First day of paramedic class, about a month ago now, my instructor walked into the room and began his speech: "If I ever hear of any of you walking into a scene and saying, 'I'm the paramedic, I'm here to fix it, I'm in charge,' I'll hunt you down and kill you."
This instructor is exactly the kind of paramedic I want to be. He's confident in his skills, open to listening to argument, has done every job imaginable, is a lead flight paramedic for Flight-for-Life, and knows what the heck he's doing. He routinely says, "I'm not as smart as you all think I am," and then teaches us in a supportive and open manner.
Contrast this with my fire department. We became a paramedic level service about a week ago. We are still working out many of the details. Apparently one of the most important details is what style of white lab coat the paramedics should wear. I argued with the lieutenant about the coats, making my case as follows:
We are a team. No one on the department is the least bit confused about who the paramedics are. Everyone understands that the paramedics have the knowledge and skills that the rest of us don't have. We know that on the serious calls, the paramedic will have tools and understanding that will be important, and we will--of course--follow their lead. However, up until now, we've worked as a team. No one has ever said to me, "I'm the intermediate here, what I say goes." We've always discussed patient care and strategies and come to agreement on the treatment plan. The team environment doesn't need to go away just because we upped our level of certification. By wearing white lab coats, paramedics are sending the rest of us a message: We are paramedics, we are different, we dress different, and you are not one of us. This message is especially arrogant in that the people on our department, every last one of them, are NEW paramedics. Not one has been a paramedic for over a year and a half, and the overwhelming majority have never run a SINGLE CALL as a paramedic. I congratulate them on successfully completing a demanding program and tough testing process, but having worked with experienced paramedics full time for several years in my other job, I'm not easy to impress with a shoulder patch, white coat, and no experience under your belt.
More importantly that the arrogance and elitism the white coats represent to me, I predict two things will happen:
First, the patients on scene are going to talk only to the paramedic. They have the coat, they're the one's the patients will gravitate to. Regardless of who is doing the transport. Perhaps I will be the one who has to transport the patient and give the report to the hospital. But the paramedic is the one who will have talked to the patient to the detriment of everyone else, and to the detriment of patient care.
Second, there will be plenty of EMTs at other levels who will stop thinking. They'll stand and wait for the paramedic to direct them. They won't start an IV until the paramedic tells them to. They won't get vitals until the paramedic directs them to. They'll shut down mentally, and will become those anonymous guys on the television show "Emergency!" who show up after Johnny and Roy do their thing, pick up the patient, and shove him in the back of the ambulance.
I'm a little way's off from becoming a paramedic, but I'm MILES away from becoming THAT kind of paramedic. I've already made my arguments, and they fall on deaf ears. I guess my only option is to model the kind of behavior I expect from others. Having run about 3,500 calls, I'm only NOW becoming the kind of EMT I really hoped to be. I'm just NOW starting to feel like I'm in my groove, but remaining constantly aware of the things I am continuing to learn every day.