# Staying calm during calls



## xrsm002 (Nov 26, 2012)

Any tips/tricks for staying calm apparently I become flustered during ALS calls I'm a medic student one of my preceptors said I get flustered this was after this preceptor kept telling me to do something while I was busy with another task. I have A.D.D. However I can't take the normal meds like Ritalin Wellbutrin or the generics for it as they cause my muscled to spasm and freeze up that anything I'm holding I'll drop. So I haven't been on those in a while and no problems.  That being said its hard for me to think fast as I was born with a non traumatic brain injury which was due to lack of oxygen secondary to my heart having a faulty valve. So I move slow but not like turtle slow. As far as moving faster with skills on the truck the only was I'll get faster is by doing them more that's the only way I've ever been able to get faster at stuff. Sometimes I feel like I'm not getting a fair shot because of my disability. I don't even want to work on the box I prefer the ER. 
So should I switch crews or what? Please give my suggestions


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## Achilles (Nov 26, 2012)

Slow is steady= steady is fast.
Everyone has something wrong. Nobody is perfect. Just because you think differently than others just means you probably have a strength somewhere else. You need to find that strength and use it to the maximum.


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## xrsm002 (Nov 26, 2012)

Well I'm good with IVs I'm just kinda mad they are wanting me to do it all their way and yet the school says to try and learn the way that best fits you


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## xrsm002 (Nov 26, 2012)

My other preceptor on same truck rocks and is more laid back then the their partner. He lets me do it my way


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## xrsm002 (Nov 26, 2012)

On this particular call I didn't feel like I became flustered until the preceptor started trying to get me to do several things at one while I was working on another task. Usually if I feel that I stop and take a deep breath or two and it helps.


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## xrsm002 (Nov 26, 2012)

Any other tips to stay calm in a situation like this


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## leoemt (Nov 26, 2012)

If you read my thread "Oxygen Question" in the BLS section, you will see that I had a similar problem with an FTO. 

You know your skills otherwise you wouldn't be in the field. You know the protocols otherwise you wont be a medic for long. That is what is important. In the mean time do what your perceptor wants you to do. You will be with them for a short time, then you can do it how u want to. 

The job of an FTO is to show you how to apply your skills to the real world. You may not always agree with them but you will learn something from him. 

That is what got me through FTO.


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## Aidey (Nov 26, 2012)

There is a bit of a difference between being a medic student with a preceptor and a new hire with an FTO. 

To the OP, have you asked your preceptor what they are seeing you do when you get flustered? Have you found yourself getting flustered in the same type of situation multiple times? Learning what makes you flustered means that you can recognize when you are getting into a situation that flusters you and you can mitigate the circumstances so you don't get as flustered.


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## xrsm002 (Nov 26, 2012)

The preceptor was causing it in this case but I didn't want to be an *** and blame it on them.


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## xrsm002 (Nov 26, 2012)

leoemt said:


> If you read my thread "Oxygen Question" in the BLS section, you will see that I had a similar problem with an FTO.
> 
> You know your skills otherwise you wouldn't be in the field. You know the protocols otherwise you wont be a medic for long. That is what is important. In the mean time do what your perceptor wants you to do. You will be with them for a short time, then you can do it how u want to.
> 
> ...



Nope I have been doing what they want for the past 2 semesters only required to ride 300 hours I am above that getting close to 400 so no I haven't been with them a short time


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## Achilles (Nov 26, 2012)

xrsm002 said:


> The preceptor was causing it in this case but I didn't want to be an *** and blame it on them.



The blame game doesn't roll around here, so it's either everyone's fault or my fault. Don't point fingers


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## leoemt (Nov 26, 2012)

Aidey said:


> There is a bit of a difference between being a medic student with a preceptor and a new hire with an FTO.
> 
> To the OP, have you asked your preceptor what they are seeing you do when you get flustered? Have you found yourself getting flustered in the same type of situation multiple times? Learning what makes you flustered means that you can recognize when you are getting into a situation that flusters you and you can mitigate the circumstances so you don't get as flustered.



Eh...tried to give a little friendly advice. Forgot you medics have to do several hundred hours of precept time. 

