# Difference Between EMT and Paramedic school Clinicals



## Jayy (Nov 17, 2014)

Hey everyone, for my EMT program we did (4) 12 hour hospital rotations, where we were basically able to just roam around the ED, writing SOAP reports, taking some vitals and shadowing the hospital staff  as they admitted new PTs.

Was just curious how the experience is different as a paramedic student. Do we get some independence to interact and care for the patients more, or are we still just there to observe/document?


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## DesertMedic66 (Nov 17, 2014)

Its going to depend on your school and the hospital you go to. 

Any skill that I was able to do the staff let me do. Everything from EJs to intubation and admin of many many medications (a decent number of the meds EMS will never see).


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## TimRaven (Nov 17, 2014)

Jayy said:


> Hey everyone, for my EMT program we did (4) 12 hour hospital rotations, where we were basically able to just roam around the ED, writing SOAP reports, taking some vitals and shadowing the hospital staff  as they admitted new PTs.
> 
> Was just curious how the experience is different as a paramedic student. Do we get some independence to interact and care for the patients more, or are we still just there to observe/document?



Paramedic students usually have a set of skills to perform during their clinical times, like starts x number of IV, x number of airway, read x number of ECG...etc


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## joshrunkle35 (Nov 18, 2014)

In my experience, any of the "skills" I had to do, like giving a medication a certain way, required a proctor. I also liked asking for advice and feedback on those skills. The way the law works in Ohio as a student, we were told by our school's medical director that we could perform exactly that number of skills being proctored, and that we couldn't exceed those as a student, but could "assist" with those skills. We could also obviously do any skill that we could do as an EMT or AEMT, depending what our cert was. So, I had free reign when I did stuff like vitals, etc. I was stuck to someone's hip for procedures, then I had free reign to "assist" at the end. So, for example, at the end, if I saw a doctor wrote an order for an IV, I would go get all of the supplies, hang the bag, etc, then let the nurse know that patient was ready, the nurse would come in and check what I had and they would do the IV (after I had finished all of my IVs) 

So, it tended to be a little random, depending on what skills I needed. Frankly, you shouldn't really want/need a ton of autonomy. Even if someone does a simple skill like taking blood pressure or a pulse, there is always another way to do it. You are there to learn, not just to practice things you learned in class.


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## Gurby (Nov 19, 2014)

I'm doing my OR time as a medic student right now.  Today I had patient who was pretty anxious but said it was okay if I did the intubation.  As the propofol was kicking in, she said "I trust you".  EMT-P vs EMT-B clinicals are a completely different ball game.


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## LocNar (Nov 26, 2014)

As an EMT student in Florida we had to do five 12 hour EMS shifts, and five 8 hour ER shifts.  As a Paramedic student I'm required to do six 12 hour EMS rides, five 12 hour ER shifts per semester, I have to have seven intubations per semester whether they are achieved in the OR or in the field.  And we are also required to do a 12 hour shift in a Surgical ICU, Neonatal ICU, and L&D (labor and delivery) each.  And as mentioned above a checklist with several skills also has to be met.  (ALS calls, IV's, tubes, etc...). The workload between EMT and Paramedic school is vastly different, but if your willing to put in the time and effort, the knowledge you gain is priceless.


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## hogwiley (Nov 26, 2014)

Paramedic school is a whole different ballgame. The difficulty and stress level is 10 times greater. As others have pointed out OR rotations can be really mentally taxing because you need to get those intubations, and its not like tubing a mannequin, and its not like tubing a patient in the field whos been down for like 1/2 an hour. You better do things textbook perfect. Touch the teeth or screw something up and those CRNAs or anesthesiologists are probably not gonna let you try another patient.

You also cant just rely on rote memorization to get by in Paramedic school. That might get you through at first, but eventually you are either going to develop critical thinking skills or whither on the vine.

I just finished medic and it was an ordeal. Was it worth it? yeah, but Im not sure if I would do it again.


