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When I first signed up for my EMT-B class I thought it would be the best thing I ever did for my medical school application. Additionally, after so much medical reading out of pure interest, I was so excited to finally get a taste of real patient care. When I envisioned my future as an EMT, I was careful not to have unrealistic expectations: I knew that most patients wouldn't be dying and I was well aware that EMT-B's have a relatively limited scope of practice. One thing I failed to realistically expect was the people who I would work with.
Some people might think this doesn't matter, and maybe it won't/doesn't to you; but let me try to paint a picture of what I've seen in a little over a year.
The Class Composition Will Probably Surprise You
My friend (who is now pre-PT, or however that works) made it to the first day of class about 5 minutes before I did and texted me "These people are trashy!"
They weren't what we expected to say the least, but we gave them a chance, and a handful turned out to be great personalities, some seemingly unlikely.
I'm not at all saying that premeds are the best people that could ever happen to EMS, there was a lot of diversity in that "good" handful of classmates: A lady whose day job was a bank teller, had no prior clinical knowledge, didn't want to switch careers, just wanted to volunteer helping her community; A pre-PA who was also an ER scribe, but was mature, and caring, didn't come across as a "gunner"; One and only one of the redneck fireman who was required to take the class but actually tried and cared; A 68-year-old widow who was bored in her retirement, also put forth a lot of effort. Some of these may never be great clinical problem solvers, but they will be due help, and fulfill their roles good enough.
Everyone else, not so good. Not intellectually curious in the slightest way, not morally or ethically upstanding, not presentable (and I'm giving a lot of lee-way), and very very out of shape - morbidly obese, most smoked, many did recreational drugs (the hard stuff.) They didn't get along, had no tact, the trashy moms would get into fights in the middle of class (raising voice and name calling, although fist fights have happened at my station.) Also, wanted to be heroes, in the tackiest way one could ever show they want recognition, ever.
Thankfully, the worst of them either didn't pass the class, could never pass the practical’s or the national written exam, or find the initiative to join anywhere once they did. Still, a lot slipped through the cracks, and a lot more who may not qualify as "riff-raff" but are still not good company.
The Trauma Junkies who think "Sick Calls" are BS (and would probably be over their head in an actual multi-system trauma that was circling the drain)
When I started my Basic course I knew from the very beginning that there would be a lot of toothaches, upset stomachs, and other non-emergent calls.
We went out on a call recently for an abdominal pain, of course she wasn't dying, but she was in real pain. I noticed my partner in the back was a little less personable with her than me, but didn't really rub me the wrong way until after we got to the hospital while writing report he complained about how it was "BS" and had a horrible attitude the whole time.
Then when we went back to the bay for her to sign she sat up and looked at me with this grimacing face and I knew exactly what was about to happen. I put on a glove really quick and got a container for her to throw up in - she was MISERABLE. I thought maybe after he saw that he would see it wasn’t such "BS."
On the way back, he STILL complained about it. He has no excuse to be burnt out or calloused - he's a month out of his Basic course.
This attitude is actually very common. Usually, among the newest members.
Hostile/Know-It-All/"Para-god"
Most doctors I've met are humbler.
This is one place where you should be open to help, suggestions, and continuing education. For many, none of these things are welcome and taken as insults.
I feel I have to walk on eggshells because of how fragile the big egos are. You can step on somebody's toes and not even know it, and if you do, they will hold it against you for a year and probably also try to turn everybody against you (this hasn't happened to me yet, but I've seen it happen.)
One EMT-B who is often at the station when I am is constantly trying to prove his superior knowledge (it's not.) He got there about 4 weeks before me and it was obvious he took great pleasure in showing me where things were, and asking me questions like "When would you use this?" "You have a patient with _________ what’s the next thing you do?" and I would usually give him an answer better than he was expecting.
Sometimes I'll correct him, and I'll basically caudle him by putting it in the gentlest non-threatening way possible and he'll defend his erroneous statement when I'm literally looking at what our protocols say.
