clinicals

[Chief Complaint]

Same rules apply. If he's competent, professional, polite and eager to learn, there should be no shortage of pertinent things for him to do.

Im sure things are different across the globe. Around here the hospitals do not want students with no certifications to do that much during their rotations.

The most they will allow is putting patients on O2, and helping with compressions should a code come through the door.

Its polite to offer to help clean beds/change sheets and what not, but there isnt much that a Basic student can do in terms of patient care in the hospital. They are usually ok if you want to assess patients but those skills might still be in their infancy depending on when in the semester the student does their clinicals.

 

[Tigger]

My post was referring to the fact that the OP is going in for his EMT-B clinicals.

At the I and P levels you should absolutely be hands on.

How does that change things though? Sure basic skills are much well, basic, but they still need to be practiced. The hospital environment is a controlled place to do just that.

I can't emphasis it enough; practicing your assessments and skills on healthy classmates does your sick patients a disservice.

And while most are not licensed during clinicals, many hospitals and EMS agencies do in fact allow their students to function to the scope they are learning, and are appropriately insured. Obviously the student should not be acting alone, but isn't a likely scenario as a student.


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[CheifBud]

lemme help lemme help!

Just try to be as busy as possible and seem as interested as possible. I know in my clinical it sounds pushy but I kind of have to ask or put myself in there since my nurse isn't thinking about me but the person on the bed... Just offer to do simple things and you might get lucky and do something cooler. Be confident but literally tell them to correct you or explain things just let them know you are interested in doing the job RIGHT, not just doing the job.

I just found a couple doctors and followed them around, they were teaching med students so I was able to just stand by and absorb the knowledge bombs. I was very fortunate in my clinical rotation having quite a few codes, a lot of CPR, Admin meds, bleeding control, and the coolest thing ever.... I got to sit right behind the surgeon for an emergency craniectomy. Not many fresh EMT-B's get to see brain surgery their first clinical. ^_^

 

[Flightorbust]

I agree fully what every one has said. When I did my clinical's, My first Pt. Was a G.I. bleed with recent hip surgery that had messed herself. After jumping in to help clean the Pt. the staff started letting me do more and ended up teaching me how to hook up a 12 lead. It's all about what you put in. Don't be afraid to ask questions but don't cross the line from asking questions to questioning the basic/medic.

 

[EMTSTUDENT25]

We were required to purchase a student insurance policy for basic class...guessing that doesnt happen everywhere?

 

[dstevens58]

As a Basic student, I did a lot of TPR's and bed making. After a few of them, they started letting me do other things like discontinuing IV's, placing 12 leads after seeing a couple. I had one of the male nurses apologize to me after he placed an IV (thinking I was a paramedic student), saying he could have let me start it. He changed his mind when I reminded him I was a "basic".

Oh, Clinical time consisted of 10 hours in the ED and we didn't have a "time" for rides, we had to have at least 10 rides.

 

[Flightorbust]

We were required to purchase a student insurance policy for basic class...guessing that doesnt happen everywhere?

There was a required fee that we had to pay ($45 I think) that covered our malpractice insurance and workman's comp.

 

[vamike]

I wish Virginia's EMTB program required clinicals. I didn't know other states required that. Clinical time would so much enlighten the EMTB, including me. I am getting ready for the EMTI class and am very much looking forward to clinical hours.

 

[WickedGood]

Yeah my state doesn't require any clinical hours for EMT-B training. It's pretty much a firefighter thing here though. You can't really get a paying job as an EMT-B unless it's a FF.

 

[Chief Complaint]

I wish Virginia's EMTB program required clinicals. I didn't know other states required that. Clinical time would so much enlighten the EMTB, including me. I am getting ready for the EMTI class and am very much looking forward to clinical hours.

I may have asked you in another thread, can't remember, where in VA are you taking your EMT-I?

 

[Bradley]

ED clinical are great for learning. Ask questions and listen, its amazing what you can learn from just watching and listening. When I was in the ED I did most everything the techs did as I like to stay busy and if there was not some skill I needed to be doing I am not above making beds and cleaning up.

