I have 1/8 shfits left in my internship and I still feel like I suck. I went straight into medic school without any EMT experience. That was definitely a mistake. I feel stupid 99% of the time. Its almost like I know what to do on calls, but I get anxious when I know people are evaluating me. I'm with different preceptors every shift and none of them have told me i'm doing a bad job. Well, my most recent shift was awful. One of my preceptors was constantly making snide remarks to me. Here's the kicker, he wasn't even the paramedic, he was the emt. It really worsened my nerves and i'm feeling like im failing at everything. It left an even worse taste in my mouth. Is this just not the right line of work for me?
Paramedic internship
- Thread starter ickyvicky
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I bet your lack of EMT experience has less to do with the way you feel than just being in medic school. Feeling stupid is part of the curriculum. Be patient, cut yourself some slack. It's hard.
I don't get the part about paramedic students having EMT preceptors. How are you supposed to learn from someone who lacks a big-picture view of your profession?
I agree. The fire station I am doing my internship with usually has 2 medics but they were short staffed that day so had to put an EMT on the truck. Unfortunately most calls were BLS calls so I was stuck in the back with him most of the day. There was a clear personality conflict which definitely hindered my learning as well. I understand that i'll have to work with people I may not get along with all that well, but I think you should be less of a douche when someone is Learning. It knocked my self confidence down a few pegs that's for sure.
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Hmmm…
NomadicMedic
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This warrants a call to the paramedic program clinical coordinator. This is a perfect example of the disconnect between the program requirements and the actual field internship experience.
A paramedic intern babysitting BLS patients when there is an EMT on board is an utter waste of time.
A paramedic intern babysitting BLS patients when there is an EMT on board is an utter waste of time.
DrParasite
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unsurprisingly, i have a different opinion:
of the EMS calls received can be managed by the EMT.
most systems have someone credentialed at the EMT level first, and then move onto ALS. That way if they can't cut it as a medic, they might still be able to work as an EMT. That's how many of the agencies near me work. IIRC, it's a 3 stage process: EMT clearance, Paramedic 1 clearance, and Paramedic 2. EMT clearance results in you being able to work as an EMT, paramedic 1 clearance means you can work as a paramedic with another paramedic FTO, and paramedic 2 clearance means you can work solo or with an EMT.
to @ickyvicky, I won't say you suck, or that you aren't cut out for this field, but EMS has some strange personalities, and some preceptors suck. Some would rather knock you down than bring you up. You also have a very limited experience level, and with more experience comes more confidence, and that takes time. And yes, a good EMT partner can help out a paramedic, while a bad EMT partner can ruin a paramedic's day.
Don't let one douchy preceptor (regardless of EMT or Paramedic) derail your career goals.
hmmm, a zero to hero program that didn't prepare you for the field? shocker
you might have test anxiety. it happens. however, now is the basic time, when you have a safety net. How are you going to be when you finish, are out in the field, and the FD is evaluating you, the family is evaluating you, and the patient is evaluating you? and if you mess up, the patient dies?
This sucks. big time. because, despite the best of intentions, every preceptor wants things done a certain way. and it typically takes 3 to 5 shifts with the same person to learn what they expect you to do, and expect of you. so having a new preceptor every shift makes it hard, since you have no idea what the precept wants.
that's a problem. Your preceptor should be making you better, not making snide remarks. That doesn't mean you shouldn't be given criticism when you screw up, but it should be done with positive intent.
Ehh, you can have an experienced EMT be a paramedic preceptor, especially if the patients you are handling are BLS patients. However, just because you have one douchy preceptor doesn't mean you aren't cut out for this.
If I had to take a guess, I would say there was a paramedic preceptor on the truck as well, but since the patient was BLS, the EMT (who may also be an agency preceptor) was put in that position. Also, it's insulting to say that only paramedics have a "big-picture view of your profession." I know plenty of EMTs who have a better big-picture view of the profession, and some paramedics who only know what they have seen at their current job. I will also say that most paramedics know more about treatment options than most EMTs, but that doesn't mean a paramedic intern can't be properly evaluated by an experienced EMT.
Welcome to real life. Most systems don't run dual medic ambulances; more often it's 1 EMT and 1 medic. if it's a BLS patient, the medic drives, and if it's ALS, the EMT drives. Some systems have the medic handling all patient care, but that's their choice. If you are the intern, with a BLS patient, I see nothing wrong with him evaluating you. And yes, you will always deal with different personalities, some that conflict with you.
