i'm really worried.

[emtgirl_in_training]

:sad: On Wednesday, in my EMT-B original class, I 120% freaked out during a scenario. I basically had a nervous breakdown. That’s not me. I’m usually the laid-back-take-charge-make-it-happen kind of chick.
The patient was up against a corner, with a large box in his lap. Stacked chairs were surrounding him, making him hard to reach. So we do the usual (I’m the EMT in charge) the BSI, the scene size up, etc. The chairs are taken out (the room was tiny maybe 8 x 10) and we got him with manual inline stabilization and right on a backboard. He was unconscious and unresponsive. We did an OPA because we “heard” snoring. And well, his breathing seemed adequate. 16/ full and regular. So I put a NRB on him, at 15 lpm. His circulation seems good; strong radial pulse; pink, warm, and dry. No major bleeds. I do the whole rapid trauma assessment and base vitals. And at this point the instructor is telling me the patient’s lips are turning blue. I’m nervous. The 2 instructors are half glaring/ half grinning at my crew and I the entire time. So even though I’m 98% positive I’m doing the right thing, I start second guessing myself. So as I’m accessing the patient’s breathing again, he tells me the patient’s feet are now blue. But the breathing is 16/full and regular. He has good lung sounds. And I stand up and I’m just like near screaming “you are telling me his lips are blue and his feet are blue and I’m giving him O2. And he’s not bleeding and I have no idea why he’s breathing and turning blue that makes no sense and I just don’ t know. I don’t know what to do.” I’m getting full fledged flustered.

Now, I know what I did wrong, I was treating numbers and not my patient. And my decision to transport took much too long. But the fact that I broke down really bothers me. What if I’m not cut out for this? I mean since I’ve started class its all I talk about. I study day and night (and I’ve NEVER studied in my entire school career). I WANT TO BE AN EMT, that’s not the issue. What if I just can’t? Academically I’m the top in my class, and in the scenarios that I’m not having “nervous episodes” I do fairly well. I don’t know. I’m just really worried that I don’t have what it takes.

 

[Wingnut]

I've had the exact same conversation with myself. Not only because I was afraid I'd screw up but because I'm prone to panic attacks already when doing nothing (I have an anxiety disorder). Throughout my EMT class I had lots of support from my instructors, my preceptors and my family. If you talk to the people teaching you these things they will help you, they instilled confidence in me and helped me relax. I actually ran a code with one of my preceptors and realized I can do this, I hope you get that same chance so you can see early on that you are capable of this.

The best piece of advice I got was from my instructor, she told me,"Don't worry we're not going to throw you to the wolves, you will have paramedics and training to get you used to and comfortable with the procedures and eventually it'll be easier, it's nerve racking for everyone for a while."

 

[coloradoemt]

I would not be as concerned with your panic attacks as much as I would be how you handle yourself during them. If you can let those around you know what is happening in as calm a manner possible it will bid well for you until you are confident enough in your abilities to be able to make it through each and every call. A word to the wise however, no one including the pt wants someone freaking out on a call...

 

[Chimpie]

Was the instructor saying his numbers were 16 and strong, or is that what you were really getting when doing an evaluation?

Remember, you're not there by yourself. You have a crew. Ask you partner what they think is wrong. Could be as simple as, "<enter name here>, do you see anything that is wrong?"

 

[MedicPrincess]

Hey emtgirl...sorry to hear about your panic attacks. During my first oral exam, I threw up, nearly on the examiner.

Think of something that is completely relaxing to you. If possible, when you know your going to have practicles during class, try to do what ever it is that relaxes you. Don't take your study sheet with you. Just relax and let it be free of your mind for a while. There is such a thing as over studying.

I like what Chimpie said too. The problem with the instructor I had was if we turned and said something like "Hey Partner. Do you see anything I am missing?" or something to that effect, the instructor would play "Scenerio God" and put the partner into Cardiac Arrest.

Their goal is that, was to help us to develop our critical thinking skills.

