# Paramedic Field Internship :(



## Noctis Lucis Caelum (Aug 26, 2010)

Currently i'm on my 4th shift as a paramedic intern. I have no EMT experience as well and i'm already stressing out like crazy. My preceptor is really cool and calm when i run calls. But my problem is it isn't really clicking at the moment. He says i just need to run more calls but it just feels like i'm not getting anywhere. I've been beating myself up at end of every shift cause its stressing my mind off. I know i shouldn't beat myself up and eventually in time i'd get the process down. But man..how long or how many hours did it take for those who were a medic intern to finally start clicking on the calls?


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## Shishkabob (Aug 26, 2010)

Shoot, it WONT click while you're a student.  It just wont.  Use the time of your internship to get a bit more comfortable with making decisions, knowing that you still have a safety net incase you DO make the wrong decision.


It doesn't start to *click* till you're on your own, learning to be your own medic, relying on only yourself to make the decisions.  It's pretty accepted that your first year(s) are where you are not only the most scared of your new responsibility, but where you also learn the most at how to be a medic.


Remember, medic school teaches you the theory... working teaches you the practicality.    We've all been in your shoes... look back to February and you'll find a post by me detailing how freaked out I was just before my internship.



There's a reason why it's called "practicing" medicine.


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## Noctis Lucis Caelum (Aug 26, 2010)

Linuss, thank you so much it means a lot to hear it from you. Even though i'm beating myself up day after day at the end of every shift. I still come in the next shift trying to improve but there are those days that just make you say in your head "WTF??" I just hope i'd pass the internship and go out and experience on my own. I take you response really serious and I thank you for the support Linuss


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## Akulahawk (Aug 26, 2010)

I didn't start really wrapping my head around the Paramedic thing until about my 18th shift on my internship. It took me another 6 months before I started feeling fairly comfortable with it. I spent more years learning how to be a medic...


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## Fbarba123 (Aug 26, 2010)

Like everyone else has said, just try to get as comfortable as you can while you can. Trying to get it to "click" and mesh right now is like trying to run before you can walk. It will take time, but you will get there.

Do all that you can, interact with your patients, ask questions, all that general stuff. Don't be shy! Get in there and get your hands dirty! There is no other way to learn!


I see your in San Jose! Keep up the great work, i'm looking at pursing medic school within a year or so. What program are you with?


-Felix


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## ShannahQuilts (Aug 27, 2010)

Noctis Lucis Caelum said:


> But man..how long or how many hours did it take for those who were a medic intern to finally start clicking on the calls?



I asked my instructor the same question, and his answer was that it's a combination of hours, and also what those hours entail.  If you spend lots of hours dealing with transports or superficial wounds, it may be a while before you click on the more major calls.

I know there are likely medics who disagree, and I am just a First Responder, but I honestly think that getting the hang of it involves honing your intuition, and every moment you spend on a call, you are doing that, whether it's obvious or not.  As time passes, there will be more and more calls that you can just respond to, without having to run the flowchart/checklist in your head.

My advice to you would be to trust that your brain is working on it, and that you will get it, and try not to get anxious about it.  That way, your brain can just get on with processing all the information.


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## Shishkabob (Aug 27, 2010)

ShannahQuilts said:


> I am just a First Responder



No such thing as "just".


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## Hockey (Aug 27, 2010)

I've learned to just stop. Step back. Take a deep breath and go okay, this isn't all that bad.  

It works actually quite well


Over time, you feel more comfortable with all of it.


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## mgr22 (Aug 27, 2010)

Try not to judge yourself relative to your preceptors. Sure, they're more confident than you right now, but they didn't start out that way. There's nothing unusual about how you feel. I almost quit several times because it was so frustrating not to "get it" as a student. I bet your instructor's right about just needing more calls.


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## 8jimi8 (Aug 27, 2010)

Remove the fear of making the wrong decision by doing a TOP-NOTCH assessment.

You may not know what the next right thing to do is, but if you miss nothing on your assessment, you'll be able to pull the facts together and make a good educated guess.  

ASSESS ASSESS ASSESS!  You'll get the hang of it!


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## Noctis Lucis Caelum (Aug 27, 2010)

Thank you for all the response, today was my 5th shift and I somewhat or should I say my "brain" got somewhat of a click but it went loose and slipped off :sad: Other than that i am working on my assessment better but still having a checklist running off. I can handle BLS calls but when calls turns into ALS on scene my head just scatters and i'm lost on my checklist/assessment besides ABC's.

I am still hanging in there and know it'll get ugly than good like a roller coaster ride. Just have sit through the whole bumpy ride and get it over with.


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## Noctis Lucis Caelum (Aug 27, 2010)

Fbarba123 said:


> I see your in San Jose! Keep up the great work, i'm looking at pursing medic school within a year or so. What program are you with?
> 
> -Felix



There's only 2 paramedic program schools in San Jose right now and thats Westmed College and Foothill College. The waiting list for Foothill is pretty far long so I went to Westmed Colelge


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## MediMike (Aug 28, 2010)

My best bit of advice is to just *STTAAAYYY CAAALLLMMMM*.

The only difference between an ALS call and a BLS call is a more involved assessment (more in-depth hx) and some neat monkey skills I'm sure ya picked up on in class ^_^

Learning how to talk to patients as people is a huge thing as well.  Just remember, its *their* emergency, you're there to mitigate their situation.  

