From Paramedic to ER PA-C: Maurice ‘Moe’ Paquette скачать в хорошем качестве

From Paramedic to ER PA-C: Maurice ‘Moe’ Paquette

In this episode I sit down with Maurice “Moe” Paquette, PA-C — an emergency medicine physician associate in New Hampshire and long-time deputy fire chief and paramedic just outside the state capital. With over 32 years in the fire service and EMS, Moe has lived through the evolution from “EMT- D-Fib” and LifePak paddles to 12-leads, MIH, and mid-levels running the department alongside attending physicians. Moe shares the story behind his legendary “greatest code save” at Mass General — the one where a whole room of residents and attendings missed V-fib, and the paramedic with the paddles didn’t. We talk about growing up in a fire family, failing the firefighter physical, finding his lane through EMS, becoming a PA, the changing culture of “chew up your young,” dark humor, mental health, and what it really means to walk out of the ED, take that first breath of cool air, and know you did good work. What we cover Moe’s “greatest code save” at Mass General and shocking V-fib in front of a full team How “Big Daddy” Paquette got his nickname and what it means to still hear it 25+ years later Growing up in a firehouse family, baby pictures in turnout gear, and the Explorer program Dropping out of pre-med, realizing college wasn’t it, and finding purpose in EMS The EMT-Defib era: LifePak 5, paddles, rhythm strips, and AEDs before AEDs were normal Early paramedic school: old-school ACLS, stacks of algorithms, and minimal 12-lead training The Rockingham / P2 culture of swagger — and why some of it was actually earned Fire vs EMS identity: failing the agility test, living vicariously, and eventually becoming deputy chief The difference between “chewing up your young” and actually mentoring the next generation Transitioning from paramedic to PA and why “physician associate” is more accurate than “assistant” Scope, collaboration, liability, and why Moe doesn’t want doctor money or doctor stress The case for PAs and physicians in fly cars, EMS-based wound care, and MIH-style models Why licensing silos (medicine, EMS, nursing) make innovation so hard in prehospital care Being a “master’s-level paramedic” and how that changes how you see field work and the ED Dark humor, dissociation, therapy, and admitting you didn’t get into this “to save people” — you got into it because you’re good at it That first breath walking out of the hospital at the end of a heavy shift What Moe wishes nurses would do more of, and how nurses and providers can communicate better on plan and priorities Chapters 01:35 Intro & guest welcome 02:28 “Big Daddy” Paquette — the origin of the nickname 04:12 Firehouse childhood, Explorer program & early pull toward EMS 06:21 Pre-med, college, and dropping out 07:50 EMT-Defib days, LifePak 5 & learning paddles 09:27 Working without 12-leads & adapting to new tech 11:36 Rockingham, P2, and the era of medic swagger 14:54 Fire vs EMS identity & the agility test reality check 16:25 Moving, weight loss surgery & path to deputy fire chief 18:44 Finding belonging in the fire/EMS family 21:23 Generational culture shift & “chew up your young” 24:42 Old-school paramedic education vs modern online classes 27:19 Students not testing, remote learning & lost accountability 31:05 Becoming a PA and the shift from “assistant” to “associate” 34:05 Name change politics, New Hampshire law & collaboration 38:21 Scope, pay, responsibility & why Moe still calls himself a medic 43:16 PAs in fly cars, home suturing & reducing ED load 48:29 Community paramedicine, masters-level medics & system barriers 53:07 Why the healthcare system isn’t working — and why we won’t fix it in our lifetime 57:21 Dark humor, dissociation & years of therapy 1:02:46 That first breath walking out of the ED after a heavy shift 1:06:59 Nurse–provider communication, plans of care & expectations 1:12:15 Intimidating vs having standards, and being approachable 1:13:36 Closing thoughts, social media avoidance & John’s content journey Guest Maurice “Moe” Paquette, PA-C Emergency Medicine Physician Associate – Southern New Hampshire Deputy Fire Chief & Paramedic 32 years in healthcare Host Paramedic To RN | John Smith TikTok: @paramedic.to.rn YouTube: @ParamedicToRN25 Spotify: Last Known Vitals Business/Booking: [email protected] Music Credit “El Camino Dreamin” — Jonny O’Brien Spotify: Jonny O’Brien Disclaimers This episode reflects the guests’ and host’s experiences and opinions only. Follow your local laws, medical director, and protocols. No patient-identifying information is shared; HIPAA maintained.