How To: Be A Great Paramedic

(Besides your schooling and the experience that will only come with time, how can you become a great paramedic?)

So you’re an EMT and you’ve decided to take the next step and go to paramedic school. Why? If you say it’s just the natural progression for your job, then that’s the wrong answer. Stay an EMT or do something else. To pass the grueling trials of paramedic school you truly have to want to do it. You have to want to have the responsibility of being the highest pre-hospital medical authority and be prepared for the legal and emotional liability that comes with it. If you start your career by going to one of the “easier” paramedic schools then you’re already setting yourself up for failure. You’re already psychologically telling yourself you’re afraid.

Once you graduate and pass your exams you have, in theory, the same amount of knowledge as any other paramedic in the country (there is no substitute for experience though, but you will only get that with time). But like most jobs, there are a couple things besides what they teach you in school, that are going to make you great at your job. Your book smarts can only carry you so far. These are three qualities you must master to be great at your job:

We see things and deal with traumas that the public typically avoids and the key to dealing with that is to compartmentalize what you do. That’s why it should be difficult for you to answer the question “what’s the craziest thing you’ve ever seen” because if you’re great at your job, not much phases you. You have to be able to leave your work at work and go home to your wife and kids just like anyone else on the planet. As a great paramedic you have to think, “I have to help this man breathe” just like anyone else thinks “I have to finish these TPS reports by Friday”. There are times where you are going to miss an IV or fail to place an endotracheal tube but you must think like a “shooter” in basketball, the next shot is always going in. You must act quickly, decisively, and without emotion because that’s what makes you the most effective with your actions and decisions. The public and your team needs you to be a pillar of strength so act like it or get another job.

Command Presence
The biggest way to act like that pillar of strength is body language, voice inflection, and appearance in that order. The military buzz word that gets thrown around with leaders is “command presence” or the qualities it takes to be a great leader. There are several intangibles also but the most important quality is your confidence. When you approach a scene you have to walk with confidence and purpose. When you speak you have to continue that by being the “emotional leader”. Then phenomenon of being an “emotional leader” exists with animals where the most dominant member of a group (a paramedic) can affect the emotions of others. Humans are animals. Speak clearly, loudly, and efficiently with respect for others. You must be able to coral the ramblings of the geriatric population so you can focus on their problem. You must be able to control the randomness of someone on a drug overdose. And for your own safety you must exert subtle dominance over those that can be a potential danger to you (meth heads, criminals, or the mentally unstable). In times of stress, the public relies on the instincts deeply embedded in their brain to make decisions and these are affected by your body language (including physique), voice inflection, and appearance. Yes, the quality of your uniform also plays a large part in how you will be treated by others. Look professional. If looks didn’t matter, then kings would wear rags and celebrities wouldn’t pay stylists. The quality of your command presence will dictate the quality of the contact with your patients.

Stress is cumulative and one of the biggest factors is your lack of sleep. You must sleep whenever and as often as you can. Lack of sleep causes you to become ineffective, cranky, and will also cause you to gain weight. Sleep deprivation also doesn’t allow your body to properly heal from lifting those 400 pound patients down three flights of stairs and all of your brutal workouts that you hopefully do in your free time. You need sleep, so even though you may work 24-hour shifts get it in where ever you can. I understand that in many parts of the country your pay is abysmal but picking up more overtime isn’t the answer. Always choose sanity over money. On your off days you need to develop a routine. Go out to dinner with your family, take up something creative, or enjoy nature as much as possible. Your recreation and off-duty activities will affect your on-duty activities. Your partner is also the one you will rely on the most so develop your gallows humor, inside jokes, and above all, make sure you like the person work with because it will make your shift infinitely more tolerable.

We’ve all looked at other paramedics in the field and said that is one that I would/wouldn’t trust with my own family member. Why? When you see a paramedic you think is great, analyze why you respect him/her so much and then adopt those behaviors when it comes your time to be in charge. The public depends on you in their time of need so in order to be the most effective you must master these things. The greatest medication you have isn’t in your blue bag, it’s your voice. There are only so many pre-hospital treatments that are effective in the field so your greatest tool at your disposal is you. Your mere presence causes comfort to those in distress before you even say a word or take a blood pressure. So master those qualities and you will truly stand out not just a great paramedic, but as a great leader.

[Photo: “What 4:00 am looks like” in New Haven, CT]


2 responses to “How To: Be A Great Paramedic

  1. Awesome article! I had a pt who came in intubated in the GI tract, who coded after she arrived in ER – she didn’t make it. Being a paramedic is a huge responsibility. One preceptor I had at the hospital emphasized that I maintain a commanding presence, so people know that they can rely on me when they need my help.

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