Clinicals friday!

[EMS49393]

Any good EMT school will have already advised the facility of clinical expectations of the students. This should not include "making beds" or anything similar. Clinical time is sparse enough in EMT school without making it less productive by being used as a skivvy for lazy arse CNAs.

I agree with tskstorm - take plenty of vitals, lung sounds etc.

My, my, those lazy CNA's have punked me into making more beds than I can count. Just who do they think they are? It shouldn't matter that they have 8-16 patients that needs labs, ECG's, urines, blankets, and all that other crap that goes along with being sick. And those nurses, they have some nerve thinking I'm put on the earth to make their beds.

What a completely RIDICULOUS statement. It takes less than three minutes to wipe down a gurney and toss a sheet on it. There are a lot of times I have to do it myself when I bring a patient into the ER. Most of the staff in our ER's are not lazy, they are overworked. The extra minute you spend doing menial tasks might just win you the "get in on the cool procedure" award. Not helping with simple tasks when needed gives off one type of vibe... "I'm too good for that job." I guarantee the lack of playing nice in the sandbox and sharing toys will not help you win friends and influence people. If you act like a pompous jerk, you'll get treated like a jerk when you start bringing them patients.

I did a ton of crap that I didn't need to do for my rotations. I also made a lot of friends and quickly became the student the nurses and doctors would seek out for interesting cases or procedures I needed. I'd hear horror stories about how crappy staff would be to some of my classmates, only to find out that they went into clinicals with a set list of things they would do and they refused to do anything more than those things. Even now I get students that have all of their IV sticks for class and flat out refuse to start an IV. Consequently, I refuse to give them stellar scores on their rotation sheets.

You have to understand, this job is all politics. You need to use this time wisely, not just for building on your skills, but for building on your relationships. Although these people are not your partner, they are people you have to interact with on a daily basis once you're in the field. I'd suggest getting off on the right foot now when your in the infancy of your career. How you deal with the many different types of people is more important than if you can start an IV in the dark, upside down, underwater, in a treasure chest, on 30 hemophiliacs involved in a bus wreck.

Be nice, be helpful, and you'll see how far you get to go in your rotations. You'll end up like I did during my rotations, being the one paged overhead to assist or perform procedures.

[scott33]

My, my, those lazy CNA's have punked me into making more beds than I can count. Just who do they think they are? It shouldn't matter that they have 8-16 patients that needs labs, ECG's, urines, blankets, and all that other crap that goes along with being sick. And those nurses, they have some nerve thinking I'm put on the earth to make their beds.

What a completely RIDICULOUS statement.

Thanks for the lecture. Now show me where in the EMT curriculum it has bed making as a psychomotor skill. Show me the clinical rotation sheet which has bed making, arse wiping and urine emptying as something which needs to be signed off on.

It is a complete waste of clinical time to be expected to make "more beds than you can count" on rotations, and if you had bothered to read your clinical itinerary, it may even have stated so.

As an RN whos real job is working in the ED of a level 1 trauma center, and who frequently assists EMT and Paramedic students - and as an ALS field preceptor who also has to sign the student off on ALS ambulance skills, I would never expect any EMT student to pick up my or my colleague's slack. Students are there to learn specific psychomotor skills consistent with what has been taught in class, not run around making beds etc. I don't see an issue with one or two bedpans etc if the student volunteers it, or if they are the nearest pair of hands - and volunteering to help with anything will always get the "enthusiastic student" on the rotation form. But take it from me, the hospital staff know that it is no more acceptable to ask these menial housekeeping tasks of EMT students ad nauseum, as it is a patient's family. It is nothing to do with being above making beds and emptying bedpans, it is a matter of getting the most out of ones clinical time as possible, and doing what is relevant to the role of the EMT. At the basic level, that means manual vital signs, lung sounds, patient history etc.

As I said, any decent EMT school will have explained to the student ahead of time, to politely refuse these tasks, and escalate if it becomes an issue. Obviously a lot of people have let hospital staff walk all over them in the past. More fool them.

Edited April 14, 2009 by scott33

[CBEMT]

Great. So not only should he be the stuck up EMT/medic student, he should be the whiny bitch that reported everybody to management. His clinical time is sure to go swimmingly now.

Your students don't make beds. Fanfreakintastic. You get a cookie. In the rest of the world, it doesn't always work that way. Adapt, improvise, and overcome. If making some beds gets him a better clinical experience, that's called initiative in my book.

