Experience?

Anyone got some examples of these "bad habits" EMTs pick up on the streets? I can't think of a single thing that I'd be in the habit of doing that would be detrimental to my learning experience. Well other than being a little rusty with a few skills seeing as I do not work a fire department and almost never get trauma patients other than falls with head injuries. Working as an EMT first seems to have helped me primarily with performing an assessment, dealing with people under drastically different circumstances, and exposed me to situations that never came up in class--just because no one ever thought of the scenario to ask a question about.


Just something to consider: Around here a lot of schools do their ride alongs with fire departments, which handles most of the 911 response/transport in the area. Even if you were to get more clinical time in during that setting, you'll get a very different view of the field than if you're working for a private, responding mostly to nursing homes, dialysis centers, doing IFTs, discharges, and doing the occasional rescue from residences. Some schools have people ride with both fire and private agencies while others call it a day with either or. Those that don't get to see the "routine" work of private ambulance services tend to be a little jarred when they enter the field after school, though it is pretty much their fault for not investigating further before going to school.
 
I vowed to never be an EMT especially during the fire academy. Few years later, I'm working security at a hospital and sorta thought about it after hanging out with some of the crews coming in. A year or so later, hospital offers to give me $2000 for school. My fiancee talked me into taking EMT since supposedly, I'm good with people.

Figure what the heck and take it. Found out, it was really interesting, and thought why not? Something different...and I was catching on quite easily...

I don't know if I want to become a paramedic. I mean thats a LOT of work and responsibility. I think I had that same mentality for EMT. The state is going to pay for my Paramedic so...heck....I might take it since I never know...

So once I finished my EMT, I decided to get a road position and try it out to see if I would really like it and can do it. Kind of like a trial thing so I didn't just take paramedic and find out this isn't for me.

So far so good ;)


I've seen people do the EMT-->Paramedic right out of school and get a job as a basic half way through Paramedic school and find out its not for them....
 
Here ya go! Two years study and one year internship. During this time of internship, the person is evaluated every two weeks and if a pattern or problems arise correctional methods is performed or the person is probation, dismissed, etc.

R/r 911
 
JROD said:
I can gaurantee that no one here experienced the wide variety of patients in the 16hrs of clinical time they had for EMT.
Click to expand...

Any school that only requires 16 hours of clinicals fails and you should demand your money back.
 
AJ Hidell said:
I do. That's why students with no experience get admission preference over those with experience when i am on the admission committee. I have no desire to spend valuable education time trying to break their bad habits and disrupt everyone else's educational experience while I argue with them because they think they know it all. I don't have that problem with blank slates.
Click to expand...

Are you sure we are not related?
 
What are the bad habits that one gets working as an EMT but not as a paramedic?
 
AJ Hidell said:
I do. That's why students with no experience get admission preference over those with experience when i am on the admission committee. I have no desire to spend valuable education time trying to break their bad habits and disrupt everyone else's educational experience while I argue with them because they think they know it all. I don't have that problem with blank slates.
Click to expand...

Eh, I don't know AJ and Veneficus, seems harsh to penalize somebody for working as an EMT. Being an EMT for 5/10/20 years then deciding to apply is clearly a red flag, but that aside. Sounds more like a personality type / attitude problem you should be weeding out, not just seeing a 3 year EMT and going "you're hopeless and will take from the education of your colleages".

Would you have denied my application to your medic school because I worked as a high rise window cleaner & night-shift Janitor for 2 years while getting an A.D. then my EMT? After all, those are both thankless piss-ant jobs, and a "20 Y/O janitor" can be easily seen as ignorant and lacking ambition, regardless of the simultaneous pursuits I took.
 
Buzz said:
Anyone got some examples of these "bad habits" EMTs pick up on the streets? I can't think of a single thing that I'd be in the habit of doing that would be detrimental to my learning experience. .
Click to expand...
.


Some of the bad habits I have seen:

Experienced EMTs telling the instructor (aka me) that the information I present is useless in the field because it is different when you are in the field.
I challenge anyone to find a principle of medical science that is different in the hospital as out. If you are taking shortcuts in your assessment or treatment because you can get to the hospital easier, that is a bad habit. (worthy of dismissal in my opinion) Your skills and knowledge become rusty. When you need it then it isn’t there.

“That’s not the way we do it!”
First off, if you take shortcuts but never learn the full way, how do you know what principles cannot be cut? Second, the practical test at the end be it NR or state requires procedures to be done a certain way. You are not only scored but have critical failures. At least where I teach we make you do it our way (aka the textbook way) so that when test day comes and you are nervous you will do exactly what you have practiced since day 1. Third, you have no idea the people that showed you “their way” are not lucky that nothing hasn’t gone wrong yet.

