Ever had to change a negative personal trait you didn't know you had? How did you go about it?

[emtdennis]

Vollies need to be handled more delicately, until they get some time and experience under their belts. As time goes by you need chat with each other and vollie finds out where you are coming from. But most of all, it does take time. I sometime find myself in a panic when an "A" or "CC" start to get irritated in the rig even if it wasn't with me directly.

Brings me to my biggest fault, I sometimes get irritated with a probie or someone who has not driven in a few months. Fortunately my crew chief is observant and has a relaxing effect and has pulled me aside.

[DwayneEMTP]

The problem that many have, and it sounds as if you do too, when viewed from a behavioral science point of view is that all of that "harden the fuck up" bullshit that you went through when you were new has a way of being superstitiously reinforcing. What that means is that it appears to be useful when in fact it has little to do, and often retards the learning, growing process. You can call that new age bullshit if you want, but you'll have a really hard time defending that point of view...

The old and ignorant point of view that you make people confident by continously beating them down until they can overcome it just isn't true. You can teach people to say "fuck you. I don't care about your opinion any more." but that's not the same as making them competent and confident. Confidence comes from competence, and compentence comes from working in an environment that allows you to take chances without constantly covering your ass.

Hardening up the new guys is very reinforcing for those doing the hardening as it makes them feel really powerful. But in fact it's just a bunch of limp dicks pounding on folks that have no way to defend themselves...pretty pitiful.

Bring people up with you. This isn't about not hurting their feelings, but about understanding that they aren't at your level yet and you can't insult them up to your level. You have to train and encourage them to that level. You'll find that if you take this path instead that you'll create rockstar medics in 1/3 of the time that it took to create you...and that should be the goal, shouldn't it?

Explain how you like things done before calls, explain what you want done during calls, do a call review on every call so that you'll both do better next time and remember that pointing out successes is 10x more powerful, at least, than pointing out failures....

It's all just good training really. Should they need it? Who cares? How does making that determination help anyone? They do need it...step up and give it to them...easy, peasy...

[DFIB]

Bring people up with you. This isn't about not hurting their feelings, but about understanding that they aren't at your level yet and you can't insult them up to your level.

But, wouldn't that makes all equal?!?

[BushyFromOz]

Thanks dwayne

Agree with what your saying. My only question would be at what point do you stop trying for the gentle gentle time consuming approach?

How do you positively reinforce some that has overwhelming confidence in themself but no competence?

Ive been reinforcing the positive message for seven weeks with nil results and my crashing CVA patient didn't have time for me to be the nice guy. I know the tone in which i asked my partner to do something was wrong, but when i say "snapped" i conveniently leave out the other 2 times i asked for the same operation to be performed in a more friendly way

Im not saying i dont have a scope for personal improvement - clearly there and with the roles i am aiming for in the future i still need to rise above that urge to snap at the guy not doing what is needed to be done - its not professional no matter which way you look at it.

My mentor said to me "Its not cool bushy, but when your working with people who cant be told and have no insight into whats going on then sometimes it just happens, it doesn't mean you have a bad attitude, it just means your human"

The next bit of advice i got was " and stop internalising verything, it will drive you mad"

Touche!

[chbare]

Agreed Dwayne. In education, I find there is a pervasive attitude that we need to beat people up because that's what happened to us. Then, we complain that our contemporary counterparts are soft and entitled when people take issue with arbitrary "ball" busting. If the contemporary providers are in fact as commonly described, then that is a reflection on the people who fostered the creation of said attitudes. Either way, the "harden up Chuck" ideology is our failure.

My litmus test for mandating an exercise is never based on what I had to do but rather does said activity promote the educational goals and mission statement of the educational programme. Also remember, as we mandate that people need to harden up, we should examine our own lives. I bet there have been times where we were vulnerable, lost, confused and in need of compassion and empathy. There is a time and place for "tough love," but we need to make sure it's done for the proper reasons.

As for the question at hand, my biggest issue is the fact that I think I sometimes articulate in a way that comes off as being overly pretentious and complicated. Sometimes that occurs here.

[rat115]

Thanks dwayne

Agree with what your saying. My only question would be at what point do you stop trying for the gentle gentle time consuming approach?

How do you positively reinforce some that has overwhelming confidence in themself but no competence?

