How to gain confidence?

[Nameless]

I'm in EMT-B training right now, and we are set to take our state tests come early December. I've got one more 8-hour hospital clinical to do (24 hours for hospitals, 48 hours for ambulance rides, 4 hours for nursing home) and I've already learned quite a bit so far with hands-on experience.

However, with my clinicals, I've mostly felt like there wasn't a whole lot I could do. In the hospital, we mostly had nurses. There were "techs" (as they called them) that were equivalent to an EMT-B, but they were trained to do things that I would not be (i.e. blood draws, start IVs, 12-lead ECGs, etc.) through the state EMT-B certification. The most I've done out of my level was attach a 3-lead ECG (not even the pads, just the probes to the pads) to transfer a patient in-hospital, and I attached them incorrectly.

The feeling that there wasn't a lot I could do mostly stemmed from my perception that I didn't know exactly what I would be allowed to do and the fact that I am extremely new to a lot of this. I feel as though I'm fumbling with everything and that I am going to mess up. I once had the opportunity to place a combitube into a real patient, but that did not go well, as my medic said I was close to puncturing his trachea. That was honestly not my intention, but I had only ever placed the tube in a mannequin twice, and only managed to do so correctly in the mannequin once.

I've been told that experience will come in time and with more practice, but the fear is still there. I have anxiety as is, so I am probably blowing my fear and worries out of proportion. I'd like to know, though, if anyone has any tips for an upcoming EMT, let me know. Do you have any advice after reading this? Any practice tips? How to inspire self-confidence? I know you guys can't see my skills in action through reading an online forum, but still.

 

[Yarbo]

Try taking a deep breath and just focus on what you're doing. Study all the procedures you're able to do. Since you're a student you need to take the initiative and do those 12-Leads, injections, blood glucose checks, foley catheters, charging lines, and whatever else you can do. These Nurse AKA ER Techs you're talking about are just working, you need to be responsible for your education. Walk into your next clinical like you're the most confident EMT there is.

 

[TripleA94]

Confidence will come with time and repetition of your skills. I don't think anyone graduated their EMT course with 100% confidence. Take a deep breath before walking on scene, gather your thoughts, and be the best EMT you can be. If you act confident, the patient will believe you. Soon enough you'll even trick yourself!

 

[Akulahawk]

Confidence with your skills should come with repetition of those skills. In effect, the more you do them, the more familiar you will be at doing those skills, the more likely it is that you'll do them correctly, the better you'll feel about doing the skills...

I don't think anyone feels quite 100% confident about what they're capable of doing when fresh out of EMT (or Paramedic for that matter) school. I hardly ever had to crack the book for EMT school and rarely had to crack the book open for Paramedic School. I did reasonably well in my clinical and field experiences through both... guess what? It still took me a while to start feeling confident in what I was doing and I had a very thorough education going into those programs.

The only other thing I could add is that you should highly consider taking college level coursework for allied healthcare fields like nursing, PTA/OTA, Respiratory Therapy, and the like. The reason is that you may find that you like one of those fields better and you'll already have your prerequisites mostly (if not all) completed and you'll also have a much better understanding of why we do the things we do for our patients... thus giving you a much better depth of information to draw from as you work with patients.

Personally, I would much rather work with an EMT that's completed all that "extra" schooling than a Paramedic whose only exposure to A&P, pathophys, pharmacology, etc was Paramedic school itself because my EMT partner would be much more capable of making informed patient care decisions and would be able to anticipate what I'm going to need.

 

[Paramedic0311]

Confidence

Let the nurses and ER tech know that you want to learn and have them coach you through some procedures. Get your hands on as many patients as you can. You need to take some initiative. Nurses love to help people, and they would love to help you become more proficient!

 

[m0nster986]

"Fake it until you become it."

http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are.html

 

[Connor]

"Fake it until you become it."

http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are.html

This. But not if it means bad pt care.

Funny story, I had a pt a few days ago who did something to her shoulder trying to climb a fence. Treatment? Sling, ice and hospital recommended. (I can't transport with the company I work for, nor would I want to for this pt.)