“Well my protocol states”
The National curriculum is not based on what you do in your service. You need to meet the knowledge and skill demands of a majority; if not all paramedics even if the service you work at today doesn’t make use of that knowledge or skill.

Medicine changes, very rapidly. Because you always did something or did it a certain way doesn’t make it best practice today. There was a time when trauma was cured with a hot poker or by using leeches to take out the bad blood. (Granted we still use cautery and leeches, but in a slightly more updated way)

Poisoning the other students.
There is nothing I love more than some “street smart” EMT telling the students on break and after class how little I know. How you really learn on the street and everything we cover in class is a waste of time because it doesn’t matter. When that EMT is on a 911 truck and other students look up to him/her they often try to emulate them, or adopt their thinking because they see it as where they want to be.

One of the biggest problems with “experienced” people is they don’t know what they don’t know. Then for their mental security they decide patients got better because of whatever specific thing they did for them rather than considering what they did made no difference, was harmful, and the actions performed by the EMT had no impact on outcome.

All of these problems are multiplied by people with lots of time as an EMT, but see relatively few patients and call it “experience.” Washing the rig, cleaning the day room, does not equate with patient care experience. Neither does load and go, do as little as possible, drop off, repeat.

But my all time favorite is when the student does not meet the class requirements because they have determined in their mind what level of skill and knowledge is passing and what is not and blame me when they fail.

They have all kinds of colorful things to say about that. “He doesn’t work on a truck anymore, he can’t possibly know what it takes!” “he is picking on me because he doesn’t like me.” “all the medics I work with do that, and they have a card.” And of course: “He demands too much, we don’t want to be doctors, he should stick with what will be on the test.”

for the record, I do my very best to prepare students for the test. But the real test is not a multiple choice exam. It is a patient. If you can pass that test, the certification exam is child's play.
 
vquintessence said:
Eh, I don't know AJ and Veneficus, seems harsh to penalize somebody for working as an EMT. Being an EMT for 5/10/20 years then deciding to apply is clearly a red flag, but that aside. Sounds more like a personality type / attitude problem you should be weeding out, not just seeing a 3 year EMT and going "you're hopeless and will take from the education of your colleages".

Would you have denied my application to your medic school because I worked as a high rise window cleaner & night-shift Janitor for 2 years while getting an A.D. then my EMT? After all, those are both thankless piss-ant jobs, and a "20 Y/O janitor" can be easily seen as ignorant and lacking ambition, regardless of the simultaneous pursuits I took.
Click to expand...

It is not what you do but how you do it. It is personality type we try to weed out. There are some very great providers who were EMTs for more than a few years before getting their medic. (won't call myself great) I was an EMT for years before getting my medic. Not because I didn't want to, because I was happy with the firefighter gig. I even complained when I had to become an EMT. One day I figured out I like rescuing people and don't give a crap about putting water on fire. Rescue led to medic, medic lead to where I am now. I like taking care of people. I would like to think I grow as a person over time.

I also know many fine providers who couldn't afford to go right to medic.

Motivations and attitudes have to be explored deeper in "experienced" candidates. I have found less problems teaching new people in all the levels I instruct. It doesn't mean I disqualify people with experience. It doesn't mean that I am not going to put forth the extra effort. Actually I take a special interest in helping students who struggle.

But I do not accept the attitude that because you have experience you somehow deserve an easier pass or are worth more than somebody who doesn't. All students must meet the set criteria. I do not like to take time away from motivated and dedicated students to drag a reluctant student along.

In any situation I would rather have 1 person next to me that wanted to be there than 1000 who didn't.
 
Well said, Veneficus! Every shift day at work, I put a "thought for the day" up on our assignment board. The one that comes to mind at the moment is: Do you have 20 years of experience, or one year of experience 20 times?

It is all what you choose to make of it as an individual. Do I think experience should be required to enter medic class? No. Do I think it is a bad thing to have happen? It depends.

Just because you are "gaining experience" as an EMT, it doesn't mean you are increasing your knowledge. Just because I get out of bed every morning and walk to the bathroom, it doesn't mean I have learned anything in the process. If I stub my toe on the same dresser every morning, I obivously haven't done anything worthwhile with that experience. If after stubbing my toe once or twice, I avoid walking into the dresser, I have preceeded to use the knowledge I have gained from that experience. Now, the knowledge gained can be good or bad, and it is up to me to do the nessecary research to determine which type it is.

