Commentary

‘It’s Been an Incredible Ride:’ NH EMS Provider Moves On and Shares Lessons Learned

The writer, not pictured here, shares how much his department meant to him as he moves on from his current role. (U.S. Air Force photo by Airman 1st Class Thomas Karol)

Editor’s note: We are sharing this resignation letter from a New Hampshire-based EMS provider as it captures the essence of serving in EMS. Both the EMS service and the writer, who is moving on to a new career as a firefighter-paramedic, has asked to remain anonymous.

I first walked through the doors thirteen years ago: a sixteen-year-old high school sophomore at the time. I was eager to arrive on time for my first day as an observer at this EMS service. My parents received a postcard in the mail advertising the opportunity to volunteer or observe at the local ambulance. Not long after that, we had to call the ambulance to our home for my grandmother’s complications of congestive heart failure. I saw the crews work swiftly and professionally delivering her to the hospital greatly improved. Not having demonstrated any semblance of determination or work ethic at this time in my life; my parents were amazed to see me place a call, complete the paperwork and schedule my first shift. “Something to do, something different,” I would say when friends asked me why I didn’t see them anymore. Little did I know at the time what this place, this company, this field of work and these people would mean to me.

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I remember like it was yesterday. My regular shift of 18:00 to 00:00 which allowed time for homework, and still be able to sleep a little before going back to school the next morning. I recall being warmly accepted by the membership despite my younger-than-average age in this role. Most figured I was a student at the local university, as many observers were, and still are. I had no background, no experience in this field and nothing significant to contribute in conversation. I was accepted and included nonetheless. As time went on, being immersed in this environment was taking its toll on me. Something sparked. Something clicked in me that up to this point, the riveting high school experience had not yet been able to kindle. I saw what teamwork looked like. I saw what human compassion for the sick and injured looked like. Above all else, I saw the fierce determination of EMTs and paramedics striving to be masters of their chosen craft and applying their whole self to this mission.

Not just functioning but thriving as a part of something larger than themselves. Controlling chaos, quietly, carefully and skillfully. Walking into nightmarish scenes that most would recoil from, but instead taking that hell on earth and containing it within an organized algorithm. Planning and executing skilled assessments and lifesaving interventions before my eyes. This display of intense skill blended with warm humanistic compassion was instrumental in shaping the mind of a young, wide eyed observer. All that stood between me and this fascinating world was a prerequisite amount of birthday’s I had not yet obtained.

When the time came, I found myself enrolled in an EMT class while still in high school, buckling down and prioritizing it greatly over the drudgery that was the algebra supporting my subpar high school grades. Within months of graduation, I’d put on that green shirt for the first time, the ink still wet on the NREMT card in my pocket. “Now the gloves come off, you don’t just get to watch anymore,” I was told by Hildi. It may have been the first important realization of responsibility that she afforded me, but it certainly was not the last. She, and many others, taught me more than they may have realized at the time. Not only about medicine, but frankly, just about life. I feel in a way I grew up in that station.

Experiences, friendships and hard lessons learned here have shaped my demeanor, my work ethic and my future. There are few aspects of my life that are truly untouched by some element of my time at this EMS service. My fiancée, countless lifelong friendships, many hard lessons and even more great memories are just a few of the things I owe this organization for. I work now as a full time firefighter and paramedic. Thriving and enjoying this profession more than a decade after my introduction to it. I can truly say I don’t know what I would have done with my life had I not taken a leap of faith to see what “riding the ambulance” was all about.

To the newer members I leave you with a few lessons learned in my time here.

-Be kind. Your reputation follows you in all lines of work, but especially in this one. Our EMS and fire service communities are vast but seem to get a little smaller the longer you do this. Be the person that your coworkers will go out of their way to stand behind in support.

-Be the first person checking the truck at the start of shift. Take the trash out without asking. Remake the stretcher when it has a crease. Take pride in the little things that seem inconsequential. They aren’t. They are your image to the public. They are our image collectively as an organization to the community you serve.

-Take pride in being a part of this team. At least one line of your resume will forever read verbatim to that of hundreds of well-regarded MDs, DOs, PAs, NPs, RNs, paramedics, firefighters and police officers. You are joining the ranks of a group that can help define your path. Let it.

-Be humble. You will make mistakes. You will feel like crawling in a hole for things you say and do here. Your mistakes will be forgotten in time. Your response to these mistakes will not be. Be honest, take the steps to correct it and never…ever… lie about it. You will not get that golden hubcap award at the banquet if you blame it on your partner.

(Sorry Harry for that tire and the countless other things I’ve broken.)

-Do not forget to check your own pulse. You will see things that no one wishes to see. You will have to do things no one should ever have to do. But we do them because they must be done. It is in our nature to bear the burden for those we care for. PTSD in this community is real, but our brotherhood and sisterhood are stronger. If you think you have seen too much, tell someone you trust and act accordingly. We are one family. We will not let you weather your storm alone.

-Keep learning. With every degree, every shiny new patch, you may feel as though you have made it. Take pride in your accomplishment, but you have not made it. You are not the best at this moment that you will be. Be excited to know that the best really is left to come. That new patch proudly sewn to your shoulder is your ticket to ride the ride, it’s still up to you to actually get on. Seek out education, whether it be a certification class or simply a conversation over coffee or (insert favorite adult beverage) with a partner while decompressing after a tough call. Be comforted to know you’ve ran this type of call before, but don’t ever let your guard down. Surprises will always come. The more you train, the less surprised you’ll be.

-Resist the grasp of cynicism. It’s not only the high acuity patient’s that can take a toll on your mental health. The fourth complaint of “anxiety or ETOH” this shift may have you underwhelmed, but the patient under your care wasn’t counting your calls. They don’t know the kind of day you’ve had, but to them this is their emergency. Eye rolling can wait to be seen by your partner after the call. Professionalism is defined by your actions. It might not be doing CPR or getting your first field IV. It might just be listening patiently to Margie tell you about her bunion that she wants to be seen for. Do it with a smile, there’s no reason not to.

Cherish the friendships you form here. They might last longer than you ever imagined. Be your very best self from the moment you put that uniform on until the time it comes off. Unless you get blood on it halfway through the shift, then change your clothes and keep being your best anyways. Practice the skills you have aggressively and train on them even harder. You owe that to the people you treat. Your time here will always mean something important to you. Have fun, laugh and joke, but know when its time to put your game face on. Hunker down and be the best provider you can be when those tones drop. Be the person you would want to show up in an ambulance on the worst day of your life.

My life has steered me away from this service, but on a path I’m overjoyed to be on. I’ll think fondly of my time here and continue to demonstrate the knowledge and skills acquired and be the very best paramedic I can be. I challenge you all to the same.

“Thanks for everything” doesn’t even come close to being enough. My gratitude to the members that helped build me up professionally (and personally) is without end.

It’s been an incredible ride. Be safe.