# Starting clinicals.



## 1979Bert (Mar 23, 2013)

I'm starting clinicals in a couple of weeks and I have to do 16hrs. in the E.R.!I didn't pass last year because I fell short 77.8 is what I had and in Rutherford Co. it has to be an 80avg,with that being said I was told by my current employer that I would never make it,but this year I am doing great and get to start clinicals just wondering how it will be in the E.R. and is it hard to be successful on IV sticks??Any advice would be greatly appreciated!


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## Medic Tim (Mar 23, 2013)

1979Bert said:


> I'm starting clinicals in a couple of weeks and I have to do 16hrs. in the E.R.!I didn't pass last year because I fell short 77.8 is what I had and in Rutherford Co. it has to be an 80avg,with that being said I was told by my current employer that I would never make it,but this year I am doing great and get to start clinicals just wondering how it will be in the E.R. and is it hard to be successful on IV sticks??Any advice would be greatly appreciated!



 Are you a basic student that has to do 16 hours or a medic student doing a 16 hour shift? 
Iv s will take practice and time to master. Dot get discouraged if you are not that great at it.


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## chaz90 (Mar 23, 2013)

Repetition is the most important thing for IV skills. You'll get the hang of it eventually. Good luck on your clinicals, and let us know how it goes.


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## 1979Bert (Mar 23, 2013)

Medic Tim said:


> Are you a basic student that has to do 16 hours or a medic student doing a 16 hour shift?
> Iv s will take practice and time to master. Dot get discouraged if you are not that great at it.



I'm a student basic,but wanting to become a medic later,just a little nervous!


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## 1979Bert (Mar 23, 2013)

chaz90 said:


> Repetition is the most important thing for IV skills. You'll get the hang of it eventually. Good luck on your clinicals, and let us know how it goes.



Thank you and I will definitely let you all know how it goes..Is there any teqniques you all use or do you learn by repetiveness.


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## Medic Tim (Mar 23, 2013)

1979Bert said:


> Thank you and I will definitely let you all know how it goes..Is there any teqniques you all use or do you learn by repetiveness.



If you haven't had the training you won't be doing it in clinical( or at least you shouldn't ) . Most places have sim hands/arms or you practice on classmates.


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## 1979Bert (Mar 23, 2013)

Medic Tim said:


> If you haven't had the training you won't be doing it in clinical( or at least you shouldn't ) . Most places have sim hands/arms or you practice on classmates.



We have practiced in the classroom twice on fake arms...it will be three times this Tuesday and then Thursday will be actual classmates sticking each other,I was just wanting to know how it was when we start our 16hrs in the E.R.,if they just say start an IV or how the nurses and doctors are with the students??Just a little anxious..


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## NYMedic828 (Mar 23, 2013)

I'm sure someone will be watching you... Highly doubt they will point to a patient and tell you they need an IV good luck.

Starting an IV in an ambulance is often more difficult than a hospital bed as well just due to lighting and positioning.


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## EMS 911 (Mar 24, 2013)

In my area, we were not allowed to do IVs during our basic clinicals. I believe that the maximum amount of clinical hours at a time in the ED that we were allowed to do is 10 hours as a basic, 8 hours as a medic (16 hour shifts were allowed in the field though), and 12 hours as a critical care medic student. I guess every program is different.

IVs are difficult at first, but over time your technique will develop and you will learn all the tricks of IV access. I had wonderful, patient preceptors for my medic clinicals that really helped improve my technique. Usually preceptors in the ED are familiar with EMS students and are good at helping you out. Just don't expect to master IVs overnight - it takes time, patience, and practice, but eventually you will see your work pay off! I am very much a perfectionist, so it frustrated me at first with my hit-and-miss IV success....but over time, I became quicker with IVs with higher success rates. Good luck on your clinical!