I'll go crawl back in my little BLS hole now


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## xrsm002 (Nov 26, 2012)

I'm god with basic calls lol


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## xrsm002 (Nov 26, 2012)

Good* ugh


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## xrsm002 (Nov 26, 2012)

I will say I've learned how when the time comes what kind of preceptor I do and do not want to be


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## Aidey (Nov 26, 2012)

leoemt said:


> Eh...tried to give a little friendly advice. Forgot you medics have to do several hundred hours of precept time.
> 
> I'll go crawl back in my little BLS hole now



I wasn't trying to discourage your advice, just pointing out that the OP is still a student, and thus the setting/relationship isn't quite the same.


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## Aidey (Nov 26, 2012)

xrsm002 said:


> I will say I've learned how when the time comes what kind of preceptor I do and do not want to be



Everyone says that, and then they get their first student and realize why their own preceptor and did things the way they did, lol.


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## xrsm002 (Nov 26, 2012)

Lol.


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## NYMedic828 (Nov 26, 2012)

It's not your emergency.


My biggest pet peeve is working with a partner who gets antsy on the radio and all worked up like the world is ending.


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## Shishkabob (Nov 26, 2012)

Experience.  That's all there is to it, really.   Experience and knowledge breeds confidence.


When I was brand new, I had never had a patient who had a seizure in my presence, I was worried about it happening.  Now someone seizes and I stare at them for a bit waiting for it to end.  (Obviously breaking out the Benzos when called for)



Remember, you are often the only Paramedic on scene, everyone from the FFs to the cops to the bystanders are looking at you to make all the tough decisions.  If they see you freaking out, they'll freak out, and then you've lost the scene and it won't flow.


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## VFlutter (Nov 26, 2012)

NYMedic828 said:


> It's not your emergency.
> 
> 
> My biggest pet peeve is working with a partner who gets antsy on the radio and all worked up like the world is ending.



I no longer get all excited when calling nurses for codes. When I first started I would talk so fast I had to repeat myself multiple times but now I am totally nonchalant about it, almost too much so. 

But when I hear a code get paged that I didn't kmow about I still haven little freak out moment scouring my monitors checking all my patients and wondering who could potentially be in PEA.


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## mycrofft (Nov 26, 2012)

1. Preceptor issues: In a calm moment, say "I felt you were loading me with multiple problems at once which as a newbie I had trouble handling. What was your goal, and what advice do you have for me?". The "easy" preceptor might be the one who gave up on you and is just waiting to fire you, so keep charging hard for all of them. 

2. Real-world issues: I cannot pretend to know what if any effects your medical status have on your ability to steady up, you must make the decision whether you can work in a pressured and erratic work environment. Generally, from my experience, do the following:
  a. WALK. Breathe. Know your role on the team and trust the other(s) to do theirs. Scene safety.
  b. Know what you are doing so you can smoothly do it. As above, steady is fast; or more to the point it takes twice as long to to something wrong then do it right (and without guarantee of a good outcome). Ain't no ninjas in your bus, right?
  c.  Act calm. Think what calm looks like and act that way. So even if you are excited inside, your actions are calm. Then it doesn't make any difference as long as your decisions are right.
  d. Maybe not everyone's process, but I find that if I'm busy telling the pt (even if unconscious) what I'm doing and why, it helps, especially if I'm throwing in some reassuring notes. Probably comes from having kids.


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## Clare (Nov 26, 2012)

Less is more, you don't have to rush in and "do something" that involves big and flash; just because you have skills or whatever doesn't mean you have to use them.  

If you have no idea what on earth is happening or what to do then just pretend that you do, act confident, and 99% of the time the patient, family and whomever else is present will believe you.

I find it very helpful to get a bit of history, start formulating a diagnosis and once I am reasonably confident that I've pegged it just STOP and think and go "hmmm, I want to do this, this and this is that a good idea?" 

Most of this will come with experience.


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## Tigger (Nov 26, 2012)

Moved out of the "Advanced Medical Discussions" subforum.


