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Google’s #1 result for “Overeducated Ambulance Driver!”*
Yeah, baby!
And my high school guidance counselor said I’d never amount to anything.
Well put that in your pipe and smoke it, Edith Shankle! Who’s the loser now, beeyotch?
*Thanks to Overeducated Twit for the help. I couldn’t have done it without her.
…and his blog. Bob and his wife Colleen live in Colorado, with eight children.
Bob posts mainly about his children; their trials and tribulations, and all the funny and tragic little moments that come with raising kids.
He also posts photos of gorgeous flowers and breathtaking Colorado scenery.
But that’s not why I read.
You see, two of those eight kids are foster children – two young children that have suffered unspeakable abuse and neglect at the so-called parents and family that should have loved them. They’ve suffered serious emotional trauma, and exhibit significant psychological and behavioral problems as a result.
Yet Bob and Colleen took them in, and willingly assumed the monumental task of molding two young lives and repairing the hurts they’ve suffered.
You can’t take on a job like that unless you love kids. You can’t do it well unless you love those kids. And they offer that love unconditionally, knowing that eventually, those kids will leave, and the permanent role of parenting will be assumed by someone else. It takes special people to do that.
And that’s why I read Bob’s Blog.
He restores my faith in the innate goodness of people. Whenever my job beats me down, I read his blog to remind me that good and giving people are out there, and more common than you think.
You’re a good man, Bob Agard. Would that the world had more like you.
…Farmgirl is being interviewed by Mark at Blog Talk Radio tonight at midnight, CDT.
I missed Squeaky Wheel’s interview last week and had to settle for listening to the archives. I was hoping Mark would browbeat her into favoring us with an aria, but sadly…nope.
[I'd have probably been screaming Freebird! in the background anyway, Squeaky.]
I say we all get likkered up and call in repeatedly, asking Farmgirl if her refrigerator is running or if she has Prince Albert in a can.
I’ve got an electronic fart machine and a case of Budweiser, and I ain’t afraid to use ‘em…
Reading Babs’ blog today, I found her offering sage advice to someone who found her blog by searching for “keys to living single life.”
Funny thing is, I used much the same search words today, but for a much more prosaic reason:
Thank you, Google. You truly are a wonder.
Disclaimer: All non-medical readers browse the archives now. Otherwise I can’t be responsible for the drowsiness this post will induce.
One of my readers is going through paramedic school, and has arrived at that portion of the course that all medic students dread…
Pharmacology.
[cue sinister Psycho music: reep reep reep reep!]
More specifically, dosage calculations. Rookie Bebe, I feel your pain, because I too suck at math.
Well, I don’t actually suck at it. I can understand mathematical concepts, and if I apply myself, can actually make decent grades in math.
What I lack is the academic discipline required to excel at it. I don’t need a math tutor. I need R. Lee Ermey standing behind me, bellowing, “You call that a quadratic equation, maggot? What the fuck is your major malfunction, numbnuts?? I WILL motivate you, Private AD, even if it short dicks every damned math geek in MENSA! Now drop down and graph me a parabola!”
Calculus is the main reason this blog isn’t called A Day In The Life Of An Emergency Physician.
Luckily, you don’t need calculus to do dosage calculations. Hell, if you can do fourth-grade math, you can calculate a dose.
Yes, you read that right. Not to put any undue intimidation on any would-be medic students, but if you can manipulate a fraction and understand the metric system, you can calculate any drug dose you want. If I can do it, I know you can do it. All you need do is remember a few basic rules, and a couple of formulas.
So, without further ado, I present Ambulance Driver’s Tips for Med Calculations:
1. Calculations ain’t the most important thing in the pharmacology section. Seriously folks, it’s just rote memorization. Memorize the formula, plug in the numbers. It is FAR more important to understand, in depth, the pharmacokinetics and pharmacodynamics of every class of drug you may be asked to administer. Do not limit this knowledge to your “drug box” medications. If you know how a drug reaches its site of action, how it works, and how it is metabolized and excreted from the body, you will be far ahead of most of your colleagues. By knowing these things, you will automatically be able to grasp why you’re giving a medication, and more importantly, why not. Don’t be one of those “because it’s in the protocol” medics.
2. Cheat. Use a calculator, write down your most commonly used formulas, use a pocket dosing guide…whatever it takes, and whatever your instructor allows. A smart EMT knows when to use his references.
3. Convert everything to like terms. If, for example, you are asked to provide the answer in milligrams or milliliters, but the theoretical drug s supplied in apothecary measurements, you must convert the apothecary measurement into metric.
This actually only applies to paramedic class. You see, we paramedic instructors just luuuurve to torture students by giving proposed drug concentrations in measurements that haven’t been used in fifty years. It’s just what we do.
Why? Because our instructors did it to us, that’s why. My paramedic instructor took perverse joy in asking us to convert from minims to milliliters. Deal with it. If you need help, try this site.
Ask him to hand the phone to a physician who was trained in the latter half of the twentieth century.
You don’t want to be taking orders from a doc who remembers the invention of penicillin and still thinks of paramedics as those guys in white smocks who drive the high-top Cadillac for the funeral home.
4. Memorize the following formulas:
Drug Dosage Formula:
(dose ordered X volume on hand) / concentration = volume to administer
Drug Infusion Formula:
Volume to administer X drip factor = drops per minute
IV Fluid Infusion Formula:
volume to administer X drip factor) / time in minutes = drops per minute
6. Reduce to lowest terms. Cancel out any like terms in your numerator and denominator.
7. Solve.
Here’s an example problem, straight from the horse’s mouth blog:
Atropine is ordered for your pt 0.7 mg I.M. stat prior to surgery. You have atropine gr 1/120 per ml. Give ____
First, convert the apothecary measurement to metric. 1/120 of a grain equals 0.5 milligrams.
Now plug in the numbers:
Reduce to lowest terms, and cancel like terms. This one can’t be reduced, so the only canceling we can do is remove the milligrams in the numerator and denominator, leaving only milliliters left, which is what we want to know.
Solving the problem leaves us with 1.4 ml to administer to the patient.
Simple, no?
This formula will work with Questions 1, 2 and 3, Rookie Bebe. Question 3 has a number of red herrings:
The only pertinent numbers are KCl 5 mEq (dose ordered), and 20 mEq/ml (concentration and volume. What a gift!). Plug ‘em into the formula.
[5 mEq (dose ordered) X 1 ml (volume on hand)] / 20 mEq (volume on hand) = 0.25 ml
Questions 4 and 5 can be answered using the IV Fluids Infusion Formula:
_____ml/h. _____ml/min. ______gtt/min
Reduced to lowest terms:
(1000 ml X 12 gtt/ml) / 480 minutes = (1000 X 1) / 40 = 25 X 1 = 25 gtt/min
Now convert 25 gtt/min to ml/min.
