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Job application anxiety and disappointment
January 22, 2014 12:16 PM   Subscribe

At the beginning of this year I finished my courses and exams to become an emergency medical technician. I finally have the certification I that allows me to work in the field, but I’m fighting against paralyzing anxiety that’s making it hard to apply for jobs. This is something that I've struggled with the past, but the stakes feel a lot higher this time and I’m looking for advice on how to proceed.

The last time I asked Metafilter about this I received a lot of good advice that proved successful in getting me a low-stakes job slinging coffee, but I feel like this situation is different enough that it warrants a new question. Whereas previously I was struggling with applying to any job at all, right now I feel like I'm dealing with the shame and fear of disappointing the people close to me if I don’t succeed in my chosen field.

I get into these terrible cycles where when I feel the pressure of high expectations I just shut down, afraid of failure. This repeated over and over again starting in middle school and continuing until I had to leave university, unable to complete my coursework due to severe depression and anxiety. I felt like I was stuck in a loop where the teacher would identify me as a "smart" or "gifted" student (descriptions I've grown to hate) because of my high test scores or class participation and expect more of me than the others in my classes. This would have the opposite effect because I’d stop submitting work or going to class for fear of disappointing them.

As cheesy as it sounds, getting that low-wage, low-stress coffee job and being able to do really well at it gave me back some self-esteem and willpower, and motivated me to get back into school. I decided that EMS would be a good path for me because it involved a combination of hands-on skills, a good amount of book knowledge, and the opportunity to help people in my community. I enrolled in a program at a technical college and for the first time in my life I consistently did really well in my classes.

My academic adviser, a multi-decade veteran of EMS, took me under her wing and generously mentored me. I was given the opportunity to take the lead on scenarios, attend conferences, and generally just be a kick-ass student without reservations for the first time ever. She often talked to me about how she expected me to become a leader and improve the whole field of EMS, but instead of being overwhelmed by my anxiety I actually felt up to the task for once.

Then it came time for the national certification exams, I totally rocked my practical hands-on portion of the test. The written portion of the test was delayed for several weeks due to issues with the testing site and moving back to my hometown with my SO. When I finally took it I was convinced I had failed. I felt like total crap for the 3 or 4 days it took to receive the results and learn that I had passed.

Even though I received my certification, I don't feel like I deserve it because I feel like I was just lucky with my guesses instead of actually knowing the curriculum. This has caused all sorts of other concerns to bubble to the surface:

1) During my required clinical time I only really experienced one true emergency call and the adrenaline turned me into a useless idiot. I'm great at scenarios, but I'm afraid I'm not up to the task of dealing with the real thing.

2) The culture of EMS, as least what I saw of it, was super macho. More than one paramedic during my clinicals commented that I seemed "too smart" to be in EMS. Do I really want to work in an atmosphere where people are shamed for that?

3) One of my EMS instructors promised to help me find to find a job with a certain organization I had my heart set on, but now it seems like they are only hiring people with a higher level of certification that I don't have and won't be able to get without months of additional school. I’m disappointing her by not being able to take advantage of her help.

4) I’m worried that while I'm unemployed I'm losing everything I learned, and when it comes time to put it to use I’ll be putting someone's life at risk.

Finally, and most importantly, my parents and my SO have been counting on me to get this job. I've moved back in with my parents until I save up enough money to once again get my own place. They've been incredible generous by letting me stay in their house and I feel like a burden on my loved ones.

Sorry this has been so long. I guess I need some impartial third-party advice as to what I should do. Should I just find another crappy job in the mean time to take the pressure off? Should I go back to school to get a higher EMS certification or even my bachelor's? Do push through and get the EMS job I've been aiming for. Something else? Any input is well appreciated.
posted by arcolz to Health & Fitness (11 answers total) 10 users marked this as a favorite
 
Try and find a job that makes use of your EMS certification, or give up on the idea of working in that field. Those are your choices.

Asking your EMS instructor for the help that she promised you moves you towards the first category.
Getting that higher EMS certification moves you towards the first category.
Doing nothing and waiting for magic career advancement to happen moves you towards the second category.
posted by oceanjesse at 12:27 PM on January 22


Should I go back to school to get a higher EMS certification or even my bachelor's?

You do the thing that gets you the job you want. If your parents are letting you stay contingent on the fact that you get the job, and you need the higher certification to get the job, you've got your work cut out for you. You haven't disappointed anyone yet. Assuming your EMS instructor knew what level of certification you had at the time she promised to help you, the mistake was hers, not yours.