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## Sublime (Nov 27, 2012)

xrsm002 said:


> Any tips/tricks for staying calm apparently I become flustered during ALS calls I'm a medic student one of my preceptors said I get flustered this was after this preceptor kept telling me to do something while I was busy with another task. I have A.D.D. However I can't take the normal meds like Ritalin Wellbutrin or the generics for it as they cause my muscled to spasm and freeze up that anything I'm holding I'll drop. So I haven't been on those in a while and no problems.  That being said its hard for me to think fast as I was born with a non traumatic brain injury which was due to lack of oxygen secondary to my heart having a faulty valve. So I move slow but not like turtle slow. As far as moving faster with skills on the truck the only was I'll get faster is by doing them more that's the only way I've ever been able to get faster at stuff. Sometimes I feel like I'm not getting a fair shot because of my disability. I don't even want to work on the box I prefer the ER.
> So should I switch crews or what? Please give my suggestions



If you want to work in the ER.... Go to nursing school. Unless you just like getting paid half of what you could be making with little to no room to progress.

Also, if your "disability" was significant enough I don't think you would of made it this far. So stop using that as an excuse. Everyone has their weak points and insecurities, you just have to work on them and get over it. 

As someone who had more than their fare share of bad preceptors.... I feel your pain. There was a massive difference in my performance when I was with someone I was comfortable with. Some people just don't need to be preceptors. Often times I had preceptors who had the "paragod" mentality and others who were just plain :censored::censored::censored::censored::censored::censored::censored:s. I felt the same way as you, I knew what kind of preceptor I would be given the chance. Now that I'm in a position where I get to precept students, I make sure they're getting a good experience out of it. 

And I agree that that going through FTOs is much different than being a student, but again your experience is largely dependent on who your FTO is.


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## triemal04 (Nov 27, 2012)

Sublime said:


> Also, if your "disability" was significant enough I don't think you would of made it this far.


This isn't directed at the OP neccasarily, just a general comment.

That's not entirely true.  There are plenty of schools that for various reasons will push their students through to the end of class no matter what their shortcomings may be.  Passing a paramedic class will qualify you to take your states tests/NREMT, but it doesn't always mean that you are really good to go.


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## Sublime (Nov 27, 2012)

triemal04 said:


> This isn't directed at the OP neccasarily, just a general comment.
> 
> That's not entirely true.  There are plenty of schools that for various reasons will push their students through to the end of class no matter what their shortcomings may be.  Passing a paramedic class will qualify you to take your states tests/NREMT, but it doesn't always mean that you are really good to go.



True, but if the OP has done over 300 hours of clinicals, she should have a good idea of whether she will be capable of handling this job or not. Sounds to me like she will be just fine with more experience and the bad preceptor putting extra pressure on her that's the problem. Then again I don't really know because I've never seen this person in action. 

Just hate to see someone use excuses for why they can't do something when in actuality they can if they just kept at it and don't let others get them down.


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## triemal04 (Nov 28, 2012)

Sublime said:


> True, but if the OP has done over 300 hours of clinicals, she should have a good idea of whether she will be capable of handling this job or not. Sounds to me like she will be just fine with more experience and the bad preceptor putting extra pressure on her that's the problem. Then again I don't really know because I've never seen this person in action.
> 
> Just hate to see someone use excuses for why they can't do something when in actuality they can if they just kept at it and don't let others get them down.


Sure, that's appropriate.  But it is still something to keep in mind, and while it may not apply to the OP (can't say without knowing them/working with them) it may apply to others reading this. 

This is the time when utter honesty with yourself and having someone who knows you, the service you are riding with, your school, has seen how you perform and can give you an objective assessment is invaluable.  But even being honest with yourself can pay off. 

Also bear in mind that 300 is less than 2 months of fulltime work.  For someone who hasn't done this before (which I think is the OP's situation) that's really not all that long to really figure out if this is for you or not.


