AEMT clinicals-- what to expect

[Kendal Krueger]

Hey everybody, I was just looking for some advice on what to expect on my AEMT clinicals. The big thing for me is starting IV's. I have only done 2 labs on starting IV's, but when I do my clinicals it will be my first time starting one on anybody. I am a little nervous because I don't want to hurt anybody, but I want to get the job done and eventually become comfortable enough to do them. I have to do over 60 hours for clinicals and I must have 10 IV attempts and of course some other things i have to do as well. If anyone has any advice, please share. I would love any help.

Thanks so much!!

 

[phideux]

Don't freak out on IVs, they are one of those things that get easier the more you do them, you won't get every one, you'll miss some "easy" ones, you'll get some "hard" ones.
Alot of times you can see the veins, alot of times you can't see them but feel some great ones, sometimes you will see and feel some on your patient, you will get used to whether the ones you see, or the ones you feel, are the ones to stick. Practice looking and feeling for veins on friends and family.
When you feel that "pop" when you get a vein, run in about 1/4in more, that first pop is the needle hitting the vein, you need to put it deep enough into the vein so the catheter is also in.
Until you get your technique down with the pulling the needle while tamping off the vein, while holding the hub, and hooking up the lock, you will shed some blood. Sometimes it seems like an impossible feat without 3 hands. Don't freak it happens, I've had some pretty spectacular blood-lettings before, you'll have some good ones too.
Don't forget to pop your tourniquet, most common rookie mistake.
If you just cant find the vein, that Tibial Plateau is easy to find, drill em.

 

[Kendal Krueger]

Thank you so much for all your great advice!! It's easy to forget that everyone was once a rookie at this at one time or another. Everything you said has really helped ease some of the nervousness that has been building up. Thank you again so much for taking the time to reply to my thread --Kendal

 

[cannonball88]

Things to do:

1. Experience the different patients and treatment aspects. The single largest benefit you'll get from your clinicals, especially in a hospital setting, is the sheer volume of patients you'll see and the ability to watch them beyond a 5-10 minute transport time. Watch how the patient comes in in a-fib, the process of assessing it, treating it, monitoring the effects, etc. This is your chance to see it all, so don't just focus on physical skills and forget this valuable opportunity. My favorite thing to do used to be to help in the triage room. I got to see every single patient that walked in, and even though I was just taking blood pressures, I saw dozens of presentations and basic assessments, which is the closest to what you'll be doing in the field.

2. Ask questions. If you ask questions, not only do you learn a lot, but it shows you're truly interested, and the people there will be more apt to go out of their way to teach you more.

3. Be a part of the team. That will mean pitching in to restock or clean rooms. That might mean doing something nice. During my clinicals, the nurses used to take turns bringing in snacks. After learning this, I started bringing things to share too. Some might see it as kissing ***, but really, it's a give-and-take, and if you work the same shift often and get to know the nurses and doctors on that shift and they feel you're a part of the team, they'll begin to trust you more as a person. This will mean the difference between "Room 6 needs an IV, get the stuff ready and we'll head in together" and "Hey, go throw a line in 6, he might need OR, so try for at least an 18."

Things NOT to do:

1. Don't write off "lower level" providers. Not only will it agitate the RNs and MDs, but you're losing valuable advice. Some of the LPNs and techs have been doing this for a very long time, and have valuable advice on patient care.

2. Don't disregard any advice that doesn't seem to pertain to life "in the field." One of the docs I worked with took the time to show me the psoas and obturator signs. My medic instructor told me later, "We don't do that in the field." Guess what? It's a good clinical indicator, and one that I use in the field regularly.

3. If they're busy and short staffed, don't be in a hurry to get out of there when your shift is over. Even staying ten minutes over to clean a room will mean a lot. If I haven't stressed it enough already, they will put extra effort into teaching someone who puts extra effort into making their job easier. Be the difference between "we have another student today" and "Cannonball is coming in, good, we could use the help today."

Just my two cents.

 

[Smitty213]

Definitely don't freak over IV's, just take advantage of every opportunity you are offered to do one, they will get easier especially if you have someone with experience watch, then ask for a critique. Take advantage of your clinical time to also brush up on and practice really good assessments as well; learn some new medications, procedures and conditions; practice all those old BLS skills whenever you can, if there are EMT students there at the same time, try and help them with their skills (it's a great refresher) and be a good role model to them.

Also, this

Some of the LPNs and techs have been doing this for a very long time, and have valuable advice on patient care.

Where I work, many of these people are just old medics who's backs have given out, but can offer great advice and have been exactly where you are. Also, just because there is an MD after somebodies name does not make them the best source of advice; find somebody who seems wizened and respected... I once had to coach a young resident on his ambulance rotation through starting a line because "they only have us use fake arms in medical school".

And this...

3. If they're busy and short staffed, don't be in a hurry to get out of there when your shift is over. Even staying ten minutes over to clean a room will mean a lot. If I haven't stressed it enough already, they will put extra effort into teaching someone who puts extra effort into making their job easier. Be the difference between "we have another student today" and "Cannonball is coming in, good, we could use the help today."

. When I was doing my clinicals, I regularly offered to stay longer than necessary and by the time I was wrapping up my clinical rotation, Nurses were handing off all sorts medication pushes to me and Doctors would grab me to assist them with advanced procedures (like RSI) because they knew me well, knew I was excited to learn more than what the clinical sheets said I had to and they trusted me.

Also, if you're currently working with a partner who is an approved preceptor/trainer for the AEMT level or above, see if they will let you practice your skills while working with them. You can't document these hours of course, but it's "real world" experience with the exact equipment you will be using.

 

[Kendal Krueger]

Thank you all so much for ya'lls advice!! The start of my clinicals are in 2 days and everything that ya'll have shared will definitely help and be put to good use. I greatly appreciate ya'll taking the time to share all of ya'lls experience. I won't lie I am still pretty nervous, but i feel a lot better with all the advice ya'll have shared. Thank you again so much!!!!

--Kendal