25 divided by 12 (gtt/ml) = 2.08, or roughly 2.1
2.1 ml/min X 60 = roughly 126 ml/hr.
In my experience, medic students tear their hair out doing dosage calculations for two reasons:
Solution: Use a calculator. If your instructor won’t let you during class, then take your time and check your work. Then, on the truck, use the freakin’ calculator.
2. They don’t know how to eat an elephant.
Solution: One bite at a time. Don’t look at the elephant. Just grab your fork and dig in. Nibble at little pieces of the problem, until eventually, you look up and the elephant is gone.
And of course, no insanely boring educational blog post would be complete without a little lagniappe, so here it is:
Ambulance Driver’s Superhuman Calculate the Dopamine Dose In Your Head Trick:
For any standard mixture of dopamine (400 mg/250 ml or 800 mg/500 ml), the following will give you an infusion rate equivalent to 5 mcg/kg/minute:
- Take the patient’s weight in pounds.
- Drop the last digit.
- Subtract 2 from the answer.
- Plug that number into your infusion pumps as ml/hr.
Johnny weighs 174 pounds and is in severe septic shock. Nurse Heather wants to save his life by administering a dopamine infusion at 5 mcg/kg/minute. Whatever shall Nurse Heather do?
174 pounds, drop the last digit, you’re left with 17.
17 minus 2 equals 15.
Nurse Heather programs 15 ml/hr into the infusion pump. Nurse Heather’s colleagues snort derisively, and look up the information on the dosing chart. Presently, said colleagues genuflect before Nurse Heather, crying, “We’re not worthy! However did you figure that in your head?”
Nurse Heather replies, “Ambulance Driver taught me. Here’s the URL to his blog.”
Ambulance Driver gets another 200, 000 hits in short order.
…349 posts, countless wonderful comments, a new love, and 200,000 hits.
You guys rawk!
And to the person from Austin, TX that was visitor 200,000, drop me a line with your snail mail address. You’ve got an autographed copy of the book coming to you, if you don’t already have one.
If you do already have one, drop me a comment and pick the subject of your very own blog post.
I mean, you read my inane little scribblings faithfully, you make nice comments, and you point me to cool stuff on the web all the time.
Your votes helped put America’s Wounded Heroes over the top in VA Joe’s contest for some much-needed startup funding, and whenever I bring a worthy blogger to your attention, you click over there en masse and show your support.
Well, one of my readers has another cause that could use your support, and a worthy one it is, too.
Many thousands of our troops will be spending the holidays overseas, in dangerous and dusty places, risking their lives to defend not just our country, but the principles and ideals upon which it was founded.
They’ll get care packages, cards and letters from home, and they’ll treasure every item received as a small slice of love and family, or a symbol of the nation they volunteered to defend.
However small the gesture, it means something.
In a time when politicians, pundits and the synaptically challenged speak from one side of their mouths about supporting our troops, yet advocate measures that would render their sacrifices meaningless out of the other, it’s important for those troops to know that their service means something to the people they are defending.
I’m not one to pass on chain letters, or propagate memes (even though I’m a sucker for playing along), but it occurs to me that if even half of the 1200 or so daily hits on this site were to send just one Christmas card to an overseas soldier, sailor, airman or even one of Uncle Sam’s Misguided Children, and urge their friends and fellow bloggers to do the same, we’d have a groundswell of support that would dwarf last year’s effort.
So please guys, go by Yikes! and read about Operation Love From Home 2007.
Then send a card. Heck, send two cards. Urge your friends to do the same. Challenge your blogreaders and fellow bloggers as well.
However small the gesture, it means something.
…does the ball have a hole in it?*
More importantly, do you and the ball share a mutual love and respect for one another? Are you willing to commit to a monogamous relationship with this ball?
Remember, that’s a big step. No more gazing longingly at the ball pit at McDonald’s Playland. You can’t play the field anymore. Or the court, for that matter, if someone else is playing. You must be immune to the charms of all other balls.
Balls get jealous when you show a wandering eye. That’s just the way they roll. Let ‘em get the idea that they’re not the only one, and they’ll bounce. So you gotta stay strong, and avoid places like bowling alleys. Remain faithful to your One True Ball…
…Even if, after a while, she starts looking and acting like tetherball, and you’re tempted to append “and chain” when referring to her.
But sure, if you’re willing to take that step, you can still have sex with just one ball. And your sex life can still be just as exciting, presuming you meet the right ball.
I mean, if it were, say, a bowling ball…presumably one could invite two close friends to join in. Variety is the spice of life, after all.
Now if it were a wiffle ball, and you both swing that way…
…nope, not gonna go there.
*Yes, I’m going straight to hell.
“You look familiar,” the woman smiles. “Have we met?” The woman’s husband and adolescent son are standing behind her, and the look on their faces says they recognize me too. Then again, I’d expect them to recognize me. It wasn’t that long ago.
“Can’t recall,” I mutter evasively. “I have one of those faces.”
I studiously ignore the woman and turn my attention to KatyBeth. We’re standing in a concessions line at the parish fair, and I pretend to study the menu board, as if the choice between the funnel cake and the cotton candy were of monumental importance.
“Your daughter is adorable,” she coos, kneeling next to KatyBeth and stroking her hair. “Are you having fun at the fair, sweetheart?”
“Yes, she is,” I tell her shortly, switching KatyBeth’s hand from my left to my right, putting myself between her and the woman. Both KatyBeth and the woman seem bewildered.
She straightens and looks at me quizzically, the smile frozen on her face as she fondles the big rock on the ring finger of her left hand. She is dressed expensively in fashionably ripped jeans and expensive boots, designer handbag dangling from her shoulder. No doubt these are her fashionably casual clothes, carefully chosen for a night among the plebeian masses. She paid good money to look this trashy.
Stay away from my daughter, you blackhearted cunt, my look communicates quite clearly. She recognizes the warning for what it is, and her smile fades as she wonders whether she has committed some faux pas.
“No, I’m sure of it,” she plunges on, “we’ve met before. I never forget a face, but I can’t put my finger on where…”
“Room Three,” I told the cops, pointing to our Quiet Room, the one with the restraint bed and few furnishings. The Quiet Room is used for all sorts of things, but we try to reserve it for our psych patients because it has its own bathroom, and little in the way of things to destroy or use as a weapon.
“Good Lord, what happened to her face?” Favorite Nurse asked. “It looks like someone poured acid on her!”
