# Student (NYC); rotation soon



## student2008 (Jul 17, 2008)

Hello everyone!  Still a student (only 5 weeks left out of 14 week program), in NYC.  Planning to do this as a volunteer, at least initially.

My rotation is in about 11 days, am scared poopless in general and definitely thinking, "am I nuts for doing this?"  I started the program much more confident, hah.

Any thoughts and tips about handling my first rotation appreciated.  In NYS only one shift is required for the EMTB students.  I picked a midweek day shift and don't know the hospital, nor area so I have no clue what to expect.  No clue if I'll keep it together and look like "I can do it" or be a total idiot and go, "duh...." every 30 seconds under the gun (or on the hot seat).

Also wondering about a nervous stomach (on the internet, nobody can see me blush) and also debating about what/how to eat so that I don't end up being a Pt. myself ::cringes::

Thank you for reading!

P.S.  I've read one of those lists of "Rules of EMS" at the beginning of the program and thought it was hilarious.  Now I'm taking it to heart (especially about newbies).


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## mikeylikesit (Jul 17, 2008)

depends on how much you know and how confident you are with what you know. the rotations will only allow you what you are trained in so don't worry about taking a situation over and going "i don't know what to do". secondly, some proctors will lets you take a few call "on your own" where you run it and they stand back and supervise. don't worry, just remember your Trauma/Medical sheets and you will actually have a more thorough report then the crew. they may make you write practice reports, but it is fun. you feel like a real EMT on these runs and it will fill you with a sense of pride the whole time. you may be nervous of what is going to happen on your first call, but as soon as you see the patient you will be fine. remember peoples lives are not going to hang in your hands during these shifts so you can be "an observer" if you want. i would eat a decent meal, nothing spicy, and don't over-do it on the beverages because they may get agitated if you take 15 bathroom breaks. Just remember in the road of EMS "if you're not completely calm and in control of the situation, then your no good to your patient".


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## rhan101277 (Jul 17, 2008)

mikeylikesit said:


> depends on how much you know and how confident you are with what you know. the rotations will only allow you what you are trained in so don't worry about taking a situation over and going "i don't know what to do". secondly, some proctors will lets you take a few call "on your own" where you run it and they stand back and supervise. don't worry, just remember your Trauma/Medical sheets and you will actually have a more thorough report then the crew. they may make you write practice reports, but it is fun. you feel like a real EMT on these runs and it will fill you with a sense of pride the whole time. you may be nervous of what is going to happen on your first call, but as soon as you see the patient you will be fine. remember peoples lives are not going to hang in your hands during these shifts so you can be "an observer" if you want. i would eat a decent meal, nothing spicy, and don't over-do it on the beverages because they may get agitated if you take 15 bathroom breaks. Just remember in the road of EMS "if you're not completely calm and in control of the situation, then your no good to your patient".



Thanks mikey i will take this advice as well.


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## NC-EMT08 (Jul 17, 2008)

Try not to be too nervous.  Usually the EMTs or medics you are riding with are fairly eager to teach you and know that you are just a student.  They aren't going to try to make you look stupid.  As long as you know the things you are supposed to, you have nothing to worry about.  My advise is to follow their lead and make notes of the questions you think of when you are watching them work.  Then after the call you can ask them.  That will show that you are interested and eager to learn, but you don't want to "bother" them while they're with a patient.


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## firecoins (Jul 17, 2008)

I am a NYC paramedic student in St. Vincent's Catholic medical Center's program.  Where are you doing your rotation?


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## Ridryder911 (Jul 17, 2008)

Basic clinicals are pretty much a "give me". Not much more than observation only. How many hours are you doing? Usually, I will allow Basic students to take vital signs and observe, maybe place oxygen onto a patient pretty much simplistic tasks. 

Couple of reasons most do not allow much more is because it is there first exposure to any medical care and procedures, they are easily overwhelmed. Second, not much they are allowed to do than as described. 

Take it easy and relax and enjoy it. You can't screw up & if you do so what...? Your a student, that is when you are supposed to...

Have fun! 

R/r 911


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## student2008 (Jul 20, 2008)

mikeylikesit said:


> depends on how much you know and how confident you are with what you know. the rotations will only allow you what you are trained in so don't worry about taking a situation over and going "i don't know what to do". secondly, some proctors will lets you take a few call "on your own" where you run it and they stand back and supervise. don't worry, just remember your Trauma/Medical sheets and you will actually have a more thorough report then the crew. they may make you write practice reports, but it is fun. you feel like a real EMT on these runs and it will fill you with a sense of pride the whole time. you may be nervous of what is going to happen on your first call, but as soon as you see the patient you will be fine. remember peoples lives are not going to hang in your hands during these shifts so you can be "an observer" if you want. i would eat a decent meal, nothing spicy, and don't over-do it on the beverages because they may get agitated if you take 15 bathroom breaks. Just remember in the road of EMS "if you're not completely calm and in control of the situation, then your no good to your patient".



Hello mikeylikesit and thanks for the reply!

