Preschool Providers

[fast65]

So this is a topic that has been on my mind for awhile now. There seems to be a growing population of younger EMS providers out there, or at least EMS providers that look young. I was wondering if any of the younger/younger looking providers out there have problems with getting respect from the ER staff, from patients, or from other agencies/providers because of your age or how young you look?

I'm a 21 year old paramedic, and for those of you who don't know what I look like...well, I look like I'm 12 I don't seem to have a problem gaining the respect of my patients, peers, or the ER staff; where I'm running into problems is with the FD, and with the staff at other hospitals. They all seem to disregard me, my orders, and my report, turning to my FTO instead for her answers. I just figured this could be an interesting discussion, so tell me your thoughts.

 

[ArcticKat]

Might part of the problem be the FTO? When my trainee provides a report and a nurse looks at me expecting me to say something, I just tell that nurse that I'm not the one giving report.

Once the trainee completes his report and I think he missed something I'll nudge him...if he doesn't take the hint I'll complete the report for him.

 

[fast65]

Might part of the problem be the FTO? When my trainee provides a report and a nurse looks at me expecting me to say something, I just tell that nurse that I'm not the one giving report.

Once the trainee completes his report and I think he missed something I'll nudge him...if he doesn't take the hint I'll complete the report for him.

I don't know really know, it may be part of it. But for anyone who doesn't know I'm in my FTO period, there's nothing to signify that I'm not just another paramedic, I have a paramedic patch just like everyone else, the only difference between my partner and I is that she has a "Field Trainer" patch on her sleeve. So perhaps that could be a large portion of it.

 

[akflightmedic]

Only time I ever had this issue was when my dad and I worked on the same truck. This was my part time interfacility job and he was only a driver. He was newly retired form military and I convinced the boss to hire him to chauffeur me around.

I was a paramedic and no matter where we went to collect patients, they always looked to him for more info or they would start directing all info to him even after I introduced myself as the paramedic and clearly demonstrated I was the lead.

No one ever believed we were related either...

 

[fast65]

Only time I ever had this issue was when my dad and I worked on the same truck. This was my part time interfacility job and he was only a driver. He was newly retired form military and I convinced the boss to hire him to chauffeur me around.

I was a paramedic and no matter where we went to collect patients, they always looked to him for more info or they would start directing all info to him even after I introduced myself as the paramedic and clearly demonstrated I was the lead.

No one ever believed we were related either...

Yeah, that's kind of the same thing that happens to me. If we have an IFT that we're picking up from the ER, the new nurses will start to talk to my partner even after I ask them "So what info do you have for me on this patient?".

My partner just started telling them it's "bring your kid to work day".

 

[abckidsmom]

Yeah, that's kind of the same thing that happens to me. If we have an IFT that we're picking up from the ER, the new nurses will start to talk to my partner even after I ask them "So what info do you have for me on this patient?".

My partner just started telling them it's "bring your kid to work day".

LOL.

I think that the issue really has a lot to do with body language, too. I notice that the nurses look away from my partners whenever they get tense and rambling and/or are obviously disorganized in their reports. They first glance around the room, or look the patient up and down, and then as it continues, they look at me, and expect me to bail them out of the difficult situation they're in: the one of healthcare provider just wanting to get on with their work, but stuck in the trap of being polite and waiting for the talking to be over with so they can say thank you and move on.

This is not saying that you are guilty of giving this kind of report, but I think at some level, all new providers, and all other providers from time to time just get pretty rambly.

Plus, sometimes the nurses are just crabby and not into the whole thing, and something like this happens to everyone.

If your FTO has been working in your system for a while, she knows the nurses, at least at the most superficial level. The nurses are going to look to the person they understand to have the strongest clue. It's just easier that way.

Harness this pressure and let it drive you to do a better job each and every time you give report. Learn the best words for everything so that you don't sound ignorant, use the same pattern every time.

 

[fast65]

Oh, I agree, body language has a lot to do with how people listen to you. During the start of my internship, I was terrified to give report, and I would ramble on like you said. However, now that I'm hired and in my FTO (with the same company) I have confidence in my reporting, and although I do occasionally ramble a little bit, I'm generally pretty competent at hand off's.

I mean, most of the nurses here know me, and they recognize me as the PIC right now, but it's the new ones that don't know my FTO or I, they just assume that she's the PIC.

I don't want to give the impression this is just during reports though, I mean the FD also seems to have a problem listening to me, even after I identify myself as the PIC.

 

[AlphaButch]

Work on your command presence. Some questions to ask yourself (and work on) and tips.

*Appearance
Do you look like you know what you're doing? Do you look like a professional? Shoes shined, uniform pressed, haircut, etc.

*Body Language
Heads up, stay alert. Do things with purpose and intent. No fidgeting, shuffling, stiffness. Let your body language display confidence.

