How to flow smoothly and not be a klutz?

[AnthonyM83]

So, I've been trying really hard to be a competent EMT and make a good impression on the FD/medics, ER staff, and the nurses during transfers.

It been hard getting things to run smoothly with my partner. Not personality-wise, but I guess more communication-wise. Like when loading patients or maneuvering the gurney through the ER for pickups/dropoffs or at scens with FD. I feel a lot of it is him trying to get through things quickly, but I find we make less mistakes when taking it real slow.

Examples:

-I'm covering patient's legs or setting my clipboard down before I can crouch to raise the gurney up. I'm turned around putting my clipboard down and I heard "Let's drop it, ready? 1, 2, 3" I have to rush to turn and do it OR I have to say, "no"...but that looks bad to staff. Him all urgently bent down ready to lift and I'm with my hands full saying "no". We should have the appearence of slow and coordination.

Or we're doing an IFT on a kid with an unset fx and he starts turning the gurney...but not realizing I'm not holding onto the other end, so the other end swings out like it's going to bump the wall, so I have to drop what's in my hands catch the other end to prevent the kid from yelling in pain. But now it looks like I just dropped my clipboard out of the blue to the ER staff.

I feel like I would usually be the one making those mistakes (he's 5 years older than me). I think part of it is that I was an explorer for 6 years...I got the "urgency" out of my system and learned how I work best. BUT we're still kind of klutzy. I'm learning to just force us to slow down and stop him to verbalize a plan before we do things...but I also want to develop more of a system of doing things and communicating.

So, I'm wondering what kind of systems you guys have with your partners. We need SOME system. If I keep bringing up every little thing, I'm going to sound like a d*** and there'll be tension and work won't be fun anymore. I was thinking of having specific things to say when we need to slow down the gurney so I can maneuver the front when going through tight spaces, like "let's slow down" (but really meaning slow the F down right away b/c you can't keep pushing at the same speed when I'm trying to maneuver a minfield of chairs and rolling vital monitors. I looks bad to always be telling him to slow down now. But I also don't want to be the annoying partner who bogs him down with "systems" and being anal.

Sorry, for the long post. Really, just looking for any systems/phrases/codewords/procedurees you guys have on-scene, with gurney, at hospitals, driving, loading patients. Cause I'm tried of this Frick&Frack team. I'm starting to take more of a lead role (which is weird for me, b/c I've always been the explorer/youngest/newest at all the real jobs I've had...most leadership has been of groups younger than me...never someone older like my partner).

[Timmy]

Well I am a cadet or what you guys call an explorer. I’m the youngest by about 20years, it’s hard sometimes, I too take a lead roll in most situations as the 3 other members I work with are either new or have no idea. One particular member I dread going on duty with as he is old and really has no idea, to give you an example, he was called to a patient, he arrived about 2 mins before me but as soon as I arrived he got straight up to let me in, I dunno why, but he does it with every patient. He also has failed all our courses and skills maintains programs but they keep him in purely to keep up our numbers, as we lack volunteers. I know what you mean when members are to emergent about all patients, we have a 4th year med student and he’s hopeless, he panics and carries on like a pork chop yelling out medical mumbo jumbo that no one understands, try’s new procedures they learnt in uni the day before and rushes everything.

There’s not much you can do about it, maybe talk to your partner, tell him that you think he works to fast and he’s putting patients welfare at risk. Make sure if he’s going to do something like adjust the stretcher that you’re aware of it. It seems kind of weird that he just does things out of the blue with out saying that he’s doing it and you must drop everything in aid of the patient. Maybe something along the lines of “I’m going to move the bed, could you support the head end”. It seems you need to communicate better, the only way this is achieved it if you speak up and openly discuss any problems that you might have and ways to resolve them in the future.

He may not be aware of what he is actually doing.

[Dustdevil]

Sounds like if your partner simply pulled his head out of his arse, the coordination would follow spontaneously. It takes two to coordinate. You can't do it all yourself. Having not observed either of you, I have to assume from what I see here that you are doing just fine and that he is a loser. He's going to have to recognise two things; First, that you you are not a mindreader, and second that he is the one who is creating the problem. Then, change can occur.

Until then, you have two choices. You can be direct and explain this to your partner, and hope that he is professional enough to agree that more coordination is necessary, and that he bears at least equal responsibility for making it happen. Or you can be indirect and simply stay with what your routine, and when he tries to force you into reacting to his disorganisation, just drop a non-confrontational verbal clue like, "Sure. I'll be right with you" or "Okay, just let me finish this real quick" or even "Hold that thought."

Either way, I encourage you to not give in to his style. Yes, there are those who will say to "choose your battles" and let this one go. But this is an important issue that should not simply be let go without discussion. And if you give in on this one, it only allows him to establish more dominance, and expect your submission in all future issues. I suspect that he is already doing things like this for the very idea of making you feel submissive and that he is in control. Don't feed that monster.

