Clinical Preceptors

[MexDefender]

I had a great experience on my clinicals, our local service is known a lot of burnouts and as the firefighters say a requirement to be a paramedic is to be fat. I had a really energetic paramedic who was really different from the other paramedics I saw that day, her EMT-B was kind of crabby sometimes but they both let me go through the SAMPLE OPQRST spike a bag and a bunch more that was really helpful in gaining confidence. It was the same way when I went on another clinical at a rural area ambulance service which almost no calls but they were also energetic and really trying to instill some of their knowledge and experience into me and I couldn't ask for a better learning experience.

My classmates had less fortunate experiences with the local service.

 

[abckidsmom]

How many of you have let a basic or intermediate student put in a npa?

Student always manages the airway as long as theres enough help/conditions allow for supervision.

 

[NomexMedic]

I love to see students, so long as they are humble and their to learn.

 

[GorillaMedic]

I have to echo the sentiments above…I don't get how paramedics can piss and moan about students. We all were students once, and I think we can all look back at great clinical preceptors who helped us become the medics we are today.

I love teaching and I love having students on my truck. At the beginning of the shift I try to feel out where they are at in their confidence and skill level, and then I let them practice their skills to the extent I'm comfortable with their competence.

I try to let them do CPR if the opportunity arises (we use LUCAS devices so this is increasingly rare), start IVs, take vital signs, etc. The only thing I'm not comfortable with a student doing is intubation, simply because the ambulance is not a very controlled environment and the risk to the patient is pretty high. Our paramedic students all get plenty of OR intubation time.

My attitude is that the better clinical time my students get, the better quality new-hire paramedics will end up on my streets.

 

[NomexMedic]

I have to echo the sentiments above…I don't get how paramedics can piss and moan about students. We all were students once, and I think we can all look back at great clinical preceptors who helped us become the medics we are today.

I love teaching and I love having students on my truck. At the beginning of the shift I try to feel out where they are at in their confidence and skill level, and then I let them practice their skills to the extent I'm comfortable with their competence.

I try to let them do CPR if the opportunity arises (we use LUCAS devices so this is increasingly rare), start IVs, take vital signs, etc. The only thing I'm not comfortable with a student doing is intubation, simply because the ambulance is not a very controlled environment and the risk to the patient is pretty high. Our paramedic students all get plenty of OR intubation time.

My attitude is that the better clinical time my students get, the better quality new-hire paramedics will end up on my streets.

Couldn't have said it better myself! Great words sir.

 

[AnthonyM83]

For EMT students, it depends on the student.

If they have a great attitude and are intelligent and I see potential, I might literally talk the entire shift and put 110% into trying to teach them as much as humanly possible in one shift. I'll treat them pretty similar to a new-hire trainee, but with less stress. Of course, there are times when I've been tired or had personal issues going on, so haven't been the best. But I always try.

I also do try to mold their ride-along to their goals. If they want to be doctors, I introduce them to doctors. Same with firefighters, nurses, etc. I'll try to connect them with other EMTs on similar career paths, but who are further along than them.

I'll also try to find their strong and weak points. For some, I know getting them to speak up and take charge will serve them best. Others, talking about theory/book material will serve them will, because they're already good with their hands and thinking on their feet.

 

[nekogirl]

Just the thread I was looking for! I do my first ride along for clinicals this Friday!! It's a 12-hr shift so we can try to get our 5 patient contacts in. We get three ride alongs to try to get those done.

I just looked at the preceptor form that they fill out on me and it is a bit scary! The form sort of implies that we need to accomplish an Assessment, Vitals, SAMPLE and PH...basic stuff but when we talked about the ride alongs in class our instructor didn't mention this at all. In fact, he said what we do is entirely up to the preceptor, which makes sense to me.

I'll be honest, I'm nervous about it. Because I just did my first sign offs for stuff and I don't think I was good enough to get signed off but did. I was signed off on Assessment and CPR (which I feel confident with.) But it's the Secondary Assessment section that I don't feel as confident in because honestly, our class hasn't had that much practice or instruction in it. We have gone over the Scene Size-up, General Impression, and Primary Assessment many times and I'm feeling pretty confident in those...but we hardly have done vitals or OPQRST, and we just learned what SAMPLE and PASTE were this last week!

Also, I know that our class is the first class since all the major changes in BLS CPR and even the recent changes in EMS so even when we get a one of the Paramedic students in to help us who are EMT-I or EMT-B they are still doing "old protocals" compared to what we are learning right now so it's a bit odd.

