On-the-Job Training

While still an adolescent in the family of medicine, each generation of EMSers brings the possibility of progress. It has never been more imperative to have quality peer-to-peer education. Whether it is a student doing a ridealong or a brand new employee doing field training, we teach our own.

New Hire Field Training
You have just been promoted to field training officer and are responsible for teaching all new hires the ins and outs of your EMS agency. Your lieutenant decides to start you off with an EMT intern to keep it easy on you. Luckily, you have an experienced EMT partner to pick up any slack.

Your intern shows up and is checking out the truck before you know it. You have already decided the first thing you want to teach this new EMT is how to drive since that will be what they inevitably spend most of their time doing once released.
As your partner walks up from his car, you get toned out for a chest pain call. You hop in the passenger seat and take on the role as navigator. The new kid makes a few driving errors on the way there, but nothing that leaves you closing your eyes in prayer.

The patient turns out to be experiencing a STEMI, and this is a load-and-go situation. You plan on having your experienced partner drive, but your intern says, “I can do it. I know exactly where the hospital is.” You are reluctant, but you would like to have the experienced paramedic in the back with you so you let him drive.

You get all your critical treatments going and call the hospital to give you report when you hear “about five minutes out” come from the driver’s seat. Wow, you think to yourself, not bad. Then you look out the back window and realize you are headed to the wrong hospital and you are going in the completely wrong direction. “This guy needs a STEMI center!” you yell, as you begin to realize the rookie has no idea what that is.

What To Teach
Field training officers often find themselves in a difficult position. Having one eye on the patient and the other on your intern can cause a great amount of stress, and strabismus. However there are simple ways to provide quality education while avoiding tremendous stress.

Step 1: Never, never, never let someone drive without direction on his or her first call.
One of the first things to consider is zone familiarization. Point out the hospitals and areas of frequent calls. Teach interns how to use the siren and proceed through traffic lights. Large maps can be great tools. Mark all of the hospitals and explain specialty centers (i.e., trauma, STEMI or stroke centers).
Some considerations specific to field training include:

• Radio use
• Documentation
• Standard operating procedures
• Driving

Prioritize everything, with the first lesson being the one with the highest degree of importance.

Teach standard operating procedures (SOPs) as soon as possible. These are specific to each EMS agency and are usually not covered in school. Payroll procedures, truck washing, uniform guidelines and station duties usually require little instruction, but they are important parts of an intern’s curriculum.

Some of your agency’s guidelines may include absence notification, tobacco use, ambulance backing, etc. It is in the nature of a paramedic to want to get straight to the clinical requirements of EMS, yet SOPs are important aspects of the job. Taking the time to teach them will emphasize their importance. Failure to follow these guidelines appropriately usually results in some form of punitive action, which may be avoided.

Using tactile drills can help facilitate good hands-on experience. This may assist you in gauging an intern’s readiness to perform certain skills. During the scenarios the intern should be able to recite the indications, doses and contraindications of a medication prior to administering it.

Keep in mind that it is not your job to teach these new hires how to be an EMT or paramedic. It is your job to teach them how to do it for your agency. The clinical part of the job will come as easy at it is for you to teach the protocol book.

Next Month: Teaching the EMT Student

Adam Thompson, EMT-P, is a paramedic with Lee County EMS in southwest Florida and an EMS educator with Edison State College. Contact him at Paramedicine101@gmail.com.