Emergency Room Clinicals

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I was recently hired as an ER tech and am often paired with EMT-B students. I received my EMT-B in 2007 and need a little refresher of what is expected of EMT-B students when in the er setting. I try and ask the student what they hope to get out of the experience but usually end up with a response something along the lines of "I don't know." What do you think I can do to make their experience better and what do you think makes a good preceptor?
 
For an EMT, most of the time just watching is very beneficial to their experience. The main point of hospital clinicals is to show the EMT what happens after the ambulance, and to see the more advanced things such as CTs, MRIs, and so on.

Try to get the student to follow some doctors when they do their assessments. Sure, the average EMT student will be lost half the time, but it's still a beneficial experience to see different types of assessments.

Let them bag respiratory arrest, apply splints, hold cspine, and most of the other things you as a tech do.


When I did my time as an EMT student, I actually had a couple of doctors ask if I wanted to start some IVs. I said it was out of my scope and they said "So? I'm allowing you to do it and I'll walk you through". THOSE are the docs you want your students to tail... the ones who will take time out of their schedule and show them the more advanced stuff.
 
Hahaha Steve tell me something I don't already know. P.S I am praying for Texas.
 
Do I know you?!
 
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:ph34r:
 
Can you give EMTs time in Triage? That might teach them a thing or two about assessment. Also, showing them what happens to patients after arrival would be helpful. Oh, and maybe some feedback about what the hospital expects of the EMTs (good documentation and presentation, not making patients worse by delaying transport unnecessarily, etc.).
 
mgr22 said:
Can you give EMTs time in Triage? That might teach them a thing or two about assessment. Also, showing them what happens to patients after arrival would be helpful. Oh, and maybe some feedback about what the hospital expects of the EMTs (good documentation and presentation, not making patients worse by delaying transport unnecessarily, etc.).
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The students are required to spend one shift out in Triage before they spend a shift in the back. One of the first things I tell the students is to pay attention to new ambulance arrivals so they can listen to the hand off report and then watch as the doctor does their assessment. I guess my concern is mostly on the nights when we are not very busy, or the shifts it seems like all I do is IV start after IV start, insert foley catheters and assist with code browns :rolleyes: (aka wiping someone's butt). Even though this is all part of my job description as an er tech, this is not necessarily very beneficial for a student. Especially when their goals are to work in the field once they have completed school.
 
Probably the most benefit I got out of ER clinicals was just interacting with lots of different patients. Obviously practice with vitals is helpful, although in an ER that largely just means pushing a button and watching a monitor. Observing doctors when they were doing physical exams and history was helpful, and any time respiratory was called I shadowed them.

I would encourage students to try to get experience doing vitals on infants and toddlers. I'm sure it's amusing to watch a student listening to and trying to record an infants heart rate for the first time.

I dont know if these students have clinical objectives, we did....a LOT of them. If they do look at their objectives packet.

At least your showing interest in the students. We were pretty much left to fend for ourselves. The ER I did mine at didnt have ER techs, just RN's and Dr's, and if we werent aggressive and took initiative, they were content to completely ignore us the whole time.
 
In our area most basics get 12 hours of ER clinical time,not nearly enough in my opinion but better than nothing. When I have a student in the house I like to keep them moving from the moment they hit the door. I usually will give a walk thru of the unit and give them the basic do's and don'ts. Most of the class instructors seem to have the students dialed in on what to expect and how to behave during clinicals but that's not always the case.

First stop is always the blanket and IV fluid warmer,I expect to see two warm blankets in a students hands when they show up to meet an ambulance or help room a patient. I let the students know that this is their time and they should not be shy about popping in on patients,it's expected and encouraged. The main goal is to have the student lay hands on and interact with as many patients as possible in the limited time available. Listening to breath sounds,doing vitals and working on their assessment skills is what these folks need to be doing. I always like to get students over to the peds side for some interaction with our little ones. Most of these students have never seen a really sick kid let alone had to deal with one. Time in the peds ER is crucial if we want competent providers on the street taking care of the little ones. I will add that we have begun seeing regular rotations in the peds ED for most of the paramedic students from our area schools so maybe things are getting better.

I really wish they allowed more clinical time for students,its far more beneficial than sitting thru endless power points listening to an instructor drone on and on about all the great calls they have worked. After you learn the basic curriculum you need to begin applying what you have learned. Hands on with patients is what its all about especially for the new folks and the controlled setting the ER offers is the best place for a student to develop their skills. I'm sure there will be some butt hurt instructors that take offense to the drone on thing but really its kind of annoying after a while.
 
Hey Ashley, you should just go out for a nice dinner and a movie with each male student you precept. Especially the ones that look like doctors.

Just don't drink too much or you'll get lectured. Also - you don't need to be shy or desire privacy when going to the bathroom or changing either... just get over it and do it in front of them - they've seen it before anyways right?
 
I know you and Ashley are close, but jeez Lauren.


I'd say I'm shocked, but that'd be a lie.
 
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