New Hire Orientation

[WolfmanHarris]

So I just finished my first week with York Region EMS, which is only week one of a three week new hire orientation program. I was chatting with some friends at other services and it became clear that how the various services handle orientation varies widely, from the multiple weeks of training to one week to as few as 2-3 days. What's included in them varies greatly as well.

My question is topic is two fold: What does your service provide for orientation (for Fire EMS services please include only time spent on non-fire orientation)? What do you think should be included in a comprehensive orientation program?

Here is a breakdown of my orientation schedule with explanations where required:

Week 1

Monday

- Welcome

- Meet and greet (coffee, fruit and snacks provided; chance to meet all the bosses and supervisors as well as a chance to meet other recruits)

- Service overview

- Introductory session for driver training (CEVO3)

Tuesday and Wednesday

- Base Hospital Certification (not sure how much of this happens elsewhere; but the Base Hospital provides medical direction and is separate from the service, so they come in for two days of protocol review and testing as well as some info on ongoing research programs)

Thursday

- Bariatric unit/supplies overview

- Bags familiarization

- Stair chair familiarization (new ferno tracked)

- N-95 fit test

- Driver training classroom session

- Regional intranet/HR/payroll computer system familarization

- Computer mapping software training

Friday

- CBRN Basic Certification (from Government of Canada program)

Week 2

Monday

- In vehicle driver training (skid pad and road)

Tuesday

- Area familiarization (drive around the region and find all the stations, hospitals, etc)

Wednesday

- OFF for Provincial Exams

Thursday

- MCI day

Friday

- Code of Conduct

- PHIPPA

- Allied agency interactions

- ACP equipment familarization

- Infection control

- Pandemic planning

- "Respect in the Workplace" (HR Comes to visit)

- "A Day in the Life" (covering all the little details of what to do. I.e. how to sign in)

Week 3

Monday

- Talk from the coroner

- Coroner's Package training (the paperwork we have to do on a death)

- Radio system

- Mike phone system

- Hospital info

- Payroll

Tuesday (most of this day is getting us caught up with the various small CME's the rest of the service has done recently)

- Obstetrics review CME

- Documentation CME

- CTAS review CME

- Clandestine labs awareness

- WHMIS and OH&S

Wednesday

- CUPE Local 905

- Draw for Seniority

- Court/Inquest Appearances

- "Attendance Awareness" (Not sure either, but it looks like HR)

- Community Referral by EMS Program

- Offload delay

- Continuous Quality Improvement (CQI)

Thursday

- ePCR training

Friday

- Crime Scene Preservation from YRPD

- Special Operations from the EMS Special Response Unit (SRU)

Following three formal weeks of orientation, as new hires we then also have to:

- Ride third crew member for three shifts

- Complete a driver probation log for 20 shifts, during which we can drive to Code 4 calls (L&S) but not back from them. (Due to not having an experienced person up front along with us)

- Be on probation for six months

[akroeze]

Well my orientation was:

1 day of base hospital cert

3 days riding as a third person with another ACP crew

I was supposed to do 8 shifts working partner with another ACP but that got canceled

So I am now out on my own after those initial 4 days

[WolfmanHarris]

Well my orientation was:

1 day of base hospital cert

3 days riding as a third person with another ACP crew

I was supposed to do 8 shifts working partner with another ACP but that got canceled

So I am now out on my own after those initial 4 days

Not actually the shortest orientation I've heard. My preceptor when he switched to working NHEMS had a couple of hours with the boss and a day of Base Hospital. Unfortunately he showed up to find the office closed. But a door was open so he let himself in, setting off the alarm. Made a quick exit, called one of the staff he knew and had just started talking to them, when they said "Hang on Chris, apparently the alarm's going off at the office." Quick explanation and about an hour late they got started. Of course it goes on from there, apparently they double booked the education staff for that day, so rather then review with him, he was left in the room with the directives to review for a test later.

Fast forward two hours and they check on him and find out they gave him the wrong directives book. Swap books, told to review those. Check in again, do the written test and sent on his merry way with a, "You'll be fine."

Glad to see HQEMS isn't making NHEMS look too bad.

[tskstorm]

day 1 intro to company administrative paperwork

day 2 PCR's medical eval fit testing

day 3 Driver ed

day 4 EVOC controlled environment

day 5 Medical finished drug test result, ppd result, intro to policies and procedures

40 hours of field training

Including ACR writing, evaluation of all patient care and driving evaluation without a patient on board.

** note, this is a rough draft from memory, has been many years since I was a new hire.

Edited June 6, 2009 by tskstorm

[Kiwiology]

It varies here depending on if you are a volunteer, paid, already certified or not and which area you are in (remember for the volunteers and new hires in Auckland, training/certification is on the job rather than done pre-employment)

If you are a volunteer you do the following (generally, not always)

- 1 day induction "welcome to us" touchy/feely session

- 1 day bridge program to bring you up to first responder level (O2, AED, BVM)

- 2 day driver course (at the end of which you are able to drive L&S if the tutor feels you can)

After which you are able to be in the truck responding to whatever the dispatcher puts you to. You will be paired (unless at an all volunteer station) with usually an ALS or ILS provider as paid BLS is rare but not unheard of.

