treatment to veterans.
Fly: If you don_t mind performing lifesaving interventions in the back of a helicopter, think about aeromedical opportunities. These highly visible positions are subject to scrutiny by other EMS personnel, hospital staff and the public. Employers generally seek experience, demonstrated proficiency and above-average communication skills from flight medic candidates.
Teach: An ideal way to refresh your knowledge of the paramedic curriculum is to teach it to someone else. ˙Teaching has become a much more common career path for paramedics during the past 10 years,Ó says Werfel. A good way to start is to get certified as an ACLS or a PALS instructor.
Manage: Supervisory positions are frequently restricted to employees with the most seniority. It_s unfortunate because the best medics don_t necessarily make the best managers. You can improve your candidacy by developing first-rate oral and written communication skills. Also, be open to projects you can coordinate and get involved in training. Above all, do your job well.
Embracing the Profession
Mark Twain once characterized classical literature as books that people ˙want to have read, but don_t want to read.Ó Had Twain„ been born 100 years later, perhaps he would have said that EMS is what many want to have done, but few want to do.„
If you are one of the few, expect hours of preparation punctuated by moments of enlightenment. Your patients are best served by your humility, honed by respect for the breadth of our field.
That card in your wallet is merely a license to continue learning.
Mike Rubin, BS, NREMT-P, is supervisor of Suffolk County (N.Y.) Medical Control and a member of the Stony Brook University paramedic program faculty. Contact him via email at„firstname.lastname@example.org.