004: 10 Tips For Surviving Your First Year On The Job

So you've made it through your interview and have been offered the job.  Now it's time to get to work.  The first few months of any new job are the most crucial, and the most uncomfortable.  It's likely you'll have a lot to learn:  new people, new guidelines, new equipment...

Here are 10 Tips you can use to help you get off to a great start!

Tips Shared In This Episode

  • Tip 1 - Prepare to be uncomfortable and embrace it

  • Tip 2 - Don't Overload Your Schedule

  • Tip 3 - Focus on Being Part of the Team

  • Tip 4 - Stop Talking About Your Old Job

  • Tip 5 - Ask For Direction.  Be Specific

  • Tip 6 - Ask For Specific Feedback

  • Tip 7 - Don't Be Afraid to Say "I Don't Know"

  • Tip 8 - Use Deliberate Learning

  • Tip 9 - Focus on What You Do Best

  • Tip 10 - Have Fun


Quick Tip #1: Prepare to be uncomfortable and embrace it

You're moving up in your career and you may be expecting thing to just keep getting easier.  Well, that's not always the case.

Making the jump from the ambulance, or ER/ICU, to working with a critical care transport team can be quite the shock if you're not prepared for the change.

Think about all the change you'll have to learn to manage: possibly a new company, new coworkers, new guidelines, new work environment, new equipment, new uniforms (yes, wearing a helmet or flight suites does change the way you work), new skills... not to mention if you've moved to a new town (or state as I did) you'll be dealing with those changes too.

Most people don't like change, but if you expect it, then you can deal with the stress of it.

There's No Pain In Change.  There's Only Pain In Resisting Change - unknown


Quick Tip #2: Don't overload your schedule

We all do it.  In this industry we're all used to balancing multiple obligations.  How many EMS professionals do you know who don't have more than one job?

We're "doers."  That's who we are.

But when you start a new job, particularly a flight or critical transport job, I highly suggest you do what you can to take those other obligations off your plate.

If you can, put your other jobs on hold.

Don't plan any vacations during your orientation.

Don't try to get involved with special committees. Many companies won't allow you to be on a committee for at least a year anyway.

Don't worry about studying for your Flight Paramedic or Flight Nurse exam just yet.

Just focus on learning your new job.  Each program is different, so take this opportunity to learn as much as you can, get to know your new coworkers, and put your best foot forward and make a good impression.


Quick Tip #3: Focus on being part of the team

The first few days of your orientation are crucial, and this is where you're most at risk of damaging your reputation with your new coworkers.

You'll have a lot to do, and will probably feel overwhelmed but make sure you take time to get to know the people you'll be working with.  You're new coworkers may not have had a chance to meet you yet so during the first few days you're on the job they're forming their initial opinion of you.

Help, and Be Helpful

Don't just sit in a corner with your face in your orientation book.  Take some time to get to know the people you'll be working with, but tone it down a little.  Be interested and engaging, but be respectful and cautious.

It can take some time to get to know the individual personalities of your new coworkers.  Something you may perceive as innocent or funny may be inappropriate, offensive, or embarrassing to someone else.

It's much harder, maybe even impossible, to fix a damaged opinion someone may have about you than it is to avoid giving them a bad opinion in the first place.

Remember, you're "the new guy" so be nice, be respectful, and take time to get to know people.


Quick Tip #4: Don't keep talking about your old job

How many times have you heard someone say, 'At my old job we did it this way."

How quickly did it get annoying?

Remember, every team is different, and constantly talking about your old job just annoys your partners.

Yes, there's a lot of value in share knowledge.  Hell that's one reason I created FlightCrit, but there's a time and a place for it and when you first start with a new team isn't the time.

If there's something that you did at your previous job that you think would work well at your new job, WAIT a while before trying to make a change.


  • This gives you time to really learn the new company to see if your idea really would work

  • It gives you time to focus on learning your new role.  In the beginning you're sorta given a hall pass to learn.  Take advantage of it.

  • It gives you time to establish some credibility with your new coworkers.  This way you're more likely to get they Buy-In.

  • It gives you time to see your idea really is better than how your new team is currently operating.

Quick Tip #5: Ask for direction, and be specific

We all know the drill.  At the beginning of your orientation you'll meet with your training officer and your preceptor to discuss the orientation process and received your orientation binder outlining everything you'll be expected to complete in order to clear for independent duty.

Some training programs are great. Others..,.not so much.

The reality is it's up to you to take charge of your orientation and make sure you get from your training departing what you need to be successful.

If your program has a well designed orientation program with clearly defined objectives and goals, GREAT!

If not, you've got some work to do.

Make sure you understand exactly what is expected of you throughout the entire process and what specific objectives you need to accomplish by the end of your orientation period.

Have an open conversation with your preceptor, and if necessary request a meeting with the training officer.

But don't wait too long.  Making sure you have a clear understanding of your orientation should be your #1 priority the first day of orientation.

Develop Your Own Plan

Once you know what's expected of you it's important to develop a daily plan for your orientation.

Start by finding out how long your orientation process is and if you'll have specific exams to complete throughout the process.

