# Finally got the job! But feel overwhelmed.



## EMTKhrys (May 26, 2011)

I finally got the EMT-B job that I had been hoping for. I couldn't be more excited! And nervous. And anxious. And overwhelmed. I've now worked 4 shifts as a 3rd rider and supposedly after 3 more, I'm supposed to be cut loose as the 3rd wheel and just have a partner. I don't feel ready. At all. I feel like some things haven't even been covered yet. I also have only lived here slightly over a year, so don't know the area as much as the others. What if i get lost on a call? That would be horrible. Anyone have any advice for this EMS rookie? I want to be an excellent EMT without being told what to do all the time, and also not be in the way. :sad:


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## HotelCo (May 26, 2011)

IFT or 911?

As for the area, get yourself a GPS, or a map book.


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## EMTKhrys (May 26, 2011)

911. We have map books, and I went over it the other night for the first time. I'll be studying it a lot.....


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## DesertMedic66 (May 26, 2011)

EMTKhrys said:


> 911. We have map books, and I went over it the other night for the first time. I'll be studying it a lot.....



Learn how to use the map books accurately and quickly. As for learning the area, time is the best answer.


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## IAems (May 26, 2011)

*Slow is smooth, smooth is fast*

Whether its mapping, patient care, or documentation, STAY CALM!  Take a deep breath and keep your head on the task at hand.  Everybody's new at some point and there's just nothing to be done about that.  Find yourself people that you respect (and who seem to know what they're doing) and take all the advice and help you can get from those people. Congrats on the job.  Welcome to EMS.    B)


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## feldy (May 27, 2011)

as for learning the area, on you off time scout out landmarks and major roads (even if its like McDonalds or a gas station especially the hospitals. And if you happen to work nights, things look different at night so get used to seeing those landmarks at night.


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## EMTKhrys (May 27, 2011)

Thanks everyone! I am trying to stay calm and plan on going around to some places in our responding area next week when I have time so I can familarize myself a little more. In the meantime, I am just trying to learn as much as I can, ask questions and review my maps and materials. I think it's just the driving around town that gets me the most because I don't know the area as well and don't want to make a wrong turn!


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## RanchoEMT (May 27, 2011)

I couldn't believe it, I came into work today to find out that our Trainee quit!!! She "Just couldn't do it" anymore.... Because she didn't feel she was "up" for it, She quit. Had she kept it up she would've been cleared in 2 days, Good To Go.

REMEMBER: THEY CAN'T COVER EVERYTHING IN CLASS!!!! SOME THINGS YOU HAVE TO LEARN ON THE JOB... Don't stress about it, just Do your best, Learn, Improve, Sleep, Repeat. You'll be fine. Just Don't give up when things get hard.


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## JPINFV (May 27, 2011)

Wow? Quit? That's a long drive from Missouri to Southern California. (yes, I know... different people ;-) )


Remember, the first procedure at a cardiac arrest is to take your own pulse.


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## Euclidus (May 27, 2011)

Don't forget that everyone you're working with went through exactly what you're currently going through, too. You've probably heard it a million times that your EMT class prepares you for a job that doesn't exist. Stay calm, ask questions, and if you screw up own up to it, learn from it, and keep moving forward. Mistakes are going to happen; we've all made them. Wisdom comes from experience, and experience comes from messing up! Just keep learning. Good luck!


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## Sasha (May 27, 2011)

Get a gps. Faster than a map book.


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## abckidsmom (May 27, 2011)

Sasha said:


> Get a gps. Faster than a map book.



And often incorrect.  Study the maps.  This job requires more than the 150 hours of training you received. 

Welcome to the learning curve.  Study a lot.


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## HotelCo (May 27, 2011)

abckidsmom said:


> And often incorrect.



If you live in the country, sure. I've used a garmin in my area for a while now, with no issues.


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## abckidsmom (May 27, 2011)

HotelCo said:


> If you live in the country, sure. I've used a garmin in my area for a while now, with no issues.



To be always dependent on GPS to find your way is not cool, IMO.  I get that it's super useful, but every person whose job it is to drive around in an area everyday should know the maps and be able to use them quickly.

