Somebody Please! help a newb...

[Jimmz]

Alright guys... I know it's been a while since my last post. Actually I've only ever posted once, but there's a reason for that. It's a bit of a story... and I feel that I need to tell it so that the rest of my post might make a little more sense. Please just bear with me if you will...

Well, it all started when I got the results from the national registry. As whomever may have read my last post might know, I passed. I thought that I had it all laid out from that point on. Finding a job was going to be easy, becuase everyone needs an EMT and there were only a few other people in my class and there were only a fraction of them wanted the same job that I did! Man I thought that I had an instant career starter on my hands... so I applied for a job with my not so local ambulance company, swearing I'd be hired in no time.

Well seven months and one interview later, I was still working my crappy retail job. I had all but given up hope on ever putting all of my hard work to good use... and then I got a phone call. Long story short, I now work as an EMT. I went through orientation and the evoc course. Everything pretty much went off without a hitch. Then I started working. My first night in the field I was extremely nervous, and I ended up with a tension headache that would not quit. Luckily I'm working with a Field Training Officer and all I had to do that night was watch.

So here's my problem. Every other night that I've been out there, I've been told to take BP's and a few other simple things... and I just can't for some reason. It all culminated when we responded to an assault and I was told to get the straps on a backboard ready, and I couldn't remember how the hell to do it! Pardon my language please, but it's just so frustrating to be out there with everyone's expectations on you, and then you fail them all. What's worse is that if I hadn't had the FTO there to help me out, it would have been a real mess as I would have screwed everyone on it.

All I'm asking for with this incredibly longwinded tale is some help. Any advice that you could offer would be a HUGE help, as I'm starting to second guess myself with most of my abilities.

I've only been out in the field for about a week, and while I'm still looking forward to going out there and helping people I'm also starting to dread it all together because I don't want to mess up again.

Thanks in advance everyone, and I look forward to reading some of your answers...

[VDCavey]

I am no veteran myself but in the beginning I had the idea that every thing I did would kill the patient instantly, my third or fourth shift I had a huge multi trauma (fall from 4th story window) from arriving thrue arriving and assistance to the trauma team, the scooping, the attaching to the spinal board, everything went on auto pilot and I had no time to worry or to make myself nervous, got a great Docter and medic on the scene who were very helpfull. we brought the patient perfectly stabilized to the hospital.

Although he died in the OR I made kind of a switch in my head and feel pretty relax since then

[john51071]

Just remember, it is their emergency...not yours. Nothing you do is very likely to kill anyone. Everyone started out with no experience, and everyone was nervous, whether they admit it or not.

[Code 8 Paramedic]

Well I have to say what your going thru is normal. I've been in EMS for 6 years, 5 as an EMT and now Im on my first year as a Paramedic. The class gives you the background knowledge that you need to do the job.. but now you need to learn HOW to do the job. Talk this over with your FTO tell him/her that your nervous, and you feel your making mistakes.. but that you want to do this right. The FTO process is for you to learn how to be an EMT in the field. After you go on a few calls, the nerves will settle and you will develop a style.

[AZCEP]

You are in the same boat as every EMT that comes out of the current system of education.

None are adequately prepared to perform the functions that this "career" requires. Your program should have had a requirement of some clincal rotations, right? If it didn't, that's not so unusual as it is unfortunate. Discuss your situation with your FTO. They got to that position because they've been around the block a few times. They will also be able to better evaluate how to correct the problem than any number of anonymous responses on the internet.

Good luck to you.

[bbbrammer]

Lets take care of something first: you are a human being. That means that no matter how long you have been working or not, occasionally you WILL mess up. Everyone does it, regardless of whether they admit it or not. Just like John5107 said, it is not very likely that anything you do will kill a pt. And everyone is nervous out there. I have been on the streets for a year and still get nervous from time to time.

NEVER EVER doubt your abilities. You know more than you think you do, and are quite capable of doing your job. Not to mention that the more you worry about it the more you will mess up. The minute you stress and go "OMG, how do I do that?", your mind will blank out and you will have trouble remembering. It happens to all of us.