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## 1979Bert (Mar 24, 2013)

EMS 911 said:


> In my area, we were not allowed to do IVs during our basic clinicals. I believe that the maximum amount of clinical hours at a time in the ED that we were allowed to do is 10 hours as a basic, 8 hours as a medic (16 hour shifts were allowed in the field though), and 12 hours as a critical care medic student. I guess every program is different.
> 
> IVs are difficult at first, but over time your technique will develop and you will learn all the tricks of IV access. I had wonderful, patient preceptors for my medic clinicals that really helped improve my technique. Usually preceptors in the ED are familiar with EMS students and are good at helping you out. Just don't expect to master IVs overnight - it takes time, patience, and practice, but eventually you will see your work pay off! I am very much a perfectionist, so it frustrated me at first with my hit-and-miss IV success....but over time, I became quicker with IVs with higher success rates. Good luck on your clinical!



Thank you for the advice!I am lucky my wife allowed me to practice on her and I just had a successful ac stick!!We still have one more practical iv night Tuesday,then this Thursday we get to start real ones on each other in the class!My wife is a nurse and like you said the more you practice the better you get!I love this Emtlife.com,everyone on here are very professional and helpful to talk to!Thanks again and I look forward to helping people in the field, once again thank you for the help and advice!!


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## joshrunkle35 (Mar 25, 2013)

My state doesn't allow basics to do IVs. But, we do plenty in Medic class. If you didn't practice something in class, DON'T do it in clinicals! Advice for basic clinicals: keep your ears open and your mouth shut at first. When you've established rapport with your preceptor, then ask the preceptor if you could take the lead in triaging people. This is a great way to make patient contact, take basic vitals, and make "transport" decisions (while you're not making real transport decisions, it does help you decide who is an emergency and who is not). After each pt, ask what the preceptor would do differently and follow their lead.


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## WyoMedic (Mar 27, 2013)

Like the other folks have been saying, IV's just take practice...even the best of us miss one every now and then. Best advice I can give someone regarding clinicals is take initiative. Don't be a recluse that plants your butt in a chair and doesn't talk to any of the staff or offer to help with patients and other tasks. Keep a positive attitude and soak up as much knowledge as you can; you are there to learn. My instructors said that clinicals are like the longest job interview of your life, treat them as such.


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## AzValley (Mar 27, 2013)

1979Bert said:


> Thank you for the advice!I am lucky my wife allowed me to practice on her and I just had a successful ac stick!!We still have one more practical iv night Tuesday,then this Thursday we get to start real ones on each other in the class!My wife is a nurse and like you said the more you practice the better you get!I love this Emtlife.com,everyone on here are very professional and helpful to talk to!Thanks again and I look forward to helping people in the field, once again thank you for the help and advice!!



I wish my wife would like me stick her with an iv or anything for that matter :unsure:


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## hogwiley (Apr 11, 2013)

Why would an EMT basic student be starting IVs?


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## 1979Bert (Apr 11, 2013)

Because in Rutherford you are required to have 5 IV sticks in order to pass our clinicals as an EMT,different states.. Different programs...where'd you take your class??


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## phideux (Apr 11, 2013)

How are you practicing IV sticks on your wife??? Is she in the class also, or are you sneaking IV stuff out of class to practice with at home???


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## rwik123 (Apr 11, 2013)

1979Bert said:


> Lol..did someone's feelings get hurt!?shes a nurse and I get my supplies online!If you can't be mature go learn how to take vitals!



You do realize you need to be precepted in order to perform an IV stick before you get your certification. Ordering supplies online and doing sticks at home seems a little sketchy to me. Just saying. If someone found out you'd be dropped from your class.


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## hogwiley (Apr 11, 2013)

I feel bad for these patients that have to get stuck by a Basic student who has zero patient care or EMS experience and the bare minimum of training starting IVs. And for what reason? Can Basics even start IVs in the field wherever the heck Rutherford is(im assuming NJ)?

Hopefully they give you people who are easy sticks to build up your confidence and minimize the pain and suffering of the patients.


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## chaz90 (Apr 11, 2013)

hogwiley said:


> I feel bad for these patients that have to get stuck by a Basic student who has zero patient care or EMS experience and the bare minimum of training starting IVs. And for what reason? Can Basics even start IVs in the field wherever the heck Rutherford is(im assuming NJ)?
> 
> Hopefully they give you people who are easy sticks to build up your confidence and minimize the pain and suffering of the patients.