“Pepper spray,” I answered for the cops, who nodded grimly. I forget that, despite her many years as an ER nurse, there are some things FN still hasn’t seen.
“Just put her on the bed, fellas,” I directed as I fetch a towel from the cabinet. I placed my hand gently on the woman’s back and leaned her forward, holding the towel to her nose.
“Blow,” I told her. “Let’s get your face cleaned up a bit, Ma’am.” Moaning pitifully, she complied, and then tried to wipe her face on the towel. I grasped her shoulder and pulled her back.
“You don’t want to do that, Ma’am,” I told her gently. “Rubbing it just makes it worse.”
“Please get this stuff off of me,” she begged. “I’ll do anything if you just wash it off…”
“Adding water just makes it worse. It reactivates the OC ingredient and it starts irritating all over again. The only thing that works is time.”
“Fuck you, miserable cocksucker!” she screamed, spittle flecking my face. “Get this shit offa me and take these fucking cuffs off NOW!”
“What’s your name, Ma’am?” FN asked patiently.
“None of your fucking business, you twat-licking whore!”
“Is that your given name, or just what your friends call you?” I asked innocently.
“Fuck you, you miserable impotent little asshole! You’re probably getting a fucking hard on from holding me here like this! Probably the only way you can get a woman, from fucking pepper spraying her and putting her in handcuffs!”
“I’ve had about enough of your language, Ma’am,” the cop told her sternly. “Now you can calm down and cooperate with these people, or it only gets worse from here.”
“Fucking liar!” she spat. “You came into my home, and attacked me! I live in a $350,000 home, and I could buy and sell you fuckers ten times over! I’ll have all your fucking jobs! I DEMAND you take these cuffs off me!”
“That ain’t happening,” I answered flatly, rapidly tiring of her bullshit, “unless you calm down. There are two ways to do this: The easy way means you do what we ask and stop abusing the staff and the police officers, and the hard way means we do whatever we feel is medically necessary, even if it means strapping your high-dollar ass down on our low-rent bed, and doing it all by force. Your choice, Princess.”
Her reply is to hork up an oyster and spit at me. What with all the snot and drooling from the pepper spray, it was a sizable loogie that struck me in the chest.
“I guess it’s the Hard Way,” I sighed resignedly as I pulled paper towels from the holder and wiped off her love offering. I turned toward the door to fetch the restraints, only to find Laid Back Male Nurse walking in with them in his arms.
“This is not the way I wanted to begin my shift,” he teased, tossing me the arm restraints. “By the way, you still have some snot wad left on your shirt.”
“Thanks for noticing,” I replied sarcastically, “Want to help me get her restrained?”
“Be glad to,” LBMN agreed. “Let’s get her legs first.”
When we spread-eagled her legs to strap her ankles to the bed, her demeanor instantly changed.
“You’re telling us that you’ll cooperate if he leaves the room? I asked dubiously. “Is that all it will take?”
“It’s an exotic hardwood,” I furnished helpfully, “often used as decking and trim on sailing vessels. Apparently, when Princess isn’t beating up her family and being pepper-sprayed by the cops, she spends a lot of time on yachts.”
“You wouldn’t know a fucking yacht if you were on one, Mr. Party Barge!” she snarled. “You’re so fucking low class, this is the only way you can get this close to a woman like me!”
“I think she means pesos,” I told LBMN, sotto voce. “And the OC residue on her lips would probably smart a bit, anyway.”
“Honey, let the men do their job,” came a plea from the doorway. “Please, I’m begging you. Just calm down.”
I looked over my shoulder to see a man standing there with a torn and bloody shirt, the scratches and bruises still livid on his face. Her husband, apparently. His presence had just the opposite effect of calming her down.
“GET HIM THE FUCK OUTTA MY ROOM!” she screamed viciously, body arching and straining against the straps. Her face, already fiery red from the pepper spray, turned an ugly purple, the veins standing out on her neck and face.
I quickly turned out the lights and left the room, closing the door behind me. Even through the closed door, her screams echoed through the halls.
“I’ve been married to that cocksucker for ten years, but I’ve been fucking Bobby Vidor for three! You hear that, sweetheart? I’ve been fucking Bobby right under your worthless nose for three fucking years! Somebody call my boyfriend! I want Bobby here NOW! Somebody please call…”
“Sorry you had to hear that,” I apologized. “People say all sorts of horrible things when they’re drunk or high. Mainly they regret it terribly when they’re sober.”
Small consolation, I know. But it’s all I have.
“Yeah, I guess so,” the man sighed. He has the look of a man who has been through this before.
You want us to tend to those scratches on your face?” I asked. “Some of them look pretty nasty.”
“They’ll heal,” he replied absently, and something told me this was the voice of experience. “I’d like you to look at my son, though,” he went on in a choking voice, gesturing to the kid sitting quietly in a chair at the triage desk. “He got hurt in all this, too.”
I pulled up a rolling stool and sit next to the kid, who looked to be about twelve. I lifted his chin and examined the scratch marks on his face, and noted what would soon be a black eye.
“Your Mom do all this to you?” I asked him softly, and he nodded. What’s your name, son?”
“Mitchell,” he answered, almost inaudibly, his eyes red-rimmed from crying.
“Where you hurt, Mitchell?” I asked gently as I wrapped a blood pressure cuff around his arm. His Mom could still be heard screaming from her room.
“My knee, mainly,” he pointed, his lip quivering. “I skinned it on the concrete and it hurts to walk.”
“We’ll get that taken care of,” I assured him as I motioned him to a wheelchair. “Right now, let’s just get you in a room and finish the exam. You shouldn’t have to hear all this going on.”
“It’s okay,” he sighed, ignoring the chair and standing up. “I’m used to it. Which way to my room?”
I silently motioned him down the hall ahead of me, and watched him limp to his room as his drunken, high mother shrieked like a harpy from three doors down.
I meet her gaze and hold it, staring stonily at her. At first her face wears a look of shocked recognition, and then it hardens in defiance.
“Cocksucker!” she spits at me, wheels around and stomps away, nearly jerking the poor kid down in her anger. Her husband flashes me an apologetic glance and trails obediently after her.
Great move, AD. You probably just earned the kid another beating. And now you’ll have to explain how your daughter heard someone call her Daddy a cocksucker.
I brood for the better part of two hours over that malevolent bitch. Two hours better spent hearing my kid squeal in delight at the view from the top of the Ferris wheel, or watching her pet a pygmy goat at the petting zoo, and instead I spend them only paying half attention to KatyBeth, a child who could charm a smile out of any man’s darkest moods.
