Students, what should we do with them?

lightsandsirens5

lightsandsirens5

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Ok people, after reading the recent posts in the 100% thread, I decided to start a new thread. If you are an FTO, like I am, you have probably wondered, also like I have, how far do we let our trainees and/or students go before they are informed that EMS isn't really for them.

Is it the first "nasty" call they can't handle? The second? Third? I know when I started, I could not handle near what I do now, there were calls I could not do much except keep my lunch down. Now, I could eat while tech-ing the same call (figuratively of course). But no one ever told me to get lost even though I used to not be able to handle burned and chewed up people.

But when do we tell out students, "Ok, that is enough, this might not be for you." Is there a time period? A certain trigger? What are you opinions?
 
I hate trachs. They make me gag. I have never thought of refusing to sit in the patient compartment with a trach patient, even on ride times. If I had, I would have expected to recieve a failing mark.

I failed the student. She refused to sit in the back with a screaming, writhing dementia patient. It's part of the job. We can't refuse to do a call because of your personal feelings. There is still a job to be done and a patient to be taken care of.

There are tons of calls I don't want to do for some reason or another, some smell, some are combative, some are just freaking annoying. It has never even occured for me even as a student to say "No, sorry, I'll sit up front."

If it's not for them, don't you want to know before you are too invested?
 
Ought to formulate an interview script.

If someone refuses to attend a patient, or consistently fails to either follow protocols or at least fail to in a reasonable manner, I think a one on one session to find out what's up is in order. If it is a misunderstanding (paradigm problem) it can be addressed and the trainee told they are going to have to exhibit some improvement. If it is an attitude problem, or the trainee is too far behind the class but still "making it by faking it", then those need to be smoked out too.
I was "eased out" of training to drive and operate fire trucks and crash trucks by the asst chief telling me that therr was a rescue school opening and they felt I was perfect for it...which was the whole point of my joining and going for the fire department, so it was a win/win.
 
how far do we let our trainees and/or students go before they are informed that EMS isn't really for them.
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I did it as soon as possible. I used to actually keep the paperwork to remove someone from the EMS programs overseen by my medical director in several places (in the clipboard behind the blank run reports, in my desk and a couple copies at home). Most EMTs are neither mature nor intelligent enough to bow out on their own, especially the younger generation who have had it drilled into their heads that if they try hard enough and just don't give up eventually they will achieve their goals. Case in point: that one "Chiefwhatshischops" on here recently who had failed the Registry exams multiple times. We were instructed to weed folks like that out before they ever got to the testing stage.

Is it the first "nasty" call they can't handle? The second? Third?
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I can't recall that ever being the reason for having someone removed from the program. Normally it was attitude issues, behavioral issues, lack of maturity, failure to progress academically, the inability to perform the technical aspects of the job, etc.

Then again, I'm the guy who threw up and passed out after his very first trauma case ever (as a civilian first aid trained bystander). I still get a little queasy over the sight of my own blood.
 
To echo usaf. Sometimes by being "too hard" on someone we are doing them a favor. They don't know when to quit and guess what, sometimes you have to quit.
 
I deal with students by not having them, and really I view them the same way I view children. It can be fun to deal with them for a little while, but at the end of the day I'm giving them back.

I would be the type to warn someone up front that if I don't see them making progress that EMS might not be for them. I am up front about the fact I would make a poor FTO based on what my company wants an FTO to be. I'm way to demanding, exacting and impatient.

For me, the deciding factors in determining if someone has what it takes are 1. Do they know what they don't know, and admit they don't know it? and 2. Do they know their strengths and weaknesses. If someone can't admit their short comings they will never be able to manage them or get pas them.
 
We spoonfed a guy through USAF fire school.

When he was finally failed and they made him a cook instead (ironic, no?), he reported it was a big relief.
 
On the other hand...

Before I even started classes but having been accepted on the basis of my transcripts to date, I was told by the Dean of Student Affairs I wouldn't pass nursing college. I dug in, borrowed money, got a job, and forced them to treat me as they did younger female students, and I passed with good grades.

The first day I was on my relief supervisor's shift at an ER, I was told by her when I was orienting that I wasn't going to pass probation. I asked her why, and her reply was "Oh, you just aren't", and I didn't. If that happened now, I'd see her in court.

It can go either way. Have objective measures in place beforehand, then apply them and document. If you don't like orientees, get away from them.
 
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Sasha said:
To echo usaf. Sometimes by being "too hard" on [YOUTUBE][/YOUTUBE]someon[GVIDEO][/GVIDEO]e we are doing them a favor. They don't know when to quit and guess what, sometimes you have to quit.
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And sometimes they adjust to similar situations merely thru field experience. Brand new EMTs don't know what it is 'really' like during a trauma call, and to assume that their first, second or even third trauma determines their career outcome is ridiculous. As i have stated before, people in general need time to grasp the concepts and skills required during any call, hence the TRAINING period. Training is the time to explain situations and try and teach the student how to better themselves. Simply giving them a failing mark defeats the whole purpose of the training. Perhaps there was a deeper reason for not being able to handle the situation, if that was the case, then an encouraging conversation would have sufficed.
 
usafmedic45 said:
I did it as soon as possible. I used to actually keep the paperwork to remove someone from the EMS programs overseen by my medical director in several places (in the clipboard behind the blank run reports, in my desk and a couple copies at home).
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ROFLOL why am I not surprised. You crack me up.

