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What does it mean to be good at what we do and can we truly measure what it takes to be a good EMS provider? If you're an EMT does being good mean you do excellent CPR? If you're a paramedic are you a good paramedic if you can conquer the difficult airway, get the difficult IV, or pick up on that subtle ST elevation on an EKG full of artifact? Those are things we can measure but I don't think those things alone make a good EMS provider.
Although some may disagree with me, I don't think being a good EMS provider is something that can be measured. I think there are a few things that make for an excellent provider, but first let's talk about what motivates us to be good at what we do.
At a very simplistic level motivation can be looked at as having a need to fulfill, performing a behavior that fulfills that need, being rewarded for that, and feeling satisfaction. There are a number of theories that attempt to explain motivation such as the cognitive evaluation theory.
The cognitive evaluation theory is based on the principle that we have two distinct types of motivators, both intrinsic and extrinsic. Examples of intrinsic motivators include responsibility, achievement, and competence. Extrinsic motivators include factors such as pay, feedback, and the conditions in which we work.
For the EMS provider I think the cognitive evaluation theory provides an excellent framework for what makes EMS providers "tick". Many of us are intrinsically motivated by a sense of responsibility in what it means to care for others, being competent and seen that way by our colleagues and patients, and the various achievements we make as EMS providers whether that be a good outcome or performing well in a complex situation. The extrinsic motivators also seem to be important to most EMS providers. Although this may only be anecdotal, providers who are treated well, provided feedback on their performance, and are adequately compensated for their work (and as a volunteer this may be a sense of fulfillment, not necessarily pay) tend to perform well. When these motivators are absent, we risk a decrease in our performance, and the people who suffer are the very people we got into this business to take care of, our patients.
How then, can we also make sure we are good at what we do and take the best care of our patients? What are the qualities that make a "good" provider?
A Constant Desire to Improve Performance
A good friend of mine always says, there is a difference between 20 years of experience and one year of experience repeated twenty times. Medicine is always evolving and pre-hospital medicine is constantly changing. Staying current and providing the best care possible is part of being an excellent provider. Pick up a book, take a continuing education course, go to a conference, listen to a podcast, and explore some of the free open access medical education available online.
The Soft Skills: Caring and Compassion
This is the reason a lot of us cite for why we got into this field... to take care of other people. As the saying goes, people may not always remember the care you rendered, but they will always remember the way you made them feel. Think about the healthcare providers you have encountered as a patient. What made the good providers good? Their medicine probably wasn't the first thing that came to mind, it was probably their bedside manner, their demeanor, the time they took with you, and how they made you feel.
Being a good healthcare provider is about being good at taking care of others, which isn't always easy. If you haven't read it, Thom Dick's "People Care" is an excellent book that should be mandatory reading for anyone in this field. If you are looking for some renewed motivation for taking care of people, give it a read.
A Desire to Improve Your Profession
The people who are often the most unmotivated are often the first to get offended when someone tosses the word "ambulance driver" around or doesn't treat them with the respect they believe they deserve. EMS will only ever be seen as a profession when we become professionals. How you dress, how you act, how you treat your patients and colleagues, and how much you know will determine how you are perceived and also sets the tone for how someone who is unfamiliar with EMS will view EMS providers.
If you want EMS to be seen as a profession, you can start by acting like a professional.
Also, take advantage of explaining to those who know less about EMS what we actually do. Instead of getting offended the next time someone refers to you as an "ambulance driver", turn it into a teachable moment. Explain to them what you as an EMS professional really do.
Humility, Reflection, and Self-Care
Sometimes we need to take a step back to reflect on what we do and why we do it. Is the reason you got into EMS the reason you are still here? Most of us did not get into this field with the hope of financial gain, a regular schedule, and low stress. Most of us got into this profession because there was some motivator to help others, to deal with high stress situations, because we were interested in pre-hospital medicine, and because we genuinely just enjoyed doing what we do. If you're not in it for that reason anymore, it may be time to re-evaluate your circumstances or look for some renewed motivation.
If you have been in EMS for more than a year you have hopefully realized the reality of the job is not saving lives very often. The reality of our job is taking care of people, bringing a sense of calm to high stress situations, being empathetic, and in the midst of all this, providing some good pre-hospital medicine. Being good at this requires the ability to be humble.
One of the most important things we can all do to stay good at what we do is take care of ourselves. Managing stress and dealing with difficult calls is an important aspect of this field and career longevity.
Recently, a friend and former co-worker, Tyler, exemplified all of these traits. After realizing that a child might not be able to go trick-or-treating for Halloween he stopped at the store and purchased some Hallowen candy for the children. Tyler wasn't expecting any thanks, any recognition, he was just doing what paramedics do best... caring. Tyler's action was humble, kind, compassionate, and made our profession look good. There are many other examples like Tyler's in EMS, be good at what you do!