The New Guy that Hates Being New
One guy lied about being a "paramedic" in a neighboring state which has reciprocity. Every time we had to call in a paramedic for a patient he would be SURE to tell them he used to be a paramedic. It really bothered him that he was an “just” an EMT.
Well, his story doesn't add up:
1.) The neighboring state has reciprocity - meaning it would have most likely transferred
2.) He said he was a paramedic there when he was 16, when I asked "A paramedic at 16?" He lied and said yes. (You can't be an ALS provider there under 18, I checked.)
3.) He didn't know how to read an EKG, although you better bet he pretended (For those of you who don't know, EKG's are paramedic territory)
Do I have STUPID written on my forehead???
You're new, realize that and take this time to learn.
Gossip
It’s like survivor.
There are people there who I, in survivor terms, thought formed a strong alliance, and suddenly when one isn’t there they’re talking about voting them off (literally.)
And it’s little things. Some time after high school I realized not to worry too hard about how I was coming across. What was it that parents always said? “People don’t care.” (as in nobody is looking at you that closely.) Well, here, some of them are critically reading into your every gesture, tone, and word; then, judging you by it and spreading it around.
It makes you wonder.
Conclusion
As a premed EMT, you may feel like the odd man out at times. There are probably 5 or 6 different "cliques" at my station, and at least 3 of them are different flavors of "rednecks." When I first got there, I was lucky enough to get in good with a couple nice groups: One of the redneck ones and one of "Day-Time Professionals." I call them rednecks affectionately, they're really good guys but obviously their background is a little different than mine, although maybe not as much as they at first thought. They picked up on my "preppy" style, the fact I was always doing homework, and talked a little differently. I guess they assumed I was such a softie that they filtered what they said the first few days and kept giving these disclaimers (trigger-warnings lol) before they said anything as if I had never heard locker-room talk before; I also like fishing, and even have (my parents have) a lot of land out in the country for hunting which really surprised them. There's also a PA, a psychologist, and couple nurses who I like running with.
Overall, it's a good experience (probably not one I would do again, for other reasons), but it was a little bit of a "culture shock." Other premed activities tend to have a common denominator that makes them sort of run together, this one just doesn't seem like the rest, which can be refreshing if you play your cards right.
Some people might think this doesn't matter, and maybe it won't/doesn't to you; but let me try to paint a picture of what I've seen in a little over a year.
The Class Composition Will Probably Surprise You
My friend (who is now pre-PT, or however that works) made it to the first day of class about 5 minutes before I did and texted me "These people are trashy!"
They weren't what we expected to say the least, but we gave them a chance, and a handful turned out to be great personalities, some seemingly unlikely.
I'm not at all saying that premeds are the best people that could ever happen to EMS, there was a lot of diversity in that "good" handful of classmates: A lady whose day job was a bank teller, had no prior clinical knowledge, didn't want to switch careers, just wanted to volunteer helping her community; A pre-PA who was also an ER scribe, but was mature, and caring, didn't come across as a "gunner"; One and only one of the redneck fireman who was required to take the class but actually tried and cared; A 68-year-old widow who was bored in her retirement, also put forth a lot of effort. Some of these may never be great clinical problem solvers, but they will be due help, and fulfill their roles good enough.
Everyone else, not so good. Not intellectually curious in the slightest way, not morally or ethically upstanding, not presentable (and I'm giving a lot of lee-way), and very very out of shape - morbidly obese, most smoked, many did recreational drugs (the hard stuff.) They didn't get along, had no tact, the trashy moms would get into fights in the middle of class (raising voice and name calling, although fist fights have happened at my station.) Also, wanted to be heroes, in the tackiest way one could ever show they want recognition, ever.
Thankfully, the worst of them either didn't pass the class, could never pass the practical’s or the national written exam, or find the initiative to join anywhere once they did. Still, a lot slipped through the cracks, and a lot more who may not qualify as "riff-raff" but are still not good company.