Agreed.
respectfully disgaree. having a paramedic intern perform no patient care on BLS patients when there is an EMT on board is an utter waste of time. if a paramedic intern can't handle a BLS patient, what makes you think they can handle an ALS one? Also. if you have 6 BLS patients, do you expect the intern to just sit up front with the driver? I will agree that the internship time should be for ALS patients, but we both know that 80%
of the EMS calls received can be managed by the EMT.
most systems have someone credentialed at the EMT level first, and then move onto ALS. That way if they can't cut it as a medic, they might still be able to work as an EMT. That's how many of the agencies near me work. IIRC, it's a 3 stage process: EMT clearance, Paramedic 1 clearance, and Paramedic 2. EMT clearance results in you being able to work as an EMT, paramedic 1 clearance means you can work as a paramedic with another paramedic FTO, and paramedic 2 clearance means you can work solo or with an EMT.
to @ickyvicky, I won't say you suck, or that you aren't cut out for this field, but EMS has some strange personalities, and some preceptors suck. Some would rather knock you down than bring you up. You also have a very limited experience level, and with more experience comes more confidence, and that takes time. And yes, a good EMT partner can help out a paramedic, while a bad EMT partner can ruin a paramedic's day.
Don't let one douchy preceptor (regardless of EMT or Paramedic) derail your career goals.
You know plenty of EMTs who have a better big-picture view of what paramedics do than paramedics have?
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Well, the good news is that none of them have told you that you're doing a bad job. The bad news is that you're with different preceptors every shift.
That's fine and definitely real-world. You need to become very, very good at recognizing and working with BLS calls. How will you know they're BLS? Because you will have learned how to properly assess patients and know they don't need ALS interventions. How do you learn to do that? You assess EVERY PATIENT to the best of your ability and pull out the ALS interventions if you need them. Having an experienced BLS provider on hand is a good thing because you could learn from them how to be an EMT. Their biggest thing is assessment. The better they get at it, the better they get to know when they should have their Medic step in.
I agree to a point and disagree to a point. Having multiple preceptors warrants a call to the clinical coordinator. There should be only one or two paramedic preceptors for a given student so that the student's growth can be maximized. Having an intern babysit a BLS patient when there's an EMT on board isn't a waste of time because the intern can practice assessments even on BLS patients.
NomadicMedic
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Well, here’s the thing. Field internship hours are already inadequate in most programs and paramedic candidates are required to meet specific requirements in the delivery of patient care. Additionally, paramedic programs are required to assign paramedic interns to a specific paramedic preceptor. Putting a paramedic intern in the back of an ambulance with an EMT, not a vetted preceptor, defeats the entire purpose of the paramedic internship process. The EMT is not able to provide a valid assessment of skills nor able to credit the paramedic candidate with any of the patient contacts.
I understand what you’re saying about paramedics needing to assess BLS patients, but that’s done at the beginning of the call and if the patient is downgraded to BLS, the paramedic intern should have no further obligation.
I receive complaints from paramedic candidates related to these type of issues in my office, and those are all documented via mail to the paramedic program with copies of the letter forwarded to CAAHEP. Failure of a paramedic education program to provide a consistent, objective paramedic field internship program can cause some big issues at reaccreditation time.
If nobody makes noise, the BS continues.
I understand what you’re saying about paramedics needing to assess BLS patients, but that’s done at the beginning of the call and if the patient is downgraded to BLS, the paramedic intern should have no further obligation.
I receive complaints from paramedic candidates related to these type of issues in my office, and those are all documented via mail to the paramedic program with copies of the letter forwarded to CAAHEP. Failure of a paramedic education program to provide a consistent, objective paramedic field internship program can cause some big issues at reaccreditation time.
If nobody makes noise, the BS continues.
DrParasite
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Yeah. You ever heard of Matt Zavadsky? you really think a paramedic with 2 years of EMS experience knows as much as he does about the EMS profession?
But you weren't talking about the profession, you were talking about EMS in general right? so why couldn't a paramedic student (who has 0 experience other than clinicls) learn something from an EMT who has spent years in an EMS system?
Well here's the thing: Last I checked, they were all patients. Isn't that what smart people say, there are no ALS or BLS patients, they are all patients?
I'm going to assume that the paramedic preceptor was driving, and deemed the patient stable enough for the EMT to handle. And you are probably right, the EMT is "not able to provide a valid assessment of skills nor able to credit the paramedic candidate with any of the patient contacts."
Assuming the paramedic trusts the EMT (again, this is an assumption) to not kill the patient, what is the downside to having the intern practice reassessments and patient communication on a stable patient? don't we always complain that many newbies do poor assessments and need to work on their communication?
And if we put the medic preceptor in the back, then the EMT driver doesn't get experience managing a BLS patient, the medic intern isn't using all of their ALS skills (so it's a waste of a patient contact), and it's just another chart for the medic to write. So how does this benefit anyone?
