Paramedic Students

[celticcare]

Hi all, I am currently practicing as an RN in a metropolitin ER in New Zealand. We have student nurses coming in and doing their rotations and have a preceptored and set program for their period of time here. We also have paramedic students come in and have a set requirement to do IV's and 12 Lead ECG's for their clinical rotations and if the ability arises assist in nursing assessment and patient care.

What I want to know, is do any of you have a proper mentored program for paramedic students, what sort of things do they do? What sort of assessments do they sit with you? I was a paramedic before I was a nurse and found hospital rotations to be that there was a real Us vs. Them attitude from the nurses to medics. Yes I know the worlds are two very different places, but I want to create a proper placement program for these students and let them do more than just the IV's and ECG's etc. I have approval from the University for these students to become part of a proper student placement program as well as the ER heads and heads of nursing here, I also have approval from the EMS agencies to do so. What I am looking for is guidence, suggestions and anything that you can share with teaching paramedic students and what would be a good set of skills for them to learn and be assessed on by RN's? Like handovers, concepts of Hospital based triage, the flow of patients through the ER, lab values etc. Anything would be appreciated and no EMS vs. RN slagging or vice versa or I will remove the comments.

Scotty

[Larry77, RN]

No formal program in our dept...we have Medic students but they just come in and start IV's and some other basic skills...we sign them off and they move on to the OR to practice intubations.

[Medic7714]

To the OP, first I need to say that it is awesome you are taking this endeavor as it is one much needed!!!!

When I was a Paramedic student we had to do clinicals not only in the ED but also in the ICU, PCU, cath lab, OR, phlebotomy, respiratory, etc. And most of the time on the floors the nurses had no clue what to do with us. In their defense, they really had no clue what Paramedic education consisted of (mine a 2yr degree program) or what the scope of practice was. Or maybe they did and just didn't feel like bothering. It was mainly just skill driven with IV starts, blood drawls, pushing some meds, ECG's, and assessments. I remember my one experience in OB, I literally sat in the break room for hours reading my textbook because that is where the nurse told me to go. The nurse said when I first got there that if a delivery happens she would come get me... well long story short a delivery did happen and she comes into the break room and says, "oh, I'm sorry... I forgot you were here". Needless to say I was ******!

When a nurse has a Paramedic student they need to be TEACHING the Paramedic student. Precepting is an active role not a passive one. This means seeking out opportunities, sharing assessment tips, asking the student questions, having them listen to lung sounds, have them to drug calculations, have the student explain to them the drug they are giving, etc, etc.

None of the hospitals in my area have formal programs for Paramedic students which I wish they did so sorry I can't help ya there. But hopefully by sharing my experience as a Paramedic student you can see how frustrating and non-productive precepting as a Paramedic student can be.

The biggest thing I would say is have the nurses attend an in-service on precepting Paramedic students and explain to them what Paramedic education consists of and tell them to treat the Medic student with the same level of attention as a nursing student. I would throw this point of emphasis in too... and that is "when the Paramedic students graduate, it may be you that needs their care and knowledge, so teach them well". Hopefully that will drive home the point of being attentive and taking an active role.

[BellaInBlueScrubsRN]

I just work with them as you would a nursing student. Maybe they won't use it specifically as a paramedic, but they get to see this side of it. Let them do IVs, EKGs, hang fluids, push meds... and grill them on what they are for :) Get them into a trauma or code if you have one... make em do CPR!

[CrashED]

We have several nurses in our department who preceptor Medic Students. It gives them an eye opener of what goes on once they drop the patient off. As their clinical rotations, they do several shifts in the ED shadowing a nurse. They also do some shifts in the OR and with Respiratory Therapy to get experience with BVM's, OPA's, intubation and resp assessments.

In the ED The RN is ultimately responsible for the patient but we allow the Students to Start IV's, draw bloods (they are only allowd one kick at the can, if they miss they are done), give IM medications, SL medications and PO withing their scope, as well as do head to toe assessments and assist in proceedures. Our students have alot of sign offs they need before they can even access the trucks and graduate.

They hope is that the hospital time and experience will give them a better understanding of the interdisciplinary team in the ED and hospital....but some of it see it as "Look at them with all the help and we do it solo, were awesome!"