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Feeling a little overwhelmed


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Hello all,

I am fairly new to this website and this is my first post. I am wondering if someone has advice for me. I completed an accelerated EMT-Basic training course the spring of 2015. The volunteer department I am affiliated with has done nothing less than support me through my training. There were countless times that other EMT's or Paramedics offered to meet with me on their own time to help me study. Two of the best Paramedics I know met with some of my classmates and I to practice patient care scenarios before the NREMT practical exam. Truly, the world of EMS is proving to be a second family to me and I feel very honored to be a part of it. 

However, through all of this I continue to lack confidence in my abilities to make the best decisions when time is critical, such as a call for a patient who is coding. I understand that we who work in Paramedicine are just as human as the patients for whom we care. We can make mistakes. However, part of the great responsibility of being a healthcare provider is that people entrust you with their safety and in that case of EMS, their lives.

This past week my Chief and Assistant Chief presented me with a First Responder bag and radio. They want me to become familiar with the equipment and begin responding to calls on my own. I am excited to do this but honestly it intimidates me. I worry that I might think I know what to do but will mess up when everything hits the fan, so to speak. 

I am currently studying to be an RN and have a part-time job at a pediatric hospital's Emergency Department. I am able to work alongside nurses, physicians, and EMS crews. Every day they teach me more about life in the world of emergency medicine. Last weekend there were three vicitims of a very bad car accident brought in. By the time my shift ended we had lost one of the kids and the other two were critically injured. It rattled me. I am confident that emergency medicine is where I am meant to be, and yet it still gets to me sometimes. It is like taking on something that both fascinates and terrifies at the same time. I love it and feel overwhelmed by it all at once.

I may be unusual in feeling this way but I thought I would put these thoughts out there in case anyone is willing to share some advice. Does this fade with time? How long did it take you to feel comfortable in EMS?

Thank you,


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Chris,  you are not alone in this and the only thing that really helps you work through these feelings and issues is time and a great mentor.  

Here are a couple of things from a guy who's been around a long time.

1.  First off - let's get the cliche out in the open - remember it's not your emergency it's the patients.  God how I hate cliches and stupid EMS sayings but this one above all others, is really spot on.  Remember this one when the shit hits the fan,  it's not your emergency, unless you are becoming the victim.  Then of course it's your emergency too.

2.  Not many things will kill you in EMS, except for bears, yeah bears will kill you, just like tunnel vision, but bears are meaner. 

3.  Get a mentor, one you can call at all hours of the day and memorize their phone number.  

4.  Keep learning and make sure to remember that when you think you have learned enough or you think you have learned as much as you think you can learn on a given subject, remember there is someone out there who can teach you more about it, or vice versa, you can now teach what you know to someone else. 

5.  Form a support group in your organization where people who are hurting, needing help, wanting to talk and needing to talk (think code green) can come to your support group and just unload in a non-judgemental environment.  But always remember and have the guiding principal that you are NOT and I repeat NOT a substitute for real professional psychiatric help for the ones who need it and let those who come to you know that if it comes to the point where you feel they need that help that you will help them get that help. 

6.  Remember that we all make mistakes, the real assholes are the ones who don't learn from those mistakes.  

7.  Remember that EMT Basic is just your starting point - keep learning.  No offense to the basics out there but don't stagnate yourself, unless you want to remain a basic, your next steps are school school school. 

8.  Form a group that can practice and work with the equipment.  Complete scenarios with each piece of equipment you have so you know how it works,  nothing F's up a scene than a moron who doesn't know how to use a piece of equipment.  The only excuse you have for not knowing how to use a piece of equipment is that you haven't been trained on it and then you should not be using it until you have been properly trained on it.  No court in the land/nor jury in the land is going to back you if you can't prove to them that at the time you used a piece of equipment that you were competent in it's use.  

9.  And above all,  remember,  the patient may be me or the patient family member might be mine or your own so you need to be on your game.  Nothing wrecks your day like having to treat your own family member or mine.  I guarantee you that I'm a bigger critic and a louder mouth.  (that's a freebie).  


Above all, remember to do all the above and have fun doing in, remember to do your best and if you did your best and can honestly say you DID your best to your level of training, then that's all that anyone can ask of you.  


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Dude, from your post, you are not one that folks worry about. You're showing situational awareness and an accurate sense of what exactly is at stake. Hard to tell from an anonymous internet forum, but it sure sounds to me that your head is in exactly the right place and you are right where you need to be.

Trust the folks above you to know what you're capable of... you'll be fine.



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Like they said, you sound like you are in the right place right now.  The first thing I would say would be to not respond to scenes on your own even though your chief is encouraging you to.  If you are not comfortable with it, don't do it.  Medicine is something that you become more comfortable with as time goes on.  Experience will make you feel more comfortable just give it time (think years not weeks).  Like Ruff said it's their emergency not yours.  Deep breath and think about what needs to be done.  Codes are the easiest pts to take care of.  They are dead and you can't make them deader.  It's the pt that is circling the drain that is sphincter tightening.  At the EMT level, there is very little you can do in most cases.  Mistakes happen, we all make them.  Luckily most are no big deal since people are hard to kill.

You sound like you have a good head on your shoulders so just keep learning and getting experience and you should do well.

EDIT: Be careful of those "best" medics and EMTs.  You would be surprised how often the "best" people turn out to be complete idiots.  You just don't realize they are idiots because they are so confident in their position.  I'm not saying that is the case with you but just something that I have seen over the years.

Edited by ERDoc
Had another thought
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Thank you (all three) for taking the time to write me back!

Ruff, that's a really good idea to seek out a mentor who has been in EMS for a while. Also good advice to remember whose emergency it is. There is somewhat of a support group in place at my fire department; not exactly an established group but it works pretty well. After my first bad call, multiple people reached out to everyone who was on the crew. There are a couple captains and lieutenants that did an excellent job reaching out to us and debriefing. What better way to learn than from someone who has experience working in the field. As far as going back to school, I am working on that right now. There's a possibility for me to become an IV tech which seems like a good step.

Off-Label, thanks for the encouragement. I really appreciate it.

ER Doc, I hadn't thought of a code like that. I suppose that takes a lot of the mental pressure off working on them, which in turn actually improves the care the patient receives. It's the cases like you describe as circling the drain that concern me. But like you said, all in good time. I hope that one day I can go far with all of this. I'd love to be a flight nurse one day, but I am just starting out right now.

I really appreciate the advice you all give and respect your experience in the field.


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I don't have much to add other than I was in your shoes once.  I'm an ER nurse now and going back and getting my basic again this summer because I miss EMS so damn much.  


Hang in there my friend :)


Katie, BScN, RN, CEN

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