Anybody else start with the "deer in the headlights&quo

[Emilea PA C]

I started my EMT-B training class last Tuesday, finally! And, I thought that I was going to be OK! The book made me queisy (sp?) and while I was poking around EMT city reading all the posts and scenerios I just keep saying to myself, "Am I ever going to be able to cut it?"

While I am an excellent student, and I want to become a physician's assistant, I just can't hack that "am I good enough" feeling.

Anybody else feel this way? How did you overcome it? For those of you in PA, did you feel that the course prepared you to go to the field? FWIW, I plan on trying to get in with the local rural EMS so I doubt that I will be seeing too many GSW's or crazy stuff...mostly drug OD's, SOB's, cardiac, MVA's, etc.

[Ridryder 911]

The queasy feeling might be just short term, and a lot of the time it passes with exposure and deeper education, sometimes it does not though. But I am concerned if the "book" and some basic scenarios over whelms you. P.A. is much definitely much harder and although, the likelihood of "gore" is potentially there, there is much more you will exposed to... pelvics, rectal abscesses comes in to mine that I see P.A.'s get to take care of.. usually whatever the physician does not want to deal with.

Definitely not trying to discourage you by any means but have you completed your cadaver anatomy, or some other basic sciences yet? As well, do you fully understand the general role of the P.A., especially in the emergency department?

Have you discussed the career with an active P.A. as well ? I would suggest doing so before going any deeper into studies.

I wish you the best of luck,

R/r 911

[Michael]

Perhaps this thread will speak to your condition.

[Thunderchild145]

Eh. Right now I'm in the "Please God don't let me kill anyone" phase of my paramedic clinicals, so yea. I feel ya.

[DwayneEMTP]

Emilea PA C,

I feel your pain! I was part way through my Basic class when it hit me...Nothing makes sense! My instructor told me to wait...it would all line up in time...and it did.

There were some things I felt were covered well, and in those situations it really isn't about me, but what I learned and how much I practiced it.

If I need to hold c-spine, do CPR etc...I know it will be there when I need it...and my instructor also reminded me that EMS is a team sport...you aren't likely to have much responsibility until you're ready. (I'm in school, not working so I could be way wrong...but others will fix it if I am)

But understand you WILL NOT learn all you need to know in Basic class. You are responsible for filling in the gaps...if you don't see them (the gaps), ask here and many people much smarter than I will point you in the right direction.

Now that I have a few semester of biology and am a ways into anatomy and physiology I feel dumber than ever!!! But take heart....some people I really respect here promise me that if I study hard, and honestly, and practice till I want to puke that everything will line up one day...and "it will be a beautiful thing".

Keep your chin up...practice till you puke...It will work out for you too!

(By the way...I am not an excellent student...So I bet you'll do great)

Dwayne

[Ridryder 911]

I remember when I was in Paramedic school, feeling overwhelmed. My professor informed us... "You should feel like I am feeding you knowledge through an NG tube in your brain"... if you don't feel overwhelmed, then I am not doing my job!..he was right.. as well as he described the light will turn on ... it will make sense!... No one knows when or where... but suddenly, when you have about given up hope..... it clicks... things begin to make sense!... Of course, you are excited and want everyone else to know... of course, they hopefully have been through it too.

So yes, you will feel overwhelmed... it is normal. Yes, the more you learn, the least intelligent ones feels. I know I do.. I have been a medic for nearly 30 years, and a RN for 17.. and now realizing if I write a prescript.. and someone dies, or I misread or miss something on an x-ray..and was not referred to surgery....it's my fault.. now that's scary!...So yes, the more you know, the more you realize, you need to know more.....

R/r 911

[AnatomyChick]

My Paramedic Instructor told us on the first day of class that we were all sponges and would be "soaking up" tons of information, but he also encouraged us to "wring out the sponge" every now and then... I found that I did most of the "wringing" on test day !

If this career line is the right thing for you, then yes... it will all come together for you in the end... Some of my very best and brightest students didn't really "get it all" until the very end, when everything all of the sudden made COMPLETE sense. Some of the students who struggled the most ended up being the greatest EMT's.

