Help!

[WannaBEMT]

Hey you guys!

Missed being here, I have been so busy in class, homework, job and mommy/wife, etc. I have a question that I hope someone can help me with. I have a good class average, I do very well on test, get 100's on homework, etc. BUT, I had my 1st practical the other day and I completely froze! I could not do anything it seemed right.......I was very discouraged and upset with myself, but kinda thinking it was a one time thing and our 1st one to boot, but then I got called out to do a scenario in front of the class and I did it again! This is embarrassing and makes me think that I won't be able to do well when push comes to shove, I am trying hard but I cannot seem to get this under control! My instructors called me in the office the other night and asked me what was going on, they told me they knew I know the material but I needed to be less meek, more confident and speak what I am thinking. Do you guys have any advice because I have to redo this practical soon?? Thanks for your time guys!

 

[Guardian]

It's heartwarming to read this stuff because we have all been there. Just do the best you can and stick with it no matter what and sooner or later you'll get it. That's about it. I wish i could tell you more but there is nothing more to tell you. Take this oportunity to practice hard because before you know it, you'll be in the field doing the real thing.........good luck!

 

[jedirye]

I am in the same boat as you, Wannabe. However, I have not gotten to my practicals yet, but am dreading them all the same. In class, I never have confidence in the material I know during different scenerios, and often times draw complete blanks. I'm thinking if I pretend my friends/parents are patients and go over the ABC's, SAMPLE, OPQRT, etc. enough I will develop some sort of assurance. There is always hope I guess...

-rye

 

[rocket]

This sort of thing happens to a lot of students. And I believe many very good EMT's have at times early in their education/careers sat and wondered if they'd be able to hack it during a high-stress situation.

I am an adjunct EMS educator. The primary instructor for the class I help to teach is an 18-year veteran of the local ambulance squad. I respect this man very much and take to heart all that he has to teach. He recently told his class that for 18 years he assumed that one day he would come across a situation that he could not handle or see something he could not overcome. 18 years has come and gone and he's still waiting for that situation to occur.

It's OK to have a little performance anxiety. It just means you want very much to do well at something that you know is very important. You will probably never shake that little devil completely off your shoulders (like the veteran instructor) and will probably spend many a post-call session silently grilling yourself, asking "did I do everything exactly right?".

I have more faith in the students that exude a little humility than the ones that exude too much confidence. When the "cowboys" freeze up they tend to really blow it and miss things that are very important and/or critical.

Here are a couple of pointers that have worked for me as a student and also for my students:

(1) Keep in mind that the practical is not a real emergency. Remember to take your time and really speak and spell things out. If you think you are going too slowly chances are you are moving at just the right pace. I can tell when most students are about to blow it...they start talking faster and faster.

(2) Take yourself out of the experience. Imagine that your evaluator knows nothing about the skill you are about to demonstrate and make it a point to explain every step. This will help you keep your place during the process. It is the difference between showing someone how to do it versus how you do it. Instead of hoping that you look like you know what you are doing when checking the patient's airway, take the time to say "I will now inspect this patient's airway. Because this is an unconscious trauma patient I want to observe spinal precautions. Therefore I will have my EMT assistant open the patient's airway using a modified jaw thrust. I will now look, listen and feel for the patency of this airway. I will look into the mouth for any obstructions such as broken teeth or blood and also look for the rise/fall of this patient's chest. I will listen for the presence of breath sounds and also for troubling sounds such as snoring, gargles, or wheezes. I will feel for the sensation of breaths from this patient's mouth onto my cheek to help get a sense for this patient's respiratory rate".

(3) Have your terminology worked out ahead of time. EMT class throws a lot of terminology at you in a comparatively short amount of time. Many students get tripped up merely by trying to determine the best way to describe what they are doing or looking for. The best way to work this out is to hear yourself saying the terms out loud. Go to a quiet corner or drive in your car; imagine the thing you are doing (e.g., a head-to-toe rapid trauma assessment) and then verbalize what you will say out loud for each step. After a few attempts you will know what sounds best and be more likely to say the right thing.

(4) Do not expect each hands-on skill to work perfectly. They seldom do in the real world either. If you are having trouble getting the BP, don't freak out. Instead say so and then try the patient's other arm. The tools will slip out of your hands, break, or otherwise be disagreeable; not all patients will be easy to assess. This will happen for everyone to varying degrees.

(5) Try to develop and memorize an outline for the task at hand. Most practical skills are just sequences of basic tasks and they follow a logical order. For example, when you get done with your ABC's can you really do anything else (major) for this patient? Your transport decision will reflect whether the answer is yes or no. More simply: transport decision follows ABC's.

(5a) Once you get an outline try to stick to it always. Students who jump around in their sequence of actions tend to get lost and forget things.


~~~~~~~

Hopefully this helps you a bit. If you can post up the specific things that are going wrong we may be able to give you more directed advice. In the meantime don't give up! If you find yourself overwhelmed yet faced with the overwhelming desire to press on then surely you are on the right path!!

-Trevor

 

[joemt]

Wow Trevor, I couldn't have said it much better. I've been an Instructor for 8 years and you have listed pretty much the same things that I tell my students.

 

[rocket]

:beerchug:

-Trevor