The First Day I Put Down the Monitor and Picked Up the Chart

Orlando Rivera
Nov 8
2 min read

(A story for every paramedic who’s ever been underestimated)

My very first day as a cath lab nurse, I walked in wearing scrubs that still smelled like the back of an ambulance. I wasn’t green. I wasn’t new to medicine. But I was new to the title.

I had thousands of runs under my belt as a paramedic. I’d held hearts in my hands, worked codes in ditches, and delivered babies in parking lots. But in that room, in that sterile, fluorescent room full of badges and degrees, none of that seemed to matter.

I introduced myself as the new nurse.

And I could feel it.

The glance.

The pause.

The unspoken: “Oh, he’s just a medic.”

They didn’t see the 4am calls or the patients I carried in my arms through muddy fields.

They didn’t see the years of trusting my gut when there was no protocol.

They didn’t see the trauma, the loss, the street wisdom you can’t learn from a lecture.

That first week, I got grilled on charting. Questioned on drips. Side-eyed on handoffs.

But I also caught a missed STEMI in pre-op. Anticipated a tamponade before the pressure dropped. And when a patient crashed on the table, I didn’t flinch. I didn’t freeze.

I led the resus.

Because muscle memory doesn’t care what your badge says. And instinct doesn’t need permission.

Little by little, the same people who doubted me started asking me questions.

Asking for my help.

Asking if I could teach them how I knew.

They didn’t realize they were speaking to someone who’d learned to hear a PE in a cough, smell DKA before the glucose came back, and spot a dying patient from the doorway because he’d had to.

That’s what paramedics do. We have to.

Now, years later, I’ve contributed protocols. Taught teams. Helped build bridges between prehospital and inpatient care.

But I never forgot that first day.

And I never forgot the look.

So if you’re a medic walking into a new world, nursing, leadership, the OR, wherever,

And you feel that glance?

Stand taller.

You’ve done more in the back of a rig than some have done in a whole rotation.

You don’t need to prove yourself.

You’ve already been proven by fire, sirens, and sacrifice.

And one day, they won’t just respect you.

They’ll need you.