Precepting....

Last night on MedicCast, Peter Canning and several other great bloggers talked about precepting and being a preceptee. I guess I thought I'd like to add my two cents in...

During the last year I have been working as an Intermediate and going to Medic school. So pretty much the entire time I have been what we call a Paramedic Intern. That means that as long as there is a Medic in the back of the truck with me, I can perform as a Medic. This has been excellent in terms of experience for me.

My partner at that time wasn't that great of a formal teacher. He never really said, "Do it this way or try this." He wasn't that great at teaching me 12-leads, or the A&P of the job. He was a stickler for the rules. He once told me that he did things by the book when asked if there was anything that he did that he knew was different from others. This is not to say that he wasn't a good Medic, he was a great one, just not a good formal educator in my opinion.

The one thing we was good at, and I am grateful for, is that he would let me do about anything I wanted to do. Just about every call he would step back and let me do all the talking and interviewing and most of the treating of the patient. He would help out and put them on the monitor or start an IV if I wanted one, but that was about it. In other words, he treated me like a Paramedic. I will be eternally grateful for that experience and freedom that he allowed me and I think it has made me better for when I am cut-loose and on my own.

He quit and went on to bigger and better about 3-4 months ago. Since then I have been in the round-robin of Medic partners. I never know who I will be working with from one shift to the next or even from one hour to the next on some days. In a way I like this as well. I am getting to see how other people do things and that helps me to form my own way. Some of the people I have worked with allow me to do anything I want. They see me as a Paramedic, even though I just finished class. Others still see me as a wet-behind-the-ears, dumbass Intermediate and they don't think of me as anything but an IV tech and a driver. Those are the days that I don't really enjoy, but it does show me what I don't want to be and how not to act. A select few Medics that I have worked with see me as I am, a brand new Medic with a several years experience as a Basic and Intermediate. They allow me to run the call, but add little hints and helpful tricks of the trade that make our job a lot easier, or subtly remind me of something that I have missed. These are the days that I love and I take away a lot of information and experience when the shift is over.

I read a lot of other blogs that are written by people in much the same situation that I am in like Baby Medic, I Heart EMS, and Medic March. It seems all of the different companies have different approaches to precepting and clinicals. Now that I have finished class and passed my test, I am waiting on all the official paperwork to finish and I will do my oral boards with our Medical Director. Then I will be able to function as Paramedic. I will still be working with an experienced Medic for at least a couple of months before I am completely cut loose. After that I will be free to work with anyone, an Intermediate or Basic partner. (In the past it has been 6 months to a year, but with the current Medic shortage, it won't be that long.) Meaning that I will be a stand-alone Medic, as we call it.

I guess we are very informal around here because we don't have any paperwork or check-list that we have to complete before we are cut-loose. In some ways I would like for that to be implemented, a list of objectives that I would have to meet so I would kind-of know where I stand. As it is, it's just a certain amount of time, it's not even based on patient contact hours. I don't think the current system is a very good idea. Everyone learns at a different pace, everyone has different strengths and weaknesses. What might take one person a year may take another only a few months to learn and get comfortable with. I think the focus should be on the individual rather than a set amount of time for everyone. Then again, I work in a rural setting. If your waiting on a code or a good trauma you might have to wait a long time. Once I ran two codes in one day and then nothing for a few months, its feast or famine around these parts.