The Ideal Medic

I have been a full-time paramedic for over twenty years and a part-time hospital EMS coordinator for over six years. Over the years my ideas of who the best paramedic is have changed markedly. I used to think the best paramedic was the one with the swagger, the one without fear, who never hesitated to act, who never allowed doubt to enter the equation. And while I still admire many aspects of that paramedic archetype, from both my vantage of twenty plus years on the street and the newer position of someone who can actually match up what happens on the street (or at least as described in the prehospital run form) and what happens to the same patient in the hospital, I have learned that many paramedics I thought were never wrong, can actually be wrong quite often, and that some of the paramedics who I thought were rather dull, have actually pleasantly surprised me time and again.

So here is my new ideal medic(s):

A great medic will call a STEMI Alert even if he is not certain the patient is having a STEMI. He will never hesitate to call for backup on a call (he is not afraid of being seen as weak or unsure) if he thinks it might benefit the patient. A great medic doesn’t always get the tube, sometimes she doesn’t even try. She’ll reach for the combi-tube if she thinks it will protect the airway sooner. While he tries to gauge the moment he enters a scene whether the patient is sick or not, he doesn’t lock in his impression. She is not afraid of saying she is uncertain. He gives the benefit of the doubt to the patient. She would rather medicate a drug seeker than deny someone in pain. He considers before acting. Sometimes he is afraid, but he won’t let his fear keep him from doing what needs to be done. But he always recognizes that sometimes, the best course is the conservative one. She understands the meaning of the phrase, “It depends…” And if he is criticized or if a nurse or a bystander says something offensive to him, he doesn’t feel the need to put them in their place. She talks to her patients as people, explains what she is doing, what she thinks might be going on, she guides them through what is happening. Sometimes he just makes small talk. At the hospital, he seeks follow-up — even and, in particular– when he thinks he may have been wrong about a patient. She tries to learn from each call. She does her job. He puts the patient first.

So here’s to you, my ideal medics out there. You know who you are. People notice. Carry on!

7 Comments

  • cindie brandt says:

    Thanks so much for this article. After 25 yrs as a medic, I sometimes just have to say “I’m not sure”. I never feel bad calling for backup or transmitting an EKG to a doc just to make sure. I get really upset when medics think they know it all….because they don’t! My motto is to learn something new everyday! Thanks again.

  • Twenty-five years as an ER doc in level one trauma centers has me in total agreement. I
    Interestingly what you say regarding paramedics also, in many ways, applies to ER docs.
    “Tries to learn from each call…puts the patient first.”
    A great post. I salute to your wisdom!

  • Sean Fitch says:

    Totally agree Peter, For too long I had the same interpretation and like you now, I would by far take your current description.

  • Shawn McCormick says:

    I totally agree. To me those make great paramedics. I work as a Operation Supervisor and encourage teamwork/backup whenever the situation calls for it. I encourage feedback from a difficult call my crews responded to. 1) they have the chance to recall the events that took place and they may self evaluate the call. 2) It gives me the opportunity to give advice/ guidance for my crews. I love it when a paramedic or EMT is humble, compassionate, and explain to a Pt. What they doing. I explain to all my crews, you’re not going to save everyone, you’re not going achieve every IV, interpret every heart rhythm, achieve every intubation, and have the correct clinical impression. Great read Peter.

  • Joseph Eriksen says:

    As a 30 year, now retired medic I completely agree. There is nothing wrong with second guessing although one should go with their gut. There are times to be aggressive and times to not. Also humor is one of the most powerful pre-hospital tools in the toolbox although it can’t be taught. When appropriate it can work better than many drugs we carry. I have seen way too much of the paragod syndrome and the damage it can cause. And I relish the big old slabs of humble pie when they are dished out. Often that is the turning point of a really good medic. How one accepts their dose foretells the kind of medic they will be or even if they remain in the field. For most patients it only takes a good bedside manner and a real empathy to save the day. And to know when to be the aggressive supermedic that can also save the day.

  • Sandy says:

    As a 24 year medic, I finally figured out it wasn’t me. Thank you for your article. You can’t teach that in any classroom. I have always found that empathy is a great tool. Use it to benefit the patient and teach others what it is all about.

  • bill says:

    very well put! aggression can be a good in moderation but over aggression can do harm. 1 year to 30 years no medic will know it all epically with our ever changing job description. thank you for your input!

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