My place as the newbie?

[TechMedic]

I just got my first EMS job at a local volunteer station and Ive done two night shifts so far. We are usually behind the truck on calls so there is always a bunch of people in a usually small room. During clinicals, most preceptors didnt seem to care what I did and I just hung back thinking I would screw something up but Ive been excited about this job and have really tried to get in the action. I still get nervous but its almost impossible to move around and the fire guys have usually done just about everything by the time I get in there. My preceptor here says he wants to see me take charge but how can I do that when Im having to fight through 10 other guys doing the same thing? I feel like that if I really force myself in there, Ill come off arrogant or something because the newbie is trying to show up the veterans.

 

[DrankTheKoolaid]

Are you Volly or paid as it is not clear. If you are paid and on the transporting ambulance then your focus and priorities are different then if you were simply and VFD FR. My partners are expected to make a B-line to the patient and get baseline VS upon arrival. Others at scene wont be offended as that is your role as a BLS partner. Once done with that if the gurney is not already in the house/scene enlist the help of another FR and ready it for loading and transport. Once back in the truck reattach everything for VS enroute and spike a line if needed. If IV is started at scene be ready to get a BGL when given the blood. Once thats done drive wherever we are going

 

[TechMedic]

Are you Volly or paid as it is not clear. If you are paid and on the transporting ambulance then your focus and priorities are different then if you were simply and VFD FR. My partners are expected to make a B-line to the patient and get baseline VS upon arrival. Others at scene wont be offended as that is your role as a BLS partner. Once done with that if the gurney is not already in the house/scene enlist the help of another FR and ready it for loading and transport. Once back in the truck reattach everything for VS enroute and spike a line if needed. If IV is started at scene be ready to get a BGL when given the blood. Once thats done drive wherever we are going

Volunteer. I might be able to do one or two things on scene so Ill do all the secondary stuff as we're going. It is helpful to have all these fire guys helping us out, but I have other reasons I need to show them what I can do. Im just a third right now, but after my preceptor says Im good enough to start riding as a second, I can get paid for each call I go on.

 

[DrankTheKoolaid]

Dont sweat it. Just make your way to the patient and do your thing. Your there for the patient and not to fluff egos of others at scene, always remember that.

 

[leoemt]

Your an EMT staffing an ambulance (volunteer) right? Learn your priorities. If its a rescue call, let fire extricate the patient. Once extricated then you take over.

I am assuming these firefighters are same dept as you. Walk in, look for the FF who is tending the pt and ask "what do we have?" Let the FF give you a short report. Once you get the short report, introduce yourself to the pt and gain consent to treat. Begin your workup. Yes you will repeat some things such as vitals but it must be done.

You are the EMT on the ambulance. You are the one who will be taking the pt to the hospital. Time for you to take charge and do your job.

The FF's are expecting you to take over, unless the FF is a higher level than you (i.e. a paramedic) you need to do your job. Your preceptor is right.

 

[DrankTheKoolaid]

Leo makes a bit of a point. I was assuming you were working ALS/BLS. And if that is the case then your partner would be doing everything he mentioned other then obviously intoducing yourself.

If working BLS/BLS then what Leo said is more appropriate.

But if working ALS/BLS then your preceptor is offbase about a BLS partners role on an ALS ambulance.

 

[TechMedic]

He is an intermediate but we also have a paramedic that usually follows. The firefighters are also trained emts And they work in sync with my guys. Its just that I have to bob And weave between them And the patients family. I guess I should just forget the formality of trying to say excuse me. I think it's the same problem as my first post here. I'm too gentle, but I don't want to just push everyone out of my way.

 

[DrankTheKoolaid]

The way I see it is YOU are not the problem. The socalled more experienced FF's already at scene seem to be. They should know to move out of the way and make room for the staff who needs to do their own assessment, VS and whatever else.

 

[Handsome Robb]

The way I see it is YOU are not the problem. The socalled more experienced FF's already at scene seem to be. They should know to move out of the way and make room for the staff who needs to do their own assessment, VS and whatever else.

