FireEMT2009 Posted August 31, 2011 Posted August 31, 2011 Hello again all sorry I have been gone for a while. I was talkin to my program director today and he said that I needed to stop second guessing myself and get confidence in myself and my knowledge. He stated that I need to lead the calls now since I will be testing out in April. He stated that if I don't start picking up and treating as a paramedic would and stepping out of the student roll and as a paramedic in itself then I would start being marked down on leadership. My question is, how do i build that self confidence? I know my treatment plans but will easily second guess myself when questioned by my preceptor as a test in itself. It is hard for me because I walked into medic school two years ago with only being an EMT for 6 months and running as a medical transport EMT for 3 months. I joined a volly rescue squad around my college to gain that street knowledge needed that I was lacking. Any suggestions would be helpful.
JakeEMTP Posted August 31, 2011 Posted August 31, 2011 (edited) I don't think there is any easy answer. Repetition is the best teacher. If you know your treatment plans (I'm guessing protocols/standing orders), then just do it! Assess the pt. and treat them accordingly. When I precept, I will on occasion question the student's treatment during the call, but usually after. Not trying to question their abilities, but just their thought process. What I would like to see them do is respond quickly with a well thought out response. Your progamme director is right in telling you to step up. Obviously the feed back from your preceptors has led to his conversation with you. The time to gain confidence is now while you have another medic with you. Your inability to want to take charge is nothing new. I'm sure all the providers on this site went through it at one time or another when they were being precepted. That being said, all of them also grabbed the bull by the horns and ran with it. If they didn't, they wouldn't be working for very long. Sometimes decisions need to made quickly when it comes to treating pt.'s. Go with what you have been educated to do and treat the pt. Someday, you will be out on your own and won't have a preceptor to help you. You need to step up now. Don't be afraid of making mistakes, that is why your preceptor is there, to make sure you don't. I'm not trying to bust your chops, and you still have until April, and by then you should be good to go with the testing w/o fear. Good luck man! Keep us posted on your progress! Edited August 31, 2011 by JakeEMTP
Popular Post DwayneEMTP Posted September 1, 2011 Popular Post Posted September 1, 2011 I had this conversation recently with another member here, and I'll tell you what I told them, right, wrong or indifferent. You are not part of the team. You are the leader of the team. You are not another cog in the wheel, you are the main gear. You can laugh and joke and have fun with the team, but in the end, this is YOUR call. You have chosen to step up to the plate and become a medic, you no longer have the right to share responsibility for your patients care. Your call, your patient, your team to use, including their knowledge when necessary, to solve problems, but not yours to shirk your responsibility off onto. I sucked at this when I first started. I often thought, "Bob has been doing this forever, this patient is in the toilet, I should ask him what's wrong, treat accordingly, and spend the time to learn on another patient that isn't so sick." Stupid, right? But that was my limp dick idea of patient advocacy. To let whoever seemed smartest of most experienced make decision while I was learning. How convenient that I was always the least smart and least experienced so I didn't ever really have to take responsibility. Also, it turned out that my logic was pretty friggin' good most times. There have been many threads here about the patients that we regret, the ones that haunt us. You know what? I don't have any dead patients that haunt me, but there are several from early on when I chose to take the advice of someone else when I was confident that I knew what was going on, and turned out retarding the patients condition instead of improving it..just like I believed that it would. I cringe when I think of walking into the hospital with my patient in much worse condition than necessary and having the nurses/doc ask..."Why did you do X instead of Y??" And the only honest answer I could have given, had I chose to be honest, was, "Because I'm a pussy and I didn't want to be responsible for making my own decisions." I used to try and figure out what I thought was wrong, decide what I thought I should do, compare that to what I believed that smart people around me would do, what the protocols said, what the doc was going to say when I got to the ER, what the jury might say should I be wrong...and finally thought, "Fuck this....I'm not smart enough to run all of those angles. I can only do my best if I commit both brain cells to a working diagnosis and logical treatment plan according to ME." And you know what man? People WILL speak up if they think that you're making a mistake. They really will. Often you will have to choose to continue on your path instead of take their advice, but they can respect that too. And they will keep quiet and jump right up on your band wagon to help the instant that they see that you are confident enough to follow. And you know what else? When you show the backbone to lead, people will actually be supportive, even when you're wrong. Because only a coward that does/tries nothing is going to succeed all the time. You can't have confidence in your decisions until you actually begin to make your own decisions. Until then you will continue to just make yourself scared. Leading seems scary from the outside looking in, but it's really just a paper dragon. Next call, fuck all what anyone thinks and lead. Use those Jr to you and Sr to you in any way that makes sense to you and, judging from your posts, I'm CERTAIN that you will find that you've been running from shadows. I guarantee you, and I rarely feel confident speaking for this amazing group of people, that one thing everyone here is certain of, is that you WILL choose to lead. You can do it today, or you can live through weeks of humiliation first, but it's going to happen. What are you waiting for? Dwayne 5
