# What don't they teach you in paramedic school?



## PacMan2006 (Apr 28, 2012)

Hey all,

I'm new here and have been digging through lots of threads and read an interesting topic about jumping from basic training right into medic school.  It sparked an interesting debate, where one poster replied that in medic school, there are simply things you're not taught (or taught well, I suppose).

It got me wondering...from your experiences, what are some things you've realized paramedic school actually didn't teach you?  What are some things in hindsight you wish could've been taught to better prepare you for what actually occurs on the job?


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## SliceOfLife (Apr 28, 2012)

Respiratory and IFT stuff such as vents and pumps.  The IFT class my company had me sit through was incredibly lacking.  I spend most of my post-school study time on this.


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## Maine iac (Apr 28, 2012)

Situational awareness.

Verbal Judo.

Going hands on with a pt.

More pharmacology.

More on street lingo and drugs.


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## Handsome Robb (Apr 28, 2012)

That's going to be dependent on the program you go to. 

Mine would be vent settings and modes, psychs and I should have paid better attention during pedis.


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## Melclin (Apr 29, 2012)

Strategies for dealing with/extracting information from difficult/elderly/poor historians.

Primary care medicine of many kinds. 

The practical implications of the pathophysiology of aging. We learnt the pathophys. But it was never meaningfully connected to our actual practice. Eg why I shouldn't leave elderly people at home with gastro when I do it all the time for middle aged people.


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## Imacho (Apr 29, 2012)

How to deal with incompetent lack of SNF employees.


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## Ewok Jerky (May 2, 2012)

Common sense


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## Sasha (May 2, 2012)

Vents, pumps, drains, different kinds of access and equipment you'll see in the hospital, anything really about dialysis patients, trach care...

Really how to work at a legit IFT company and not just to do renal roundups.


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## exodus (May 2, 2012)

Melclin said:


> Strategies for dealing with/extracting information from difficult/elderly/poor historians.




Do you have any medical problems? - Nope.

Have you ever spend the night in the hospital? - Oh yeah quite a few times.
What were the stays for? -- xxx


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## Sasha (May 2, 2012)

exodus said:


> Do you have any medical problems? - Nope.
> 
> Have you ever spend the night in the hospital? - Oh yeah quite a few times.
> What were the stays for? -- xxx



More like this:

"Do you have any medical problems?"

"Nope."

"Heart problems?"

"Nope."

"Cancer?"

"Nope."

"Asthma or COPD?"

"Nope."

"Do you take any medication?"

"Oh yeah, lots of them."

"What are they?"

"Oh I don't know..."

"What are they for?"

"I don't know, my doctor tells me to take them and I take them."

"Do you have any allergies?"

"Yes... But I can't remember. I think it starts with a C"

Thank god for patient charts.


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## EMSrush (May 2, 2012)

EMS Politics in different agencies.


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## Epi-do (May 2, 2012)

Just the general _how_ to be a paramedic.  Every program has topics they are lacking in, regarding the basic knowledge you need to get started.  For me, it was vents and other medical equipment.


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## Epi-do (May 2, 2012)

Sasha said:


> More like this:
> 
> "Do you have any medical problems?"
> 
> ...



But Sasha, don't you know that if you are taking a medication for a chronic illness, you no longer have that problem because the medication helps to control it and relieve the symptoms?  If you no longer have symptoms, you are obviously cured and it is no longer a problem you have.

Actually, I have tried to get around that sort of thing by asking if they have a medical history or anything they have seen a doctor for.  The problem with phrasing it that way is they want to tell you about everything from the athlete's foot they had when they were 16 to the wart they had burned off their big toe last week - and they are 87.


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## Sasha (May 2, 2012)

Epi-do said:


> But Sasha, don't you know that if you are taking a medication for a chronic illness, you no longer have that problem because the medication helps to control it and relieve the symptoms?  If you no longer have symptoms, you are obviously cured and it is no longer a problem you have.
> 
> Actually, I have tried to get around that sort of thing by asking if they have a medical history or anything they have seen a doctor for.  The problem with phrasing it that way is they want to tell you about everything from the athlete's foot they had when they were 16 to the wart they had burned off their big toe last week - and they are 87.



I also love the 

"Nope. No medical history. I'm healthy as a horse." And that's because they haven't been to the doctor in 20 years. Just because you've been ignoring your body and skipping out on your Dr visits doesn't mean you're not sick.


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## TheLocalMedic (May 2, 2012)

Biggest recommendation I can make to anyone before thinking about medic school is to work (ideally full time) in a 911 system as an EMT for at _least_ one year.  In fact, I know of a program near me that actually requires this now.  

One of the hardest challenges is just general scene management.  Don't get waylaid by the fire captain who wants to give you a 10 minute report on the patient, learn how to re-direct the patient's ramblings to things that you actually want to know, and learn better ways to ask questions.  

BEST LITTLE PIECE OF ADVICE GIVEN TO ME BY MY PRECEPTOR:  "Do you have any medical problems that you take medication for regularly?"  

This gets rid of any confusion about them telling you about their broken toe in 1956 or the fact that the "don't have" hypertension because their medication is taking care of it


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## Chief Complaint (May 3, 2012)

I wish they would have at least briefly covered the fire service a bit.  I know that its not their job to do so, but EMS is fire based here unless you want to do IFTs.  It would have been nice to get a little bit of info regarding the fire service since almost every graduate finds work with an FD.


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## firecoins (May 3, 2012)

ceramics. 

my paramedic school did not teach me how to be a filmmaker.

Never covered public relations.


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## Aprz (May 3, 2012)

Chief Complaint said:


> I wish they would have at least briefly covered the fire service a bit.  I know that its not their job to do so, but EMS is fire based here unless you want to do IFTs.  It would have been nice to get a little bit of info regarding the fire service since almost every graduate finds work with an FD.


