Internship Notebook · During all clinical and internship shifts you should consider yourself to be...

EMT-Basic

Internship Notebook

This book belongs to:

If found, please call 303-340-7219

Z:\P&P and clinical manuals\Policies & Procedures 2011\Clinical and internship PP Basic Aug 2011.doc

Last updated: December 6, 2011

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The Clinical portion of the CCA EMS curriculum is meant to provide students with a

realistic means to master the knowledge, skills and behaviors necessary to become EMS

professionals. Additionally, students will have the opportunity to interact with a wide

variety of ill and injured patients (both as team leaders and observers) under the direct

supervision of an experienced preceptor. Students will develop leadership and delegation

skills and an appreciation for the role of each team member as an integral part of the

emergency medical healthcare system.

You will be required to complete four (4) internship shifts. Two will be in 8 hour shifts in

a hospital emergency department, and two will be 10 to 12 hour ride-alongs with

Rural/Metro Ambulance crews, for a minimum of 36 hours. During these four rotations,

you are required to complete five (5) patient care reports. Please use the attached CCA

Patient Care Report for this purpose.

*All releases must be signed and turned in before starting clinicals.

Above all, we want your shifts to be a positive experience for you. If, for any reason, you

must miss or leave a shift, you are responsible for notifying the clinical coordinator and

your primary instructor within 24 hours. Failure to do so will result in a missed shift.

CCA Program Staff Contact Information

CCA Staff Office Phone Email

Patrick Schooler (Department Chair) 303-340-7217 [email protected]

Angela C. Cutler (Clinical Coordinator) 303-340-7219 [email protected]

Kris Andersen (PT Primary Instructor) 303-340-7126 [email protected]

John Spera (PT Primary Instructor) 303-340-7126 [email protected]

Cindy Smith (Administration) 303-340-7070 [email protected]

Stephanie Agner (Administration) 303-340-7076 [email protected]

Angela Love (Marketing & Special Projects) 303-340-7072 [email protected]

CCA EMS Fax 303-340-7209

Missing a shift without informing the clinical coordinator and your primary instructor

within 24 hours of the missed shift will not be tolerated. All phone numbers listed

above have time and date stamped voice mails. If you do not get an answer, leave a

detailed message, as this will serve as your notification.

mailto:[email protected]








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ABSENCES

Due to the limited availability of clinical and field shifts, it is very important that

students attend all scheduled shifts and turn in completed paperwork in a timely

fashion!

Students who miss one clinical or fail to turn in paperwork on time will drop

one letter grade to a grade of B.

Students who miss two clinical shifts or fail to turn in paperwork a second

time will receive a grade of C.

Any student who is charged with three absences for any reason will receive a

grade of F and will have to reregister and repay for the EMS 170 Internship

course. Students who fail their internship will not be allowed to take the

course final practical exam or National Registry written certification exams.

Students will receive a prescription for each clinical missed or failure to turn

in paperwork within the proper time limit.

CLINCAL GRIEVANCE POLICY

Students who receive an absence for a clinical rotation may be allowed one rescheduled shift at the sole discretion of a committee made up of the primary instructor, clinical coordinator and the program director. For a reschedule to be considered, the student must submit a written grievance and any documentation that supports their grievance (i.e. doctor’s note, hospital admission forms, accident report, etc….) All paperwork must be submitted to the primary instructor at the start of the next classroom session attended by the student, with no exceptions.

The grievance committee will determine whether missing the clinical rotation was justified. Their decision will be made within 3 working days (Monday-Friday) of submission. Students who successfully grieve a missed rotation must complete any rescheduled shifts before the classroom final written exam.

Documentation of completed shifts is the sole responsibility of the student. Lost

or incomplete paperwork will result in a shift being counted as an absence.

Students are strongly encouraged to make copies of any paperwork turned in

to the program.

Proper documentation of a shift includes a daily evaluation sheet signed by the

students’ preceptor and all patient care reports completed during a rotation. These

forms must be turned in to the clinical box outside the EMS building the next

class period following a completed shift or through arrangements with the

primary instructor. Failure to provide proper documentation (especially a signed

daily evaluation) will result in an absence.

All paperwork should be turned in to the clinical box outside the EMS building

but it may be turned in via fax as well. Students may not email paperwork.