As a newbie to EMS I have to say I was absolutely useless on my first couple of runs. Granted I don't think I would have refused to ride in the back with a patient but I do remember a specific patient with severe dementia who spit and screamed and I honestly almost didn't go back, I thought about giving it up. I really really didn't want to continue my rides after that call. I thought to myself if this is what EMS is about then I can't handle it. But I did go back even though I wasn't really sure I wanted to and I think it was the right choice for me. I very nearly said screw it and I would have never finished my basic and that means I wouldn't have started volunteering and that would have been a shame because I think I'm pretty good at this now. Sometimes I think the folks that are most affected by what they see and feel are the people best cut out for this job and that's a shame because they are the ones least likely to last long doing it.
 
YCALR, yes, but...

Sometimes first impressions are revealing, because they don't know how to fake it through.

There've been a couple times I have had an orientee who was shocked out of their game, and I used the opportunity to get inside their guard for a little while and give them the "411". One dropped the tough guy act and got on with orientation, the other felt I was unfair and eventually was fired after probation for insubordination because nothing was his fault.
 
BigBaldGuy (can we call you "Moose"?)

The people most shaken up by it are not the best. It's the folks who act calmly then ask questions later who are the best. If you identify with the patient you can become worthless very quickly, and will burn out.
 
mycrofft said:
The people most shaken up by it are not the best. It's the folks who act calmly then ask questions later who are the best. If you identify with the patient you can become worthless very quickly, and will burn out.
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Yes you may call me moose but you better smile when you say it :)
 
bigbaldguy said:
ROFLOL why am I not surprised. You crack me up.

As a newbie to EMS I have to say I was absolutely useless on my first couple of runs. Granted I don't think I would have refused to ride in the back with a patient but I do remember a specific patient with severe dementia who spit and screamed and I honestly almost didn't go back, I thought about giving it up. I really really didn't want to continue my rides after that call. I thought to myself if this is what EMS is about then I can't handle it. But I did go back even though I wasn't really sure I wanted to and I think it was the right choice for me. I very nearly said screw it and I would have never finished my basic and that means I wouldn't have started volunteering and that would have been a shame because I think I'm pretty good at this now. Sometimes I think the folks that are most affected by what they see and feel are the people best cut out for this job and that's a shame because they are the ones least likely to last long doing it.
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Exactly, you made that decison, you chose to go back. What if the decision wasnt yours, what if someone failed you for one of your first calls? Only you, yourself know whats best for you. If i quit everytime someone told me I couldn't succeed in something, then i would be no where in life. When I hear "you can't do this, its not for you", guess what, that just motivates me so much more. Now I am a 21 yr old, female working with AMR finishing up my Bachelors in both Biology and Psychology. Tell me again I 'can't' succeed!!!
 
"YCALR, you can't earn the Nobel Prize"

(heh heh):ph34r:

Point taken.
 
mycrofft said:
Sometimes first impressions are revealing, because they don't know how to fake it through.

There've been a couple times I have had an orientee who was shocked out of their game, and I used the opportunity to get inside their guard for a little while and give them the "411". One dropped the tough guy act and got on with orientation, the other felt I was unfair and eventually was fired after probation for insubordination because nothing was his fault.
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I agree, first impressions are revealing, however your first impression may not always be true to character. Some people should be failed, but without giving the fair opportunity to have an educational conversation regarding performance, then what is the point of training?? Some EMTs need guidance not just a door shut in their face.
 
YCALR, see my earlier replies

I was a victim of stereotyping before and I suggest a pre-planned interview to evaluate the issues .
As they say in the vernacular, "go girl, get somewhere". I guess ;)
 
YCALR said:
And sometimes they adjust to similar situations merely thru field experience. Brand new EMTs don't know what it is 'really' like during a trauma call, and to assume that their first, second or even third trauma determines their career outcome is ridiculous. As i have stated before, people in general need time to grasp the concepts and skills required during any call, hence the TRAINING period. Training is the time to explain situations and try and teach the student how to better themselves. Simply giving them a failing mark defeats the whole purpose of the training. Perhaps there was a deeper reason for not being able to handle the situation, if that was the case, then an encouraging conversation would have sufficed.
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It was not a trauma call.

It was what is actually a very routine transport. Patients scream. They scream because they're pissed, they scream because they're scared, they scream because they're hurt and they scream because they don't know any better. We don't get the option of going "Hey nope, not feeling this patient today. I'm gonna sit up front so I don't have to listen to them."

We had already had one lady with CP who let out blood curdling screams in the middle of the hallway taking her out. It is something you get used too. If you are not going to even try to get used to it, then you've got to get out.

If she had tried to sit in back and half way through go "You know what, I can't take it." Maybe I would have been easier on her, because she at least made the attempt to get acclimiated to the job. But no. She went directly to the front.

And this is NOT her first clinical.
 
a specific patient with severe dementia who spit and screamed
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We had a psych with serious bipolar disorder and schizophrenia who was combative and a spitter. It was a great opprotunity to show her sometimes it's all how you approach the patient and every patient deserves your respect. Sitter tried to manhandle the patient onto the stretcher and got swung at, my partner and I were very nice and "Would you mind sitting here on the stretcher so we can get you out of here?"

And we had zero trouble with him the entire transport.
 
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