[Relish]

Dust gives some great tips...you absolutely have to get your partners attention and be sure that he waits for you to prepare. Lifting/transfering patients is detailed work and done incorrectly can lead to injuries in the patient and YOU! Transfer techniques were created for a reason, so don't let your partner bowl you over and make you ignore them as well. If he is as "quick" to make a move without you, then you have every right to speak up and let him know that it was inconsiderate to not wait for you to get your bearings first, just a "whoa! give me a second...", "not in position", will hopefully get his attention, if not, wait till you are alone somewhere and properly address the situation...your patients and your back depend on it.

THere are nurses at work that are the same way, some that just flip through it with no discussion on what is going to be done and how we are going to follow through- MANY times during the day I have to speak up and ask "whoa, what are you planning to do?" "So you are going to lift from the left and you'd like me to direct the legs?". Maybe I sound stupid, but I really don't care. We just recently got a bariatric patient on the unit, and all of a sudden the nurses are paying attention to the transfer techniques and ensuring that their partners are clear on the actions we are to make and that we are positioned properly. It just got me thinking, why does it take a 400lb man to make them realize the importance of team work, it should be second nature with every patient, every co-worker and situation.

I hope that you are able to solve this, I know how frustrating it can be. ](*,)

[JPINFV]

I know a person who would fit that description. He now runs a glorified gurney van (technically an ambulance) shuttling patients between 2 buildings at a local hospital [he never even leaves the parking lot].

First things first, realize that some people just lack situational awareness and can be completely beyond help. Sometimes the best thing you can do if you're working basic/basic is to kick the person out of the back of your ambulance. Be sure to talk to management too, chances are they know about it already, but are so hurting for people that they can't justify firing him.

Second off, don't worry about the RNs/Medics/etc. The RNs at hospitals sees different basics all the time, especially in So Cal. Patient care and safety should take precedence over showing off to the medics or RNs.

[Ridryder 911]

Like Dust described, most of the time coordination will come; but, if if does not I would confront him and discuss it with him after an incident. Be firm, not argumentative. Inform him, WE almost .. dropped, or ran into the wall... etc.. Remind him, that it's a "we" thing, and you don't plan on getting hurt, hurting the patient, and plan on getting our act together. Enough is enough... Hopefully, this will awake him enough to remove his cephalic region....

R/r 911

[AnthonyM83]

Thanks for the advice guys.

And really he's not incompetent or anything. He's new. It's exciting. He reminds me of when I was a new police explorer eight years ago. He's interested in being a good EMT, though...but just get carried away in the rush a bit much. I still do it too sometimes. Another aspect is that he's always the driver (until I get training in a month or so), so he doesn't always realize the paperwork the other things I'm attending to. Pt care is always first, but I'm not always in a rush to load up and go, especially for IFTs.

[KSEMT122]

This really sounds like a typical problem we all experience with new partners. Especially when you are fresh out of school. That is exactly the situation we are all in at one point or another. It just seems worse because your new and don't really know if you're doing it right or not. Good news is it gets better. It took about 6 months for my partner and I to finally get to the point where we didn't have to talk to eachother to know what we were doing. We verbalized important stuff, but not the everyday stuff. We each knew what the other was going to do. It just takes time. Hang in there. If you work for a dept where you don't have a steady partner, things will take much longer to come together for you. I've seen Fire Depts who do first response or actually run the EMS calls who NEVER flow because they never have the same 2 techs on the trucks together. It usually looks like a bumbling idiot parade. Just depends on how your dept. is. Hang in there it will get better. And be confident in yourself that you KNOW you're doing things right.

[Dustdevil]

Ah, I think I get the picture now. From the first post, I was imagining him being an overbearing jerk, thinking his month of experience made him somehow better than you. Apparently, he's just an immature n00b who needs some Ritalin.

This sort of reminds me of the situation where some idiot is riding your arse on the freeway. The way to handle that is to take your foot off of the accelerator and slow down, forcing him to do the same. The same advice could apply here. If you make your actions more deliberately paced, your partner will be forced to pay more attention to what you are doing. The result is, you are passively taking the lead and he now has to pay attention and follow. This, of course, will only work if you stick with it and don't give in to his impatience.

Obviously, one of you must change. However, only one of you actually needs to change, and it isn't you.

[Lithium]

How about ... just TALK to your partner? If he's going to fast, tell him to slow down (as diplomatically as possible), if your hands are full, tell him, I'm busy, one second!

It's not about looking cool, and being suave and slick; it's about communicating with your partner. Just because you're new doesn't give you the excuse to be a "klutz". I'm not saying you are, but don't worry about what other people think. If you need an extra few minutes, tell him or her. No worries! They should be professional enough to let you do your thing.

Besides, how are you suppose to develop your own routine if you keep following everyone elses?

peace