Being an adult in EMS, With my own commentary of an article I saved 10 years ago . Ive been a medic since 2014. I came into the field of EMS not on purpose, it was just a calling, a placement. I didn’t know I’d be a paramedic, matter of fact, I thought when I was little, and growing up that I’d be a school teacher or work somewhere with my own office, that I could decorate pink , and have cool pens, and post-its. I do have A lot of pens now, pens everywhere, and my post-its come in the form of silk tape, or whatever I can write on. Sometimes, its a gauze package, or top of a container that my lunch was in.
I saved this article in my notes over 10 years ago. As I read through it today, I find myself adding my own thoughts and experiences to each piece of advice. Over the years, I’ve had the opportunity to precept many new medics, and I absolutely love it. There’s something inspiring about seeing the eagerness and excitement of new providers. I genuinely love helping others, and I believe God blessed me with the gift of discernment. I can often tell when someone isn’t meant for EMS — whether it’s a lack of nurturing spirit or a missing sense of genuine care for others. I can see it clearly.
Back in 2012, I was in my early twenties, just beginning my journey toward earning a college degree. Following my advisor’s guidance, I was taking core classes for an associate’s degree and had begun prerequisites for nursing school. As electives, I took First Aid and CPR classes — and it was during First Aid that I discovered a strong interest in emergency care. My advisor suggested I enroll in the EMT Basic course, but at the time, I had no idea what I was getting into. I thought it would just be another medical class.
From the very first night, I realized this wasn’t just a course — it was a pathway to certification and a real career. With every class, my excitement grew. I became passionate about learning how to make a difference. Despite applying to nursing school multiple times — even being selected as an alternate — I kept facing rejection. Meanwhile, during EMT training, I completed clinicals and ambulance ride-alongs.
EMS was a whole new world for me. I grew up sheltered — so much so that I wasn’t even allowed to watch shows like The Simpsons or King of the Hill. I had no real understanding of how harsh the world could be. Meeting EMS providers, I found a group of people who, despite their rough edges, shared a deep desire to help others. They treated me like family, and for the first time, I felt like I truly belonged. I learned from them that even when we can’t fix everything, we can still try.
My motivation to learn was deeply personal, too. My mom had suffered a stroke a few years earlier and battled multiple sclerosis and diabetes. I was determined to learn everything I could about her conditions — and later, about the seizures she began having — so I would always be ready to care for her if needed.
After completing EMT Basic, I applied to the paramedic program — and to my surprise, I was accepted on my first try. Looking back, I realize that all the rejections from nursing school weren’t failures — they were God’s redirections. His plan for me was not what I had imagined, but it was exactly what it needed to be.
I’ll never forget my paramedic program interview. Sitting before the director and a panel of senior medics, I shared my simple, heartfelt reason for wanting to become a paramedic: I wanted to help people and make a difference. They laughed gently and said, “They’ll eat you alive.” To them, my idealism might have seemed naive, but it was (and still is) the truth. I wanted to learn as much as possible about the human body, about cardiac rhythms, about how to intervene when emergencies happened — so that if God ever needed me, I would be ready to be His instrument.
I was shy and often unsure of myself throughout training. I cried before my first skills check-off, hiding in the bathroom until my instructor came to find me. I’m forever grateful that she did. She believed in me, and deep down, I knew the skills — I just needed to believe in myself. I passed every check-off.
Through clinicals and field experiences, I met more EMS folks — and again, they made me feel like family. There’s something unique about EMS culture that’s hard to explain: We can meet as total strangers and within hours be sitting together at a table, sharing stories. We bond through shared experiences — we laugh, we listen, and we understand each other.
EMS is not about flashing lights and sirens. It’s about answering calls in the middle of the night, walking into a stranger’s home, and doing everything possible to help. It’s about crawling down embankments to reach someone trapped in a crushed car, holding C-spine until firefighters can cut them free. We don’t do this for the money — far from it. We do it because we care. We face situations so heartbreaking and surreal that you couldn’t even make them up if you tried.
This calling, this bond, this purpose — it’s something that can’t be taught in a classroom. It has to come from the heart.
1) You aren’t required to know everything. More than likely you will never know everything, actually you will get to the hospital and give report, only for your patient to give a whole different complaint than they Gave you. don’t let that discourage you.
