A personality problem? Help!

[Eydawn]

Alright folks, I got the pen thing licked fairly quickly. The tape did the trick. I have a much stickier problem now.

I've had one field instructor tell me that I come across as a know it all and argumentative.

Scenario: Verbally started talking about the Narcan and its possible use in a potential oxycodone OD before I physically started taking BP. I understand that I need to focus on my basics and making my part of the call run smoothly, but when we're told to think along the same lines as the medic and really think about assessment and anticipate what might happen... I'm confused as to how that was a screwup. Maybe because I jumped to the treatment before getting everything else put together? We did get a first set of vitals from the FD (pretty reliable 90% of the time from what I hear) so it wasn't like I was thinking cold without any objective data.

I also expressed confusion about an IV site selected by this particular instructor... I was taught never to stick right under the thumb due to the potential for stabbing the radian nerve and REALLY pissing your patient off... and apparently I said "yea but what about the radian nerve?" instead of what I thought I said... "but what about the radian nerve there?" I hope you guys can read the tone difference there right... One is apparently challenging while the other is questioning. I can see how my FI would have felt it was a challenge- they told me to stick a vein and I asked a question instead of doing what I was told, but due to my confusion from my instruction from my recent class, I thought it was a question of potential patient welfare.

How can I phrase something like that where I genuinely have a question and don't want to screw up through my relative inexperience, without seeming to challenge the medic's authority? I had no intention of doing so...

So what I did on my shift today as a result of the discussion I had earlier in the week with one FI was approach my new field instructor and tell him what the previous one said. He was very helpful on ops and mapping today... I feel much better than I had previously and was totally comfortable on a shift for the first time since getting here. I warned him that I was blunt and that I had come across as a know-it-all or otherwise and asked him to let me know if he got any of that so I could figure out to fix it. At the end of the shift he said it wasn't so much a know-it all as much as I seemed slightly abrasive (and believe me, today I tried to be super polite, worked my ass off at studying protocols and maps etc.) but he couldn't put his finger on why I seemed that way.

Anyone been in a similar boat or have any ideas on how I could figure out how I, a normally blunt and honest woman, can cease to piss off my new coworkers by just being myself? My FI today did say that perhaps they just need more time to get to know me and get used to my personality... but I'm really confused by it all.

Any feedback would be greatly appreciated!

--Wendy

[Don1977]

wow, i was just kidding too......

[Dustdevil]

First, I need clarification. Is this at work, or is this in a paramedic school clinical? The use of the word "instructor" confuses me as to exactly what the scenario is here. Going (for now) on the assumption that this is your job, and not a student scenario, I understand why you are confused. But I also understand his annoyance.

Don't take this personal, because again, I understand your confusion. It is natural. But here is my honest appraisal of the situation. You're not an EMT student anymore. It is no longer necessary -- nor even acceptable -- for you to verbalise everything you think and do. He asked you to be thinking about it, not talking about it. If you specifically need to alert your partner to something you are doing (leaving his side to go get equipment, delivering a shock, moving the patient, etc...), then by all means do so. Otherwise, in the immortal words of Nike, just do it. No discussion is necessary. This is especially applicable to discussion of modalities way beyond your scope. It doesn't matter how non-confrontational your tone is, or how appropriate it sounds to you, it is not appropriate. You are there to assist the medic, not to distract him. An EMT is to be seen and not heard. Speak when spoken to, or in an emergency, but not otherwise. The medic has enough on his hands without having to worry about what you are babbling about.

Remember the boy who cried wolf? That is the scenario here. If you are following the above advice, then your verbal input becomes significant. If the only time you speak is when there is something of immediate importance, you maintain immaculate credibility. Your partner will know that, if you are speaking, it's something he needs to hear. Every word you speak that is not of immediate importance only serves to diminish your credibility as a partner.

It's not what you said, or even how you said it. It's the fact that you were talking at all when it was clearly not necessary.

[Eydawn]

Work, and "field instructor" three person team phase, to answer your questions.

