ALS Truck Time Help.

[JBEMT93]

Hey guy's so I'm at the end of my paramedic school experience. I've passed my tests, I know my stuff. I have a few years of some urban BLS experience under my belt. Problem is I'm almost at the end of my truck time and I am not doing well. My preceptors aren't happy with my performance, and I'm not happy with it either. My assessments are scattered, my communication skills are lacking, and I get nervous and scatter brained on calls. The one common comment is I lack confidence.

My Preceptors know I put in the work, but I'm just not getting the hang of it. I'm hoping someone might have some advice that I haven't tried, or some similar experience. I love my job, but I'm scared that I may not be able to cut it as an ALS provider.

Thanks for your time guys!

Sincerely,
A struggling medic student

 

[NomadicMedic]

You will never be a good medic until you have some swag.

Walk in and OWN the calls. Have your partner get a set of vitals while you start asking questions.

The majority of calls can run as a VOMIT. Vitals, oxygen, monitor, IV, transport.

Start by telling people what you want, rather than asking. The minute you say, "uhh, maybe I'll give him some aspirin?" You've failed. Be decisive and stand up. You're a medic. Get on it.

 

[Ewok Jerky]

Scattered Assessments: make a routine. Use the standard Hx of present illness > medical Hx > Surgical Hx > social Hx > meds > allergies > review of systems > physical exam
You can always pause and say "let me make sure I understand this right..." and repeat what the patient has told you.


Communication: who are you having problems with? patients? radio reports?

Nervousness: slow down. Delegate tasks to your partner, fire crews, even your fto. LISTEN to what the patient is telling you.

Confidence: you obviously are smart enough to do this. Like @DEmedic said, you need to command the scene.

 

[JBEMT93]

Thanks guys. I've never really been one to go out there and just take charge. I know that's an integral part of being a medic.

As for the communication, I think its an issue of how I communicate with my partner and let them know what's going on.

 

[Eleventy7]

Fake it til you make it. Don't *****foot around. There's nothing that's going to magically give you confidence.

What do you have for outlets - positive outlets. I'm all about that meditation game.

 

[hogwiley]

Paramedic internships are tough. Your new at this and you learned the text book way of doing things and now you have to apply it to the real world, and may have a preceptor whose been doing all these things so long its second nature. I think Interns tend to want to overtreat patients.

I remember My preceptor had a few laughs at my expense when I'd do this super thorough assessment on a couple patients they could instantly tell were just drug seekers, only for me to find out eventually that was the case. Im putting them on the monitor and wanting to start an IV and crack the drug box, and he'd be standing back watching me, waiting for that light bulb to pop on in my head.

 

[Carlos Danger]

Start by telling people what you want, rather than asking. The minute you say, "uhh, maybe I'll give him some aspirin?" You've failed. Be decisive and stand up. You're a medic. Get on it.

This. Even if don't feel like you know what you are doing, act like it you do. Make statements, not requests. Be decisive. Don't worry so much about making mistakes.

Scattered Assessments: make a routine. Use the standard Hx of present illness > medical Hx > Surgical Hx > social Hx > meds > allergies > review of systems > physical exam

And this. Routine is your best friend. Use the same opening lines with every patient, ask the same questions in the same order, and do your initial assessment in the same order.

 

[Angel]

I had a hard time too. Take a deep breath, take a step back, and just LOOK at what you have and what you are doing, collect yourself and keep moving. The best way to limit your audience (and thus nervousness) is to give everyone a task. That way they are busy and not paying attention to you.
Kind of go over radio reports in your head before getting on the radio, and always do them the same way (order), and your verbal/hand off report should be very similar, with maybe just an update on last vitals and meds given and any changes if any.

It is normal to be nervous and bit unsure, but the minute you SHOW it, or bring that attitude to a call, people notice and it doesn't look good.
Some tidbits I learned was to ALWAYS have a good reason for doing something, or NOT doing something, ie a big one for us was Cspine or not.
good luck!