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Students are not allowed to fill out their own evaluation forms. The preceptor

must fill out all portions of the sheet related to hours spent at the site, number of

skills, and evaluation of performance. Falsification of documentation will result in

immediate termination from the program.

Students are not to attend any clinical or field shifts that are not scheduled through

the CCA Clinical Coordinator. Any student who represents themselves as a CCA

student at an unscheduled rotation or who fails to schedule a rotation through the

CCA clinical coordinator in advance will fail their internship.

Students who choose to attend unscheduled rotations on their own time will not

be covered by state workers’ compensation insurance or other program insurance

policies, and do so at their own risk. Hours spent at these shift locations, as well

as any patient contacts acquired, will not receive credit.

In the event a student is sent home by the clinical site due to a student not wearing

the proper student uniform, not carrying an I.D. badge, not bringing proper paperwork, misconduct, poor hygiene or any other valid reason, the student must notify the Clinical Coordinator and Primary Instructor immediately. The student will also be charged with one (1) missed clinical rotation. Failure to notify the Clinical Coordinator and Primary Instructor will be considered falsification of documents and the student may be dismissed from the program.

The conduct of students reflects upon the individual, their agency, the CCA EMS

Program, and the EMS profession as a whole. Therefore, students must conduct

themselves in a mature, professional manner at all times.

Students should display professional attitudes towards patients, patient’s family,

preceptors, and other members of the emergency healthcare system at all times. Patient

confidentiality will never be violated for any reason. Students are subject to immediate

removal from a clinical or internship site at the discretion of the preceptor for

misbehavior and/or mistreatment of patients or staff, and may be subject to further

disciplinary action by the Program staff.

Other reasons for immediate termination of a clinical or internship may include:

Disregard of directions given by preceptor or other agency personnel

Physical or verbal abuse of a patient, patient’s family, bystanders, other crew

members, or any other people involved in patient care

Inability to function under stress

Inability to perform at an EMT-Basic skill level

Lack of professionalism

Dishonesty

Failure to adhere to agency or program policies and procedures

Students must adhere to the policies set forth by the CCA EMS Program and host

agencies during their internship experience. Failure to do so will result in disciplinary

action that may include dismissal from the program.



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All students must arrive at their internship site at least 15 minutes prior to the

beginning of the shift, and students are expected to complete the entire shift as

scheduled. (Students may stay longer on a shift with the permission of their field

preceptors.) If a student leaves a scheduled shift early without permission from the

Clinical Coordinator, their Primary Instructor, or their preceptor, they will lose credit for

the entire shift.

You may not participate in any fire fighting or extrication activities while you are a

student. You are also prohibited from handling the ambulance stretcher while there

is a patient loaded on it. Insurance does not cover you for these activities.

The student should make arrangements to provide his/her own meals during the

internship shifts. It is advisable to take a lunch that does not require refrigeration. If

afforded an opportunity to participate in a meal at a station, the student must pay their

appropriate share.

During all clinical and internship shifts you should consider yourself to be a guest of the

facility or agency, and conduct yourself appropriately! You need to participate in

morning car-check, equipment and supply inventory and restocking and any other

assigned tasks. Any work you do during your shifts should be under the direct

supervision of your preceptor or his designee. You are not there to be utilized as another

employee. Do not get involved in agency, shift or personnel politics. DO NOT give your

opinions regarding policy, etc. Also, use your down-time wisely. This does not mean

watching television, using the internet or playing video games. During times when you

are not running calls or performing other work-related tasks get your books out and study

for the National Registry Exam. This is also a perfect time to learn local protocols.

Do not touch food or any other item that does not belong to you.

When doing clinical shifts at any hospital you must remain in the clinical area you were

assigned to. DO NOT go to other departments if the one you have been assigned to is

slow, even if directed to do so by the nursing staff. If the staff tries to send you to

another clinical area tell them that Program policy, as well as facility policy, do not allow

for students to move between clinical areas. When in the Emergency Department at the

Medical Center of Aurora EMS students are to stay out of the EMS lounge unless taking

a lunch break. Loitering in the EMS lounge will not be tolerated.

Any physical, mental or sexual harassment must be brought to the attention of the

Primary Instructor or Clinical Coordinator immediately.

Look at every call as a learning experience. You will be able to learn something new on

each call, even if what you learn is to be more comfortable on that particular type of call.

