I think I'm a good paramedic. I have enough experience to see patterns in clinical presentations, I keep up on literature, and I adjust may care accordingly. I'm also pretty good with patients. I develop a rapport with them, stay calm when things get crazy, and know how to get reluctant patients to go to the hospital.

It wasn't always this way. I used to hate calls that didn't flow like scenarios in school, or when patients didn't read my textbook before calling. At some point everything clicked, and now I enjoy challenges. I've tried to think back to when that happened.

I got some insight on this from Malcolm Gladwell's book Outliers. He discovered that people who excel in their field practice it for 10,000 hours. The Beatles played eight hour long concerts several days a week in their early years, and Bill Gates fell asleep almost ever night programming computers. Professional athletes, performers, and others have achieved their success after about 10,000 hours of practice.

I've been in EMS for 10 years; full-time as a paramedic for the past 8. Working 50 hours a week is about 2500 hours a year. I would have hit 10,000 hours after four years, which is about when it clicked for me.

Of course I don't spend every hour I'm at work on calls. About 30% of them are, and my eyes may even be closed for some of the others. I'm not as fanatical about EMS as the Beatles or Bill Gates were about their fields, but I do spend down time and off-time reading, writing, and doing other EMS Stuff. I care a lot about the care I deliver, and worked very hard to get to the level I'm at now.

I still have a lot to learn, but what changed after 10,00 hours is that I finally got comfortable with being uncomfortable. I stopped getting nervous on the way to calls. Things that I used thing were emergencies suddenly slowed down, and more things became automatic. Now I smile at newer medics who have the same excited look that I used to have.

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Comment by Robert Waugh on September 1, 2010 at 7:04am
I couldn't agree more, we hear all the time the idea of molding the critical thinking medic right out of school and I've always believed this is not completely possible they need those hours to develop there skills and experiences to start to have those light bulb moments, the challenge is to keep them caring about the job and continue there knowledge base until this occurs and not get frustrated or complacent, all of this you said very well in your blog.......Cheers Rob Waugh
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