Ride Along/Hospital Clinical Tips?

ChewyEMS13

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hey y'all... I'm just about ready to sign up for my ride along clinical as well as my ER shift clinical. Any tips, tricks, or stories? Any areas to particularly pay attention to? How can I be a good ride along/shadow? Get the most bang for my buck without sounding too loud? Thanks!
 

Lo2w

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Show up on time. Be respectful. If you're not out on a run bury yourself in your textbook and study. If there are skills or things you struggle with discuss it with your preceptor and see about getting some practice between runs.

And donuts, donuts never hurt.
 

Lo2w

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What do you mean by practice? Like, actually do a pt assessment or...?

Say you're having issues with taking BP. You can practice that or do manuals on every patient. Get the stair chair out, practice with the cot, Reeves or other equipment. Have them go over the truck and location of supplies.
 
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ChewyEMS13

ChewyEMS13

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Say you're having issues with taking BP. You can practice that or do manuals on every patient. Get the stair chair out, practice with the cot, Reeves or other equipment. Have them go over the truck and location of supplies.

Oh, gotcha! Thanks. and should I go glazed or creme filled? lol xD
 

medichopeful

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Try to ask if you can schedule some time in the ICU as well. You'll learn a whole new definition of "sick."
 
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ChewyEMS13

ChewyEMS13

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You'll learn a whole new definition of "sick."

On a completely unrelated note, I just visited my grandfather in the CVICU of our hospital (He just got a triple bypass done). The people in there seemed "sick" to me. It was crazy. My girlfriend called me a sociopath because I kept talking about pulmonary edema and the pathology behind it and she kept talking about "the most horrible cough I've ever heard"... To me, it was interesting to see what the conditions that you read about in the book actually look and sound like.

While I was reading the book, I thought to myself, "Well, how do I know what Rales actually sound like?", and quite frankly, it's obvious I know what Rales sounds like!
 

medichopeful

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On a completely unrelated note, I just visited my grandfather in the CVICU of our hospital (He just got a triple bypass done). The people in there seemed "sick" to me. It was crazy. My girlfriend called me a sociopath because I kept talking about pulmonary edema and the pathology behind it and she kept talking about "the most horrible cough I've ever heard"... To me, it was interesting to see what the conditions that you read about in the book actually look and sound like.

While I was reading the book, I thought to myself, "Well, how do I know what Rales actually sound like?", and quite frankly, it's obvious I know what Rales sounds like!

I hope all is going well with your grandfather! I don't do CCU/CVICU, but I do know they do some excellent work there.

ICU is a fascinating area. You'll seriously learn more in a busy ICU about illness in one day than you'll learn in an entire week in the ER or on the ambulance.
 
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ChewyEMS13

ChewyEMS13

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I hope all is going well with your grandfather! I don't do CCU/CVICU, but I do know they do some excellent work there.

ICU is a fascinating area. You'll seriously learn more in a busy ICU about illness in one day than you'll learn in an entire week in the ER or on the ambulance.

He's good. They were supposed to replace his mitrial valve also, pig replacement, but the doc said that he couldn't "see" very well and he would do more harm than good if he tried to go in blind. They claim that the pressure on the leaky valve will be reduced due to increased cardiac output, but I don't know too much about cardiac problems yet, especially that advanced.

So how would you recommend going about asking? While i'm doing me ER clinical?
 

Lo2w

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He's good. They were supposed to replace his mitrial valve also, pig replacement, but the doc said that he couldn't "see" very well and he would do more harm than good if he tried to go in blind. They claim that the pressure on the leaky valve will be reduced due to increased cardiac output, but I don't know too much about cardiac problems yet, especially that advanced.

So how would you recommend going about asking? While i'm doing me ER clinical?

Talk to your program director/instructor. Is this EMT or medic?
 

medichopeful

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Talk to your program director/instructor. Is this EMT or medic?

This. If that doesn't work, call the hospital, tell them you're an EMT-B student, and ask to do a "shadow day."
 
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ChewyEMS13

ChewyEMS13

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This. If that doesn't work, call the hospital, tell them you're an EMT-B student, and ask to do a "shadow day."

