Volunteer agency leaders are often discouraged by what seems like a lack of interest in continuing education or participation in monthly drills. Yet, ask any EMT if they want to provide the best possible care for their patients and the answer is a resounding “Yes! Absolutely!”
How do you, as an EMS leader, fix that disconnect? Find out exactly what kind of training your EMTs feel is meaningful and relevant using a SWOT analysis and change the way you provide education and practice. Low call volume requires creative, dynamic education, multiple opportunities for training and positive feedback. Here are 10 effective ways to develop confident EMS volunteers.
1. Practice like you play.
Standing around a manikin on the squad room floor or listening to EMS war stories posing as lessons does nothing to prepare an inexperienced EMT for reality. Experience develops pattern recognition and increases situational awareness. The ability to perform a rapid assessment, form a treatment plan and coordinate patient movement becomes second nature and builds self-confidence. Training and education needs to be creative and focused on effectively addressing that experience gap to develop competent, confident EMTs.
2. Build muscle memory.
Use a detailed scenario every training session. Start with the dispatch information and end with hand-off to the emergency department. Utilize moulage, and incorporate use of basic equipment such as stretchers, stair chairs, scoop stretchers and pediatric transport items such as car seats and restraint systems.
Load and drive your simulated patient around the block. During transport use the on-board suction and oxygen delivery equipment.
Keep in mind that most calls are medical and resist the temptation to challenge inexperienced EMTs with once-in-a lifetime calls and overwhelming trauma cases before they are confident with the basics of everyday emergency care. Always leave time for a post-scenario discussion to ensure everyone understood the exercise, and talk about what the group feels should be the next priority.
3. Practice documentation skills.
Designate everyone not actively involved in the patient scenario as scribes. Have them enter all pertinent details of the scenario into your ePCR just as they would for an actual call.
Create a folder full of scenarios for additional practice charting. Use fictional characters from Star Wars movies and television shows to keep it interesting and fun.
The only way to become proficient at navigating an ePCR is practice. Reward the completion of every 10 practice charts with a $10 gift card.
4. Take it to the street.
Whenever possible, get out of the station and into a public place for drills and practice. Invite members of neighboring departments to your practice sessions. Include local fire department and police, even public works personnel as often as possible. By working together, you can create multiple training opportunities, thus mitigating scheduling conflicts and giving members opportunities for extra training.
Public demonstrations are fun, challenging and give the community a chance to see local EMS in action. It also creates a captive audience to talk to about the use of 911, opportunities to volunteer and to answer questions about concerns and expectations.
5. Schedule field trips.
Visit assisted living facilities, nursing homes, group homes and senior centers. Use the visit to become familiar with the facility itself, practice interview skills and obtaining vital signs on real people in a non-emergent setting. Observe what normal baseline mental status and work of breathing looks like in people with chronic illness and dementia. Learn how to safely move elderly patients from wheelchairs and hospital beds, and the best way to interact with patients with autism or developmental disabilities. Most residents of these facilities love to have visitors and their regular caregivers can give valuable insight on how to provide reassurance as well as care during a crisis.
6. KISS your equipment.
KISS is an acronym for “Keep it simple, stupid!”
All EMS providers, not just volunteers, are notorious for letting “what if?” syndrome determine ambulance inventory. Streamline your ambulance inventory to the minimum required by your governing body and packaged in amounts that make sense.
Rethink your first in bags. You only need carry what you’d reasonably need to care for one or two patients in the first 10 minutes of patient contact.
Standardize the bag layout so every bag has the same contents in the same locations. Have the crew members work out of the first-in bag during transport. At the end of the call, restock the bag from the ambulance. Not having to think about where everything is during an emergency prevents confusion and fumbling around on scene or in transit. It also makes it simple to direct a first responder or bystander on scene to fetch an item you need.
Don’t be afraid to try new products, but use them to update your practice. Replace an existing item with the new product rather than adding another option to think about. You don’t need every splinting, bandaging or hemorrhage control product on the market; carry only what members are familiar with and are comfortable using.
7. Limit reliance on memory.
Provide and encourage members to use field guides, smartphone apps, checklists and pre-filled kits.
Consider purchasing a portable vital signs monitor with a printer. This takes the pressure off EMTs who might check a blood pressure or take a pulse only a few times a year. Having a tool to provide fast, accurate handoff information to intercept medics or ED nurses can minimize or eliminate made-up numbers, on scene delays and keeps the initial focus on patient presentation and history taking.
If you purchase a vital signs monitor encourage your EMTs to also take manual vital signs. Use the machine as an accuracy check and to take serial sets of vital signs during transport.
8. Involved medical director.
Do your volunteers need remediation or just reassurance and reinforcement? Work with your medical director on closing the information loop after each call. After-care follow-up and feedback is invaluable for all EMTs. Understanding what happens beyond the emergency department door goes a long way towards encouraging critical thinking and creates clinicians out of technicians.
9. Don’t skimp on the education budget.
The training budget must be realistic and non-negotiable. Provide access to a variety of media options including books, DVDs, print and on- line journals, phone apps and access to online CE classes. Keep training equipment, such as CPR manikins and AED trainers, in good condition and accessible for members to practice on their own time. Encourage attendance at seminars, conferences and CE presentations offered at hospitals and colleges. Cover or offset the cost of registration and travel.
10. Acknowledge strengths.
The quiet, compassionate EMT whose soft skills are second nature represents your agency in a meaningful way to patients. The eager newbie who asks a million questions is challenging the status quo. Older members are the tribal elders. They are the historians, protectors of the core principles and culture that provided the foundation for today’s EMS. All members are unique and vital components of your squad and they need to hear that at every gathering, not just at award banquets.
Keeping your EMTs interested and engaged in continuing education is challenging. Giving your squad members the tools they need to succeed is investing in the agency’s most valuable asset.
“We don’t rise to the level of our expectations, we fall to the level of our training.”
- Archilochus
What are your tips for developing confident and skilled EMS volunteers?
