Prior to being cut loose from any training in the country you have to have two things: a formal classroom education and precepting time with a formal field training officer. To some paramedics and EMTs, completing training means the end of their formal education, other than the occasional IST to maintain certification, but I would argue that the best learning comes from seasoned mentors.
Mentoring is an essential function in EMS. At entry level we have a "prove-yourself" mentality, but expect safe and quality services. It's a paradox very few new providers can manage alone.
Mentoring, whether forced or by natural occurrence, works. A mentor can help the "new guy" learn what's not in the books, such as how to get around office politics, where to go for information, best secret places to eat, and how to navigate the local jargon. Along with easing the transition of a new employee, mentoring is excellent for teaching best clinical practices. While there is no replacement for experience, we can teach what we already know. Mentors can help sharpen any skill set. Most often, a simple, slight change in hand placement or technique can radically improve IV success rates. Mentors with experience can share their wealth of knowledge, thereby improving patient outcomes.
So what's the difference between a mentor and a field training officer? FTOs are part of the official orientation process. They ensure that the candidate can operate on his/her own by following proper procedures, policies and standing orders. Mentors develop a strong relationship with candidates, and act as a sounding board for complaints and frustrations without being judgmental. They can help with issues directly without needing to run to the administration. They are honest, trustworthy and influential in this new arena of lights and sirens.
Implementing a Mentorship Program
Given the benefits, how does an organization implement a mentorship process? My recommendation is to first identify the providers in your organization across all levels of certification who want to train and help new employees. Have them set up a council and let them decide how they want to approach the issue organically. Establish ground rules that allow both the new employee and mentor to change partners without it being punitive. Mandate that the new employee or student has to meet with his or her mentor at least once a month for the first six months (more if the decision is mutual). Make connections, which means giving out personal information like cell phone numbers and schedules. Often, the newbies just need to talk to someone. Establish a budget for meals for the first six months, and evaluate what your employees think.
Mentors motivate and expect key behaviors while holding the student accountable to both professional standards of behavior and personal goals. This also means that mentors sometimes have to tell candidates news they don't want to hear, while coaching them on how to get better.
Mentoring is both a gift and a responsibility--a benefit and an essential part of any great service. It is intrinsically rewarding to the staff, candidate and administration without incurring any costs to the organization. When done effectively, mentoring will decrease turnover, especially in the first year, increase engagement, and foster long-lasting relationships.
I am grateful to my EMS mentors, named here. First and foremost is Randy Romadka, without whose tutelage I would have never succeeded. Patrick Small taught me all the stuff the books don't; Greg Padget helped guide me in a new system; and Mitch Brittain led me through critical care.
Patrick Pianezza, MHA, NREMT-P, is a consultant experienced with Studer, HCAHPS, Gallup and Press Ganey principles. Along with nearly a decade of experience in the prehospital arena, he has worked for Johns Hopkins Hospital and Studer Group. He is currently the manager of service excellence for San Joaquin Community Hospital in Bakersfield, CA. E-mail firstname.lastname@example.org.