Continue to study! Those who excel in EMS do so because they know there is always

something else to learn. This will keep you prepared for your certification examination.



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Dress Code

Students are expected to conduct themselves as medical professionals at all times. This

includes dress and hygiene standards as follows:

CCA EMS photo ID badges must be clearly visible at all times.

Students must wear the CCA EMS Program shirts issued to them and dark blue or

black uniform pants at all times. (Students may be subject to the dress code of a

host agency.) Uniforms are expected to be neat and clean, without stains or tears.

Sturdy, closed-toe work shoes are required. Dark tennis shoes are acceptable, but

not recommended. No cowboy boots, sandals or crocs.

Students are expected to wear appropriate undergarments, including socks.

Undershirts with logos and graphics that are readable through the uniform shirt

are not acceptable.

Jewelry can present a safety hazard and should be kept to a minimum.

Hair should be secured out of the face.

Perfumes and colognes can cause severe reactions in patients and other staff

members and should be avoided whenever possible.

Students are expected to exhibit good personal hygiene at all times and are subject to

dismissal from their clinical or internship shift at the discretion of the preceptor.

Equipment

Students should carry certain equipment with them on all shifts:

A working pen

A watch

Eye protection



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Stethoscope

Clinical/internship manual

EXPOSURES

If a student is injured or exposed to a potential pathogen while on a field internship

rotation, necessary emergency care should be sought immediately. Any follow-up care

(or non-emergent medical care) must be coordinated through the CCA EMS Program as

required by the State of Colorado Workers Compensation Program. Students are asked to

follow these reporting procedures:

Notify your preceptor immediately.

Notify your Clinical Coordinator immediately (contact numbers are included

in this packet

Notify your Primary Instructor immediately. (Contact numbers are included in

this packet.)

Follow all agency/hospital reporting policies.

Complete the enclosed Incident Report, and return to the CCA EMS staff

within 24 hours.

Failure to comply with these procedures could result in a denial of compensation

claims by the state.

Incident Reporting

Should a student be involved in or witness an unusual or noteworthy incident that

may or may not cause injury or harm to any person, the Primary Instructor or

Department Chair should be notified immediately. Students should follow the

reporting policies of their host agency and document the incident on one of the

enclosed Incident Reports. This documentation should be returned to the CCA EMS

Program within 24 hours. The program will then takes appropriate action and

provide follow-up as necessary.



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EMT-Basic Acts Allowed

Acts that Basic students are allowed to perform under the direct supervision of a

preceptor (of equal or higher certification) while at his or her clinical sites include, but

are not limited to:

o Vital signs: pulse, blood pressure, respiratory rate, and breath sounds

o Airway management of patients: O2 delivery via nasal cannula, non-rebreather

mask, suction, OPA, NPA, and bag-valve-mask

o Physical assessments and histories of medical and trauma patients

o Ability to assist patients with the administration of their own medications (per

protocol: nitroglycerine, epi-pens, oral glucose, and metered-dose inhalers)

o Trauma management: C-spine stabilization and immobilization, bleeding control

and bandaging, bone/joint stabilization and immobilization

o CPR

o Any other reasonable basic-level skill (i.e. wound care and irrigation)



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The EMT Code of Ethics

Professional status as an Emergency Medical Technician

is maintained and enriched by the willingness of the

individual practitioner to accept and fulfill obligations to

society, other medical professionals, and the profession of

Emergency Medical Technician. As an EMT, I solemnly

pledge myself to the following code of ethics:

o A fundamental responsibility of the EMT is to conserve life, to alleviate

suffering, promote health, to do no harm, and encourage the quality and equal

availability of emergency medical care.

o The EMT provides services based on human need with respect for human dignity,

unrestricted by considerations of nationality, race, creed, color, or status.

o The EMT does not use professional knowledge and skills in any enterprise

detrimental to the public well-being.

o The EMT respects and holds in confidence all information of a confidential

nature obtained in the course of professional work unless required by law to

divulge such information.

o The EMT, as a citizen, understands and upholds the law and performs the duties

of citizenship. As a professional, the EMT has the never-ending responsibility to

work with concerned citizens and other health care professionals in promoting a

high standard of emergency medical care to all people.

