Clearing New EMTs

[OoO 24]

I'm curious to hear what process agencies use to clear their new EMTs and ensure they are ready to run a call on their own.

One agency in which I belong to requires you to be supervised by another EMT until the captain feel you are ready. In the other agency I ride with, a written report is filled out after each supervised call you run and the cleared EMTs meet periodically to review the reports and decide when someone is ready.

How is it done where you ride?

[Goose 188]

Always had to do orientation tours of various lengths with an FTO. FTO would report back to a shift commander or Lt. Most places i've worked have generated paperwork about FTO tours, as well. Also, a few places i worked, the bosses would pop in on jobs give us a hand and then generate a field performance evaluation and review it with the reviewed employee at some point during the tour.

[Mark Z 18]

10 calls minimum with another EMT in the back with them and then it goes to the Chief (FD) who makes the decision to clear you but it is pretty close to automatic at that point. which says more about how well they are trained then it sounds. I only know of one person who needed more than ten calls and a couple who might have been cleared with less but did the ten anyway.

[PEMO3 523]

A new EMT should be placed with members that are designated as FTOs not just anyone. These members should be able to not only evaluate the new EMT's readiness to perform solo but be able to orient them to equipment locations, paperwork, routines, protocols, how to avoid bad habits, pitfalls of short cuts, etc. The FTO should be a mentor not a babysitter being there to make sure that the rookie is comfortable to be solo along with being able to perform solo. While a new EMT may have the skill set need to do the job he/she may be apprehensive about making those calls solo. A good FTO will foster that sense of confidence in them so that they can perform freely without second guessing their own actions. To put a time frame of 5, 10 or 15 calls on this experience is a disservice to both the organization, the patient and the EMT. When the FTO feels the EMT is ready then it is time. Also it is important to have an FTO that "remembers when" they were a rookie and how it felt to be evaluated, judged and looked at as unequal because they were "not as experienced". This mentoring attitude can go a long way to build that confidence level up quickly.

[ny10570 745]

A new EMT should be placed with members that are designated as FTOs not just anyone. These members should be able to not only evaluate the new EMT's readiness to perform solo but be able to orient them to equipment locations, paperwork, routines, protocols, how to avoid bad habits, pitfalls of short cuts, etc. The FTO should be a mentor not a babysitter being there to make sure that the rookie is comfortable to be solo along with being able to perform solo. While a new EMT may have the skill set need to do the job he/she may be apprehensive about making those calls solo. A good FTO will foster that sense of confidence in them so that they can perform freely without second guessing their own actions. To put a time frame of 5, 10 or 15 calls on this experience is a disservice to both the organization, the patient and the EMT. When the FTO feels the EMT is ready then it is time. Also it is important to have an FTO that "remembers when" they were a rookie and how it felt to be evaluated, judged and looked at as unequal because they were "not as experienced". This mentoring attitude can go a long way to build that confidence level up quickly.

In a perfect world, absolutely. However who has the resources to do this? Even you're former employer big bad FDNY can't get any kind of functional mentor program for their medics let alone the revolving door that BLS is becoming.

[PEMO3 523]

In a perfect world, absolutely. However who has the resources to do this? Even you're former employer big bad FDNY can't get any kind of functional mentor program for their medics let alone the revolving door that BLS is becoming.

Yes my post was written for a perfect world which is the direction every discussion leads. If you do not aim toward a "perfect world" then you may as well hang up your boots now. Also I do not believe anything in my post led to your line "big bad FDNY". Is every dept perfect - no. Does FDNY have a functional mentor program - yes and no. Most of the medics that like to precept ride alongs are "mentor" quality. Is BLS a revolving door - of course. In any department fresh young meat is cheaper than someone who is going to hang around, get longevity raises and vest a pension. All agencies sacrifice experience for the almighty dollar.

[x635 4,066]

When I started at Empress as a new EMT in 1997, we had like 3 weeks of classroom time and training everything from EVOC to stairchair and doing some ridetime, and afterwards you had to ride with an FTO for a bit. At the time, you had to start off doing transports, at three months you could bid to work a "Tac" bus (Yonkers 911 BLS ambulance), at 6 months you could bid to work as an EMT on an ALS bus in the Yonkers system after taking an ALS interface class and riding along 1 ALS shift, and after a year you could work Mount Vernon. After a year and a half, you could work Pelham 38-A-1. I felt this system work excellent because it allowed skillsets to be developed among EMT's before they moved onto the next level.

x129k was a very prominent FTO at Empress and was intergral in the program.

The better you were however, the faster you progressed.

[FiftyOnePride 100]

New EMT's ride with experienced Peers until they are deemed suitable of flying solo. For some has been quick, for others not so much. All depends on the individual.

[SageVigiles 1,194]

For New Fairfield, its 10 BLS calls where the "rookie" runs the call and does the report themselves (under the supervision of the senior EMT, obviously.) After that EMS officers make a determination as to whether or not the EMT is ready. Pretty good system but it takes a long time since a majority of the calls are ALS. But probably the best way to run it in a volunteer department where you can't run organized shifts with an assigned FTO

[ny10570 745]

Yes my post was written for a perfect world which is the direction every discussion leads. If you do not aim toward a "perfect world" then you may as well hang up your boots now. Also I do not believe anything in my post led to your line "big bad FDNY". Is every dept perfect - no. Does FDNY have a functional mentor program - yes and no. Most of the medics that like to precept ride alongs are "mentor" quality. Is BLS a revolving door - of course. In any department fresh young meat is cheaper than someone who is going to hang around, get longevity raises and vest a pension. All agencies sacrifice experience for the almighty dollar.

But this thread is about how agencies are doing it, not how we all wish it could work. My reference to big bad FDNY is the general belief that FDNY is the biggest and baddest agency in the land. Not a dig. FDNY has functional mentors. The system is shot.

New FDNY Medics now do 6 months assigned to mentor unit as interns. There is a list of skills, like assessment, presentation, IV access, intubation, pacing, etc that interns must track. However at the end of the 6 months or when the next medic class comes out (which ever comes first) all the medics are released to potentially become mentors themselves. For example, my internship was 5 months and one class later many of my classmates were mentors. As for the skill sheets, they all have ideal skill quotas, but how many people are pacing 5 patients in 6 months? Luckily no one cares. As long as the mentors don't raise serious objections to the intern moving on, away they go. Many of the good mentors are burnt out after the parade of interns and have been asking for transfers to different units. The crap ones don't care so don't get burnt. The program is at the point where interns are now being assigned to a unit for 2 weeks before being rotated to another station. The plan is to minimize the impact of poor mentors and quiet areas.

Its been a while since my BLS internship, but it was a similar format, intended to be 6 months with required skill sheets (although I didn't know about them and never submitted one, so how required are they). After 3 months there were a few vacancies and I was taken off my internship and assigned to a unit.

As far as the ride alongs go, I have no clue how they chose those. As a first year medic working with a miserable prick of a partner I was frequently assigned students for ride alongs until enough complained and the academy sent them elsewhere.