1. Paramedic Clinical & Internship Requirements

2. Remember, it is the total number of successful experiences that count! Program Requirements:  256 Hours (minimum) hospital – Subspecialty  264 Hours (minimum) Internship  Clinical agreement to be initialed and signed  Instructor and/or Medical Director permission

3. Eligibility  EMT-B Licensure and/or NREMT Certification  Must have an 80% in class  IV skills signed-off by Instructor  Intubation skills signed-off by Medical Director  Immunizations completed Reminder: all immunizations must be current…Tb within 1 year, if it expires during your program you must get another or you will not be allowed to go to clinicals and this will not be a reason for clinical extension.

4.  University of Michigan - ER, OR, Trauma burn, Peds ER, Psych, L&D, CCU  St. Joseph Mercy - ER, Peds ER, Psych  Chelsea Hospital - ER, OR  Henry Ford Wyandotte Hospital - ER (will be available 2012)  Heartland Skilled Nursing Center

5. By the END of Module 2  16 Hours in the U of M or Chelsea Hospital OR with 5 successful intubations.  16 Hours at Heartland Skilled Nursing Center with a minimum 6 of the total 25 required “complete” geriatric assessments. Must complete a head to toe assessment including medications and patient history  48 Hours required in the Emergency Room Emphasis will be on airway, IV and assessment skills complete assessment minimum of 2 patients PER SHIFT/written. Skills tracker for each clinical Fisdap: 2 patients assessments/and skills

6. By the END of Module 3 All students will be required to PASS their AHA ACLS provider program during this module.  8 Hours at the CCU (critical care unit) with an emphasis on the pathophysiology of acute/chronic pathology including long term treatment goals.  72 Hours required in the Emergency Room Emphasis will be on a wide range of emergent etiology with emphasis on Cardio-pulmonary assessment and management.

7. By the END of Module 4  16 Hours at the U of M Trauma Burn Center with an emphasis on the effects of trauma and burns with regards to acute/chronic pathology including long term treatment goals and outcomes.  48 Hours required in the Emergency Room Emphasis will be on a wide range of emergent etiology with a focus on a greater understanding of the emergent patient assessment process and intervention.

8. By the END of Module 5  16 Hours at the U of M Pediatric ER with an emphasis on the assessment and treatment challenges that pediatric patients pose in addition to IV and airway skills.  8 Hours at St. Joseph Labor & Delivery or U of M L & D Emphasis will be on witnessing and/or participating in the assessment of newborn. You will also consider all the physiological changes that occur with expecting mothers.  8 Hours at the U OF M Psychiatric unit  Emphasis on the “careful” assessment and questioning techniques utilized with behavioral emergencies.

9.  Professionalism - Attendance mandatory - Never being late (BE 15 MINUTES EARLY) - Taking the initiate to participate - Asking valuable questions - Never leaving early - Patient confidentiality HIPAA - Attitude regarding the clinical experience - Looking professional (uniform & hygiene) - Never using profanity Respecting & learning from other medical professions!

10. Let’s take a look at the clinical forms!  HVAEDU.ORG (website for all clinical forms) All student clinical forms, directions including FISDAP scheduler and skills tracker is under the student zone Paramedic tab. www.hvaedu.org

11. Quality assurance starts with you!  A Clinical and Internship scheduler  A skills tracker  A clinical quality marker  Provides program with benchmark goals reports required for graduation and accreditation!

12. Let’s take a look at FISDAP  You will be issued a FISDAP serial number  Must sign up or cancel a minimum of 7 days prior to clinical or internship experience  Print your schedule  Do not sign up for shifts unless you can for sure  Be sure to enter “ALL” data and skills performed within 72 hours  No back-to back shifts  Trading shifts with classmates is permitted  You are required to keep up with your data entry for Graduation. www.fisdap.net

13. Attitude makes up approximately 99% of the outcome!  Transitioning from classroom cognitive knowledge to clinical hands-on skills increase NR pass rates  Networking with different clinical healthcare professionals  More in depth understanding of the patient care continuum  Training provided by 2 of the top world renown healthcare and research facilities  Training with the largest accredited ALS Paramedic fleets in Michigan  Limited opportunity to learn skills that will last a lifetime

