My First Lesson

As a new paramedic, I feel pretty fortunate. My company has a tendency to put new medics into the field with little field training time and this is apparent in the quality of the paramedics that work for us. I had a month of FTO time before I was put on my own, which was more than most and very welcomed. I finished my field internship in July of last year, which means that from July until when I tested in August, then received my certifications in September, I hadn't practiced as a medic. I needed the field time with a senior medic to re familiarize myself with the skill set. I started in October as the senior tech on the ambulance; we staff an ALS transported ambulance with one paramedic (the senior tech) and an EMT-Basic (the junior tech).

My first call as a paramedic was a gunshot wound to the chest. Now, I live in a small community with virtually no violent crime and virtually no firearm related accidents. As an EMT, when you hear of a gunshot wound you immediately get pumped up; you're thinking about blood, guts, and carnage, which is what our EMT training was all about. As the paramedic, the guy ultimately responsible for the patient and your crew, I was thinking about our safety and trying to put together a treatment plan.

But I was nervous. This was my first call and up until this point, the only gunshot wound I'd ever been to was a through-and-through to someone's leg. I'd never dealt with anything this potentially life threatening on my own before and I was a little scared.

The first arriving sheriff's deputy advised us by radio that this was a confirmed GSW to the chest, but that it was a hunting accident and safe for us to approach the scene. The patient was in the back of an SUV, having been brought down from the woods by friends, and was not in good shape when I approached him. He was hurt, but he was conscious.

So I started communicating my plan right away to my partner, the firemen, and the sheriff's deputies. I then went back to the ambulance to give a preliminary radio report to the hospital and activate the trauma team. It was at this time that I learned possibly my most important lesson (so far) about being a paramedic. When I returned to the patient to see the progress made in moving him from the SUV to the ambulance, nothing had been done. So I communicated by plan again, which at this point was simply get him on a backboard and into my ambulance.

Still nothing happened; the firemen seemed to have their own idea about what to do. So I communicated my plan again, punctuated by a "now!" It was no that the fire chief turned to me, told me to calm down, and that they were working on it. Now, if there is one sure fire way to piss me off, it's to tell me to "calm down," and the sheriff's deputy saw it. He turned to me and said, "I know. I'll take care of it." And he did. Within the next two minutes, the patient was on the board, in the ambulance, and we were transporting.

It was a short trip, less than 10 minutes, and I had my hands full starting IVs, getting him onto the heart monitor, oxygen, and checking for other injuries. We arrived at the hospital, turned over the patient to the trauma team, and then I went to go have a conversation with the fire chief. He started immediately apologizing and said "I thought your partner was the paramedic." In other words, he thought my EMT partner was the one in charge and had told his firemen to listen to my partner, not me.

So now, whatever call I'm on, I always start with, "hello, my name's Jeramy and I'll be the paramedic taking care of you." And you know what, I've never had a problem of mistaken patient care responsibility since.