A guest post by Sean Fontaine.
I’ve been bugging Sean to write a guest post for the blog for a few years now. I don’t usually harass my friends about writing content, but Sean is so enthusiast about his work that I just couldn’t help myself. As a first year paramedic, Sean has a unique perspective on what it takes to make the transition from EMT certification to paramedic. In this post, he shares with you five things that can make the difference between success and failure.
Sean is a graduate of Regis University and a Firefighter / Paramedic for The South Metro Fire Rescue Authority. He lives in Denver, Colorado with his lovely wife Oz and their two sons Jonas and Axel. If you’re considering making the jump from EMT certification to paramedic practice, you won’t find better advice anywhere.
Steve and I have been discussing the possibility of my writing a guest post for The EMT Spot for a couple years now. So, after paramedic school and clearing as a new paramedic were done, he proposed that now was a great time to stop backpedaling and get on it. I’ve been accused of dragging my feet on getting this done. Shooting topics back and forth, we came to the obvious conclusion that an article discussing five tips for new or perspective students would be far more uplifting than the pediatric death and dying discussions that I’ve been having with the current paramedic school students.
With that said, here are my top five tips for fledgling paramedic school students.
Tip #1: Get Ready for Paramedic School
Let’s start with the question I’ve heard prospective and new paramedic school students ask over and over again, “What do I need to read to ensure that I’m ready for paramedic school?”
Don’t worry, everything you need to read to be ready for paramedic school is in your EMT-Basic book. There’s a reason every EMS class and every EMS book you’ll come across stresses the ABCs; these are the basic essentials that we use to evaluate and treat every patient. These are the basics we need to be prepared to treat and have within normal limits before we move forward with our patient assessment. These are also what you should fall back on when your advanced interventions aren’t working or cannot be performed for any reason.
It sounds trite, but every good paramedic begins as a good basic. Without good assessment skills and the ability to use your five senses, instead of your machines that go ping, it will be an uphill battle to work up your patients. To re-emphasize that point, you should have a systematic approach to your physical assessment of patients when you’re arriving at the door of paramedic school. This systematic approach will save you time and again. It’s your job to find out what is wrong today, not theirs to tell you. Quite often, they can’t or won’t tell you.
Your EMT-Basic book also teaches basic anatomy/physiology, patient presentation, and how to address insults to the ABCs. All of these are foundations to what you will begin building upon as a paramedic student.
One of the most important lessons you can learn early on in paramedic school (if you haven’t already learned it as a basic) is to learn from your mistakes. Mistakes are inevitable, they’re going to happen. No one is perfect. Perfection doesn’t exist in medicine. (Hence the practice of medicine.) There’s a learning point to every call, rookie or vet. Learning from your mistakes means recognizing where you’ve gone wrong, and likely 90% of the time you’ll realize it as you’re making the mistake, or soon there after The other 10% your preceptor will let you know. Then you can mentally bookmark what you did, why it was wrong, how to correct it in the future. Then move on and don’t dwell on it. Go on to your next call in two minutes or two hours with a clear head and treat the next patient.
Learning how to move on, so that you’re not dwelling on the mistakes you’ve made, will help you continue moving forward and learning, so that you can competently listen to and treat your patients appropriately. Dwelling complicates things, muddies your thoughts, and doesn’t allow you to learn from the mistake. It usually stems from that nagging need to be perfect. Again, remember that perfection doesn’t exist in medicine. It’s an environment where we’re constantly learning and can always strive to do better at something every day.
In addition, there will be numerous subtleties that you likely won’t clue in to yet, with regards to patient presentation. Don’t beat yourself up over this – it is normal during school. The purpose of your clinical rotations and field rides is to reinforce pattern recognition and patient presentation; this is where you start learning the subtleties. This is why, when you watch your preceptors run calls, they may only ask a handful of pointed questions and seem to be confident in the direction they’re heading with treatment, while you’re still trying to figure out why the patient called 911 today.
Medicine has numerous shades of gray and you’ll learn that what was right to treat one patient may not be right with another of similar presentation due to subtleties of their disease process/injury.
Tip #3: Communicate Effectively and With Confidence
In order to begin running calls in any capacity (Meaning you begin, then your preceptor takes over or you run a call from initial contact to the final destination.) you will need to be able to talk effectively to your patients. This skill doesn’t come easy for every one and usually isn’t seamless early on in your clinical experience, but this is another skill that your clinical rotations and field rides will reinforce again and again.
Steve wrote a post around a year ago about how, if you actively listen to your patient after asking a question, you’ll likely hear some of the answers you were looking for. However, when your head is overloaded with material from class and your desire to find answers outweighs your patience to listen, you won’t hear this information.
