New Boots: Weathering the Agony of Newness

EMS Reruns is an advice column designed to address dilemmas you may have experienced in EMS that you did not know how to handle. But it offers you a luxury you don’t have on scene: plenty of time to think. If you think of an example like the one that follows, send it to us. If we choose to publish your dilemma, we’ll pay you $50. We don’t know everything, but we do know a lot of smart people. If we need to, we’ll contact just the right experts and share their advice with you. Send ideas c/o emseditor@aol.com.

You feel about as untried and stiff as your shiny new boots, and completely out of place on the bench seat of your newly assigned, slightly worn Type III ambulance. The deck looks scruffy, the cabinet doors reveal the powdered residue of someone’s gloved fingertips, and you’ve noticed a vaguely sweet odor since the moment you first opened those rear doors. Now you’re sitting between your preceptor, Bill, and his partner, Ann.

These two are clearly not new to the game. They communicate on two levels simultaneously: verbally with you, and silently in some kind of sign language with one another. Their actions are smooth and practiced as they go through the jump kits—discarding a half-used roll of Kerlix, restocking a fistful of red-tops. Their manner is polite, but they’re laughing at the marked contrast between the mirror shine on your boots and the scuffed appearance of their own—in fact, the generally unpressed, unpolished world they obviously live and work in.

“You should rub some sand on them boots,” Bill says, and you’re not sure if his grin means he’s kidding.

Your first call is for a man in his 70s complaining of chest pain. On your way, seated in the captain’s chair, you notice that just about everything in the compartment could use a good cleaning. You identify the source of the sweet odor as a Glade air freshener, Velcroed to the action wall. You feel silly as you glance at those shiny boots and wonder where you can find some sand.

Q. Do you really stand out that much in these people’s daily environment, and should your inexperience feel like a face full of zits?

A. There’s not much you can do about inexperience, but don’t try to hide it. “Be what you is,” an old woman once said. “You may be old and you may be ugly, but be what you is.” A few people may find some amusement in your newness, but you’ll find most willing to share what they know. If you cover it up, you may fool a few of them and cheat yourself out of some valuable lessons. (The vast majority, whom you won’t fool, will have a really good time at your expense.)

Q. Is it unusual for EMSers to shine their boots and keep their compartment surfaces clean?

A. Lots of agencies don’t insist on cleanliness. Many do. But you will find crews everywhere who set their own professional standards, regardless of who insists on what. They’re the true pros.

Q. Is it possible that your polished appearance will jeopardize your learning experience with Bill and Ann?

A. That would be hard to imagine. Laughing is one of the best things in the world, as long as it’s not malicious. If these folks didn’t want you in their ambulance, they’d probably be giving you the silent treatment. Tell you what, though. Even if they do enjoy a laugh or two at your expense, they’ll respect you a ton more as a sharp-looking new EMT than they will if you return next shift as a sloppy new EMT.

Q. Is appearance that important to a preceptor?

A. Not all by itself. It’s hard work mentoring a new EMT, and even harder teaching a new paramedic. It demands more concentration, more job time, more paperwork and much more responsibility. It interrupts routines that every crew relies on. If you want to make your preceptors’ roles as rewarding as they can be, convince them beyond the shadow of a doubt that you really care about what you’re doing. When you are on calls, pay attention. Participate. Help out.

When you’re not on a call, spend some time cleaning that ambulance. Study, especially if you’re a new paramedic. Consult your patients’ x-rays and read their hospital charts. Ask questions, not only of your preceptors, but also the ED staff (and maybe your agency’s medical director). And after you’ve done all that, remember the most important thing—the thing that most new EMSers everywhere seem to forget. Say thanks!