By Bryce Patton, BA, NRP
I never planned on working in EMS.
My original plan was the military and, eventually, medical school. Life had other plans. I became a phlebotomist and started nursing school, thinking I’d eventually land in trauma, critical care or emergency nursing.
But nursing never quite clicked for me.
Then a paramedic walked into my emergency department with a cardiac arrest patient and completely changed the direction of my career.
The trauma bay was chaotic. Everyone was moving, talking and trying to do something at once. In the middle of all of it was a paramedic from the local EMS agency.
She was quiet. She was calm. And she demanded respect.
She didn’t have to yell over everyone. She remained confident until the room settled down enough to listen to her. I remember standing there completely in awe of her.
I wanted to be just like her.
I drew the patient’s blood, took it upstairs to the lab, processed it and immediately started looking up EMT classes.
That was it.
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EMT: The patient is more than the call
I wish I could tell you I stepped onto an ambulance for the first time and immediately became the calm, confident provider I had watched walk into that trauma bay.
Absolutely not.
I was nervous. I was excited. I was probably a little too confident at times. I was terrified of screwing something up.
I even crashed an ambulance within my first few months on the job.
So much for the graceful entrance into EMS.
But somewhere in the middle of figuring it all out, I fell completely in love with the job.
I loved knowing that when someone was having one of the worst days of their life, I could be one of the people who showed up to help.
Over time, though, my understanding of what that meant changed.
When we’re new, it’s easy to see patients through the lens we’re taught to use. Chest pain. Shortness of breath. Altered mental status. Fall. Cardiac arrest. We need chief complaints, algorithms and differential diagnoses because they help us make decisions.
Eventually, I stopped looking at people as their chief complaint.
I started looking at them as people who happened to have a chief complaint. They had stories. Families. Fears. Entire lives that existed before they called 911 and would hopefully continue long after I left.
Being an EMT taught me that good patient care starts with remembering there is a person underneath all of the medicine.
That sounds obvious.
It isn’t always.
Paramedic: You don’t have to know everything
I knew pretty quickly that I wasn’t going to be satisfied assisting forever.
I wanted more knowledge. I wanted more responsibility. I wanted to make the decisions. More than anything, I wanted to be the person standing between my patient and the grave.
Then I became a paramedic in the middle of 2020, because apparently, I have excellent timing.
The entire healthcare system was trying to figure out how to function during a pandemic. There was fear, uncertainty, constantly changing information and a whole lot we simply didn’t know yet.
And somewhere in the middle of all of that, I was trying to figure out how to be a brand-new paramedic.
I was baptized by fire.
There is nothing quite like finally earning the patch you’ve worked so hard for and then realizing everyone is suddenly looking at you for the answer.
Sometimes I had it.
Sometimes I didn’t.
And sometimes, at 5 a.m. while working a cardiac arrest, I accidentally cut straight through my four-lead cables while trying to cut off my patient’s clothes.
Humility comes in many forms.
Being a paramedic taught me that being responsible for the decision doesn’t mean having every answer. It’s OK to call medical control. It’s OK to call another medic. It’s OK to say, “I don’t know.”
Knowing when you need help is part of being a good clinician, not evidence that you’re a bad one.
But being a paramedic also taught me the other side of that lesson. Sometimes you have to trust what you do know.
I was once dispatched to a patient who was 2-weeks postpartum and actively seizing. She had a history of epilepsy, so the initial assumption was understandable.
But something didn’t fit.
Her blood pressure was extremely high, and she continued to seize despite initial treatment. Her postpartum status, hypertension and continued seizure activity made me concerned about eclampsia, and I treated her with magnesium sulfate.
That call eventually led to an in-service with our medical director and the adoption of a new protocol within our agency.
That call stuck with me. Not because I knew something someone else didn’t, but because it taught me to not stop thinking just because someone had already given me an answer.
Sometimes you need to ask for help because you don’t know.
Sometimes you need to speak up because you do.
Both require humility.
Burnout: Sometimes moving forward means stepping away
And then, after falling completely in love with EMS, I left it.
There wasn’t one bad call or one terrible shift that finally did it.
By then, I had spent the beginning of my paramedic career working through a pandemic. I was also going through a divorce and carrying more personally than I knew how to handle.
Eventually, the weight of my personal life, the accumulated trauma from the job and the culture of simply pushing through became too much.
EMS has a strange culture around struggling.
We’re all going through stuff, right? But we’re also supposed to be the people who fix problems for everyone else.
We’re supposed to show up. Handle the call. Keep it together.
Then we’re supposed to leave whatever happened at work at work and whatever is happening at home at home, as if the human brain has separate filing cabinets for the two.
Mine apparently did not.
Eventually, I crumbled under the weight of all of it.
So I left.
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I had earned a degree in education, and I became a special education teacher. For about a year, I had the normal schedule I thought I was supposed to want.
And I wasn’t fulfilled.
As much as I probably should have appreciated never being woken up at 3 a.m. for toe pain, I missed the truck. I missed taking care of patients. I missed EMS.
But teaching wasn’t wasted time.
Special education taught me something that would eventually become central to the way I approach EMS education: people don’t all learn the same way.
Different students need different approaches, different explanations and sometimes a completely different path to get to the same destination.
Turns out, EMS education isn’t all that different.
We can put 20 EMT students in the same classroom, give them the same PowerPoint, the same lecture and the same exam, but that doesn’t necessarily mean we’ve actually taught 20 people.
I didn’t realize it at the time, but the year I spent away from EMS was teaching me how I wanted to teach when I eventually came back to it.
And eventually, I did.
During my interview to return to EMS, I was very clear about what I wanted. I didn’t want to promote. I didn’t want additional responsibilities. I didn’t want a title.
I wanted to come to work, take care of my patients and go home.