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## MSDeltaFlt (Nov 29, 2012)

xrsm002 said:


> Any tips/tricks for staying calm apparently I become flustered during ALS calls I'm a medic student one of my preceptors said I get flustered this was after this preceptor kept telling me to do something while I was busy with another task. I have A.D.D. However I can't take the normal meds like Ritalin Wellbutrin or the generics for it as they cause my muscled to spasm and freeze up that anything I'm holding I'll drop. So I haven't been on those in a while and no problems.  That being said its hard for me to think fast as I was born with a non traumatic brain injury which was due to lack of oxygen secondary to my heart having a faulty valve. So I move slow but not like turtle slow. As far as moving faster with skills on the truck the only was I'll get faster is by doing them more that's the only way I've ever been able to get faster at stuff. Sometimes I feel like I'm not getting a fair shot because of my disability. I don't even want to work on the box I prefer the ER.
> So should I switch crews or what? Please give my suggestions



When you are precepting a student you are for all pretences an educator.  By being an educator in the fieldit is your responsibility to make sure your student is able to adequately apply their knowledge in the field that they gained in the classroom.

Notice that this also implies that not all seasoned and skilled medics should be preceptors.  Some just don't have the disposition for it.


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## xrsm002 (Nov 29, 2012)

Ok another question has anyone gone all the way through medic school passed all the classes got on the truck and noticed the medic level wasn't for you? How did you handle it? I don't even want to work on the truck as a medic I prefer being in an ER. I'll be at 400 hours after Monday's clinical.


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## VFlutter (Nov 29, 2012)

Nvm deleted comment


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## triemal04 (Nov 29, 2012)

xrsm002 said:


> Ok another question has anyone gone all the way through medic school passed all the classes got on the truck and noticed the medic level wasn't for you? How did you handle it? I don't even want to work on the truck as a medic I prefer being in an ER. I'll be at 400 hours after Monday's clinical.


So I just spent some time going through your old posts (hey, I'm bored with nothing else to do today) and am going to revise my statements.  There's 2 versions of this, the niceynicey version, and the blunt version.  Scroll down for the blunt one.

#1:  It really sounds like at this point you are starting to realize that working as a paramedic is not for you, that you aren't really cut out to do it, and would prefer to be doing something different anyway.  And to that end are looking for reasons to quit the class.  

This is when you should be honest with yourself.  If you want to work in a hospital or any other type of non-field environment, then go do it!  Become a CNA, or RN, or RT or whatever.  But don't keep trying to become something that, by all appearances is not what you want to do, and not for you.  You've said that you have worked both 911 and transfers before; while it may have been in a different type of setting, you still should have been aware of what you were getting yourself into.  The fact that your internship keeps getting extended (that's how I read your comments anyway) should, at this point, be something that you are paying attention to.  If you really don't want to be a field provider and are struggling with patient care and your performance in the field, then now is the time to listen to yourself and move on.  Think of how many people are in your class and how many are interning with that particular service; are they all having the same problems you are?  

There's no shame in it.  EMS isn't for everyone.  What would be shameful would be getting pushed through to the end and becoming a paramedic even though you aren't qualified, OR forcing the issue and causing your school to remove you from class when you don't even want to be there.

Take a couple days and think HONESTLY about it.  Don't delude yourself, don't let people who may not know you/your wants/capabilities sway your decision.  Think about what attracted you to medicine in the first place and what you really want your role in it to be.  Look into what other medical jobs are out there.  Then think about what attracted you to EMS and how both your career and time as a paramedic intern have gone so far.  Think about the criticisms you've gotten so far and how well you could really correct your deficencies.

The decisions yours, but it really sounds like you allready know what you should be doing.

#2:  Get out before you cause problems for yourself.  Being a paramedic is not something you should be doing.


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## xrsm002 (Nov 29, 2012)

The thing is I have graduated from the class portion as on they had a graduation for my class for surviving the medic classes. I don't think they would have let me go this far if they thought I was struggling. I am not ABOVE working as a medic in an ER or hospital setting I don't want to be a nurse, or anything else. I have wanted to be a paramedic since I was little. Originally I was attracted to the adrenaline rush but that wore off when I realized there's other places I can work as a medic and don't have to be on a  EMS service,  my cardiologist's office in my hometown they hires medics.


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## xrsm002 (Nov 29, 2012)

People can't say being a medic isn't something I shouldn't be doing just from my posts on here as they don't know me that well, they don't know what kind of past issues I'm dealing with from PTSD.


