voices Posted May 6, 2014 Posted May 6, 2014 I am a NREMT-B student and we have to do 10 field accessments to sit for the practical test. in class i do well with my accessments with passing proformance since the half way point in the class. i even find myself helping other students who are struggling. three times in class though when we would have a serious scenaro to test our skills I would get past the scene safety/bsi and such then freeze and my mind goes blank. after taking a few calming breaths i can dive in and do my thing without much trouble. out in the field however it is a different story, once i get up to the patient i kind of go brain dead like i have no idea what i'm doing. any advice?
island emt Posted May 6, 2014 Posted May 6, 2014 Welcome to the city Welcome to the world of reality, Do you have any experience in interacting with people you don't know? Often times getting out and actually doing hands on emergency care is much different from many other skillsets. When socialization is lacking it can be a hard barrier to break down. This is not one of those things that can be done by texting . At what point do you freeze? When meeting & greeting ?, Or when having to let your brain take over with what you have been trained to do in your assessment.
HellsBells Posted May 6, 2014 Posted May 6, 2014 I had a similar problem when I first became an EMT in 2004. I was lucky to have understanding preceptors and mentors to help me through my rookie phase. There is no easy way to get over this situation, you have to do assessments repeatedly until you develop confidence and competence in your practice. The good news is that it gets better with time, now that I'm ten years into it doing assessments is second nature and I don't have to worry about freezing up on calls any more. The one piece of advice that helped me was to not think of the assessment as a rigid set of questions you have to ask, but instead a problem you have to find a solution to. I found initially when I first started I was trying to rush through a series of predetermined questions without really listening to the patients answers, then getting stuck when I forgot what the next textbook question should be and also realizing I hadn't listened to anything the patient had told me. Try to really listen to what the patient says, then integrate that into your line of questioning. Generally that will get you out of your head and help with those awkward brain freezes. Also, don't be too hard on yourself, others have been where you are and got through it, so can you. 1
mikeymedic1984 Posted May 7, 2014 Posted May 7, 2014 No matter how I type this, it will sound like a slap against EMT-Bs, but I promise it is not. As a student at any level you should be very nervous with your first patient encounters, as there are a ton of things that ARE NOT and CAN NOT be covered in a classroom. As you gain experience, you will become more confident. At the EMT-B level there is not a whole lot that you can screw up (in most States you are more or less the ambulance driver who will be paired with someone of a higher skill level, and experience level), unless you refuse to transport someone or wreck the truck, so realize that the chances of you being responsible for a patient's death is very remote unless you are totally irresponsible. Lastly, realize that for the most part (or at least I hope), we do not create the injury or illness that your patient is experiencing -- we are just there to manage it in the moment of crisis, and realize that patients die despite our's and the medical community's best efforts to not let that happen. We can not undo 20 years of smoking cigarettes or being 100 lbs overwieght; nor can we stop the drunk driver from hitting you or undo the damage for not wearing a seatbelt. Stick with your ABCDs, be a patient advocate, and do the best you can. There is a very good chance that you will make mistakes, but remember we do not have x-ray vision or the ability to confirm our diagnosis with lab results as doctors do. If you make a mistake, learn from it, and do not repeat it. I would also suggest "volunteering" as a tech in your local ER, where you will get the opportunity to see more patients, but not be in charge -- so you will gain valuable experience in just a few month's time, without the stress of being the 2 person crew that is in charge, in the field.
Just Plain Ruff Posted May 7, 2014 Posted May 7, 2014 No matter how I type this, it will sound like a slap against EMT-Bs, but I promise it is not. As a student at any level you should be very nervous with your first patient encounters, as there are a ton of things that ARE NOT and CAN NOT be covered in a classroom. As you gain experience, you will become more confident. At the EMT-B level there is not a whole lot that you can screw up (in most States you are more or less the ambulance driver who will be paired with someone of a higher skill level, and experience level), unless you refuse to transport someone or wreck the truck, so realize that the chances of you being responsible for a patient's death is very remote unless you are totally irresponsible. Lastly, realize that for the most part (or at least I hope), we do not create the injury or illness that your patient is experiencing -- we are just there to manage it in the moment of crisis, and realize that patients die despite our's and the medical community's best efforts to not let that happen. We can not undo 20 years of smoking cigarettes or being 100 lbs overwieght; nor can we stop the drunk driver from hitting you or undo the damage for not wearing a seatbelt. Stick with your ABCDs, be a patient advocate, and do the best you can. There is a very good chance that you will make mistakes, but remember we do not have x-ray vision or the ability to confirm our diagnosis with lab results as doctors do. If you make a mistake, learn from it, and do not repeat it. I would also suggest "volunteering" as a tech in your local ER, where you will get the opportunity to see more patients, but not be in charge -- so you will gain valuable experience in just a few month's time, without the stress of being the 2 person crew that is in charge, in the field. Dang that was good mikey, but I'll add this, this is the reason why you are going to school and also why you have a experienced emt or medic watching your back. If you do not have someone like that in your field preceptorship then it's time for you to look at another EMS agency to do your rides with or requesting a more alert and engaged person to work with you. My first emt job was at a city service, I don't really count this as my first job because my preceptors sucked big donkey balls and did not help me at all. I was left to flounder while my two seasoned partners told me "you are here to drive and that's it, don't expect to do any skills." and then they would go into the back of the unit and put a sheet up so I could not see what they were doing. Many people told me they were a couple and they hated men. (these were two women who I worked with). I only drove, was their gopher and at my time to get off evaluation they would not approve me off because they said I had not proven myself as a quality EMT even though they let me do NOTHING with patients. So I quit I then moved to a city service about 20 miles away, first day working I have told everyone here about but the learning atmosphere as a new EMT was night and day different. I say that this service made me the EMT I was until I got to medic school. Then I got my medic and worked for a great hospital based service and my preceptor was one of the best medics I've ever worked with bar none. So you can do it, don't let anyone say you cannot and keep your chinup.
ClutzyEMT Posted May 13, 2014 Posted May 13, 2014 At the EMT-B level there is not a whole lot that you can screw up (in most States you are more or less the ambulance driver who will be paired with someone of a higher skill level, and experience level), unless you refuse to transport someone or wreck the truck, so realize that the chances of you being responsible for a patient's death is very remote unless you are totally irresponsible. Good advice mikey and Ruff if the poster is an area that routinely uses EMT's as a dual partner to a medic. But if he's in an area where EMT's are routinely running the calls solo, not so much...... There are a whole lot of things that an EMT can 'screw up'.......whether you like it or not or agree with it or not, EMT's run calls solo in many states with rural services. ND, SD, and Minnesota for example.... Not so sure I agree with the statement that they couldn't be held responsible for a patient's death unless they were totally irresponsible....
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