Pictures of my boots

[strippel]

I'm not a blogger. And for those excited about looking at my boots, I apologize.

I am no longer a "student" as defined by a previous Dust reply, but I still have a lot of learning to do. I have been working as a paramedic for about one week now. I figure I can let the students know how I've been doing.

I am currently an apprentice. That means I am a second paramedic on the ambulance. There is a senior medic and an EMT also on the ambulance. I will be third person for a few more days. After that, it will be just a senior medic and me for a few weeks.

I have run about 25 ALS calls. Most pretty non-descript. Couple of generic chest pain, difficulty breathing, weakness, dizziness, etc. My two current downfalls are: 1) IVs. I did OK with them in school, and in the ER, but now my previous phlebotomy experience is hurting me. 2) The protocols that I knew, I now find myself not remembering. I knew the ALS protocols as a BLS provider. I am probably thinking too much and doubting myself.

I was told I needed to cut my on scene times. I would like to be faster, and more detail oriented. Considering all of my student time, I really had no critical patients.

That is where my boots come in. Last night was it. Shooting victim, robbery. Single wound to an artery. He bled out and was in PEA. Supervisor and I were hoping he had no activity, but... Called medical command, who of course said to bring him in.

So, one week as a medic, I had my first critical call. Patient transported to the Trauma center, where they cracked his chest, open heart massage, gave him blood, to no avail.

So, two hours late coming home from work, spent that time in the police station. All of us had our boots photographed. Mine are sitting outside, still with blood and barf on them. Luckily my new ones just arrived UPS.

So students, take advantage of everything you can. Do as much clinical time as possible, maybe even more. Don't over think, or obsess. Pick a "diagnosis", and treatment algorithm, and run with it. Keep on learning.

[mediccjh]

Strippel,

Sounds like you have RPS...Rookie Paramedic Syndrome. You will question yourself over and over again. You will not be comfortable for the first 2 years as a Paramedic. You will get into your own rhythm; it takes time to develop. Once you develop that, your scene times will go down. All in due time.

Be confident in your treatment, and don't be afraid to pick the brains of the elders. You will learn valuable information from them.

[Capman]

Strippel,

Congratulations on your advancement. Comfort level will come in time. do not expect it to arrive in your first week or month for that matter. Know your skills and be confident in them. I will share a little story about my first week as a paramedic where there was an incident when I doubted myself even though I was right.

I followed the advice of a 10 year veteran paramedic who misinterpreted a cardiac rhythm for PSVT even though I called it right as a Vtach. (as if they are even close) However, having held my paramedic license for about a week, I second guessed myself due to the intimidation of contradicting the call of a veteran paramedic who would not budge on the possibility that it was anything else other than PSVT. It was one of the largest mistakes of my career and came close to costing me a license, but it was a valuable learning experience that I am not ashamed to share with others; so that it will not happen to others.

The lesson here is about not second guessing yourself if you are confident in your skills. As soon as you doubt yourself, you open yourself up for this sort of incident.

We all know how it feels at the paramedic level when for years we were the ones who looked at the paramedics for the answers and to handle those difficult situations. Now all of the sudden we find ourselves on the receiving end of those inquisitive glances. It is somewhat intimidating, but it will wear off eventually.

Another last piece of advice I can offer you is if you run with basics, is to not sell them short of their capabilities. All too often I see this happen with various services and even within the service I work for. I will tell you that I would rather be with a good basic than with a mediocre paramedic. The point here is that from experience I will tell you that it is not too often I get overwhelmed by paramedic level care. Some of my most overwhelming situations have arisen out of situations that EMT basics are equipped to handle. So let them work and let them help you. Do not get wrapped up in one of those mentalities that acts like when you are with a basic, then you are alone. It couldn't be further from the truth. I would work with a good EMT basic any day.

So keep these few pieces of advise on your mind as well as the other advice others offer. I wish you the best of luck and welcome you as a new paramedic.