Why does pt. care or EMS experience have anything to do with learning to start an IV in a class? It's a technical skill like any other that has to be learned and practiced at some point. Whether someone is an EMT student, a medic student, or a nursing student, someone has to be their first stick. You can have your opinion on whether or not the OP should be ordering supplies online and starting them for practice on his wife, but the class seems perfectly appropriate. There are plenty of places in the country where EMT-Bs can start IV lines, and apparently he lives in one of them.


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## dfisch235 (Apr 11, 2013)

I'm positive its not for NJ. I think he initially posted Rutherford Colorado.
Regardless, I do know that every soldier learns to do iv's very shortly upon entering their first duty assignment when the take CLS. So, I don't know why ivs tend to be such a taboo for people.


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## hogwiley (Apr 12, 2013)

chaz90 said:


> Why does pt. care or EMS experience have anything to do with learning to start an IV in a class? It's a technical skill like any other that has to be learned and practiced at some point. Whether someone is an EMT student, a medic student, or a nursing student, someone has to be their first stick. You can have your opinion on whether or not the OP should be ordering supplies online and starting them for practice on his wife, but the class seems perfectly appropriate. There are plenty of places in the country where EMT-Bs can start IV lines, and apparently he lives in one of them.



Yes someone has to do their first stick sometime, but a Nursing and Medic student has considerably more training and knowledge of human anatomy and a little bit of proven competence when they attempt that first stick than your typical EMT student when he/she begins clinicals. 

As for non medical military personnel starting IVs, its my understanding that has been discontinued and that CLS courses no longer include it, so apparently it didnt work out too well. Not to mention theres a huge difference between starting an IV on a healthy athletic 20 year old army PFC and a dehydrated 85 year old diabetic and lifelong smoker.

Where I work as a patient care tech we can do blood draws, 12 leads, check placement on NG tubes and even DC them, start foleys, do tube feedings, stage 2 dressing changes, BGL checks etc, but mess with an IV line and you are fired. We cant start them, discontinue them, flush them or anything to do with them. Even LPNs arent allowed to. It has to be an RN, so I guess I've had it ingrained in me that while learning to start one isnt a big deal(Ive seen a thousand of them started), its still something left to people who have a higher level of training and licensure for a variety of reasons.


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## chaz90 (Apr 12, 2013)

hogwiley said:


> Yes someone has to do their first stick sometime, but a Nursing and Medic student has considerably more training and knowledge of human anatomy and a little bit of proven competence when they attempt that first stick than your typical EMT student when he/she begins clinicals.
> 
> As for non medical military personnel starting IVs, its my understanding that has been discontinued and that CLS courses no longer include it, so apparently it didnt work out too well. Not to mention theres a huge difference between starting an IV on a healthy athletic 20 year old army PFC and a dehydrated 85 year old diabetic and lifelong smoker.
> 
> Where I work as a patient care tech we can do blood draws, 12 leads, check placement on NG tubes and even DC them, start foleys, do tube feedings, stage 2 dressing changes, BGL checks etc, but mess with an IV line and you are fired. We cant start them, discontinue them, flush them or anything to do with them. Even LPNs arent allowed to. It has to be an RN, so I guess I've had it ingrained in me that while learning to start one isnt a big deal(Ive seen a thousand of them started), its still something left to people who have a higher level of training and licensure for a variety of reasons.



I think you're getting too caught up on what you're used to. A foundation in anatomy and physiology is great and irreplaceable in many circumstances, but it is not necessary to start IVs. The one placing the IV is not necessarily using it for anything. I could imagine a job in a hospital, even if it would be unbelievably boring, that would only entail starting IVs and drawing labs. Do you know what the minimum education would be for that? Probably a stand-alone IV or phlebotomy certificate with zero background in physiology. 

I also don't think other students automatically have a stronger foundation or competence before their first live stick. Even in nursing schools, I know I've seen students who have done a couple mannequin practices and then show up in the ED for their live sticks.


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