Clinical Credit For Work

[screaming pizza]

Diddn't want to hijack the P-School thread, so I continued here.

In regards to GAHAZmedic's remarks concerning work for clinical credits, I fully agree, I think it's a poor practice that is being employed to attract students, then bending them over for tuition and releasing them unprepared onto unsuspecting patients. I've seen more than one new paramedic that is very proud of the fact that the majority of their clinical third-ride hours were completed while up fron driving. They then proceed to nut up on calls and can never figure out if it's 1.0 mg rapid SQ Benadryl for allergic reactions (true story!) or 5.0 mL IO of atropine for tonic/clonic? How is that teaching them to be a medic?
The only compromise I've seen that I'm comfortable with is those occasional situations where a firefighter or another crew member drives in while the EMT is helping the medic tech a critical patient. The EMT brings in a copy (HIPPA safe, of course) of the DHR signed by the medic and is THEN given partial credit. I can see getting procedure credit while working, only if their partner is an FTO or proctor, though, and the practice is limited in scope.

If I've stepped on anybody's toes, sorry, I'll find you some sympathy and some Bacitine. My school was hell (and yes, I know some still are) and as much as I wanted to injure my instructor, I am very thankful for the number of hours I spent riding in the captain's seat (if I was lucky). The only way some one is going to learn how to be a successful medic (start drinking heavily, for starters) is by a shiitpile of hours of patient contact in addition to school. Those schools that let students turn in work hours for credit with no limitations are cheating the students and their coworkers. Oh wait, lets not forget the poor patients! Aren't they the ones that all of this matters for?

Forgive my rant. There is a school around here that I hold in very low regard that cranks out people that know how to pass registry, not how to be medics. And since their entrance requirements are low (and tuition very high but easily financed), they spill a lot of graduates out there that I have seen do more harm than good.

[GaHazMedic]

Excellent, excellent post SP!!

I once had a medic from a program like you mentioned who wanted to give 0.4mg of lidocaine for VF. He then had the audacity to argue with me when I corrected him.

[screaming pizza]

Excellent, excellent post SP!!

I once had a medic from a program like you mentioned who wanted to give 0.4mg of lidocaine for VF. He then had the audacity to argue with me when I corrected him.

I had a Roswell firefighter argue with me and refuse to give me lidocaine in the middle of an arrest once. He swore up and down that I needed to give and epi instead. His rationale? He was in paramedic school and just finished ACLS. Wetard. Go figure, the patient ended up walking out of St. Joes.

This'll date me: I maxed out my bretyllium by the time we got to the ER.

[GaHazMedic]

I had a Roswell firefighter argue with me and refuse to give me lidocaine in the middle of an arrest once. He swore up and down that I needed to give and epi instead. His rationale? He was in paramedic school and just finished ACLS. Wetard. Go figure, the patient ended up walking out of St. Joes.

This'll date me: I maxed out my bretyllium by the time we got to the ER.

I feel your pain, brother. I remember teaching the update when Bretylium was first added to the protocols. When I went through medic school, they were still teaching intracardiac injections, pericardiocentesis and subclavian lines. I used to hate working an arrest because we had to do a subclavian on every arrest.

[mediccjh]

The quality of EMTs and Paramedics coming out of school these days sucks. They are not taught how to think; they are only taught how to be protocol-monkeys.

We need to start a riot and fix this. If I operated my own EMS Academy, it would be the toughest class on the face of this planet.

[medic pathetic]

I agree. I don't think it should happen. You don't learn behind the wheel. I personally like the idea of working for 6 mos with someone more experienced in the field. As the field is changing, and doctors are given internships, i think we should have something similar. We just talked about this similar topic in class. There are some things that can only be learned through time and experience. Sure life experience can help, but i have three people in my class, two of them top runners, who have been EMT-Bs since about May, which incidentally is when they graduated high school. It is physically impossible to gain the experience needed to be a paramedic when the majority of time since you have had your patch has been spent in paramedic class. You can see it when we do scenarios, they freeze up and lack the experience needed to ask the questions you don't think to ask. I have only been here for two years, and i seem to be the only one who thinks deep down that i'm not nearly experienced enough to be a medic...

I think classes should be tougher. Harder. Not so much.... love and coddling. Because we all know that there is no coddling when you are on the stand in court for negligence in patient care.