Here's the problem though. They want us to discuss what we're doing and not "Just do it." It's *uber* wierd. I tried doing the whole thing just like I was actually running a call... but every call turns into student-teacher discussion type dynamic. I do my assessment in my head... and then get reminded that I need to assess.... *_*

So I keep my mouth shut when I'm thinking about meds and treatment lines from now on... but what if I have a legitimate question like that and don't want to do something just because the medic said so, and I've been taught otherwise? Do I just dodge aside and say hey, you better get this line on this particular patient? Do I just do something that doesn't sit well with me? Not sure how to handle that without pissing people off. I was taught that IV access there is a no-no because it is an unnecessary risk. WTF?

Here's the real rub. Instead of being taught to be the paramedic's assistant, I'm being pushed up front to assess and run calls, while the other EMT sets things up, go-fer, gets the cot ready, etc. I feel like I'm sort of learning how to BLS a call without learning how to assist an ALS call.

Also... when they say "what are we going to do for this patient" and I respond with something about the monitor, because I know the event warrants a look see by the medic, is that overstepping my bounds? Some think it is. Dunno... I thought syncope/near syncope in the elderly indicated possible cardiac even w/o chest pain...

You see where I'm stuck?

--Wendy

[Kaisu]

Oh Wendy girl I feel your pain. Being the newbie just sucks. You are doing the right thing coming here and asking for input. The experienced people on this forum have helped (and I am sure will continue to help) me so much. I credit them for saving my job. I can't help you because I am struggling to find my place here too. It can be overwhelming. It helps that I really don't give a rat's behind what people here think of me personally. I am doing everything I can to be the best paramedic I can. Now that I am on my own without instructors/preceptors, overseers - whatever you wanna call em looking over my shoulder I am finding my own rhythm.

When I was being introduced to the field, I was blindsided every day by crap that made no sense. I worked very hard at staying non-defensive, being open to input and thanking people for taking the time to try and teach me - even if in my heart I thought they were full of s***. It's amazing with the big egos in EMS how quickly the person's mind turns to themselves. They go on and on with their half baked self justifications while I nod my head and look suitably impressed. About half the time, people tell you stuff that is valuable and really constructive. I made sure not to take stuff personally, even if it was personal because they really didnt know me just like they really don't know you. Listen, evaluate, learn and grow. It hurts - but it is worth it. Good luck gal.

[akflightmedic]

Alright folks, I got the pen thing licked fairly quickly. The tape did the trick. I have a much stickier problem now.

I've had one field instructor tell me that I come across as a know it all and argumentative.

Anyone been in a similar boat or have any ideas on how I could figure out how I, a normally blunt and honest woman, can cease to piss off my new coworkers by just being myself? My FI today did say that perhaps they just need more time to get to know me and get used to my personality... but I'm really confused by it all.

Any feedback would be greatly appreciated!

--Wendy

Kudos to you for recognizing and trying to rectify a perceived personality problem. I snipped this quote from you because it is the only part I can relate to...well, everything except for being the "woman".

I am very blunt, I speak my mind and I do not mince words on calls. I do the same around the station and with my coworkers. It took me many years to realize it eliminates a lot of confusuion, leaves nothing to interpretation, and facilitates patient care.

I can and do come off as argumentative and sometimes a know it all. I do not care. I will do what I can for my patients with whatever knowledge I have. What others think of me is their opinion and right. I have even been called an asshole many times. I have been told I just give off that impression initially; some think I give it off all the time. Again, for the ones who take the time to get to know me, they soon realize I am who I am, and when I say something it is usually not to be mean spirited. They also VALUE what I say as they know it is my honest opinion, no fluff..guarenteed. I just give instructions or thoughts out loud and most times I do it with a high degree of confidence which some confuse with cockiness or authoritativeness. I view it as me speaking slowly, clearly and leaving no room for error or time wasted asking me to repeat.

This is not about me, I just wanted to share what I have experienced as I relate very closely to what you are saying and can definitely say, Been There, Done That...still doing it.

