Ready for an unpopular idea?

[NomadicMedic]

Between here and Facebook I've been reading an awful lot of threads from people who have felt like they're not ready for EMS or have had significant amounts of difficulty in passing the test. Invariably the question comes up, "Am I cut out for this job?"

Let's look at this from a different perspective.

I'm a 44-year-old fat guy. I would very much like to be a professional baseball player. I've always wanted to be a professional baseball player. Ive studied the history and stats. I know how to do it inside and out! I envision myself in the uniform, standing at home plate pointing my bat towards the sky like Babe Ruth, calling my shot. The crowd cheering, sportscasters reverently muttering my name into their microphones. I've worked for jerks sitting behind a desk, and even if they didn't pay me much money, I'd be happy being a professional baseball player… Because I know in my heart, that's what I should be doing. Playing America's game. But every time I try out, I realize I can't hit, can't shag a can of corn and run the bases like a wheezing asthmatic.

Does pro ball sound like a realistic goal for me?

I mean, I KNOW how to do it, I just can't deliver who I need to...

It doesn't make me a bad guy, just not pro baseball material.

So why do we continue to blindly cheer on the people who can't pass the NREMT, console the guy who throws up every time he sees blood, and continuously remediate the paramedic candidate who just can't start an IV?

If I tried out for the majors and never made the team I'd hope that someone would give me a nudge and say, "hey knucklehead, maybe baseball isn't your game. Try ultimate frisbee".

Its my belief that will and interest may not always equal job suitability. No matter what they tell you in paramedic school.

 

[STXmedic]

This should be a sticky in the NREMT section.

 

[MrJones]

...So why do we continue to blindly cheer on the people who can't pass the NREMT, console the guy who throws up every time he sees blood, and continuously remediate the paramedic candidate who just can't start an IV?

If I tried out for the majors and never made the team I'd hope that someone would give me a nudge and say, "hey knucklehead, maybe baseball isn't your game. Try ultimate frisbee".

Its my belief that will and interest may not always equal job suitability. No matter what they tell you in paramedic school.

I consider it to be one of the by-products of the "every child gets an award" mentality that seems to permeate society these days. If a kid's never been told he couldn't cut it growing up why should he expect any different as an adult?

 

[VFlutter]

I could not agree more.

This mentality is even more prevalent in nursing. The Nursing forums are filled with touchy feel sentiments and encouragement for people with threads like "Failed the NCLEX for the 4th time! Help!".

If you fail an exam, designed to test the bare minimum level of competence, multiple times then there is a problem. You do not meet that level of performance. And chances are even if you do pass after your 5th try you will not succeed in clinical practice.

 

[JPINFV]

Oh, please. Nursing and EMS has nothing on medicine. Between the "What are my chances?" section in the pre-med forums on SDN to the Caribbean folks who've failed the USMLE 3 times and are essentially shut out from US medicine (a lot of states will deny licensure if you take more than 3 attempts), medicine wins this race.

 

[Carlos Danger]

I don't completely agree. Sure, there are people who are not cut out for EMS, and I'm definitely not known for telling people what they want to hear just to be a nice guy.

But let's face it, learning to be a paramedic is not rocket science. You need 2 semesters and a single textbook written at a tenth-grade level. With good instruction, there are probably relatively few high school graduates who can't pass a paramedic program if it's what they really want to do. I don't mean to be insulting to those who have chosen paramedicine as a career, and I'm certainly not suggesting that paramedics as a whole are an unintelligent bunch. I'm just saying that the bar is set low enough that most anyone in possession of average intelligence and basic reading skills can probably manage the necessary schooling.

My perception of the situation of many of these struggling wannabe's is that they simply aren't being instructed properly. Classroom instructors in EMS often have no real training in education, field preceptors often like to eat their young, and ED nurses are often very unhelpful for a variety of reasons.

EMS education is often very poorly executed, and no small part of the problem with it is that some people who would likely turn out to be competent practitioners really struggle because the quality of their instruction - both didactic and clinical - sucks.

 

[Carlos Danger]

Oh, please. Nursing and EMS has nothing on medicine. Between the "What are my chances?" section in the pre-med forums on SDN to the Caribbean folks who've failed the USMLE 3 times and are essentially shut out from US medicine (a lot of states will deny licensure if you take more than 3 attempts), medicine wins this race.

But that's because medical education is truly rigorous, and many people aren't cut out for it.

Paramedicine and entry-level nursing, by comparison, should be able to be mastered by pretty much anyone of average intelligence.

 

[chaz90]

Paramedicine and entry-level nursing, by comparison, should be able to be mastered by pretty much anyone of average intelligence.

Let's make sure we keep a distinction between "master" and "demonstrate bare minimum level of competence." In my book, becoming a master at anything means you've surpassed that which the vast majority would be able to obtain.

 

[fma08]

Oh, please. Nursing and EMS has nothing on medicine. Between the "What are my chances?" section in the pre-med forums on SDN to the Caribbean folks who've failed the USMLE 3 times and are essentially shut out from US medicine (a lot of states will deny licensure if you take more than 3 attempts), medicine wins this race.

Don't forget the "academic dismissal" threads for failing x number of classes. The evil medical schools think they can kick someone out for not getting the material they'll need to understand how to take care of someone? How dare they. Maybe the other disciplines (nursing, EMS, etc.) ought to stick to their guns with similar policies. But what do I know. Back to studying now.

 

[JPINFV]

Don't forget the "academic dismissal" threads for failing x number of classes. The evil medical schools think they can kick someone out for not getting the material they'll need to understand how to take care of someone? How dare they. Maybe the other disciplines (nursing, EMS, etc.) ought to stick to their guns with similar policies. But what do I know. Back to studying now.

