ACP Student Life- Finding a Balance..

[J306]

Hello everybody,

It's been a while since I've posted. Unfortunately, I have adopted the habit of only accessing this site when looking for advice or information, which many of us do. However, since I am now an ACP student, I am going to put in the effort to post scenarios, interesting encounters, and EMS topics.

After spending the summer in the Northern part of the province working as a wilderness guide and first aid attendant I was worried that my knowledge base wouldn't be where it should be when returning to school last week. Fortunately, the first two weeks are "Advanced Care Preparation" and are basically a review of our BLS skills, which if we are entering the ACP level we should all be profecient in anyways.

So far things have been going quite well. We have a great class, some good teachers, others, not so good..But so far I havn't felt the need to study too extensively. We have scenario testing tomorrow, which I've been told the instructors try and make you feel as though you have a long ways to go and challenge you on controversial topics.

One topic which came up today was in regards to pain management. Local protocols state that if patient cannot self-administer Nitrous because of billateral wrist or hand fractures than Nitrous is contraindicated. I spoke up and said that just because they are unable to grip the mouth piece or mask doesn't mean they don't qualify for pain management. My instuctor disagreed along with several other classmates. I responded with the solution that you could fasten the piece to an uninjured part of their hand or wrist so they can still self-regulate the Nitrous PRN. Still, we were unable to see eye-to-eye. I have a suspicion that if I were to do this in a scenario tomorrow, that I would fail if the instructor, or any other instructors sharing this viewpoint were evaluating me.

It's only been a week, and already I'm already running into situations where I'm voicing my opinion then instead of engaging in a discussion about the subject, it's being dismissed or overruled. My hope is that ACP would be a forum in which we could have those collaborative discussions in class, because that is how I learn, but if I am just being an annoyance to the teacher, I'm wondering if I should just hold my tongue and just try and focus on getting my work completed..

I really am trying to find a balance between how much I should stand up for what I believe in, and what I believe is to the greatest benefit to the patient, or to save that for practicum or when I have completed the program.

As for workload, I have heard that this program becomes very intense and almost unmanageable at times. I don't want to be one of those people who are always studying and are always tense and on edge, but I also want to be able to gain as much knowledge and wisdom from the program as possible.. I am in the process of getting a tutor through the school I'm in, but I'm a bit nervous that it won't be enough..

I would love to hear some of your personal strategies and methods from when you attended ACP school!

[Arctickat]

Well, nice to see that ACP school in Regina hasn't changed in the last 20 years. My favourite philosophy for school has been to do it their way until I get the sheepskin, then I can start doing it the right way. In my experience, instructors don't like to be asked common sense questions in front of the class because they are self conscious for not having thought of it themselves. If your instructor has an ego too great for his skills he will become defensive, and that's a bad position for you to be in. If you must clarify something in the future, I'd ask the instructor 1:1. If you don't like his answer, accept his reasoning, no matter how unsound, then move on to ask the person who will sign your paycheck after you graduate.

Think of this...what would you do for Alvin Law?

Enjoy School.

[croaker260]

Shut up, sit down, learn all you can, and then learn more. If your mouth is running, you arent learning. If you fail out, you cant learn.

Remember that as a student, while you have a brain, you dont have the tenur nor the experiance to have an opinion yet.

Its not fair, but it is true.

Good luck.

[rock_shoes]

Shut up, sit down, learn all you can, and then learn more. If your mouth is running, you arent learning. If you fail out, you cant learn.

Remember that as a student, while you have a brain, you dont have the tenur nor the experiance to have an opinion yet.

Its not fair, but it is true.

Good luck.

I'm going to have to disagree to some extent. There exists both a time to speak and a time to listen. While the majority of your educational time should be spent with ears open and mouth closed, there are times when it's appropriate to speak.

Speak with respect, do not be dismissive, and always follow the appropriate chain of discourse. Other individual, instructor, academic chair, finally dean; in that order.

Always remember; while you do have the right to hold an opinion, you also have the responsibility to back that opinion with sound and evidence based research. If you are going to disagree with an instructor show them the respect they're due. Do it in private and back your position with well researched articles. Any instructor worth their salt will welcome the challenge and appreciate the respect you show.

Sent from my SGH-T989D using Tapatalk 2

[BEorP]

Always remember; while you do have the right to hold an opinion, you also have the responsibility to back that opinion with sound and evidence based research. If you are going to disagree with an instructor show them the respect they're due. Do it in private and back your position with well researched articles. Any instructor worth their salt will welcome the challenge and appreciate the respect you show.