It just takes a little practice and familiarization.


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## LucidResq (May 27, 2011)

A local fire dept that also transports does periodic tech free days to make sure everyone's up on their mapping due to some issues they were having. We shut down our CAD and mapping periodically to ensure we can still dispatch and such in case of an emergency that takes it down (which has happened). I think they're a good resource as long as you also have the ability to use a map. Batteries die, weather interferes with satellites, Etc etc.


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## HotelCo (May 27, 2011)

abckidsmom said:


> To be always dependent on GPS to find your way is not cool, IMO.  I get that it's super useful, but every person whose job it is to drive around in an area everyday should know the maps and be able to use them quickly.
> 
> It just takes a little practice and familiarization.



I never said to rely upon it solely.


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## firetender (May 27, 2011)

*Welcome to the Circus!*

For a while you'll probably feel like an actor who got on the wrong stage and is trying to use lines there from someone else's play!

That's called a learning curve. Maybe the most important part is learning not to flinch. In the beginning, most everything falls into the category of "Wow, didn't know that kind of stuff goes on!"

That includes what the professionals around you do as well.

So, at first just keep your mouth shut until you really feel you've seen enough to make comments. REALLY pay attention. Forget the GPS, you need to learn to make your brain think like a computer -- to visualize and memorize your routes and exits rather than depending on a screen outside of yourself.

All of these things fall in the broad category of your need to develop "critical thinking" in all of the phrase's aspects. This demands patience, especially with yourself.

Oh, yeah, don't know if anyone mentioned; if this doesn't turn into something fun in a few months, have the smarts to get out!


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## Sasha (May 27, 2011)

abckidsmom said:


> And often incorrect.  Study the maps.  This job requires more than the 150 hours of training you received.
> 
> Welcome to the learning curve.  Study a lot.



My phone GPS has never been wrong. You press a button, speak the address or name of business/facility, it finds it for you, and gives you a picture of the house when you arrive to know exactly which one it is. It even gives you an accurate ETA based on traffic conditions.

Mapbooks beat that how?


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## JPINFV (May 27, 2011)

You don't have to charge map books.


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## Sasha (May 27, 2011)

JPINFV said:


> You don't have to charge map books.



Mapbooks don't automatically update and it's fairly easy to tear a page out and take longer to use.


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## LucidResq (May 27, 2011)

I can run over a map book with an ambulance and it probably won't break. Map books don't rely on satellites (and therefore can't be interfered with by weather or geologic conditions). Map book pages can be easily referenced  when trying to tell someone else where something is (I guess you can use lat/long, but coordinates are long and easy to mess up).


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## LucidResq (May 27, 2011)

I'm not saying GPS is useless, and it's probably totally appropriate and useful for most situations. However, I feel strongly that one should be able to use low-tech resources as well as high-tech. Saying you don't need to know how to use maps because you have GPS is like saying you don't need to know how to take a manual BP or HR because you have a monitor that can do it for you.

My opinion is unabashedly biased, of course, due to being on many a SAR mission for people who relied entirely on their Garmin.


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## abckidsmom (May 27, 2011)

Sasha said:


> My phone GPS has never been wrong. You press a button, speak the address or name of business/facility, it finds it for you, and gives you a picture of the house when you arrive to know exactly which one it is. It even gives you an accurate ETA based on traffic conditions.
> 
> Mapbooks beat that how?



In urban areas, GPS is fine, and accurate, but by following directions, you don't really KNOW the layout as well as you could.

Two anecdotal and recent GPS failures I've encountered:

Navigating the GPS to 1678 Three Notch Road, the GPS never did accept the typed or spoken address, and wanted to code it as 16783 Notch Rd.

Also, I had the GPS on with the address keyed in properly, and when I turned on the road, I knew from our numbering system that the house would be 1.1 miles on the right (1000 numerics per mile, one every 5.68 feet, even on the right from the biggest intersection with that road).  The GPS had me make the first left onto a dead-end road, which was't going to get me there.

