On a regular basis emergency responders (EMTs, paramedics, firefighters, etc.) are exposed to a wide variety of situations that most people won’t experience. It’s well known they see trauma, tragedy and death, but the work has a positive side too. There are moments of joy when a mother gives birth, when a patient makes an unexpected recovery, or when a family stops by to say thank you.
This emotional mix gives the emergency responder some different and perhaps hard to understand attitudes in regards to tragedy–at least when compared with the “civilian” population. Understanding and developing these attitudes can be a challenge when writing a three dimensional and believable emergency medical character.
Many factors influence the attitude an Emergency Medical Service (EMS) responder may have.
The experience of a Paramedic working out of a suburban fire department running 3,500 calls a year is vastly different from an inner-city Paramedic whose service runs 60,000, 100,000, or more calls for service a year. As will the experience of an EMT who volunteers with the local rescue squad.
Regional differences also play an important roll. EMS is regulated on a state by state basis, though based on national guidelines and practices, the type of care a Paramedic in one state provides may be different from another. Even jurisdiction to jurisdiction the types of equipment used and protocols followed may be different. All of this will influence how EMS personnel approach their day.
At this point I will interject that I have worked most of my career at the suburban department described above, 3,500 calls a year from three stations. I am both a firefighter and a Paramedic and my department handles both fire and EMS emergencies. In other jurisdictions different services provide EMS and fire protection. Where I work, a fire truck and ambulance respond to every call, with five people, at least, on scene. In some places only an ambulance will respond with two people.
If you are writing EMS personnel as significant characters, get to know the responders in your area. Typically, they will be willing to talk about their experiences and may allow “ride alongs”. Seeing them in action on the rig, and around the station between calls can offer insight for your character. But, give it time, you may need more than one ride along. It’s not unusual for a ride along at my department to get “blanked”, not responding to any calls for service during their time. As with anyone, it will take EMS folk time to open up to an outsider and it might not happen in one 8 or 12 hour shift.
We are Not Ambulance Drivers
To start: today’s Emergency Medical Technicians and Paramedics are anything but simple ambulance drivers. We are trained in many advanced techniques, and in some instances can provide the same medications and procedures as a hospital emergency room could, and we must do it while bumping down the road, lights and sirens piercing the night. EMTs and Paramedics are skilled health care professionals that operate under protocols approved by a Medical Doctor; we do not simply drive an ambulance.
Don’t turn to TV or Movies for Guidance
This may be obvious, but it’s surprising the number of new authors who rely on television or movies. I don’t watch EMS and fire shows, they drive me insane. I’ve yet to see one that has reliably written an EMT or Paramedic, and their technical details are so often laughably wrong that I run the risk of destroying my TV while watching them. Such shows written for drama are often detached from the reality of an emergency responder’s actual day-to-day life. Those shows are not a good resource for a realistic EMS character. Find a real EMT and talk to her for a bit, you’ll get a much better window on her world.
Burning, burning, burnt
The burned out, callous medic is a common stereotype, and there is no doubt that she exists. I have been on the job fourteen years and I still enjoy riding “the bus” and taking care of people. Extremely busy inner-city paramedics do “burn out” more often than someone in my situation, but that does not mean that there aren’t plenty who still share my enthusiasm for the job.
Reasons an emergency responder may burn out do not always involve the constant stress of patient care. It may include frustration with management practices and policies from their chief administrator or even from their medical control doctor.
Even those thought to be “burnt out” often display great compassion for their patients. They may not be much fun to sit in an ambulance with, but when it’s time to work they’re a different person. Burn outs can be interesting and complex characters, but they are not the only type of medic out there.
Meh… seen it
EMS professionals tend to have a different response to emergency situations if, for no other reason, then they see them day-in and day-out. Even during off-duty hours, should she encounter something out of the ordinary, an EMT or Paramedic is much more likely to be cool and calm, at least on the exterior, because of that exposure to intense situations.
At times this can come across as detached, or not seeing the urgency in a situation, but we are trained to do just that. If an EMS responder is just as excited as those to whom the emergency is happening, it is unlikely she’ll be effective on the scene. The responder’s attitude could add to the family or friends worry and stress. Don’t mistake professional detachment for a lack of caring either, often being the most efficient at your job is the best way to provide care to a patient in need.
Yup, seen that too
Most EMS professionals with more than few months of experience are generally not as affected by horrific scenes as other people are. We come into contact with death and injury more often than anyone outside the emergency services and military. By the nature of this experience we typically get used to it.
Everyone has some things that will continue to affect them. For many it is calls involving children. For me, it’s elderly patients who are alone with no one to care for them. These things do affect us, but we learn to deal with these experiences in a variety of ways: talking with colleagues, spouses, and friends, physical exercise, gallows humor, etc.
I really don’t want bad things to happen… but…
There is a somewhat uncomfortable reality of emergency services: when things we find exciting and challenging occur, they occur to real people with real lives who suffer real consequences. I will be honest: I enjoy running a challenging medical call, or a “gnarly” trauma.
It’s what we train for. This is when we get to use our skills to their fullest. Just as a firefighter wants to fight fire, EMS people want to use the skills they’ve worked to hone. It may sound strange to hear an EMT or Paramedic say they’re hoping for something to happen on their shift. We know how it sounds and we don’t want bad things to happen. But the reality is bad things happen and when they do, we want to be on the call. It is one of the central dichotomies of working in the emergency services. Most EMS professionals are careful about when and around whom they talk about their desire for action.
Sorry, I don’t know what the best gout treatment is
EMS personnel are trained and highly skilled, but those skills relate to a narrow part of the medical world: emergencies. We handle medical problems while transporting our patients to hospitals where doctors provide “definitive care”.
We may not know what is causing the abdominal pain, but we will treat symptoms, and take you to the person who can tell with certainty. Because of this specialty, we generally aren’t good at non-emergency medical questions that might get asked around the holiday dinner table. Having said that however, many experienced medics have been around health care for years and year, and we do pick things up. Under the right circumstances, most of us are happy to share what we’ve learned, but we’re also ready to say, “I don’t know” or “that’s beyond my scope of practice”. There are those, on the other hand, that prefer to leave their work at work and aren’t interested in talking medicine at home.
This is by no means a comprehensive guide to the mind of an EMS professional, but I hope it gives points to consider when developing EMS characters.
Want to learn more? Check out: – Emergency Medical Services Terminology and Procedures.
Captain/Paramedic Patrick Furlong has worked for a suburban Kansas City Missouri Fire Department that is also the area’s Advanced life Support EMS agency for the last 13 years. Patrick became an EMT-Basic in 1997. He fell in love with the work and went on to become a Paramedic, then a firefighter, and ultimately left his career in information technology behind. Patrick doesn’t watch Fire or EMS shows as the details just bug him too much. He is a long time Science fiction and fantasy fan.