So I slung it in the bus, mind you I haven't done one since training and forgot how to do it well. The pt. asked me if it was my first time, to which my partner laughed hysterically. <_<

Anyways, I told the pt. no, I've done it before but it's been a while. I remained confident and because of that she kept her confidence in me. It was still a really sloppy sling though. So I sent her off and used my partner as a training dummy. I figured out how to do it well again, then tracked down my pt. (this was a very small sports venue so it was pretty easy), told her I did a sloppy job and realized it in hindsight, and fixed it.

Her confidence in me and my company was maintained because I remained confident, and she still had a damn good tube sling at the end of it.

You can't learn to swim without being neck-deep in water!

 

[wanderingmedic]

1) relax
2) realize that you just being there means a lot for the pt
3) fake it if you have to...but never loose an opportunity to learn
4) build relationships with more experienced people who can mentor you and help you grow
5) take criticism and don't get defensive

 

[Dan216]

Yeah man like what everyone is saying. I'm not sure how old you are, but I just turned 20 and got my EMT-B certification at the beginning of 2013.

I've never had any confidence. Things that have happened in my personal life etc.. I had a ton of friends in high school and was popular, but still always felt like the odd man out.

After I got that EMT-B certification, I still had no idea what I was doing but my confidence improved slightly. I joined a fire department as a volunteer and have been fortunate enough to go on calls and transfer the patient to the hospital.

I learned quickly to act confident around patients, even if I don't know everything.. Granted your scope of practice as a basic isn't extremely high. Speak with authority and you'll be fine man. Everyone was in your place at one time.. Even the paramedics who you think know everything about EMS.

 

[enjoynz]

Practice,practice,practice. Study,study,study....and believe in yourself!

 

[O2andDogs]

I had one of the highest grades in my EMT class (90% was required to pass, I finished with around 97%). That being said, on my first real patient contact all that knowledge seemed like it went out the window!

In EMS, unless you are in a crazy busy area, there is plenty of downtime. I suggest talking to your teammates! Pick a piece of equipment that you are not familiar with and ask someone to go over its use with you. Practice as many skills as you have the time, equipment, and willing victim to practice. When you go on a call, volunteer to perform the skills that you are confident in, and watch the others being done. If the patient is stable, ask if you can lend a hand with the more difficult procedures.

That is how I am personally gaining confidence in my skills and abilities. Good luck!

 

[Glucatron]

With experience you will get much better. When I started I was scared and had no confidence. I'm about 1 3/4 years in and I am telling you if you stay with it, humble, ask questions and don't be afraid to get yelled at occasionally it does get easier. Don't expect perfection. I'm still making mistakes and have plenty to work on. Eventually you realize "ok, I screwed up that IV on that critical call and I need to work on that, but we got the pt there alive"

 

[hobozach]

I had one of the highest grades in my EMT class (90% was required to pass, I finished with around 97%). That being said, on my first real patient contact all that knowledge seemed like it went out the window!

This.

Also your clinical requirement for your EMT is probably the most extensive I have ever heard of, what state are you in? My clinical only consisted of 12 hours on ambulance. Just remember your training and learn new things every chance you get from those more experienced. Class is one thing, but being in the field is a whole other animal. So many things like talking to the PT, writing PCRs, doing notification patches, and hand-off reports, just to name a few, you learn by doing. For instance, during my first hospital notification, I was shaking like a leaf (and left out the PTs LOC :unsure: ). But learn from every mistake and be a sponge for advice. (Even if what you learn is beyond your scope, it does not hurt) and medics really appreciate it if you know how to assist them with ALS procedures.

 

[trespassingproductions]

also be humble and dont be afraid to make yourself look stupid with a dumb question. better you learn from a dumb question than you learn in a pt setting

 

[hdarkace]

for me it was blood pressures! I know this is a very basic skill but for the life of me i could never get them right.. so i always faked it in the field (meaning tried to get as close as possible) and got a mroe accurate one in the truck with the automated machine...Like everyone said the key is confidence.

During downtime i just did blood pressures on my partner all day! We even played some music and he talked to me about random stuff to simulate the ambience in the truck while waiting for the pulse sound.

A good Medic will always show you the ropes like i tell people the EMT-B is a springboard fake it with your patient but be straight up with your Medic. if there is something you can't do tell them the worst thing you can do is have your partner loose confidence in you it makes for a long 10, 12, 14, or 24 hour shift