Even worse, I know it’s irrational, but I’m powerless to stop thinking about it. Knowing I give her the power to ruin my day, even away from work, makes me hate her all the more.
Why do you subject yourself to this? Every day, all day, you take care of people you’d rather avoid in any other setting. Drug abusers, drunks, whiners, malingerers and people just too damned sorry and irresponsible to care for themselves, and not a damned one of them shows the slightest bit of gratitude. You devote more time and energy to them than you do to yourself. Fuck them. There are better ways to make a living.
I’m leaning on a fence, watching KatyBeth ride around in a little pink jeep on a serpentine track, but my head is in another place. She yells and waves madly whenever the track brings her close to my vantage point, and I dutifully smile and wave back, but in my mind I’m replaying the conversation from two hours ago, wondering if she’ll drive home, smoke a rock and chase it with some vodka, and flip out again and start beating her kids.
And God help me, I find myself sincerely wishing that she’d just do everyone a favor by overdosing. I’m actually hoping she kills herself, and rationalizing in my own mind how that might be a good thing.
I’m so black and seething, so lost in bitterness and self pity, that I scarcely notice the man next to me, other than to nod absently at him as he takes a position on the fence next to me.
“You don’t remember me, do you?” comes the soft voice at my left elbow. I turn and look at the man, and he’s smiling at me, offering his hand.
“Sorry,” I apologize, shaking his hand. “Normally I just suck at names, but I can’t place your face, either.”
“That’s no surprise,” he replies. “I’ve gained thirty-five pounds since you saw me last.” Seeing the quizzical look still on my face, he chuckles and fills in the blanks. “Almost five months ago,” he reminds me. “I came into the ER, drunk and coked out. You took care of me.”
“Oh, now I recognize you! Nice to see you again,” I smile politely, not really meaning it. I don’t remember him, and I don’t really feel like talking, either. I let go of his hand and turn back toward the fence.
“One hundred and thirty-four days,” he muses, resting his forearms on the fence rail next to me. “That’s how long I’ve been sober. Kicked the crack, kicked the meth, haven’t even had a beer. Got my wife back, too.”
“Congratulations.”
“Anyway,” he sighs, straightening from his position on the rail, “didn’t mean to intrude on your family time. I saw you over here with your little girl and figured I’d thank you.”
“Don’t mention it,” I say automatically. “That’s my job.”
“Yeah well, it meant a lot. So thanks.”
“No problem,” I tell him, not even bothering to turn my head. We watch the cars navigate the track for a few minutes more, and my curiosity gets the better of me.
“So tell me,” I ask, turning to face him, “what did I say to you?”
“Well, first you told me that you always got the rectal and oral thermometers confused,” he laughed. “And you waited until I had the thermometer in my mouth to tell me that.”
“I say that to everybody,” I grin. “It’s my standard line. Eases tension.”
“Well, it worked,” he grins back. “I didn’t really want to be there. I was drunk that day, in fact. Scared, really. I didn’t want to admit I couldn’t lick it on my own.”
“That’s right,” I remember. “Your wife brought you in. You told me that she coerced you into rehab, said she’d leave if you didn’t.”
“Yeah, that was me.”
Yeah, I do remember you. You were drunk when you came in, but not so drunk that you weren’t scared. You didn’t put up much of a fight. You wanted help, you were just to proud to ask. And I also remember not wanting to deal with you. I told you that we didn’t do substance abuse rehab, and that you’d be better off going somewhere else. But something told me that if you left, you wouldn’t go anywhere else. So I didn’t try very hard to point you anywhere else, either.
I tell the guy as much, and he just nods. “Took a lot for me to even get in the car,” he agrees. “I had used and drank my marriage into the toilet, and I was about to lose my business. Even then, I thought I could handle it.”
“So what changed your mind?” I ask. “What made you get in the car?”
“Him,” he nods at a little boy in the red fire truck just behind KatyBeth. “I knew I’d die if I lost him. And I knew I wasn’t being much of a father if I kept using.”
The son waves at his daddy as the ride passes near the fence, and Katy waves at me. We both grin and wave back. The boy is the spitting image of his father.
“So what was it I said?” I press. “You still haven’t told me.”
“Wasn’t so much what you said as what you did,” he says seriously. “After my wife left to fetch me some clothes, I was sitting alone in that room, and I…”
And I told you that God put me here to help stubborn-assed people like you get the help they needed.
“…and you said that God made you a medic to save dumbasses like me, and who was I to interfere with His plan?”
Yeah, or words to that effect.
“And you kept calling those rehab places, trying to find me an opening. Every time you took me outside to smoke, you’d update me on how things were going.”
“Twenty-one psych rehab and chemical dependency units,” I remember. “I got turned down twenty-one times before I found an opening…”
“The next afternoon when you came back on shift,” he finished. ” I was in the ER for almost 24 hours before you found me a spot. But what you said to me before I left was what stuck.”
“And what was that?”
“You said that the measure of a man’s strength is not how proud he is when things are going right, but how much he’s willing to humble himself when everything has gone wrong. And asking for help when you know you can’t do it alone is a mark of courage, not cowardice.”
“I really don’t remember that,” I confess. “But it sounds like something I might have said. My Daddy used to say pretty much the same thing to me.”
“Well, I remember it,” he assures me, “and I’ve reminded myself a lot of times since. So anyway, thank you. It m
eant a lot.”
“No, thank you,” I offer, shaking his hand again. “It’s nice to hear a success story now and then. It came just in time.”
As I drove KatyBeth home from the fair that night, she dozed off not five minutes into the trip. Ipassed the rest of the drive in silence, alone with my thoughts and the drone of the radio for company.
And not once did I question why it is that I do this job.
…and not Fallujah on the Mississippi New Orleans, go read Mostly Cajun.
He’s got some pictures and commentary of the ongoing recovery in that part of Louisiana wiped out by the forgotten hurricane, Rita.
You know, where the citizens of my state are rebuilding and getting on with their lives, not living in perpetual victimhood.
…you find an example like this.
One of the common refrains among the EMS instructors I spoke with this weekend was the general decline in the quality of students.
Everyone has horror stories of EMT students with impressive, shiny GPAs and high school transcripts that still only have the most tenuous command of the English language. Spelling and grammar are atrocious, and the ability to converse beyond internet slang is apparently too difficult for many. Asking them to form a coherent thought and express it in a research paper or patient care report is an exercise in frustration.
The consensus was that American children, in another couple of generations, will have devolved to the point that their communication skills will consist primarily of grunts, hoots and crude gestures.
Lunofajro over at Rainy Day Dreams has a teenage daughter who, when asked to write a poem describing who she was and from whence she came, wrote the following:
I Am From
I am from sweet potato pies, fried chicken and pinto beans.