*Eye Contact
Maintain it

*Speaking
Are you speaking with confidence and competence?
Are you concise and articulate?
Do you listen?
Critique your tone and delivery.


Do you have anyone who can coach you on command presence? Many law enforcement officers, fire dept officials, military personnel and professional speakers have received training on leadership that covers command presence.

 

[fast65]

Work on your command presence. Some questions to ask yourself (and work on) and tips.

*Appearance
Do you look like you know what you're doing? Do you look like a professional? Shoes shined, uniform pressed, haircut, etc.

*Body Language
Heads up, stay alert. Do things with purpose and intent. No fidgeting, shuffling, stiffness. Let your body language display confidence.

*Eye Contact
Maintain it

*Speaking
Are you speaking with confidence and competence?
Are you concise and articulate?
Do you listen?
Critique your tone and delivery.


Do you have anyone who can coach you on command presence? Many law enforcement officers, fire dept officials, military personnel and professional speakers have received training on leadership that covers command presence.

I hope I'm not sounding arrogant, but I think I have all of those areas taken care of. I never leave the house without my uniform being spotless, my boots are shined, and I'm never unkempt. I keep a high standard for what I consider to me professional, and I maintain that.

I keep good posture, I move with purpose, and I don't go shuffling around the kits without knowing exactly what I'm looking for. I ensure eye contact when I speak to people, and I use a firm tone of voice that conveys confidence. I will on occasion find myself searching for a word, but that's usually during conversations with my partner.

My tone and delivery have been something I've been working on for the past few months, and it has come quite a ways since I first started. My orders are clear and concise, and I make sure everybody knows what I want, how I want it, and when I want it. I'm always open to suggestions, and I'll either take them, or explain why I'm not taking them. I mean, there's always room for improvement, that I realize, but at this point, I feel as though there has to be something more to it than that.

However, I will make sure to ask my FTO tomorrow how she thinks I'm doing in the aforementioned categories. Perhaps I just have a inflated view of myself?

 

[AlphaButch]

However, I will make sure to ask my FTO tomorrow how she thinks I'm doing in the aforementioned categories. Perhaps I just have a inflated view of myself?

We all do That's why I mentioned finding a coach. Having someone else's perspective can help you identify the things that may be improved upon.

Some of your command presence on a scene will also come from your FTO and other providers. As they may already have built a rapport with persons on scene, establishing command upon arrival should be step 1.

I do this in a few ways as an FTO/preceptor.

I'll normally get people used to establishing command by asking the cadet/student "Where do you need me?" when we approach providers on scene. This reinforces the cadet/student's situational awareness, makes them more comfortable with delegation and establishes command.

In the hospital, I try to avoid visibility/contact with the nurse until after the cadet/student does. This is usually done by just being busy with something (looking at monitor, talking to patient, etc). If they look at me first or ask me a question first, I normally state that I'm just there for the ride (or something along those lines).

Other than the direct question to a cadet/student establishing command, I try to instruct cadets/students to delegate without himming and hawwing. Once I'm comfortable with them taking lead, I don't let them do basic skills (vitals, acquiring a strip, etc). They are assessing, delegating and diagnosing.

 

[fast65]

We all do That's why I mentioned finding a coach. Having someone else's perspective can help you identify the things that may be improved upon.

Some of your command presence on a scene will also come from your FTO and other providers. As they may already have built a rapport with persons on scene, establishing command upon arrival should be step 1.

I do this in a few ways as an FTO/preceptor.

I'll normally get people used to establishing command by asking the cadet/student "Where do you need me?" when we approach providers on scene. This reinforces the cadet/student's situational awareness, makes them more comfortable with delegation and establishes command.

In the hospital, I try to avoid visibility/contact with the nurse until after the cadet/student does. This is usually done by just being busy with something (looking at monitor, talking to patient, etc). If they look at me first or ask me a question first, I normally state that I'm just there for the ride (or something along those lines).

Other than the direct question to a cadet/student establishing command, I try to instruct cadets/students to delegate without himming and hawwing. Once I'm comfortable with them taking lead, I don't let them do basic skills (vitals, acquiring a strip, etc). They are assessing, delegating and diagnosing.

Haha, well, I'll see about getting my FTO to critique me tomorrow.

I'm not having a huge problem during my hand-off's to our local ED, because they all know I'm the one in charge, but it's more the FD and hospitals that we sometimes do IFT's to. But I have noticed that if my FTO sees that others aren't acknowledging my lead on scene, she'll kind of push me to delegate them like: "What would you like these guys to do?" and things of that nature. And like you said, she doesn't let me do basic skills either, I'm there trying to assess, diagnose, and delegate.

I think a lot of the problem with the FD is that they're mostly volunteer out here, and they always seem to show up on scene first, so they kind of have a hard time handing pt. care over. I mean, a lot of the time, it runs pretty smoothly, but there seems to be a few that have a hard time listening to me, and would rather "freelance".

