How to Onboard New EMTs
My dirty EMS secret is that I love onboarding new EMTs. Now, this doesn't mean that it's always sunshine and rainbows. Sometimes new EMTs make my life horrifically difficult and require some extra mentoring. But a majority of the time, I love onboarding, and I find the work very gratifying. This post Is not a definitive guide to onboarding new EMTs but rather a framework. This is how I carry out my department's onboarding process and I believe this method has been successful. My methods will not work for every department and agency in the universe. It is not one size fits all. However, the basics are all there and hopefully this will help solve some of your agencies own onboarding problems.
What are your goals?
When designing an onboarding program you first need to decide what you want to get out of it. Yes, the end goal of onboarding is to transition a new EMT into an effective and resourceful member of your agency. But this is a super broad goal. It leaves a lot of wiggle room with very little specificity. As a leader within your agency you must decide what being an effective and resourceful member of your agency actually means. This begins with understanding your agency/department and its needs. Each agency will have different needs and values based on a variety of factors. BLSFR agencies will have different priorities than rural long-distance transport agencies. If your district has a highway with a bunch of wrecks every year you may wish to emphasize trauma and extrication. Maybe your daily responses to a dialysis clinic make you more inclined to focus on sepsis.
Understanding your district also applies to the resources available to your crews. As a first response agency, it is valuable to educate your new members on who they will be working with. Maybe your district is split between multiple transporting agencies, each with its own pieces of equipment and procedures. Set your crews up for success by providing them with as much useful information as possible on the agencies you work frequently with.
Hard vs Soft Skills
Now that you've decided on your goals and values, it's time to decide what skills you would like to train your new EMTs on. This brings in a discussion of hard vs soft skills. Traditionally hard skills are physical skills with specific goals. Examples of hard skills include IV starts, taking vitals, and splinting. While soft skills tend to be more non-specific. Examples include empathy, communication, and stress management. It is up to you to decide which hard and soft skills you'd like your EMTs to be proficient at.
Hard skills are straightforward. Your new EMTs should be expected to know how to obtain vitals, splint broken limbs, and so on. In my experience, it is always easy to find hard skills to train on. However, listing every single skill an EMT should be proficient at can be exhausting. My advice is to combine as many hard skills as possible into brief training tasks. Going over the monitor can include taking vitals. Splinting a patient can involve hemorrhage control or wound irrigation. Ultimately your imagination is your own limitation!
Soft skills can be slightly more difficult than hard skills. Honestly, soft skills are rarely an aspect of EMT onboarding, but I think they play an important role. My philosophy when training new EMTs is that while I do care if you can take a blood pressure and dress a wound, I also care about your thought process. It's important to develop skills like assessments and triaging, but also non-EMS skills like communication and problem-solving. Taking the time to develop your new EMTs soft skills will pay dividends in the future. Spend the time and develop these skills through scenarios and debriefs. I promise that it's worth it.
Putting Pen to Paper
It's finally time to write down your onboarding process. You now understand your agency and have a general idea of which skills you would like to reinforce in your EMTs. When you begin your writing process, I find it best to lead with your goals and objectives. This makes it so that the first things you see when you start EMT onboarding are clear goals and objectives. There is no room for ambiguity, and clear expectations are vital for EMT development.
There are also some design elements to work out here. Do you want to utilize a printed pamphlet? Or would you rather use an online platform? Would like room at the bottom of the page for comments/concerns? Or would you like to leave a space for it at the end of the packet? All of these are valid concerns but honestly, you shouldn't spend a bunch of time on it. Just make it look organized and it'll be fine.
Documenting Calls
Some may disagree with me here but I believe part of the EMT onboarding experience should include taking real calls followed by a thorough debrief. Try all you like, you will never be able to perfectly replicate the stress and randomness of actual calls. Personally, I have my new EMTs take 5 ish calls with debried before I sign them off. Obviously, there is room to add calls if need be.
Final Thoughts
So there you have it! This is how I build my EMT onboarding programs. Did I miss stuff? Probably. But this post should provide the basics. It's important to remember that your onboarding program should be fluid. Medicine changes almost every day and it's important to keep up with improvements in care. Finally, the onboarding process may end, but you should never stop learning!