Paramedic clinicals

[frosted2]

Hey guys and gals,
I will be starting my clinical hours soon in the ED (followed by the OR). I wanted to come get some opinions on what I can do to stand out as a medic student and leave a good impression on the Physicians that I work with. I already know the basics of showing up on time, being respectful, etc. I also know how to start IVs, do EKGs, Orthoglass splinting, phlebotomy, etc. if that counts for anything.

I work in the ED and on the rig so I know a fair amount of each side... With that being said, from a Physicians point of view, what are some things that you would expect of a paramedic student?

Thanks in advance!

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[Blue Goose]

Clean the beds and change the linen when patients are discharged. Help the staff out and they'll be more likely to find you when good procedures/skills are available. A box of doughnuts on your first shift won't hurt, either.


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[alpinism]

Find the most agitated overweight patients with no veins. Do IVs and ECGs on those patients.

 

[EParker37]

Find the most agitated overweight patients with no veins. Do IVs and ECGs on those patients.

And to add on to this, don't be afraid to miss either, its going to happen. You will miss IV's, we all do. But if you get so nervous about missing on the tough sticks and only seek out easy sticks in clinicals you are going to do yourself a huge disservice. Be calm and confident. I've seen too many medic students miss IV's just because of nerves and forgetting even some of the simple stuff. If you need to center yourself, take a second to lay out your supplies before you start the line. Second, don't be afraid to ask the doctors to pull you in on interesting cases, ask relevant questions of them, be curious, show that you are genuinely interested and they will gladly show you the really cool stuff. And practice your ECG interpretation, try to work it out yourself and compare it to the notes from the ED docs or cardio guys, if you aren't seeing it, ask them, I learned a lot from the ED docs about interpretation when I was doing my clinicals.

Above all else, use your ears twice as much as your mouth. Scrub the beds, change sheets, do the scut work without hesitation and the benefits will come.

 

[frosted2]

Thank you all so much! I should be starting clinicals/ride time within the week. I am excited yet nervous... I will be sure to update as I go along!

 

[frosted2]

Thankfully working in the ED I have learned a few tricks of my own (as well as from some of the nurses) about difficult IV sticks. I have even given tips to some seasoned ED nurses (some of the best sticks in the hospital IMO) that they were very appreciate of!

I completely agree. I need to just remember to stay calm, feel that vein and get the stick like a champ

 

[EParker37]

Thankfully working in the ED I have learned a few tricks of my own (as well as from some of the nurses) about difficult IV sticks. I have even given tips to some seasoned ED nurses (some of the best sticks in the hospital IMO) that they were very appreciate of!

I completely agree. I need to just remember to stay calm, feel that vein and get the stick like a champ

The nurses will be an invaluable resource too, find the old hats and stick with em. You said you have been an EMT a while, as someone who was in your shoes, learn to step back and lead. Don't just jump in and start doing, evaluate and give instructions to the team, you aren't on the box to just get sticks etc, learn to be the leader and break out of the basic mindset of doing rather than leading. That was the most difficult transition for me.

 

[CajunMedic]

Clean the beds and change the linen when patients are discharged. Help the staff out and they'll be more likely to find you when good procedures/skills are available.

This. I pushed stretchers to radiology, brought patients to the floor, cleaned, stocked, etc. I was in a smaller ED, so by the end, the nurses trusted me enough to take shifts in Triage and the docs would send me to see patients other places in the hospital and run codes in the ICU.

Now that I'm on the receiving/teaching end: Be active in your learning, but it sounds like you won't have that problem. Keep an ear to the EMS radio if they have one and be ready to rock if something bad, or even out of the ordinary comes in. Nothing aggravated me more than to roll in with an good teaching case, see 6 medic students leaning on the nurses station playing on their phones, and no one even looked up to see what I was bringing in. Try to be on the receiving end of the medic's report, you can hear the best and worst of them and start formulating your own style (pick your partners brain too).

 

[frosted2]

The nurses will be an invaluable resource too, find the old hats and stick with em. You said you have been an EMT a while, as someone who was in your shoes, learn to step back and lead. Don't just jump in and start doing, evaluate and give instructions to the team, you aren't on the box to just get sticks etc, learn to be the leader and break out of the basic mindset of doing rather than leading. That was the most difficult transition for me.

@EParker37 I just re-read this thread and I just wanted to give an update!

I attempted to do that during clinicals (on the truck at least) and I had preceptors tell me that I needed to be 'more aggressive' and 'just do it.' I do not necessarily agree with that... I would rather build a cohesive plan and then implement it rather than piss in the wind and screw something up and kill a patient.