What to expect in basic clinicals?

[blachatch]

I have a checklist of stuff that I have to complete but can you guys give me your experiences in your basic clinicals? Did you observe the nurse before they let you do anything? Any tips I should know before going in? Did everyone get go do CPR atleast once?

Thanks so much

 

[tnoye1337]

I recently just finished my EMT-B course and the instructors recommended that we do our hours on an ambulance if possible. You are training to become an EMT so why not do your clinical with EMT's in the field?

 

[STXmedic]

I recently just finished my EMT-B course and the instructors recommended that we do our hours on an ambulance if possible. You are training to become an EMT so why not do your clinical with EMT's in the field?

Some places make you split your time between both

 

[tnoye1337]

Some places make you split your time between both

Well I guess it's different in other areas, but where I took my class they wanted 10 hours of ride-a-longs or clinicals, but they preferred to have us ride on the ambulance.

 

[Maine iac]

Depends on where you are.... In a single ER shift you might see upwards of 20 patients. You won't see that on the majority of EMS shifts.

You will probably be able to talk with pts lots more in an ER setting, and most of those pts will be there for a few hours.

As for what will happen during the clinicals just depends on how gungho you are. Most nurses will probably show you a few times how to talk with the pt, and will probably let you do the vitals. You can see tons in an ER (and i'd recommend doing a shift (or as many as you can) in the ER versus the truck), and learn a lot about the continuity of care in a hospital.

Out of the 800 odd clinical hours I've done, I only did CPR once.

As for tips, try and go into every patients room, and see everything and anything. Know when to step back and let the nurses/doctors do their thing. During a basic clinical I got to "help" stitch up a guys face. He smashed his nose on a steering wheel, managing to separate the top of his gum, and because his nose was very broken you could look up into his sinus cavity.

 

[blachatch]

We only get the option in Ohio to do ER time which I'm not happy about I wan tto ride on a sqaud and see how it's done from start to finish. I know it will be akward for me since I've never had any patient contact. Hopefully the patients arnt to hard on the students!

 

[Shishkabob]

If you get a chance to choose who to follow, choose a doctor first, then a tech. Follow nurses last, unless that's all that's left. Doctors open your eyes and tell you what to look out for, techs have been where you're at and as such try to get you educated, and the typical nurse uses you as free labor. (Are there exceptions? Yup... but alas...)


What will you do? As a basic, not much. Shadowing, taking vitals, cleaning beds, other menial tasks.


Get to do CPR? If you're lucky. I did all my EMT clinicals, all my medic clincials, and all but my last medic internship time without a cardiac arrest... in a big urban area.

 

[tylerkd07]

I got to clinicals and ride a longs. I did my clinical at a level trauma center and I saw a lot and 2 cardiac arrests. When I was on the truck I had 1 cardiac arrest. Overall though I got a lot of experience at the hospital rather then the truck.

 

[MedicBrew]

Well I guess it's different in other areas, but where I took my class they wanted 10 hours of ride-a-longs or clinicals, but they preferred to have us ride on the ambulance.

10 hrs? Really?? Holy crap!!

When I did my basic back in 1993, we did 96 hrs on the ambu, and 40 hrs in the ED and in my opinion that was nowhere near enough.

I’m not bashing you; please don’t take it that way, but WOW 10 hrs? AND you got to choose either or? :sad:

 

[rwik123]

10 hrs? Really?? Holy crap!!

When I did my basic back in 1993, we did 96 hrs on the ambu, and 40 hrs in the ED and in my opinion that was nowhere near enough.

I’m not bashing you; please don’t take it that way, but WOW 10 hrs? AND you got to choose either or? :sad:

For medic or basic? I'm pretty sure we are talking about basic and 10 hours sounds about right.

 

[MedicBrew]

For medic or basic? I'm pretty sure we are talking about basic and 10 hours sounds about right.

That was for my basic.

Paramedic, if memory serves me correctly were:

240 hr Ambulance
80 hr ED
40 hr OB-L/D with a minimum of 5 deliveries
40 hr OR with minimum of 10 live intubations (that’s on top of the intermediate requirements)
40 hr ICU
16 hr Burn center
24 hr Psych
30 Peds
24 hr Geriatric
16 hr Nephro (dialysis specifically)
That’s what I remember, there may have been more. It's changed since then, I think there's even more requirements now, including several hrs interning with a physician in the ED.

