Asking medics questions

[tanman70@hotmail.com]

WOW THATS A LONG SENTENCE.

But really, in that instance, why does it matter if they ask in front of the patient? They patient isn't going to know. They are dead!

[DwayneEMTP]

No offense taken Mike!

In fact, if you had a choice of say...going to prison, or reading the entire history of my post..and were so foolish as to choose to read my posts, you would see many poorly written, tactless entries...so I'm certainly am not above needing the advice you've given.

It just seems that, when speaking with paramedics, questions closely related in tone and content (or at least they appear so to me), are much more likely to be considered a challenge than when speaking to other health care providers.

In fact, It's likely that my questions 'in hospital' are much more blunt, as I've come to understand they don't need to be couched in "I don't think I'm smarter than you" disclaimers.

The reason for my questions is two fold.

Is this actually the case, and if so, why?

Is it possible that my perceptions are incorrect? It's been known to happen...I mean, I once thought becksdad was young and good looking...sometimes we're just wrong.

Shoot...I look forward to your opinions. If you think I'm acting the bonehead...no more apologizing when you say so!!

Thanks for your thoughts.

Dwayne

[Dustdevil]

To the medics...though I know none of “you” have (has?) ever done this. What gives? Is it possible this is part of what the basics and intermediates are tripping over? That they are trying to learn (like me) but instead instantly being seen as a "know it all"?

I do think that happens. And I think that it happens a great deal in EMS because of the structure of the current educational process in EMS. In EMS, the primary focus is on training, not education. And with little formal education behind themselves, those medics doing the precepting have little understanding of the educational process. The old adage about being a good medic does not necessarily make you a good teacher is very true. Way too many paramedics who are precepting students -- no matter how good they are at their jobs -- simply have no understanding of how to educate or relate their experience to others. But neither did those who precepted them, so it is a vicious cycle.

That said, obviously not all field preceptors need to be professional educators. But they do have to have an understanding of how the educational process works. Look at how the medical school process works. See one, do one, teach one. Every student in medicine, whether a freshman, an intern, or a resident, is involved in teaching. Everybody comes out with experience on both sides, both as the student and as the teacher. Therefore, they are able to relate to both roles. This produces practitioners who are forever in educational mode, both as a student and as a teacher. With this outlook, nobody is threatened by the questions of students, because they too still understand what it is like to be a student. That's why you get such positive response from physicians, but not with many medics. This is what needs to happen in EMS in order to facilitate the educational process.

But yeah... some people simply don't have the personality or temperament for teaching. That doesn't necessarily make them a bad medic. But those people -- regardless of their professional competence -- should not be in positions to precept students.

Do nurses constantly tell stories of medic and nursing students 'challenging' them?

I can't say I have ever heard it. Now, mind you, I have heard (and participated in) many a bitch session among nurses about medic students over the years. But it was the opposite of what you suggest. It was complaining about those under motivated students who did not show adequate motivation to participate or get involved. Aside from the obvious slugs who only want to sit at the nurses station and talk on their cellphones all night, there are a lot of medic students who think they are only there to get IV sticks and medication pushes, and show no interest in anything else. Two reasons seem to exist for this. First, they don't care enough to ask the kinds of questions you are describing. We wish they did! But a great many medic students seem to think that they don't have to make any effort to actually learn. They expect that everything they need will just be taught to them without them having to participate in the process. It's like, "I paid my money, so now make me a paramedic." And second, somehow these students are making it all the way to clinicals in medic school with their school still not having taught them that paramedic practice is about much, much more than just skills. Having read of your experiences, Dwayne, I know you know the kind of guys I am talking about and how common they are.

Good question! Certainly one that we all have to deal with at one point or another, on both sides of the fence.

[chaser]

...It just seems that, when speaking with paramedics, questions closely related in tone and content (or at least they appear so to me), are much more likely to be considered a challenge than when speaking to other health care providers...

I think I am missing what you are after. I was hung up with the phrasing and approach in questioning, and of course, timing. I know you better than to think you would question in front of a patient. There should be a way to ask your questions without feeling like you have to sugar coat them to get the answers you are after.

Asking a question to a medic in the field, and the identical question to an ER doc, I would expect a different response, attitude, and answer. Apples and oranges.

Interpersonal communication can be a tricky avenue, and the slightest variances in vocabulary can evoke a very different reaction, especially when stress is involved. And egos.

[firemedic05]

Dust Devil hit the nail on the head. Nice response. I totally agree, I had students signing up for my shift due to me "being a nice guy". I am a nice guy but when I was presented with utterly incompetent students, I wasn't so nice anymore. I asked to have my name taken off the preceptor list because I realized that I do have a hard time explaining Why I do the things I do, sometimes. How do you explain things like: ex. why you like a certain music over another or why your favorite color is _____? I am trained like everyone else but use my gut instinct a lot and don't know how to instill that into others. Not everyone, automatically has common sense. I would like to teach and instruct but till I find a way to handle questions from students like " Do you think this person is going to die" in ambulance with patient listening or the student who told the motorcross patient " I guess this is a career ender, hugh?" while chuckling; I will have to work on my patience and self-control. To me the ultimate answer to your question will come when you finish medic school and have a few students yourself. Then you might see the other side of the coin, so to speak.

[bunnos]

I dont know about you guys, but generally when i have a final year student working with me - I end up asking all the questions

[Dustdevil]

I dont know about you guys, but generally when i have a final year student working with me - I end up asking all the questions

Damn fine point, if I understood you correctly.

We can never, ourselves, stop being students. We can never close our minds to new voices and new ideas. Ideally and hopefully, our students are coming from an environment where they are freshly absorbing the latest in theoretical and scientific knowledge. They should be receiving cutting edge information and ideas. Not to mention, they are freshly carrying many of the things we somehow forgot about along the way. It is important to both of us to engage them in intelligent discussion, not just lecture them about how we do things. I am never afraid to learn something from anybody, even those many years my professional junior.

[bunnos]

Yup Dust, thats what i was getting at

[DwayneEMTP]

I didn't mean to ignore the responses...I'm seem to be having selective internet issues.

I called my service provider up and asked nicely "Look you pricks! When are you going to get this fixed!"

Of course they copped an attitude. I think the whole damned place is staffed with paramedics...

Dwayne

[fiznat]

Nobody has touched on it yet, so I'll go ahead and bite the bullet.

I think a lot of medics take offense easily because there is often a bit of a superiority complex. Coupled with the shallow nature of the paramedic education and the wealth of what we do not know, I don't think it is any surprise at all that paramedics are touchy when they get questioned on the "whys" and "hows" by probing students. A lot of medics think that they know everything, and in the EMS world, it is easy to present yourself as such among EMTs with less training. Pointed questions tend to root out the fact that there are still gray areas, though, and I think it is very telling that some paramedics get sore when students start poking around. To me, the "how dare you question me" response seems to illuminate insecurity rather than the opposite.

Naturally there is still professional etiquette in the way a question should be asked, but I think my point stands.

Now don't get me wrong. I am a paramedic myself, and I have LOTS of respect for MANY paramedics who are incredibly adept at what they do, who are very well (albeit self) educated, and are humble about the things they do not know. These people amaze me. The sad truth of the matter, though, is I don't think these people are of the majority.

I don't claim to be an exception, but it is something that I fight against and think about every time I am at work.