Experience is the best teacher to react to the unplanned or unknown
Those at the top of the EMS pecking order often have the knowledge and experience to successfully respond to spontaneous situations
Rather than plan, prepare and fine tune a response to a situation, I wait for it to happen and then figure out what to do.
Usually I manage to get through whatever it is that I got myself into, then dwell on what just happened for a few hours, or days, depending on how things went. Years of firefighting and EMS probably molded my present operating procedures- but then again, maybe not. Perhaps I’ve always been this way, and my career only enforced my present modus operandi.
I think it is also part of what makes me an effective medic.
Those in other occupations have the luxury, even necessity, of pre-planning. Imagine being a cook, and just expecting to come up with a plan when the dinner crowd arrives, or a financial planner who waits until the end of the year to try to place other people's money in investments where it will grow. Or imagine a carpenter who wings it, trusting his instincts to see him through. My guess is there would be a lot of hungry, broke people living in dilapidated houses if everybody reacted to situations as they arose rather than planned for them.
Don't misunderstand, a lot of practice, education and experience is needed to shoot from the hip. The most important ingredient of spontaneity is knowledge. Being well versed in what you do not only makes you better at what you do, it also brings a certain measure of respect.
Desire to help others keeps us together
No matter where we are in the Fire/EMS pecking order - and make no mistake, there is a pecking order whether we like it or not - we are there by our own making, and our own capabilities. Patients, their families and the staff at area emergency rooms, nursing homes, dialysis centers or wherever our trucks may roam could care less that I'm a Providence Rescue Captain, or that guy is a first year basic, or she's a part-time private ambulance employee, or he's a paramedic, or she's in school to become one.
It also doesn't matter to the first year basic, the paramedic student, the volunteer or the Providence Rescue Captain that Dr. comes before a person's name, or MD after it. What stands out, and keeps us together (or sets us apart) and on top or bottom is our shared love of the job, and genuine desire to help our fellow human beings by being the best at what it is we do. Mutual respect is earned, and titles, badges, affiliations or degrees will never change that.
Being comfortable in our place, and knowing our part makes the system work, and work well when all of the players are on the same page. The whole would not be possible without those parts working together, rising to whatever occasion presents itself and doing the job we are trained to do.
When we give our best it shows
The people who stay at the bottom of the pecking order are those that just show up for the paycheck. They are the ones who will not last in EMS, will never grow in our field and remain stagnant and miserable. By following a steady progression of learning, experiencing and performing the job you are trained for, our part in the continuation of care will be solid. Without that foundation, any future opportunities will be created on unstable ground.
When we give it our best, it shows, and everybody can respect that and be proud of it. Nothing is more satisfying than being confronted with a problem and instinctively knowing how best to fix it, and that comes with experience, and the desire to seek out educational opportunities. When we are at our best, we're able to effectively react to spontaneous situations becasue we have the training, knowledge, and lessons learned from past calls. I have the luxury of looking back over the last few decades, and seeing that much of my success is a direct result of being accepted into the ranks of people who continue to learn, respond to situations effectively through their experience, and let their actions, rather than their titles, define them.