...these are people's lives you're dealing with."
That's a quote from my EMT-Basic instructor. He said it on the first day of class. He was trying to make us understand the gravity of the subject we were about to learn. Since then I've taken this statement to heart and used it in my own classes and with students that I precept.
A few days ago I got switched to another station and worked with an Intermediate that was in Medic school. He was a month from graduating. I figured that I wouldn't have to do too much those 2 shifts. He should be able to function pretty much without me. Boy, was I wrong...
First call we get is for chest pain. The first mistake he makes is taking the clipboard in with him. Leaving me to get the stretcher and equipment. I follow him into the house to find him writing down basic demographic info on a patient who looks like shit; pale, sweaty, breathing about 30 times a minute and I can hear her gurgling from across the room. He has no equipment, so he hasn't even taken a blood pressure, nor has he asked her anything except her name, social security number, date of birth and phone number. I quickly step in and do a quick assessment and direct the patients son to help me get her on the stretcher.
My student/ partner gets the idea and finally helps us wheel her out to the truck, forgetting the monitor and jump bag in the process. Eventually he gets everything back to the truck and starts helping me treat our patient. He wants to give her nitro and aspirin before the IV, monitor or even a B/P. I calmly give him the cuff and stethoscope and point to her arm as I get her on some oxygen while asking her all the pertinent questions.
Eventually we get all the basics done and I move some leads around to see if that big fat inferior MI has a friend. Sure enough, she's got an associated right sided MI as well. My partner is looking at me as if I just grew a second head as I do all this. I really wanted to have him back here on this one so he could maybe learn a thing or two. But I can't wait, we've been on scene for almost 10 minutes as it is. I just tell him to drive...
After the call he just sits there in the drivers seat and asks no questions whatsoever. I'm not sure if he's thinking it over, or he really isn't curious about what I was doing and what was wrong with our patient. When I was in his position, you wouldn't have been able to shut me up for all the questions I would have been asking.
I let this go on till we get back to the county line. Then I start asking him questions. Like, what the hell was he thinking not taking anything in with him? Why was he asking demographic questions instead of accessing the patient? etc, etc. As we move on in my questioning I start to quiz him on his drugs. That's when I start to get even more concerned. The boy doesn't even know his basic drugs. Like the dose for aspirin, nitro, charcoal and the like. So once we get back to the station we go over every drug in the box...all 46 of them. I tell him that I'm gonna give him another quiz later that night. Well, he studied some, but retained nothing. Eight hours later, he couldn't remember anything we went over that morning.
I get almost disgusted when he starts to blame his instructor. I tell him that the EMT-Paramedic course is a college level class, taken at a college, this isn't grammar school. You have to take the initiative to learn on your own, to study on your own and to ask for help if you need it. He seems to understand and take what I am saying to heart.
The next shift is no better. He still knows nothing of his drugs, ACLS, ITLS, or even his own protocols. I'm not sure if I should just give up, help him, or brow beat the hell of out him.... I end up spending the rest of the shift trying to give him a crash course in pharmacology and patient assessment. I have no idea if it did any good or not. It scares the hell out of me that there is a possibility that he will eventually be out there on the streets treating patients, maybe even me or my family...
I just don't understand some of the students nowadays. Maybe I'm just too hard on them or try to judge them against myself. When I was in class, we had to make at least an 80 on every test and keep an 80% average or we were gone. My thinking on this was...if I make an 80, then statistically I know 80% of the information. What if I need that other 20% to help someone, or what if someone dies that could have been saved because I didn't know that 20%? Now I made 100% on a lot of tests...but not all, not by a long shot. But that made me sit down and study even harder to learn what I had gotten wrong. And even making a 100 doesn't mean that you know all the material.
I didn't fuck around in class like many of my other classmates, I didn't make fun of others that were called to the front to do a mega-code and didn't do the best. I was usually one of the ones that always raised his hand when the class was asked for an answer and I often made the class longer than usual because of my questions. For this I was dubbed "Rescue 911" from some of my classmates. But I didn't care, because I knew that eventually it would be my ass out there with a life possibly on the line.
I haven't changed my thinking or reasoning on this subject and I doubt I ever will. Because this ain't basket weaving, these are peoples lives we're dealing with....