County of Fauquier Department of Fire, Rescue and Emergency Management Preceptor Program Training Lieutenant Mary Hart
Purpose : To recognize and assist Fauquier County preceptors become experienced for his/her role as a trainer of – Enhanced -AEMT- Intermediate and Paramedic Students and Interns. Goal : A Fauquier County preceptor is an individual who works with one student to provide appropriate clinical learning experiences to enhance student knowledge and facilitate role transition from an observer to team member to team leader; and ultimately to entry level ALS provider status. Provide a “ POSITIVE” role model for the student and INTERN
Duties and Responsibilities of a Fauquier County Preceptor • Guide, monitor and evaluate the preceptee /student’s performance to assure successful completion and identify those who • Maintain a PROFESSIONAL demeanor. Lead need remediation . by example at all times. • Provide FEEDBACK. ALL feedback should be: • Each call is a new opportunity. Focus on • Constructive current situation and move past previous • mistakes. Specific • Frequent • Valid
Laws of Learning • Individuals accept and repeat responses that are pleasant. • First impressions are lasting. • Repetition yields habit. • Skills not practiced are forgotten. • Train the way “ You Will Do It for REAL!” • Dramatic experiences leave lasting impressions. (YOU will be remembered the way your were perceived, positively or negatively.)
Establishment of an Environment Conducive to Learning • Mutual Respect • Collaborate *NOT* Compete • Open communications between Preceptor and student/intern • Offer ongoing feedback. Encourage and enhance growth with our new • Everyone is HUMAN……Remember, You were there once!
H U M A N • H = Hear them out • U = Understand their feelings • M = Motivate their desires • A = Acknowledge their efforts • N = Never…Never put them down, make personal attacks, display harsh or blaming attitudes
Role of the Preceptor in the Learning Environment • …Acts as a facilitator of learning rather than a controller of learning. • …Directs the process of learning while the student/intern sets the pace, asks questions, and controls the learning.
FEEDBACK • Information that helps people to decide whether their behaviors have had the intended effects. • Start with POSITIVE feedback...even if all the student did right was not fall down.
Principles of Giving Feedback Intention Positive Feedback • Recipient open to feedback • Changed behavior • Describe student/intern Behavior • Personal Impact • Accept responsibility (Preceptor & Preceptee) • Understanding • Encouragement
Communication Stoppers Don’t Do This… - Interrupting - Mind-reading or assuming - Ridiculing or blaming - Controlling - Ignoring/denying feelings or ideas - Ordering/commanding
(Enhanced) -AEMT-Intermediate and Paramedics
Five Characteristics of an Effective Preceptor Is this what we want them to Do you have what it takes? think? • Strong desire to EDUCATE as well as TRAIN • Technically proficient • PATIENCE • MOTIVATION – COMMUNICATIVE • MATURITY AND RESPECTFUL
What is expected of the Preceptor? • We MUST ALL be on the same page. According to the CoAEMSP (Committee on Accreditation) - when the question was asked: What are the on-going preceptor training/update expectations? The answer was: Preceptor updates include any new information on paramedic intern expectations, feedback from problems that have or may occur or inaccuracies in evaluation (QA issues) as well as any program personnel updates that should be contacted or evaluation tool update. All MUST be “singing from the same hymnal” are the bottom lines.
Fauquier County Defines Geriatric Patient as: anyone over the age of 65
Geriatric Patients • Once you have completed all of your geriatric competencies, you may count patient contacts toward Adult competencies.
Patient Contacts
You do not need to count patient contacts only toward one category. i.e., a patient who is having chest pain along with difficulty breathing. Typically, this has counted as only Chest Pain. Fauquier County allows you to count both as competencies.
• During the course of field and hospital clinical rotations, the student will make various patient contacts. In order to receive credit for a competency, the student must actually perform the skill and perform the skill successfully. For example, credit for an IV access competency would only be granted after the student cannulates the vein and confirms a patent IV site. Merely obtaining flashback does not constitute successful completion of the skill. • All patient contacts in the field must occur on an EMS unit. “Team leader” calls must be transports to the hospital on a transport EMS unit. The student must accompany the patient to the hospital and transfer care to the receiving facility. Students must complete a Patient Care Report for Team Leader calls.