The Trauma Junkies who think "Sick Calls" are BS (and would probably be over their head in an actual multi-system trauma that was circling the drain)
When I started my Basic course I knew from the very beginning that there would be a lot of toothaches, upset stomachs, and other non-emergent calls.
We went out on a call recently for an abdominal pain, of course she wasn't dying, but she was in real pain. I noticed my partner in the back was a little less personable with her than me, but didn't really rub me the wrong way until after we got to the hospital while writing report he complained about how it was "BS" and had a horrible attitude the whole time.
Then when we went back to the bay for her to sign she sat up and looked at me with this grimacing face and I knew exactly what was about to happen. I put on a glove really quick and got a container for her to throw up in - she was MISERABLE. I thought maybe after he saw that he would see it wasn’t such "BS."
On the way back, he STILL complained about it. He has no excuse to be burnt out or calloused - he's a month out of his Basic course.
This attitude is actually very common. Usually, among the newest members.
Hostile/Know-It-All/"Para-god"
Most doctors I've met are humbler.
This is one place where you should be open to help, suggestions, and continuing education. For many, none of these things are welcome and taken as insults.
I feel I have to walk on eggshells because of how fragile the big egos are. You can step on somebody's toes and not even know it, and if you do, they will hold it against you for a year and probably also try to turn everybody against you (this hasn't happened to me yet, but I've seen it happen.)
One EMT-B who is often at the station when I am is constantly trying to prove his superior knowledge (it's not.) He got there about 4 weeks before me and it was obvious he took great pleasure in showing me where things were, and asking me questions like "When would you use this?" "You have a patient with _________ what’s the next thing you do?" and I would usually give him an answer better than he was expecting.
Sometimes I'll correct him, and I'll basically caudle him by putting it in the gentlest non-threatening way possible and he'll defend his erroneous statement when I'm literally looking at what our protocols say.
The New Guy that Hates Being New
One guy lied about being a "paramedic" in a neighboring state which has reciprocity. Every time we had to call in a paramedic for a patient he would be SURE to tell them he used to be a paramedic. It really bothered him that he was an “just” an EMT.
Well, his story doesn't add up:
1.) The neighboring state has reciprocity - meaning it would have most likely transferred
2.) He said he was a paramedic there when he was 16, when I asked "A paramedic at 16?" He lied and said yes. (You can't be an ALS provider there under 18, I checked.)
3.) He didn't know how to read an EKG, although you better bet he pretended (For those of you who don't know, EKG's are paramedic territory)
Do I have STUPID written on my forehead???
You're new, realize that and take this time to learn.
Gossip
It’s like survivor.
There are people there who I, in survivor terms, thought formed a strong alliance, and suddenly when one isn’t there they’re talking about voting them off (literally.)
And it’s little things. Some time after high school I realized not to worry too hard about how I was coming across. What was it that parents always said? “People don’t care.” (as in nobody is looking at you that closely.) Well, here, some of them are critically reading into your every gesture, tone, and word; then, judging you by it and spreading it around.
It makes you wonder.
Conclusion
As a premed EMT, you may feel like the odd man out at times. There are probably 5 or 6 different "cliques" at my station, and at least 3 of them are different flavors of "rednecks." When I first got there, I was lucky enough to get in good with a couple nice groups: One of the redneck ones and one of "Day-Time Professionals." I call them rednecks affectionately, they're really good guys but obviously their background is a little different than mine, although maybe not as much as they at first thought. They picked up on my "preppy" style, the fact I was always doing homework, and talked a little differently. I guess they assumed I was such a softie that they filtered what they said the first few days and kept giving these disclaimers (trigger-warnings lol) before they said anything as if I had never heard locker-room talk before; I also like fishing, and even have (my parents have) a lot of land out in the country for hunting which really surprised them. There's also a PA, a psychologist, and couple nurses who I like running with.
Overall, it's a good experience (probably not one I would do again, for other reasons), but it was a little bit of a "culture shock." Other premed activities tend to have a common denominator that makes them sort of run together, this one just doesn't seem like the rest, which can be refreshing if you play your cards right.
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