Sounds like you're keeping a mental checkilst of assessment steps, thats good! Over time you'll figure out which ones you really need on that call and which ones you can skip over.  Long ago we had to point out to a fellow student that, No, tactile vocal fremitus, bronchopony and egophony were not necessary on a tib/fib fx :wacko:

You're gonna do great bud, just put in your time, relax, and make a good rapport with the patient


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## rhan101277 (Aug 29, 2010)

My last 10 - 24 hour clinical shifts - was really where everything starting falling into place.  When you do the team lead calls, my preceptor basically just did what I asked him to do.  They won't let you kill a patient and if you are moving to slow they may step in.  However you can't really do a call like you want until you are own your own.  Some of my preceptors liked to do stuff a specific way, while others did it entirely different.  Some like to stay and play, on non-emergent calls, while others just would load and go as soon as consent was given.

Its a stressful time, just keep at it and when your done it will be worth it.  I have recently became a brand new medic.  I haven't even worked my first call while being precepted.  I still have to do my first call, alone.


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## Hockey (Aug 30, 2010)

rhan101277 said:


> My last 10 - 24 hour clinical shifts - was really where everything starting falling into place.  When you do the team lead calls, my preceptor basically just did what I asked him to do.  They won't let you kill a patient and if you are moving to slow they may step in.  However you can't really do a call like you want until you are own your own.  Some of my preceptors liked to do stuff a specific way, while others did it entirely different.  Some like to stay and play, on non-emergent calls, while others just would load and go as soon as consent was given.
> 
> Its a stressful time, just keep at it and when your done it will be worth it.  I have recently became a brand new medic.  I haven't even worked my first call while being precepted.  I still have to do my first call, alone.



You in MI?


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## rhan101277 (Aug 30, 2010)

Hockey said:


> You in MI?



No mississippi


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## Medic50321 (Aug 30, 2010)

I am in the finishing stages of my Paramedic program (3 shifts to go) and I have to tell you that unless you have a little time on the squad (6mos to 1yr) as a Basic, it will take you longer to get to the "Ah-Ha" moment you are seeking.

Even having that time under mybelt, it still took about 100hours into a 250hour EMS clinical rotation to really hit that mark.  Alot of it to me was the "All inclusive" nature of being a Paramedic.  In the end, it was easier for me to accept the team role, directing the Fire department, my partners and getting the job done.

Remember, Slow is Fast, Slow is smooth.


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## Shishkabob (Aug 30, 2010)

Slow is smooth, smooth is fast.


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## Epi-do (Aug 30, 2010)

You are still early in your internship!  By the time you are done with it, things will sort of make sense - at least enough for you to feel ready for that first patient that you find yourself on your own with.  If your preceptors are good, they will let you flounder just enough to realize you really can do this, and you really do know what to do, but not let you flounder so much that you get discouraged.  I was always told that medic class teaches you the _what_ part of being a medic, but it is that first year or so that teaches you the _how_.

Don't worry, you will get through this.  All of us have been there.  Before you know it, you will be the "old guy" that all of the medic students want to be like - cool, calm, collected, and appearing to always know exactly what to do.  (Notice, I said _appearing_.  None of us have seen it all, or done it all, no matter how long we have been doing this.)  A large part of this job is looking on the outside like you know what to do, even if you are having a moment of shear panic on the inside.


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## firetender (Aug 30, 2010)

*This site works!*

Just a big thank you to _*all *_for being so supportive, from so many directions. What I like most about this is the FNG, with your help, is coming along! And to him I say, thanks for taking the risk; it's showing us at our best!


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## firemed17 (Aug 31, 2010)

Hey man, Im on your same boat, well somewhat, I just started my EMT B class last week and im crapping my pants. I start riding in about 2 weeks and have no clue what to expect.


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## Akulahawk (Sep 1, 2010)

Linuss said:


> Slow is smooth, smooth is fast.


Slow is smooth. Smooth is fast. Slow is fast. 

As stated earlier, the biggest thing to remember is that BLS calls and ALS calls are all in one continuum. You have the _what_ knowledge now... BLS calls are ALS calls... they only differ in what you need to do. Most patients will only need a little TLC, hand-holding (literal or figurative) and a ride. You'll still assess their problem and your findings will drive you towards what needs doing. Some patients need a bit more... Some patients will present to you while they're having their "Oh Crap!" moment and your assessment will show you that you're going to need to throw everything at them (including the proverbial kitchen sink) just to give them a chance...

But it's all on the same continuum. 

Also, one reason why I (and others) suggest 6 months to a year time as a working Basic is that it helps get the basic ambulance mechanical stuff out of the way and get you to the point where you don't have to think as much about the mechanics of doing an assessment... you just _do_ it. If that makes any sense. And I also agree with an above poster in that since you have minimal time as a Basic prior to this point, it'll take a little while longer for you to find your own rhythm. It's kind of like music that way... You try out different styles and then you'll find your own groove. When you do, your preceptors will see it. You might not see it at first. They will...


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## Noctis Lucis Caelum (Sep 1, 2010)

Update: I'm starting to feel a LOT more comfortable in the back of the rig. Flowing through my assessment while hooking patients up on basic monitor, spo2, o2, all that good stuff. I'm getting the feel of turn over reports. Getting 2's out of 3's from my preceptor so i'm making progress thats for sure. I'm not sure if i'm 2 hard on myself and shouldn't beat myself up at the end of the day which i always do after a eval report with him. During the day my confidence grows while going on calls but by the end of the day i just beat myself down cause of the eval. By this sunday i'm at 120hrs ^_^


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## firetender (Sep 2, 2010)

Noctis Lucis Caelum said:


> By this sunday i'm at 120hrs ^_^



If you're busy counting the hours, you'll miss the moments! Fill every one up.


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## Oiball (Sep 2, 2010)

firemed17 said:


> Hey man, Im on your same boat, well somewhat, I just started my EMT B class last week and im crapping my pants. I start riding in about 2 weeks and have no clue what to expect.



Whereabouts in Florida are you?  I'm a recent Sunshine State EMT-B myself.


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