Speak Out, EMT!

I’m fond of saying; “it takes at least one good EMT to keep a Paramedic out of court”. Like most great anecdotes, there is always truth in the words.

Sometimes I see Paramedics talking down to their EMT’s.  I also see many EMT’s that are reluctant to speak up during a call to ask a question, or voice a concern. Reluctance to speak out is usually caused by having done so before, and as a result having been made to feel stupid by their Paramedic.

These are signs of inexperienced Paramedics who have let their ego off its leash. A good EMT simply MUST speak out and be heard. A good Paramedic will NEVER speak ill of an EMT  who does so, and here’s why.

Most of what Paramedics really do is EMT level. Over 90% of the job is BLS, and most great clinical saves are achieved because of good BLS. Since your EMT is fully trained in over 90% of what you do, their comments or concerns are no less valid then yours. Nobody is so smart they see everything.

Paramedics can also become task focused and might loose track of time or objectivity. A good EMT will remind you of what you need to be awareof. Their comments may call your attention to something you did not notice. I remember one great EMT I worked with for over two years. He would often let me know when I was missing something.

One example is that I would sometimes get kind of tunnel vision when intubating. Bob would always let me know “Hey, you maybe want me to bag him a minute while you prepare to try again?” This was his polite way of letting me know I had lost track of time. He also often picked up on subtle environmental clues to patient behavior like pointing out the spoon and works under the bed, or seeing a psych drug on the kitchen table while  I was busy doing an assessment.

My EMT’s extra set of eyes and ears combined with a lot of good commonsense actually kept me alive on one occasion. They must be respected and valued for their skills and abilities. An EMT has an important obligation to speak up when they see something that concerns them. Just like a good ER Nurse will let the ER Doctor know when something they notice may have been missed. It is not an option it is your professional obligation.

If you remain silent, you are not doing your job. Just because you have the misfortune to work with a Moron Medic, does not remove this obligation. He or She will have to get over it,  and if they can’t its on them and not you.

Don’t let demeaning comments go unanswered. Pull the Medic aside AFTER the call, and explain that you feel obligated to speak up when you see something that you think might be important. “No matter how dumb you think I am Mr. Medic, I still have to say something. I only hope you can react a little more professionally next time. When you show me a lack of respect in front of a patient, it can easily cause them to be less confident in our care. I don’t want that, and I’m sure you don’t  either.”

How the Medic answers this exchange is really not important. What is important is to speak up, and if the Medic has a problem, fine. You still have to do your job, and speaking up is an important part of it.

Paramedics please have a little more patience and grow up. You are not the sole source of righteous truth in the world. Yes, maybe today’s comment or observation by your EMT was off the mark. That does not mean you should demean your partner. The next time, they may see the handgun out before you do. You sure do not want to have “trained” your EMT to  remain silent when it matters most, do you?


About Dan White

I'm a retired Paramedic and EMS Instructor with 35 years EMS and emergency medical product experience. I love canoes, cars and EMS. I have written a lot about EMS Technology on the Paramedic Blog, the Insights on Innovation column for EMS1.com, on AmbulanceWorld.com and Multibriefs.com. I can be reached directly at 573-240-0002.
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7 Responses to Speak Out, EMT!

  1. Ty says:

    Bravo!I cannot tell you how many time I have sponken up when a medic is focused on starting a line that he forgets about ABC\’s. Sometimes, only get a sharp rebuke (usually from fire dept medic that thinks they took a better class than the ambo crew). I jsut found your blog, but am adding it to my favorites.

  2. Unknown says:

    One of the major issues that I see, first as a member of the general public, but second as an Basic, is forgetting that you treat the patient, not the illness or the machine. Paramedics become exceptional at their technical skills whilst letting their people skills sink lower and lower. There\’s a reason why many RNs have a tremendous disdain for Paramedics, and it is often due to the way that Paramedics interact with allied health professionals.One of the most interesting studies I\’ve come across discussed ligitation versus patient satisfaction. Even among doctors who were not the best technically, when the patient felt listened to and validated, even if the care was average, they were delighted. It\’s not about how you treat the disease or injury that satisfies the patient. It\’s about how you treat their mind and spirit. Paramedics that dismiss such a statement as that in the preceeding paragraph are waiting to have their day in court, and waiting to have their arrogance bring about their downfall. I was quite glad to read your remarks on the importance for Everyone to remember that there is always more to learn and more to be gained than lost when people repeat orders or inject helpful commentary on a missed step.

  3. Dan says:

    You could not be more right – today\’s hospitals are teaching the marketing techniques of sales professionals to affect the PERCEPTION of Quality Care. The perception & reality are two different things. I once worked with two different EMS Physicians. One was the best diagnostician I\’ve ever seen before or since. The other doctor made huge mistakes. The first one had less than zero personality. He got into EMS so he would not have to sit and visit with folks, like he did in private practice. But he was the best. He also got sued three times, not one of them legitimate. The second doctor had a great bedside personality. He could make you feel like the only patient in the world that mattered. He could get you to thank him right before you checked out. Never got sued once. Perception IS Reality.

  4. Unknown says:

    What a coincidence that your post is similar to nursing vs doctors.. I am currently looking for some evidenced based practice protocols that prove that paramedics improve the quality of survival since obtaining a greater scope of practice over the years.. Please stop by and read my current post and I would love any input from paramedics/EMS on the doctor\’s comments…Thanks so much!

  5. vb says:

    I need w/the term PEARL.  I am in EMT-I school and our instructor has asked us to define PEARL.  I am almost sure it is a  mnemonic.  Thanks for the help.

  6. Steve says:

    I am an emtp in ga and we get treated like garbage by rns. even murderous lpns in nursing homes thing we are below trash.can anyone relate? why can rns say anything demeaning but if you reply you get crucified.I had a vent transfer and asked for the info and the nurse asked if I was on a need to know basis,I\’m sick of it.

  7. Steve says:

    I am an emt p in ga and we often rendezvous with atl fire. I got a call at our airport for a women with chest pain. the firemen never treat the pts w o2 or any part of mona because then they have to transport. so they wait 39 minutes for us to get there. they always rule out mi because their 3 lead looks good. this is crazy for them to rule out mi in the field just because they are lazy

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