GPS and phone help with navigating is fun and helps a lot, but it's not an exclusive thing at all.  Google maps doesn't have a single street view entry in our county.


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## DesertMedic66 (May 27, 2011)

I think Sasha should come and work for a system that only uses mapbooks for a little while haha. We hardly get cell service in my operational areas. Mapbooks are great and a really useful tool if you know how to use them. You don't need batteries or any kind of service at all to use them. I would love to hear "medic 519 out of service due to empty GPS battery". And the map books are only around $30. And that's before the EMS discount if you get one. Much better then a $300 GPS that only relies on technology to work lol. 

^^ that all was IMHO.


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## Aerin-Sol (May 27, 2011)

Don't let people walk over you. Actually taking the time to use outside resources to seek out ways to improvement makes you more professional/ready for success than most of the EMTs I've worked with. You aren't going to kill anyone, you aren't going to do anything critically wrong, and everyone you will work with has been where you are at some point. EMS has a lot of impolite people in it -- that's just how the field is and you aren't going to change it. Constructive criticism can get harsh, and to a small degree you're just going to have to deal with it, but don't let anyone abuse you. Don't let anyone call you names, curse at you, or insult you, and remember that you're just as important as any of your coworkers when it comes to non-medical related issues: don't be afraid to tell them to get off their phone if they're driving, to tell them you'll talk to them when they're done smoking, or to say you're hungry and ask when you'll be getting lunch, etc etc.


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## sweetpete (May 28, 2011)

Memory over mapbook/gps. Learn your territory so you can respond to most of it by memory.

At the very least, know the main roads/highways that run thru it. Prior to getting out of FTO, we had to learn all the main roads in each district. Then, the side streets were a little easier to grasp.

When all else fails, your partner should be able to help you and dispatch should be able to provide some direction too.

Take care and welcome to hell.
Pete


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## medicdan (May 28, 2011)

I cannot emphasize enough knowing ALL of your area hospitals. Know your designated trauma center, stroke center, STEMI center, burn center, community hospitals, know community clinics, urgent cares, SNFs, all of it. In an urban or suburban area, I encourage you to get to know your Level Is, IIs, IIIs, Pedi Facillities, where medflight can land, etc.

You should start thinking about hospital of choice as soon as you receive a dispatch, and planning your route of exit as readily as your route to the call.

Good Luck!


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## JPINFV (May 28, 2011)

sweetpete said:


> Memory over mapbook/gps. Learn your territory so you can respond to most of it by memory.
> 
> At the very least, know the main roads/highways that run thru it. Prior to getting out of FTO, we had to learn all the main roads in each district. Then, the side streets were a little easier to grasp.
> 
> ...



That's not always possible. The first company I worked at ran calls throughout a 700+ square mile area that contained over 3 million people. There's a lot of main roads in 700 sq miles.


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## DesertMedic66 (May 28, 2011)

JPINFV said:


> That's not always possible. The first company I worked at ran calls throughout a 700+ square mile area that contained over 3 million people. There's a lot of main roads in 700 sq miles.



Yeah same here. We operate in an area 70 miles North to south and 60 miles east to west. With over 18 different cities that we respond to. It's not possible (for an average person) to learn all the main roads and side streets. Along with SNF and urgent cares.


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## LucidResq (May 28, 2011)

Alright, working for a city of 150+ sq miles and just under 400k people, I don't know every street. I do, however, know the hundred block system and the major roadways that serve as benchmarks. I also know what side of the street an address will be on (with few exceptions) based on the numbering system we have, and if you give me an address, I will be able to tell you 95% of the time if it's in our city or not, and the general area. Basically, if you give me an address or cross streets I could drive there 85% of the time with no assistance. I think that's more than enough, but also helpful. By no means do I know every street, though. I think the important thing is, if there's a rhyme and reason to how streets are numbered or named in your city, use it to your advantage.


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## sweetpete (May 29, 2011)

JPINFV said:


> That's not always possible. The first company I worked at ran calls throughout a 700+ square mile area that contained over 3 million people. There's a lot of main roads in 700 sq miles.