o The EMT shall maintain professional competence and demonstrate concern for

the competence of other members of the Emergency Medical Services health care

team.

o The EMT assumes responsibility of individual professional actions and judgment,

both in dependent and independent emergency functions, and knows and upholds

the laws which affect the practice of the EMT.

o An EMT has the responsibility to be aware of and participate in matters of

legislation affecting the EMT and the Emergency Medical Services system.

o The EMT adheres to standards of personal ethics which reflect credit upon the

profession.

o The EMT who advertises professional services, does so in conformity with the

dignity of the profession.

o The EMT has an obligation to protect the public by not delegating to a less

qualified person any service which requires the professional competence of an

EMT.

o The EMT will work harmoniously with, and sustain confidence in associates,

nurses, physicians, and other members of the emergency medicals services health

care team.

o The EMT refuses to participate in unethical procedures, and assumes the

responsibility to expose incompetence or unethical conduct of others to the

appropriate authority in a proper and professional manner.



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Community College of Aurora

EMS Program Daily Shift Evaluation

Student: Please give this form to your preceptor at the beginning of the shift so they are familiar with what you are to be evaluated

on. This form must be completed and signed by your preceptor, and turned into your primary instructor at CCA before you can get

credit for the shift and the patient contacts.

Preceptor: Please take a few minutes at the end of the shift to complete this form. Please note that students cannot complete these

forms and will not receive credit for a shift if this form is not completed.

Student Name: ______________________________ Date: ____________________

Preceptor name (please print legibly): ______________________________________

Shift location:____________________________ Dept: ________________________

Please rate the student in each category using the following scale:

1 = Unacceptable – needs intervention and remediation.

2 = Tentative – needs frequent guidance.

3 = Competent – needs occasional guidance.

4 = Good – entry-level competence.

Topic Evaluated Score

Professional appearance and behavior

Ability to perform appropriate motor skills

Appropriate medical knowledge

Written and verbal communication skills

Preceptor comments or concerns: _____________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Preceptor signature: _______________________________________________



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Community College of Aurora EMS Program

Preceptor Feedback Form (To be completed by student)

Student Name (optional): ________________________________________________

Clinical Site: ________________Dept: __________________ Clinical Date: ____________

Preceptor Name(s) __________________________________________________________

Please take a few minutes to evaluate your clinical site and preceptors. Your input helps us

recognize valuable experiences and preceptors, while improving things that could be better. Use

the following rating scale:

1= poor 2 = fair 3 = acceptable 4 = good 5 = excellent

Score

A clinical preceptor was assigned and available to me upon my arrival.

My clinical preceptor showed me around the facility and introduced me to other

staff members.

My clinical preceptor took time to find out what I was there for and what I could

do.

My clinical preceptor explained what was expected of me and what I could

expect from my clinical.

My clinical preceptor allowed me to interact with patients and actively

participate in their care.

My preceptor allowed me to perform the skills that I am qualified to perform.

My clinical preceptor was readily available throughout my shift, answered my

questions, and offered constructive feedback.

My clinical preceptor showed enthusiasm towards teaching, and having students.

My preceptor was available to sign my paperwork and answer any questions I

had at the end of my shift.

Would you recommend this preceptor to other students? YES NO

Explain:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________



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Was this clinical site beneficial to your learning experience? YES NO

Explain:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Were the facilities and equipment adequate? YES NO

Explain:_________________________________________________________________

________________________________________________________________________

________________________________________________________________________

What would make this a more valuable experience?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________



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Dear Prehospital Preceptor:

Thank you for giving your valuable time to precept our CCA EMT Basic student today.

Each student should provide you with forms that explain clinical objectives specific to

their rotation today as well as being able to describe the acts that they are allowed to

perform while with you today. They should provide you with a performance evaluation

form for you to fill out and return to them at the end of their shift. Please be honest and

fair in your evaluation: we count on you to identify areas of weakness as well as strength.

We value your feedback immensely-you are the guardians that help us prepare the next

generation of EMS providers.

We hope that this experience is positive for both you and our student. If you have any

questions, concerns, or suggestions concerning a student of our program, please

don’t hesitate to contact the EMS staff at any of the following numbers:

Patrick Schooler, Department Chair 303-340-7217

Basic Instructors 303-340-7126

Angela Cutler, Clinical Coordinator 303-340-7219

Again, thank you for sharing your time and experience with our student today.