The other thing to consider is does experience as an EMT really prepare you for being a paramedic? When you get right down to it, probably not. Yes, you may be exposed to the environment of being in the field/on an ambulance, but beyond that it really doesn't "gain" you much. You can get a job working at McDonalds to learn how to interact with strangers. Want to learn how to deal with different crises? Get a job as a councelor at a summer camp. Every skinned knee, bruised elbow, or episode of homesickness is a crisis for the kid involved.

As an EMT, you are taught nothing more than first aid - treat the symptoms and go to the doctor. If they are blue and can't breath, give them oxygen. If they are confused, give them oxygen. If they are bleeding, cover it up.

As a paramedic, even though educational standards need to improve, you are taught to assess the situation, determine a working/field diagnosis, and do what you can for the cause of the problem. If they are blue and can't breath, is it because they have hyperventilated? Maybe they have asthma, COPD, or CHF? Are there signs that could indicate a pneumothorax? You need to be able to discern the difference. Asthma exacerbation is going to be treated differently than CHF exacerbation or a tension pnuemo. Without understanding disease processes, A&P, or respiration vs. ventilation, you can't possibly make the best treatment decision for you patient.

If the argument for experience as an EMT is "to learn assessments" or "to learn documentation" or one of countless other similar arguments, increase clinical/field time during medic class. We already need to increase the didactic portion of medic class anyway, so what's "a few more hours" in the big scheme of things. Really, do EMTs "assess" patients in the true sense of the word?

Let's join the rest of the medical community and move past "stepping stone" type training, and demand true education. With the proper foundation, everything else will fall into place.
 
Veneficus said:
One of the biggest problems with “experienced” people is they don’t know what they don’t know.
Click to expand...
For me it has been quite the opposite.
The more patients I see, the more I appreciate the complexity of human body. I see patients who have illnesses I have not heard about and who take medications I don't know how to spell, let alone what they do. It constantly reminds me how little I know, as well as motivates me to look for more info about these conditions (and when I read about pathophysiology of these illnesses, I see how little I know about normal physiology).
 
Foxbat said:
For me it has been quite the opposite.
The more patients I see, the more I appreciate the complexity of human body. I see patients who have illnesses I have not heard about and who take medications I don't know how to spell, let alone what they do. It constantly reminds me how little I know, as well as motivates me to look for more info about these conditions (and when I read about pathophysiology of these illnesses, I see how little I know about normal physiology).
Click to expand...

Now imagine how much more you can get when assessing a patient when you already know those conditions and you have an understanding of the pathophysiology. Things really start to make sense then. Unfortunately, if you don't understand the processes with patient in front of you, that patient will not get the full benefit of what you will learn when you look something up later and say "gee, I wonder if that was causing this and I should have done something else."

Thus, I only recommend remaining an EMT-B for as long as it takes to finish a good Paramedic program with a few prerequisites to get you started. If you only have a limited knowledge about the human body, you will only be able to a very limited assessment with little understanding of what the body is trying to tell you.
 
vquintessence said:
Would you have denied my application to your medic school because I worked as a high rise window cleaner & night-shift Janitor for 2 years while getting an A.D. then my EMT? After all, those are both thankless piss-ant jobs, and a "20 Y/O janitor" can be easily seen as ignorant and lacking ambition, regardless of the simultaneous pursuits I took.
Click to expand...
Did you even read my post? What does any of that have to do with what I said? If you screwed around for two years as an ambulance driver, then yes, I would quite possibly give preference to non-experienced EMTs over you. However, your previous jobs have nothing to do with that. I find your two years of "thankless piss-ant jobs" to be a good reflection of your character, showing that you are used to hard work and committed to doing whatever is necessary to further your education. Quite different from someone who played EMT for a few years INSTEAD of getting an education. And anyone with any college degree moves to the head of my admission line, which is a whole nother thread topic!

Between Veneficus, VentMedic, and Epi-Do, there's really nothing much else left for me to say.

EMT school teaches you to simply paint by the numbers. You do an assessment on a body that you have very little understanding of, and elicit data (subjective and objective) that you are not educated to interpret. The EMT assessment is simply going through the motions with no understanding of why, or what it means. Then everyone gets high flow oxygen, and again, you don't know why, or why they might ought not to have. When you spend a year or two doing that, that only cements the belief in your mind that medicine is about "skills", and that you don't need all that book learnin', causing you to come to my class with a closed mind about what you need to know.