The other thing I would add to this is what there will always be cases where protocols/medical directives/clinical practice guidelines aren't perfect. Many of these are hypothetical situations that won't be likely to commonly arise in real life, though it can still be frustrating to see these. If you work in a system that allows you to use your judgement in these situations, that is wonderful. Unfortunately, many systems do not allow this. If this is the case in your system and the protocol says they need to hold it and that is that and the medical director or whoever writes the protocol wants it to be that way, then there isn't much discussion to have. Yes, what you suggest may be reasonable, but if it is not in line with the written guidelines that you need to follow then there's no sense in discussing it with your instructor who obviously didn't write the protocols.

I'm not sure which province you're in so I don't know how it works with your protocols, but if on the other hand the medical director or whoever authored the protocols would support your solution and you know this to be true, then I would ask you what benefit will come from arguing with your instructor. Do it their way in class and then do it your way in real life.

I'm not saying that we shouldn't take a close look at our protocols and ask questions about them. In fact, we probably should be doing more of that and taking our questions to the medical directors who write them. The key thing though is that those issues need to be taken up with the people who actually wrote the protocols. A paramedic arguing with an instructor (or for paramedics working on road, a supervisor) about a protocol that was written much higher up serves no purpose.

So I guess what I am saying is that you should definitely be having discussions in the appropriate setting and challenging the views of others with your supporting evidence, but that this isn't always appropriate if it is simply a protocol issue. Besides, discussing and debating things where there is actual evidence and not simply protocols to fall back on is much more fun!

[DwayneEMTP]

All good points but there is much to be learned when you're told that, I'm assuming, you're only pain management is contraindicated on a small population of patients that will need it most.

And discussion isn't only about change, it's also, and more often, about learning, developing logic trees, playing out "what ifs" in class so that you can be more prepared in real life.

And I couldn't really hate the, "take it up with them in private" argument worse than I do. We all know that many of the questions that others have asked were in our heads as well, and we want to take an, assumed, appropriate question, as this one seems to be to me, asked in (I hope) an appropriately respectful manner and have it moved into the back room where only the two people will benefit from the discussion? I just don't get that...

I read a quote when I was young that said, "I've never known a truly intelligent person that didn't say 'I don't know' on a regular basis." That resonated with me for some reason generations ago, and I paid attention to it, and have found it to be very true.

If your questions aren't being satisfied, if your teacher is unwilling to explore issues that they don't have an instant answer for, then it's high time that they stopped pretending to be an educator.

[Arctickat]

I dunno Dwayne, when dealing with an immature educator my thinking was to discuss with him 1:1 and then he'd have the opportunity to discuss the change with the entire class. That way they can save face. If this is a regular occurrence though, it would be time for the class as a whole to ask for a change. One person dissatisfied with an instructor would be labelled as a trouble maker, but it's hard to ignore the entire class.

In this case though, the class also disagreed with the OP, so he wasn't likely to get any support from them either.

[BEorP]

I dunno Dwayne, when dealing with an immature educator my thinking was to discuss with him 1:1 and then he'd have the opportunity to discuss the change with the entire class. That way they can save face.

That was my thinking as well (immature being the key word). I would love to be a student in paramedicine with an instructor who could respond well to challenging questions in class, but too many of us in our industry take those questions as some type of personal attack and respond negatively. By having the discussion one on one, you show that you are genuinely interested in it and not simply trying to show up your instructor.

I do agree with Dwayne that it shouldn't be that way, but I think that in many places it is. We've put ourselves in a bad spot by putting people into management and education roles based solely on their time on the road and not their actual education in management or education.

[rock_shoes]

And I couldn't really hate the, "take it up with them in private" argument worse than I do. We all know that many of the questions that others have asked were in our heads as well, and we want to take an, assumed, appropriate question, as this one seems to be to me, asked in (I hope) an appropriately respectful manner and have it moved into the back room where only the two people will benefit from the discussion? I just don't get that...

There is a fine line between spurring useful discussion and being a smartass. If I expect my comments to promote intelligent discussion I make them at the time. If I expect a negative, non-productive response I save it for later when I can pursue things intelligently.

I read a quote when I was young that said, "I've never known a truly intelligent person that didn't say 'I don't know' on a regular basis." That resonated with me for some reason generations ago, and I paid attention to it, and have found it to be very true.

I like it. It demonstrates an open willingness to learn.

If your questions aren't being satisfied, if your teacher is unwilling to explore issues that they don't have an instant answer for, then it's high time that they stopped pretending to be an educator.

Sometimes all that’s needed is an attitude adjustment.

[DwayneEMTP]

Yeah...I see all of your points and stand corrected. Though it shouldn't be that way in an optimum learning environment, you're right that these environments most often are that way, and we need to work the best we can within the paramaters allowed, until they can be changed.

Thanks all...