Instead, after you ask a question, you’ll likely be distracted from the patient’s answer because you’re thinking of the next one you’d like to ask, and then as soon as they stop talking, you repeat the cycle again. This rapid fire questioning and not listening is very common during some portion of paramedic school for most people. Frustrating as it is, it will pass.
One of my partners described the paramedics who could seamlessly transition between different populations and have similarly good patient interactions with them all. (A social chameleon.) Eventually you’ll need to be able to speak competently, without jargon, to people of any age group, income or education level. Your ability to cultivate this skill directly correlates with how quickly and effectively you gain patient trust and build a rapport. Strong rapport is built quickly. Patients observe how you carry yourself, the respect with which you speak to them and others, the confidence that you convey, how you discuss their current situation, how you would like to remedy it and the calm manner of your delivery.
Rapport cannot be underestimated. Without it, calls tend to run with more difficulty and patients do not have as much trust in you or your skills.
Tip#4: Your Habits and Attitude Will Make or Break You
Your attitude can make or break your paramedic school experience. A positive attitude, a clean uniform and respect for your preceptor, your patients and the hospital staff will go a long way toward ensuring that your reputation is a good one. Along with the previously mentioned items, a strong work ethic and the realization that you don’t know everything will further cement that good reputation for you. This is a good mantra: work harder everyday than you did the day before. Whatever reputation you have, good or bad, everyone at the agencies where you’re doing your clinicals and rides will know that reputation before they know you. Reputations precede and follow you everywhere you go. A bad reputation is exceedingly hard to get away from.
Part of your strong work ethic should include learning the par levels and location of all of the equipment (on the ambulances you’ll be working on) as early as possible. It’s your job as a student to know where everything is. Your preceptors already know this stuff.
Another aspect of illustrating a good work ethic is a dedication to studying your classroom material. Bring your books on rides for slow times. Be cautious with reading them during clinicals, because there’s almost always something you can be doing instead of reading when you’re in the hospital. (The OR rotation might be an exception) You don’t need 100% on all of your exams, but you should be able to discuss and apply all of the material appropriately. Remember, your patients won’t care what your grades were; they will care that you can treat them with a solid, common sense approach.
The key to studying well is finding out how you learn most effectively and using this approach consistently throughout school. In addition, ensure that you budget your time wisely with regard to studying and scheduling your clinical hours. If you get behind in either one you will quickly feel overwhelmed. Then that focus on a positive attitude will suffer (as will your work ethic) because you have diverted your energies elsewhere.
Tip #5: Take Care of Your Family, Your Friends and Yourself
Lastly, all of the above things don’t matter if you don’t take care of yourself and your family. Though I just stressed the importance of vigilant studying, learning from mistakes, learning to talk with others, attitude, work ethic, and all, none of it matters if you’re a hermit with failing relationships due to stress and exhaustion.
You should have days where you put down your books and go out with your family and friends and decompress. You’re going to need it. One of my friends told me just prior to school that I should put my books in a box on those days, because he knew if I could see them I’d be inclined to open them. You’re also going to reach a point where you’ve studied enough and further studying will only stress you out instead of reinforcing the material. It took me a while to realize when I had reached that point. As time went on, I could feel it and I would walk away, go for a run, go out for dinner with my wife, get ice cream with my kids, even do house chores.
Hopefully, your family supports your decision to go to paramedic school and understands that you will be intermittently absent both mentally and physically. You will have periods where you can’t get away from school, be it clinicals or studying, and they may resent this from time to time. In those times, seeing the end goal is huge for all involved, even though, yes, the short term can suck. As your family supports you during school, you should support them. Let them know that you appreciate their love and support. Let none of it go unnoticed, no matter how exhausted or stressed you are.
The other crucial part to taking care of yourself (and I fully admit it doesn’t happen all the time) is ensuring you sleep, eat, and rest as best you can. My mantra became, “Sleep, eat, rest, repeat.” and when you can’t, stock up on your migraine meds. I refilled my Imitrex and Phenergan prescriptions a few times during school.
For all you’ll hear about paramedic school, including it being one of the most stressful times of your life, it’s entirely what you make of it. I had numerous migraines. (All atypical presentations and a handful during my clinicals and rides.) I slept anywhere between one and eight hours a night, but generally less than four. I frequently didn’t eat or drink during field rides. I often went what seemed like a week without seeing my family. I studied all of the time and increased my already elevated coffee intake exponentially higher.
Through it all, I smiled just about all day long during every clinical and every field ride. I made some great friends. I learned to stop over thinking my calls and I learned how to feel good standing at the front and walking into the call. I learned more than I ever thought I could file way in my head and competently use when needed. I found dozens of good and cheap Mexican food stands throughout the city of Denver. I enjoyed myself immensely and I had a great time.
In hindsight it’s a bit like high school. Would I do it again? …Not if I didn’t have to, but damn it was fun.