Public Safety Training Facility

Monroe Community College
Rochester, New York

MCC Paramedic Program at Strong Memorial Hospital

Paramedic Student Handbook

Table of Contents

1.Mission Statement                Student Dress10. 

2.Course Description Patient Care Restrictions11.

3.Clinical Preceptor Role Illegal Substances12.

4.Communications Clinical Objectives13.

5.Problems or Questions Documentation14.

6.Student Health Evaluations15.

7.Incident Reports Patient Care Report16.

8.Media Policy Skill Tracking Log17.

9.Patient Confidentiality Universal Precautions18.

1. Mission Statement:

Educational programs administered by Strong Memorial Hospital will provide quality medical education to prehospital professionals within the region of Monroe and Livingston Counties of New York. To this end, the Hospital will maintain cooperative education agreements with Monroe Community College. A continuous quality improvement program insures that high standards of practice and integrity are maintained.

2. General Course Description

The Emergency Medical Technician-Paramedic (EMT-P) provides prehospital emergency medical care under physician direction to patients sustaining illness or injury. The curriculum of this 12-month, certificate program is designed to provide the student with theoretical and practical aspects of emergency medical care in the prehospital setting, and meets the State of New York curriculum requirements.

3. Role of the Clinical Preceptor

The role the clinical preceptor is extremely important to the development of an outstanding paramedic. At no other point in the curriculum is there a closer integration to applying the didactic knowledge and basic laboratory training to actual patients in a controlled clinical setting. The preceptor will find, teach, and validate specific paramedic skills within the hospital setting. Students will be evaluated using clinical area objectives in specific skills in accordance with the attached evaluations. Using the standard program data collection form, the preceptor will evaluate each student after each clinical assignment. Evaluation information may be from direct observation or supplied by other health professionals that have interacted with the EMT-P student.

4. Communications

Day to day communications between the preceptor and Office of Prehospital Care (OPC) will occur by two methods. A mailbox will be located in the ED area, by the department mailboxes. Completed evaluation forms should be placed in the mailbox at the end of each shift.

The second method of communication is by phone or pager. This format should be used if a problem or question arises during clinicals that requires an immediate response. Those numbers, in order of precedence are found below.

5. Problems or Questions

In the event of an urgent problem or questions involving the clinical preceptor experience, the people below should be contacted in listed order.

a. Craig Weise, RN, EMT-P - EMS Clinical Coordinator.

b. Melissa Brokaw, MD - Medical Director of Prehospital Education.

Preceptors are encouraged to use common sense and experiential judgment in solving the problem at hand. If necessary, a student may be suspended from the remainder of the clinical shift pending further investigation of the problem. (See the Clinical Termination Policy)

6. Student Health

No formal arrangements are in place by the Hospital nor its affiliates for the provision of student health services. Routine health care for program participants should be provided by the student's primary care provider. Emergency medical care for program participants will be provided by the closest appropriate medical facility. Any incident requiring emergency treatment will be documented and reported to the EMS Clinical Coordinator and the Medical Director immediately.

The students have signed a Student Agreement whereby they are responsible for the treatment of accident, illness, or injury suffered in the course of the education program.

7. Incident Reports

An incident is any occurrence which is inconsistent with the routine operation of the agency, classroom or routine care of a person.

The incident report is filled out when an event, as described above, involves a patient, visitor, employee, student or instructor. This report should be filled out completely and confidentially returned to the Coordinator. Completion of an incident report should NOT be documented on the ED record, student evaluation or student PCR. (See Appendix B)

Should an event involve SMH equipment, facilities and/or a patient. The standard SMH incident report MUST be completed and a copy should be attached to the program incident report.

8. Media Policy

Access to information by the media shall be coordinated by the SMH Public Information, Marketing Department and MCC. This shall include, but not be limited to, financial information about SMH; its departments, or patients; photographs and interviews of patients, visitors, and employees; and information about patients' conditions. This policy applies to all students in all phases of the Paramedic Program. Failure to comply with this policy may be grounds for dismissal from the program.