2) You are required to know the foundational knowledge and skills of your job. No excuses. You do however have to know your skills, and you need to be knowledgable of medications, and side effects, and always stay up to date on new trending medications , because drugs like the new ozempic drug causes some side effects that are less desirable, and you need to know these, because I Guarantee, you will get calls from these side effects.
3) Always be nice. It’s a force multiplier. I don’t care if you are having a bad day, or if you stayed up late before your shift, you need to be nice, even if you have to bite your tongue, they called you because they needed help, whether it’s an actual emergency or not, they are depending on you and your reaction. Drug dealer, or preacher, it shouldn’t matter how you treat them.
4) There is no greater act of trust than being handed a sick child. Scratch out the part of being handed a sick child, because you aren’t going to be handed a sick child, the mom, or caregiver will more than likely throw you the child before you can get out of the ambulance good, so be ready. You don’t have time to realize it is a child, it’s just a smaller adult, and you need to go into Paramedic mode, you will have time later, whether it’s on your way home to realize you were handed this child, or what actually happened, for now, just concentrate on the fact that you were trusted with a sick child.
5) Earn that trust. YES! Earn That trust, know what you need to do, don’t second guess yourself, Tuck your shirt in, look confident, even if you are scared to death, don’t let the patient or family see that you are scared. Stand tall, and talk with confidence, even if you had to google the condition or problem that you were responding to. They are trusting you, and when they called 911, they were depending on you and your knowledge.
6) Don’t ever lie to your patient. If something is awkward to say, learn to say it without lying. You are going to have to answer the question of “am I going to be okay?”, and you are going to be looked dead in the eye by a patient that is dying, and told “Don’t let me die”, when you often are spending the last minutes of their life with them. Don’t tell them they are dying, but don’t lie, just tell them you are going to do your best to not let this happen, but sometimes, their is nothing you can do to stop it, just try.
7) Read Thom Dick’s, People Care. Then read it again. I can’t say that I read this book, so I don’t Actually Know what it’s about …
8) You can fake competence with the public, but not with your coworkers. The public might not know that you don’t have a clue what to do, but your coworkers will know, and you can be sure that they will remember it, and hopefully a seasoned medic will teach you, or show you where you messed up, or how to fix it. Too often some medics are burnt out, and they will just judge you. Don’t let this discourage you, learn from your mistake, research and study what you don’t know.
9) Own your mistakes. We all make them, but only the best of us own them. Everyone makes mistakes, they are lying to themselves if they say any different. Do better though, learn where you messed up, and take constructive Criticism. Take all of the education oppurtunities you can. You must want to know more. You never stop learning. You shouldn’t anyway.
10) Only when you’ve learned to own your mistakes will you be able to learn from them.
11) Experience is relative. While it is relative, it is not everything, I know some medics that have been a medic for 20 plus years and some of the new medics know more than they do. You must learn by experience, otherwise, its Just another call.
12) Proper use of a BVM is hard and takes practice. If you don’t seal a BVM correctly, you aren’t doing any good. You have small hands, admit it, and ask one of the EMRS, or Fire to help you hold it, so you get a good seal, otherwise you absolutely are doing a useless job. You are literally just going through the motions, and not doing a dang thing else.
13) OPAs and NPAs make using a BVM less hard. Have you ever tried to blow air into a pool Float, without squeezing it open? OPAs and NPAs are like squeezing the opening to let the air in. Don’t work harder, work smarter.
14) Master the physical assessment. Nobody in the field of medicine should be able to hold a candlestick to your physical assessment skills. Be able to look at a human body from head to toe, and realize when something looks off. You might respond to chest pain, only to realize Your patient has excess fluid in their abdomen, or swollen hands and feet. This swelling pushes up on the chest, and might even be a severe back call. You Won’t realize this without a full assessment.
15) Keep your head about you. If you fail at that, you’ll likely fail at everything else. Don’t get distracted, keep you head on a swivel, otherwise, you might not realize you are in danger. Always be observant. Never stand in front of a door, stand to the side, and be cautious of windows.
16) There is a huge difference between not knowing and not caring. Care about the things you don’t yet know. This is huge, you might not know the answer, or you might not have known that your altered patient fell 2 days ago, but you have to care, listen to them, and communicate with family that knows them, they will often tell you A lot. Some useless Information, but some very valuable.
