We often have no idea what we are doing. And we can’t have.And there is literally no idea that we ever can.
Imagine this: To study medicine you go to uni full time for 6 years around here. And then you have another 6 to 10 years until you become a specialist in your respective field.
Only then, we as a society believe and trust you enough that you can deal with everything life can throw at you and you will work without any consultant, etc. covering your back in some way, including all emergencies, no matter how rare it is.
Now, that’s of course only valid for your own field, none would expect a cardiologist to deliver a baby, even less a breach position. In the back of a car in a snowstorm.
Now. Paramedicine and EM?
We get everything whenever they are worst off.
My last few shift (I only work occasionally these days, more in a management role) we had to deal with life threatening emergencies from 6 different specialities: Vascular (Typ A aneurysm),neuro(Cerebral bleeding),Gyn(acute postpartum hemorrhage leading into cardiac arrest), paediatrics (patient with a syndrome even the ED Paediatrician had to google it), trauma.
Sure. We don’t have to operate on the cerebral bleeding, but these are the easy ones. (And we won’t be sure it is one anyway, no imaging besides the emerging ultrasound for us…)
The first breach delivery I did was the second birth I ever saw - and my colleague with 20 years more experience never saw one that wasn’t his wife before…
The first real life-treatening paediatric emergency? A 4 year old traumatic cardiac arrest post high speed collision.
And now,after 20 years in all roles this field can offer,from remote/wilderness work, helicopter, fixed wing, crit care,etc…I can safely say: While the “normal stuff” like heart attacks or strokes do no longer make me feel thrilled - there is always that stuff waiting around the corner you either never saw before or -almost as bad- haven’t seen in a decade. Only to be hit three times in a week by it. (When training to become a paramedic after working as a EMT I did not see a single cardiac arrest for the whole multi -year traing period. After graduation? Five in my first week…)
This makes this profession only viable for people who are good at ignoring this or people who can really fake it well - competence simulation is a key. But no matter how much you fake it,you will never make it fully.
Because people REALLY don’t want to see a panicked paramedic.
(And in the end it comes down to an old joke of the profession being true: If the patient is in a situation we can’t make sense either it’s not urgent or it will soon be a situation we know very well: Cardiac arrest)
Paramedicine/Emergency medicine?
We often have no idea what we are doing. And we can’t have.And there is literally no idea that we ever can.
Imagine this: To study medicine you go to uni full time for 6 years around here. And then you have another 6 to 10 years until you become a specialist in your respective field. Only then, we as a society believe and trust you enough that you can deal with everything life can throw at you and you will work without any consultant, etc. covering your back in some way, including all emergencies, no matter how rare it is. Now, that’s of course only valid for your own field, none would expect a cardiologist to deliver a baby, even less a breach position. In the back of a car in a snowstorm.
Now. Paramedicine and EM? We get everything whenever they are worst off. My last few shift (I only work occasionally these days, more in a management role) we had to deal with life threatening emergencies from 6 different specialities: Vascular (Typ A aneurysm),neuro(Cerebral bleeding),Gyn(acute postpartum hemorrhage leading into cardiac arrest), paediatrics (patient with a syndrome even the ED Paediatrician had to google it), trauma.
Sure. We don’t have to operate on the cerebral bleeding, but these are the easy ones. (And we won’t be sure it is one anyway, no imaging besides the emerging ultrasound for us…)
The first breach delivery I did was the second birth I ever saw - and my colleague with 20 years more experience never saw one that wasn’t his wife before… The first real life-treatening paediatric emergency? A 4 year old traumatic cardiac arrest post high speed collision.
And now,after 20 years in all roles this field can offer,from remote/wilderness work, helicopter, fixed wing, crit care,etc…I can safely say: While the “normal stuff” like heart attacks or strokes do no longer make me feel thrilled - there is always that stuff waiting around the corner you either never saw before or -almost as bad- haven’t seen in a decade. Only to be hit three times in a week by it. (When training to become a paramedic after working as a EMT I did not see a single cardiac arrest for the whole multi -year traing period. After graduation? Five in my first week…)
This makes this profession only viable for people who are good at ignoring this or people who can really fake it well - competence simulation is a key. But no matter how much you fake it,you will never make it fully. Because people REALLY don’t want to see a panicked paramedic. (And in the end it comes down to an old joke of the profession being true: If the patient is in a situation we can’t make sense either it’s not urgent or it will soon be a situation we know very well: Cardiac arrest)