9. Patient Confidentiality

During clinical rotations the students are exposed to privileged patient information. This information must remain strictly confidential and only discussed with other health care professionals involved in the patient's care. Students may discuss medical diagnosis and interventions done during clinical time, but no references may be made to specific patients. No part of the patient's chart may be copied or taken outside of the clinical area. The only exception is EKG rhythm strips that have no patient identifiers on them. These are to be used in class and for educational purpose only. Any discussion of a patient outside of these guidelines may result in immediate dismissal from the clinical program.

References: Strong Memorial Hospital Policy; Section 6.2.1

Public Health Law, Sections 17, 18, 498, and Article 27-F

10. Student Dress

In order to maintain a professional image, dress code guidelines are to be followed by all students at SMH. Any questions concerning these guidelines should be addressed to the coordinator. Inappropriately dressed students may not be allowed to attend class, clinical rotations, or internship sessions. Please see the MCC Student Handbook for class dress code policy.

Clinical Dress Code

The Strong Memorial Hospital paramedic student uniform must be worn during all clinical rotations. The uniform must be neat, clean, pressed, and meet the following specifications. The student is responsible for purchasing and maintaining the appropriate clothing for the clinical rotations.

Shirt: White button down style, long- or short-sleeved uniform shirt. Neckties are optional.

Any garment worn under the shirt must be white and not visible below the length of the sleeve.

Pants: Dark blue pants

Lab Coats: White, hip-length (short), blazer style lab coats with long sleeves must be worn.

Shoes: Shoes or boots must be black and made of non-porous material. They must be clean, shined, and in good repair.

Badge: Student ID badges must be worn at all times. The badge must be clean and no part of it may be covered or altered. Replacement of lost badges is at the cost and the responsibility of the student. Badges are to be worn above the belt with the picture and title full visible at all times while on the clinical campus.

Scrubs: Hospital supplied scrubs may be worn in the Operating Room and in Labor and Delivery only. The white, short lab coat and ID Badge must be worn at all times unless student is dressed in sterile gown.

Other: No radios, telephones, voice/tone pagers, or other portable communications equipment may be worn during clinical rotations.

11. Patient Care Restrictions

During the EMT-Paramedic course work the student will not be allowed to have participation in certain procedures. Specifically, the student may NOT:

1. Perform any advanced level skills without the presence of their preceptor or other designated RN or MD.

2. Administer any medication without prior instruction and presence of preceptor.

3. Have any participation (other than observation) in the administration of blood or blood products.

4. Administer insulin.

5. Administer heparin or other anticoagulants without preceptor's assistance in dose calculations and presence at time of drug administration.

6. Have any participation (other than observation) in the insertion of central venous catheters or CVP determination.

7. Have any participation (other than observation) in the insertion and/or manipulation of the diagnostic procedures associated with a Swanz-Ganz catheter or other type of invasive hemodynamic monitoring device.

8. Have any participation (other than observation) in the insertion or care of a transvenous pacemaker.

9. Administer an enema.

10. Administer any thrombolytics.

NOTE: It is the student's responsibility to KNOW AND ABIDE BY ALL RESTRICTIONS. Failure to comply with restrictions will result in disciplinary actions which could include termination of training.

12. Illegal Substances

Any student that is suspected of being under the influence of drugs or alcohol will be asked to leave the clinical site immediately. Behavior consistent with illegal substance abuse needs to be documented, witnessed and co-signed by an administrative representative of the facility. The student will be treated in accordance with existing SMH policy.

13. Clinical Objectives

Clinical objectives will be developed for each area of the hospital that a student may be precepted. These objectives will be based on the skills afforded by each individual area and generally sequenced so the skill is demonstrated or discussed in class prior to its requirement in clinical. This is particularly true of invasive patient skills.

It is recognized that many students may already be certified as an EMT-Intermediate or EMT-CC and may be asked to perform skills out of the curriculum sequence. As a general rule, EMT-I's/CC's must follow the curriculum progression in the same order as the EMT-Basics.

14. Documentation

The EMT-P student may document vitals, medications given or other pertinent data on the patient charts only when it is observed and cosigned by the preceptor. The student Patient Care Report is NOT to become part of the patient's chart.

