Clinicals & Ride-Alongs

Clinicals are where the book turns into real people. They are also, quietly, a job interview. Crews talk, and the EMS world is small.

Before your first shift

• Paperwork done: immunizations, background check, badge, and any site orientation your program requires.
• Know exactly where to go, who to report to, and when. Arrive early.
• Uniform clean and complete, per your program's policy. Hair and jewelry squared away.
• Bring: a watch with a second hand (or one that shows seconds), a pen that works, a small notebook, your stethoscope, a penlight, and whatever forms your program needs signed.
• Eat before you go and bring water and a snack. Calls do not wait for lunch.
• Review your scope of practice. Know what you may and may not do as a student at that site.

On the ambulance

• Introduce yourself to the crew and ask how they want you to help. Every crew is different.
• Ask about the rig. Where the jump bag, oxygen, suction, and BVM are. Be useful on the first call.
• Help with the unglamorous stuff. Restocking, cleaning the cot, carrying bags. Crews remember students who pitch in.
• Get your hands on patients when the crew lets you: vitals, history, assessments. That is what you are there for.
• Stay out of the way when it is serious. If the crew says "step back," step back without taking it personally.
• Scene safety is real. Follow the crew's lead on when to enter, where to stand, and when to leave.

In the emergency department

• Ask the charge nurse or your preceptor who you will be working with.
• Take a lot of vital signs. Manual blood pressures on real people are a skill you build with reps.
• Watch how nurses and physicians talk to patients and to each other. Watch EMS handoffs at the bedside.
• Respect privacy. Never take photos of patients, monitors, or charts, and never talk about patients outside of approved learning settings. HIPAA applies to students.

How to get more out of every contact

1. Before the patient: think about what the dispatch information makes you worried about.
2. During: do a structured assessment. Primary first, then history and secondary assessment.
3. After: ask your preceptor one specific question. "Why did you choose that hospital?" "What made you think this was a stroke?"
4. Write it down that day, with no patient identifiers: chief complaint, key findings, treatment, and one thing you learned.

What not to do

• Do not be on your phone.
• Do not do anything outside your student scope, even if someone tells you it is fine.
• Do not argue with your preceptor in front of a patient. Ask later.
• Do not fake it. "I don't know, but I'll find out" is a great answer.

This guide is general education written by Forrest Munden, a 21-year firefighter/paramedic and EMS educator. It is not medical advice and it does not replace your program, your state EMS office, your medical director, or your local protocols. Program requirements vary. Always confirm details with your own school and with the National Registry (nremt.org).