Relevance of EMT Training to Life as a PA

[UGoLong]

I was PMed to ask if taking an EMT course would be a good way to get a feel for what it’s like to be PA. I thought I’d share my answer in case there are others out there who might be interested or have their own take on this.

 

There are as many PA jobs as there are PAs, so the relationship between EMT training and my particular job is really all that I’m qualified to answer. I’ve been in EMS for 27 years and still ride as a paramedic a few times each month, so I’ve kept a hand in both camps.

 

With the notable exception of ACLS and the cardiac training we did in medic school, relatively little of what I learned there has been directly applicable to my job as a cardiology PA. For the most part, my job involves collecting and assessing information and then issuing orders. An EMT also uses clinical judgment, but their field experience often relies on hands-on skills that I seldom use as a PA. On the other hand, many of the lessons I learned in the field as an EMT and paramedic continue to be valuable:

 

- Working smoothly on a team: the essence of both jobs.

 

- Quickly establishing rapport with a patient you’ve never met: A key to being an EMT and being a PA.

 

- Seeing patients with many different acute and chronic disease states: As an EMT, you never know what to expect and, after a while, you’ll think that you’ve seen everything. That’s a useful knowledge base but, after all these years, I still see new things in the field all of the time.

 

- Quickly making the “sick/not sick” decision: This is still the first thing on my mind when I walk into the room.

 

- Focusing on what’s important: Filtering out all of what a patient is telling you and not getting sidetracked with minutia.

 

- Paying attention to the subtle effects of your treatment decisions.

 

- Describing medical concepts to patients in terms they can understand: EMT and medic school use simpler words than PA school does and I often dredge them up to discuss concepts with patients.

 

In conclusion, I don’t think that the course you take to become a newbie EMT is much of a guide to what at least my life as a PA is like. On the other hand, the total EMS experience is an excellent route to deciding to become a PA, and the lessons you learn in the field are extremely valuable as you move forward.

 

Good luck!

[ktcan10]

This was really relevant and helpful. Thank you! I've been an EMT for five years, and these are many of the qualities that I am considering mentioning in talking about how my EMT experience is relevant to my future as a PA.

[Acebecker]

I agree with everything and really have little to add. I work in urgent care so my EMT preparation may have been a bit more applicable to what I do now, but exactly in the same way as what you stated - sick/not sick, establishing rapport rapidly, etc. I'd add that being an EMT has helped teach me to be calm under pressure - something I had struggled with in athletic medicine prior to delving into emergency medicine (in athletic medicine I'd routinely have one player complaining of paresthesia into an extremity and have to leave that player to run onto the field for a c-spine injury and I'd get a little worked up when that happened). The other thing that EMT training did for me was to open my eyes to the whole patient - as an ATC I generally had focal injuries and would rarely have multi-system trauma. EMT training prepared me for taking more general histories, looking at medications, doing head-to-toe examinations, etc. It was a great bridge to PA school in my case because we listened to lung and heart sounds, pushed on bellies, evaluated strokes, etc., and treated what we could when we found it. Now... I don't do a ton of the same things anymore - rarely do I deal with collapsed lungs, flail chests, tamonade, cardiac arrest, et al; but the training of the EMT program was a springboard into PA school and was really worth my time and effort.

 

My $.02

[EMEDPA]

I could not do my current job the way that I do without my prior training as a medic. when stuff gets bad the medic brain kicks in, everything else gets quiet and I can go to work and take care of business. there might be folks out there who can do this without strong training to fall back on but I haven't met many. A number of my colleagues who were not involved in ems are fine as em pa's until it hits the fan then they freak out( or "spin" as we used to say in ems). I caught one of my non-ems partners trying to put a nasal airway in a guys mouth during a code a while back. dude had no clue. poor guy, I asked him if he needed help and he gave me the deer in the headlights look and almost pissed himself.

those of us who were medics get more efficient as patient volumes and acuity increase. priorities become clear. The BS waits, the critical gets done.

