1. OK, I am a Graduate Paramedic….Now What?
Ten things expected to be demonstrated….EVERY TIME the tones go off!

2. I am only good as my last call. What a cliché, right?
Not one of the ten, but…

3. The Plan… Prepare graduates to understand the realities of EMS work.
Understand the affective domain's importance for program graduates.
Redirect students toward compassion for patients and the job.

4. Your Annual Evaluation Happens Everyday…
Every call is a final exam (for someone)
Attitude
Facial expression
Tone of voice
Words
Clinical competence
Knowing what you don’t know and admitting it!
Teachable moments

5. Decisions… Integrity…
Fifteenth call of the day is the 3rd time you have been to see 82 y/o Aunt Molly for non-specific complaints.
Integrity…

6. Patients Live in Spite of Us…
You are called to a 43 y/o asthmatic that the fiancé says has been getting progressively worse over the last 4-6 hours and Rx meds are not helping. What are you supposed to do? What did you do?

7. The Job Will Direct Your Growth…
Mentally
Emotionally
Personally
Professionally

8. Speak your mind, your patients expect it of you…
You’ve brought Mr. Roberts to the ED twice in the last 5 days from an assisted living facility for the same complaint of non-descript itching and skin splotches. Only difference today is mild diaphoresis and raspy voice. Nurse directs you to triage since the ED is swamped.
Patient just began taking a new medication for Parkinson’s symptoms.

9. There are good days and bad days…
Babies are born without complications
AED shock and your patient awakens
Tourniquet stops arterial bleed from the chainsaw injury to the arm
Telling a wife her husband is dead after an unsuccessful resuscitation
4-legged family member doesn’t survive the collision that your patient walks away from

10. You do make a difference…
EMS and United Airlines do the same thing most of the time…
Move people from point A to point B
The difference is…
your attitude
your reaction to their need (not yours)
Holding a hand and a conversation is a therapy

11. It’s about the 5%... You wont affect 95% of the people you encounter
We aren’t the author of miracles, we just get to deliver them occasionally…
Being the intervention in an abusive situation
Resuscitating the 42 y/o father at his son’s birthday party
Listening to the suicidal patient while convincing them to go to the hospital after taking an overdose of Tylenol

12. Learning begins the day you graduate…
Multi-unit apartment fire with multiple burn patients and you are the only ambulance on-scene and a mother is in labor across the street
You deliver your small caliber GSW to the shoulder patient to the ED and the doc asks if there is an exit wound…
You are the “red patch” on the scene of an unsuccessful resuscitation of a 50 y/o man and the wife is in the next room…

13. Just Breathe… Sometimes that is the only thing you can do…
You can’t fix everything
Sometimes the job will suck
Stick it out and seek others to help you through it
Sometimes it will be rewarding
Relive those moments often
Never give up

14. Final Thought…
There will come a point in your career where you will be faced with a decision…
Do what’s easy or do what’s right?
Never let fear or hopelessness or anything keep your from doing what’s right!

15. Questions? Presentation will be available via Tex-EMS website or
See me with a flash drive

16. Full Disclosure… The examples are from personal experiences.
The lessons are the same and the concepts are important for your graduates
This is the affective component of the curriculum…