In my opionion, relaxing and doing something non class related right before you go. Free your mind for a little while.

 

[Celtictigeress]

you have to be able to work as a team

remember your not alone there are others with you... you wont know if your cut out for it until your actually taking a real call, right now place in your head the cause of the panic attack, take a moment to focus and breathe and try to figure out better ways to handle the stress...

Best Peice of advice that I can offer you is this....trust in yourself Trust in your partners... Second guessing in the long run can cause problems, always go with your instinct run the numbers in your head... take control of the crisis and situation, evaluate yourself and others... and remember no matter what happens you are NOT alone... you ARE part of a team

 

[Wingnut]

I like what Chimpie said too. The problem with the instructor I had was if we turned and said something like "Hey Partner. Do you see anything I am missing?" or something to that effect, the instructor would play "Scenerio God" and put the partner into Cardiac Arrest.

.

Mine did that to me too, I asked what my partner thought I was missing during a scenario and my instructor said "Your partner falls to the floor shaking violently."
I was not happy.

Another idea, I tried this but it didn't work because I don't have a trigger for my attacks, it might work for you. But expose yourself to your stressor in a controled enviornment. Start at home having someone read you through scenarios then ask someone in the field to run you through them. The fire dept did this for me. There's a station right down the road from my apt and I told them I need to study scenarios for my test, they offered to run me through several if I came down. It'll help desensitize you. But really you'll find out for sure when you do your ride-a-longs and don't worry about it that only makes it worse.

I've been living with these damn things for years. I hate them but I've managed to overcome them for the most part and grant it I've been medicated for them, but even that wouldn't work unless I found a way to deal with them.

Good Luck, Get through your class and don't make any rash decisions. You'll be fine if your determined.

 

[emtgirl_in_training]

it really wasn't a panic attack, it was more of like "oh poop! i'm in charge of someone's life! my teachers are making faces at me, we haven't covered 98% of this at all and even with reading ahead i'm clueless. my partners are more or less in the same boat. and now with 'normal' breathing, this guy is blue!!" truth be told, i'm worried that i'm going to pass everything, go out in the field and have the touch of death.

 

[Stevo]

scenarios just aren't real emtgirl

i've run plenty of stations over the years for initial and recerts (as well as taken part in them) and can honestly say one can't see or treat what simply is not there as well as what IS apparent.

the bodily changes would stand out a tad quicker if you were to view it happening along with ALL the signs and sympthoms , instead of someone simply telling you they were

now just about every instructor out there likes to throw in the unknown, the unexpected, the twist, because that is very likely to happen in the real world where we work one obvious angle , only to find that we've gone done the wrong path

that's expected....

unfortunatley i have found many ems nazi's whom like to present a no win situation to those involved, and inasmuch as the grim reaper will get the best of us i do not relish said futility being some sort of macabe hazing inclusive in station scenarios

that's lining people up for failure....

~S~

 

[TTLWHKR]

scenarios just aren't real emtgirl



~S~

No, but they are to prepare you for what is real.

 

[Stevo]

grand, so lets keep it within the realm of reality and not claim a patient has coded after having good vitals shall we?

~S~

 

[Wingnut]

grand, so lets keep it within the realm of reality and not claim a patient has coded after having good vitals shall we?

~S~

It would be nice but I think the instructors just like messing with us.

 

[Carpe Diem]

I ask myself the question of am I cut out fo this at least once a month, Usually if you are worried about it then that means you really care and will do fine, what worries me are the ones who go through with thier nose in the air and dont study or really give a crap if they pass. You will do great, if you can cope with the stress they put on you here, it will give you a good foundation for when you are out there for real.

 

[emtgirl_in_training]

It would be nice but I think the instructors just like messing with us.

oh boy!! mine are out of their minds! they are AMAZING! chances are i'll be the 4'8", female verison of either of them (or my parents). i figure they are both my instructors and 'rents are on the job over 20 years each, so they have to be a little completely insane. if i make it in the field i hope, in 20 years, to messing with plenty of kid's heads.