17) Train like someone’s life depends on it. Train like you are running a marathon. Learn how you equipment works, and Be Familiar with your truck. memorize it inside and out. Know where everything is, so that when you have seconds to make a difference, you don’t know where something is, or how it works. Watch you tube videos or listen to podcast, whatever it takes to mean the difference in life or death.
18) Drive like nobody’s life depends on it. You want to drive safe, you want to pay attention to other drivers, because you may see them, but they are not going to necessarily stop because you have lights and sirens. Some folks have no idea what to do when they see an ambulance. If you are driving like an idiot with your partner in The back, they can’t take care of patient.
19) Pet the dog. (Even when you’re wearing gloves.). Ha Ha, I always pet the dog, unless it’s wanting to kill me, or sees me as a threat.
20) Have someone to talk to when the world crashes down. Don’t be afraid to vent, you matter, and I promise you are going to want to have someone that will listen. It may be a therapist, and it may be a coworker. You family probably Won’t understand, but don’t keep it inside, it will destroy you.
21) Let human tragedy enhance your appreciation for all that you have. You will see things that are tragic, but let it change the way you see life. Capture the sunrise, capture the sunset, visit your grandma, and realize how things can change in an instant. Don’t take the little things for Granted.
22) Check the oil. If the ambulance don’t have oil in it, you might not make it to the next call. You have to respect your equipment, because if the ambulance won’t go, you can’t get them to the hospital. If the ambulance don’t have oil, you can’t get to the Emergency.
23) Protect your back. It will quite possibly be the sole determining factor in the length of your career. Raise the bed, Raise the stretcher, Get your patient to assist in moving if they can. I promise your back will hate you later, if you pull, tug, and lift more than you needed to. Work Smarter, not harder.
24) Say please and thank you even when it’s a matter of life or death. Respect goes a long way. your patient’s will Remember that you were nice to them, and that you had manners.
25) Wipe your feet at the door. Don’t track mud into a strangers house. Would you want someone to come in your house, and track mud and dirt all over your floor ?
26) When you see someone who is really good at a particular skill say, “Teach me how you do that.” Always learn. Always take advice from others, you might figure out a better way to do something.
27) Nobody can give you your happiness or job satisfaction. It is yours and yours alone. And you have to choose it. If you hate your job, you will not do your best. It doesn’t matter what ambulance service you work for, if you hate it, find something Else to do , or Somewhere else to go, Because the last thing someone who is having a horrible day needs, is someone showing up that hates being at work.
28) We can’t be prepared for everything. Actually, you won’t every be fully prepared for everything, nothing could prepare you for some of the things you will see, or do.
29) We can be prepared for almost everything. you can expect the worst though, and make sure you have what you need for what you know.
30) Check out your rig. It’s more meaningful that just confirming that everything is still there. If you don’t check out your ambulance, I can assure you, you will need something that won’t be there. The excuse of not checking out your truck won’t matter to the patient, or their family.
31) Tell your patients that it was a pleasure to meet them and an honor to be of service. Sometimes they won’t be a pleasure, and you are just ready to drop them off at the local hospital, but don’t treat them with disrespect. Self Control goes a long way. Don’t take their words personal when they are mean, they don’t feel good, and sometimes, conditions like UTIs can really effect the level of meaness.
32) Mean it. Be Kind, they might not experience kindness from a single Soul but you.
33) Keep a journal. My journal is my blog, and it really makes a difference in getting your feelings out.
34) Make it HIPAA compliant. Don’t use names or identification in it, you don’t wanna loose everything you got, on being careless.
35) Thank the police officer that hangs out on your scene for no good reason. Always be appreciative of your help. They didn’t have to be there. They are like family too.
36) Recognize that he or she probably wasn’t hanging out for no good reason. They might know more about a situation than you do, so appreciate them hanging around to make sure you are okay.
37) Interview for a job at least once every year, even if you don’t want the job.
38) Iron your uniform. You might not iron, I Don’t, but look professional, and don’t wear wrinkled dirty clothes to work. You need to look the part.
39) Maintain the illusion of control. Nobody needs to know that you weren’t prepared for what just happened.
40) Apologize when you make a mistake. Do it immediately.
41) Your patient is not named honey, babe, sweetie, darling, bud, pal, man or hey. Use your patient’s name when speaking to them. Sir and Ma’am are acceptable alternatives. In the south, this is a hard one, but try to call your patient by name, they will respect you more for speaking to them by name.