The one thing I don't necessarily agree with is going on transports to the floors unless it's a critical patient ie learning opportunity. Don't risk missing something in the ED because you're taking Grandma Drippy Drawers up to her Med/Surg bed for an overnight observation.

Edited April 14, 2009 by CBEMT

[brentoli]

Great. So not only should he be the stuck up EMT/medic student, he should be the whiny bitch that reported everybody to management. His clinical time is sure to go swimmingly now.

Your students don't make beds. Fanfreakintastic. You get a cookie. In the rest of the world, it doesn't always work that way. Adapt, improvise, and overcome. If making some beds gets him a better clinical experience, that's called initiative in my book.

The one thing I don't necessarily agree with is going on transports to the floors unless it's a critical patient ie learning opportunity. Don't risk missing something in the ED because you're taking Grandma Drippy Drawers up to her Med/Surg bed for an overnight observation.

+1

On the other thread I mentioned volly entitlement. Thanks for showing me its not just them that feel entitled.

Treat others the way you expect to be treated.

If you want to have a good clinical experience, then make your self willing to have one. When you have the can do attitude and jump at oppertunities to interact with staff members that is called networking. You don't have to go to the extent of being the charge nurses pet, but, a little effort can go a long way in making your experience meaningful. Not only that, but when job time comes around in a year and you are applying for the medic position in the ER against the other kid who refused sticks because his check sheet was full, who do you think will get the job?

[scott33]

The one thing I don't necessarily agree with is going on transports to the floors unless it's a critical patient ie learning opportunity. Don't risk missing something in the ED because you're taking Grandma Drippy Drawers up to her Med/Surg bed for an overnight observation.

It just gets better. Transports to the floors

If making some beds gets him a better clinical experience, that's called initiative in my book.

In my book, it is called sucking up to the nurse to get a good report, or let go early. Seen it from both ends many times and is completely unnecessary.

And it won't get him a better clinical experience, it will get him better at making beds.

Edited April 14, 2009 by scott33

[NOMedic119]

so making beds isn't part of emt/medic practice??? last time i checked you make the stretcher after every call. There isn't something for you to do for the entire hospital shift, why not help out by making some beds and just making it an easier night for the nursing staff. They will like you more and will be ready to teach you when something cool comes in, instead of just walking right past you.

[EMS49393]

It just gets better. Transports to the floors

In my book, it is called sucking up to the nurse to get a good report, or let go early. Seen it from both ends many times and is completely unnecessary.

And it won't get him a better clinical experience, it will get him better at making beds.

In my book it's called teamwork and development of interpersonal skills, and you just proved how well developed you are. I think I've run across a few of your paramedic prodigies. They're the ones that trash ambulances on routine transfers and stand by smoking a cigarette while their EMT cleans it up. They're the ones that walk into a supervisors office and make the broad statement that all the new EMT's suck, yet they refuse to do anything to improve things.

That's okay though, because those paramedics make me look like Mother Theresa, especially when my EMT opens the back door of the truck to see that I know how to hit a trash can.

I'm sick of this "it's not my job" mentality and the lazy idiots that preach it. Clinicals do more than provide technical skills practice, they provide a chance for the student to begin to develop relationships and teamwork with other health-care professionals.

From Merriam-Webster:

Teamwork - (noun, c. 1828) work done by several associates with each doing a part but all subordinating personal prominence to the efficiency of the whole

[scott33]

I think some of you are getting the completely wrong end of the stick, but I make no apologies for trying to encourage vectored learning.

Judging by some of the replies, there have obviously been a few people conned into doing much of the mundane tasks that they should not be anywhere near, and clearly that is where the overly-defensive tone of some of the replies are coming from. By some of your own admissions, one or two posters have spent way too much of their clinical time making beds and other tasks not related to the EMT curriculum. Whereas this is no big deal if it is kept to a minimum, it serves no purpose other than to relieve those who chose not to do it, of their obligations. On the typical 120 hour EMT course, in which only a fraction of that time is clinical exposure, bedmaking and piss-pot emptying should not be one of the main expectations of the student.

The EMT student is not part of the nursing or medical team, lets get that straight - they are an adjunctive component to the daily running of operations in the facility, not an integral one. Nursing staff who pair up with EMS students are usually hand picked (if they don’t volunteer) and should have an insight into the clinical expectations of the student. Many of them are in EMS themselves, so are ideal in bridging the gap between roles. Others are just very good tutors at any level, so can offer a lot of relevant information on the basics. Unfortunately though, some of them slip through the net, and there will always be those who will see the extra pair of hands as an excuse to have an easy shift, at the expense of the student’s learning experience. I have witnessed this several times.