Hence my shock. Not saying it's wrong, I just had more requirements I guess.

 

[Medic Tim]

10 hrs? Really?? Holy crap!!

When I did my basic back in 1993, we did 96 hrs on the ambu, and 40 hrs in the ED and in my opinion that was nowhere near enough.

I’m not bashing you; please don’t take it that way, but WOW 10 hrs? AND you got to choose either or? :sad:

That is longer than most emt programs with clinical included .

 

[MedicBrew]

That is longer than most emt programs with clinical included .

I guess.

I remember complaining while going through that the clinical and didactic hours were close to being equal.

I don’t regret having done it, but it sucked while going through it. Got married and really close to divorced during.

The course at the time prided itself as being the toughest course in the state with the highest 1st attempt pass rate. At least that's what they told us.

 

[STXmedic]

That is longer than most emt programs with clinical included .

That's actually exactly how all the programs down here are...

 

[Pavehawk]

Our local state college program has 24 hours of ER time, and 36 hours of ride time 24 of which MUST be on a transport unit. So they get 12 with fire nontransport and then 2 12's with the county third service EMS. They must also get five patient transport contacts and must do more rides if they happen to have slow shifts with the ambulance and fail to the five contacts in 2 rides. This is all for EMT basic and some is state mandated (the transport agency and patient contacts)

Bottom line know what your school/state requires jump in and help as much as you can, be the one is asking questions, and learning... not the one sitting around like a lump of mud.

 

[Medic Tim]

That's actually exactly how all the programs down here are...

I wish more programs were like that. When I did my emt a number of years ago we were only required 5 pt contacts and at least a shift each in the er and ambulance. It wasn't until intermediate and Medic that clinical was much more comprehensive. It would be great for emt to be more than a 120- 300 hour class.

 

[MedicBrew]

Bottom line know what your school/state requires jump in and help as much as you can, be the one is asking questions, and learning... not the one sitting around like a lump of mud.

Agree 100% Sorry, didn’t mean to derail the thread there.

If you don’t know your preceptor, then talk to them before hand and figure out your game plan. Walking into a call isn’t the best place to figure out what your preceptor wants or doesn’t want you to do.

This could be tricky, as some medics don’t particularly like 3rd riders. I’m not sure why, they were the new guy once upon a time.

 

[jjesusfreak01]

If you get a chance to choose who to follow, choose a doctor first, then a tech. Follow nurses last, unless that's all that's left. Doctors open your eyes and tell you what to look out for, techs have been where you're at and as such try to get you educated, and the typical nurse uses you as free labor. (Are there exceptions? Yup... but alas...)


What will you do? As a basic, not much. Shadowing, taking vitals, cleaning beds, other menial tasks.


Get to do CPR? If you're lucky. I did all my EMT clinicals, all my medic clincials, and all but my last medic internship time without a cardiac arrest... in a big urban area.

Had 1 code during my intermediate clinicals. Got to do CPR, bag, and push drugs all during the same code.

I took time outside of EMT training to shadow ER docs as i'm headed to med school, and it's definitely a good experience, but when you're doing ALS clinicals the nurses are who help you get all your skills done.

 

[Mad Max]

Not really meaning to hijack the thread here, but I find myself in a similar position and was looking for some feedback on the subject. I'm starting my EMT-IV clinicals in the next week or so, through Fisdap (I think that's what it's called,) 48 hours on an ambulance, and 16 hours in the ED. While I know that everyone is different, I was wondering what the general consensus is on how I should act for these ride alongs. Do the medics want me to be all hung ho and everything, jumping at every chance to do something? Or would they rather me just stay out of the way and keep my mouth shut? I realize that this is a learning experience, and that I need to observe, as well as do as much as I can, but these are also the people that I hope to be working with in the near future, and I don't want to come off the wrong way, as either too excited for my own good, or not excited enough.

 

[CritterNurse]

My Basic clinicals involved one shift in an urgent care center (instead of an ER), and one shift with an ambulance.

In the urgent care center, first they had me observe, then they put me in triage to take vitals. If they had an interesting case come in, they pulled me out of triage to observe.

On the ambulance, apparently I was a white cloud, and there was only one call. On that call I took vitals and since it was a singing patient, I ended up singing along when the patient got 'stuck' and couldn't remember the next line. I did help with truck checks and the other everyday chores that EMTs at that service do.

I am very active with my local fire/EMS service, so I've had a lot of hands on experience there over the past couple years.