By Greg Friese, MS, NRP
I recently self-transported to an urgent care for worsening flu-like symptoms, shortness of breath, wheezing and chest constriction. After four days of worsening body aches, chills and night sweats, my wife insisted, “People that are as sick as you go to urgent care.” I relented.
I was shown to an exam room by an urgent care based paramedic, who was accompanied by a paramedic student. I think the urgent care is a great work and educational setting for paramedics. Lots of patients with a wide variety of medical and trauma complaints allow numerous repetitions of assessment and treatment skills. Since I am always willing to be poked and prodded by a student, my spirits lifted a bit at the prospect of helping this paramedic student practice his craft.
Have an action orientation
The student, George, backed himself into the exam room corner as the paramedic began to ask me OPQRST history questions.
“George, get in here and check my vital signs,” I said.
With the vigor of a wet noodle George put the automatic blood pressure cuff on my arm too loose and clipped the pulse oximetry probe to my finger. If he was counting my respirations, it was by looking at my reflection off the toes of his boots.
Students, maximize your opportunities in the clinical setting by having an action orientation. Volunteer to do anything within your scope, training and authorization. There is no maximum for the number of times you can assess vital signs, listen to breath sounds, start an IV or administer medications.
Clinical preceptors and other staff, at the hospital or on the ambulance, should remember you as the “Can I do ... " guy or gal.
Be equipped to assess the patient
With a chief complaint of “shortness of breath and wheezing,” I was expecting to mildly hyperventilate while the paramedic and student auscultated my chest from side to side to pinpoint the location of my wheezing.
Nope. George eased himself back into the corner.
“George do you have a stethoscope,” I asked?
“Not on me,” he casually mumbled.
“Do you not own a stethoscope or you don’t know where your stethoscope is?” I asked after giving him the long blink.
“It’s either in my car or my friend’s house,” he explained.
Paramedic students, you need these things on your person at the start of every clinical experience:
- Stethoscope
- Wrist watch
- Pocket notepad
- Two or more black, medium point, ballpoint pens
- Your protocols or assessment sheets
Optional products for paramedic clinical success include breath mints, a pocket field guide or app, trauma shears and a penlight.
Share your tips and must have equipment for paramedic clinical time in the comments. How would you remediate a student that was reluctant to assess a patient or came unprepared?
