1st shift with my new preceptor...

[DwayneEMTP]

You know, everyone told me after my rough start with my phase one clinicals that it wouldn't always be that way. Well, tonight I started phase two with a new medic and basic...and it was so good!

When we were introduced, the medic said, (paraphrasing) “I don't really care where you're at in your clinicals, all the calls are yours. The scene, the patient, the decisions...this is your truck.”

I said, “I'm not sure exactly what that means?” ( I was a little gunshy after my first preceptor).

He said, “I want you to lead. You make whatever decisions you feel are best. If you're wrong, we'll help steer you right. If you miss something, we'll suggest it to you. If you get lost, we'll step in and take over until we can discuss it later, OK?”

I said, “Ok.”

And, God bless them, that is exactly what they did!

First call, I grabbed the jump bag, went in and tried to run right over fire (Fire controls the scene and patient until released to the privates)...The medic touched me on the back, whispered “Step back, I'll explain later.” When the patient was delivered he explained that I had some things to learn about working together with fire, and I should follow his lead on scene until I got the hang of it. I wasn't an idiot, there was no yelling involved, simply a mistake that needed to be educated away. Cool as hell.

I tech'd 13 calls, and tried to find the zebra on every one. At the end of each call I was expected to explain my rationale for each intervention or assessment direction, which I was thrilled to do as I'm not very confident in ANYTHING so far.

On one call he said, “Why did you decide to do a 12 lead on a 90 y/o woman with shoulder pain and no history or other indications of cardiac issues?” I said, “Hell, you know what, I don't believe she needed a 12 lead...I was simply covering my ass.” :oops:

He said, “With your experience, I think that was a very good decision.”

Anyway, I could go on for pages...the difference in educational value with a good preceptor is so immense it's impossible to put into words.

I was just reading Tskstorm's post, which is what made me think about posting this. Once again the 'council of elders' told me to keep the faith, so I did, because things would get better, and they did.

Thank you all for the time you spend to teach and mentor those of us that so desperately need it.

Have a great day all!

Dwayne

[Ridryder 911]

Hang in there... glad to see to see a positive change. Just like life, it sucks some times and sometimes it's great. Appears, you are getting some real life lessons and are learning to apply your knowledge to the workings of EMS.

Good luck!

R/r 911

[AnthonyM83]

Awesome to hear, Dwayne. Exciting times.

[akroeze]

I've only had one student so far but that was the way I did it too.

To me there is no better way to learn.

[Eydawn]

Sweet! Glad to hear you actually have someone invested in teaching you, rather than making you wade through your learning alone! It's never fun to get stuck with a bad teacher. Sounds like this could be the turning point for you, Dwayne!

Wendy

CO EMT-B

[Kaisu]

Man you really paid your dues... I am glad that you are having a decent experience now. It took a lot for you to stick with it after that idiot you had. I hope you can turn it to good and turn the negative to a positive.

[medic511]

Great to hear things are going well. It really takes someone who is really, and justifiably, self-confident to make a good preceptor. The ones that belittle you do so because they do not feel comfortable enough with their own skills. They may only know one way to do something and jump to the conclusion that your way is "wrong" rather than just different from theirs.

[DwayneEMTP]

It really takes someone who is really, and justifiably, self-confident to make a good preceptor. The ones that belittle you do so because they do not feel comfortable enough with their own skills.

Man, I believe that is so true. The only time I've been truly uncomfortable with my current (completely fictional preceptor :wink: ) was following a cardiac arrest...

She was reading my (fictional) PCR and said (along the lines of..)

Medic: "Are you comfortable with this PCR?"

Me-thinking (Hell, I think we gave too little bicarb....I had written "administered sodium bicarb", like a wuss "forgetting" to put the dosage)

Me: " Yes ma'am"

Medic: "So you're comfortable with the types and amounts of drugs we pushed, and the times that we pushed them?"

Me-thinking(God damnit! Why didn't I mention the bicarb first?!?!?!? She's going to bring up the bicarb!) (She gave one amp of bicarb while we were moving the patient, when 80mEqs would have been more appropriate, and then went back to epi/atropine when we got into the ambulance) (Certainly pointing out her mistake isn't the right thing to do?)

Me: "Except for the bicard, I believe we didn't give enough."

Medic: "Did you believe that then?"

Me-thinking(Of course I have to say yes...then she's going ask why I didn't speak my mind!!)

Me: "Yes"

Medic: "What kept you from speaking up?"

Me: "I felt it was possible that with your larger body of experience that you had decided something else was more important, or perhaps it was a mistake, and based on the current body of research, a very minor mistake."

Medic: "And is it your belief that allowing me to overlook that mistake was somehow doing me a favor? That I find being "right" better than being good? Or if I am the type of medic that didn't care that it was a mistake, was it instead your thinking that you were being an advocate for future patients by allowing my behavior to go documented?"

Me-thinking (Ok, I really, really, hate this conversation!)

Me: "This is what I now believe. That I tried to do the "right thing" by being vague on my report. That in doing so, I cheated you by not mentioning this at the time when it could have been corrected. Also if you were a different kind of medic, I didn't do my job, by allowing you to continue to do sloppy medicine, and in both cases cheapened myself and my word to people that might count on it/me in the future. And what I know most of all? that I will NEVER put myself into a position to have to justify such stupid reasoning again."

Medic: "Good enough for me. Want a pepsi?"

Me-Thinking (I could never have made those points, that well, with no one feeling intimidated if I had 20 years and a brain transplant from a smart person.)

Me: "Yeah, thanks. And thanks for making me think that through."

Medic: "No problem."

As we're getting off of shift several hours later, she says "Dwayne. Have a good day! By the way, it was a mistake. I wish you would have said something" She hands me a copy of her PCR that was completed several hours before our fictional conversation. "See you tomorrow." Of course her incorrect dosage of bicarb was well documented...

Of course the fictional conversation didn't go exactly like that, but pretty close. And should the fictional medic in question ever read it I hope she sees the spirit of our conversation captured here.

Anyway, I know I look like a dork when I go on like this...I just keep hoping that if others see that there are amazing preceptors, lessons to be learned, and opportunities to learn them..they'll keep searching until they find them...

Have a great day all...

Dwayne

[Kaisu]

Dorks RULE!

[scparamedic98]

I'm glad to see that you have found a preceptor that is taking an active role in your education and not a passive, just let's get through the shift one. I know I have seen co-workers precept students that were too busy trying to make sure they were seen as super-medic to properly evaluate and educate the student. I like the way that your preceptor handled the shift. It is similar to how I try to precept, except I like to have the student for more than one shift and I like for the student to "watch" for the first few calls and be more of a team member and gradually during the shift, transition the student to more of a team leader. Which seems to be similar to what you got, but it seemed that wasn't what was offered to you in the beginning.

Overall I think you had what anyone would call a positive clinical experience. Glad to hear it went well for you and I hope this is just the first of many positive preceptors you have.