The student and the hurt feelings

I hurt that poor paramedic student’s feelings today. Poor guy. I’m always cordial with students, and nice as I can be. But I was apparently very mean today.

First, I hurt his feelings when I suggested he get some real-world experience as an EMT before even thinking about taking the National Registry exam for paramedic. I know the commercials on late-night TV make this job look easy, and they tell you that you won’t get judged for not working on an ambulance until you have “P” on your patch, but that’s not true.

Then I hurt his feelings when I wrote in his evaluation something along the lines of “there is a lot that happens in the back of the ambulance, but this student wouldn’t know, since he spent the entire 12 hours napping, playing on Facebook, or staring out the back of the ambulance with his hands in his pockets. I guess my suggestion that he spend his time asking questions or reading his book didn’t go over too well.

I hurt his feelings once more when I suggested that he could start an IV if he wanted to, but he had to actually want to try and that it would be his responsibility if (God help us, when) he becomes a paramedic.

And lastly, I hurt his feelings when I suggested his bedside manor was more in line with someone who made a living selling used clothes on eBay.

This ain’t no Sadie Hawkins dance. I’m not going to grab your hand and tell you what to do.

Poor guy. I guess his complaint was warranted, after all.


  1. Another FTO and I got terrible reputations for a while with the local students. They showed up looking for Dr. Patch Adams, and instead they got Dr. Gregory House! Their feelings were crushed when they learned I was more concerned about that student’s future patients than I was for that student’s feelings. I’ve tempered it a bit more now for the rare occasion that I’m in the field with a student, but I can empathize with your situation.

    • I don’t think you were out of line at all. I am an EMT and currently in Paramedic school on the fast track. I’d prefer to get experience on the road first but situations do not allow for that.

      Also; it is a tough field. We all need to be able to accept criticism, be able to learn from the many mistakes we will make and adapt/deal with the many different personalities that we will deal with without being ultra sensitive.

      This type of career is also a go out and get em/learn and absorb as much as you can with any method at your disposal. If we are complacent and lazy, someone may die due to our negligence and wasted time on FB.

      When I do my clinicals my face is always in a book or doing research on the computer to learn what I came across that day or get different perspectives. This is a hands on, get down and dirty career. Definitely not a spectator sport.

      If he takes the positive spin on what you told him then he will be a better medic for it. If not then he should maybe find a new career.

  2. Azirishmedic says:

    Hey I pay to be there so I will do what I want and look like I want. You need to provide better customer service to me. All joking aside, keep up the good work training people in the method you are. The future patients require it.

    • You’re joking, but some of the trainees I’ve seen aren’t. I suggested to one training officer that he send his student home because he looked like he had dug his clothes out of a hamper. In fact, he smelled like he had dug his clothes out of a hamper. The training officer wouldn’t do that because he was afraid that he’d get in trouble. I settled that by not letting the student in the back of my truck at any point during the shift.

  3. This is literally a life and death job. Traumatic injury & medical emergencies do not suffer fools and indecisiveness. I’m not here to destroy a student, but I will make them work as long as they show a modicum of desire and initiative. Contrary to oft-witnessed common belief, this is NOT the Cool Kid Club.

  4. Flash Larry says:

    I expect students that I precept to be focused and interested in what’s going on. Unfortunately, that’s not the case some of the time and after they graduate, it’s not the case when they’re working next to me. That’s the first issue.

    But I agree with your partly unstated opinion that a person should have experience as an EMT before entering paramedic school. Here is a person who hasn’t yet learned how things work with a variety of patients and conditions and he is now going to be administering medications for something that he’s never seen before but only heard of. Bad idea.

    Paramedic precepting with me is a continuing oral exam on all sorts of topics and expectations that the person will actually perform. I suppose that’s why I am not chosen to do it any more.

  5. Wow! You’re a toughie! You write mean things on their evaluations. Mean, because they are true.

    At least you don’t do what I used to do. Give trainees that were failing an employment application for a fast food restaurant and suggest a rewarding career serving others.

    A former co worker of mine made a trainee cry on a call. He didn’t yell or swear. He just asked some questions the answer to which any EMT should know. This guy didn’t and the more my friend asked, the more he cried.

    There is no crying in EMS.

    I agree that a person who wants to apply to paramedic school should have one year of full time experience as an EMT as a prerequisite.

  6. Hmm, I don’t see anything too bad in there; but I do feel the need to play Devil’s Advocate here:

    What do you all consider “experience”? Does it have to be on an emergency response car, or is a BLS transport ambulance enough experience? My anecdotal experience seems to indicate that the emergency response EMTs have good scene management skills but need work on patient contact; while the IFT EMTs tend to be good with patient contact but weak on scene management.

    Also, we need to be honest and admit that there are some preceptors (too many IMHO) who just get a sick thrill out of tormenting their interns. Critiquing errors, even while shouting, is one thing; but when you’ve got a preceptor who’s bitching out his intern in the middle of the ED, that’s over the line. If the intern is doing that badly, send him home; don’t make the rest of us an audience to your power trip.

    Along those lines, exactly how is an intern supposed to perform when the first thing their preceptor tells them is, “I don’t think you should have been allowed to enter paramedic school.” IMHO, any preceptor who says that to an intern should not be given interns because they’ve showed they’ve already decided to fail the intern before even meeting them.

  7. While many express their frustrations with students, it makes me question the preceptors commitment to actually educating them.

    I hear and see it all the time. The student doesn’t know this. The student doesn’t know that.

    How about the preceptor? Does the preceptor know everything? If so, why doesn’t the preceptor educate the student?

    It’s about being a mentor. Share your experiences and let them know the lessons and mistakes you’ve learned that have made you a stronger provider.

    It’s about being a coach. Listen to your student. Ask them the tough questions. If they don’t know the answer, review it with them. It’s not just about the questions, but about the answers.

    There is a lot of content that EMT and Paramedic students aren’t taught in class….such as communication and connection with their patients….and each other. How are they supposed to learn that? Oh…through the preceptor.

    The student is only as good as the educator.

    • It is my job as a preceptor to orient the student to the field. It’s not my job to make them want to be there.
      When I am teaching, which I have done for the better part of 14 years, it is my job to make sure the students know the material they need to know to perform as EMTs or Paramedics. I don’t expect a preceptor to pick up my slack, and I don’t expect a preceptor to have to educate the student.
      Students have begun riding earlier and earlier in their schooling now, to the point that paramedic students are doing clinical time before they even come close to learning anything ALS. If my student doesn’t know how to read a strip, is it my job to teach them how to read one? Sure, if they want to learn.
      But what if the student doesn’t want to learn, as was the case with this student? If someone is on my truck to “do their time for school” and isn’t actually interested in what we do, then he can go home.

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