# Skills Tracking



## Dominion (Oct 12, 2009)

So I did my first shift in the ER today and I found myself almost lost in tracking all the numerous skills I performed.  I was so busy that I kinda lost track and just found it inconvenient to go back to my paper every few patients.  Anyone know of any good PDA software to use to track skills?  Not fisdap...don't want to pay for Fisdap for JUST the tracking software.


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## JPINFV (Oct 12, 2009)

This isn't free, but it's pretty cheap and only takes a few minutes to use.


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## amberdt03 (Oct 12, 2009)

JPINFV said:


> This isn't free, but it's pretty cheap and only takes a few minutes to use.



lol....love it!!!!



just go buy a small notepad to keep in one of your pockets and write down everything before you move on to the next patient. then when you get some down time, go to your papers and document everything you need to.


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## Epi-do (Oct 12, 2009)

I would just grab a label from the patient's chart and stick that on a piece of paper and then jot down what I did.  Only took a couple seconds and if I ended up going back and doing more for/to the patient, I just added it to my list.


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## Dominion (Oct 12, 2009)

Epi-do said:


> I would just grab a label from the patient's chart and stick that on a piece of paper and then jot down what I did.  Only took a couple seconds and if I ended up going back and doing more for/to the patient, I just added it to my list.



I like this idea.  I did the paper and pen today but I like technology


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## medicdan (Oct 12, 2009)

Epi-do said:


> I would just grab a label from the patient's chart and stick that on a piece of paper and then jot down what I did.  Only took a couple seconds and if I ended up going back and doing more for/to the patient, I just added it to my list.



Isnt that problematic re: taking patient's information (Name, DOB, MRN, etc)? If its just you keeping track of skills, why do you need patient identifiers?


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## Dominion (Oct 12, 2009)

I have to do my own assessment and that will help me to have that label on there when I document, I can always tear the label off later and toss it in the shred box.


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## SES4 (Oct 12, 2009)

My program builds the cost of FISDAP into the first semesters lab fees.


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## Epi-do (Oct 12, 2009)

emt.dan said:


> Isnt that problematic re: taking patient's information (Name, DOB, MRN, etc)? If its just you keeping track of skills, why do you need patient identifiers?



We had to turn in the labels/lists of skills to our instructor.  We were required to black out the patient's name & DOB.  Our instructor used the MRN to pull the chart and make sure that we really did do what we said we did.  If we didn't initial on the chart or get the RN to document that we were the one that did the skill, we didn't get credit for it.


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## JPINFV (Oct 13, 2009)

Epi-do said:


> We had to turn in the labels/lists of skills to our instructor.  We were required to black out the patient's name & DOB.  Our instructor used the MRN to pull the chart and make sure that we really did do what we said we did.  If we didn't initial on the chart or get the RN to document that we were the one that did the skill, we didn't get credit for it.



Now that brings up an interesting idea. Would paramedic clinicals be better if paramedics acted more like medical students and low level residents and instead of following a nurse or physician around, after an orientation period saw patients by themselves, presented the patient to an attending physician with a plan, wrote the the orders, and had the physician cosign the order?


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## Epi-do (Oct 13, 2009)

JPINFV said:


> Now that brings up an interesting idea. Would paramedic clinicals be better if paramedics acted more like medical students and low level residents and instead of following a nurse or physician around, after an orientation period saw patients by themselves, presented the patient to an attending physician with a plan, wrote the the orders, and had the physician cosign the order?



One of our clinicals that we we had to do was a shift shadowing one of the ER docs.  The day I was doing it, the medical director was there for the last half of my shift, and I probably learned more in that 6 hours about being confident in your decisions than I did the entire rest of medic class.  

When he got a new patient, after he evaluated them, he would send me in to do my own patient interview/assessment.  After doing that, he would ask me what I thought was going on with the patient, what I wanted to do, and why I wanted to do it.  We would then talk about my decisions and how I arrived at them.  

Sometimes, I was dead on what he was planning on doing for the patient, other times, I would miss the mark a bit.  However, I still made decisions that were not detrimental to my patient.  It was just my inexperience showing.  

Towards the end of the shift, he told me that if I got nothing else out of the experience, he wanted me to walk away with the idea that no matter what you decide to do, stand by your decision.  There is nothing that says if it doesn't work, you can't reassess the situation and reach a new conclusion.  Just have confidence in yourself, you really do know this stuff.

Overall, it was one of the best clinicals I had the entire time I was in class.


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## Dominion (Oct 13, 2009)

JPINFV said:


> Now that brings up an interesting idea. Would paramedic clinicals be better if paramedics acted more like medical students and low level residents and instead of following a nurse or physician around, after an orientation period saw patients by themselves, presented the patient to an attending physician with a plan, wrote the the orders, and had the physician cosign the order?



I kinda of do this, in my ER clinicals for the first couple shifts I go in and get oriented to the system. My first day was spent getting my name into the supply pixis and getting me used to just being there.  By the end of the first day though my RN was coming up to me and saying "Bed x needs portable EKG, I need the rhythm and vitals for admission, Bed y needs blood draws, and bed z needs an IV with 1L at 250mL/hour, if you need help with the IV and blood draw come get me".  I'll be shadowing for a couple more shifts then the idea is to add me as a 'team member' gradually taking me from the low priority beds to the high priority beds like that.  

If anything serious comes in I'm considered part of the 'Tech' group even though I"m under the nursing scope.  So if we get an arrest or anything serious I can go on over to that area and do what they need from me.


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