 

[emtgirl_in_training]

I ask myself the question of am I cut out fo this at least once a month, Usually if you are worried about it then that means you really care and will do fine, what worries me are the ones who go through with thier nose in the air and dont study or really give a crap if they pass. You will do great, if you can cope with the stress they put on you here, it will give you a good foundation for when you are out there for real.

thanks for your support! i'm still worried but i'm trying to work thru it. fake it til you make it, confidence-wise, i guess.

 

[Ridryder911]

I always tell my students to "control the situation, don't let the situation control you "... I learned off a very wise physician, once. He was in charge of a pediatric code... he never raised his voice, becam excited, actually was in control of the situation. I talked to him later, and told him how impressed I was on the performance. He later told me that he learned that " the crew follos the Captain"..meaning, if you are calm, and appear to know what you are doing, the restof the crew will follow. Yes, it is wise, to ask for help or even suggestions... but, do it at your pace, when appropiate.

Think about it .. if the physician starts yelling .. the rest of the team will follow.. before long, things starts getting thrown around, and screaming and things getting flung around. This is true on Fire, Police, and yes even EMS.
There is no need to "loose it".. if one can remember ABC's and the worst has happened (the event). even if the ABC's are not there.... we know what to do... if they even die.. we still know what to do. You can't get worse than death. Confidence comes with knowledge and experience.. you are not out of school yet.. don't be too hard on yourself..

I have seen "normal signs with patients only chief complaint being " something is not right !".. no pain, no abnormal v.s. etc.. only to have them code on you in a few minutes later... yes, it does happen.

I wish you luck,
R/R 911

.

 

[Stevo]

yes RR, we are the eye of the patients storm per se'.

i just don't think station scenarios should incorporate the outlandish (allbeit it does exist) for students

let them be practiced to normal run of the mill scenarios that they'll see 99.9% of the time

that initself is enough for starters, the wierd stuff that some instrcutors feel they need to introduce should come later on, not initially

~S~

 

[Ridryder911]

I agree, they should have more "normal scenarios".. and I am aware, that many instructors do go overboard sometimes. However; I know some that also do it to add a little "spice" or to cause the student to think "outside the box", especially in the later part when so many students become compliant with studies. I get so tired of students only knowing what is on the check sheets or can only recite the memorics .. BSI, O2 high flow, etc....this is not real life. Real calls are gray, not black & white.

When they do respond to the unusal call.. all heck breaks out.. and basically, they stand there in disbelief with their thumb in an orifice. School is the time to explore some of these issues, not when a real patient life is on the line. The time to screw up is in scenarios..

True many calls can be classified as "routine' but how many of routine calls turned out to be disastarous ? Throwing an unpredicted event should not cause such a dismay .. I do wonder, if this is a such an event in training, what would happen on a call that grandma fell in the floor and then has a CVA enroute will cause ?

That is why this job is never classified as routine...

Be afe,
R/R 911

 

[MedicPrincess]

grand, so lets keep it within the realm of reality and not claim a patient has coded after having good vitals shall we?

~S~

Does this not happen?

I can recall being initially dispatched Alpha response for a general illness, been not feeling well X2 days. About 1/2 mile from scene we were upgraded to Delta for patient is now seizing, and when we were around the corner, they upgraded again for the patient now being in Cardiac Arrest.

I am sure its not the NORM, but why shouldn't it be presented as a possiblity?

 

[Jon]

Does this not happen?

I can recall being initially dispatched Alpha response for a general illness, been not feeling well X2 days. About 1/2 mile from scene we were upgraded to Delta for patient is now seizing, and when we were around the corner, they upgraded again for the patient now being in Cardiac Arrest.

I am sure its not the NORM, but why shouldn't it be presented as a possiblity?

I had a partner tell me how he once got a billing signature (Confirmation of transport) from a dead guy.... guy was talking with him onscene, having some mild chest pain, etc... well, he had the big one and his heart gave out on the ride in to the ED. Oops.... Well, at least billing got their signature.