I am from birthday parties with a BBQ with all the fixin’s.
I am from my special green blanket, softer than a bunny rabbit.
I am from midnight walks down my street.I am from a neighborhood with a long straight road lined with red and purple flowering trees.
I am from Allen Road, Sugarloaf, and others.
I am from North Carolina, South Carolina, Georgia, Florida, and Tennessee…
There is more, and you should read it all.
I bitch as much as anyone about the ignorance of today’s kids, and I, like many others, lament the decline of the US educational system. I also believe that when we discover kids deserving of praise, we should offer it loudly and publicly.
This young lady is deserving of praise. Drop by and give her some, would you?
…and I’m sorry to say, the naysayers were right. Everyone who said, “How can you love this person if you’ve never even met?”
Well, they don’t know Babs like I do, I thought.
*sigh*
They were right. I should have listened to Nurse K. Babs was totally different than I expected.
As it turns out, BabsRN is a…dude.
Yeah, you read that right. A dude. Male. Possessor of a Y chromosome. Packing wedding tackle.
Babs’ real name is Maynard Finkelstein, and he’s a sophomore in high school. He lives in his parents’ basement, and he works the fryer at McDonald’s after school. He stands about an inch shy of five feet, weighs about three-fifty on the hoof, and has a really bad case of acne. He looks a lot like a Weeble with buck teeth. The boy can eat corn on the cob through a picket fence.
And you know, at first I was repelled and disgusted, because hey, I thought I had been professing my love to a hot blonde chick for the past few months.
But then, I started to see a glimmer of the inner Maynard, the part that manifested itself as the Babs I had grown to love. And folks, I fell in love all over again. I absolutely adore the disgusting little toad, despite the halitosis and racing stripe in his underwear.
Because you see, I’m not really a guy either. My real name is Tiffany Frippel, and I’m a senior at Ann Richards High School in West Bugscuffle, TX.
I’m captain of our cheerleading squad, and my two BFFs, Heather and Amanda, encouraged me to start this blog as my senior creative writing project. I mean, if two 16-year-old girls can convince the entire blogosphere that they’re virile, manly cops, I can do this Ambulance Driver schtick, right?
Anyway, I like, totally fell in love with the real Maynard, and we hung out in his room and played Guitar Hero on his PS3 and we made out and I let him get to second base and it was kinda nice and I realized that my lesbian thing was just a phase and that I totally dig guys who wear retainers and snort when they laugh. Plus, he looks totally hawt in his band uniform and when he plays his tuba for me, it makes me all tingly in my naughty parts and, and…
…I wanna marry Maynard Finkelstein and have his babies.
So as soon as he graduates, we’re gonna move to Montana and he’s gonna buy us a cattle ranch in the mountains and we’ll live in the romantic old farmhouse and raise our babies and I’ll make turquoise jewelry to sell in town while he’s out herding the cattle and we’ll love each other 4evah and evah!
And when we get married, Heather and Amanda are gonna be my bridesmaids. I haven’t decided which one is gonna be maid of honor yet, because both of them are like, really competitive and I’m all like, “Hello??? Isn’t this my wedding?” and they’re all like, “But I’m your best friend!” and I’m all like, “Whatevah, I don’t need all this drama...”
So anyway, I was so deliriously happy that I just doodled all in my diary on the bus ride home, dreaming of my sweet Maynard…
Tiffany *hearts* Maynard.
Mrs. Maynard Finkelstein.
Maynard and Tiffany: The Finkelsteins.
Tiffany Finkelstein.
Tiffany Frippel-Finkelstein.
He is the man I want to spend the rest of my life with. I love you Babs Maynard Finkelstein.
I’m in Georgia for a few days, so expect light blogging until the 19th.
Very light blogging.
As in nonexistent.
But y’all feel free to pad my hit count browse my archives while I’m gone, and I’ll be sure write something meaningful upon my return.
Oh, and Chris in Southeast TX? I couldn’t have said it better myself.
Watch an experienced nurse.
One of the reasons I chose EMS as a career was the perception I held that nurses had to beg the doctor for permission to do pretty much anything.
Give oxygen? Ask the doctor for orders, and then only at two liters per minute, lest the Hypoxic Drive Fairy come steal your poor COPDer’s breath away.
Defibrillate someone? Check with the doctor first. He may just have some weird-assed joule setting that they only teach proctologists in medical school.
Wipe an ass? Only if the doctor has confidence in your ass-wiping skills.
As a young EMT working for the Little Ambulance Service That Could, I had a great deal of autonomy in the way I practiced. As a young paramedic, I had the luxury of being able to write my own protocols. We had an excellent medical director who trusted his medics to use their brains. Such a system is a real luxury for a new paramedic eager to learn his profession.
Now, over the years, my perception of nurses changed somewhat. Partly it was being married to one for so long. The first thing I noticed about Ex Missus when we first met was “Hey, she thinks like a good medic!”
But as my skills and knowledge grew, so did my perception of the nurses I encountered. I began to notice a lot of them like my wife. They were capable of thinking for themselves, and they did. The doctors didn’t seem to get all huffy about it, either.
I also began to notice a lot of medics who weren’t deserving of the trust I and my colleagues at TLASTC had been afforded by our medical director. Quite frankly, a lot of them were poorly educated Protocol Monkeys who had no idea why they were doing things to patients.
And then came the epiphany: Competence rises to its own level of trust.
The docs recognized good nurses and medics when they saw them, and granted them a higher degree of trust and respect. They also held them to a higher standard than their colleagues. Rather than be offended by the nurse or medic thinking for themselves and practicing a little initiative, they expected it.
Rarely have I had a doctor deny me orders. On the frequent occasions I found it necessary to treat first and ask permission later, rarely was I chastised, even when they disagreed with my treatment.
Some of my colleagues used to ask me, “How is it that you get orders from Dr. X, when he turns down everyone else?”
I simply answered, “Because I know exactly what I’m asking for, and why. And I only call when it’s necessary.”
What I didn’t say was, “Maybe it’s because I don’t sound like an effin’ idiot when I pick up the phone.”
But if you’d really like to see a master manipulator, watch an experienced ER or ICU nurse, one of those trained in the days when nurses were required to all but genuflect in the doctor’s presence. Masters of subtlety, they are. They know how to get what they want, without ruffling physician feathers.
The old battleaxes who have worked for years in teaching hospitals? They can intimidate a first-year resident with just a look. If the look doesn’t suffice, a growl usually will. Rarely do they need to show their claws, but woe betide the arrogant resident who pisses off the nursing staff. The good doctors usually figure that out pretty quick.