At times (during lectures and practice labs) I feel like I really know my stuff; other times, not so sure.  I'm planning to try and review everything to date as thoroughly as possible (which all of us are supposed to be doing anyway, heh) so at least the knowledge is somewhere in my head even if I have a bout of performance anxiety (stage fright).

In general, I need more practice with vital signs (particularly BP), review trauma/medical.  I haven't really gotten the PCR down yet, thanks for reminding me on this.

Eat a normal (not spicy, LOL) meal, easy on the beverages (fewer bathroom runs):  thanks!  Do you know I was debating getting the <a href="http://www.biorelief.com/stadium-gal.html">Stadium Gal</a> (or for the gentlemen, <a href="http://www.biorelief.com/travel-urinals/stadiumpal.html">Stadium Pal</a>)?

Thanks again.


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## student2008 (Jul 20, 2008)

NC-EMT08 said:


> Try not to be too nervous.  Usually the EMTs or medics you are riding with are fairly eager to teach you and know that you are just a student.  They aren't going to try to make you look stupid.  As long as you know the things you are supposed to, you have nothing to worry about.  My advise is to follow their lead and make notes of the questions you think of when you are watching them work.  Then after the call you can ask them.  That will show that you are interested and eager to learn, but you don't want to "bother" them while they're with a patient.



Heh, thank you.    A few of my classmates that are doing their rotations earlier than me were getting nervous about what was expected of them during the rotations, including whether or not they should be more assertive (aggressive?) about asking questions and participating, or being more passive (but eager to respond).  It's sort of a fear of overdoing the newbie enthusiasm, or underdoing it and appearing to be a bump on a log.

I guess during the rotation, it depends on how well the student-newbie picks up on communication styles as well as determining suitable context etc.


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## student2008 (Jul 20, 2008)

firecoins said:


> I am a NYC paramedic student in St. Vincent's Catholic medical Center's program.  Where are you doing your rotation?



Hello fellow NYC student!  

I'd like to say, but don't want to jinx myself (hey, the EMTs I do my rotation with might be *reading* LOL!), but it is one of the Brooklyn hospitals.  The medical facility is chosen by my program and etc.  The only details the students choose is the specific shift (at least until fully signed up and last I checked, there were only a few left).

Since you're a paramedic student currently - particularly in NYC itself - would you like to share what your first rotation was like, etc.?  (No need to share specific facility and related, just wanted a sense of your mental and training preparedness contrasted with what the reality was like, heh.)

Also I think someone asked (but can't seem to find the specific now), but my rotation is only an 8-hour (08:00 - 16:00 ) day shift, though some shifts are in the evening, or slightly overlaps.


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## student2008 (Jul 20, 2008)

Ridryder911 said:


> Basic clinicals are pretty much a "give me". Not much more than observation only. How many hours are you doing? Usually, I will allow Basic students to take vital signs and observe, maybe place oxygen onto a patient pretty much simplistic tasks.
> 
> Couple of reasons most do not allow much more is because it is there first exposure to any medical care and procedures, they are easily overwhelmed. Second, not much they are allowed to do than as described.
> 
> ...




Ridryder911, thank you for your response.

LOL!  I sure hope it will be "fun" and exciting, as well as educational (all in a good way).  

From what I understand, the least that might be expected is that the EMTs will probably have us at least do vital signs.  Also several of the instructors have indicated that if there is a situation in which CPR needs to be performed, it is apparently common for our EMTs to expect us to do the compressions.  (And if so, we'll find out immediately how different it is to do it on an actual person and not latex CPR Annie!)   Since training protocols here (in NYC) require that we have passed CPR (for health professionals) before we continued with the rest of the EMT program, apparently it will be a significant opportunity for us to prove our training and understanding on this particular skill, at least.

Also I had clarified explicitly with our instructor that the EMTs understand that we are students (and obviously each student will vary in terms of strength, weaknesses, and confidence) and will not expect anything beyond the scope of our training.  He said that if there was something that is asked of us students, but we weren't trained in (or familiar with yet), that we need to inform them immediately that we don't know it, but never to fake it or try and bluff our way.

Thanks again.


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## firecoins (Jul 20, 2008)

student2008 said:


> Hello fellow NYC student!
> 
> Since you're a paramedic student currently - particularly in NYC itself - would you like to share what your first rotation was like, etc.?  (No need to share specific facility and related, just wanted a sense of your mental and training preparedness contrasted with what the reality was like, heh.)



I am going from being an EMT-B to a paramedic so my mindset going into rotations is going to be a bit different than yours.  

MY first NYC rotations as a paramedic student were difficult. My first 10 rotations were on a BLS ambulance.  My preceptors and myself were all working EMT-Bs. We all had a style of how we work. On one shift an a preceptor would insist on doing things 1 way. On a second rotation a different preceptor would be critical for doing it the way the first preceptor did things.