 

[emergancyjunkie]

Are standbys good for clinicals as well cause I just volunteered for one in october

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[Backwoods]

We are only required to do 20 hours where Im at in ohio. Not nearly enough!

 

[IRIDEZX6R]

To second what others said. If you hear the tones for a trauma alert, head to the trauma room and help the trauma nurse or er tech prep. Additionally if someone calls in and the charge nurse answers.. LISTEN. It'll help with your call ins later on as well as allowing you to prepare yourself for whats comming in, i.e. CVA or a full code *had quite a few on my hospital clinicals*. In your down time, if you see a bed that needs to be decon'ed and the linens swapped, go a head and do it; the nurses LOVED me on my clinicals for that. If you see a 5150 attacking a nurse and security hasnt arrived yet, glove up and jump in; just remember scene safety *if they have a weapon or if theyre big enough to hurt you, stay out of the way*. **and yes, I had that happen on my clinicals**

When the hospital is slow, start talking.. Make some friends with the medics or emt's standing around, they make great references for future employment. But I have to warn you, don't be the kid that talks so much that you annoy everyone and their mom that will get you no where; it may even hurt your chances at employment.

ASK.. If a code comes in, ask the er tech if you can take a rotation on chest compressions. Asking is a magical thing that will make your clinicals that much more of a learning experience.

 

[traumaluv2011]

I think the last part of your statement is very true, but the first part is a direct contradiction. One of the reasons that students are required to have some clinical time is to, you know, see some sick patients and learn how to assess/treat them to their scope. All of your classmates are "stable" patients without ALOC, that's who you learned your assessments and whatnot on. When it comes time to go to the ER or ambulance, you want to be able to help to attend the sickest patients. You are in an environment with much more supervision than usual, so take advantage of the fact that you can make a mistake and it will be instantly caught (hopefully). As a student, your clinical time is the time to take what you learned in the classroom and actually apply it for the first time, don't do yourself a disservice and stay away from sick people. Get right in there and do what you've been taught. Waiting till you are licensed/employed to finally treat sick patients does you, your coworkers, and especially your patients a serious disservice.

Your probably right. On my clinical time I never really got any codes or unstable pt's or anything to help out with.

You should have your CPR card at least when you do hospital time so if they need someone to ventilate/do CPR, you're at the bottom of the ladder,

 

[emergancyjunkie]

When I start my clinicals I'm not really going to get a lot of calls the company averages 4000 calls a year while another one in my area averages 16000

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[silver]

If things quiet down during your clinicals and you are looking for stuff to do, ask to follow the patient places such as the ICU, cath lab, OR, interventional neuroradiology lab. Go and ask questions.

scientia potentia est

 

[emergancyjunkie]

What would be the best time to do the clinicals so its almost always gonna be busy

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[Flightorbust]

What would be the best time to do the clinicals so its almost always gonna be busy

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Roll some dice, Flip a coin. It can be random but usually Fridays and Saturdays can be pretty good.

 

[Dpiner42]

I know from personal experience clinicals are extremely important. In my paramedic program some peers were not allowed to test due to not meeting the class requirements for live intubations. Although this wasn't a state requirement, it influenced their ability to test.


My advice:

Start your clinicals as soon as possible - a lot of my classmates waited until the last minute to start their emergency department time which totaled 120 hours. Over a 10-18 month span, it's not that much if you do 8-16 hours a week.

Suck up! - Yea, your classmates will pick on you for it, but it's worth your while. Back to those intubations. I got six in one day, because I sucked up - one of the anesthesiologists had an interest in motorcycles, so I began a conversation regarding this topic, and at the end threw in - hey by the way i saw you had a case that required an ET tube, can I come in and visualize the vocal chords at least? - The response, absolutely - the end result one successful intubation!

Show your worth - Nurses and providers we are asked to shadow are apprehensive about teaching newbies. If something goes wrong, it's on them. Go the extra distance and clean up rooms, chat with patients, ask questions - show you're willing to learn and you want to do things right. Make yourself seen as a help not a hindrance.