Now the new nurses and medics, however…
They’re scared of their own shadow. They have just enough education to know that they don’t have enough education, and they’re rightfully intimidated.
Most of ‘em, that is.
Occasionally, you find a new nurse who displays a confidence and subtlety beyond her years. One that knows how to manipulate a doctor into doing her bidding.
Y’all go by and say hello to Dixie Laurel at Nautical Dawn, and see for yourselves if she isn’t a worthy addition to your blogroll.
I feel the force is strong with this one.
I have moved some folks from the Blogs I Read Every Day down to the Reciprocal Blogroll, not because I don’t still think they’re all that and a bag of pretzels too, but because life, jobs and other assorted reasons preclude their posting frequently.
Likewise, some of the names on the reciprocal blogroll are blogs I read every day, thus deserving of recognition for the hours of wasted productivity enjoyment they bring me.
Those blogs have moved up the heirarchy, so to speak, and I urge you to give ‘em a read.
Y’all welcome Medic March, Murphy, Farmgirl, Say Uncle, and Squeaky Wheel to the party.
Dey izz da shiznit, yo.
On another note, if you have noted the dearth of quality posts from Yours Truly in the past week or so, my apologies. A few pressing deadlines for paying projects have taken up the vast majority of my writing time of late, but I shall return to supplying the blogosphere with a steady diet of toilet humor and silliness within the next few days.
…announced mainly for The Pixie, Kate, and Chas Clifton.
Check out the Pagan Blacksmith and give him some encouragement, you guys. He’s brand new.
Welcome to all you folks coming over via Tom Reynolds at Random Acts of Reality.
Y’all feel free to browse through the Greatest Hits while you’re here, and if you bought Tom’s book, you might like mine, too.
*grin*
And Tom? Should you run into him, tell Steven Hines that I said hello.
I have no idea how I managed to go this long without adding Anarchangel to the blogroll, but that gets rectified as of today.
Edit: Let’s not forget to add the newest, a frequent commenter and old-time Texas lawman, JPG. Y’all welcome the Expert Witness. I can’t wait to read some of his stories.
JPG, if you’d like to collaborate on the next Perspectives post, the invitation is open.
…but I giggled like a fiend all the way through this poor fellow’s impassioned plea.
Not to sound like an intolerant redneck, but back in my high school days I’d have slapped Mr. Drama Queen until he got a hold of himself, and snarled, “Shaddup! Be a man!”
Then I’d have probably pulled his underwear over his head, and shoved him in a locker.
But I’ve evolved beyond that. I’m more mature now. I wouldn’t…
…ah hell. Who am I kidding? I’d still want to push him into a locker.
Hat tip to Pseudo Doctor.
…because I have been given a little blog love by Sandy G.
Even better, it doesn’t require any extra thought or effort from me. Simply name five other bloggers I can’t get enough of, and I get to put his cool icon on my ego wall sidebar. Suh-weet!
Now there’s a meme I can get behind, people.
It so happens that two of my favorite bloggers have recently taken a break to devote more time to their families and life away from the Magic Elf Box.
To MonkeyGirl, I say: recharge your batteries, girl. Watch football (or whatever that game is they play outside the SEC). Have some fun. Take it easy. When or if the muse returns, I’ll still be reading. Cuz you know, I’m a huge fan.
To Babs: Well, I’m a lucky man. I still have the pleasure of your contact every single day. It’s the rest of the blogosphere that I feel sorry for. You’re the best, honey.
As far as five other bloggers that Ambulance Driver just luuuurrrves, here they are:
Scully, at Skywritings. Look, I can occasionally turn a witty phrase. People tell me I can alternatively make them laugh or cry, and they never know which one it will be. Such praise pleases me no end. But this woman…she writes, with a depth of insight and emotion that I can only aspire to. There’s no better way to describe it than poetry. Short of her taking you up in a biplane, her blog is the closest thing you can come to knowing what it’s like to slip the surly bonds of Earth and touch the face of God.
CrankyProf, at Cranky Epistles. I’d have killed to have a professor like this in college. Killed, I tell you. She holds a back belt in snark, and she ain’t afraid to use it. Or is that a PhD?
Danny Evans, at Dad Gone Mad. Laugh-out-loud funny, and the guy is just flat-out in love with his kids, just like a Dad should be. Now if he’d only link me, I might get some of the traffic his blog gets.
Crystal, at Boobs, Injuries and Dr. Pepper. Never has the F word been uttered with such artistry and outright hilarity. I luuurves me some Crystal.
Farmgirl, at Tractor Tracks. Country girl, can chase down a runaway horse and still go on a date afterwards with mud and blood on her clothes, and not think twice about it. My kinda girl.
Y’all give ‘em a read. They’re all worthy additions to a blogroll.
…but wouldn’t that make it really hard to hear Barry White on the stereo?
From the Not Really Any Of My Business Files:
You see, I have a favorite blogger. This blogger has legions of flying monkeys worshipful acolytes adoring fans who also hang on her every written word, just like me. I’m not going to mention her by name, because really, it is none of my business. Her smarter acolytes probably know who I’m talking about.
But I am a huge fan. Can’t get enough of this particular blogger’s brand of snark.
I’ve heard that this blogger wouldn’t care to do a Blog Talk Radio interview because she thinks she has a voice made for silent movies.
Meh.
Rather than shock her fans with the fact that she’s not a mezzo soprano, I’d think the more likely outcome from such an interview would be crashing Blog Talk Radio’s server with the avalanche of traffic it would generate.
Me, I’d be the first to call in to shriek like a berserk fanboy pay my respects.
Her fans oughta offer her some encouragement, and exhort her to give us a command snark performance.
If she’d still rather not do it, fine. Won’t make me any less of a fan.
Well the owners of St. Rita’s were found not guilty.
Of 35 counts of negligent homicide.
For refusing to evacuate a nursing home full of helpless old people in the face of an oncoming Category 3 hurricane.
Ever stop to think that a jury of your peers is largely composed of 12 people too stupid to know how to get out of jury duty?*
On a more positive note, I just watched a local news story on the recent rash of home invasions. The story was well-balanced and informative, and refreshingly free of anti-gun Pants Shitting Hysteria. The most the local sheriff had to say could be paraphrased as “know how to use your weapon. Get some training.”
Good advice, that. It’s nice to live in an area where responsible firearms ownership is considered a given.
*That was a joke, people. Don’t avoid your civic duty.
That’s what my pass rate was for my students’ EMT-Basic exam yesterday.
On the face of it, that doesn’t seem so bad, but when you’re used to a pass rate of 96%, it’s cause for disappointment.
