Print PDF

The title catches you off guard right?!  A paramedic who is claiming to be a clinician!  It may outrage some and may even make some smile.  Think about it for a second, are we as instructors creating a culture of technicians or clinicians?  I understand that the T in EMT-P stands for technician.  However, in this ever changing healthcare climate we are continually asked to do more and to have more knowledge and continuing education than ever before.  I think it is safe to say that we are in need of more clinicians and not technicians.

I will be the first to come out and say I take full responsibility for the students I teach.  I am always talking to them about the more clinical part of their job to get them to have those critical thinking skills and to cultivate their clinical mind.  Inevitably it starts with the education we receive and what we are told is standard practice.  For example if you are taught IV, O2, Monitor, hospital then that is the recipe for most patients.  It does not mean it is wrong, but why are we doing these things?  What is the science that supports our practice?  What are the medical director’s thoughts on the matter?  These are all questions you have to ask yourself.

The next thing that needs to be addressed is where am I in the mix of clinician versus technician?  I hope in the age of Free Open Access Medical Education (FOAMed), Twitter, and all other avenues to receive information that you are more on the clinical side of things.  So many times I hear from paramedics that it is not their job to know XYZ things because that is for the doctors to decide.  I understand why this is said, however, we are doing patients an injustice if we carry this thought process with us to work every day.  So, my challenge to you is to embrace the clinical side of things.  Challenge yourself to understand deeper pharmacology, pathophysiology, and the science behind clinical practice guidelines.

One thing that most of us have heard a lot lately from podcasts and reading blogs is the quote, “In moments of crisis you don’t rise to the occasion, you sink to the level of your training.”  This was quoted by Rich Levitan, MD and he got it from a book on the psychology of combat.  I personally believe this to be true and relevant to this conversation.  As instructors we need to insure that our students are being held to the highest possible standard and understanding of why we practice medicine the way we do.  Not just because the protocol states we give Aspirin in chest pain patients.  A true clinician understands the why behind things and is always looking two steps ahead.

Regardless if you are working for a service on the cutting edge or just excited to be in EMS, critical care, or in the Emergency Department, keep learning.  Most of my colleagues at Distance CME LLC continually read about and lecture on things we do not have in our own scope of practice, but understanding the procedures, concepts, and science make us better clinicians.  Go out and be the best clinician you can be.

Side Note:  Anyone going to SMACC US in Chicago June 24-26?  If so, want to meet me and have dinner?  Contact our Editor-in-chief for more information and meet me at SMACC 2015!  Not going to SMACC, but live in southeastern NC and want to meet?  Contact us for an opportunity to meet and discuss Emergency Medicine and Critical Care!