Patient Care Report The student/intern is responsible for completion of the particular patient care report utilized by the agency where the student is participating in field internship. Completion of a PPCR is required on all calls where the student functions as the team leader. It is recommended, that the student/intern complete a PPCR on every patient contact during internship. The preceptor is responsible for reviewing the PPCR for accuracy and completeness. The preceptor will evaluate the student/intern’s documentation skills on the Daily Clinical Evaluation Form.
Patient Care Report The preceptor must make sure the student is receiving credit for all skills performed on the PPCR.
Counting Skills on Duty • Skills cannot be counted if the student is one of only two assigned to the ambulance. The skill actually should not be done by the student if he is working as an EMT and not as an ALS intern or student. • DO NOT perform an ALS procedure and then get up front and drive as a preceptor/student/intern.
Make sure the medication you are attempting to gain a competency for is within that level of certification’s scope of practice . It should not be an EMT Skill!! You already know how to do that. ALWAYS remember – BLS before ALS – That skill will NEVER Change!
Protocols • We are currently using the Rappahannock EMS Council, INC. • JUNE 2007 Version of the Protocols (You must follow the current State Scope of Practice) • Everyone will be notified appropriately when the Department transitions any new protocols.
Virginia Scope of Practice
Virginia Scope of Practice
Virginia Scope of Practice
Virginia Scope of Practice
Virginia Scope of Practice
Virginia Scope of Practice
REMS Scope of Practice
REMS Scope of Practice
REMS Scope of Practice
REMS Scope of Practice Remember! Providers CANNOT perform any skills that they have not been trained to perform and released to do so. Please feel free to call the Training Division with any questions you may have regarding this. (540) 422-8811.
Enhanced Providers • They CANNOT perform IV’s on Pediatrics. • They MAY perform IV’s and Draw Blood with IV starts on Adults. • They MAY use the Intranasal Medication Administration device (MAD). • They CANNOT perform IO’s on Adult or Pediatrics. • They MAY use CPAP with ON-LINE medical control order PRIOR to attempting the procedure. • They MAY use a Superglottic Airway Device, i.e., King Airway
Enhanced Providers • Medications: • Epinephrine (1:1000) 0.3 mg. to 0.5 mg. SQ or IM • Benadryl – 25 – 50 mg. IV/IM • ASA – 324 mg. PO • Albuterol – 2.5 mg. via nebulizer – Max dose of Three • Nitro tablets – 0.4 mg. SL, may repeat every 5 minutes for a total of three doses (1.2 mg). Do not administer if systolic BP is <100 mmHg . • Zofran – 4 mg. – IV/IM – May repeat once to a maximum total dose of 8 mg. • Narcan – 0.4 0 2.0 mg. IV/IM/IN • D50 – 25 grams • Glucagon – 1.0 mg. IM or SQ
Paperwork • Review Often for Accuracy • All paperwork should be given to your preceptor As It Is Created , so… one call, one patient contact submitted to your preceptor.
What if the student/Intern has one more competency they just can’t get?
ALS Release Program Final Release Forms Incomplete Competencies • Please complete this with your Intern by going over a scenario and documenting your discussion. • Use the Incomplete Competencies Form to document this. You may not exceed two competencies in this manner.
When the student/Intern has completed all required calls and paperwork, … • WHA WHAT IS NE T IS NEXT? XT?
Fauquier ALS Release Program Preceptee Evaluation Form • Be Sure You are Familiar with All Forms within the Packet. You should review these with the Preceptee who will have to Complete these Forms. • ALL FORMS may be found on our website at: Fauquier Precepting Forms
Letter of Recommendation • When you feel your Intern is Ready for Release – Write a Letter of Recommendation to be placed in the front of the preceptee’s release book. • Make sure you have discussed this and have your Batallion Chief’s Approval
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