Author: Maria Zagorulya
Institution: University of Rochester
At the most critical times they come to your rescue. They always know what to do. Never afraid, never hesitant, they quickly size up the scene, assess the situation, make a firm decision and act immediately: the adeptness is astonishing. You trust them with your life. Skillful, confident and always prepared, paramedics are the superheroes of today.
“Paramedicine is an excellent career choice if you like to interact with people, and feel that you can assist them through what may be very stressful times,” suggests Sharon F. Chiumento, a volunteer paramedic, with over 14,000 hours of log time and 3-4,000 calls in her career. “There is a lot of satisfaction with that, and with the challenge of putting the ‘pieces of a puzzle together’ to do what is best for a patient.”
She relates the job of a paramedic to that of a detective. Arriving to the patient, the emergency responder is the “the eyes, ears and hands of the physician at the scene”, and the goal is to collect all the clues and present a picture as complete as possible to the receiving physician. “I enjoy the challenge of assessing patients who are ill or injured and obtaining a good history to then make decisions on how to best help those patients,” shares Chiumento. “Perhaps there are internal injuries that are not so readily or quickly apparent, or maybe there are emotional problems like depression, or relational issues such as abuse.” Solving the riddle of events leading up to the emergency is the intellectually stimulating element of the profession. And the importance of this information for appropriate patient care makes the effort worthwhile and exciting.
The ability to help a person in need is certainly the major motivating factor for paramedics. When a patient is traumatized in a vehicle accident, has a heart attack or is on the verge of committing suicide, rapid emergency care provided by a paramedic is crucial to the patient’s survival. In such life or death situations the actions of an emergency medical responder have a direct and immediate impact. It is no surprise that paramedics choose to be paramedics: nothing can be more rewarding than saving a person’s life.
However, the job of a paramedic is not an easy one. “There are many challenges for EMS providers”, confesses Chiumento, “long hours, shift work, working weekends and holidays, potential back injuries from lifting or other medical problems, and stresses related to working with very ill or badly injured people, knowing that even your best efforts may not be enough.”
Balancing family life and a profession in the EMS is another concern. “There were times when my children resented sharing ‘Mom’ with the ambulance, and it was hard feeling their disappointment if I could not go to a soccer game or watch them bowling.” Like any other profession, paramedicine requires prioritizing and sacrifices. But these can be kept to a minimum: “overall … I was able to balance family life, EMS and eventually a full-time EMS-related job most of the time”. Though difficult, it is not impossible to find an equilibrium.
Yet, paramedicine requires more than just will. Staying calm and making quick decisions under pressure, handling critical patients in singular as well as multiple casualty incidents, dealing with panicked bystanders and operating in unforeseen, at times dangerous, circumstances – in order to manage the constant stress, emergency responders must be mentally and physically strong. . Moreover, Chiumento admits that people with “open-mindedness and lack of bias” in patient therapy, “persistence in keeping as up-to-date as possible with current treatments” and “good listening skills and empathy” make the best EMTs.
Contrary to popular belief paramedics do not only work with ambulance services and fire departments; there is a wide range of paramedic jobs available. They can work in air ambulances transporting patients on helicopters and fixed-wing aircrafts. There are military medics and tactical medics providing immediate medical care in the field; the latter work in conjunction with SWAT teams. Search and rescue teams in the wilderness and in the urban setting also require EMTs. Paramedics work in the industrial safety field, on factories, mines and oil rigs. There are also paramedics who work overseas.
“For many paramedics, EMS will be a stepping stone to … opportunities in EMS administration or education, or to hospital-based careers such as nurses, physician assistants or even physicians,” acknowledges Chiumento.
There will always be a need for EMTs and paramedics to provide immediate medical care during emergencies: fires, traffic collisions and natural disasters. Due to increased population aging it is predicted that the demand for emergency medical services will rise.
“The potential of community-based paramedics – evaluating or doing procedures on patients in a non-emergency setting, such as in their homes or in a clinic setting – is on the horizon. Particularly with the movement towards cutting medical costs and keeping patients from using hospitals as their primary care source, paramedics will likely be seen as a major resource, but it will not be in the traditional emergency-based ambulance setting," comments Chiumento.
Chiumento continues, "In some parts of the country, there may well be paramedics staffing urgent care centers under the supervision of a physician. Additionally, paramedics will probably continue to expand their roles in interfacility transport, from just assisting hospital staff accompanying a patient, to providing more independent transport treatment, such as administering blood transfusions or maintaining chest tubes and arterial lines on relatively stable patients.”
For undergraduates considering the career in the EMS talking to professionals and riding with an ambulance will be helpful in making the decision. Many universities provide the opportunity for students to take the EMT course, and often there are student-run medical emergency response teams on campus. Becoming involved and getting hands-on experience is the best way to understand if it is the right career path.
“[Be] fully aware of the stresses that may face you, but also to be aware of the rewarding nature of helping people,” advises Chiumento. “For many paramedics, EMS will be a rewarding profession in and of itself. For others, it will be the beginning step towards finding a lifelong career in other arenas of patient care.”