ER Orientation

Week 1 of Clinical and an Orientation to the ER

This week, I went on a 1.5 hour tour of the hospital ER to get oriented to the space and to meet our Clinical Instructor. We did not have any patient contact during our orientation but this orientation provided my first opportunity to see a hospital and specifically an ER from the perspective of a medic. We entered through the ambulance bay and left our bags in the paramedic office. We observed working medics bringing patients in, calling CACC for numbers after doing the TOC, completing their ACR, and socializing/decompressing with other medics - and we cannot forget the coffee orders. It was fascinating to be this close to working medics, almost in the secret behind-the-scenes area... it was far too easy for my attention to be drawn to the medics and away from our Clinical Instructor. I need to work on that, but to be honest, if I wasn't excited to see all of this in action, I would probably be going into the wrong profession.

Being Tested

Within five minutes of meeting our Clinical Instructor, we were being put to the test. Our task was simple, answer one mathematics question using the four times table (I had 4x23... I won't put the answer incase anyone wants to practice). The four times tables are important in medicine because we use them to calculate vital signs at a per minute rate (respiratory rate and heart rate). Even though I have always been strong with math, when being put to the test in front of our Clinical Instructor, I felt my heart rate skyrocket (I was definitely tachycardic). My learning from this is that I will be tested many times in my career as a medic and I need to be prepared for it and develop confidence. I will be asked questions, easy and difficult, and I will quickly have to give an answer. I will be tested by my superiors, by patients and their families, and by doctors and charge nurses. If I study hard and work hard, I will have the knowledge to answer most questions but I need to have the confidence in myself and my abilities.

First Semester Material is Still Relevant

Throughout the past semester, our professors always tested us cumulatively. Anything we had learned previously in a course was fair game for the next test or final exam. This was a big change from university where most often the material was not tested cumulatively, and once you had memorized the content for a given test, you could quickly forget it. I soon learned that this is not the case in the Paramedic Program and this is something I am grateful for. I am looking at the program as the start of a new career and that everything I learn and retain, will assist me in the workplace. This encourages me to continue reviewing previous material. Our Clinical Instructor must also believe in this philosophy as during our orientation, he quizzed us on what forms are used to place a 72 hour hold on a psychiatric patient (Form 1 - Physician, Form 2 - Justice of the Peace). Being tested on this material out of the blue has encouraged me to keep reviewing older class material when I have a spare hour or two.

Auscultate, Auscultate, Auscultate

The last part of my ER orientation that I want to touch on is my goals for future clinical placements. I have been fortunate to assess vital signs on many patients during my two years as a First Responder, but the vast majority of patients have had vitals within the normal range, or slightly outside of. In the ER, I will have the opportunity to take vitals on patients with abnormal rates, rhythms, or qualities. This goal was brought to my attention when our Clinical Instructor asked us how many times we had auscultated lung sounds in the past semester. My guess was very few. Auscultating lung sounds are notoriously hard for people to be proficient at and my goal to prepare for my next ER placement is to review my path notes on adventitious lung sounds, listen to videos of lung sounds on YouTube and practice auscultating on my classmates in lab and after-hours lab.

Alright, this blog is long enough.. on to the next week!