Yes. In one main way.
When you show a Labrador retriever a stick or a ball, they start to go a little nuts. They shake and whine until they get to retrieve. This same thing can happen when new paramedics see the drug box. Instead of shifting into deep clinical decision making, they shake and whine like the Labrador retriever until they get to stick some device or medication into a patient.
Maybe it isn’t exactly like that… but it seems that way sometimes.
We’re not saying that new paramedics’ decisions are bad. We’re just saying that there are times when more experienced medics might take a slightly more conservative approach—often, one with more clinical thought and less focus on opportunity to use a drug or device.
These differences fuel age-old stereotypes. New paramedics and those in training sometimes call their more experienced counterparts “slugs,” because they think the experienced medics try to avoid using meds and skills. For their part, experienced medics often sit back and sigh as the new medic treats a patient using what seems like an overly aggressive approach.
Here’s the difference between a new paramedic and an experienced paramedic, boiled down to two sentences:
The new paramedic says: I can give the medication.
The experienced paramedic asks: Should I give the medication?
For providers of any experience level, three questions will help sort out the most correct approach with a patient. These questions aren’t a traditional part of the patient assessment and decision-making scheme. Instead, they sum up the practical application of the “five rights” of medication administration:
- Does it matter whether I give this medication?
- Can it cause harm?
- Am I really doing it for the good of the patient?
One of the greatest pleasures in education comes from teaching the process of critical thinking. We can think of few things more rewarding than helping a new EMS provider learn a process for making good decisions. Educators aren’t the only influence here. Agencies, patients, and trial and error all help to shape a clinical provider’s thinking skills.
If you’re a trainer or a field training medic, we’d love to hear your responses to these questions:
How do you teach students decision-making skills?
How can education help to create providers with more clinical decision-making competence at the outset—and less Labrador retriever instinct?
We look forward to reading your comments!