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I have thought about this for awhile. I did some Internet searches, but came up with nothing. I even asked some of the veterans in the profession whether theyâ€™ve ever thought about it. None had, but they quickly offered their suggestions. I agreed with some of them and disagreed with others.
What I wanted to know is why some paramedics act differently toward the job than others. Why do some paramedics exhibit high levels of enthusiasm while others seem to be just going through the motions? Why do others have more energy than a 3-year-old child who just drank a can of Jolt?
This has been puzzling me because, over time, I have seen one particular paramedic display all of the behaviors I just described. The answer is simple: There are different phases of being a paramedic.
Phase one is the â€œNewbie Phase.â€ This phase is represented by new paramedics â€“ those who just received their licenses, completed their firefighter certification classes and have been hired by their first departments. They are full of excitement and probably had a hard time sleeping the night before their first shift. They have their new paramedic licenses in their hands and they want to take them out for a spin to see what they can do.
Their approach to the job and the profession is pure excitement and adrenaline. They look forward to coming to work every day and dread missing a â€œgood call.â€ Within their six months on the job, however, they discover not every call involves a shooting, stabbing, car accident, major trauma, heart attack or cardiac arrest. Sure, some of those â€œgood callsâ€ are mixed in, but the majority of calls are routine. They begin to think, â€œWait a minute, I watched those old reruns of â€˜Emergency!â€™ and Johnny and Roy were always going on exciting calls and saving lives. I donâ€™t remember any calls where somebody called because they needed a prescription refilled.â€
This is when the new paramedic begins the slow and methodical journey into phase two â€“ the â€œBurnout Phase.â€ This phase comes about slowly, over time, and can take years. In essence, the paramedics came into the profession with idealistic fantasies about what they are going to be doing and accomplishing and what kind of difference they were going to make. But responding to too many 3 A.M. calls for people who have had rashes for weeks begins to eat away at their conviction toward the profession.
Another factor enters into the equation: In school, paramedics are taught to be independent and autonomous decision makers. After all, this makes sense. Many times, they will have to function on their own without the benefit of another paramedic. Now, here comes the dichotomy. Particularly in the fire service, paramedics are integrated into a very structured environment. They are always accountable to someone, even if that person is not on the scene. This tug-of-war can cause conflict in paramedics and accelerate the Burnout Phase.
This is a critical point and can also last for years. Will the paramedics survive? They are vulnerable at this point. Complaints from citizens will increase because of the paramedicsâ€™ attitude on calls. Their use of sick leave increases and they become more susceptible to injuries. Paramedics in this phase will find themselves trying to talk patients out of going to the hospital.
Many will begin thinking about another career. Some will think about bridging over to nursing. Others will think about going into completely different lines of work, which can include joining a family business or even taking a lesser-paying job without benefits.
Many will leave the profession, but others will move to another department thinking that will solve the problem. In some cases, a move to another department will help. Paramedics who leave poorly managed departments where morale is low and suddenly find themselves in better-run departments, on good shifts in good engine houses may find that their burnout becomes more tolerable and may be offset or even reversed. Still other burned-out paramedics will find support from peers while others will consider giving up their licenses and performing only firefighting duties.