42) Forgive yourself for your mistakes. Don’t beat yourself up, don’t think you are less of a caregiver when you make a mistake, just learn from it, and do better next time. You are going to miss things, you are Human
43) Forgive your coworkers for their quirks. Your coworkers are not always going to be in the best mood, they are going to get hangry, realize this , and don’t use it against them.
44) Exercise. Even when it isn’t convenient. this is definitely a weakness of mine, and my exercise often come more from moving, walking and lifting patients , but exercise is good for the mind and body.
45) Sometimes it’s OK to eat the junk at the QuickyMart. It’s not always the best, but you will have days that the gas station is your only option, and only chance to grab a bite to eat.
46) It’s not OK to always eat the junk at the QuickyMart. Sometimes the gas station pizza has been in the warmer since the store opened, so you will take a gamble sometimes when you eat the pizza, or biscuit that crunches and flakes everywhere when you try and bite into it.
47) Don’t take anything that a patient says in anger personally. This goes back to what I said about elderly patient’s with UTIs, or patients with dementia.
48) Don’t take anything that a patient says when they are drunk personally. Avoid small talk with the drunks, they won’t even probably Remember that you Picked them up tomorrow.
49) Don’t ever convince yourself that you can always tell the difference between a fake seizure and a real seizure. If they are faking a seizure, they are still sick, due to the fact that they feel like they have to fake a seizure, Treat them with respect. they want attention, for whatever reason.
50) Think about what you would do if this was your last shift working in EMS. Do that stuff. I always keep this in mind when I leave for the day.
51) Carry your weight.
52) Carry your patient.
53) If firefighters ever do #51 or # 52 for you, say thank you. (And mean it.) i always tell them thank you, Because no way I could have moved some paitent’s Without them.
54) Being punched, kicked, choked or spit on while on duty is no different than being punched, kicked, choked or spit on while you’re sitting in church or in a restaurant. Insist that law enforcement and your employer follow up with appropriate action.
55) Wave at little kids. Treat them like gold. They will remember you for a long time. Show them the lights and sirens so they aren’t scared when they see an ambulance. Pure excitement from little ones will make your day better too.
56) Hold the radio mike away from your mouth. For petes sake, we don’t need you putting the mic in your mouth to talk. Talk clear, and make sure you can be understood.
57) There is never any reason to yell on the radio….ever. You will not be understood if you are yelling.
58) When a patient says, “I feel like I’m going to die.” believe them. Pretty much Every time someone Has told me they are going to die, or they feel like they are fixing to die, they have.
59) Very sick people rarely care which hospital you’re driving toward.
60) Very sick people rarely pack a bag before you arrive. Sometimes they pack a bag, because they have been down this road before and they know they will be staying a while.
61) Sometimes, very sick people pack a bag and demand a specific hospital. Don’t be caught off guard. Treat everyone the same, and you won’t have to figure out which one they are.
62) Bring yourself to work. There is something that you were meant to contribute to this profession. You’ll never be able to do that if you don’t show up.
63) Clean the truck. Would you want to get in a nasty truck?
64) Clean your stethoscope. It has all the germs from every call you go on.
65) Your patient’s are going to lie to you. Assume they are telling you the truth until you have strong evidence of the contrary. They will lie, and it will make you mad when you find out they were Lying, but treat them like they are telling you the truth anyway.
66) Disregard #65 if it has anything to do with your personal safety. Trust nobody in this regard. Always care about yoursel first, Your safety is first always.
67) If it feels like a stupid thing to do, it probably is. If you think you shouldn’t do something, probably shouldn’t do it.
68) You are always on camera. Even if you don’t see it, you are Probably being watched by someone, or filmed through a ring camera, iPhone, or video Surveillance somewhere. Don’t do anything you wouldn’t want recorded.
69) If you need save-the-baby type “hero moments” to sustain you emotionally as a caregiver you will likely become frustrated and eventually leave. You will not have too many days that you feel like a Hero, if you need this kind of validation, you are setting yourself up for complete disappointment.
70) Emergency services was never about you. EMS is far from being about you , don’t do it if you need a complex, because you are there for others,
71) The sooner you figure out #69 and #70, the sooner the rest of us can get on with our jobs. If you have to be a Par-GOD, or need to be patted on the back frequently, do us all a favor, and don’t work with us. Don’t start another shift on the ambulance, go find another job, not in healthcare at all.
