As a student, I remember being stoked up about EMS. You're excited to start using your skills, diagnose people, and get in on all of the car accidents, cardiac arrests, and child births. Sure, after being in class for a while, you realise that it's a little different from what you expected, but still exciting, especially when you get into your ride-alongs.
As time goes by, your perception of the field begins to change, you start to see the truth about it. It's like dating someone you are highly attracted to. You see all the great things about the person, but after a year or so, you begin to see the flaws. EMS is similar. I have only been in EMS for about 4 years at the time of writing this, but I have learned a lot in these last few years. It seems like the more you see about the profession the more you realise the downfalls of the job, but also learn some of the greatest joys you wouldn't imagine when you're in class. Here are some things I think I've learned the most in past few years.
Becoming an Asset
I've always tried to be the best employee I can be and do my best to make my boss's job easier. I've tried to keep a good work ethic. And what you will find is if you make yourself an asset to the company it will mean 2 things: 1) you will be valued and appreciated as an employee and 2) there will become a high demand for you. It's great to be valuable employee. But the downside is when you become an asset to a company, there will be a high demand for you which means a lot of your time and energy will be demanded of at work. If you don't learn to say "no" sometimes, you will be pushed to your limits and taken advantage of.
Burnout is Real
As a student and a new EMT or paramedic, you want to put in all the shifts you can and experience all you can. That's great and really, that's a good time to do it. It seems like when you are new to the profession, burnout seems impossible. But don't kid yourself, anyone is vulnerable to burnout; it only takes time. As a student, I decided I would never fall to burnout, but when you are worked to the bone with very little sleep and constant stress from the job, it's not hard to become irritable and even question staying in the profession. Sometimes it's not even the field but the internal issues within the company built up on the stress of the job. Find a hobby or two and make time to relax and leave work at work. I know it sounds cliche but you need time to go home and not think about work. It's when you have constant exposure to work over a long period of time that burnout occurs.
You Will be Underappreciated
It's nice to think about the movies where the medic saves someones life and the patient is forever grateful. In reality though, you will encounter many patients that you will care for and do all you can to help and they will turn around and spit in your face, swear at you, try to assault you, or become abusive. If the patient doesn't, there's always family who is dissatisfied with how you treated their family member, just because you did things different from what's on TV. Just learn to brush it aside and move on. People will be critical of your work and will be unappreciative.
People Will Question Your Skills or Competency
Unfortunately, too many people have a warped view of EMS. There's the side where they think everything should be just like on TV. Then there is the other side who think all we do is drive and transport. There will be many people who think you can't make medical decisions (or have the authority to do so) and people who will question whether you are competent in a skill just because you're and "ambulance driver". This is especially true if you are young. I can't even say how many people questions whether I can read a 12 lead or start an IV or know what medications to give, not to mention drug doses.
People Will Try to Tell You How to Do Your Job
Whether it's hospital staff, a nursing home nurse, or a patients family member who's best friend has a cousin who had a roommate 30 years ago who was a medic. You will have people who think they know your job better than you and think they know your protocols better than you. Unfortunately, this happens a lot. Don't let other people squash your confidence, though. If you know what you're doing, competent in your skills, and know your protocols, stand up for yourself and don't let these people make you second guess yourself.
Speaking of Standing Up For Yourself...
When I started as a new medic, I tried to be as diplomatic and friendly as I could regardless of how patients or family treated me. As time has gone by I've come to learn that many people will push you and try to press your buttons. Know that you still have a right to stand up for yourself. If a patient is verbally abusive or giving threats, it's OK to become stern and tell them that you won't put up with it. It's OK to tell a patient that if they don't cooperate and cause problems, you don't have to treat, transport or be near them until law enforcement arrives. You have the right to defend yourself, verbally and physically, if need be.
Call Preference Changes
As an inexperienced EMT, medic, or student, you may look forward to the gunshot wounds, car accidents, fatalities, cardiac arrests, and childbirths. These calls are exciting, but only for a while. After you have had a 20 year old hang herself and have to tell the mother her daughter is dead, or you have your first infant death, those calls don't seem too desirable anymore. After while, those calls just become "another call". Yes, they may get your adrenaline going, but in the end, it's another call. I've found that the calls I look forward to the most are the ones where I accurately diagnose and treat a critical illness and have the patient genuinely grateful for it. As time goes by, the calls you look forward to begin to change.
Most of these things I've learned and shared with you seem negative, but as time goes by, you start to see the downfalls of the job. However, you also see and experience things that you wouldn't expect as a new provider. Things like keeping a child calm while on an inter-facility transfer, to have that child wanting you to stay with him. Things like a hug from a patient or family member, a thank you letter from a patient, or successfully reviving someone from a code. EMS is a special calling. If it wasn't rewarding, most people wouldn't stick around long. The negatives and low pay need to be out-weighted by the joys of working the job. Find what you enjoy and find time to relax and forget the job while at home and this job can be the most enjoyable.
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