No one likes it to be pointed out that they have been hoodwinked into doing something they really shouldn’t be doing, and perhaps this is why there seems to be a lack of objectivity in some of the replies. Learn from it and move on. Think about it though, would you rather have a clinical experience that concentrates on the key clinical skills as per your curriculum, and as per your classroom studies. Or would you rather be used as a runaround, hand-maiden, and dogsbody doing things which do not reflect the limited practice of EMS work? Sure, what student is really going to object to anything asked of them, as the ED is always an exciting place to be for outsiders. The problem is that it provides zero benefit to the student as an EMT. The "social networking" aspect can best be developed at the patient's bedside, not sucking up to nursing and ancillary staff, some of whom will happily take advantage of the student who just can't say no. This is my job, I hear the stories of gullible EMS / Nursing students all the time, who get used and abused as fetchers and carriers. It is wrong - end of.

And before anyone comes back to remind me (like I don't know) of all those jobs which need done in an ED, there is a little-known fact that the more "tasks", a non-staff member is detailed with, the slower the ED will run. The students are operating under someone else's license and with patients assigned under someone else's care. It stands to reason that the combination of the student’s inexperience and an extra pair of eyes upon them, will often make certain things run in "floor time"

Those few ED staff who haven't actually witnessed first-hand, the wrong-doings of the EMS students, who take it upon themselves to do their own thing, will have at least have heard the many horror stories. Hey, 5hit happens, but this is why many of the nursing staff flat out refuse to take anything to do with EMT students…it means a little extra work, and a lot of extra responsibility (read accountability) for them.

As for occupying time when it is quiet – if I were able, I could spend a whole shift interviewing my patients and developing basic history taking techniques if there was nothing exciting going on in the trauma room. I would much rather see the students even having idle chit-chat with the patient about their visit, than running about with commodes and handing out food trays. Just what "skills" does the latter help to develop, to help the EMT in their role... as an EMT? Some of the offers to assist in the running of the ED, are reminiscent of the overly enthusiastic family member who insists on speaking over her loved one –the patient, by answering all their questions. It just can't be seen from an experienced perspective here.

But, going way off topic, so I would suggest to the OP, as well as those who have already gone through clinical rotations, that they review their clinical policy and procedure for their school.

I cannot imagine being in a situation where I would need to ask an EMS student to do my dirty work for me if I am able to do it myself. I take the nurturing of the EMS students way more seriously than to do that. It is also something which could easily come back and haunt me if I did so, perhaps even relieving me of preceptor status. It is an abuse of power, counterproductive to the clinical experience, and not what the students are there for. If they are there to learn vitals and lung sounds, then they can usually spend an entire shift doing just that, by repetition, until it is second nature. That, is making the most of ones clinical experience.

I would love to see some official evidence of ANY EMT school endorsing or turning a blind eye to this practice - but we all know, none exists.

Question for the RTs, phlebotomists, rad techs, pharmacy techs, and medical students here…How many times a day are / were you asked to make beds, or assist with toileting the patients while on clinicals?

Thought so.

Edited April 14, 2009 by scott33

[mobey]

Question for the RTs, phlebotomists, rad techs, pharmacy techs, and medical students here…How many times a day are / were you asked to make beds, or assist with toileting the patients while on clinicals?

That is not a routine part of thier job. Bad example.... try again. No one is advocating for students to do things they are not going to do after practicum.

As for occupying time when it is quiet – if I were able, I could spend a whole shift interviewing my patients and developing basic history taking techniques if there was nothing exciting going on in the trauma room. I would much rather see the students even having idle chit-chat with the patient about their visit, than running about with commodes and handing out food trays.

Sooo.... instead of having several interactions with a variety of patients each with thier own challenges (speech, hearing, language, etc) You want them to sit for hours and interview 1 or 2 people?? What skills does that teach? .... How to interview that one person

Edited April 14, 2009 by mobey

[scott33]

That is not a routine part of thier job. Bad example.... try again. No one is advocating for students to do things they are not going to do after practicum.

And I suppose handing out food trays, doing runs to the lab, and

Transports to the floors [end quote] are a routing part of the EMT's job.

One born every minute.