[CombatMedic]

I know some departments will give credit for certian things when it comes to riding when yoiu are on the clock. My department will give you credit for the skills only if you are only riding a 2 person crew. Thas is if you need an IV stick (say for I students) or you need to give Solu-medrol but you don't have a third to let them drive. Then the student, under the direction of a county approved preceptor, can give that. They only get the credit for teh skill or medication, not the time. This is important because there are many times when you are just a skill or two short and there may just not be a call for you to use. Some students are getting kicked back because they are not getting their intubations, when NO patient presents the need for an intubation. I know in my part of the county, I have had the need to intubate once, (code) and it still required a combi-tube because of difficulties. I am in a lower call volume area.

Some places just don't have the call volume.

P.S. I think that I just screwed my self for tonights shift.

[CHASgirl6204]

P.S. I think that I just screwed my self for tonights shift.

What were you thinking?! Yup, JINX! :)

[Dorkfish]

The school I just finished , kicked 2 people out for doing field rotations while " on shift " . This happened 2 classes before the final exam . The new program director went through all the sign off cards and checked dates and times . When he found anything funny , he investigated it . He started showing up checking to see if people were showing up and staying for their time . Not that I checked out early on mine , but glad I was done with them before he took over . It scares me all the people in my class that came straight out of basic into medic never working in the field . The time spent doing rotations is very valuable and should not be spent driving the ambulance . I have been in the field in one form or another for a long time . I have developed my pt care skills from doing the job . Do I know everything ? Hell no I don't know everything , but I am more ready to be turned loose on the public than some others in my class .

Oh yeah , the guys that got kicked out , they work for the FD that the new program director is the Chief of . Kind of ironic , don't cha think ?

[screaming pizza]

I agree. I don't think it should happen. You don't learn behind the wheel. I personally like the idea of working for 6 mos with someone more experienced in the field. As the field is changing, and doctors are given internships, i think we should have something similar. We just talked about this similar topic in class. There are some things that can only be learned through time and experience. Sure life experience can help, but i have three people in my class, two of them top runners, who have been EMT-Bs since about May, which incidentally is when they graduated high school. It is physically impossible to gain the experience needed to be a paramedic when the majority of time since you have had your patch has been spent in paramedic class. You can see it when we do scenarios, they freeze up and lack the experience needed to ask the questions you don't think to ask.

I like to tell my third-riders that the a paramedic is nothing more than an advanced EMT. they look at me like I grew a third arm and just nod. But, it makes more sense when you get your disco patch and realize how many calls are actually ALS. If you aren't to the point where EMT-B/I is almost instinctive then you better be nowhere near P-school. How can you learn to be an advanced EMT if you can't even operate successfully as an Intermediate? You'll be exactly what was mentioned before: a Protocol Monkey. You become "That Guy", the one that does things because the protocols say so and will argue up and down that you're right. We all know this person, the one that gets snotty when you ask why he gave a 29 y/o/m exercise freak Atropine. According to ACLS, any heartrate under 60 is considered bradycardia! Therefore, Muscleguy is brady because his resting rate is 50 BPM! Technically, he's right and he won't consider any other course. Like, you know, logic, common sense, et cetera.

[FlyDoc]

way back in the early 90's when I went to P-School we had students that worked for the local services they were only credited time that they spent with the PT, so at work they would only get 15min of credit per call. that worked out Ok no one complained and it turned out good medics.

[medic pathetic]

way back in the early 90's when I went to P-School we had students that worked for the local services they were only credited time that they spent with the PT, so at work they would only get 15min of credit per call. that worked out Ok no one complained and it turned out good medics.
Wow. Not THAT would be something! I think i would like that a lot. lol

[KSEMT]

Yeah, I've actually done some research into my medic class that I'll be taking next fall. It's against the state/school policy to allow any type of clinical hours while on the clock. That being said, having spent 2 years as a basic (including as a I/D) and 1.5 as a I/D, and will be spending another half a year as both in respective classifications, I'm super glad that I did. And some say that I've got a nice cushy hospital job, and I'll admit, at times it's a little too cushy for me, but I've learned a lot of **** on the end of the hospital care, and have built amazing relationships with the medical director as well as the ER docs for when I go back to the field. I know that while I do my clinical ride times, that I will be the definition of **** catcher with the crews I work with, because I will tech EVERY call and fill out every report, of course with a medic there to make sure that my ducks are in a row. My 2c. anyhow.

[medicmade]

Did i miss something? I dont get a credit for working, and i dont think i should. dont get me wrong, I think working for ems as a student has helped me out alot, but yall are right i cant do the skills or do a start to finish with a pt. Im here everyday, work two days, Intern 3 days, work 3 day intern 2 days...Thank god im done in a week. What thread was this on?