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## EMT11KDL (Nov 26, 2014)

Now all Paramedic Programs for NREMT standards managed by CoAEMPS.  They have minimum standards for number of skills performed and patient contacts that are required for a paramedic student to complete before they are considered completed for the Program.  I do not know what the minimum standard is, I tried looking it up on the CoAEMPS website and could not find it.  

The program I went through required over 120 hours of ER Time.  12 Hours of RT, 36 hours in OB, 36 hours of ICU.  12 hours OR, 12 Hours of Med Surg, and 12 hours of Pediatric Floor.  In each of these, I was also required so many patient contacts and skills I had to perform.  For Example I had to have 2 patient contacts for age under 1 month old.  The best place to get those is the OB, but I was able to get 1 in the ER and 1 in my OB rotations, so I completed that requirement.  Also once we completed all the Clinical requirements, I than went to my Field internship, I had to do 240 hours and also had to have so many patient contacts in different types like, AMS, Cardiac, Medical, Trauma, Psych, OB, along with them being in certain age groups.  On top of that, so many 12 leads, IV, Medication Admins, Intubation, and other skills.   With so many Team Leads on the Ambulance, meaning I had to operate as the PIC (Paramedic in Charge).


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## EMT11KDL (Nov 26, 2014)

I am sure there is a Paramedic Instructor on here, that can go more into the requirements for CoAEMPS and Paramedic Program Accreditation .


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## teedubbyaw (Nov 26, 2014)

EMT11KDL said:


> Now all Paramedic Programs for NREMT standards managed by CoAEMPS.  They have minimum standards for number of skills performed and patient contacts that are required for a paramedic student to complete before they are considered completed for the Program.  I do not know what the minimum standard is, I tried looking it up on the CoAEMPS website and could not find it.
> 
> The program I went through required over 120 hours of ER Time.  12 Hours of RT, 36 hours in OB, 36 hours of ICU.  12 hours OR, 12 Hours of Med Surg, and 12 hours of Pediatric Floor.  In each of these, I was also required so many patient contacts and skills I had to perform.  For Example I had to have 2 patient contacts for age under 1 month old.  The best place to get those is the OB, but I was able to get 1 in the ER and 1 in my OB rotations, so I completed that requirement.  Also once we completed all the Clinical requirements, I than went to my Field internship, I had to do 240 hours and also had to have so many patient contacts in different types like, AMS, Cardiac, Medical, Trauma, Psych, OB, along with them being in certain age groups.  On top of that, so many 12 leads, IV, Medication Admins, Intubation, and other skills.   With so many Team Leads on the Ambulance, meaning I had to operate as the PIC (Paramedic in Charge).



This, but it's not all about numbers. You're in the process of evolving out of 'technician' mode. You're expected to run calls from start to finish with your preceptor being there to make sure you don't eff up.


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## EMT11KDL (Nov 26, 2014)

teedubbyaw said:


> This, but it's not all about numbers. You're in the process of evolving out of 'technician' mode. You're expected to run calls from start to finish with your preceptor being there to make sure you don't eff up.



That is correct, as it stated in the last line I wrote, "With so many Team Leads on the ambulance, meaning I had to operate as the PIC (Paramedic in Charge)"


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## sir.shocksalot (Nov 27, 2014)

When I went to paramedic school we had around 700 hours of clinicals. 500 hours were spent on the ambulance being lead on calls. Even that didn't feel like enough. EMT school for me had 36 hours of clinicals and I didn't have to really do much more than observe, take vitals, and assist where I knew how.


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## Jayy (Dec 2, 2014)

Thank you everyone, some great responses in here so far. I'm expecting Paramedic school to be a tough but rewarding experience.


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## medicdan (Dec 3, 2014)

Paramedic school clinicals are about developing confidence with the skills and assessments, and is your opportunity to see sick patients, pick the RN/MDs brains. 

Some argue the first half of your shifts should be with a nurse to get the lay of department, skills and patients.... Once you grow comfortable start shadowing docs, flexing your clinical decision making skills, formulating diagnoses, treatment plans, etc.  

This is your opportunity to listen to other Paramedic's notes, watch RN and MD assessments, and learn about hospital assessment and management for the patients you bring in...


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