Clinical/Field Advice

[Ecnalubma08]

Being hott helps.

I've never flunked a hott chick.

You remind me of Hawkeye Peirce Dust! ha! :wink:

[Mateo_1387]

I remembered something else. My memory was triggered from another post.

ALWAYS ALWAYS ALWAYS make sure to have copies of your clinical packet !

This is why...

[jmp6753]

As a preceptor, I always tell my students to ask lots of questions. Also one of the things that I attempt to do is to review the call before going back into service. That way it is still fresh in your mind. Talk to the Dr after they have done their assessment, get their impression and and explain what led you to your impression.

As far as patient care goes, give every patient an IV, Oxygen, EKG and a Blood glucose. If you do these 4 things on every patient you can almost never go wrong.

Good luck!

[nsmedic393]

Get to know your preceptor(s) if you ride with them for multiple shifts. First impressions are really important. You will want to be a team player as much as you can. Your goal is for them to view you as a partner rather than a student (although you will always be "the student"). To get to this point make sure you know what you are doing, and always work for improvement.

I suggest when you first get on shift make sure to introduce yourself to the crew you will be riding with, and try to have a positive attitude. Talk to them early about how things will work on the ambulance so that you are not figuring it out on a call. They will probably ask how comfortable you are with patients and etc. Be ready to make mistakes but be strong enough to work through them and improve.

I completely agree....

First impressions are very important. Make sure your uniform is clean and tidy, you have all the necessary equipment and paperwork you will need for the shift as a student. Come in with a positive and open attitude and make sure it is clear to them through your words and actions that you are there to learn. I know personally as a preceptor i like it when a student has the attitude that they are there to learn as much from me as they can...

I have had students with the "know it all" attitude and if it doesn't change in a hurry than i usually tell them that if they know it all there is nothing more i can teach them, and say goodbye.

As a preceptor, I always tell my students to ask lots of questions. Also one of the things that I attempt to do is to review the call before going back into service. That way it is still fresh in your mind. Talk to the Dr after they have done their assessment, get their impression and and explain what led you to your impression.

Reviewing the calls with your preceptors is also a great way to learn and build your preceptors confidence in you. Be prepared to explain not only what you did, but exactly why you did it. "because it is the protocol" is not a acceptable answer...we are talking A&P and pathophysiology here...

As far as patient care goes, give every patient an IV, Oxygen, EKG and a Blood glucose. If you do these 4 things on every patient you can almost never go wrong.

Im sorry...but im gonna have to disagree here...

Not every patient you see is going to need all of these treatments...EKG and BGL are pretty standard on every call but not necessarily a priority. I would be more impressed by a student that was able to evaluate a patient and decide on a appropriate treatment plan based on what this patient actually needs than one who is just running down a predetermined list of things to do...

And lastly...the advice i give to every student and all paramedics in general.

Everyone makes mistakes...What makes a great paramedic is that when you do make a mistake, you own it, learn from it and apply what you have learned to future patients. You follow that philosophy and you wont go wrong...

[AMESEMT]

Thanks for the words of advice! You guys reaffirmed what I was already planning to do and was advised to do by our clinical/field coordinator. I am going to go in there ready to learn, ask questions when I have them or don't understand why they might have done something a different way, do the scut work IMMEDIATELY, be prepared, and be nice. I am a little nervous because it is not like doing your field and clinical time as a basic where all you are doing is vitals and SAMPLE. As a medic student you may possibly doing invasive procedures, like IV's (the thing I am nervous about doing), as well as being held to a higher regard due to the knowledge and skill set I posses. I am ready but nervous and hope my preceptor understands that the first day.

I got my bag packed, forms ready (with extras!), and am ready to start. Hopefully they will have the schedule done by Monday or Tuesday.

Thanks again!

Ames

[Riblett]

Great advice Mateo, and stop me if I sound catty with mine. One thing I want to add, and there are those who might disagree, but just because you are a student does not mean you have to take crap. Your preceptors are professionals, and should conduct themselves accordingly. Over the last two years my experiences in clinicals have been overwhelmingly positive. But I had one paramedic who was really rude to me, cursed at me over something trivial. And I got mad and told him he was being an asshole. The jerk made me ride up front on the next call, and he did all the skills. I called my clinical coordinator, who called the lieutenant and had me moved to another unit. Not the most excellent choice of words in my response, since for several weeks I was referred to as "that (insert college name here) student who called (insert asshole medic name here) an asshole." But hindsight is 20-20. Not suggesting you follow my vocabulary, but you should not have to take crap just because you're "the student." You are a person who is there to learn and gain experience. If you have an experience like I did, follow the proper channels and report it. This whole 'eating our young' attitude among EMS preceptors has to stop.

[WelshMedic]

Riblett,

I agree wholeheartedly with the sentiment on EMS eating it's young, we are there to nuture our young, securing our future as a profession. However there seems to be a tendency within our younger generation to scream and shout and throw their toys out of the pram when they don't get their way. Why did you immediately call your coordinator? Wouldn't it have been more prudent to try and talk to your colleague about this? If you'd not got the right answers then you could have called. We have to need to be able to trust one another in this job, I don't want a partner that will rat on me every time we disagree.

WM

[Dustdevil]

I dunno. Once she dropped the A-bomb, I think the window of opportunity for diplomacy was pretty well closed.

I do agree that two professional adults should be able to settle many matters through professional adult communications. However, that requires that both of them actually be adults, and it appears in this case that at least one of them was not. Assuming the guy really was an arsehole, I would have to agree that trying to talk it out is not usually productive, and that attempts to do so commonly only results in you both becoming more miserable. Sounds like it was indeed time to move on, if for no other reason than this timeless truth: He who complains first wins. If you wait til the preceptor goes and complains on you to discuss it with supervisors or instructors, you lose.

Strike first. Strike hard. Strike often.

[Riblett]

I actually did try talking to him first, even apologizing for my choice of words. That got me no where. But it did make it apparent that me staying on that unit would not be beneficial to either of us. So I wanted to talk to my clinical coordinator, before anyone else did.

I see this sort of behavior a lot, as a student and at my own agencies. I have rarely been the target, as I try to walk the fine line between maintaining my dignity in the role of "the student" and flying under the radar. I see preceptors being unprofessional or even downright mean to "the student" or "the recruit", to which they are so commonly referred as. It says a lot if they can't even be bothered to know their name. Many preceptors are being forced into the role prematurely or unwillingly. And it shows. Besides that we as a culture in EMS encourage or at least tolerate this sort of pseudomilitaristic treatment of new comers. I understand that there should be a reasonable weeding out. But I see preceptors who were treated this way while they were in school and continue the behavior down the road, because it is all they know. We need to remember that we were all in their shoes at one time. We are all a team in the field and so should we be in and regarding the classroom.

On that same note, it is worth noting that we are in a profession that forces us into teaching and command staff roles earlier than most. Paramedic schools (especially ones consisting of a college degree) need to place more emphasis on leadership, management, teaching, and just general "getting on with folks".

[WelshMedic]

I take my words back. You are a well=balanced, enthousiastic student that approached this correctly. Your preceptor was, however, an a$$hole. There are some everywhere, unfortunately.

WM