Saying Goodbye to Rookieworld- Caroline Schwester

Saying Goodbye to Rookieworld: Thoughts after Recertification

Recertification cycles where I’m from occur every three years. To some, three years may seem like a long time, but to an EMT like me, those three years flew by.

When I first got my certification, the US was between waves of a pandemic. My first patients went into cardiac arrest after EMS arrival. I’ve served multiple different communities in my state, and have had to adapt to their customs and languages.

I’d be lying if I said this was an easy thing to do.

But, on the upside, it definitely gets easier. You get into your flow with your partner of how you manage a scene, and everything else that we’re taught starts to become second nature. When I get on a scene, I have a job to do, which is to provide the best care I can. But I also have to self-acknowledge that I’m a human with emotions. It’s a weird feeling after a pronouncement where you, your partner, and the paramedics know that you did everything you could. After that, you walk away, mentally resetting before your next job, and yet, the family is screaming at you to keep trying, to bring them back, to do more.

These calls were the ones I’ve struggled with, even from the very beginning.

In Rookieworld, I talked about my first cardiac arrest and what changed between my first truly critical patients, where I was conflicted about showing my emotions. Am I allowed to cry after a bad call, or after a call that goes wrong? How will other people in this job view me if I do?

Now, when I see a critical patient, I still feel those emotions, but not to the extent that I did when I first started.

Is it possible to be sympathetic in these situations while still remaining professional? I think so.

But sometimes in these instances I feel like I’m losing the part of me that cares. No matter what, I’m still giving my patient the best care I can. But is that enough? What more can I do?

I’ve been lucky in having a great support system in other EMTs, paramedics, and even doctors that have been in my shoes before. They’ve always been able to give me good advice, especially when I’m feeling like this. They highlight my compassion, while also acknowledging that it’s human nature to feel upset on a tough call. They can also acknowledge times when they’ve felt that same way. Also at times when I start to feel this way, I find myself turning to my hobbies (reading, trying new recipes, or working out), or spending time with my friends. All of these things have made me realize that there’s more to life than just being an EMT, and that no matter what, you’re not alone and always have people to support you.

Also in Rookieworld I’ve discussed how hard it was being a legacy in EMS, and how the start of my EMS journey was plagued by many different people comparing me to my dad. It’s been a little bit easier since I now work primarily in a different county than he does. But since then, I’ve had to make a name for myself and prove not only to the medics, but to my partners as well that I know what I’m doing and that I belong on a 911 ambulance in a busy system.

My confidence has grown immensely since I’ve moved. Many of my coworkers who first knew me as the shy, quiet girl are now so surprised that I can speak up for myself and have a little bit of an attitude. I feel more confident in my ability to make a decision, and my partners (and most of the time, the medics) are able to trust me, but also give me guidance when I need it and ask for it. I’ve also begun to meet some of the different doctors and nurses in our hospital systems and have been able to establish a relationship with them, which is helpful. I’ve learned that these relationships are very valuable to me and it’s always helpful to see a familiar face on a call, or in the hospital when I’m bringing in a patient. For example, I always appreciate it when I bring in a very sick patient and the doctor tells me that we’ve done a good job taking care of the patient on the way to the trauma center. It gives me reassurance that I’m doing the right thing.

In some cases, I’ve also amazed myself. Not only am I more confident in my ability to think critically, I’m (slightly) more confident in my ability to communicate with my patients who may speak a different language than I do. While my ability to speak and comprehend is far from perfect, I am able to get my point across to my patients and have them understand me. Every shift, I find myself learning a few more words that I can add to my vocabulary in order to better communicate with my patients. I’ve found that it eases their apprehension a bit, and they are grateful that I am trying to communicate with them in their primary language. Patient encounters like these have inspired me to learn the languages of the communities that I serve in order to help make them feel more at ease when they call for an ambulance.

Being an EMT for only three years may not seem like a long time.

Truthfully, it really isn’t.

But I’ve surprised myself with how much I have grown in both my critical thinking ability and my confidence. It means a lot that the people I work with also have that same confidence in me that I have in them. Some of the partners I’ve worked with over the years, even the ones who have helped teach me how to be the EMT I am today, are now some of my best friends. And while I still doubt myself sometimes, I’m able to get reassurance that I’m on the right track and doing the right thing to help my patient.

After these past three years, EMS is something I’ve fallen in love with (much to the dismay of my father). I love the chaos, and I love the unpredictability of what a shift can bring. It’s something I’m passionate about, and something that will benefit me as I plan on applying to medical school next cycle. Being an EMT has made me realize that I want to do more for my patients, and help them get the care that they need. I believe that I can do that as a future emergency medicine physician.

EMS has taught me so much, both about the field and medicine in general, and about myself.

Don’t worry, I’m not going anywhere just yet! I’m still going to continue to blog about all the cool things I’ve been up to in the past few years, including how important research is to EMS and beyond, founding a simulation team (that placed in the top 3 at a competition!), and more.

So here’s to the next three years… and beyond!

Declaring Independence

The status quo has changed.

Surely, we’ve all heard that from one healthcare organization in some form. “Here at Jimmy’s House of Medicine our brand of medicine is different” and we’ve all heard the classic trope of “We’re not co-workers, we’re family.” I can say for the duration of my career I’ve heard my various employers parrot the same empty rhetoric about how the way they do things is “moving medicine forward” or extending another platitude that their system or service is superior to the other by using some tired wordplay like “Moving at the speed of life.” We use these recruiting tools to bring people into our hospital systems, and then we expose them to the same exhausting, short-staffed, long-hours, toxic work environments that we’ve all gotten used to. Then a new generation of employees come in, and the cycle perpetuates. We often talk about the need for things to change, but then we never act on it. I submit that this lack of change is often to do a systemic lack of will. That is, organizations writ large are fearful of change so they elect to do nothing and offer non-answers as solutions. Of course, this is done while saying the organization will always do whatever it can to stay current.

Why is The Job Different?

Why does this happen to the around 1,100 EMS clinicians of FDNY*EMS, and not the 118 female firefighters of the FDNY? Why is it that the members of FDNY*EMS are given short shrift? Why is turnover so high in the command that paramedics leave to drive garbage trucks, EMTs stay only a few years before getting out, and so few stay on long enough that a pension may as well be a lottery ticket?


Maybe the answer is staring us in the face.


Suicide in EMS: Same as It Ever Was

An old friend of mine killed herself last night. She wasn’t the first. She won’t be the last. 

Read that again. 

In EMS, we know depression, stress and suicide to be among the highest in any industry in the United States. We know these statistics, but we continue to do little about it. Why is that? Why are we so convinced that the simply researching this issue is significant enough to cause a change in our culture? We’ve already determined that suicide rates among EMS providers is exponentially higher than the general population[1] and we continue to provide lip service to the importance of mental health in our profession without committing to any real change. But as long as all our charts are completed on time, our employers are happy.