MariB Posted March 9, 2013 Author Posted March 9, 2013 well next day I went to a trauma center. in 12 hours they had a good 200 patients. I hated it there. Yes, I could have been done, they would have signed a blank check had I handed it to them, but I took a couple tramas, watched from a corner, marked what I did (observed) had them sign and then I took the patients I enjoyed, and spent the day caring for them. I need 2 more. I cancelled the next day with the trauma center due to weather , well it was supposed to snow and I called the first place back. He stated they loved having me there and doors were open for me. If I get my medic, I have a job waiting I will plan to go back next weekend. I wanted to actually care for my patients, not watch and get stupid papers signed. I could have been done ten times over, but I wanted to do it right.
scubanurse Posted March 9, 2013 Posted March 9, 2013 Welcome to EMT-B clinicals.... by caring for them what did you think they would let you do? I'm just curious because it's sounding like you were expecting to be able to fully care for them while in the ER and that isn't what EMS is... By observing you'll learn a lot of what happens once you drop the patients off not how to care for them in the pre-hospital setting. I hope you continue to learn and stay excited, just be careful about expectations.
MariB Posted March 9, 2013 Author Posted March 9, 2013 Well, at the first hospital, I did blood pressures, I did 12 leads, I did assessments. I helped the doctor set a broken tib/fib I did a lot of hands on. I had a lot explained to me. It was a great experience. The second hospital, I could have said I did brain surgery on my paperwork and they would have signed it. I posed the BP machine a couple times just to say I did something... it just wasn't like the first place. don't get me wrong, I wasn't turned loose in the first place, but they let me do everything withing my scope of practice.
scubanurse Posted March 9, 2013 Posted March 9, 2013 In my experience every hospital has a different set of rules for students. One of my rotations we basically sat around and did nothing, couldn't chart, couldn't do much at all. Now on my current rotation, I have pyxis access and I am able to chart on the patients medical record under my own account. This is at the RN level, but it carries everywhere. It's all up to how the hospital perceives students and their past history. One clinical site we have doesn't allow student rn's to give any meds even with our preceptor because a few years ago a student was stealing drugs from patients (giving 1mg instead of 2mg etc). Did the trauma center allow you to ask questions and explain things at least?
MariB Posted March 9, 2013 Author Posted March 9, 2013 In my experience every hospital has a different set of rules for students. One of my rotations we basically sat around and did nothing, couldn't chart, couldn't do much at all. Now on my current rotation, I have pyxis access and I am able to chart on the patients medical record under my own account. This is at the RN level, but it carries everywhere. It's all up to how the hospital perceives students and their past history. One clinical site we have doesn't allow student rn's to give any meds even with our preceptor because a few years ago a student was stealing drugs from patients (giving 1mg instead of 2mg etc). Did the trauma center allow you to ask questions and explain things at least? the trauma center told me to go wherever I wanted and I could talk to patients. However I didn't have the direction I did at the other hospital. I don't know. Speaking to the my instructor , he had the same problem there during his clinicals and found a much better experience elsewhere. Some places just seem to be better teaching hospitals. 1
BEorP Posted March 10, 2013 Posted March 10, 2013 the trauma center told me to go wherever I wanted and I could talk to patients. However I didn't have the direction I did at the other hospital. I don't know. Speaking to the my instructor , he had the same problem there during his clinicals and found a much better experience elsewhere. Some places just seem to be better teaching hospitals. Although maybe not seeming as fun as being "hands on," do not underestimate the importance of practicing history taking, which you have a lot of freedom to do in this type of situation where no one is paying much attention to what you are doing. I agree that it is probably not ideal to not be under someone's wing, but if you're in that situation again I would suggest that you just go patient to patient (with patients who will tolerate being bothered by a student) and take a good history. Being able to take a good history in a reasonable amount of time does take practice even though asking a set of questions seems like it should be easy. If you are left on your own to do whatever you want, you might as well also at least do some kind of assessment on the patients. Lung sounds is probably one of the most important assessment skills for a student prehospital provider to be able to assess well. Everyone has lungs so even if they aren't in with a respiratory problem, have a listen. Knowing normal will make it easier to recognize abnormal.
MariB Posted March 11, 2013 Author Posted March 11, 2013 Well, before going I asked what should I bring, they said just myself, they had everything I need there. I had no access to a stethoscope so that was out. I would follow the nurse in as the patient came in so taking a history would pretty much be a repeat performance. I say trauma center, because it was, but it is also a functioning ER so a majority of patients were flu, colds etc. It was just. Eh
scubanurse Posted March 11, 2013 Posted March 11, 2013 For future reference... Borrowing stethoscopes is gross...never leave your house without your own.
MariB Posted March 11, 2013 Author Posted March 11, 2013 For future reference... Borrowing stethoscopes is gross...never leave your house without your own.the thought is, I have my own awesome one, but our ambulance is equipped with one we clean with swabs. It's disinfected each use. Ears and all. I don't loan mine out though in fear of not getting it back
BEorP Posted March 11, 2013 Posted March 11, 2013 Well, before going I asked what should I bring, they said just myself, they had everything I need there. I had no access to a stethoscope so that was out. I would follow the nurse in as the patient came in so taking a history would pretty much be a repeat performance. I say trauma center, because it was, but it is also a functioning ER so a majority of patients were flu, colds etc. It was just. Eh I guess the point that I was trying to make is more just that clinical placements often seem less than ideal but it will really end up being up to you to make the most of it. If there were a bunch of lower acuity patients that the nurse was assessing, you could have asked if you could go in and speak with them before the nurse did to take 5 minutes or so to get a history and then try presenting it to the nurse as if you brought the patient in and were giving a report. Or if that wouldn't work logistically (e.g. no place for you to speak with the patients), then you could have tried asking if you could ask some questions to get the history started even with the nurse right there. I obviously wasn't there so I don't know exactly what would have worked in this situation, but there is almost always a way to make a bad clinical placement into something worthwhile. I am not trying to criticize you but I am trying to offer real suggestions for how you could make the most out of one in the future that may seem less than ideal since obviously you are quite ambitious and eager to learn.
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