82 | Getting comfortable saying “I don’t know” | Advice for newbies | Learning from those lower than you on the perceived hierarchy
12/29/24 • 31 min
Batching work applies with nurses too. Do multiples things when you enter the room, so you don’t have to go in and out many times
Ben talks about efficiency in the field being important due to the limited time and resources
As providers we must get comfortable with saying “I don’t know”
In medicine in general we don’t know everything, nor can we diagnose everything. Especially true in emergency medicine
Chest pain is a great example. We don’t get a clear answer or diagnose most of the time
We must be careful what we tell patients is going on when there is not a clear answer. Specific diagnoses will follow patient for a long time
Ben talks about some struggles new EMT and paramedics have and how the scope of a paramedic is still poorly understood, they often hear “I didn’t know you could do that?”
Teaching the EMT and paramedic students the context of the “why” behind treatments and not just the skills themselves
The difference between magic and medicine is we can trouble shoot and analyze medicine, we know why it works and if it doesn’t there is usually an explanation
Keep your mind open and learn from others. You can usually find someone that has a similar style as you, but you can also learn a ton from those who practice different from you
Ask a lot of questions, grow your confidence gradually
You need to master the more mundane tasks before moving to the exciting in some circumstances
Charge nurses need to help develop their team and communicate well
Be a mentor and correct people in a non-public setting, grow people instead of getting rid of them if they are struggling
Find a mentor or multiple mentors when you are new and when you have some experience, mentor people
You must be constantly teaching newer people and learning from more experienced people in medicine
You can make or break someone’s medical experience when they are new to the field
Cultures can be developed by the poor attitudes of a few crews or staff
You have to guard against the bias that those that are burned out can bring
Constructive criticism can come from even those that are not nice or not tactful if you can be open enough to take the feedback
You can learn from anyone, even those lower on the perceived hierarchy
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Batching work applies with nurses too. Do multiples things when you enter the room, so you don’t have to go in and out many times
Ben talks about efficiency in the field being important due to the limited time and resources
As providers we must get comfortable with saying “I don’t know”
In medicine in general we don’t know everything, nor can we diagnose everything. Especially true in emergency medicine
Chest pain is a great example. We don’t get a clear answer or diagnose most of the time
We must be careful what we tell patients is going on when there is not a clear answer. Specific diagnoses will follow patient for a long time
Ben talks about some struggles new EMT and paramedics have and how the scope of a paramedic is still poorly understood, they often hear “I didn’t know you could do that?”
Teaching the EMT and paramedic students the context of the “why” behind treatments and not just the skills themselves
The difference between magic and medicine is we can trouble shoot and analyze medicine, we know why it works and if it doesn’t there is usually an explanation
Keep your mind open and learn from others. You can usually find someone that has a similar style as you, but you can also learn a ton from those who practice different from you
Ask a lot of questions, grow your confidence gradually
You need to master the more mundane tasks before moving to the exciting in some circumstances
Charge nurses need to help develop their team and communicate well
Be a mentor and correct people in a non-public setting, grow people instead of getting rid of them if they are struggling
Find a mentor or multiple mentors when you are new and when you have some experience, mentor people
You must be constantly teaching newer people and learning from more experienced people in medicine
You can make or break someone’s medical experience when they are new to the field
Cultures can be developed by the poor attitudes of a few crews or staff
You have to guard against the bias that those that are burned out can bring
Constructive criticism can come from even those that are not nice or not tactful if you can be open enough to take the feedback
You can learn from anyone, even those lower on the perceived hierarchy
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Previous Episode
81 | New panel | Charge RN advice | Physician efficiency tips | Developing Confidence
New panel! Lucas (ER physician), Kendra (Charge RN, NP student), Ben (paramedic and educator)
Kendra talks about her advice for new charge RN’s
Have some ER experience first. She says it was difficult starting as a charge when she was so new to ER. Have a good set foundation.
You need to be able to have difficult conversations with people in a tactful way to address problems
Getting to know the providers on a more personal level also allows you to better counteract interpersonal conflicts
Lucas talks about how a good charge nurse is a problem solver. He doesn’t view himself as the captain of the ship as an ER physician. He views the charge nurse as the problem solver and it’s their job to make sure every patient is managed in the department
The progression from EMT to paramedic is a similar advancement as RN to charge RN. Thinking outside the box instead of just task-oriented work
Paramedics must learn to allocate resources appropriately rather than do the tasks themselves
Simulation based training has help new paramedics learn to lead calls and see the time it takes for tasks to get completed
Paramedics do tend to have chips on their shoulders, a lot of this has to do with the difficulty of the job and how it is fairly new by comparison and the history of EMS is often us trying to prove ourselves
Lucas discusses efficiency tips in the ED
Chart with the same basic structure regardless of the chief complaint
The physical exam can be very basic and general with a very detailed focused physical exam based on the complaint
Sometimes documenting a physical exam that is too thorough can bite you later when you have to answer why you did a cranial nerve exam on an abdominal pain patient
Document what was done and do what you document
More is not always better
Document twice as much as you think you need to on the relevant components
When you are new as a physician or APP you should be ordering more and documenting more
Try to batch tasks. When you get up go see multiple patients rather than one at a time
It’s better to do the right tests rather than use a shot gun approach every time
You should be able to answer what you are looking for with a given test
On most patients, you should be able to form a plan after getting the HPI and physical exam
We should seek to avoid stacking orders, sometimes it’s inevitable when unexpected results pop up
Stacking orders reall
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Next Episode
83 | Is medicine your entire personality? | Get off on time | Burnout | Compassion fatigue | A physicians personal experience with the ER
Don’t make your career your entire personality, extra shifts will affect you over time. Sometimes the extra money is not worth the burnout
The culture is shifting from working a ton to a better work life balance
Your family will remember that extra shift you worked far longer than your employer
Get off on time
Control the variables you can control that give you higher chance of getting off on time
Leave work at work
Burnout can be short term or long term, acute or chronic
If you cannot take care of yourself, you cannot take care of others well
Strive to live a healthy lifestyle
Don’t let your relationships falter because you are too busy
Don’t take those patients that are terrible to you personally. We are seeing patients on the worst day of their lives
The environment we work in is one of the most challenging out there
Learn what burnout looks like for you individually
Schedule time to relax and spend time with friends
Have a system for overcoming burnout, maybe therapy, maybe exercise
You have to manage and recognize compassion fatigue to avoid taking out your stress on other people that don’t deserve it
Don’t wear things as a badge of honor that are not good things: like not drinking water all shift
Avoid the bad habits that allow a short-term benefit for a long-term detriment
Selflessness is a big part of who we are, but this can be a point of damage if you don’t take care of yourself
Understand that we are all working as a team. You have to understand your role and work efficiently within that role
Lucas talks about a very personal experience with EMS, law enforcement and the ER. He realized that anyone of these people could have been the last to see his son alive. And we are that for other people many times. We are a tribe.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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