 

[Tigger]

So this is a topic that has been on my mind for awhile now. There seems to be a growing population of younger EMS providers out there, or at least EMS providers that look young. I was wondering if any of the younger/younger looking providers out there have problems with getting respect from the ER staff, from patients, or from other agencies/providers because of your age or how young you look?

I'm a 21 year old paramedic, and for those of you who don't know what I look like...well, I look like I'm 12 I don't seem to have a problem gaining the respect of my patients, peers, or the ER staff; where I'm running into problems is with the FD, and with the staff at other hospitals. They all seem to disregard me, my orders, and my report, turning to my FTO instead for her answers. I just figured this could be an interesting discussion, so tell me your thoughts.

Definitely feel your pain there. My issue is usually in the ER where the triage nurse always seems to go to my partner for a report when I'm the tech. Where I work we have to tech for three months before driving privileges are given, so I feel like I have had enough practice that I can give a solid report. Plus it's a BLS report, there's just not that information and I find that I can avoid looking like an idiot if I know what the nurse is going to ask before she does so.

On a good day I might be 20, the last guess my age contest in the ER resulted in a "17." Ouch.

I don't have an issue anywhere else really. I have good partners who understand that the 24 to 20 age gap is not massive, it's not like I'm getting babied on scene. Every call is my call (sadly), and they respect that and let me do my thing despite being young and lacking experience.

I also have to say that working for my college's sports medicine program is great since my bosses (ATCs) are all used to working with students. I think that is where some of the issues in the ER stem from, the 50 year old triage nurse is maybe not the most comfortable with dealing with an EMT that is her son/daughter's age.

 

[Handsome Robb]

I have a random thought. If we want to be viewed as providers and further this job as a profession why do people refer to it as "teching" rather than attending? Idk about you guys but I'm not a technician, I'm a clinician. Well working my *** off to get there soon at least

 

[Tigger]

I have a random thought. If we want to be viewed as providers and further this job as a profession why do people refer to it as "teching" rather than attending? Idk about you guys but I'm not a technician, I'm a clinician. Well working my *** off to get there soon at least

I'm just used to it since I have to sign my name/number next to the "tech" box on the PCR. Valid point nonetheless.

 

[Handsome Robb]

Tigger just a clarification, I wasn't singling you out by any means. I have heard tons of people say it, including coworkers.

Like I said a random thought more than anything.

 

[fast65]

I have a random thought. If we want to be viewed as providers and further this job as a profession why do people refer to it as "teching" rather than attending? Idk about you guys but I'm not a technician, I'm a clinician. Well working my *** off to get there soon at least

I completely agree. The term "teching" seems rather demeaning to our profession. That being said, I've never actually heard that term anywhere outside of this forum.


Sent from my iPhone using Tapatalk

 

[Aidey]

When I started at my current job I was 22, and had been a paramedic for almost 2 years. I had the occasional issue, but now that I've been here for a few years the FFs and hospital staff know me.

The only place I run into issues now is at facilities. It wouldn't be a huge deal, but my partner is....unique...and won't interrupt people to tell them I'm the one they should be taking to. So he'll walk in the door first and they'll start talking to him, while I'm 6 feet back at the end of the gurney unable to hear anything. I finally had to enact a rule that I walk in the door first after we pissed off a few nurses who had to repeat their whole report.

 

[Jon]

I usually run P/B. I had a regular partner who'd been in EMS for ~15 years. He was about 50... He knew the area and was a fantastic partner. Was usually able to know what I needed without me having to ask, and he saved my bacon a couple of times. Sadly, he left the service in question, so I don't work with him anymore.

On more than one occasion he had to explain to a SNF LPN that they needed to talk to "my paramedic" because "he's in charge" or "that's his decision"... He did it in a way that showed bemusement on his part, and I on more than one occasion, I explained how much I appreciated how he handled it.

 

[Jon]

Might part of the problem be the FTO? When my trainee provides a report and a nurse looks at me expecting me to say something, I just tell that nurse that I'm not the one giving report.

Once the trainee completes his report and I think he missed something I'll nudge him...if he doesn't take the hint I'll complete the report for him.

That's how I handle it when precepting. I'll only step in if they miss something or things are sliding downhill.

 

[mycrofft]

Careful of trying to act "commanding"

Especially when you might look young; they will think you are a self-important tool and go to your partner to avoid you.
I was the one they'd go to instead of my partner. I always would let them talk as long as we were both there to hear, then say "I'm the tech, this is ___, (s)he's in charge".
Then I went to nursing, and some female nurses would not give adequate report to a male nurse. Hope THAT has changed.

Tell you what, as you roll up, arrange with your partner to give her/him some orders, such as "Go get the sheets, I'll give report" or something. They'll get the idea.