Perfect. Will do that. Thank you for the insight. I see that you're an ICU RN. Quick question before you sign off, how hard would it be to make the ladder moves: EMT-B --> Paramedic --> RN --> ER/Trauma/ICU/CC Nurse? And would it be worth it? I know there are threads on here about it already... but since I have an audience...
 

Lo2w

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Perfect. Will do that. Thank you for the insight. I see that you're an ICU RN. Quick question before you sign off, how hard would it be to make the ladder moves: EMT-B --> Paramedic --> RN --> ER/Trauma/ICU/CC Nurse? And would it be worth it? I know there are threads on here about it already... but since I have an audience...

A lot would depend on your area. ERs use medics as techs and depending on the area you may have a decent scope.

I started as a tech prior to my EMT in the Surgical/Trauma/Burn ICU of a Level 1 trauma. Basic stuff like vitals, daily hygiene care, 12 leads but the nurse managers loved hiring from within if you had a good run as a tech following your graduation from a nursing program.
 

medichopeful

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The only thing I would change is I wish my ICU time was later in my program, I didn't fully appreciate what there was to learn in the ICU.

I truly think that there should be more ICU time required throughout the program for paramedic. My medic program only required about 16 hours (8 in ICU, 8 in CVICU). In fact, I would rather see more time in ICU and less time in the ER for medic students. ER time is great, but there is just so much to learn in the unit.

Putting it later in the program absolutely makes sense though. Build a foundation, then go to the unit to see follow up and extended care of the sickest of the sick.
 

medichopeful

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Perfect. Will do that. Thank you for the insight. I see that you're an ICU RN. Quick question before you sign off, how hard would it be to make the ladder moves: EMT-B --> Paramedic --> RN --> ER/Trauma/ICU/CC Nurse? And would it be worth it? I know there are threads on here about it already... but since I have an audience...

It's easily doable, but personally I would suggest changing it up a bit to the following:
EMT-B -> RN -> ER/TRAUMA/ICU/CC RN -> Paramedic.

The order may sound strange, but that is the way I did it (full disclosure, RN is still my full time job. Currently, only working in EMS as a medic per-diem).

Putting yourself through nursing school while working as a paramedic is doable, but unfortunately financially may be difficult. Get your EMT, then start applying to nursing schools (Bachelors degree programs) if that is what you want to do. Focus on nursing, with EMT on the side. After you get your RN, look at Nurse Residency programs in your area. Also try applying to in-hospital RN positions that will hire new-grads. You might not get the exact position you want, but get some experience and then apply to a critical care area if you don't.

If you're lucky, you'll get hired directly into a critical care area (my ICU just hired two new-grad RNs for the Nurse Residency program straight into the ICU at a Level 1 trauma center, so it is possible). Get some experience there, then if you still want to, put yourself through paramedic school (or challenge the exam if you're able to in your state. But that is a totally different discussion entirely). Paramedic school will be a walk in the park with in-hospital critical care experience. It will also make you a much better, more educated medic; you'll be able to see the whole picture, know who is truly sick, and understand more than just the initial treatment and stabilization of a patient.

Once you have both RN and paramedic, decide how you want to divide your time. Personally, I would spend more time in the hospital as an RN, but work part-time or per-diem as a medic. You'll make more, and you'll be in contact with sicker patients more often, helping you develop as a clinician. You'll also be around MDs/DOs, other RNs, RTs, and others, and you'll learn a ton.

Long-story short, get your RN first then go from there. More job opportunities, more in-depth knowledge, and it will help you if you do decide to do your medic. If you want to do flight nursing, RN/Medic combo is more desirable than just one or the other.

I hope this helps? If you have any other questions, feel free to ask them here or shoot me a PM. Best of luck!
 

medichopeful

Flight RN/Paramedic
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Perfect. Will do that. Thank you for the insight. I see that you're an ICU RN. Quick question before you sign off, how hard would it be to make the ladder moves: EMT-B --> Paramedic --> RN --> ER/Trauma/ICU/CC Nurse? And would it be worth it? I know there are threads on here about it already... but since I have an audience...

I forgot to add, yes it is absolutely worth it. Being an RN in a Level 1 ICU has its issues, but it's one of the greatest jobs in the world.
 
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