I feel awful about not writing more frequently… but ya know what? This is time I need for myself. I need time to study and learn and process all of the new info that I’m sucking up every day. Just being around the medics I’m working with is great. I’m getting a lot of the nuts and bolts of day-to-day practice almost by osmosis. Just by working with them, and watching how they interact with patients and each other, I’m learning the art of having presence as a medic. And, to a lesser extent, I’m making careful note of the things I’ll never do when I’m a medic. These are valuable lessons my friends.
I’ve been on some excellent calls recently. Calls that I’m sure seem mundane to my preceptors, but present me with a new learning experience every time I step out of the medic unit. Every chest pain call is an opportunity to hone my assessment and interview skills and tighten up my IV skills. I’m working hard on delegating tasks to the EMTs and other medics with me. These guys and gals want me to run the scene and they’re poised, ready to jump when I say the word, all to help me succeed. I just need to tell ‘em what I want. And that’s a little hard, when sometimes I don’t know myself. But I’m getting better.
I made some mistakes over the past few days. I’m moving fast. Sometimes too fast. Going down the checklist in my head at a chest pain call at 2 in the morning…
“Okay, Tom, let’s get this gentleman on the monitor and some O2… Dave, can you grab me another set of vitals while I get the aspirin and nitro?”
Tom, my Medic preceptor, hops right to getting the patient on the monitor and some Os flowing on a cannula while Dave, the Firefighter EMT that’s with me, looks up from his BP cuff and says, “As soon as I’m done here, I’ll go spike a bag for you and set it up in the truck. I’ll make sure to set the nitro next to your IV roll.”
“That’s great, thanks Dave.” I mouth a silent “thank you” in his direction. He winks back.
And don’t think that Tom didn’t catch that. On the way back to the station after that call Tom asks in the headset, “So, how’d you do?”
I review the call in my head before I answer. I had a great rapport with the patient, we were laughing and joking on the way to ED. I did an great Q&A. Got a 12 lead in the first 5 minutes in the door, got ASA on board quickly, got an 18 gauge in the right AC while we were en route…
“Well,” I start.
Before I could go any further, Tom says, “It was pretty nice of Dave to save your ass with the Nitro, huh?”
“Yes. Yes it was.” I answer slowly.
These guys aren’t out to bust my balls. They’re working to make me the very best medic I can be. And I appreciate that. That’s why I don’t mind helping with chores around the fire house or cleaning up after dinner. These guys don’t get paid to teach me. They like teaching. And I appreciate it.
And yeah, I wasn’t gonna give that guy any nitro ‘til I had a line. I know better than that. But Dave was there to back me up.
I love riding with these guys.
One of the states where I work its not required to have a line started for NTG, as a matter of fact our EMTs can give NTG before I even get there….
EMTs where I am can assist with a PTs own NTG, not administer it outright. Can I give NTG without a line? Sure. But it’s not something I like to do often. And this guy had never taken NTG before… It very well could have wiped his pressure out. It’s better to build that safety net first, right?
I really think I have a lot more studying to do before I even attempt to actually go out on the field!
It’s not ‘required’ to have a line established prior to NTG, but the way I was taught was to have a patent line before administering any meds in case of an adverse reaction or allergic reaction. We were taught to just go in and “O2 IV Monitor” everyone.
Just as a little bit of advice, always go through the list of contraindications/precautions with every drug before administration. Make sure that your patient doesn’t hit any of the contraindications and that you have a way to rebutle any precautions should anything go wrong. If your patient starts sucking mudd… well that’s part of the game, but you don’t want to sit yourself up for failure either. Good Luck
Exactly. I think it’s easier to have my IV access established with things are calm than to be scrambling with things go sideways.
Sounds like you have a good set of guys there, I too enjoy precepting students and in my 25 years experience I learned that shortcuts are never to be taught, they are learned individually to meet the situation at hand. The new medic must be capable of all tasks, even if it means not completing the care plan entransit. EMS, done right is one of the noblest jobs you can do in life. Thanks for joining the team.
They are just making sure you don’t forget that without your basic, you are a medic with one hand tied behind your back… Don’t ever, ever think you are above your basic….and remember their saying..”paramedics save lives….basics save medics…” I am a medic that never forgets that…and I remain a happy medic, because of that! Calls go much smoother when you work as a team…