When did you know YOU were ready?

[fiznat]

My preceptorship was about 2 months which added up to something like 150-160 ALS patients before I was "cut loose" to work on my own with an EMT partner. Still, I didn't really feel like I was getting into a groove until 6 more months on my own. It does take a while, and even then like others have said there will still be calls (often!) that shake you loose.

[brentoli]

Hey fiznat! Been wondering if you ditched us for another girl

[fiznat]

haha I'm here! Pretty busy lately but I'm always at least lurking...

[Eydawn]

Yay! Fiznat's back!

Can I say I've never been completely comfortable as a medical provider, even though I'm just a basic? I think complacency leads to arrogance and mistakes, whereas knowledge of one's shortcomings helps to compensate for them...

Wendy

CO EMT-B

[kavfd413]

As long as you never quit learning and when you get to the point where you think you know it all, that is when you best get out. Before you hurt someone or hurt yourself. Education should be a lifetime goal. You get out of life what you put in it and as long as you keep yourself in check you should be fine

[DwayneEMTP]

I've discovered that EMS can be very humbling if you take your performance seriously. I don't mean the things people point out to you, but the things you, (at least I do), beat yourself over the head with later.

During my first three phases of clinicals I'd never had to have anyone start and IV for me because I'd missed. Peds, old, young, fat. I could pretty much put a cath on the end of a line, throw it in the general direction of the patient, and have the line established. Hell, I was already coming up with the proper verbiage to use while bragging about NEVER needing assistance throughout all four phases...

Yeah, well. A 100 y/o patient from a nursing home, DOB. When we get there the care givers (not sure of certs) report n/v x 3 days, and no one can really remember seeing her drink anything. ALOC, in and out of consciousness, very poor turgor to her skin, BP...I can't remember..but high 70s/low 80s systolic, Afib with rvr @ about 160.

She weighs about 12 pounds, veins about the size of rolls of nickels EVERYWHERE. Fire says, "We really need this IV, are you confident you can get it?" Of course I said, "Positive."

I grab an 18g, throw on the tourn., make my stick in an AC as big as my thumb...and miss it.

The vein is right there! My catheter is directly in it, I can see it with my xray vision! But no flash...I dig around a little....I just can't find it. So I ask for another 18. Fire asks if I'd like something smaller, I say no, and make another stick. Other AC, same ridiculously large vein...You guessed it. No flash. I can feel my face getting fat, and hot, about to explode, but continue digging until the fire medic asks to step in and gets it no problem. (He must have had a will of iron, as at no time during this call did he use the word ‘idiot’)

Now, I can conceive of only one possible explanation. Once my catheter pierced the skin, it was immediately transported into another dimension. A dimension of not only of sight and sound, but one completely void of veins or blood of any kind. Yeah...I'll bet that's it.

Anyway. My point is that I’m always very much aware of my limitations, and that my limitations are massive, but should I forget at times, EMS karma is sitting patiently on my shoulder waiting to remind me.

My confidence has grown greatly since working with great preceptors, but it’s difficult for me to imagine a time when I’ll be completely comfortable… And I’m committed to keeping Karma at bay.

Dwayne

[Richard B the EMT]

DwayneEMTB, you just illustrated why FDNY EMS only runs pairs of Paramedics, instead of the so called MensaMedics: If even the best Paramedic in our system has a bad day attempting establishing an IV line, the partner can then attempt one.

[als2170]

I've been 'cut loose' for about a year and a half, and finally now my heart doesn't pound as much when responding to a call. I agree with everyone about keeping on your toes, not being the 'paragod', but now that I'm a little more experienced , I try to pay more attention to the things I can continue to learn on the job. I run in a medic/EMT system, so I rarely get someone to bounce ideas off of which is frustrating sometimes, especially on intercepts with 5 volunteers waiting for me to 'do something'.

Dwayne- even the most experienced medics, nurses and docs have 'off' days. Sometimes I can't get a line to save my life. I think the trick to being a good medic is to be able to roll with, take what the call throws at you. Keeping that in mind helps me be calmer and more in control on calls.