15. Evaluations

The principle tool for documentation of student skills will be the "Clinical Evaluation form." Students are responsible for filling out all portions of the form with the EXCEPTION of: 1) Grade, 2) Preceptor initials, 3) Comments.

Preceptors are encouraged to document as they deem appropriate. Positive assessments and evaluation are especially encouraged. Remember, your analysis of this clinical education portion is a critical component to paramedic program.

Students are required to complete the preceptor/clinical evaluation after each clinical shift. This evaluation must be completed and returned as directed for the student to receive credit for the clinical shift.

16. Patient Report

Each student will complete at least eight patient care reports (PCR) during clinical courses. Reports should be clearly written progressing in a logical format. Formats may include but are not limited to "head-to-toe," "primary-to-secondary," "A-B-C-D-E," etc. The goal is to collect, present and document objective data within the prehospital arena. When grading the PCR, a penalty will be assessed for each misspelled word or inappropriate abbreviation.

The patient care report should be completed as follows:

a. Two patient initials (No full names)

b. Clinical date

c. Patient age

d. Race C=Caucasian, AA=African American, H=Hispanic, O=Other

c. Sex M/F

f. Estimated weight Lbs/Kg

g. Estimated height

h. Procedures

i. EKG interpretation

j. Vital signs Minimum of one on AEC/Diag patients

Minimum of two on Major/21 patients

k. Times Chart in military time

l. C/C Concise Chief Complaint

m. Hx Chart a pertinent history

n. Meds Chart pertinent medications

o. Allergies Documented of "NKA!' and by whom

p. Narrative Chart a logical narrative that "paints a picture of this patient." If the student chooses to do this in a prehospital radio report format, that is acceptable. Two questions need to be answered:

i) Could this report 'stand alone" if used in legal proceedings?

ii) Does this report convey reasonable and prudent standard of care?

q. Impression This is a "reality check" question. It should not be scored as part of the documentation criterion; however, if problematic, needs to be noted in the comments.

r. Student signature

s. Attach and interpret an EKG strip

17. Student Skills Tracking Log

The Skills Tracking Log (SKL) is an informal tool used by the student to record overall progress of skills completion. It is quantity oriented.

18. Universal Precautions

Students in the Emergency Department are at risk for exposure to blood borne pathogens and infectious diseases. All bodily substances should be considered potentially infectious. Personal protective equipment (PPE) is readily available in the ED and should be used at any time where possible exposure to blood borne pathogens. The minimum recommended PPE includes:

Gloves: Disposable gloves should be worn BEFORE initiating patient care when there is any risk of exposure to bodily substances. This includes any invasive procedures ( e.g. starting IVs). Some procedures require sterile gloves as well. When gloves have been contaminated, they should be removed and properly disposed of as soon as possible. This is mandatory to prevent transmission to other patients and/or equipment. Always wash hands after gloves have been removed. For students with latex allergies, alternative gloves are available.

Masks and Protective Eyewear: Masks and protective eyewear should be worn when there is any risk of blood or other bodily fluids splashing or spattering. This includes intubation, childbirth, trauma patients, open fractures, etc. Both patients and health care workers should wear masks when there is a potential for airborne transmission of disease. Standard corrective eyeglasses are NOT sufficient protection.

Gowns: Gowns should be worn when there is any risk of blood or other bodily fluids splashing or spattering. This includes intubation, childbirth, trauma patients, open fractures, etc.

Special consideration: Trauma patients: When treating any trauma patient when there is any risk of exposure to bodily substances, gloves, gown, mask and protective eyewear MUST be worn. All of the above must be worn if the student is to enter within the "red lines" of the trauma room.

Hand Washing: Hand washing is mandatory before and after any patient contact. All students must wash their hands after eating or using the restroom facilities.

Any student who is exposed to a patient's bodily fluids should immediately decontaminate themselves and report the incident to their preceptor.


URL: /depts/pstc/backup/paraclpo.htm

Updated: Sept. 15, 1999