I found this post by “Hot Lights & Cold Steel” a while back, and it’s kind of stuck with me ever since. You should go check it out for yourself, but I’ll summarize briefly for the point of this post. Basically, there are four levels of an EMS provider: unconsciously incompetent, consciously incompetent, consciously competent, and unconsciously competent. In the first, you don’t realize what you don’t know. In the second, you are aware of all that you don’t know, and almost overwhelmed by it. In the third, you can provide great patient care when you are focusing and thinking about everything you’re doing. In the fourth stage, you provide great patient care without having to think every little detail through…it just comes naturally.
Well, a piece of me wonders if this theory involves some oscillation. I do remember being in awe of how little I actually knew. I realized that my knowledge base was so small…and the things I thought I knew really only consisted of superficial knowledge. It was daunting. As time went on, I ran more calls, saw more things, and learned more from others. I began running calls with confidence. There was a fluidity to my movements, a steady process to everything. I was calm. As a EMT-B, I knew what I needed to do, and was able to do it.
Now, if all goes according to plan, I’ll be a licensed AEMT within a month. That terrifies me. Honestly, I didn’t feel that my program really adequately educated us. But, to be fair, I know that’s only part of the problem. That fear still remains, whispering poisonous thoughts, catalyzing my moments of discouragement. Although I try very hard not to show it, my methods and my thoughts all seem to be similar in nature and feel to those I had when I first started running calls: disjointed and somewhat anxiety filled. Maybe that’s because of my broadening and deepening knowledge base. Maybe it’s because I don’t get to tech as often as I used to. Maybe it’s because I’m starting to realize the much greater responsibility I have to my patients as an ALS provider. Maybe it’s all of the above, plus so much more. Regardless, I feel that my thoughts are uncoordinated and clumsy again. Maybe not to the extent that they were when I first started EMS. But, deep down, I do worry. What will it take to earn that confidence back? Was that original confidence deserved in the first place?
Maybe these are good, healthy concerns to have. Maybe this will help me become a better provider. But for now, it’s a little scary.