County of Fauquier Department of Fire, Rescue and Emergency - - PowerPoint PPT Presentation

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 need remediation.

• Provide FEEDBACK. ALL feedback should be:
• Constructive
• Specific
• Frequent
• Valid
• Maintain a PROFESSIONAL demeanor. Lead

by example at all times.

• Each call is a new opportunity. Focus on

current situation and move past previous mistakes.

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
• r 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

• Recipient open to feedback
• Changed behavior
• Describe student/intern Behavior
• Personal Impact
• Accept responsibility (Preceptor & Preceptee)
• Understanding
• Encouragement

Positive Feedback

Communication Stoppers Don’t Do This…

• Interrupting
• Ridiculing or blaming
• Ignoring/denying feelings or ideas
• Mind-reading or assuming
• Controlling
• Ordering/commanding

(Enhanced) -AEMT-Intermediate and Paramedics

Five Characteristics of an Effective Preceptor

Do you have what it takes?

• Strong desire to EDUCATE as well as TRAIN
• Technically proficient
• PATIENCE
• MOTIVATION – COMMUNICATIVE
• MATURITY AND RESPECTFUL

Is this what we want them to think?

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

• n-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

• ccur 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

• btaining 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

• n 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

PROTOCOL TEST

• Once all required paperwork has been completed and ready to be submitted to the

Training Division, the Intern needs to make an appointment to come to Training to take their PROTOCOL TEST.

• They must score a 90% or Better on the TEST
• Their paperwork will be reviewed and once approved, it will be forwarded to the

OMD for their signature and then to the Chief for his signature and Release.

• They will be issued their KEY (when appropriate) and they are off and running!!
• Congratulations on a JOB WELL DONE!!

Now, please proceed to the

• nline Review for completion

Go to the Online Review