OWN YOUR PRACTICE

It goes without saying that your future is of great value

     On the day the big envelope shows up in your mailbox with the suitable-for-framing certificate that says you have passed your certification examination, anyone within a 50-yard radius can hear the whoosh of moving air as you breathe a sigh of relief. Whatever level of certification you've obtained, it's something to be proud of. This month, I'd like to offer up a three-step roadmap on how to take ownership of your practice of prehospital medicine after your big mail moment.

Own Your Patch
     Once you've sewn that new patch onto your shirt, it will take at least six to 12 months before you begin to feel even mildly comfortable doing your job. Simply put, it takes time to make the transition from classroom to street. There is no question that running 10 or 12 ALS calls a shift will get you quickly up to speed, but even in a high-volume system, there's a lot about your practice you have to develop, aka "your style." Deciding what equipment you generally like to take in on calls, what approach you use with patient assessments and how you write patient care reports are examples of parts of your practice that you must develop and personalize, and that takes time and experience.

     You will also develop an appreciation for the responsibilities that come with your certification. When you realize that an assessment or patient care error on your part can cost another human being his life, the weight of being an EMS provider is heavy.

     You will have to learn how to professionally, politely and kindly deal with death. One of the most difficult tasks we face is having to look into the face of a distraught elderly woman and say, "I'm sorry. We did everything we could, but your husband is dead." Developing not just the art but the "heart" of medicine also takes time and commitment.

     When you feel comfortable with your medicine, accept and carry out your responsibilities to the best of your ability. If you have learned to deal with death, I would say you now own your patch.

Own Your Education
     When you make a commitment to the pursuit of excellence in prehospital care, you also recognize that maintaining your credentials in EMS means committing to a "lifetime of learning." A drug that was the latest and greatest a year ago comes under intense scrutiny. Three months later, it's moved down in the patient care algorithm, and three months after that, it is removed from protocols completely. Events like this play out every day in EMS. We learn, rethink and learn some more.

     It is essential that we remain inquisitive throughout our time in EMS. Never hesitate to ask about any aspect of medicine of which you are unsure. Every now and then, attend continuing education classes above your certification level: EMT-Basics should attend ALS-level classes; paramedics should periodically go to physician-level CME. Stretch yourself educationally. Work to cultivate a positive attitude about learning.

     Another good investment is obtaining some form of college degree. At some point, I do believe that we will see nationwide licensure in EMS, but I don't believe we'll see it without a minimum of an associate's degree.

     College opportunities for adult learners are increasing, especially in the area of distance learning. If you take even one class a quarter, you will get your degree hammered out. Too often, the decision to get a degree fades in importance, especially if it isn't a job requirement. One important note: If you are pursuing an associate's degree, try to get what is termed a transfer degree, i.e., one that will make you a junior should you decide to pursue a baccalaureate degree. Also be aware that technical arts degrees typically don't transfer well, with 15 credits often the maximum amount you can transfer. That's not good when you have 60 technical arts credits.

Own Your Future
     Next, it's time to develop and carry out your educational plan so you can take ownership of your future. Many years ago, a third-year medical student/paramedic named Joe Nelson did a number of ridealongs with me. When I asked where he saw himself in the future, he told me, in no uncertain terms, that once he became a physician, he was going back to Florida to become an EMS medical director and make some positive changes in EMS. I saw Joe at EMS EXPO in Orlando a couple of months ago, and he's gone one better than that—he's the medical director for the state of Florida. And yes, he's doing some great things for EMS.

     Your future is yours for the owning. Take whatever steps are necessary to make your future happen. You will need to commit to the hard work that accompanies all things of value. It should go without saying that your future is definitely something of great value.

     When you own your patch, your education and your future, you can truly say that you own your practice, and that's no small feat in my book.

     Until next month…

Mike Smith, BS, MICP, is program chair for the Emergency Medical Services program at Tacoma Community College in Tacoma, WA, and a member of EMS Magazine's editorial advisory board.