80% marks the lowest pass rate I have ever had. Failing an exam station, even just one, is an anomaly.
My students just don’t fail.
If they fail, it means I have failed. I invest a lot of emotional capital in my students. To me, that’s the difference between teaching and instruction.
A few years back, I wrote a little article for an EMS e-zine outlining my personal philosophy on teaching EMT students that works better than anything I’d scribble here. Give it a read, and then we’ll come back:
On an EMS discussion list recently, I happened to mention that I had once trained retrievers professionally. Given what I currently do, I took a lot of ribbing about the similarities between training retrievers and teaching EMT students. Gary Saffer was particularly droll, inquiring if I had ever had to whack an EMT student on the nose with a rolled-up copy of JEMS.
Although I’ve been tempted, I’ve never had to go that far, nor have I ever had to rub an EMT student’s nose in the puddle of biohazardous waste they left on the floor of the rig. I was however, struck by the similarities between my former career and my current one. Many training principles are universal, whether applied in the classroom or the training field, and I thought I’d write down some of the truisms I’ve discovered along the way.
1. “You can’t polish a turd.”
I’ve only been training EMT students for about ten years, but I started training retrievers professionally at age fourteen. In the ensuing twenty years, that much has become obvious, distilled down into one line borrowed from Greg Margolis.
Natural instinct cannot be taught.
A wise old dog trainer told me once about teaching a dog to do multiple retrieves, “Son, as long as the dog can mark and remember a fall, I can teach him to count.” The trainer realized that the dog has to have some innate ability to excel at his job.
This concept holds equally true for EMT students. You can’t teach a student to think laterally rather than linearly. Students either have the ability to think on their feet or they don’t. In class, we develop those traits, but we can’t teach it to them if it’s not already there. Sure, you may teach a student enough to earn a patch, but they’re not going to excel as a street medic without those traits. And sadly, traditional EMS education often actually suppresses those traits.
You can force a retriever to do a lot learned tasks, but they’re not much fun to hunt with. Also, the student, either canine or human, has to have the smarts to make it all the way through the training program. A great many simply don’t have what it takes. The trainer has to identify those that don’t have what it takes very early in the game and screen them out. It’s the only fair way to do things – further polishing of the turd only serves to smear feces on the entire class.
2. Fundamentals are learned in the classroom.
You know, they call it a classroom because the students go there to well, you know, learn things. The street, your job, is where you put what you’ve learned to good use. Real life is not a kind teacher. It can be especially brutal to those EMTs who lack the critical skills necessary for learning those lessons the street provides. Those skills are called fundamentals, and they’re learned in the classroom.
I take issue with the types who tell the rookie medics when they hit the streets, “Here’s where the real learning begins, kid.”
Not so.
The street amounts to an extensive postgraduate education in EMS, but if the rookie didn’t have a sound undergraduate education, they are going to fail.
I like to call the EMS instructors who subscribe to this philosophy “The STREET Society.” They teach their classes with endless war stories that begin with the refrain, “When y’all get to THE STREET…”
Retriever trainers have a similar nemesis in the “by gosh, by gum” club of dog owners. They introduce their retrievers to water by throwing them in, or introduce to gunfire by dragging the puppy out to the gun range. “By gosh, it seemed like a good idear, so I figgered, by gum, I’ll give ‘er a whirl!”
The sink or swim instruction method is not a character builder, folks – it’s an esteem destroyer. While I made of great deal of money fixing the mistakes of idiots like these in the retriever training business, in the EMS profession it drives good people out of our ranks.
3. Even an EMT can get collar wise.
A “collar wise” dog is one who knows when the electronic collar is on and when it’s off. In competition, they realize they can screw up with impunity. The problem occurred because the trainer screwed up – used a training instrument as a punishment tool. Sounds a lot like a poorly set up QA program doesn’t it?
Before long, the medics resent the FTO, and rebel in a million little ways. Often they don’t take him seriously in situations where he can’t punish them. The relationship between the FTO and medic is damaged, often irreparably. Inadequate supervision often encourages the EMT to screw up when the FTO isn’t looking.
A collar wise retriever is extremely difficult to fix. A collar wise EMT may not find peace with the current FTO or company – all because a tool that should have been used for improving the EMT’s performance was used to punish instead.
4. Don’t neglect the positive reinforcement.
In any one EMT class or retriever training string, a certain percentage will excel no matter how pathetic a teacher you are, a certain percentage will lie around licking their testicles (or flirting with their classmates, or sleeping), and the rest will lie on the bubble of passing or failing, depending upon your skill as an instructor.
This last group needs to hear the words GOOD JOB as often as we can find a reason to say it.
The unmotivated or talent-deprived fall into that category of unpolished turds, and our best choice is to separate them from the rest of the class as expeditiously as possible.
The top people in your class are largely self-motivated, and could pass an EMT by correspondence course with flying colors. The best you can do is harness their energy and enlist them in your goal of helping those on the bubble. Negative reinforcement (punishment) usually doesn’t work on the majority of them, and may wind up creating a collar wise dog or EMT. Judicious negative reinforcement of your top achievers is sometimes effective in harnessing their energies, but is very delicate ground to tread.
5. Create a positive learning environment.
Retriever training, as simply as I can put it, is all about contriving a situation where it is easier for the dog to do the correct thing, and then offering positive reinforcement when they do it.
EMT training follows the same guidelines – show the student the right way to do things, and then supervise them doing it. Praise them when they get it right. Give them a break when they get tired. If it’s easier to sit and semi-consciously highlight the textbook or chat with their neighbor than listen attentively to what you are saying, have you contrived a situation where it is easier to do the right thing?
6. Never pass up a teachable moment.
Mistakes happen. Dealing with that fact of life will become much easier if you learn to view a student’s mistakes as learning opportunities. As EMT instructors, we strive to make sure those mistakes occur in the classroom rather than on the street, but this is an unattainable goal.
When I had retriever who appeared to have mastered a training scenario, I immediately started to get suspicious. I would add variables, trying to make it easier for the retriever to do the wrong thing. The difference was, I knew that the dog already knew what was expected of him. In other words, I was trying to create a teachable moment, contriving a situation where the retriever could make the mistake in a setting where I could correct it.
I don’t need to do that with EMT students – real life provides more teachable moments than I could ever hope to contrive on my own. But I keep my eyes open for the lessons that can be learned from them.
7. Practice does indeed make perfect.
And perfect practice makes for perfect execution. In the street, we’re going to screw it up. That’s a given.
Want a recipe for disaster?
Take one EMT student
Add practice in artificial, classroom situations.
Repeat until confidence is gained.
Let cool on the street.
Proceed directly to chaos.
