Medic Students

[Hastings]

Depends a great deal. We have Hospital Clinicals and then Ride-Alongs, followed by an Internship in the Summer.

To sum it up, after learning a certain skill, we are signed off on a little slip of paper that we carry with us. We are expected to act as a paramedic in regard to all skills that we have been signed off for, as well as all basic EMT skills. And we are expected to participate directly in patient assessment and care.

At the hospitals, we are expected to - under the guidance of the nurses - to start all IVs, EKGs, perform physical and verbal assessments, and create the reports. We are also often expected to be involved in treatment as well, especially if it involves pushing drugs. And while it's all a "who wants to do this one?" deal, the ones that step up benefit a great deal from doing so.

On ride-alongs, you're the only student and are expected to act in an active role in patient interaction, although there's a huge difference between ride-alongs with private services and ride-alongs with the fire departments. Typically, the private services will let you do everything (and encourage you to do so), while the fire departments will push you aside and have you simply watching. It's hard, because the departments around here automatically send a fire engine on every EMS call, and they typically arrive before the medics. All firefighters are paramedics, so the work is usually done by the time the student arrives.

If nothing more, being active and taking offers to do countless IVs rose my confidence a lot. And of course the only way to get truly good at a skill is to practice it in a real situation. It's scary, but it's so valuable.

As for internships in the Summer, typically the first third is just watching, the second third is participating as a co-medic, and the third third is acting alone with a veteran medic in the ambulance simply as assistance.

 

[paccookie]

Wow.. Around here, this is a can of worms. When I started my medic program several years ago, my class was informed that unless we were in a clinical envroment with a preceptor, we were JUST an BLS provider.

I was occasionally offered IV's... and I turned them down. At one point, my medical director was also working for the priviate service I work for... and was providing onsite medical direction at a large event... he told our RN to let me do everything... including IM meds and IV Narcs... because he was the medical director for my school, I didn't question him . There were photos taken, and they even showed up in the banquet slide show, to everyones amusement.

I've occasionally assisted ALS practicioners with ALS skills... like "setting up" glucometers and code meds.... but sometimes I've done things that have been in a gray area. (as is much of street EMS). I've had senior medics have me assess patients at an ALS level, with them confirming what I do... I don't mind, but they still have to write the chart. I enjoy the practice. I've been done with medic school for long enough now that my EKG skills are beyond rusty, and it is nice to be challenged once in a while.

I guess it's a little different for me because I'm an EMT-I, not a B. It's within my scope of practice to do things like IVs, blood glucose, etc. It's part of my job to put the patient on the monitor and set up the IV fluids while the medic is doing other things. The way we work is that one of us is interviewing the patient and getting vital signs and an IV while the other one is dealing with any airway issues (O2, intubation, etc), putting the patient on the monitor, and starting the computer documentation. If the patient needs intubation, obviously I'm the one getting the IV.

Today we had a 6 am wake up call - an unresponsive person. Turns out she had taken a heck of a lot of codeine-containing cough syrup. She was still breathing fine at that point, so I put her on the monitor and a NRB at 15L and popped open the drug box for the narcan while my partner found an IV (he is extremely good at IVs, I'm still learning). He pushed the narcan and I checked her blood glucose. I drove in and the patient needed a tube by the time we got to the hospital. My partner intubated before we unloaded her and I bagged while my partner and the fireman who rode in with us pushed the stretcher in to the ER. We work as a team and I think we work well together. There's a lot of trust involved and I can't imagine working as well with someone else. I actually prefer the less emergent calls because there are more opportunities for my partner to teach me things I don't know. He gets a kick out of it and I get to learn something new that will help me when I start paramedic school in the summer.

Anyway, I think I've rambled on enough. lol