Apparently, nobody told my future leadership team about that plan.
My supervisor and operations manager saw potential in me that I wasn’t ready to see in myself. They encouraged me, challenged me and pushed me toward opportunities I probably would have talked myself out of.
Looking back, leaving EMS taught me something I couldn’t have learned by staying.
Loving this career doesn’t mean sacrificing yourself to it.
And stepping away doesn’t always mean you’re done.
FTO: Teaching isn’t about proving what you know
When the opportunity to become a field training officer came, I actively wanted it.
I wanted to be the mentor I had wanted when I was a brand-new EMT.
After a call, the conversation didn’t start with me telling a trainee everything they had done wrong.
I asked them: How do you think that went? What went well? What didn’t? What would you do differently next time?
The good, the bad, and the ugly were all fair game.
My job wasn’t just to evaluate them. It was to help them learn how to evaluate themselves.
Eventually, I wasn’t going to be sitting beside them anymore.
People need room to say, “I don’t know.” They need room to admit, “I screwed that up.”
Accountability matters. Standards matter. Patient safety absolutely matters.
But none of those require humiliation.
If we make new providers afraid to admit they don’t know something, we aren’t creating stronger clinicians. We’re teaching them to hide their weaknesses.
And in a profession where hidden weaknesses can eventually become patient safety problems, that’s not a culture we should be interested in creating.
Clinical education: I didn’t seek the role. It sought me.
I didn’t apply to become a clinical education coordinator.
I wasn’t even looking for the job.
I scheduled a meeting with our company’s CEO because I wanted to discuss something that had been frustrating me as an FTO. We were expected to train our providers, but doing that well was difficult when we didn’t consistently have the equipment we needed.
The conversation lasted about 10 minutes.
Within 5 minutes of it ending, my phone rang.
It was our director of clinical services.
We talked for nearly an hour about my concerns with the quality and consistency of training at the individual operation level, what providers needed, and where I thought we could do better.
I ended that phone call with a job offer.
I didn’t seek this role.
It sought me.
I’m still new enough to this chapter of my career that I’m not going to pretend I already know everything it’s going to teach me.
I don’t.
But maybe that’s fitting.
As I write this, I’m 2 weeks away from becoming the lead instructor of an EMT academy.
There was a time when that would have been a far-distant dream.
Now it’s my reality.
I started this career because I watched one paramedic walk into a chaotic trauma bay and thought, I want to be like her.
I went upstairs, processed my patient’s blood, and immediately started searching for EMT classes.
Now I’m about to stand in front of a room full of people who are searching for their own beginning.
And I don’t see my job as simply getting them through the NREMT on their first attempt.
Of course I want them to pass. But if that’s the only measure of whether I’ve done my job well, we’re setting the bar way too low.
This is their introduction to EMS.
What happens in that classroom can shape what kind of clinicians they become, how comfortable they are admitting what they don’t know, how they approach their patients, and maybe even how they feel about this profession.
My students won’t all learn the same way because they’re not all the same person.
My job isn’t just to prepare them for a test.
It’s to give them a beginning worth building on.
To the brand-new EMT
If I could sit in an ambulance with the brand-new EMT version of myself for 5 minutes, there are a few things I’d tell her.
First, it’s OK to not be OK.
I wish someone had told me that sooner.
But there’s something else I wish someone had given me permission to do.
It’s OK to fall in love with this job.
Actually, I think EMS desperately needs providers who do.
Somewhere along the way, cynicism became confused with experience in our profession.
We joke about the eager new EMT who wants every certification, volunteers for training, and still gets excited about medicine.
Then we wonder why, a few years later, that same provider is burned out and looking for a way out.
For a long time, I thought loving EMS made me naive. Like eventually, I was supposed to become jaded because that’s what experienced providers did.
I wish someone had told me I didn’t have to.
Maybe if I had felt like I was allowed to love this profession, I would have fought harder for my place in it when I was struggling. Maybe I would have stood up for my career more. Maybe I would have understood that loving the profession and struggling within it could both be true at the same time.
I can’t know whether that would have changed my decision to leave.
What I do know is that leaving taught me how much this profession meant to me.
When I came back, I chose EMS again.
So love the job if you love it.
That doesn’t mean pretending EMS doesn’t have problems. It doesn’t mean sacrificing yourself for it. And it definitely doesn’t mean ignoring burnout or carrying everything alone.
You can love this profession and still demand better from it.
You can love your patients and still have boundaries.
You can love the work and still admit when the work has hurt you.
You can love EMS and still believe our culture needs to change.
We shouldn’t have to teach people how to care about EMS again after we’ve spent years teaching them not to.
So take the classes. Chase the certifications. Ask the questions. Be the person who still gets excited about learning something new.
Apply for the position you don’t think you’re ready for.
And when you don’t know something, say so.
Nine years ago, I stood in an emergency department and watched a paramedic walk into a chaotic trauma bay. She was calm and confident, and I remember thinking that I wanted to be just like her.
That moment started all of this.
I don’t think the goal anymore is to become her.
The goal is to keep becoming the clinician, mentor and educator that my patients, my trainees and my organization need me to be.
And maybe, somewhere along the way, I can be that person for another brand-new EMT who is still figuring out who they want to become.
If they fall in love with this profession too, I hope nobody ever makes them feel like they have to apologize for it.
ABOUT THE AUTHOR
Bryce Patton, BA, NRP, is a clinical education coordinator and paramedic in Kentucky with experience in field training, EMS education and emergency medical services. She began her EMS career as an EMT in 2018 before becoming a paramedic and later serving as a field training officer. Today, she works in clinical education with a focus on developing confident, thoughtful clinicians and creating learning environments where providers can ask questions, learn from mistakes and continue growing.