After the student has learned the fundamentals of a skill, we add layers of complexity until we’re approximating, as closely as possible, street conditions under instructor supervision.
Most of the real work of retriever training is practiced endlessly on a baseball diamond, or on a field with grass no higher than a golf course fairway. Layers of complexity are slowly added in training, until we’re approximating situations the retriever might see in competition or the duck blind.
EMTs do not learn those basic skills on the street, and retrievers don’t learn them in the duck blind.
Those are the places where you find out if the practice paid off.
To be able to do things without conscious thought, especially under stress, there is no substitute for constant repetition.
8. Paper training EMTs and paper training retriever puppies is very similar.
If you’ve ever done chart review of EMS run reports, you feel my pain. Some of the veterans are as bad as the students and rookies, much like the retriever who was raised in the yard that suddenly becomes a house dog.
Like retriever puppies, EMT students’ paperwork tends to be messy, there is usually too much shit on the paper, and all too often something really important shit doesn’t wind up on the paper at all.
Given patience, guidance and positive reinforcement however, both of them seem to get much more efficient with paperwork as they get older. Some of them learn to do without paper entirely.
I’m talking about the retrievers, folks. Maybe your EMS system has pen-based run reports, but some of it still goes on paper, right?
9. EMTs and retrievers filter their information through a prism of past experiences.
Adult learners feel the need to relate what they’re learning to their own life experiences. As they become experienced EMTs, they’ll compare patient presentations and situations to ones they’ve seen in the past. The more experiences they have, the more meaningful a new learning experience is likely to be.
This puts a tremendous responsibility upon the shoulders of the instructor to ensure that these initial learning experiences be positive ones, because the student is likely to forever after approach new situations with “that’s not the way we learned it in class.”
When a retriever steps to the line in competition, or in a duck blind, he flips through a mental photo album of all of the past retrieves he has catalogued until he finds a photo that resembles the scene in front of him. If some of those photos are flawed, there is always the chance he will choose a flawed photo as the template to make the next retrieve. The more experienced the retriever, the larger his mental photo album and the more likely he is to find the right photo to help him make an accurate retrieve.
Like a good preceptor will make sure the student has made the right diagnosis, a good trainer recognizes when the retriever is looking at the proper picture.
10. Set limits, and stick to them.
Dog training is exactly like classroom management in this regard. Set clearly defined limits, let the students know what they are, and let them know the consequences for exceeding those limits.
Do not bend on this issue.
If you call for att
ention three times before you finally wind up shouting at everyone to shut the hell up and settle down, be prepared to have to call for attention three times and finally shout every time you need the students’ attention.
In dog training, the principle we follow is never give a command you are not prepared to immediately enforce.
11. The really good ones can amaze even the teacher.
I believe that some retrievers possess critical thinking skills. Laugh if you will, call it anthropomorphism if you want, but I’ve seen champion retrievers work out complex situations time and time again that I know they weren’t trained for. The only explanation I have is that they were figuring things out.
Like these once-in-a lifetime dogs, occasionally we have those students as well. They grasp abstract concepts in a flash, master skills without breaking a sweat, charm colleagues, patients and fellow students alike, and go on to bigger and better things.
If they were retrievers we would breed them, and make lots of money doing it. With our EMT students, what we hope to do is impress upon them the importance of what it is that we do, and their place in our wonderful profession. And we stay in touch with them as much as we can and keep encouraging, because we need these people to pass their gifts on to the next generation.
And maybe one day if we’re lucky, they’ll mention us by name in a national EMS publication or dedicate their first textbook to us – the EMS instructor’s equivalent of a “Hi, mom!” on a nationally televised football game.
12. At some point, you gotta let ‘em go.
You can’t ride the rig with your student, and you can’t go hunting with the dog after you’ve sent it back to its owner. By the same token, it looks pretty silly for the student to haul textbooks around on the job, and it looks pretty sad to see a retriever wearing a training collar in the duck blind.
You can be certain that once class is over, some owners are going to screw up their dogs, and some EMTs are going to wind up at agencies that waste their talents at best, or ruin them outright.
Your graduate will often make you proud, and sometimes they will embarrass you. Sometimes the best of them will do both. I’ve trained champion retrievers, and I’ve trained excellent paramedics.
The last two recipients of the Robert E. Motley EMT of the Year award were my students. I’m proud of both of them. They’ve also done things to disappoint me.
The best you can do is hope that the education you gave them will sustain them on the street, and that you’ve helped instill the attitude that the learning is now up to them.
Anything more than that is not worth your ulcer.
The parallels here could go on, but you get the picture. My last retriever, Epi, was trained using the same principles that I used to break in my last partner on the ambulance. It’s debatable which one is the better companion – Epi holds a big edge in the swimming in freezing water department and follows directions much better, but Bodie has a slight advantage in IV starts and EKG interpretation.
Bodie is also is a national award winner. Epi’s bad luck in being born without opposable thumbs, I suppose…
Lots of EMT instructors blame their students’ failings on the exam staff. They paint the exam staff as a bunch of trained seals who don’t really understand the nuances of the skills they are testing. Personally, I’ve always felt that was a cop-out. I was a Quality Assurance monitor at our National Registry Exam for years, and we had a good bunch of examiners. With very few exceptions, most of them were practicing EMTs, and good ones. They could think on their feet.
But judging from my students’ experiences yesterday, somehow we’ve gotten some trained seals in examiner positions. Some of them failed my students because of pure chickenshit, or simply not knowing how to do their jobs. That is inexcusable.
Don’t get me wrong. They failed some of their stations purely on stupid errors. Those are easy to fix. Most every time I’ve had a student fail an exam, they knew exactly what they had done wrong.
But when your best student (one who had already been an EMT in the past) fails his strongest station, and doesn’t know why, and then goes back and passes his retest by doing it in exactly the same way, we’ve got a problem with the trained seal doing the testing. I saw that pattern repeated several times yesterday.
I suppose I’m going to have to do more bomb-proofing of my students in future classes.
Before yesterday, that meant that I drilled them to the point that they could go to the exam hungover from the night before, get in a fight with their spouse that morning, have a flat tire on the way and hike to the exam site, get a call from their CPA telling them that they’ve been hit with an IRS audit right before they walk into the exam room…
…and still kick ass and take names.
Now it looks like I’ll have to include what to do when you are smarter than your examiner.
And Ryan, Missy, Matt, Frank, Joey and Tommy? It was a pleasure to be your teacher. I’m proud of each and every one of you guys.
Yeah, even you, Joey.
You’re going to be good EMTs, and it’s not your fault that you were smarter than some of your examiners yesterday.
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