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chet

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How's it goin?
I just became a NREMT-B, got a job offer, was told it would be completely IFT's. I'm taking it as I need the work and the competition is intense around here. I am just wondering what am I in for? Been reading the posts that IFT's are for losers and so on. I just want some experience and am happy to get work! Thanks to any who reply.....
 
chet said:
How's it goin?
I just became a NREMT-B, got a job offer, was told it would be completely IFT's. I'm taking it as I need the work and the competition is intense around here. I am just wondering what am I in for? Been reading the posts that IFT's are for losers and so on. I just want some experience and am happy to get work! Thanks to any who reply.....
Click to expand...
You could be in for a lot of boredom. Really. It's not going to be high-speed, low-drag kind of work. However, if you take the time to actually read about your patients, learn their pathologies, what medications they take (and why) and really take time to assess them, you can learn a LOT from your IFT patients.

Or you can do the minimum....
 
I assume you're in western mass? If you live within an hour of Boston it's not very competitive, and there are a lot of companies you could consider working for where you'd get some amount of 911 experience.
 
You've been reading the wrong posts if all you see are the ones about IFTs being for losers.

IFTs can be great learning experiences. I've worked both (currently only working 911), and can honestly say I saw sicker patients on a more frequent basis working IFT than 911. If you manage to get on a box with a paramedic, or one that does critical care transports, you'll see even more sick patients. Transport a patient on 4+ drips and a ventilator, or an IABP just one time, and you'll see what I mean. A provider used to only 911 would :censored::censored::censored::censored: himself.

IFTs allow you to see patient conditions, see the actual diagnosis, how they present with that diagnosis, what medications they're prescribed for said conditions, etc.

The caveat to that is you have to be proactive on your own to get that experience and that knowledge. The packets, the nurses, even the doctors will all be at your disposal. However, if you do the minimum required to get your patient from point A to point B, and disregard all of those resources, you won't learn a thing and will get very little, if anything out of your experiences. You'll get out of it what you put into it.

911 often leaves little closure for your worst-off patients. You'll often be stuck wondering what the patient you brought actually had. 911 also isn't as glorious as you may be lead to believe. When you're on your 13th call of the shift, and the patient's chief complaint is a poor appetite, you'll be doubting how glorious 911 truly is.

Both have their pros and cons. I don't think either is really superior to the other- they're just different. Make the most out of your time in either setting, and continue learning. Best of luck.

Edit: tl;dr- what akula said. :lol:
 
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I'll repeat what was stated above. You can do the minimum and hate your job, or you can learn, become a great EMT and enjoy your job. I've done IFT for the last year and love my job.

Just because youre in IFT doesnt mean you wont get serious patients. I regularly had code 3 (emergency) transfers of very sick patients. They are less frequent, but when they come, pay attention, and there is a lot to learn there as well.
 
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Ignore anyone telling you IFT is for losers. I find that most people with that attitude turn out to be the true bottom skimmers of our profession. What do you think teaches you more about proper EMS care? Running a 30 minute transport time transfer to a higher level of care or screaming Code 3 to an occasional minor MVA while sitting with the other Ricky Rescues talking about how we're all such heroes? Hint: Insuranceitis gets old quickly. IFTs are a service that needs to be provided, just like 911 transport. As others have mentioned, you can learn a lot about patient interaction and disease processes if you put some effort into doing your job with pride. IMO, there's no better way to learn the ropes of EMS than spending some time running even basic IFTs. Patient interaction and complete assessments can be difficult to teach in a classroom (at least to where the provider is competent). Go in with a positive attitude and enjoy yourself!
 
STXmedic said:
You've been reading the wrong posts if all you see are the ones about IFTs being for losers.

IFTs can be great learning experiences. I've worked both (currently only working 911), and can honestly say I saw sicker patients on a more frequent basis working IFT than 911. If you manage to get on a box with a paramedic, or one that does critical care transports, you'll see even more sick patients. Transport a patient on 4+ drips and a ventilator, or an IABP just one time, and you'll see what I mean. A provider used to only 911 would :censored::censored::censored::censored: himself.

IFTs allow you to see patient conditions, see the actual diagnosis, how they present with that diagnosis, what medications they're prescribed for said conditions, etc.

The caveat to that is you have to be proactive on your own to get that experience and that knowledge. The packets, the nurses, even the doctors will all be at your disposal. However, if you do the minimum required to get your patient from point A to point B, and disregard all of those resources, you won't learn a thing and will get very little, if anything out of your experiences. You'll get out of it what you put into it.

911 often leaves little closure for your worst-off patients. You'll often be stuck wondering what the patient you brought actually had. 911 also isn't as glorious as you may be lead to believe. When you're on your 13th call of the shift, and the patient's chief complaint is a poor appetite, you'll be doubting how glorious 911 truly is.

Both have their pros and cons. I don't think either is really superior to the other- they're just different. Make the most out of your time in either setting, and continue learning. Best of luck.