You will need to complete 10 calls as the driver including P1 (L&S) then you get signed off as being able to drive on your own.

If you are doing the internal education track you need to do 3 online modules (about 12 weeks), 6 days in class and document 20 calls explaining your treatment, rationale, self reflection etc and have 3 of those reviewed by a mentor. If you are successful in that (which can take anywhere from 4 months to a year depending on your station workload and how fast you complete the modules) you become a qualified Ambulance Officer (BLS) where you can give NTG, ASA, O2, use the AED, and insert an LMA/NPA.

However if you are a new graduate of the Bachelor of Health Science (Paramedic) degree (having just completed 3 years of study at ALS level, having to have gotten so many intubations, so many IVs (I think it's 100), so many drugs etc) you must go through an "intern" program where you get screwed over by being "demoted" back to Ambulance Officer (BLS) level where you are "gatekept" to progress through the levels (Ambulance Officer, Paramedic (intermediate) and Advanced Paramedic (ALS)) as the service sees fit; which can take 18 months or longer; one of the Intermediates I know said she took five years post graduation to become an ALS provider.

[fireflymedic]

My most recent change prompted a six week orientation covering literally anything and everything complete with skills verifications, med director meetings, safety information, how to handle PR stuff, emergencies, etc, along with other stuff because it was an arena I'd never been in before. Prior to that, my service had a "progressive" orientation. You got the initial orientation to a transfer truck and all the routine stuff. During this time, you rode for a month as a third person to get oriented to the service prior to being cut loose. You were on full probation for 6 months from date of hire. After those six months, a skills evaluation was done, clinical competencies proven, an overall assessment, sit down with med director and service assistant director and main director. If you passed that point, then you were progressed into a 911 truck during which you rode as a third for a month allowing you to orient to any new protocols you were not familiar with as well as the area. You then went onto functioning independent 911 and with that 6 further months of probation. So essentially a year of probation. Following that you underwent another evaluation and if successful, you were full privledges and given a permanent partner for the duration of your employment. I liked how the orientation there went as it progressed people that came from different types of services orientation into rural aspect and also the different demands and protocols we had in place as well as a safety net for newer medics and EMT's to get acquainted during the transfer truck period.

[CBEMT]

My first EMS job orientation was two 10-hour days as a third rider, with a third added on at my request so I could get some driving in. Currently most employees get two 8-hour days as a third, second day should be driving. But that second day could be eliminated if someone calls out- in that case, the new employee fills that slot.

[FormerEMSLT297]

When i worked for NYC*EMS, back in the 1980's, they did at least a 4-6 week academy that was basically an EMT- refresher, and orientation to radio codes, NYC Protocols, and EMS Operating Guide Procedure, followed by a 1 week EVOC class.... Then that was it, you were out there usually you rode with a senior person for a few days or weeks if possible.

When I worked as a Paramedic in the ER based sysytem, the orientation was 1 week, and that was more hospital procedures, than anything else.

My current job as Flight medic is a minimum 120 days before you can ride as senior medic.

[rock_shoes]

Matt I have to say kudos to your employer for providing a fairly comprehensive new hire package. It's certainly a lot more than I received. When I started with BC Ambulance I was handed a "New hire package" that needed to be completed within my 6 month probation period and I was given 3 shifts as a third. The "New hire package" included WHMIS, ICS 100, the alpha bravo charlie... alphabet, company radio codes, and a review of company policy. No one is allowed to drive until they have completed a vehicle operations course. After completing the vehicle operations course everyone must complete a driving practicum with a driving preceptor before they can drive L&S.

Operational area orientation was learned entirely on the job. There was no base hospital orientation because everyone in the province is bound by the provincial SOP for their respective license level. In order to drive in the Greater Vancouver Regional District you must complete the Vancouver Post Orientation Program. Basic CBRNE training, CTAS training, etc. are all provided via the Clinical Education Division but are not part of the orientation program. Clinical Ed courses are open to anyone who has yet to do that particular course.

BC Ambulance seems to rely on new hires being somewhat familiar with operations because anyone trained in BC will have precepted with BC Ambulance. This didn't help me at all when I started out as an Emergency Medical Responder (roughly equivalent to EMT-B ) who didn't receive any kind of preceptorship. I did my PCP program after I started with BC Ambulance so initially I was essentially thrown to the wolves with minimal education and expected to "figure it out". I'm still around so I guess I made it out of the den.

Edited June 11, 2009 by rock_shoes

[MedicAsh]

At the service I am on now, I am on an accelerated orientation. 2 days after hire I went for a fit test, blood work, and agility test ( tough but not bad). Then I went to a 2 day orientation to the hospitals (we are a combined hospital). Day two of orientation was general hospital Computer Based Training, Then I started in the ER/ambulance. It starts with a tour of the hospital and a get to know everyone. Then went out to the ambulance to start going through things. I spent a few hours going through the ambulance then I went driving around town to get to know streets (important ones). The days after that are getting to know rigs, checking things, helping in ER and being the 3rd emt on calls. By june 20th I will be on my own. The orientation is not bad. I guess it helps to have a hospital back ground too.

clear as mud?