The best advice I can give you is to study, get involved in hands on as soon as possible (don't stand back and be a wall flower) and ask questions.. if you're embarrased to ask them in class, then pose them here... Good Luck, and let us know if there is anything else we can help you with.

[Emilea PA C]

Thanks guys and gals!

I'm still in my undergrad as far as PA goes, but I have shadowed more hours than most (my mom is an RN in the local ER, so I have an "in").

I have completed A & P, gen bio, gen chem, o chem, botany, genetics, etc. I did just fine in all of those classes!

It just seems that as I read through the scenerios on this board, everyone seems to know the right answer, and yes, it's overwhelming! I must keep in mind that so far we've only gone over the first three chapters in the book, so I'm not equipped even with the most basic knowledge to apply in these situations!

What hit me the hardest is the realization that yes, my actions in the field do, and will, mean something to somebody! It's not the classroom anymore; my eraser is gone!

[rocket]

Good on ya for wanting to get some true patient care experience prior to embarking on your PA certification training. 8)

IMHO the primary reason new EMTs/students freeze up in a situation is not because they cannot handle the situation. If they couldn't hack it they wouldn't have climbed into the back of the ambulance in the first place.

That leaves us with uncertainty and gravity. The provider is aware of the gravity of the situation and therefore wants to be absolutely certain they are doing not only the right thing for their patient but also doing it the right way. This is a good sign; it means the provider has the best interest of their patient in mind. Better to realize how dire things are than to be oblivious to the nature of the situation....for the sake of not only your patient but also yourself.

Here are a few tips that I have found to help bridge the gap between book learnin' and the actual blood-and-guts stuff:

(1) Coursework is solitary stuff. So is testing. Unlike your coursework, you will not be alone when 'tested' in the field. More often than not you will have the counsel and help of your crew and other EMS, etc. This is a truly invaluable resource.

(2) It is very infrequent that you actually see a complete breakdown of provider activity in the midst of the call. While you might be beating yourself up inside for not thinking to do something 'fast enough' chances are others on the scene never picked up on what feels like an eternity of inactivity to you. Chances also are that a moment's pause for thought won't break the flow of care being delivered to the patient nor will it affect the patient's outcome.

(3) This is not a hard and fast rule but it can be appropriate for getting your head around a lot of the basic stuff: The patient will (either by word or presentation) often "guide" you in the direction of doing the right thing, just like strangers, friends, and loved ones do. If I said I was hungry you would feed me. If I said I was thirsty you'd give me something to drink. If I was cold you would cover me up. If I was hot you would cool me down. If I were bleeding you would stop the bleeding. If I was having trouble breathing you would help me to breathe. The message is that you will probably have a pretty good idea of what needs to be done as soon as you recognize what is wrong with the patient.

Hope that helps suppress your anxieties a bit. I have a feeling that many of them will go away even more once you get out ther e and find yourself doing it. Wanting to always do what is best for your patient is a "good problem to have". :wink:

Good Luck!

-Trevor

[scrappy]

I always told the new EMT's I trained in the field that it was perfectly ok to stop, take a breath, let silence reign for a little bit to get their thoughts in order. Not only that, but if they forgot where they were in the questions/history taking, repeating a question was a good idea, since sometimes the patient would give more or better info, and it gives you time to get the rest of your thoughts in order. Plus, even as an EMT with almost 10 years experience, I have often turned to my partner to ask for a double check on a BP or pulse or something. Your partners and training officers are tehre to help you when you start in the field. They aren't going to leave you out to dry, because it's as much their butt on line as it is yours.

As for the feeling queasy bit, when i first flipped through my EMT book and saw the pictures in the back, I readily admit my stomach flipped several times. When I would watch 'Operation' on TLC and they made that first incision, my stomach thought it was on a trampoline. However, I watched my grandmother's knee replacement surgery (including the first incision) and had no problems, and I have been on calls where things were much worse than a first incision and not had a problem, so I wouldn't put too much stock in that.