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Woking Under Pressure


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Hey everyone.

My EMT class just started and all is going well so far. I've been thinking about clinicals lately, and I just have one question. How do I lower anxiety so that I can make better "on the spot" decisions? I have a history of anxiety, and am trying to overcome it.

Thank you.

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The more comfortable you are with your skills and knowledge base the less anxiety you will feel. Also, time and experience will lessen anxiety somewhat...

In my experience a certain level of anxiety in EMS should be expected and is a good thing. You are making big decisions for people in some circumstances and you need to realize the consequences of those decisions.

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For starters, may I suggest practicing with others until you have it down pat to where it is second nature to you?

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I get anxious for a lot of reasons. Some of these reasons are legitimate and others are just dumb. Setting aside the dumb things that give me the jitters always seemed to help. Here are some things that come to mind.

The expectations for EMT students are not very high.

At one time I worried a lot about what my peers or preceptors might think of my performance. When I realized that my preceptors don't know me, and could really not care less about how I did it made things easy. I was just another student moving through. I was surprised at how little expectation they had of students, almost like they expected us to know nothing. This was a little disappointing and liberating at the same time. It is not that your preceptor are mean, simply that students are temporary and not every student is good. I was always treated with respect and professionalism. I enjoyed my clinical rotations very much.

You will only get from your clinical what you take from them.

During my ED clinical I noticed that the hospital staff would not ask the students to do anything really necessary. It was more like they would let us do things that were within our protocols like moving a patient or placing EKG leads. There were some other students present that were not very motivated. The staff was perfectly happy to let them hang out by the nurses station and do nothing.

Clinicals can be really fun, so enjoy!

I loved my clinicals because I stayed busy. Taking out trash, changing bed sheets, wiping counters, carefully organizing leads and tubes after the patents were gone. By helping the staff do their job (the menial stuff) I got to do a lot of other things that are EMT related that other students were not doing. After a while nurses would ask for help with the tasks that I was indeed there to practice. It also helped that I showed up with cookies or doughnuts!

Medic girl and dudley hit the nail on the head. knowledge and practice provides speed and confidence.

Work hard at your clinical, ask questions, participate, pitch in for pizza, use all of you knowledge and skills they will allow you and you will do fine.

Edited by DFIB
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It's also, and in my opinion, mostly, about attitude. You need to adjust your attitude on how you feel about making errors, especially in front of others.

In my experience students often try and appear more inept than they actually are, either consciously or subconsciously trying to lower the expectations of those around them so that less will be expected of them with the intent of "Doing better once I'm more comfortable." Every experience is an opportunity to get better, and stronger, but too often a students goal is simply to "get through." And this is a bad, but also, really scary place to be.

And forget about speed. You will "perform as you practice" so practice as perfectly as you can. You can't do that fast. Should you make this a career you'll likely be able to count the number of patients 20 years from now that were positively effected because you got an IV in 30 seconds instead of 90 on one hand most likely.

When you practice your skills, slow down. Place your hands an feet in the places that you want them to be with purpose and decide why you wanted them there. Slowly. Always focus on slowing down and doing everything correctly the very first time, you will naturally become quicker with time. In EMS you will gain speed by eliminating wasted steps, not by moving faster. Trust me on this.

Focus on what YOU think is wrong or right in every scenario or patient contact. Understand that you are going to really suck in the beginning, and sucking is exactly where you're supposed to be in the beginning...there is no shame there. The shame should come when you discover that you've decided that you're to important to make mistakes. That mistakes are for others. That you're not committeed enough to put your best effort forward every time so that it can be judged and improved.

I don't think that I've ever come away from a scenario or call and didn't think, "Dang it...I wish I would have done this sooner, or done that instead."

I'm never uncomfortable now working in front of people because I'm confident that I've done my best to prepare, that I'll focused just on my tasks instead of wasting brain power wondering what others are thinking. I remember that I'm just a simple country paramedic..that I'm going to make mistakes, that is a certainty, but they won't be stupid mistakes made by trying to hurry, or appear super human, and that I will learn all that I can each time so hopefully make fewer next time.

If you find yourself at any time thinking, "I don't know what to do, God, I'm such an idiot." Then understand that you're wasting your time, the time of those trying to help to educate you, and giving very poor patient care, because those thoughts are taking up the majority of your mental and emotional energy that should have been applied to succeeding instead.

When you don't know what to do...slow down and ask more questions. When you're scared, confused and can't figure out the simplest thing...slow down more, get more information. When everyone around you is freaking out and telling you to hurry, slow down again, gather more information still, until you know the right thing to do. Action is never, ever a substitute for calm thought, though you will find that most around you feel that it is.

Slow down, breath, think. You'll do awesome.

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I've learned over the years that the pressure I wok under is mostly in my mind. I was always worried, is the chicken cooked enough, how is the beef? If I used a pressure wok it always made the veggies in the stir fry way too limp. There's no need for wok pressure to have an effect on your life. Just understand, the stir fry will turn out the way it turns out. Once in a while it'll be a slimy mess, other times the meat might be undercooked. So long as no one gets sick from your cooking in the end, everything is fine.

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