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Original Contribution

Stay Hungry!

October 2012

A great pleasure of my job is being able to ride along and see for myself if my students have actually learned all they needed to learn during their time in the TCC paramedic program. When it’s all said and done, the question that must be answered before a student gets cut loose is both simple and direct: Is their knowledge base adequate, and the essential skills of the craft mastered, such that the student is safe enough to work as a competent entry-level provider?

The icing on my cake is that I also get the privilege of watching some of the most outstanding paramedics in Washington pass on their craft as they precept my students. These pleasures have been part of my professional life for more than two decades.

Over the years, as I’ve worked beside these men and women who give back to the EMS profession by working as preceptors, I have noted some remarkable commonalities. There are four particular qualities I’d like to put on the table as the focus of this month’s BTB.

First and foremost, they are one and all consummate professionals. They always look and behave like the medical professionals they are, treating patients, friends, loved ones, bystanders and colleagues with respect and courtesy. Day in and day out, these folks walk the walk, and their professionalism provides a platform upon which to build a solid medical practice.

Another remarkable quality I’ve seen is having the ability to remain calm under virtually any circumstances. Without question, one of the easiest ways to melt down an emergency scene is to have the lead medic spin up and start yelling orders at everyone. That behavior never contributes to a positive outcome, and in truth frequently complicates patient care. I should also throw in the word polite. Requests prefaced with please and followed with thanks keep everything moving forward in a stable, controlled fashion.

Third on the list of qualities top-notch preceptors bring to the table is a never-ending can-do attitude. Over time, problem-solving for the expert provider transitions to an almost automatic mode. The patient is gurgling? Suction. The patient is sonorous? Reposition. The patient is wheezing? Bronchodilate. The patient’s breathing is silent? Breathe for them. Problems appear, problems get addressed. The veteran provider gets increasingly adept at figuring out and implementing solutions.

At some point in your practice, when you’ve gotten a chance to see lots of pitches, fewer and fewer pitches surprise you. But it’s not just time in grade and running calls that really make the difference in our world. Both contribute to overall growth, but it’s the ongoing pursuit of excellence that fuels the practice of the expert. Again, the development of pattern-recognition skills is a huge factor in the growth and development of the quality EMS provider. It is that desire to fill the gaps between what you currently know and what you want and need to know that serves as a driving force.

This drive, this never-satiated hunger to know, is the most important quality of all I see shared by great paramedics. They constantly want to know more about their medicine, which feeds their desire to know more about what they know. The pull to widen and deepen their knowledge is a big part of what drives the caregiver who truly wishes to excel. In one way or another, I’ve seen this hungry-to-know-more quest play out in countless ways.

For example, on one call a patient’s 24-item med list contained several medications none of the four medics on scene had heard of. As soon as we got back in service, the next item of business was to fire up the computer. Within a minute or two, the unknown drugs were identified, as well as their primary applications. When we got back to quarters, a quick call to the other responding medics got that information into their hands as well. Learn more, and share what you’ve learned—it’s a great model.

Another great connection for feeding that hunger to know is access to ER docs and nurses. When time allows, a brief two- or three-minute exchange can provide insight into that complicated medical case you just brought in. This type of professional dialogue also builds a collaborative relationship between field providers and the docs and nurses with whom they interface. I also believe quality caregivers take notice of other caregivers who seek to learn more, polish their skills and ultimately improve their practice and the care they provide.

All you have to do is stay hungry!

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 the EMS World editorial advisory board.


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