If you find that you are having problems on a call, take a step back, take a deep breath, and tell yourself that you DO know what you are doing and you CAN do it. There is alot of little things that happen on calls that school is unable to prepare you for and no one can expect you to know it all when you are new. You could also try having your FTO run over some things with you to practice when you have some down time, kind of like you did when you were in school or prepping for your practicals. Beyond that I would try what some of the others have suggested-talk to your FTO about some of the problems and get them sorted out. The best medics out there have screwed up before, but they talked to someone about it and learned from it.

Just remember, you CAN do this!

[Just Plain Ruff]

I read something in this that I hit on right away. You ahve not been performing skills for over 7 months. That is a long time to be expected to retain the information and skills. Everyone loses skill ability if they are away from performing the skills for long enough.

The advice above is good - you are human, we practice medicine we are not perfect.

I would suggest this -

Get a group at your service together and work on skills stations. OR

Take a refresher course on your days off. You will be back in the full swing of things in no time.

But stop kicking yourself in the arse and stop drinking the Kool-aid in the belief that you should be flawless and polished. As a new emt there is no way that I would expect you to be polished and not a little bit rusty.

Any FTO worth his salt would be sitting down with you prior to the shift start and asking you -- what do you want to learn today or what do you want to go over today that you feel you need help with.

If your fto doesn't ask you then go to him before shift and say, can we work on this or whatever.

You should be taking as many blood pressures and pulses and whatever else you can think of. The only way you get better is to do it over and over.

Here are some other things to do

1. read your book - it helps to review things

2. listen to lung sounds

3. listen to the heart

4. take many many many bp/pulses

5. Review the equipment so you understand it's use

6. ask ask ask questions - your fto might begin to hate all the questions you have but if you don't ask you don't learn.

Good luck, you will do fine but it does take practice practice practice.

[emt_blazer]

Hey, DON'T PANIC!!!

I have been an EMT for just under a year, and I was the same way when I first started. I do not work as an EMT (for $$$), but I respond with the volunteer fire department where I live. I have learned to harness the terror! Also, you just has to know you can do it. Knowledge and Skill is a small fraction of what you actually need to do, confidence is HUGE!!! Also, when in doubt, fall back and punt. Go back to the basics and slow down and think. If you still feel like you're at a loss for what to do, practice with the equipment and with your skills. Are you nervous about the assessments and all? PassEMT (a video) is a great review! Just relax. I know its scary, but most importantly, you have to remember, it's not your emergency! Whoever called you needs your help, not the other way around. Also, don't worry too much about hurting tha patient! Often, there's no place to go but up.

[Ridryder 911]

Okay I will describe as one of my favorite character "Dr. Perry Cox", on the television show "Scrubs":

Okay, newbie! .. Listen up! You are supposed to be scared!... That is why they have a FTO with you.. for god's sake, we don't expect you to be a Roy DeSoto out there on your first week! Now what we do expect is for you listen, watch and learn..and yes asks appropriate questions.

We want you to be scared.. it helps for you not to be so cocky and confident that you thought you already knew all the stuff just because you passed a few tests.(Your not the 1'st newbie) Now, the real learning begins on how you will apply all that goop that they taught you!

In the book House of God; one of the ten commandments is to "take your own pulse on a cardiac arrest." There is a actual reason for this.. think about it.

So yes Newbie, we will pick on you, we will laugh at you at times, and we will quiz and question you... uh, that is because that we are supposed to do and expected to do. It is our mission to teach you, be sure you don't kill someone and by-god actually do some treatment and maybe with luck actually help someone... so that later, maybe by chance you will do the same in return to another newbie someday.

Now good luck, things will get better with time... give yourself a chance..

R/r 911

[mobey]

You are getting excellent advice here, and everyone has gone through it.

These 2 steps made the world to me:

When the tones go off take a second, stop moving, take a deep breath and overpower your adrenaline, it is hard but you can do it.

Secondly NEVER EVER EVER RUN. I used to run at some point during almost every call, and I think it forces you to panic. My heart would race when I ran and never slow down during the entire call making it hard to concentrate.

Just what worked for me.

Mobey