Basically, I do not think your assertiveness is a bad thing nor should it be corrected. Others will learn who you are and this SKILL may serve you very well in the future, as you will develop credibility and respect; just do not spew off at every single little thing. Stay true to who you are, because if you are constantly worrying about your demeanor and how others perceive you, it will wear you down and compromise the very inner workings that developed and made you who you are.

I am at the end of a very long shift, I am tired and realized I am rambling. I hope some of this made sense and the point I was trying to make reared its head. Maybe a reread and adjustment after I sleep may clarify.

[Richard B the EMT]

One possible problem could be the same as mine. If asked to verbalize what I am doing, as opposed to just doing the deed, I find it slows me down. I am also told it is quite common.

[EMS49393]

I'm going to give you the same speech I got from my nurse manager Friday when I was brought in for a meeting (on my friggin day off).

"I can't teach you to be a certain way. You have to figure out how people perceive you, and how you can change that perception. You should come up with an action plan. You might want to confide in a nurse that you trust, and just ask them to gently let you know when you might be giving off an impression to those around you that you don't necessarily mean to give off. I know how you paramedics are, I'm married to one. Blah, blah, blah..."

I thought it was a little bit of nonsense, but maybe it would help you. I know what you're going through. No matter what I do, I come off wrong to people. Honestly, I have no idea how to fix it. I even have to come up with an "action plan" of how to fix my impression on people. Unlike you, I was accused of not being sympathetic to patients and not conveying the message that I care about their emergency. You were taken the complete opposite of me, being a know it all, and maybe too compassionate about your patient. Incidently, I am compassionate. I do, however, have a pretty low BS tolerance. It doesn't work well in a ghetto.

I'll get to the point. I work every weekend, and one day during the week. The weekend team is my team. We get along great. No admin around, we have a good time, and we take great care of our patients. I trust them, so I enlisted their help. I told several of them about my reprimand. They couldn't believe it. One of the nurses looked at me and said she knew why I came off that I didn't care. I don't get excited. That's it. I don't get excited, I'm very matter of fact, and I pay attention to making sure the patient that needs the most help gets it first. Apparently, it really upsets patients that are complaining of having a cough when an elderly lady with obvious respiratory distress and chest pain go back ahead of them. Who knew. :roll:

I don't know how new you are at your job. Perhaps there is someone there you can confide in that can help you with whatever behavior is causing you problems with people. You might even be able to talk to this instructor (outside of a call) about this problem. The fact that you want to be proactive should portray how seriously you take yourself and your job. If this guy, who I assume is pretty high up on the company food chain, won't help you, well, he probably sucks. If that's the case, then it's probably a no win situation. That's okay as well. Sometimes you just don't fit in with an organization.

The deal is, you're bright as all get out. You can hold conversations with the best of the paramedics here, and we all respect you because of your dedication to continued learning (and your grammar ). You're also a chick, and it's sometimes pretty hard to be a chick with a brain. You remind me of a lot of the gals here, sometimes we are just too damn smart for our own good.

You're going to find your groove, it just might not be with this job. It probably won't be as an EMT. You're bound for greatness grasshopper, and it might be your greatness that gives you your groove.

[Eydawn]

Thanks, folks... I really appreciate the feedback. I feel like I'm not crazy anymore.

I'll keep you posted on where/how it goes...

Wendy

CO EMT-B

[rock_shoes]

Try asking this particular medic a couple of questions.

1)How would you describe the perfect EMT partner?

2)What do I need to do to fulfill that role as best I can?

If he/she is a good medic they will be receptive to those questions and answer them with verbs in their sentences. The easiest way I've found to get along with superiors is to ask them what their expectations are. Then if for whatever reason you have difficulty meeting those expectations ask them if they have any ideas as to how you can better meet them.

Never be afraid to ask questions. Just know when to ask them. On the scene of a call isn't the place unless failing to ask the question has the potential to harm yourself, your partner, or your patient in that order.