72) People always remember how you made them feel. People know if you are a burden to them, they feel it, and they know if you really want to be there are not. Don’t make them feel like they are getting on your nerves. Think about Whether it really matters at the end of your shift, after all you are getting paid by the hour anyway.
73) People rarely sue individuals who made them feel safe, well cared for and respected.
74) You represent our profession and the internet has a long, long memory.
75) Don’t worry too much about whether or not people respect you. You will in fact encounter many of folks who don’t respect you, and they will be entitled, so just be respectful. Do your best.
76) Worry about being really good at what you do. Don’t give anyone a Reason not to respect you.
77) When you first meet a patient, come to their level, look them in the eyes and smile. Make it your habit.
78) Never lie about the vital signs. If the patients vital signs change dramatically from the back of the rig to the E.R. bed, you want everyone to believe you.
79) Calm down. It’s not your emergency. I’ve heard this from the beginning. It was never your emergency.
80) Stand still. There is an enormous difference between dramatic but senseless action and correct action. Stop, think and then move with a purpose.
81) Knowing when to leave a scene is a vital skill that you must constantly hone. Know when the Environment isn’t safe, and get out quick as you can without making a scene.
82) The fastest way to leave a scene should always be in your field of awareness. You will always be able to spot a way out even at church, or a restaurant. you won’t feel safe sitting faced away from a door.
83) Scene safety is not a five second consideration as you enter the scene. It takes constant vigilance. Every scene can become unsafe in an instance. Always remember that.
84) Punitive medicine is never acceptable. Choose the right needle size based on the patients clinical needs.
85) Know what’s happening in your partner’s life. Ask them about it after you return from your days off. You will spend more time with your partner than you do your family, so know what’s going on, and learn their kid’s names.
86) If your partner has a wife and kids, know their names. Absolutely, just repeating the above. Your partner’s family will be like your family too.
87) No matter how hard you think you worked for them, your knowledge and skills are not yours. They were gifted to you. The best way to say thank you is to give them away.
88) Learn from the bad calls. Then let them go. Don’t keep re-living your bad calls, they will Destoy you. Some calls will stay with you forever, but ultimately if you did everything you could, that is all that matters.
89) When you’re lifting a patient and they try to reach out and grab something, say, “We’ve got you.” If you don’t have them, get help.
90) Request the right of way.
91) Let your days off be your days off. Fight for balance. Don’t overwork, your job will replace you when you leave.
92) Have a hobby that has nothing to do with emergency services. Find something else like working in a flower garden or some type of fun Activity that Doesn’t involve EMS.
93) Have a mentor who knows nothing about emergency services. Visit your family that has no idea what you really do for a living, some of them will think you just drive an ambulance, and sit on the side of the road all day. Let them think that, it’s better for them and you.
94) Wait until the call is over. Once the patient is safe at the hospital and you’re back on the road, there will be plenty of time to laugh until you can’t breathe.
95) Tell the good stories. discuss the good stories and outcomes of patient’s with your partner. Appreciate the little accomplishments, they will mean A lot to you later.
96) You never know when you might be running your last call. Cherish the small things. Always feel like every call is your last. You never know what might happen before you make it back to the station. You never know what might happen on your way home.
97) You can never truly know the full extent of your influence.
98) If you’re going to tell your friends and acquaintances what you do for a living, you’ll need to embrace the idea that you’re always on duty. You don’t have to tell them all the tragic details, if they ask if you had any bad calls today, you don’t have to tell them if you had a life changing experience, let them in on some minor details of a not so tragic call instead. They don’t need to know everything. It’s better off that they don’t know.
99) Be willing to bend the rules to take good care of people. Don’t be afraid to defend the decisions you make on the patients behalf. If you were the patient’ advocate, be ready to stand up and explain to a doctor, or a lawyer why you did something you did. Be able to justify every decision you made, whether it was why you did something, or why you didn’t do something.
100) Service is at the heart of everything we do. The farther away from that concept you drift, the more you are likely to become lost.
101) There is no shame in wanting to make the world a better place. Sometimes nothing you Can do would change the patient’s outcome, but always try your best, and treat other like you would want yourself or family treated, and you won’t be wrong.
Pass this on, maybe it will remind us all what “EMS” really means..
- Chastity Elgin NREMT-Paramedic
Stitches of My Heart 