Sincerely,

Angela C. Cutler

Clinical Coordinator



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Most commonly used abbreviations in documentation

1. a…………......……before 2. AAOx____...........alert and oriented times______ 3. abd…………....….Abdomen 4. am…………..…… morning 5. ………….….….approximately 6. @.........................at 7. BP........................blood pressure 8. BS………….…......breath sounds 9. c...........................with 10. ………………….change 11. C/C………………..chief complaint 12. C/2…………………code2 / non- emergent 13. C/3………………...code 3/ emergent 14. C/4…………………code 4 / scene is secure 15. c/o………………...complaining of 16. CMS………………circulation, movement, and sensation 17. DOA………………dead upon arrival 18. DOB………………date of birth 19. Dx…………………diagnosis 20. .......................decreased 21. ea…………… ……each 22. ETA……………….estimated time of arrival 23. ETOH……………..alcohol 24. …………………equal 25. Fx………………….fracture 26. ………………….female 27. GSW………………gun shot wound 28. >……………………greater than 29. hr…………………..hour 30. Hx………………….history 31. ………………….increased 32. lbs…………………pounds 33. lg…………………..large 34. L ..………………..left 35. LOC……………….level of consciousness 36. <…………………...less than 37. ………………….male 38. MVC……………….motor vehicle crash 39. N/A…………..……not applicable 40. n/c……………..….nasal cannula

41. O……………..……none

42. NKDA………………no known drug allergies

43. NVD…………..…….nausea, vomiting, diarrhea 44. p…………………….after 45. PERL……………….pupils equal and reactive to light 46. POV………….……..privately owned vehicle 47. ……………….….psychiatric 48. pt……………………patient 49. PTA…………………prior to arrival 50. q…………………….every 51. R.....……..………....right 52. RR………….……….respiratory rate 53. R/O…………….……rule out 54. Rx…………….……..treatment or prescription 55. s……………...……..without 56. SOB…………..……shortness of breath 57. Tx…………..………treatment or transport 58. U/A…………….……upon arrival 59. unk………….………unknown 60. via………….……….by way of 61. V/S………………….vital signs 62. w/c………….………wheel chair 63. WNL………..……...within normal limits 64. wt…………….……..weight 65. x (‘s)………………...time(s) 66. y/o…………….…….years old

Patient positions: …………..laying on back …….……..sitting ……….…..standing …………...laying on stomach …………...standing on head (anyone paying attention?)

Student’s name

Date of call Shift location Medical Trauma Both

Patient’s chief complaint Patients age and gender

Patient care narrative ( Continue on back if necessary)

Past medical history

Medications

Allergies

Patient vital signs

Time Respiratory

rate Heart rate Regular?

Blood pressure

Pupils L R

GCS Eyes Verbal Motor

Skin appearance Pulse ox Blood sugar

/

/

Medical Interventions

Time Intervention performed

Patient’s response to intervention

Performed by:

Patient’s problem: Same as chief

complaint?

Yes No

Preceptor Name__________________________________ Preceptor Signature___________________

Community College of Aurora EMT Basic Student Patient Report Form

Z:\P&P and clinical manuals\Policies & Procedures 2011\Clinical and internship PP Basic Aug 2011.doc 16

Community College of Aurora

EMS Program

Incident Report

Student Name: ________________________________ Date: ____________________

Preceptor Name: ________________________________________________________

Description of Incident: __________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Student Signature: __________________________________________

Instructor Follow-up: ____________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Instructor Signature: ______________________________________________________

Z:\P&P and clinical manuals\Policies & Procedures 2011\Clinical and internship PP Basic Aug 2011.doc 17

Community College of Aurora EMS Program

Student Clinical and Field Ride Contract

I, __________________________________________________________________

(Print Name)

on ________________________________

(Print Date)

attended the required Clinical Orientation Class and have read the Community

College of Aurora Emergency Medical Provider Program Student Clinical Policies

and Procedures Manual.

I understand its contents and fully understand that failure to comply with or complete

any portion of the clinical requirements will result in a failing grade, and I will not be

allowed to graduate or participate in post-graduate certification testing.

Student Signature: _____________________________________________

Primary Instructor Signature: ____________________________________

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