Then, after reviewing your entire orientation manual, start making a schedule for yourself with specific and realistic, goals for each day.


Make sure each goal is specific enough so you know exactly what action you need to take that day.  Don't put on your calendar, "Study Protocols."  That's to vague.  Rather try something like, "Study RSI protocol including all adult and pediatric drug dosages."

Make sure each goal is realistic.  Don't put on your calendar, "Visit Cath Lab" if you're working a night shift since you can't be sure you'll be able to complete this task on your shift.

Its better to be conservative in your planning, and if you're able to get more done...BONUS!

To create your plan, try using a blank calendar and write in the goals you want to complete on the day's you'll be working.  You should also plan for study time when you're off duty.  Write this into your calendar too.

You can print a blank calendar off from a site like Print-A-Calendar or type it directly into an online calendar like Google Calendar.

Either way, make sure your calendar is in an online calendar somewhere so you can access it from any computer in case you lose your phone.

Another Tool

Here's another tool that I use everyday the helps keep me focused on what I need to get done each day.  It's called "One Big Thing".


Quick Tip #6 - Ask for specific feedback, and make sure you get it.

Make sure you're getting constructive feedback, positive or negative, from your preceptor after every call AND at the end of each shift.

One of the most dangerous situations a new employee can find themselves in is reaching the end of their orientation period and not have met the objectives necessary for independent duty.

This happened to me.

As I eleuded to in episode 1, my orientation for my first flight job was rough.  My preceptor, who by all accounts was a very good flight medic, was not a very good preceptor.

The feedback I received after each call, and at the end of each shift was vague and not specific.  I got feedback like, "Everything went fine" or "I don't have anything to add."

Then, when it came time for my bi-weekly progress meetings with the training officer my preceptor blindsided me with nothing but negative comments about my performance, providing few suggestions for what he wanted to see.

This was devastating for both my confidence and the confidence my team had in me.

If you're having a problem, you need to make sure you understand exactly where the problem is immediately and then develop your own SPECIFIC Plan of Action to correct the issue.

You must demonstrate to your team that you're working hard and making progress, otherwise its likely you won't make it off orientation.

So how can you avoid this type of problem? My suggestion is to conduct a post mission debrief that's written down providing a brief description of the call, the learning objectives for the call, comments about your performance (both positive and negative), and ways to improve.

Keep a running log of each mission debrief.

Then, at the end of the day, sit down with your preceptor to review each mission, discuss what your learning objectives were for the day and how you feel you did, and make sure you're preceptor gives you useful feedback that you can use on your next shift.


Quick Tip #7: Don't be afraid to say "I Don't Know"

This is a new job and you're not expected to know everything.

Don't be afraid to say "I Don't Know" and whatever you do,  Don't try to Fake It.

Remember, you're working with a team of professionals.  If you don't know something and you try to fake your way through a procedure or through a call you're team members will call you out and nail you to the floor.

Not only will you have missed out on a learning opportunity, but you're also likely to lose credibility with your team members and will likely have a difficulty time regaining their trust.

Quick Tip #8 - Use Deliberate Learning

Avoid performing and learning at the same time.

What I mean by this is when you're on a call that's the time you're expected to perform without making mistakes.  That's not the time to be learning how to set up the ventilator, hang a new pressor, or perform a surgical cric.

Yes, this how we've become accustomed to learning the skills of EMS and Critical Care, but if at all possible, try to avoid learning when you're expected to be performing and you'll find you'll improve much faster.

Below is a TED Talk that explores this exact concept.




Practices Until Until You Can't Do It Wrong


Quick Tip #9: Focus on what you do best

When you were hired it was because of the skills you demonstrated as a paramedic or a nurse.

But as a transport professional, you're expected to be proficient in both roles and it's easy to become distracted by all the new information and skills you're expected to learn.

In the beginning, focus on learning to apply the skills and knowledge you already have as a paramedic or nurse to your new role in the transport world.

The medicine is pretty much the same, it's the way you apply your experience and the environment you're doing it in that changes the most.

If you're a paramedic, don't get overwhelmed with learning the Critical Care side of the job.

If you're a nurse, the same goes for you.  Don't get overwhelmed with trying to learn scene management, initial stabilization, airway management, etc...all the stuff the paramedics excel at.

That's why most programs pair you with an experienced partner who will complement your skills.

The rest of it will come with Deliberate Learning when you're between calls.

By initially focusing energy on learning to apply the skills and knowledge you already have to this new environment, you'll make a strong first impression and settle into your new position much faster.


Quick Tip #10: Have fun.

Yes, this job is challenging and will really test your abilities as a clinician, but the people you'll be working with are some of the best around.

Learn from them, but also learn about them.

People have lives outside of work.  They have families, hobbies, interests, and problems that share who they are.

Take the time to discover their "other side."

Getting to know a little bit more about the people you work with can have a profound effect on your working relationship and make the job so much more enjoyable.

I hope you enjoy the show.

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Until next time remember...

"Education is good, but excellence through collaboration is so much better!"

Fly Safe, and Live Well!