New medic and SCARED!

[HERBIE1]

Thank you! I should tell you that they did put me with an FTO for several weeks (don't want you to think I work for a crazy company that throws newbies out by themselves). I was released from orientation by 2 FTOs per policy.

Did you express your reservations to the FTO's? What advice did they give you? They should have options that could help you- more time with an FTO, clinical time, etc.

Again- relax as much as you can, trust your knowledge, and always do what's right for the patient. You'll never go wrong if you keep that in mind.

Being "scared" is a good thing. The adrenaline rush keeps you sharp, you just need to focus that rush in the right direction.

As was mentioned, even us old farts that have been doing this a long time still have those "Uh-oh" moments. A bizarre rhythm you aren't sure about, conflicting signs, symptoms, and presentations of your patients- just take it step by step. Ask questions every chance you get. Most docs- especially students and residents- are more than happy to explain something to you- it reinforces their skills. There's an old adage in medical training of new docs- SEE a procedure, DO a procedure, TEACH a procedure. If you can adequately and accurately explain something to someone, then clearly you have a firm grasp of the material.

I recall years ago seeing a funky EKG strip we simply could not identify. We treated the patient appropriately and transported. I asked the ER doc(who I knew and respected a lot) to identify the strip for me- I wanted to know what I was missing. The doc looked at it, shrugged his shoulders and said- "Beats the hell out of me. That's what cardiologists are for." I sat there with my mouth hanging open, but that's when I also realized- NOBODY knows it all.

Don't ever let pride get in the way. If I don''t know something, I have no problem saying- I have no idea what's going on here. Doctors call in specialists when they are in over their heads or beyond their area of expertise- why can't we? That's what your partner or medical control is for. The vast majority of our calls are pretty straight forward, but occasionally we get those puzzlers that really make you think. That's why keeping current and reviewing your knowledge base is so important- regardless if you are brand new or an old fogey.

You need to have a firm grasp of the things we are supposed to know, and be familiar with as much as possible.

I LOVE those mysteries. I love the challenge of trying to figure out a complicated medical/cardiac presentation- even if the treatment is beyond our scope, I always try to guess what the hospital will do to fix the problem. It keeps me fresh.

I also suggest working in an ER- you learn an incredible amount just by witnessing and being a part of the care. You learn about normal/abnormal lab values, reading Xrays, CT's, ultra sound exams. You see what tests are ordered based on the patient's complaints. You will be amazed at the amount of knowledge you absorb, and it helps you explain to family and patients what will happen once they hit the hospital doors.

Edited August 8, 2010 by HERBIE1

[JC816]

I told them that I was nervous, but it was basically get off orientation as a medic or switch to EMT status and there were no full time openings. I worked in an ER for a bit before I started medic school, but had to quit because they would not work with my school schedule. They wanted me to work 3 12's and then I had school 3 days a week plus clinicals. There was no way that was happening. I am doing my bridge to RN right now (sort of, I need to actually DO it) and I will feel a lot more comfortable working as a RN with lots of other RNs and doctors right there with me. I sure will miss being on the ambulance though. I am a 2nd generation, mom & dad met as EMTs. My mom always told me there is something about being on an ambulance that sticks with you, gets in your blood. That whole year I was in between school and job, I would get so sad everytime I saw an ambulance go by!

[rock_shoes]

Your pretty coherent with your post (more than mine says rock_shoes) your not freaking out your asking am I normal ? (YES) This the just first step in the staircase that should never end.

True. You do always seem to know when to bring out a great Ralph Waldo Emerson quote so I’ll have to forgive you for now.

I feel like I am just waiting for that one call to show me I don't know what I am doing and shouldn't be on the street.

It isn’t just a matter of time until you run a call that proves you should hang it all up and find another job. What really determines whether or not you should get out of the field is how you react to that call. Do you piss and moan about how you screwed up or do you take the time to figure out what you could have done better? Sometimes the end result will be the end result no matter what you do. That doesn’t mean you can’t learn something along the way.

The fact that you’re asking the question now tells me you’re not the provider with too much bravado to learn from your errors. As long as that’s the case I don’t expect to see you on the evening news being blamed for some triage/patient care catastrophe.

You too I still get the butterfly's after 30 + years .. this is absolutely normal and when this goes away your burnt out. You are a human after all not a caped superhero !

Damn it Squint you’re stepping on my cape! Do you have any idea how hard it is to get greasy Albertan out of a poly-cotton blend?

In all seriousness your butterflies sound so much more pleasant than the writhing pile of snakes I end up with on occasion. If you’re never nervous that just means you’re too dumb to realize that grandma-broken-hip actually fell because she was having a CVA. IT’S OK TO BE NERVOUS. It’s not ok to let those nerves paralyze you to the point you treat your patients with the “Stare of Life.”

The best thing I ever started to do was look absolutely everything up every time I have even the slightest twinge of doubt about how a call went. A patient rattles off a medication I’m unfamiliar with, I look it up. If I haven’t had a patient with a particular condition before a call I look it up after, even if the condition is completely irrelevant to the original presenting problem. I’m very fortunate to have a good working relationship with the local hospital staff. If I bring in a patient with an interesting history and or presentation I am frequently able to follow up on that patient. If that’s possible with the service you work for do it every chance you get. If one or more of the local hospitals hosts interesting case rounds participate as often as possible. The best providers know that they will never be perfect, yet strive for it anyways. The best way I know of to seek that unattainable goal is to participate in research and continuing education every chance you get.

You know we have all been there, some days I wish I could go back.

I don't have a flux capacitor in my Toyota ... well quite yet .

Should have shelled out for the DeLorean! It’s all about the paint-free stainless steel body man!