Who remembers their first month/year as a brand new medic?

I feel like no one ever talks about this awkward period, and after barely surviving my 1st month, I totally get why:

It's a hot mess...a thread 1/

A hot mess that I figured I'd share, cuz If I can't make fun of myself for being an absolute noob, then this is gonna be a very broody year... 2/

Things I have come to realize my first month as a brand new medic: 3/

Medic school was just an appetizer; an amuse bouchée if you will. You get acquainted with Nancy Caroline and then have to pass various tests. If you pass these tests, you do not suddenly become a medic, no matter how fast your card arrives or how high you score. 4/

Passing medic school merely means you're somewhat competent enough to start PRACTICING as a paramedic. The real medic school starts your first shift, and every shift from that point on, expect a pop quiz...or like....14. 5/

It's a PRACTICE:

The practicing part is complex. It's a whole new arena of responsibilities, operations, PCRs, commanding scenes, calling shots, calling medical control. The list grows each shift. 6/

Not to mention all the mental models you realize you DO NOT have, no matter how many podcasts/tweetorials/EKG cases you've nerded out on. To put it simply, you're not back at square one; you're on a whole new block. 7/

my inner dialogue most shifts: 8/

Clocks in: I got this
During shift:
- I don't know as much as I thought I did
- What I don't know isn't in a book
- I won't know what I need to know until I know it (aka until I see, hear, smell, and or feel it, hopefully not taste it)
Clocks out: "I know nothing." 9/

I've also realized that none of this is all that bad:

Yes, You're going to make mistakes and say dumb shit, but it's not the end of the world. These are the moments where you learn the most, the moments that will make you better, that make it all start to stick. 10/

Don't let it eat you alive. Keep your chin up, make sure you still have your narcs on you, and go stumble right on into your next call. 11/

Go home and refresh your knowledge on calls that made you feel lobotomized. Reinforce the IRL experience you just gained. Your calls are your new study guide. 12/

Pregaming helps mitigate looking like a total fumbling idiot on scene. PREGAME 13/

Cardiac arrests become the more straightforward calls to run. 70 yo AMS meemaw suddenly becomes way more complex. 14/

Work smarter, not harder. This applies to basically everything. 15/

Treat the pt not the monitor also applies to STEMIS 16/

Being humble about your rookie status is always recommended. Talk things out and communicate with your partner when you don't agree or understand their line of treatment (or lack thereof). HOWEVER, choose the time to do this wisely. 17/

Yes, your partners have more experience than you, but if you genuinely feel like they're skelling on pt care, don't just tell yourself they know better. Sometimes they don't know what's going on and think skelling is easier than being wrong. 18/

At the end of the day its not about your ego its about the pt. 19/

Your partner isn't always right just because they've been on a truck longer than you. If you feel like a note should be called, remember you have your own radio and access to a notification line. 20/

If you feel like your patient isn't stable enough to wait around to be triaged, it's probably noteworthy. You'll get more shit for not calling a note on a critical pt than the other way around. 21/

If you called a note and they do downgrade it, no biggie, follow up and learn why it didn't need to be a note. A doc will usually judge you less if you are proactive about understanding where you went wrong. 22/

I had a call where I wanted to call a note / put a pt on CPAP. My partner said no, and made me feel dumb for even considering it. We get to the ER, partner goes to the triage nurse and says, “Hey, so this probably should have been a note...." 23/

triage nurse replies, "Then why tf wasn't it a note?!" then puts the pt on BiPAP. Come to find out, my partner actually agreed with me, but admitted they don't like calling notes because they dont wanna sound dumb and “we were close to the hospital anyway”. 24/

That's fine. Sounding dumb over the air is my specialty these days, ill gladly send a botched note if it helps the pt. In the end, not providing proper care looks way worse than a few 'ums' in between reporting your pts vitals to dispatch. 25/

Respect BLS, clean up after yourself when your riding in their rig, throw away your goddam sharps. 26/

Thats all the rookie intel I’ve gathered via many moments of pure embarasment, second guessing myself, and full on imposter syndrome during my first month as a medic...but most definitely 'to be continued'.

'a couple of bumps' is the understatement of the year. 27/

disclaimer: no patients were harmed in the making of this medic.
28/