The problem with medical school is that I think too many schools have too light of a trigger for dismissal and too many don't pull it early enough. Depending on the total picture (a couple of failures at 69 percent is a bit different than a couple of failures at 50 percent), I think it's appropriate to require a student to repeat a year before going the dismissal route.

 

[fma08]

The problem with medical school is that I think too many schools have too light of a trigger for dismissal and too many don't pull it early enough. Depending on the total picture (a couple of failures at 69 percent is a bit different than a couple of failures at 50 percent), I think it's appropriate to require a student to repeat a year before going the dismissal route.

In all fairness, many of them do have some sort of a remediation program (including the one I'm at).

 

[firetender]

On one hand I agree, some people just ain't cut out for the work and the more quickly they realize it the better off we all are.

But that doesn't really become clear for a while. People deserve time to adjust and find that they ARE capable of being effective in the field if they can stick with it. For most the beginning is the scariest time; the time that churns up the most insecurities.

We get to see a lot of that here because the FNG's are too FNG to know to keep their mouths shut! They learn fast out in the real world.

The culture identifies the expression of weakness as a sign of inability to serve. That's out and out wrong. Each of has his/her personal threshold where honest expression is necessary to work through some of the complexities of the work.

But here, on-line in an anonymous Forum it doesn't have to be as harsh as "out there".

Out of balance encouragement in the beginning is not so bad really. Why? Because the beginning is much too early to predict how valuable a medic will become.

Sometimes the chorus of vultures seeking fresh meat here is deafening. The loudest voices are usually those who wouldn't know a wall if they hit it. It truly IS the luck of the draw and any one of us could kill a patient in our first week as easily as get test-freaked out and bomb one or more times before getting into the back of the truck.

I would prefer to encourage every one on this site to make a little bit of room for your peers to express insecurities. Realize that an important part you can play in strengthening the profession is to make space for your peers to be human.

Who knows, someday you may need an open ear and a little support yourself. If there's a little bit more room to be able to honestly express yourself when you start to hit your personal walls maybe you won't have to suffer alone and then slink away into the shadows with the countless other burnouts who had nowhere to go with their humanity.

Just another point of view to help open dialogue a little bit more real than Question: "Gee, am I really cut out for this work?" Answer: "No, get out!"

 

[NomadicMedic]

Russ, I see your point of view, but I respectfully disagree. People fail in the educational process all the time. Welders, barbers and auto mechanics all fail out of their programs. They move on and do something else. "Sorry Joe. You're jut not good enough at Tig Welding to make this a career." We just see more of it here and on facebook because newbies are taught to see EMS as some sort of heroic civic duty, rather than a technical profession. There's actual book learnin' to accomplish! Just because you WANT to doesn't mean you can (or should)

So sorry. You can gather you friends together and give 'em all a hug and sing a few rounds of "kumbaya" but I still hold that this job is not like intramural softball. Not everyone who shows up deserves a jersey. But they do deserve the honesty of being told that... Not a hand holding stroll down the primrose path to "everything is gonna be okay land".

 

[Altered Mental Status]

My two cents (and I'll be breif because I myself struggle with insecurities): I'd often rather deal with someone honest about their failings who works hard and has a good attitude (but maybe needs to take the long way 'round) than an arrogant jerk who's a "natural" from the start but forever functions with a blind spot when it comes to ingenuity and acceptance of fresh ideas because he's been "spoiled" from day 1 by the luxury of never being challenged because he's always been at least adequate.

This goes for any field of work or study.

 

[DesertMedic66]

I agree with everything you stated. The fact is not everyone is cut out for EMS. I know many smart students who have either taken the class and failed out or taken the class, passed it, but failed many tests later on.

We get students who will pass out at the sight of blood. You may be able to get over that issue but until you can you should not be working on the streets.

With the new generation (I'm in that age group also), they feel like they are entitled to everything. That is something that really doesn't work out in EMS.

 

[Emtsgv]

hope ur not a training officer haha

 

[STXmedic]

I hope he is! Too many training officers pencil through people who have no business being cleared because they can't or won't differentiate between the capable and the worthless.

 

[Emtsgv]

I hope he is! Too many training officers pencil through people who have no business being cleared because they can't or won't differentiate between the capable and the worthless.

if you make it into an amb, u have to be doing something correct people need time to understand book/real life and i think that some people get better with time.....cant just cast people aside because the first time they didn't do something perfect , im not saying oh he killed someone, or hurt someone its OK! hes learning but i think you can get the just of what i mean

 

[Tigger]

if you make it into an amb, u have to be doing something correct people need time to understand book/real life and i think that some people get better with time.....cant just cast people aside because the first time they didn't do something perfect , im not saying oh he killed someone, or hurt someone its OK! hes learning but i think you can get the just of what i mean

No one is suggesting that new providers not be given an opportunity and sufficient time to learn the job. However after a certain time if you just don't get it and keep making the same mistakes, more time is simply not the answer. A new career path is.

 

[STXmedic]

if you make it into an amb, u have to be doing something correct people need time to understand book/real life and i think that some people get better with time.....cant just cast people aside because the first time they didn't do something perfect , im not saying oh he killed someone, or hurt someone its OK! hes learning but i think you can get the just of what i mean

I hear what you're saying. However, being alone shouldn't be the time you are trying to figure out if you can hack it. That's what the FTO period is for. You get your feet wet while having a watchful eye. Once you're competent, you're cleared. Unfortunately, most systems have a horrible FTO period, very often with people who have no business being training officers. So as long as that holds true, people will continue to be cleared no matter their ability level.