My instructor just told us to ask the preceptor what they expect from us and go from there. I am just going to be honest and do my best. If I don't know how to do something I'll ask and speak up. If I'm asked to do something and I haven't a clue what to do I'll be honest and ask if I can watch the preceptor do it the first time and then try it on my own after that.

You think that will work? I don't want to get in the way and I certainly don't want to be a wall flower either. I want to challenge myself and use what I'm learning and have learned this far but I don't want to put anyone's life at risk for that experience either.

I hope my preceptor is cool with students otherwise, I am the type of student who will let my Program Director know whether that preceptor was professional and helpful or rude and made me feel uncomfortable. Honestly, I don't care what you have going on personally in your life, it's not my issue and it should be my problem either it should left at home, not work. We are adults. Because if you are taking it out people at work then that could mean patients aren't getting the best care either. Besides, I am spending my personal time on this ride along and the preceptor is getting paid to do their job still. It's not like I'm just there for my health. haha!

It should be a great experience for both of us, at least that is how I see it.

 

[GorillaMedic]

Just the thread I was looking for! I do my first ride along for clinicals this Friday!! It's a 12-hr shift so we can try to get our 5 patient contacts in. We get three ride alongs to try to get those done.

I just looked at the preceptor form that they fill out on me and it is a bit scary! The form sort of implies that we need to accomplish an Assessment, Vitals, SAMPLE and PH...basic stuff but when we talked about the ride alongs in class our instructor didn't mention this at all. In fact, he said what we do is entirely up to the preceptor, which makes sense to me.

I'll be honest, I'm nervous about it. Because I just did my first sign offs for stuff and I don't think I was good enough to get signed off but did. I was signed off on Assessment and CPR (which I feel confident with.) But it's the Secondary Assessment section that I don't feel as confident in because honestly, our class hasn't had that much practice or instruction in it. We have gone over the Scene Size-up, General Impression, and Primary Assessment many times and I'm feeling pretty confident in those...but we hardly have done vitals or OPQRST, and we just learned what SAMPLE and PASTE were this last week!

Also, I know that our class is the first class since all the major changes in BLS CPR and even the recent changes in EMS so even when we get a one of the Paramedic students in to help us who are EMT-I or EMT-B they are still doing "old protocals" compared to what we are learning right now so it's a bit odd.

My instructor just told us to ask the preceptor what they expect from us and go from there. I am just going to be honest and do my best. If I don't know how to do something I'll ask and speak up. If I'm asked to do something and I haven't a clue what to do I'll be honest and ask if I can watch the preceptor do it the first time and then try it on my own after that.

You think that will work? I don't want to get in the way and I certainly don't want to be a wall flower either. I want to challenge myself and use what I'm learning and have learned this far but I don't want to put anyone's life at risk for that experience either.

I hope my preceptor is cool with students otherwise, I am the type of student who will let my Program Director know whether that preceptor was professional and helpful or rude and made me feel uncomfortable. Honestly, I don't care what you have going on personally in your life, it's not my issue and it should be my problem either it should left at home, not work. We are adults. Because if you are taking it out people at work then that could mean patients aren't getting the best care either. Besides, I am spending my personal time on this ride along and the preceptor is getting paid to do their job still. It's not like I'm just there for my health. haha!

It should be a great experience for both of us, at least that is how I see it.

Take heart! Every one of us felt challenged on our first clinical. Just go in with an open mind, be willing to jump in and work, stay humble/teachable, ask a lot of questions, and don't judge anyone. You'll do fine.

 

[EMT91]

Just yesterday, I did a ride along and I loved my preceptor, he made sure that after every call he would ask what questions I had, what things I noted etc. really involved me with patient care.

 

[leoemt]

We didn't do ridealongs, we went to Haborview instead. While I thought the Harborview experience was great I was a little upset that we were told we weren't supposed to touch patients, um it is a teaching hospital how are we supposed to learn (apparently a prior med student paralyzed a patient)?

Me and my partner were fortunate that we had a ER Tech that took us under his wing. He showed us around and explained things to us that other students didn't get to see. We also had some cool nurses that encouraged us to observe procedures.

I remember one patient that was a sexual assault victim. The EMT's bringing her in were concerned for her privacy (as they should be) and asked us to step out of the room. The patient told them "no I want them to stay if their students they might help me someday".

We also got lucky and got to observe a neuro consult. An IFT had come in with a patient complaining of a headache. The hospital did a CT Scan and diagnosed her with a brain tumor and sent her to Harborview. The neurologist approached us and asked if we were the EMT students. When we said yes he told us to follow him. He explained the CT images to us and let us observe his initial diagnosis of the patient. It was all above my head but definately something interesting to learn.