That's area dependent too though. Depending on what crew I'm responding with I'll let fire do the whole assessment while I just stand back and listen and observe to take in the whole picture unless there is something that I need to immediately intervene on or I don't trust the crew I'm running with. Some are great others not so great.

OP I'd talk you your preceptor and find out exactly what he is looking for. "Take charge" doesn't really help a whole lot. if you are the Basic on an ILS truck.

If you gain a reputation as the new guy who steps on everyone's toes it isn't going to help you in the long run. I've found that please and thank you go a long, long way in getting things done and having good relationships with coresponders.

 

[TechMedic]

It may not be their duty but they seem to make it work. They just don't see me as one of them yet. My guess at least. I've worked with Houston firefighters before. I just don't know How to play on their level especially as the rookie, And a rookie that That's not even on their crew.

Rob- they basically want me to be the lead on the call. That's one of the things they look for before making you a full member. I mean I'm already driving the ambulance And I haven't even been in the front seat before this.

 

[Handsome Robb]

It may not be their duty but they seem to make it work. They just don't see me as one of them yet. My guess at least. I've worked with Houston firefighters before. I just don't know How to play on their level especially as the rookie, And a rookie that That's not even on their crew.

Rob- they basically want me to be the lead on the call. That's one of the things they look for before making you a full member. I mean I'm already driving the ambulance And I haven't even been in the front seat before this.

If you are the medical authority on scene it doesn't matter if they think you are "one of them" or not, your word is the final word. The trick is finding out how to go about it without making people angry.

If that's the case then when you walk in ask for a report, generally here one FF will be doing the assessment while the other sets up gear and the captain is taking down notes and writing down meds and then the captain relays taht information to us when we arrive. At that point if they are still asking questions I would like to ask then I just let them do there thing while I work on finding out a transport decision/destination, other information from family, getting things gathered that the patient needs/wants to take with them as well as the best way to extricate the patient from their current position and out to the ambulance. Generally if you are leading you should be delegating these tasks but EMS is a dynamic environment and no one call is alike.

Depending on your response times they may already have all the information you need to know and unless you need to treat something on the spot work on getting moved out to the ambulance, getting whatever else you would like done then moving towards the hospital.

Your mileage may vary seeing as I don't know how your system works exactly. I hope this helps

 

[TechMedic]

It is still on me because I need to learn How to work with these fellows. Technically I'm the least qualified but I understand my preceptors encouragement to act like the lead. I also think that because of tonight's shift, it's probably partly due to tiredness. I didn't notice till now because I had adrenaline rushing the last two times. Tonight was slow with only 2 bs calls. If you have any tips on How to deal with night shifts that would be nice. I still find it hard to sleep.

Also my preceptor lives around the corner so we have to wait for him till we can leave.

Anyway I'm not saying they dominate the scene. They hand over control to my partners but I'm barely noticed. I usually try getting vitals first thing but both ems And fire guys completely surrounded the patient. There are about 10 of us that respond to some of these calls

Frankly I never practiced this because I can only think of two rotations during clinicals where I was ever encouraged to act like a real emt. The rest didn't seem to give a :censored::censored::censored::censored: either way And still gave me top marks on my evals. I'm a little sleep deprived right now but any preceptors reading this, be lazy. Let the students do the work.

 

[abckidsmom]

It takes time. You are still learning, and being actively observant is very good for the learning curve.

Have some patience, and in time it will happen. You took a very basic class, and you are still learning now.

 

[Veneficus]

just curious?

Have you talked to the firefighters before calls and told them you need to be in charge in order to get signed off and ask them for their help in that?

 

[DrParasite]

Anyway I'm not saying they dominate the scene. They hand over control to my partners but I'm barely noticed. I usually try getting vitals first thing but both ems And fire guys completely surrounded the patient. There are about 10 of us that respond to some of these calls

Its really hard to "take control" when your preceptor is in charge (and has to approve everything you do), especially when you are new. The best thing to do is have partner/preceptor needs to say "hold on, you shouldn't be talking to me, I'm just the driver, the other guy is who you should give a report and control to", so EVERYONE knows your in charge.