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## xrsm002 (Nov 29, 2012)

Oh in addition I know some of the medics where I am at rode 600 hours


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## Sublime (Nov 30, 2012)

xrsm002 said:


> The thing is I have graduated from the class portion as on they had a graduation for my class for surviving the medic classes. I don't think they would have let me go this far if they thought I was struggling. I am not ABOVE working as a medic in an ER or hospital setting I don't want to be a nurse, or anything else. I have wanted to be a paramedic since I was little. Originally I was attracted to the adrenaline rush but that wore off when I realized there's other places I can work as a medic and don't have to be on a  EMS service,  my cardiologist's office in my hometown they hires medics.



I really don't understand this... You want to be a paramedic but don't want to work on a ambulance? Then do something else. Paramedics in the ER are "techs". What you get to do will vary greatly from place to place but generally you will be doing labs, ivs, 12 - leads, and transporting patients. You get to assist in code situations but generally you are doing CPR or setting up the intubation stuff for the docs. I worked in a level 1 trauma center as a paramedic, and trust me.... most of the techs end up being nurses. The grass is really greener on the other side. If you want to work in a hospital... be a nurse. Unless you just don't want the extra responsibility, which is understandable I guess.

Also, you will generally make less in the hospital as a paramedic than in the field. There are a few exceptions, but from what I've experienced it's usually less. As a nurse you can make double what a field medic or tech can. 

I just don't get why you would insist on being a paramedic and work in a doctors office. It's not like your job would be any different than a nurses except the fact that you'd most likely make significantly less money.

If you want to work on the box and that's your passion thats one thing, but if you want to work in a hospital I just can't understand why wouldn't want to do nursing.



xrsm002 said:


> People can't say being a medic isn't something I shouldn't be doing just from my posts on here as they don't know me that well, they don't know what kind of past issues I'm dealing with from PTSD.



Well when you come on here asking for advice we really have nothing to go off of except your posts, so what do you expect?


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## VirginiaEMT (Dec 1, 2012)

Linuss said:


> Experience.  That's all there is to it, really.   Experience and knowledge breeds confidence.
> 
> 
> When I was brand new, I had never had a patient who had a seizure in my presence, I was worried about it happening.  Now someone seizes and I stare at them for a bit waiting for it to end.  (Obviously breaking out the Benzos when called for)
> ...



I hope EXPERIENCE is the answer. I still get flustered occasionally as we work with 2 man crews and have very short transport times. As an example, with a chest pain patient, I am still trying to get my time management down. I have about 10 -15 minutes usually to get 12 lead, vitals, O2, IV access, spike and hang N.S, aspirin, nitro, and any other necessary interventions, radio the call to the hospital. It is definitely a busy time..


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## xrsm002 (Dec 1, 2012)

Well I have an interview for an emt basic position with one of the local 911 services in my area. I'm going to see about taking a semester off from medic rideouts and continue in the summer. In hoping it's lack of experience. I haven't done actual 911 since 2005.


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## JDub (Dec 1, 2012)

VirginiaEMT said:


> I hope EXPERIENCE is the answer. I still get flustered occasionally as we work with 2 man crews and have very short transport times. As an example, with a chest pain patient, I am still trying to get my time management down. I have about 10 -15 minutes usually to get 12 lead, vitals, O2, IV access, spike and hang N.S, aspirin, nitro, and any other necessary interventions, radio the call to the hospital. It is definitely a busy time..



I don't know how things are run there but here usually the Basic or second medic would get vitals, 12 lead, O2, Aspirin, Nitro and hanging the bag all done before he hops up front to drive.

It sounds like you may not be utilizing your partner to the full.


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## VirginiaEMT (Dec 1, 2012)

JDub said:


> I don't know how things are run there but here usually the Basic or second medic would get vitals, 12 lead, O2, Aspirin, Nitro and hanging the bag all done before he hops up front to drive.
> 
> It sounds like you may not be utilizing your partner to the full.



I'm definitely not..


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## xrsm002 (Dec 1, 2012)

My problem is the only experience I had was a transfer service but they wouldn't let basics do any ER calls all we did on those was vitals, and drive the only calls we could take were the patients going home from the ER back to their residence or SNF, or hospice. That being said we were able to take our time on most calls going to ER. The 911 system in my hometown was fire based and I don't want to be a ff so I wasn't able to get on with them.


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