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New Medic Jitters


AMESEMT

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So I have my first job as a paramedic. I am a little nervous. Going from student to the one in charge in the back is a little nerve racking. My preceptors say I know my stuff and I will make a great medic, and the National Registry says I am knowledgeable (since I passed the test). But I am still a little nervous. Maybe because for the past month I have been looking for a job and have been working part-time at a grocery store and have not been in the field, the other part of me says it is because I have had someone looking over my shoulder before and now I won't. Any words of advice to a new medic?

Ames

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My advice is simple, when you start in Iowa. Get a copy of your protocols, standing orders, tx guidelines and learn them. If you want place them in sheet protectors and a 3 ring binder and carry them with you. Also get the profiles of the drugs you will be carrying that you are not familiar with. Last but not least get a little composition book that will fit into your pocket. Carry this with you and write door codes, patching channels, hospital phone numbers, etc. Or anything else you need to remember on a daily basis. I know you can do this with a cell phone but batterys die and people change phones. Above all stay calm, and welcome to being a medic.

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You have good reason to be nervous, there is only so much you can learn from the books, now the real lessons begin. There are many things you will only see a handful of times in your career (for instance, did you know that when a sarcoidosis patient has respiratory distress, the only thing that will fix it is prednisone, and they will deteriorate on you quickly -- this is what killed Bernie Mac, but when I encountered it some 10 years ago, i had never heard of it).

Follow these rules, and you will be fine:

1. Always remember ABC. when you roll up on your first clusterF***, and everyone is running around in circles -- remember ABC.

2. When in doubt -- transport; then try to follow up to see what was really wrong with the patient.

3. Document too much.

4. Transport all drunks, everyone under age 5, and everyone over age 70 regardless of complaint, until you get 5 years of experience under your belt.

5. When you screw up, dont lie. the natural instinct is to cover your butt, but lying in most departments is an automatic termination, whereas your screw-up will probably result in a suspension at worst.

6. Take classes -- youve only scratched the surface of what you need to know, and alot of what you know now will be obselete in 5-10 years.

7. Drive you ambulance (or tell your EMT) like a 3 year old is riding on top of the box. The number one killer of our kind is still ambulance crashes. The most critical patient you will have is an arrest, and less than 5-10% of them ever survive to walk out of the hospital -- not worth dying for.

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Take a deep breath, hold your nose, and jump in. Just like with swimming, you are going to have to get your feet wet sometime, and the sooner you do the more comfortable you will become.

The first step is to check your own pulse. Once that is handled, then you can worry about everyone else.

Make sure that you can go home at the end of the shift with the same number of parts in the places they are supposed to be.

It is not your emergency, no matter what you may think the patients will not give it to you because you are a kind face.

Absolutely continue your education beyond what your employer requires.

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You're moving to an area you're not familiar with, starting a new job, try to get the company you're working for to post your for the first few shifts (atleast one) with an experienced medic to help you get the feel for the job and the expectations. See if they'll let you third crew (for free even) before your first shift that way when it's all on you you've had a chance to get a feel for the company and the nuts and bolts and won't be as distracted from patient care.

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I graduated from paramedic school in May of this year. I did nothing related to EMS until I started a brand new job at the end of September. I did no time as an EMT and went directly to paramedic school. All my ride time was in a dual paramedic system - with me as a student, that meant there was 3 paramedics on board. I went into a system that runs 1 EMT/1 Paramedic per rig in a brand new state several thousand miles away in a system and a city that I have NO familiarity with. I was scared s***less.

While I would not recommend this approach to anyone, it has been 2 months plus and I am feeling pretty good about the job and my ability to cope. I went to a good school and I was determined to do my very best. I am sure luck had something to do with it. My first calls were either cardiac (which I am very comfortable with) or BS. While I am still hesitant about that MVA with multiple casualties, I am confident that I will do what I am supposed to do when I am supposed to do it.

By the way, after EVERY call, I think of at least 2 or 3 things I could have done better and whenever there is something I don't understand, I ask someone. I will continue learning every day, and when that stops, I will find something else to do. Good luck to you.

PS - the people on this site were absolutely invaluable. They gave me straight answers that I could trust in those very difficult early days.

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We've all been there. Like a couple of other posters said, "Have fun with it". Relax. Stay with your basic (not Basic) Medic training. Don't get in a hurry. Stay calm at all times. Use good old fashion common sense along with your training. You'll do just fine. Sounds like your preceptors have good faith in you. But do use your Basic training when that's all you need. You'll know when to use ALS over BLS. Don't over-complicate things.

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AZCEP hit it on the head (with a nice House of God reference to boot!). The first step for every call is to check your own pulse. Relax. You don't have all the answers and 99% of your patients will require IV/O2/Monitor and nothing more.

Know your protocols, and understand that there is no shame in looking up the answer if you don't know. I still carry my protocol book with me in the event of an unusual patient or the (more frequent!) brain fart.

You WILL become more comfortable with things as you gain experience. Try to keep this "newness" as long as you can. New medics are always scared about missing something and - in my experience - this can be a redeeming quality. Never let yourself believe that you've seen it all. Patients will surprise you on your first day, and they will surprise you on your three thousandth day as well.

I've been a medic for two years now so I think I can still say that I was (or am) recently brand new. I've been writing a blog about my experiences since I was in medic school if you'd like to give it a quick read: http://babymedic.blogspot.com

Good luck!

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