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Home > Columnists > Kelly Grayson
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The Ambulance Driver's Perspective
by Kelly Grayson

Coach or cannibal with rookies?

Since when is being treated like a leper a time-honored and sacred rite of passage?

By Kelly Grayson

Rookie EMT: It's the other white meat.

One of the legends of the Greek philosopher Diogenes is that he often carried a lamp around in the daytime, searching in dark crevices and alleyways for an honest man. He never found one.

I sometimes feel the same way when reading an EMS social media comment thread. While the Internet allows access to information at the speed of thought, ignorance travels just as fast, and sometimes the signal-to-noise ratio is distressingly low. Mostly I skim the threads for the comments of a select few whom I know always have something insightful or constructive to say and ignore the rest.

Yeah, I know it's probably intellectually dishonest, but it keeps my head from exploding.

Reading one of those comment threads the other day, I was reminded that the cannibalistic approach to mentorship is still alive and well in EMS. Frequently, an EMS rookie will post a request for advice, something along the lines of, "I'm a new EMT with Podunk Volunteer Ambulance Corps, and I'm having a problem fitting in with the older members of the squad," or "I just ran a really bad call the other day, and I'm having problems dealing with it. How do I get past it?"

And I was appalled at the number of comments that were some variation of, "Harden up, cupcake."

Really? Forty-plus years into this profession, and we're still eating our young?

I'll grant that EMTs need to develop a thick skin as some measure of psychological protection against job stresses, but is it really necessary that a new EMT harden up to fit in? Why shouldn't some of the older, more seasoned EMTs learn to soften up? Since when is being treated like a leper a time-honored and sacred rite of passage?

After all, that's one of the best things about a rookie — you get to vicariously experience EMS through a fresh set of eyes. They remind you of all the good things you've forgotten about EMS, all the things you take for granted after the grind has beaten a little of the humanity out of you.

We don't need to crush the idealism of our rookies. We need to harness it.

I've often mused that EMS would be better served if we stopped recruiting adrenaline junkies and trying to teach them compassion and started recruiting compassionate people and teaching them to function under pressure. The first step would be to ditch this notion that cynicism is desirable.

It may be inevitable, but it is never desirable.

The dictionary defines preceptor as "an expert or specialist, such as a physician, who gives practical experience and training to a student, especially of medicine or nursing."

That "practical experience and training" encompasses volumes of volumes of tradition, science, art, wisdom and BS. It is the lore of our profession. The good preceptor passes on the collective wisdom — and sometimes, inadvertently, the BS — of our profession to the next generation, and I mean all of it; what EMS was, what EMS is and what EMS should be.

Pay particular attention to that last part: what EMS should be. In that way, we are all preceptors. If you want to know what a preceptor really does, you have to go back to the root word:

Precept: [pree-sept] - noun

  1. A commandment or direction given as a rule of action or conduct
  2. An injunction as to moral conduct; maxim
  3. A procedural directive or rule, as for the performance of some technical operation
  4. A law

All four definitions are important. All four have direct bearing on our practice as EMTs. They encompass our traditions, our attitudes and our expectations of proper behavior. They are our professional ethos. The role of the preceptor is to be a steward of our profession and, in so doing, prepare the next generation of EMTs to be stewards of the profession as well.

So why is it that many preceptors only pay attention to no. 3?

My sweetheart works for an EMS staffing agency, and she has a mantra: "Hire for attitude, train for ability." She recognizes that of all the skills that a good EMT possesses, the so-called "soft skills" are the hardest to teach.

Learning how to board a patient, apply a traction splint or auscultate lung sounds is a matter of repetition. EMT class should have accomplished that before they reach the streets, but even if it didn't, it's still a relatively simple matter for a good partner to correct any deficiencies.

What is far harder is to instill in a new EMT is the right attitude, and doing that requires someone far more valuable than an EMS instructor or a field training officer.

It requires a mentor.

In your moments of greatest stress and indecision, whose advice do you crave? Who do you first think of when you want to share the elation of a professional triumph? When you feel beaten and discouraged, whose voice whispers your mental pep talk? Who plants the metaphorical foot in your behind when you need the motivation?

Right now, you're probably smiling, thinking of just such a person: Your mentor. The best part is mentoring doesn't require any special training, an extra stipend or a job title. It just comes by setting an example for the next generation.

And the first step is realizing that you can season the new meat without needing to eat it afterwards.

About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

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