That's odd cause here they sorta merge Fire and EMS here in the classroom, but don't go over IFT at all, and most of us will never work in EMS and even less will ever get into Fire because it is so desired. It's sad cause it hits the students real hard afterward - they think all ambulances respond to 911, go lights and sirens, etc. They like to believe "if they work hard", they'll get into Fire and be set for life.


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## Chief Complaint (May 3, 2012)

Aprz said:


> That's odd cause here they sorta merge Fire and EMS here in the classroom, but don't go over IFT at all, and most of us will never work in EMS and even less will ever get into Fire because it is so desired. It's sad cause it hits the students real hard afterward - they think all ambulances respond to 911, go lights and sirens, etc. They like to believe "if they work hard", they'll get into Fire and be set for life.



Part of the reason i wish that my program had gone more in depth on the topic of the fire service is that there is no mention that if you are out of shape, you will likely never get a job.

There were definitely some really fat/unhealthy people in my class.  Its stupid to lead these people to believe that they will ever get a job in our field.  I think they should have at least planted the seed in their brains to start thinking about fitness if they want to do this as a career.


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## firecoins (May 3, 2012)

Chief Complaint said:


> Part of the reason i wish that my program had gone more in depth on the topic of the fire service is that there is no mention that if you are out of shape, you will likely never get a job.
> 
> There were definitely some really fat/unhealthy people in my class.  Its stupid to lead these people to believe that they will ever get a job in our field.  I think they should have at least planted the seed in their brains to start thinking about fitness if they want to do this as a career.



Many fat unhealthy people work in EMS.  Just not by you.


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## DPM (May 3, 2012)

Chief Complaint said:


> Part of the reason i wish that my program had gone more in depth on the topic of the fire service is that there is no mention that if you are out of shape, you will likely never get a job.
> 
> There were definitely some really fat/unhealthy people in my class.  Its stupid to lead these people to believe that they will ever get a job in our field.  I think they should have at least planted the seed in their brains to start thinking about fitness if they want to do this as a career.



These people are grown ups, it shouldn't be the schools responsibly to ensure they are in shape. If they don't know enough about their future careers to get in shape then it's their own fault for being unprepared. No one told me to not be a fat :censored::censored::censored::censored::censored::censored::censored:, and no one needed to.


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## Handsome Robb (May 3, 2012)

exodus said:


> Do you have any medical problems? - Nope.
> 
> Have you ever spend the night in the hospital? - Oh yeah quite a few times.
> What were the stays for? -- xxx



"Do you have high blood pressure?"

"Well I did, but my doctor gave me a pill for it so it's not high anymore."

:facepalm:


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## NomadicMedic (May 3, 2012)

DPM said:


> These people are grown ups, it shouldn't be the schools responsibly to ensure they are in shape. If they don't know enough about their future careers to get in shape then it's their own fault for being unprepared. No one told me to not be a fat :censored::censored::censored::censored::censored::censored::censored:, and no one needed to.



Funny, part of my paramedic program was called "Paramedic Total Fitness". It was basically gym class for medics. We had a great time. Everyone worked out and we got to play games. It was good for the cardio and good for team building.

I wish my program was more advanced in 12 leads. You left knowing how to identify a STEMI, but anything more advanced than that was on you.


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## firecoins (May 4, 2012)

Fat people do work in EMS. 

People are also entitled to become a paramedic that is not driven by employment at a fire department.

I really wish we spent more time on 18th centure literature.


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## Chief Complaint (May 4, 2012)

firecoins said:


> Many fat unhealthy people work in EMS.  Just not by you.



That's a shame.



DPM said:


> These people are grown ups, it shouldn't be the schools responsibly to ensure they are in shape. If they don't know enough about their future careers to get in shape then it's their own fault for being unprepared. No one told me to not be a fat :censored::censored::censored::censored::censored::censored::censored:, and no one needed to.



Correct, it is not their job, i just think it's something they should have at least touched upon.  



firecoins said:


> Fat people do work in EMS.
> 
> People are also entitled to become a paramedic that is not driven by employment at a fire department.
> 
> I really wish we spent more time on 18th centure literature.



Around here, getting on with an FD is the only way to make a real career out of EMS.  If you were just enrolled in the program for fun, so be it, but the majority of students aspire to work for the fire department after graduation.


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## NomadicMedic (May 4, 2012)

Chief Complaint said:


> Around here, getting on with an FD is the only way to make a real career out of EMS.  If you were just enrolled in the program for fun, so be it, but the majority of students aspire to work for the fire department after graduation.



No. THIS is a shame.


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## firecoins (May 4, 2012)

Fd based EMS is terrible. Should be a third agency


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## Amberlamps916 (May 4, 2012)

Tell that to the meatheads of Southern California. Out of 30 students in my medic class, I'm the only one with no fire aspirations, I actually respect medicine and am anxious to continue my path to Physician Assistant. And this is not a biased generalization, the people in my class couldn't give less of a crap when it comes to medicine.


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## Chief Complaint (May 5, 2012)

n7lxi said:


> No. THIS is a shame.





firecoins said:


> Fd based EMS is terrible. Should be a third agency



Agreed, but thats just the way it is here.  The privates here only do IFTs and they max out at around $14/hr for medics.  You can make twice that working for the fire departments, and you get to actually use what you learned in school.


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## EpiEMS (May 5, 2012)

firecoins said:


> Fd based EMS is terrible. Should be a third agency



+1

Or hospital based, I suppose. As long as it isn't fire-based.

(Though I'm ambivalent about EMS-based fire-suppression  )


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## treyford2008 (May 21, 2012)

Very informative..gives me a lot to think about as well!


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