[Davo]

I could not do my current job the way that I do without my prior training as a medic. when stuff gets bad the medic brain kicks in, everything else gets quiet and I can go to work and take care of business. there might be folks out there who can do this without strong training to fall back on but I haven't met many. A number of my colleagues who were not involved in ems are fine as em pa's until it hits the fan then they freak out( or "spin" as we used to say in ems). I caught one of my non-ems partners trying to put a nasal airway in a guys mouth during a code a while back. dude had no clue. poor guy, I asked him if he needed help and he gave me the deer in the headlights look and almost pissed himself.

those of us who were medics get more efficient as patient volumes and acuity increase. priorities become clear. The BS waits, the critical gets done.

 

Im a brand spanking new PA but an old medic and even I have seen this a few times so far, Im hoping my medic training is seen as valuable to a physician for when the SHTF.

 

As far as being an EMT, as mentioned above there were many beneficial aspects to going that route, I think. Not mentioned was that there is some degree of autonomy in some EMS jobs, so you are making decisions-and answering for them soon after-this is enormously beneficial, and helped me later in PA school I think.

[jsfelder0417]

I could not do my current job the way that I do without my prior training as a medic. when stuff gets bad the medic brain kicks in, everything else gets quiet and I can go to work and take care of business. there might be folks out there who can do this without strong training to fall back on but I haven't met many. A number of my colleagues who were not involved in ems are fine as em pa's until it hits the fan then they freak out( or "spin" as we used to say in ems). I caught one of my non-ems partners trying to put a nasal airway in a guys mouth during a code a while back. dude had no clue. poor guy, I asked him if he needed help and he gave me the deer in the headlights look and almost pissed himself.

those of us who were medics get more efficient as patient volumes and acuity increase. priorities become clear. The BS waits, the critical gets done.

 

^This x100. I can only speak for myself, but my prior Army Medic/EMT foundation has been helping tremendously. During didactic year, it wasn't as apparent until we went over the EM module, but now that I am in rotations and the FM doc that precepts me covers Urgent Care and admits at the local hospital (town of 10K folks in rural Idaho,) the benefits of my prior experience are shining through. Suturing, stapling, casting, injections etc are all things I did before PA school, and now I am getting better. Also, and probably of the biggest benefit, is the ability to work fast under pressure. My inner medic kicks in when things get hairy, and instead of getting frazzled, I get more efficient. I prioritize, and use my time wisely to tx the pts with the highest acuity. I love it. As a clinical student, I often joke that I am functioning like a 'Super Whiskey' (Slang for Army Medics) and I believe it to be true. Being a medic gave me a solid foundation, PA school has strengthened it.

[EMEDPA]

the ability to work fast under pressure. My inner medic kicks in when things get hairy, and instead of getting frazzled, I get more efficient. I prioritize, and use my time wisely to tx the pts with the highest acuity. I love it. As a clinical student, I often joke that I am functioning like a 'Super Whiskey' (Slang for Army Medics) and I believe it to be true. Being a medic gave me a solid foundation, PA school has strengthened it.

bingo. if you don't go into EM or trauma/critical care you will find yourself wishing you did....:)

[Just Steve]

I love the hyper focus of being in the thick of things...kept me motivated to go to work on the medic every day, tolerating the 95 % crap calls so I could be damn good at the 5% where it mattered.

[Davo]

I love the hyper focus of being in the thick of things...kept me motivated to go to work on the medic every day, tolerating the 95 % crap calls so I could be damn good at the 5% where it mattered.

Outstanding outlook! I agree 100%.

[generalfluff]

I'd say staying calm and focused under pressure is more of a matter of having being exposed to it enough times, that you're used to it. It doesn't really have to be a job as a medic, though it is very good experience. As I'm learning how to run a full physical and patient assessment, the instructor keeps emphasizing practice until the movements become routine, that I don't have to think about it, and won't be distracted even in times of pressure.

 

Grace under fire. Keep calm and carry on.

[Davo]

I'd say staying calm and focused under pressure is more of a matter of having being exposed to it enough times, that you're used to it. It doesn't really have to be a job as a medic, though it is very good experience. As I'm learning how to run a full physical and patient assessment, the instructor keeps emphasizing practice until the movements become routine, that I don't have to think about it, and won't be distracted even in times of pressure.

 

Grace under fire. Keep calm and carry on.

 

Its a great amount of stress being alone (or with a rider) with a critical patient, including making the right assessment and treatment decisions. Its not simply a matter of doing something over and over again-though that doesn't hurt.

[ToppDog]

Dammit! Just when I think I have myself talked out of going for this thing one more time, you guys go & post this.