Ive been reinforcing the positive message for seven weeks with nil results and my crashing CVA patient didn't have time for me to be the nice guy. I know the tone in which i asked my partner to do something was wrong, but when i say "snapped" i conveniently leave out the other 2 times i asked for the same operation to be performed in a more friendly way

Taking the risk of having someone bitch, I'm going to ask. Does your partner have a hearing loss or tinitus? There are those (even young) who don't realize that they have these issues or figure it's "normal" because it's all that they've known. Where they don't normally cause a problem, they can in high stress situations.

I have a person on our service that I can't get to understand the simple thing of DON'T THROW STUFF AT ME. I have lazy eye and don't have the depth perception to catch something small thrown at me. Because of this person throwing a pulse ox and expecting me to catch it, I was trying to reach over an unconscious pt when our driver gave a massive disel bolus and threw me into the back door causing me to mess up my knee to the point that I required surgery. The person who threw the pulse ox STILL doesn't believe that he wasn't being a team player.

I have been told that I'm too exacting in areas. Two of my major areas are cleaning the ambo and restocking. It pisses me off when I get into a rig and either something's not there or I find trash from previous crews that hasn't been cleaned up. Where we're a volly crew, we don't do the checks at the start of our shifts like would be done on a paid service, so this stuff isn't caught until you're needing the ambulance. It just pisses me off. I, also, refuse to change that. I've told people, "Sorry... Deal with it.... When you reach for something and it's not there, you'll understand where I'm coming from."

[DwayneEMTP]

You know Bushy, a couple of things...

First the arrogant, though ignorant know it all...man, that's a special case and I think that everyone has issues with them. My way is to pull them aside and say something like...

"You know what Brother? Enough of your bullshit. You pretend that you know it all and have seen it all, yet your making simple mistakes that even a rookie should be able to avoid, and you're making those mistakes way too often. Someday you're going to come to understand that you're using that nonsense to cover your fear. I know that you can do this stuff, you're just choosing to occupy your time acting tough instead of being competent....and it's not fooling anyone. I need you to step up to the plate. If I can't trust you to follow simple instructions then we're going to have to take this to the next level and have management sort it out. Let's be partners, kick ass, and leave all of the nonsense to the kids, ok?"

Then s/he'll either back off and try harder, or whine and tell everyone what an idiot you are because you can't see his/her brilliance and think s/he's posing.

Also, the 'nice' way works way, way, faster if used properly than the old way. There's a good primer, a book called, "Don't shoot the dog" (not really about dog training by the way)..it goes into reinforcement theory pretty well in layman's terms...it's tiny, but well worth the read.

Snapping during the crumping patient? Yeah, I've always certainly tried to avoid it, but I would have to have a talk with the partner that couldn't handle that.

[BushyFromOz]

I dig this word "crumping". Im gonna use that

As for the question at hand, my biggest issue is the fact that I think I sometimes articulate in a way that comes off as being overly pretentious and complicated. Sometimes that occurs here.

I would not say i have ever seen you being pretentious at all ch.

Thank you all for your honesty

Edited September 28, 2012 by BushyFromOz

[emtdennis]

Now I know why I tell many of the newcomers to these boards, that there is a lot to learn and much great insight. These last several posts have proven it.

[DFIB]

You know Bushy, a couple of things...

First the arrogant, though ignorant know it all...man, that's a special case and I think that everyone has issues with them. My way is to pull them aside and say something like...

I like to integrate this kind of interaction into a system of constant post-run debriefings for every run, from the MVC with blood and patients everywhere to helping grandma into bed. Every single run gets a sit down to talk about what we did well, and what we could do better next time. These routine conversations usually remove the veil from the guy you mention in the quote. It helps keep us all focused on reality.

This was hard to do when I was doing my clinicals but without failure I would ask the proctoring medic. The conversation would go something like this What did we do well on this run? I would ask "you were fine" the medic would respond. Then I would ask "What could we have done better?" and the medic would respond "You were fine"

Sometimes I would get more than that depending on the medic but it has a threefold effect on the team. One is the one I mentioned before, the second is like having a CISM session right after every call, and the third quasi parallels a CQI system, even when one doesn't exist.

I like it.

Edited September 28, 2012 by DFIB