Agreed.  Nobody could be expected to memorize that large of a territory. I'm just saying that it's usually possible to memorize the mains and highways of the "district" you're assigned too.

Usually, in a city (regardless of size), each ambulance/fire truck is assigned a district or zone that covers a percentage of the city, not the whole thing.

But, I agree with you. You can't be expected to memorize a large city street index.

Pete


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## rogersam5 (May 29, 2011)

EMTKhrys said:


> I finally got the EMT-B job that I had been hoping for. I couldn't be more excited! And nervous. And anxious. And overwhelmed. I've now worked 4 shifts as a 3rd rider and supposedly after 3 more, I'm supposed to be cut loose as the 3rd wheel and just have a partner. I don't feel ready. At all. I feel like some things haven't even been covered yet. I also have only lived here slightly over a year, so don't know the area as much as the others. What if i get lost on a call? That would be horrible. Anyone have any advice for this EMS rookie? I want to be an excellent EMT without being told what to do all the time, and also not be in the way. :sad:



Back to the original Idea, I just started with my town department and I have learned much more about the roads then i ever knew living in the town. Before I started working I knew 4 or five roads by name and how to get to them. But now I know numbers and direction. and upwards of 25-30 roads in my district. You will pick up the roads fast once you start using the knowlage.


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## Sasha (May 29, 2011)

We cover four counties and will transport anywhere within the contenintal us if its paid for. We have gone up to NY and routinely go on 2-6 hour transports. It is impossible to "know your district" because my district is four counties wide, with one county being as big as the other three combined.


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## cruiseforever (May 29, 2011)

If you think you are going to have trouble.  Ask for help before you leave the scene.  PD, Fire, your partner or take a minute and look in the map book/GPS.  I have even asked family members what way they like to go to the hospital.  

Always tell my new partners I will not get upset if you stop and ask me where to go.  I will get upset if you just start driving and get lost, then ask for help.


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## Horn229 (May 31, 2011)

I work in a in small city of 70K people. In our system, we have three levels of drivers.. non-drivers, non-emergency drivers, and cleared drivers.

The non-drivers do not have an EVO card yet.

The non-emergency drivers have EVO, is not permitted to use RLS, are able to navigate to the hospitals, however they may not get there the quickest way. 

The cleared driver is expected to be able to drive directly to any address upon dispatch without using a reference. The cleared driver is able to use RLS. To become a cleared driver, one must go out with a supervisor who will admister a driving test where the driver must drive to five locations within each of our city's four grids. 

I would recommend driving your area when not on calls, and as stated earlier in the thread, learned the major streets first, then learning the short streets will be easier. Also, learn more than one way to each hospital in case you need to redirect due to traffic or an MVC.


As for feeling overwhelmed, thats natural, and will go away with time. I know I haven't seen everything yet, and find myself learning every shift I work. You just need to stop, check for you own pulse, recognize it's not your emergency, and then go from the top "Scene safety, resources, BSI, C-Spine, A/B/C..." 

As for not wanting to ask your partner all the time, you most likely will for the first little while. I had a patient in a 9th floor apartment who needed c-spine precautions to be taken. The problem was the elevator was only 4' x 3'. My partner had no clue how to maintain cervical immobilization and get her out. So I told him to set up the backboard on the stretcher in the lobby, and to bring up the stair chair and KED. 

There are some things you won't know how to approach, but if you're with an experienced partner, he may be able to help you through the random situations. Don't be afraid to ask for help.

Good luck, and God speed...


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## jgmedic (May 31, 2011)

firefite said:


> I think Sasha should come and work for a system that only uses mapbooks for a little while haha. We hardly get cell service in my operational areas. Mapbooks are great and a really useful tool if you know how to use them. You don't need batteries or any kind of service at all to use them. I would love to hear "medic 519 out of service due to empty GPS battery". And the map books are only around $30. And that's before the EMS discount if you get one. Much better then a $300 GPS that only relies on technology to work lol.
> 
> ^^ that all was IMHO.



Since our GPS works only about half the time, it pays to have the Thomas and know how to use it. BTW, I quoted your post because I know where you work and I was on M519 for a year.


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