Me and my partner were the only EMT students that actually got to do some patient handling. We had a female who was struck by a car and our ER Tech had us help log roll her while the nurses stripped her and checked her posterior.

I feel my class was fortunate in that we got to go to Harborview for our precept time. I wish we could have done a little more like vitals but I was thankful for the experiences we did get.

I do wish we could have also rode on an ambulance as well though. Would have been nice to see ambulance ops on a real call. I would trade in my Harborview time for anything though.

We got lucky. I hope that in the future when I have students I will remember the EMT's, medics and ER staff that helped us out at Harborview and will be a good preceptor myself.

 

[Handsome Robb]

I like students, if they are willing to learn.

I always tell them at the beginning of shift that this ridealong is what they make of it. If they want to jump in and learn I'm happy to help, if they want to be a bump on a log sounds good to me, if they want to be a skills monkey go for it but you can bet I'll be pushing those students in the direction of doing assessments.

I don't gain anything by precepting students, in fact it generally makes my job more difficult but I'm still happy to do it but I'm not going to force a student who doesn't want to learn to participate.

Students don't touch the gurney, period. It's a company policy that started after a student was injured during a lift. Technically they aren't allowed to carry gear either but I'll let that one slide.

 

[xrsm002]

My preceptor wants me to "run" the call I thought I was doing this I would be the first person on scene form my general impression, get information from FD who usually get on scene before us, then I start thinking what I will be doing for the patient. I'm a paramedic student so I'm assuming this is what my preceptor means by run the call. Unless he doesn't want me to ask him questions

 

[281mustang]

It seems most preceptors on the site are superior to preceptors IRL.

On my second to last rotation as a Medic student my preceptor cut me off as soon as I start interviewing the patient on the first call and gave me 'the look.'

I got chewed out when we got back to the station and was told that "under no circumstances are students to address the patient on scene", and if I wanted to assess them or get a hx to do it on the way to the hospital.





That was the one negative student eval I received.

 

[Veneficus]

It seems most preceptors on the site are superior to preceptors IRL.

On my second to last rotation as a Medic student my preceptor cut me off as soon as I start interviewing the patient on the first call and gave me 'the look.'

I got chewed out when we got back to the station and was told that "under no circumstances are students to address the patient on scene", and if I wanted to assess them or get a hx to do it on the way to the hospital.





That was the one negative student eval I received.

It has been my observation that the more of a jerk the preceptor is, the more questionable their abilities as a provider.

 

[the_negro_puppy]

I have only recently received my Medic qualification and recently worked with a student as their direct supervisor for the first time. It was a strange feeling, and slightly scary. We have Paramedic students at university that can fill in shifts as casual employees with a Medic supervisor. Having never worked with them before its difficult to gauge where they are at. Also as the qualified officer we are responsible and accountable for patient care, so if the students does something wrong or omits to do something we can also get in trouble. We work 2 up either Medic/Medic or Medic/Student

I enjoy teaching as part of the job. Its far better to work with a student (say over 6 weeks) than 1 shift.

 

[281mustang]

It has been my observation that the more of a jerk the preceptor is, the more questionable their abilities as a provider.

In my experience the worst of the worst cook book Medics either tended to be ****s or extremely lackadaisical in regards to any preception and pretty much gave me free reign over nearly everything.

The Medic I referenced in the above post got extremely pissy when I politely asked to do an IV attempt after he already failed two attempts. His response was "If I missed twice a student isn't going to hit a vein, don't ever ask to do procedures. If I'm okay with you doing something you'll know." He later told me I 'disrespected' him with my question.

Whenever I got a stick as a student that a previous Nurse or Medic missed the provider was always cool about the situation. Fella definitely seemed to be self conscious of his skill set/knowledge base.

 

[Veneficus]

In my experience the worst of the worst cook book Medics either tended to be ****s or extremely lackadaisical in regards to any preception and pretty much gave me free reign over nearly everything.

The Medic I referenced in the above post got extremely pissy when I politely asked to do an IV attempt after he already failed two attempts. His response was "If I missed twice a student isn't going to hit a vein, don't ever ask to do procedures. If I'm okay with you doing something you'll know." He later told me I 'disrespected' him with my question.

Whenever I got a stick as a student that a previous Nurse or Medic missed the provider was always cool about the situation. Fella definitely seemed to be self conscious of his skill set/knowledge base.

I think anyone who has been doing IVs for any length of time knows there are days when you cannot stick the broad side of a barn.

a new set of eyes and hands is definately a good idea.