As I sit in the airport terminal, waiting for my flight home from Crash and Learn ‘22, I can’t help but sit back and reflect over all of the amazing people I met, and conversations we had, over the past several days. While this blog isn’t about CAL specifically, I am going to say that we, as organizers, were extremely proud (Okay, okay, I’ll fess up… I was really excited.) that we were able to create an event whereby attendees and lecturers alike, were able to literally sit around the same campfire and talk about experiences, concerns, and ask questions that we may have been otherwise reluctant to ask elsewhere. This conference gave me not only the opportunity to share my experiences in the industry, and hopefully offer a new perspective to others, but also to gain additional insight myself. There was no divide between lecturers, organizers, and attendees. It was a conference of medical professionals sharing ideas and information. I was just as much the student as I was the teacher, and for that I say, “thank you.”
During the course of my week(end), I came to realize that we as a critical care transport industry do not do a very good job of recruiting our successors and, more importantly, providing them the tools to be successful once they’ve been hired. Recruiting is largely left to the perceived glamor of flying, and once a clinician finally gets their “dream job”, they are left to find their own way and may quickly begin questioning their new career choice. While there are definitely exceptions to this generalization, and a huge hats off to the agencies that take the initiative to provide new-hires and current employees alike with the tools to ask questions and succeed, this is not the hard fast rule.
I heard from a number of attendees that expressed feelings of inadequacy and fears that they wouldn’t be “good enough” to ever land, or even maintain, their desired job, whatever it may have been. Some of these feelings were personally rooted while others were based on negative experiences from past employers. Conveying the message that one isn’t “good enough” to be in the industry, without trying to build that person up, seems far more commonplace than I feel it should be. Instead of holding co-workers and employees back, we should be helping foster their success. Hire for attitude, teach the skill. Skills can be learned. As an employer, I would rather hire an inexperienced person with a positive attitude and desire to learn, and teach them what I need them to know, rather than hire the individual with the cocky or otherwise bad attitude that simply checks all the checkboxes. Think about it: One’s attitude is contagious, be it negative or positive, and injecting negative attitudes into an organization can be the cancer that destroys it from within. As an employer, I’ll get a bigger bang for my buck by hiring someone that wants to be there versus someone that may not be as invested in the organization. Just like the line from the movie Remember the Titans (via the newest HLTH member, Amanda Ventura), “attitude reflects leadership.”
For those new to the industry, or considering entering into it, there are a few things you should remember:
- First and foremost, you have two jobs when you go to work: do no harm and make it home at the end of your shift. Medical crews are not simply “self-loading baggage”, and you either succeed or fail as a team. Everyone in your vehicle, whether it has wings, rotors, or wheels, has just as much of a right as the next to speak up when something doesn’t seem right. If you are continuously forced into scenarios that you feel are unsafe, perhaps it may be time to explore alternative employment, and that’s okay. Your life, the life of your patient, nor the lives of your fellow crew members, are worth a job. Say that again: Your life is not worth a job.
- Things you may have never thought about like IV lines freezing, what’s this weight and balance thing, or why shouldn’t I use this jake-brake thingie in the winter may never have crossed your mind. For all those new to aviation, the simple act of flying is intimidating enough. How does it fly? What do those buttons do? Where’s the headset jack? Why do I have to know how to use the radio? Slow down, take a breath, and relax. All the knowledge you need will come in time. Become comfortable with the clinical aspects of your new position before you go on trying to tackle the laws of aerodynamics, retreating blade stalls, and dynamic procession. When you’re ready, bring your pilot’s favorite snack and have a conversation. Ask questions. Most of the pilots I’ve flown with love to share their aviation knowledge just as much as they love to fly.
- In the same breath as my previous point, take time to learn how your aircraft or ambulance works and how to interpret aviation weather forecasts. Nobody expects you to be a pilot, but you should at least know what you’re looking at when you sit up front. I was once accused of being “self-loading baggage that knows too much” which was just fine with me. Now, as a new flight clinician, your new position can be daunting. Let’s be realistic: It can be like drinking from a fire hose for a while. Not only are you learning new skills, you’re doing them in an environment that can be slightly (insert extreme sarcasm here) intimidating. There are all kinds of new sounds, smells, and procedures.
- Find a service whose ethics match your own. Don’t be in such a hurry to get your dream job that you ignore a culture that may not be aligned with yours.
- Go with your gut. Too many times junior clinicians, especially those flying, are pushed into circumstances that cause the hair on their neck to stand up but are told things are normal and not to worry. Unfortunately, and by no fault of their own, many junior clinicians simply don’t know what they don’t know when it comes to the vehicles they’re in and may succumb to the pressure of agreeing to a transport in far from optimal conditions. You don’t do your patient any good if you get stuck in a blizzard or fall asleep behind the wheel after your third across-the-state run of the night. Don’t be the one that is convinced into believing something is okay and it’s, in fact, not. If there is any question, remember that your life is not worth a job. I would rather be out of a job than have someone show up at my door one morning with bad news for my family. I can earn a paycheck anywhere but my family can’t get a new husband, dad, or son.
- Find a mentor. Someone, or a few someones, that you trust to ask questions no matter how silly you may think they are. Some organizations are great at mentorship while others leave you to find your own way.
- Remember, flying, and even transport in general, isn’t for everyone, and that’s okay. Even though I was hooked from the very first time I got in an airplane, others are less certain, and there’s nothing wrong with that. For those that have been ground-based for years now making the transition to air-based transport, for the first time ever you are actively involved in the movement of your vehicle. No longer are you simply sitting down in your captain’s chair, fastening your seatbelt, and having relatively little concern for what happens between point A and B. That’s intimidating all by itself.
- There is a harsh reality to this job, and that reality is that you are going to lose some patients. Transport crews tend to deal with the sickest of the sick. Sometimes these patients have conditions that are ultimately incompatible with life, and there is nothing that you would have been able to do to alter the ultimate outcome. That’s not to say that you shouldn’t try. It’s to say that sometimes things are beyond your control.
- When you find yourself working in a place that you can no longer get behind, and are contemplating a change, draw your line in the sand and don’t second guess yourself. You’re the one that has to figure out where that line is, though. I’ve left toxic workplaces, taking as much as a fifty-percent pay cut, only to be in a happier place.
- Sometimes all change needs is a little spark to light the fire. Be that spark.
- I make this last point once more, because I feel it is so important: You need to worry about #1 (yourself). Your physical and mental health are not worth a job. The unit will always be under-staffed. There will always be overtime available. And there will always be patients who need to be transported. What there won’t always be is time to watch your kids grow up, the family summer camping trips, or that date night with your significant other that you’ve been putting off for weeks. Both fortunately and unfortunately, I’ve gotten burned out before, so I know when it’s time to take a step back. My wife and I have been together for better than twelve years, and she’s excellent at pointing out when I should consider making some changes. In that same breath, find a support group and talk about things. It really does help. Most of us are Type-A personalities, so asking for help can be one of the toughest things you do, but it is so important. If you don’t have any immediate support, get a hold of one of us. Sometimes talking to a stranger is easier than talking to a friend.
There are two main things I feel this conference emphasized, and they are: 1.) Your phone-a-friend option; and 2.) You are not alone in this industry. Many of us have gone through the exact same situations and had the exact same questions as you. Please, do not hesitate or think twice about reaching out to and using those resources. Learn from the experiences and mistakes of those around you. This is a small enough industry that even if you don’t personally have the answer for X, Y, or Z, or know someone from ABC Flight Service, chances are pretty good that we know someone that does. The six degrees of separation are more like one or two here.
I truly hope this information was helpful to you and wish you all the best on the paths life takes you.