A crappy job in the mean time is just going to take away time and effort you can put toward taking advantage of the opportunity you're getting from your parents and going to school to get the other certification you need. Unless by "crappy job" you mean a different EMS (or related) job, in which case it would probably be a good idea to get some practical experience in before taking on more schooling.

If you're worried about losing what you learned, then study, practice and stay sharp on your own. It's your responsibility to make sure you're up to the task at hand, so you need to take the initiative. Wherever you see a problem, figure out a solution, or go talk to someone (like your adviser) who understands the problem and can help you come up with a solution. You have to take that first step, though and I know that anxiety makes it hard and you can't see anything but the shittiest resolution to your actions, but the more you do stuff, the more you discover that the worst case scenario is probably not what is going to happen. Pushing through anxiety is a virtuous circle.

As far as the culture and pressure? You're the only one who can decide if you can make it work for you. Try to get some practical experience sooner than later, and you'll find your answer. If that means you absolutely have to take a few more months of school, then that's what you have to do.
posted by griphus at 12:43 PM on January 22


1. You don't have much experience. It's common for people training for medical professions to have not so useful reactions to certain situations the first few times.

2. I don't know, do you? Are you sure you were being shamed, or was the paramedic just surprised? Do people ever feel you are too smart to sling coffee, even if they aren't saying it to your face?

3. Ask her if she can help. If she can't, you'll either need to go back to school, not have your heart so set on working at a specific place, or give up on working in that field.

4. Like oceanjesse said.

FWIW, everyone I know who has taken EMT classes is pretty smart. To actually get certified as a paramedic seems to take a certain amount of smart.

Just because other people have labeled you as having the capability of doing intellectual work of a certain level doesn't mean you have to do that. You have the capability of doing something else instead, it's your life. Worry more about disappointing yourself and less about disappointing other people.
posted by yohko at 12:51 PM on January 22


I also trained to be an EMT-B many years ago. Here are my thoughts about your questions:

Even though I received my certification, I don't feel like I deserve it because I feel like I was just lucky with my guesses instead of actually knowing the curriculum. It is highly unlikely that you could pass the test just being "lucky." You know stuff, but you don't know everything. That's OK. You'll learn a lot and re-learn a lot by working. The test is designed to weed out people who are clueless. You're not clueless, so you're in good shape.

1) During my required clinical time I only really experienced one true emergency call and the adrenaline turned me into a useless idiot. I'm great at scenarios, but I'm afraid I'm not up to the task of dealing with the real thing.
This is all about exposure and practice - the more emergencies you deal with, the easier it will get. And I doubt your instructors would think so highly of you if you actually turned into a useless idiot.

2) The culture of EMS, as least what I saw of it, was super macho. More than one paramedic during my clinicals commented that I seemed "too smart" to be in EMS. Do I really want to work in an atmosphere where people are shamed for that? The "macho" thing is pretty accurate in my experience, but shaming for being smart wasn't something I experienced. Some people are going to be jerks wherever you work, but by and large if you can do the work, you get respect.

3) One of my EMS instructors promised to help me find to find a job with a certain organization I had my heart set on, but now it seems like they are only hiring people with a higher level of certification that I don't have and won't be able to get without months of additional school. I’m disappointing her by not being able to take advantage of her help.
You can totally take advantage of her help. Just because they don't have a posting on their website for your level doesn't mean they can't hire you. It may be as simple as the instructor putting in a good word for you with the hiring manager, and POOF, a position appears.

4) I’m worried that while I'm unemployed I'm losing everything I learned, and when it comes time to put it to use I’ll be putting someone's life at risk. There's lots of training and re-training in EMS, and you won't be allowed to make decisions independently without being determined to be competent.

I think you should take this one step at a time. Step 1: Get a job in this field, using your connections and leveraging the goodwill of your instructors. Call/email the instructor who offered to help you and let her know that you would love to work at X, but they only have Y jobs posted right now and does she have any advice on how to proceed?

Step 2: Once you get the job, learn how to do your job. Ask questions. You're a rookie, so don't expect yourself to know everything - you won't.

