Being a paramedic student is difficult. When you start, you never know what to expect. Different paramedic preceptors have different attitudes, work ethics, and paces. While a student might not match up perfectly with their preceptor, they must be ready to take as much as they can from their shift.
First of all, a student should walk in the door ready to learn. One of my favorite questions to ask a student is “why are you here?” In a way, I am setting them up. I’m hoping that I don’t hear what I don’t want to which is “I just need hours” or “I’m just looking for a tube or electricity.”  No one is welcome on my truck if they intend on sitting back and twiddling their thumbs for twelve hours. Paramedic school does not teach a person everything, and there is always plenty more to learn.
Make sure your preceptor understands your comfort and experience level, because they are two totally different things. A friend told me the other day about a student he recently had on his truck. They were rushed out the door on their first call, and when they finally got to the hospital and turned over their patient, he asked the student how much experience he had. The reply he got was “actually, that was my first time in the back of an ambulance.”
Shocking answer, huh? In my area we are seeing students getting on trucks with less and less experience that does not mean that they’re not capable though. One must keep in mind, however, that as a student with less experience, there is more to learn, and the journey to being a well-rounded provider might be a longer one. For the student described above, on his or her first shift out, I’d be more concerned about their ability to take a blood pressure in a moving ambulance, or bandage up a laceration than I would be about how well they could establish an IV or read a 12-Lead EKG. Student time is a great opportunity to learn how to walk before you’re required to run. It is best though that you know how to crawl first.
My favorite time as a student was after I had my requirements out of the way. My tube was accounted for. My cardiac arrest, my electricity and my drip were in my book and signed. For the last forty hours of student time that I did I got to play a little game I called “playing paramedic.” I was driven by patient care and learning how to really be a paramedic and not by that desire to poke and prod at a patient. I was also lucky to have a preceptor who, on my last 16 hour shift with him, said to me “the truck’s yours today. I’m just going to sit back and do paperwork.”
Also, have a way to find the answers to questions that might have you stumped. I once asked a paramedic student what the contraindications were for Lidocaine. After giving me one or two, I asked what else there was, and the reply I got was “I don’t know.” My student then sat back and did not say another word. He didn’t open his field guide, and didn’t break out any text books from his bag. He sat back and waited for an answer.
What do you think would have happened if he was treating a patient at the time? We are expected to know what we are giving, and what it might do. Many of the most experienced paramedics I know still carry a field guide with them. Some of the more aggressive folks that I see working have their smart phones filled with protocols and references.
The student I want on my truck would have known where to look to answer the question. There needs to be some sort of self-sufficiency shown. The time for learning the book smarts is over. It is time to learn the street smarts and learn to put your hands on a patient, take care of them, and function on your own.
Being a good paramedic student isn’t difficult. Come in the door with a positive attitude, a willingness to learn, and a desire to work and you’ll be fine. If you walk in ready to count IVs and chase codes though, it could be a long shift.
Many of you out there are preceptors as well, and everyone with a paramedic card in their pocket had to go through ride time. What makes a good student in your eyes?
Nicely said Scott – JOnathan
Boy, you sure learned a lot in your years since school. Very well said.
What can I say, sir? I’ve had some great people teaching me along the way!
I don’t supposed you’d be willing to give career advice: I seem to keep getting wrapped up in the work of the call and spooled up emotionally when I’m supposed to be in charge. I worked a code the other day, I butchered the airway having forgotten all my technique and continually had to be prompted to be in leadership role. So I guess my question is this; do you remember when you were new and inexperienced? What did you do to remain in control? What are some ways I can make myself a better medic and a better leader? Besides time, what can I do to improve my confidence?
Hi, FiremedicJP. Thanks for reading.
Time will definitely help with confidence. The three biggest tips that I can give you are: do one thing at a time, delegate when you can delegate, and be aware of what is going on around you.
Often times, we realize that on these calls, there is a lot that needs to get done, and not always enough hands to always get them done at once. When you are in those types of situation, pick a task, start it, and see it through to its end. Far too often, I’ve seen newer medics running a call with three or four half-completed tasks.
That said, be willing and ready to delegate when you are able to. Is there someone there who can put the patient on the monitor, or spike a bag for you? If so, use them! If you have an ALS partner, don’t be afraid to talk to them on the way to a call to make sure that you both are on the same page. “You grab the airway after you put them on the monitor. I’ll do the line and meds.”
Thirdly, when you ARE in charge, you need to do everything that you can to avoid tunnel vision. Judging from your screen name, I am going to guess that you work for a fire department. Think about a captain or lt leading a crew into a house. They have to be active participants in the rescue or fire operations while still knowing what their guys are doing and giving orders to them. Being a paramedic running a cardiac arrest is no different. Keep an eye on the time, and stay focused on the ENTIRE task at hand.
All in all, keep your head up. Experience makes such a difference in those situations. Before long, things will become automatic, and your training and experience will take over.
-Scott