14. Please remember, this is your education!  DO NOT get behind with your clinical rotations  DO NOT get behind with your clinical paperwork and data entry within 72 hours  DO NOT forget to make copies of all of your clinical work  DO NOT miss a clinical  DO NOT turn in paperwork that is “substandard”  DO NOT falsify any documents and/or signatures  DO NOT show up without the proper paperwork, uniform/ID  DO NOT take these clinical experiences for granted

15. When arriving, always report to the nurses desk and introduce yourself.  ER rotations: Require 2 complete assessments and documentation per shift  OR Chelsea primarily utilizes LMA and not ET induction  CCU Requires drug sheets and some pathology research  Geriatric Assessment: Requires a full head to toe assessment including drug sheets and pathology research  L&D may require you to return to observe/participate in a delivery and assessment

16. DO NOT WAIT UNTIL IT IS A CRISIS!  Clinical coordinator lanaya@hva.org

18.  Will occur in Module 6 no earlier than SCHEDULE or INSTRUCTOR PERMIT  Must have an 80% in class  All Hospital including subspecialty rotations must be complete  All internship rotations will be conducted with HVA  All students will be required to meet all benchmark skills as mandated by HVA clinical and internship guidelines  Any student who fails to meet the minimum requirements will be subject to being assigned additional internship hours as applicable.

19.  Appropriate uniform and ID badge  Bring bagged lunch  Always demonstrate professional & ethical behavior  Take initiative  Be honest and sincere  Understand your limitations  Know when and how to “stand down”  Respect the crew’s space  Sign up for 1, but no more than 2 cars (maintain same mentors)  Riding on cars that provide good experience  Student assessments including narrative on all patient encounters including being entered into FISDAP

20.  Orientation of rig, drug box and basic operation of equipment as required  Review performance  Be fair and non judgmental  Complete student evaluation forms including signature  Review student PCR for accuracy and completeness  Dismiss students who fail to participate or demonstrate unprofessional behavior  Discuss issues as appropriate  Act as a responsible “role model”

21.  Rides 1 - 5 - All v/s taken manually - Familiarize yourself with all ambulance compartments and equipment including drug box - Gain more confidence by interacting with patients - Set up and attempt to start all IV’s - Set up and conduct all 12 lead ECG as appropriate - Learn how the senior and junior Paramedic prefer to interact with patients - Work on good patient moving and packaging skills - Focus on proper documentation

22.  Rides 6 - 11 - Continue to improve patient interaction and questioning - Complete the RN/LPN hospital reports - If comfortable, consider giving radio in-bound report - IV skills should start to show marked improvement - If permissible, consider ATTEMPTING advanced airway skills (ET) - Interact during any mega code or critical patient as permissible an/or appropriate

23.  Rides 12 – 22 or completion - Continue to improve patient interaction including confidence with decision making - Complete full patient assessments - Continue to build mentor trust with your assessment questions including treatment options and patient care decisions - Manage all aspects of a “stable” ALS call

24.  All internship patient care PCR paperwork including mentor signatures should be copied  A mid-point and a final evaluation will be conducted by the senior medic/mentor  All paperwork will be audited for accuracy and completeness  All ‘benchmark’ goals must be achieved prior to the conclusion of the internship rotations  All paperwork must be signed-off by instructor and/or clinical coordinator (original signatures must be retained for file)  Student will conduct a complete write-up on all patient encounters.

25.  Recognize the need to treat the patient, family FD, PD and co-workers with respect  Able to discuss difference of opinion &/or patient care in a respectful manner  Refrains from using derogatory or demeaning language  Able to relate why protecting & respecting patient confidentially & dignity is necessary  Able to manage patient care while accommodating patient's limitations  Critically evaluate mistakes made in patient care & works to improve performance

26.  Has the student been punctual, dressed appropriately and had the proper paperwork?  Does this student take initiative to complete assignments?  Does this student follow through on task without constant supervision?  Does this student speak clearly, write legibly and communicate well with the staff?  Do you feel this student has the skills necessary to be an effective entry level paramedic?  Would you recommend that this student pass or fail the internship program? Failure means remediation is necessary along with additional third-rides with another F.I.

27.  Contact me via EMAIL at lanaya@hva.orglanaya@hva.org  Come prepared for weather, with your paperwork and uniform (jackets) and ID  Please read directions to each specific area as well as parking and how to get in...  Contact me ASAP with ANY problems  Remember…be on time…they will not wait for you!

28. DO NOT WAIT UNTIL IT IS A CRISIS!  Clinical coordinator lanaya@hva.org