Steps 3, 4, 5: Decide whether you like the job itself, the culture of EMS and what you would like to do next (become a paramedic? go to PA school? get a disaster management certification?)
posted by jeoc at 12:53 PM on January 22 [1 favorite]


A middle ground might be doing some volunteer EMS work while working a crappy job and/or completing your advance training. Or trying to find a crappy job in a place that puts you in contact with EMS services (hospital ER, 911 dispatcher, etc). I would talk to your mentor about your questions and concerns and ask if she has a recommendation for a volunteer opportunity that would give you a chance to be exposed to the EMS culture, stay sharp and get some more true emergency experiance.
posted by macfly at 1:09 PM on January 22


I did an EMT-1 and I WAS useless at first. They will have you shadow someone, or someone will "precept you". Then you'll get it, then you'll be fine.

Trust the system. Trust the system.

Apply for positions, have your instructor be a reference, and ask about their training program/period.

Just do it.

It's the only way it gets done.
posted by Ruthless Bunny at 1:22 PM on January 22 [1 favorite]


I don't have direct experience, but I have a customer which is an ambulance company and I've absorbed a certain amount of shop talk. It's a very certification-driven field, obviously. One things that comes to mind is branching out from only 1 mentor or a small number of mentors or whatever you're dealing with now and going out and talking to the agencies or private ambulance companies you're interested in working for. Get more data points about what certifications you need to have a realistic shot at a job. In my state there's work for the minimally certified individuals - they have to be paired with more highly certified people, but there's a place for them (since they get paid less).

If you've been in only 1 real emergency situation, I wouldn't worry about your reactions and nerves. I can't imagine NOT being nervous in that situation. A good organization should keep you teamed up with more senior people at first.

I don't know about fire departments and the like, but the private companies I've worked with don't seem to have an excessively macho culture at all. A lot of male and female paramedics, and a lot of different personalities. I've been picked up off the side of the road after a motorcycle accident by very competent paramedics and I've seen good paramedics save my Dad's life after a surgical wound came unsewn when he was home. Please don't give up on the field because people are telling you you're "too smart." We need more smart paramedics, not dumb ones!
posted by randomkeystrike at 1:26 PM on January 22


Paramedic here, and one who understands entirely about anxiety and kicking yourself in the teeth so you don't have to fail. Get some therapy for your anxiety, because it seems to be the only thing holding you back from an awesome career.

First, let me say that I'm so happy you had a good experience learning to become an EMT. I wish I had been forward-thinking enough to attend conferences when I was just a basic! That feeling of "wow, I'm up to the task!"? Remember that, and hold onto it. You will get there many, many times over the course of your career, and it's an awesome feeling.

I'm going to touch on your concrete concerns for right now, although please absolutely feel free to MeMail me if you want to talk shop, talk about the anxiety front, or talk out protocol issues and clinical standards and future directions of EMS. Seriously, MeMail me. I like talking about my job.

1) This is fixable. The only fix, however, is experience. Everyone starts out rough, and if they say otherwise, they are lying. You only had one emergent call. One. Things will get smoother when you are running one (or more!) per shift. Give yourself at least a year before you start worrying that you can't handle emergency situations. Besides, working as a student/ridealong is a very different experience from working as a provider, especially if you have set partners and can really get into a rhythm with your partner. Get yourself some experience. Every EMS-related job helps. ER tech, transport EMS, volunteer EMS, amusement park or casino security/EMS, hospital-based 911 EMS, big-city civil-service EMS. Find a gig somewhere. Desensitize yourself to the adrenaline.

2) The culture of EMS is not universally super macho. It is, however, often filled with gallows humor, self-deprecating banter, and some unfortunate burnout. People don't give out compliments unless they are a little backhanded like that. But take it as the compliment it is anyway. The appropriate response to "You're too smart to be in EMS" is "Ahaha, well, I guess that's marginally better than being too dumb to be in EMS. But really, tell me more about (xyz phenomenon that we saw on a call today)?" Or whatever you can come up with that is light-hearted and redirects the conversation to things that are interesting and useful. Don't let the grumpy medics get to you. Find the inspiring ones instead.

3) a) Have you reached out to this instructor recently and told her 'hey, it looks like Awesome Station isn't hiring basics from their website, what should I do?'? Let her make some contacts within the organization and have her tell you if there's absolutely no hope for you to get a job with them just now. Let her give you some contingency plans. You're not "disappointing her" because there are no jobs available. You're not in control of Awesome Station's open positions. How could that possibly be your fault? That's the anxiety talking again, which is bollocks. Seek therapy/treatment.

b) Don't get your heart set on organizations so early in this business. Many people have to "pay their dues" before they get to work 911 EMS, whether that means volunteering at night while they work their crappy day job or working dialysis-to-home transport runs, until they have enough networking and experience under their belt to move up. You are in an excellent position with a mentor who wants to help you. Work hard to do what she tells you, but if you don't get into the organization in the first go-around, pay your dues, never stop studying, and try again.