MedicAsh Posted September 7, 2011 Posted September 7, 2011 Dwayne said it perfectly. Ill tell you that as a new medic there is a lot going on. Hiding in your shell isn't the best thing. You may be out of your comfort zone but you just have to do it. Its been hard for me to do but it helps to just step up to the plate and bat rather than just stand there hoping for a "ball". 2
nypamedic43 Posted September 7, 2011 Posted September 7, 2011 LOL Ash...I guess my tough love talk worked. In a perfect world, every patient will be a stay and play type, giving you time to think about what your going to do and then do it. No pressure, no stress. However, in the real world, we often do not have that kind of time. Now is the time to find your feet, your way of doing things. Hone your critical thinking, decide on your treatment plan and then...just do it. There will come a time, when you won't have a safety net and right or wrong, you will be responsible for your actions. Be prepared to stand by your decisions and defend them if necessary. Its that first big step that hangs ALL of us up. We all have gone through this and survived it. You will too. Take the plunge...you won't regret it and you will be amazed 1
crotchitymedic1986 Posted September 7, 2011 Posted September 7, 2011 Yes, I would say take the plunge as well, because now is the time to make mistakes and learn from them. Hiding in your shell in class will not help you in the field when you are the lone medic who has to make the decision. Even if your employer puts you with a strong veteran, there will be calls that you only see once every 10 years or so, so now is the time to step up. If you are second guessing yourself constantly then I would say you either 1. Didnt learn A&P, assessment, and/or protocols fully or 2. You just dont have enough experience. Obviously if the first is correct, study more. IF it is the second you might go talk to your local ER manager and see is she will let you volunteer to observe (not treat) patients for a few shifts. You will see many different illnesses/injury and can see the step-by-step treatment process for each. I am guessing it is the first though since you are the only one being singled out, and the rest of the class started out on equal footing. You might try finding the star student in your class and ask how they study/practice and then mimic them.
FireEMT2009 Posted September 8, 2011 Author Posted September 8, 2011 Thanks all I took lead on the externship I had the next day and it felt really good and I got remarked that I did well just need to slow down a bit. I actually am one of the top students in my class I just have very little EMS experience so I'm still gaining my footing but hey, baby steps. The patient I had was a load and go treat on the way. 1
MedicAsh Posted October 13, 2011 Posted October 13, 2011 Book smarts and street smarts are very different. Take the opportunity to get your confidence up while you can. I have learned that you need to be confident but not cocky. Once you get out there on your own, its a whole new world. Prior experience or not, Its just like starting over again. There are some things I wish I would have done more of in clinicals. I am slowly building up my self confidence in the field but it hasnt been easy. Baby steps are good but the best thing to do is step out of your comfort zone and just do what you need to do. I hope classes are going well.
nypamedic43 Posted October 13, 2011 Posted October 13, 2011 One of my preceptors told me this.."Be a duck..calm on the surface and paddling like Hell under the water". The only person stopping you....is you. One of the EMT's that rode with me and my preceptor alot ( RIP Ryan) looked at me and told me this.." You have the makings to be great in you...you just have to get out of your head. DO what needs to be done". I had HUGE confidence issue while I was in school. I didnt want to cause the patient anymore discomfort. Then, like someone flipped a switch, it didnt matter if I did or not. They needed an IV, they got one, even when they flinched, tensed up or pulled away. It will only get easier with time.
speedygodzilla Posted October 13, 2011 Posted October 13, 2011 Confidence comes over time with experience and knowledge. Clinicals is the time to build that confindence with experience. Make sure you know your stuff, the protocols and most importantly the why and how it works so when they ask why did you do this you can explain why with more than it is protocol. As a preceptor I want my students to know why they are giving or doing xyz. Don't get worried when the preceptor wants to reflect on a call or call you on the spot. A good preceptor should in my opinion do this. Ask for constructive feed back. We want you to be ready to run the calls by yourself when you are finish. You never know where you'll end up working and we need you to be ready to lead. Good luck!
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