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## mikeylikesit (Jul 20, 2008)

Student2008. I have encountered numerous new EMT's that had troulbes with BP's. I actually found out that 90% of them that stated that they can't hear anything, was due to the fact that they had the earpieces facing rearward instead of forward and towards the ear canal. The other ten percent were using these what i call "disposible stethascopes" which i can still pick up a good BP on but they had trouble still. i let them use my Littmann and they got accurate BP's first time right away. Im not saying that an expensive steth will help, but a decent on (non-double tubing) will help immensily. I assume your problem is being able to detect the sound that you were taught to listen for amoungst the other noises that you hear. Don’t worry, there are actually 5 sounds that you need to hear but that is for more training at a later date. The noises that you hear are usually the steth tube hitting the surface of something or the bell rubbing on the skin and it get confusing. The best i can offer you is to instead of placing the bell of the steth on the patients’ ac (interior elbow) try placing it slightly under the cuff on the brachial artery. You will be amazed at the Huge Huge difference in clarity of sound.... good luck.


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## student2008 (Aug 17, 2008)

mikeylikesit said:


> Student2008. I have encountered numerous new EMT's that had troulbes with BP's. I actually found out that 90% of them that stated that they can't hear anything, was due to the fact that they had the earpieces facing rearward instead of forward and towards the ear canal. The other ten percent were using these what i call "disposible stethascopes" which i can still pick up a good BP on but they had trouble still. i let them use my Littmann and they got accurate BP's first time right away. Im not saying that an expensive steth will help, but a decent on (non-double tubing) will help immensily. I assume your problem is being able to detect the sound that you were taught to listen for amoungst the other noises that you hear. Don’t worry, there are actually 5 sounds that you need to hear but that is for more training at a later date. The noises that you hear are usually the steth tube hitting the surface of something or the bell rubbing on the skin and it get confusing. The best i can offer you is to instead of placing the bell of the steth on the patients’ ac (interior elbow) try placing it slightly under the cuff on the brachial artery. You will be amazed at the Huge Huge difference in clarity of sound.... good luck.



Late reply, but thanks mikeylikesit for your comments about BP and the steth.  Yes, I think those are/were some of the issues and I had borrowed someone else's good (not cheap) to be able to hear the difference.

Also an embarrassing and belated update:  I'm one of the students that didn't make it to the finals.  This happened a couple of weeks back; for better or worse, this also happened just before my ambulance rotation so I never figured out whether or not I would have gotten motion sickness or if the other remedies would have worked.  Meanwhile, I got the various bits of things I was hoping for (including the proper type of "shears" which have teeth and that protective - blunt - end, etc.).  

Though I was feeling pretty down about it in the immediate aftermath, I am debating re-taking the program again in a couple of semesters.  The good thing is that I'll have the opportunity to steady the material better and hopefully I'll find willing victims, er volunteers, so I can practice some of my assessment skills etc. as well (especially vitals).  One of the instructors was really supportive and encouraging and told me that I might do better the next time.

At any rate, I've gained a lot more understanding about how tough the job can be.  Oh, and yes, at least I have been officially trained in CPR *grins* (CPR is fully taught and tested for within the first 10 classes).

Thanks to this comm for all the useful replies and general information (even when not directed at me).  Hoping I can still lurk (maybe sometimes participate) though I'm neither an EMT nor a student, at least for a while.


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## silvercat354726 (Aug 18, 2008)

Thats too bad you didn't make it through the class.  What happened that you didn't make it through was it the practical or the written part?  I am wondering and maybe someone with more knowledge can answer this.  I too am from NY and when I was in class I had to do 16 hours on a ALS rig, nothing in the hospital.  How come this is different?  If people are from the same state why are the rotations different in the same state?!


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## student2008 (Sep 18, 2008)

silvercat354726 said:


> Thats too bad you didn't make it through the class.  What happened that you didn't make it through was it the practical or the written part?  I am wondering and maybe someone with more knowledge can answer this.  I too am from NY and when I was in class I had to do 16 hours on a ALS rig, nothing in the hospital.  How come this is different?  If people are from the same state why are the rotations different in the same state?!



Sorry late in getting back to your reply (not on the forum as much at this point obviously, heheh).

At our program, the practicals come first for the exam, though regrettably I didn't actually make it to the final exams.  (Hard to explain it here, but the program does require a few heavy-duty in-program tests and stuff before the actual state exam).  In short, its the practicals that make me nervous.

Rotations:  Honestly I never thought to ask why min. 8 hours instead of min. 16 hours because most other programs indicate 16 hours, too.  It could be simple logistics perhaps, I don't know.  Also previously both E.R. rotations and ambulance rotations, but I'm told that it was a logistical and legal complexity depending on the hospital, etc.  I think there are a ton of logistical & legal stuff about getting approvals for students or whatever, but I never thought to ask "why" though. 

Related:  at least one student ended up doing a full 16 hours because of circumstances (but for obvious confidentiality reasons, he didn't detail to anyone except to the senior instructor when submitting his paperwork).  He was exhausted and also irritated (has an outside full-time job in addition to the program) and the unexpected double-shift created some personal problems, but he acknowledged that he learned quite a bit.


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