4) a) Find some websites to help you practice your book knowledge. Study your protocols. Study your textbook. As far as the practical stuff goes, ask your mentor. Maybe you can help out with upcoming classes on their skills days, or maybe you can get a CPR instructor cert and teach some CPR classes in local schools. Maybe she can set you up with ridealongs in local organizations, beyond the clinical hours you were mandated to do.

b) Don't frame things in your head about you being inadequate and injuring patients. You don't get thrown into the wilderness on this job. If you mess up, someone will help catch you and teach you. You are not the only person on an ambulance, and there are few things an EMT can do to severely endanger a patient. You know what those things are, because your textbook covered them, and you knew that material well enough to pass your class. Again, this is the anxiety talking.

5) Your parents and SO have not been counting on you to get This Job. They have been counting on you to get A Job. Find a transport company and work there for a few months so you can get some money in your bank account and so you can learn about the physicality of moving patients. Work a crappy dead-end day job and volunteer on the weekends and nights so you can network and get some experience for your resume. Walk into ERs, ask to talk to the nursing supervisors about ER tech jobs. Of course you should be proactive about getting your dream job, because you deserve it! But don't be proactively nervous about getting or not getting your dream job. You will get there!

A word of warning. Do not go back to school to become a paramedic or an EMT-I before you have some 911 EMS experience under your belt. Good EMTs make good paramedics. It's very hard to get a 911 medic job without having worked as a 911 EMT. So focus your efforts on getting your brain in a healthy frame of mind and getting that 911 gig, through whatever means you need to make it happen.
posted by skyl1n3 at 3:24 PM on January 22 [6 favorites]


1) During my required clinical time I only really experienced one true emergency call and the adrenaline turned me into a useless idiot. I'm great at scenarios, but I'm afraid I'm not up to the task of dealing with the real thing.

You've got to have realistic expectations for yourself - what normal person wouldn't have a surge of adrenaline in an emergency? How can a person who's never done something before be great at it the first time they try it? I would worry about you more if you were in an emergency and felt like you knew everything and it was no big deal - to me, that would be a huge red flag you were overconfident and might do something dangerous. What's BETTER, and normal, is to question things at first, to know your own limits, to always ask when you're not sure about something or you don't understand why something is the way it is. That is how you can safely gain experience in patient care and become a great medic.

You might also be overhyping this job a bit. Although a good and experienced EMT has the potential to handle a case a lot better (and a medic obviously has many other skills and capabilities), a lot of it is just transport, transport, transport as fast as you can to get the person to a higher level of care. In a lot of rural areas of this country, high school students serve as volunteer EMTs.

In any case, the docs who you bring the patients to/your medical director will certainly appreciate you being smart!!
posted by treehorn+bunny at 5:39 PM on January 22


This is a perfect situation for you to volunteer in a large ED. You will be supervised and not allowed to do some things, but you will learn a lot from real- world scenarios and that is confidence building. There is no learning that can replace experience and this is a quick and easy way to get it. In the meantime, if not possible to get any job without the higher qualification, then do it. You will be fine. Don't worry so much about what others say-macho or otherwise unless they are your superiors giving you guidance and orders. Even if the macho thing were true-so what? Try to concentrate on what you are doing. You will have an opportunity to do a lot as a volunteer in an ED and focus on patients rather than your own fears.
posted by claptrap at 1:44 AM on January 23


I don't know anything about EMS, but it's worth remembering ('cause I'm sure you know this - everyone knows this, it's just so hard to put into practice): the only person whose feelings you are responsible for managing is you.

Your parents' feelings are not your responsibility.

Your advisors' feelings are not your responsibility.

Your SO's feelings are not your responsibility.

I'm not talking about things you do directly to them (which, sure, could hurt their feelings) - I'm talking about how they feel about the choices you make.

If (and it's a big if, because it sounds like you've got a lot of anxiety talking here) all of these people do wind up feeling disappointed by whatever you do or don't do (or if they're already disappointed in you), those feelings are their problem and their responsibility to deal with. Not yours.

And if you can learn to live your life in a way that doesn't involve undue worrying about how the people you care about are going to feel about the choices you make, you'll almost certainly be happier and less anxious.
posted by terretu at 5:20 AM on January 23 [1 favorite]


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