Question re: clinical rotations in Boston hospitals

[john_boston]

I will certainly talk more with my instructors re: preexisting relationships that they have with hospitals. I certainly don't want to go somewhere where there is an incomplete understanding of my capabilities and education or where a medic intern would be ill-suited. That said, however, I find it a bit bizarre that so many here are quick to dismiss and condemn a program they know absolutely nothing about. Yes, there are lots of crappy medic programs and even more crappy medics who are an embarrassment to us all.

That said...maybe lay off a little with the negativity and griping? It's kind of too much to listen to after a while around here.

For those that offered constructive, encouraging feedback...thanks!

[p3medic]

Any medic doing his/her clinicals in a Boston teaching hospital will have a clinical coordintator at the facility, with the knowledge of what is expected. I don't think anyone would just show up blind, at least I hope not. Anyhow, good luck.

[VentMedic]

That said, however, I find it a bit bizarre that so many here are quick to dismiss and condemn a program they know absolutely nothing about. Yes, there are lots of crappy medic programs and even more crappy medics who are an embarrassment to us all.

That said...maybe lay off a little with the negativity and griping? It's kind of too much to listen to after a while around here.

For those that offered constructive, encouraging feedback...thanks!

You are taking that very personally!

Do you realize how many students or professionals in training at a large teaching hospital? Many are competing for the same skills that a Paramedic student is doing. And yes you are competing with people who have much higher education then you and with very set schedules. If your instructors has not petitioned on your behalf for a piece of the action, then don't blame others.

Even MDs and DOs are from different programs and will have different privileges on the hospital property. I can not allow some of the residents to intubate either in our ED if it is not part of their program or if they are not cleared for that skill by their senior. I may have 15 people sign in with me for a chance at intubation or for the physicians, an art stick or A-line. I may only have 5 intubations in the ED or emergently inhouse for that 12 hour shift. The Chief of CC Medicine may also give me a priority list. That being said, I will still try to work with others or ask if there is an OR rotation available for some students.

I don't think you quite realize the responsibility someone has who is mentoring you on a live patient for "skills" especially if they do not know your background or anything about what was already expected of you in your program. I have even had students of all types come expecting to intubate and not know which hand to put the laryngoscope.

So don't take things so personally or act like you are entitled to special treatment because you are a medic student. If you cop that attitude, no one will have time for you.

If your school has made the proper arrangements, get the name of a contact person and don't let them tell you to "just show up".

An ED in a large city teaching hospital will be the most chaotic but controlled scene you will ever have to work probably in your entire career in EMS.

[john_boston]

VentMedic - All I was addressing is the incredible amount of negativity that I've seen exhibited by some people around here (you know who they/you are) at the drop of a hat. After merely asking for opinions about where other medics in the area have had positive experiences, I get these responses about all the crappy medic programs and unprepared students there are out there, how I'd better not show up without having met with a program coordinator (duh...), how I am apparently entitled and want special treatment? I have nothing but respect and deference for the doctors and nurses at these hospitals -- indeed I hope one day to be in their position. Very strange, very strange.

"I don't think you quite realize the responsibility someone has who is mentoring you on a live patient for "skills" especially if they do not know your background or anything about what was already expected of you in your program."

What gave you any indication that I don't understand that responsibility? I was merely asking where medics in my area have had positive clinical experiences. How is this being misinterpreted?

I was commenting on the larger issue of negativity on the boards, negativity in American EMS culture in general. It's pervasive and poisonous and totally accepted for some reason. It's also self-perpetuating and tiring to listen to over and over again.

Anyway, that aside, thank you for the info. I'll be sure to word my question much more precisely and carefully next time.

[Dustdevil]

VentMedic - All I was addressing is the incredible amount of negativity that I've seen exhibited by some people around here (you know who they/you are) at the drop of a hat.

You've tossed out your fair share of non-productive negativity here lately too, so don't get too self-righteous on us. Take it for what it's worth. But if you aren't interested in all feedback, don't ask for it.

[jsadin]

Nice to see we're all on our best behavior. That being said, I did my intermediate clinicals at Boston Med. I thought the ER staff was excellent. Very friendly and I didn't have to fight anyone for my skills. 12+ IV's in a shift was not uncommon, plus blood draws, EKG's, etc. I was always encouraged to scoot over to the trauma room when something "good" was coming in and even got to participate in a few fast paced traumas. I lucked out during my OR time because the new residents weren't in yet and the old ones didn't need any tubes. I had all my tubes by the third day. The OR was nowhere near as friendly as the ER, but from what I've been told that's pretty much the norm anywhere (you're either agressive or you're a wall flower). OB and pedi were both fine. I didn't have to do any ICU time. Parking is a b*tch, but not a problem for you if you're taking the T or a bus (my partner and I drove in from central MA every day).

Offer to help in any way you can and your clinicals will go much easier. Change beds, take patients to x-ray/CAT scan, etc. After you've spent a shift or two with the same crew, let them know what skills you still need and I'll bet they'll hook you up.

[john_boston]

Exactly the kind of reply I was looking for, thanks jsadin!

[jsadin]

Glad I could be of some help John. Obviously you'll need to get more skills for your paramedic rotation than I did for my intermediate, but I don't think you'll have a problem at BMC. BTW, the Menino ED was definitely busier than the Newton. The Newton Pavilion is much smaller, but I still was able to learn a lot in my time over there. I did get more skills on the Menino side, however (and the Dunkin' Donuts was much more convenient - out through triage and take a right).