Edit: tl;dr- what akula said. :lol:
Click to expand...

All good points. My personal philosophy to be a well rounded emt/medic one should have access to be doing both IFT and 911 response. Critical Care transport and 911 have different priorities and utilization of skills. Need to perform both aspect of the job systematically to be proficient one is not necessarily better than the other, they are different jobs with different skill sets.
 
I also agree with the majority of the people, that you can learn a lot from IFT. You can learn about conditions of the patients, how they are treated and the related medications. For CCT IFT, you see more advanced things already put into place. However, with all this in mind it depends alot on how much you put into it and want to learn, especially on the BLS IFT. I work for a company were many of the EMTs during a BLS IFT will sit in the captains seat and not talk with the patient. They will copy a history and meds, but do not research what the meds are actually for or what they do. I personally, sit on the bench seat on every BLS IFT and talk with my patients. I go over what their conditions are, what medications they are on, and how their conditions are treated. Its also good when there are conditions that you dont know anything about. We took a patient that had RSD, some people had no idea what it is but just write it as history and nothing further.

I do also agree though, that companies (like the one I work for) that do both IFT and 911 are the best way to go. You can learn a lot from 911 to and get valuable experience in treating some patients that are critical. Other things that IFT can be good for are practice with vitals, history taking, lifting/moving, and talking to patients.
 
Hey thanks to all, I am considering going on to be a medic in time, and your suggestions to learn the conditions and meds are great. Thanks again...
 
chet said:
Hey thanks to all, I am considering going on to be a medic in time, and your suggestions to learn the conditions and meds are great. Thanks again...
Click to expand...
Remember, a lot of our suggestions were based on the premise that you're working for a strictly IFT company. I'm certainly NOT saying that you shouldn't do 911, rather just that you should use the time on IFT to expanding your knowledge in all the ways discussed in this thread. The more you learn and can correlate with patient presentation, the better off you'll be later. Quite literally, one day you'll have that "lightbulb" moment when stuff you're learning about and what you see in a patient just suddenly "clicks" and you understand what's going on. Suddenly you just intuitively know what you must do for your patient because the interventions you've been reading about make sense. It's also the time that you can become more dangerous because you might make erroneous assumptions about a patient's status without actually assessing them.

When that happens, slow down, assess your patient, and move forward. You might surprise yourself how quickly you got things done. Slow has just become fast... When you take that to 911, you'll be one of those EMTs that just "get it" and will seem to intuitively know what your Paramedic needs. You'll be one of those EMTs that we all like working with. And everything just moves that much faster... and when you move up the chain to Paramedic, you'll have a strong knowledge base to draw from because you did your own learning. Don't neglect formal education though! Take A&P and other courses along the way to getting into Medic School. You'll be one of those medics that actually think through problems, understands the underlying issues and can provide appropriate care for your patients even though you have horrible protocols to work with and work from.

Hopefully I've shown you a roadmap that connects where you are to where you want to be. Even when you reach the end of the "map" that I've put forth, keep learning. You may decide to become a PA or an RN... or along the way you may come to realize that while this is fun, something else has such a powerful pull that you must follow it.
 
I just wanted to add one thing, that I have yet to see mentioned with IFT. Doing IFT runs gives you an opportunity to develop one of your most important skills as an EMT, giving a transfer of care report.

With an IFT you generally have the time to do good assessments and include details. Most patient's (even critical) have been stabilized and give you time when transferring care to give a good report and ask for feedback on your report from the nursing staff.

I have seen many times in BLS IFT, that EMTs will document the transfer of care and state that they gave report when in reality they didn't. Many times patients are dropped off and staff just signs and the truck pulls away.
 
Now that someone brought up the report thing. ;) Something I used to do is ask the receiving nurse if they'd personally gotten report from the sending facility. If they state they had, I would launch into report to state simply what changes occurred during transport. If it's been a while since report had been called over, or the receiving nurse hadn't personally gotten report from the sending facility, I launch into the full report that contains essentially a snapshot of the patient, my own findings from my own assessment, the background of the patient, any recent labs that were immediately pertinent, vitals, how the transport went, and so on. You can imagine which one took only 30 seconds and which one often took a few minutes. I would also end with "any questions?"

When I started giving these reports, I would often ask the nurses what information they wanted, so that I could give them what they needed instead of what I thought was pertinent. There are things that pretty much all nurses want, and then there are floor-specific things. Once you understand what they want, it's easy to create a mental script and then follow it when giving report. It also makes you sound more intelligent (or something) and the receiving nurses might then start seeing you as a competent EMT. Yes, they know your education is not so good... but when you're presenting good, accurate information in a way they understand while showing you've got some grasp of things, clearly you're smarter than a box of rocks.

Especially with ED types, as that happens, they look less and less at the patch on your sleeve as they realize you're very good at assessing/evaluating what's going on, and (kind of) trust that when you're relaying something about the patient, that's what's going on. I've had that happen on more than a few occasions when I was at the top of my pre-hospital game.
 
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