Administration and Leadership, Columns

Being the ultimate FTO goes beyond the policy manual

Issue 40 and Volume 41.

The responsibility of a field training officer (FTO) extends well beyond simply ensuring clinical proficiency. Verifying a new provider can rapidly apply a tourniquet to a severed extremity or defibrillate v fib without hesitation is certainly an important function of the FTO. An equal, if not more important function, is teaching your student how to survive the physical and mental aspects of the streets.

Although you’re eager to impart the clinical expertise you’ve developed during your tenure, don’t forget to disclose the personal survival tactics you’ve also acquired along the way. This goes beyond scene safety or deploying defensive maneuvers. I’m talking about sharing the strategies that keep you functioning day-to-day in this physically and mentally demanding profession.

These pearls of wisdom can’t be found in a protocol book or a policy manual; they’ve been learned through years of experience.


Much of this helpful information resides in your locker or personal duty bag. I’m guessing among the many items in your ensemble you’ll find your nonsteroidal anti-inflammatory drug (NSAID) of choice, something to curb an upset stomach, and the all-important stain remover pen to keep your uniform pristine. You carry most of these items after having learned the hard way, but consider providing your student with a list of the essentials to give them a head start. Don’t underestimate the importance of a couple of Tylenol at 3 a.m. when you have a pounding headache.


An emphasis must be placed on building relationships early in your trainee’s career. During my rookie year, I would quickly return to the ambulance after dropping a patient off at the ED. I’d prep the unit for the next call and then sit in the cab waiting on my partner to return. I knew very few people, making it difficult to strike up a conversation with other providers. I mean, who wants to talk to the new guy anyway?

This pattern of returning straight back to the truck provided me minimal opportunity to unwind from the previous call or to create a network of support. Keep in mind that your apprentice is probably new to the stresses encountered in normal day-to-day operations. Make as many introductions as possible during their time with you, helping your recruit realize they’re not alone. Although becoming acquainted with other responders and medical professionals will definitely provide informal support, make sure the trainee is aware of the professional assistance that’s available as well.


As an FTO, you invest countless hours teaching new employees to be first-class clinicians—but have you ever taken the time to teach your trainee how to be a good partner?

There are many characteristics that make a good partner. The first thing that comes to mind is trustworthiness. You have to know your partner has your back when the going gets tough. Communication is another important factor. While communication between partners may be urgent, it should always be tactful and professional.

A third major concern is personal hygiene. No one enjoys working with the stinky guy. Of course, this is probably one of the toughest and most embarrassing topics to address. One tip to tackle this issue is adding some hygiene items to the list of necessities discussed earlier.

The best way to illustrate the concept of being a great partner is to demonstrate it. Let your trainee observe how you and your partner interact for the first few calls. This will certainly set them up for success.


FTOs are often thought of as the gatekeeper, weeding out those lacking the required clinical skills. Although this is important, the FTO must also embrace the roles of mentor, educator and advocate. It’s our duty to provide the new recruit with all the tools they need to be successful.

There are so many uncertainties lurking in the world of prehospital medicine. You can’t predict exactly what your trainee will face once released from your protective supervision. Passing on your experiences, helping them build a support network, and teaching them to be a respectable partner will ensure they’re able to meet any situation head-on.