You would be shocked at how much time is wasted in paramedic school arguing with "experienced" EMTs with the attitudes that Venificus described, listening to their pointless war stories, and having to explain to them why they need to know what they didn't know before. In a paramedic course, it literally takes hours away from the learning process. It not only makes it harder to teach them, but it makes it harder to teach the rest of the class.

Not only do I know this from teaching, but I know it also as a student. Being a paramedic hurt me in nursing school. I had a lot of preconceived notions that kept me from achieving maximum benefit from nursing education. I often made assumptions from my paramedic experience that equated to mistakes in my nursing assessments and care. I had to learn to forget all that experience and look at things objectively without preconceptions before I really hit my stride in nursing school.

This isn't just something that Veneficus, Vent, and I made up to torque people off. This is a well established concept of educational science. Ask any education professional, like a school teacher or college professor. Just like I analogized before, it is easier to raise your own child from birth than to take over raising someone else's 13 year old. And when you take a paramedic student with years of EMT experience, you're getting the 13 year old.
 
Last edited by a moderator:
P
AJ Hidell said:
Did you even read my post? What does any of that have to do with what I said? If you screwed around for two years as an ambulance driver, then yes, I would quite possibly give preference to non-experienced EMTs over you.

so what your saying is that a graduate of a horrible school gets priority over an experienced "ambulance driver" as long as the dumbass that graduated from the horrible school doesn't have any experience in the field. Please correct me if I'm wrong, but that just seems like a really bad way to promote the prestige of the EMS industry as a whole. I believe that an experienced EMT is better than a "factory produced" EMT any day of the week. I'm sure you disagree, as you do in most other topics that I post, but this just seems extremely closed-minded; especially coming from an open-minded paramedic like yourself.

P.S. - another thing i learned while gaining experience as an EMT is that a COPD patient can get hi flow O2 for more than a 30 min transport if they need it. I know that seems like common sense but after being questioned by an RN, you begin to second guess yourself. Many RNs in this area (not sure how RNs think in your area) seem to think that this is bad becuase of the COPD pts defense mechanism, not realizing that it takes an extended period of time for the COPD patient to actually stop breathing after receiving hi flow O2 treatment. Thats a NREMT-P question by the way...(after the RN made me feel like an idiot becuase i was "just an EMT" the DOC made her look like an idiot by putting the patient back on an aggressive O2 treatment to help combat the respiratory distress they were experiencing). I know this sounds pretty basic, but keep in mind, any EMT or Paramedic that is questioned by an RN or Doc would second guess themselves in regards to any treatment, right or wrong...
Click to expand...
 
Last edited by a moderator:
JROD said:
so what your saying is that a graduate of a horrible school gets priority over an experienced "ambulance driver" as long as the dumbass that graduated from the horrible school doesn't have any experience in the field. Please correct me if I'm wrong...
Click to expand...
You're wrong. All EMT schools are horrible. That's just the way the curriculum is set up. But nowhere have I said anything about judging anyone by the school they attended, so please don't presume to put words into my mouth.

I believe that an experienced EMT is better than a "factory produced" EMT any day of the week. I'm sure you disagree, as you do in most other topics that I post, but this just seems extremely closed-minded; especially coming from an open-minded paramedic like yourself.
Click to expand...
You refuse to consider long established, scientifically validated concepts of education -- in which you obviously have no formal education -- and I am closed minded for refusing to accept your opinion? Puhleeze.

Regardless, "factory produced" and "experienced" have nothing to do with each other. They are completely separate factors to be considered. And I don't care what factory they came out of. They will be judged on what they know, as measured by entrance examinations. Every student is different. If the "factory produced" EMT scores better in his knowledge of the medical and physiological concepts that should be known at the EMT level, then he is a better candidate than the one that went to the school you think is best. Choosing candidates based upon what school they went to is the epitome of closed-mindedness.
 
in your previous posts, you never introduced the concept of testing the applicant. You simply stated that an unexperienced EMT would receive priority over an experienced EMT because you don't want to deal with bad habbits...you implied that an unexperienced EMT was better than a "field experienced" EMT...I am happy to learn that you actually do use entrance exams as a basis for admittance....thank you for clarifying...if you would like me to reference exact quotes, then I will...
 
No, I understand what you are referring to, and I understand how that was misunderstood. But this thread is very specifically about the experience requirement, not about the admission process as a whole. That's why I have not comprehensively listed all the factors that are used to determine admissions eligibility.
 
I understand that, and as stated before, I appreciate your clarification. I just wanted to be clear that a good EMT with prior experience would not be ruled out over a bad EMT with no prior experience.
 
You must log in or register to reply here.
Back
Top