So what should they do? should the paramedic intern have been riding up front with the paramedic driver? Or maybe the intern should just get an uber back to the fire station, since they have no further obligation?
"Failure of a paramedic education program to provide a consistent, objective paramedic field internship program" is that what you call getting BLS patients? or having to handle BLS patients? I don't know of a single EMS agency that only gets ALS1/2 patients, at least as per the CMS definition. If they are in a tiered system, and only go on ALS calls, sure, but that is clearly not the case.
I'm also curious... what did the paramedic program say in response to the candidates' complaints? Did they revoke the EMS agency's ability to handle students? were those paramedic preceptors disciplined for having their EMS ride in with the BLS patient?
In a perfect world, a paramedic (and paramedic intern) would ONLY see ALS patients. This isn't a perfect world. if I was an EMS agency director, and a paramedic program director was giving me grief about having an experienced EMT oversee a paramedic intern on a BLS patient, while the paramedic preceptor drove to the hospital... I would probably reconsider my desire to be affiliated with that educational program. but that's just me.
I was talking about the paramedic profession. And yes, I know Matt Zavadsky. He and I serve together on the same board. He's a smart guy -- too smart, I think, to claim he knows more about a job he's never done than someone who has.
NomadicMedic
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@DrParasite your opinions, if nothing else, are entertaining.
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My interns are the lead on all calls. If during the initial assessment the patient is noted to have complaint not warranting any sort paramedic level treatment or assessment, the intern and EMT will often be in back on for the transport. I have evaluated the intern for the call at this point so I am comfortable with the intern filling out a FISDAP report for the patient, which will go towards the patient categories as required by the programs.
FISDAP reports are much, much shorter than the chart I am going to write. The time I spend writing a chart than my EMT could be writing takes away time throughout the shift that I could be using to develop simulations or provider other education at the station.
If at any point I think there is some sort of educational value for me to ride the call in and write the actual chart, I will happily hop in back. Ditto if the intern is really struggling and needs help with even "BLS" patients.
FISDAP reports are much, much shorter than the chart I am going to write. The time I spend writing a chart than my EMT could be writing takes away time throughout the shift that I could be using to develop simulations or provider other education at the station.
If at any point I think there is some sort of educational value for me to ride the call in and write the actual chart, I will happily hop in back. Ditto if the intern is really struggling and needs help with even "BLS" patients.
DrParasite
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and I will say, if you can't rebuke a solid argument with actual facts, logic, or critical thinking, and insist of simply dismissing them because they don't agree with your flawed way of thinking, then I will leave you to your flawed way of thinking and wish you a good day.
CCCSD
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NomadicMedic
I know a guy who knows a guy.
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This is why I usually just ignore him.
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We can talk about the topic, or we can lock this thread.
CCCSD
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Discussion is great. A poster shutting members with years of experience down because people disagree with him isn’t.
VentMonkey
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Three things:
1. @DrParasite would seemingly make a good lawyer.
2. I can’t remember the last time I saw @Tigger pull the admin card.
3. As far as internships, I think there all several factors that come into play.
Does the preceptor even want to precept (i.e., are they burned out?)?
What are—in fact—the dynamics of the preceptor and intern from a personality standpoint, because it does matter to an extent?
And yes, a “zero to hero” intern would greatly benefit from solid BLS fundamentals. This can be provided at the discretion of the crew and their configuration.
As far as the level of the provider teaching? You’re as good as you care to be. All I got.
1. @DrParasite would seemingly make a good lawyer.
2. I can’t remember the last time I saw @Tigger pull the admin card.
3. As far as internships, I think there all several factors that come into play.
Does the preceptor even want to precept (i.e., are they burned out?)?
What are—in fact—the dynamics of the preceptor and intern from a personality standpoint, because it does matter to an extent?
And yes, a “zero to hero” intern would greatly benefit from solid BLS fundamentals. This can be provided at the discretion of the crew and their configuration.
As far as the level of the provider teaching? You’re as good as you care to be. All I got.
Martyn
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Quote 'I understand what you’re saying about paramedics needing to assess BLS patients, but that’s done at the beginning of the call and if the patient is downgraded to BLS, the paramedic intern should have no further obligation.'
WRONG...the whole idea of ride-a-longs/preceptorship is to learn, 'Oh it's only a BLS patient, I'll sit this one out' ain't gonna learn ya nuffink!
WRONG...the whole idea of ride-a-longs/preceptorship is to learn, 'Oh it's only a BLS patient, I'll sit this one out' ain't gonna learn ya nuffink!