Well, here it is. A week after everything is done.
Here's how it went down after my last post:
Tuesday, 5/16: Study Study Study Study and study some more. I took 3 pre-tests and passed them all. Went to bed early.
Wednesday, 5/17: The written exam. I finished the 180 question exam in an hour and a half. I walked out of there feeling pretty good about how I did. Considering I passed all my practice exams and reviewed the questions I missed, I felt pretty good. Ok.
Thursday, 5/18: Showed up at school around 9am and practiced my stations for the practical over and over. I had a plan, I had to do each one correctly without failing 3 times. If I failed a station, that didn't count towards my total. I had a checklist and I meant business. I worked my butt off. One thing that was giving me fits was a taping method to secure an IV. I don't have a picture nor could I find one online. I had been taught by everyone I know that a good way to be sure an IV is secure is to put a loop of tape over it and make a "chevron" to keep the catheter from getting pulled out.
Well, with gloves, sticky tape and such, it's a difficult endeavor for the beginner. Since it's been taught to me as the way to secure an IV, I practice and practice and practice. I want to get this right. Eventually, I get the hang of it and get it down. I've seen a lot of nurses and paramedics do this and I want to be sure I get the IV skill station perfect.
I spend a lot of time working up my dynamic cardiology, static cardiology, trauma assessment, spinal immobilization (seated and supine), bleeding and shock control, adult intubation, medication administration, pediatric intubation and intraosseous access. When I leave the lab Thursday afternoon, I'm feeling confident that I can get this thing done. Which is a good thing since my volunteer firehouse has a kickball game that evening and I end up pretty smashed on cheap beer. (UGH)
Friday, 5/19: Almost the day from hell. Woke up with a hangover (Damn you, Miller Light in a can!). Spent most of the day getting ready for a party I'm DJing that night for Herself's company on board a dinner cruise boat. The problem with this is I expected to show up with my laptop, iPod and mixer and just plug in to the existing system. The dinner cruise boat tells us at the last minute that it's against company policy for anyone to use the shipboard equipment except the house DJ.
An amazing friend comes to the rescue with amps, subwoofers, speakers and other electronic madness. We lug it all in a minivan to the dock, load it up and the party's rockin! Maddog has got mad tunes!! Fortunately for me, at 10:30pm, the crew shuts us down. I mean 10:30 on the dot! Pull the plug! Normally, I'd be cranked as I like to keep it going all night. Not tonight, though. I have to get up at 5:30 am to be at the community college for my paramedic practical exam.
I actually manage to get home, get about 5 hours of sleep!
Saturday, 5/20: I woke up on time, had a good breakfast, packed a lunch, reviewed my drug dosages and headed out the door! I got to the testing center early and the atmosphere was jovial. My first station was bleeding and shock control for the basic skill. I go through it, pretty well, I think, and walk out of there feeling good.
I keep telling myself to visualize a positive outcome. I don't dwell on my past performance, I keep focused on the next task. The next task is dynamic and static cardiology. I go through and think I did ok. There were a few points where I wasn't sure but I reviewed my protocols and am sure I go it right. Sort of. There's still a lot of doubt. Technically, I did the right thing but did the evaluator see it? Did I miss something critical?? It's nerve-wracking!!! I see all of my classmates doing the same thing. Ugh!
You see, with national registry testing the evaluators are not allowed to give you any feedback on your performance. The logic is that the testing is an evaluation of one's skills and abilities, not an opportunity for learning. As a result, I walk out of each station with only my own assessment as to whether or not I passed. The results are tabulated and given out when everyone has completed all the stations. It really does take a lot of effort to focus on the next evaluation and not repeatedly review one's past performance.
The day goes on.
Trauma assessment. Perfect!
Pediatric airway: Perfect!
Pediatric IO: Perfect!
Adult Airway: Double perfect!
Oral Station (where one has to talk through a call from the time dispatched to patient delivery at the hospital, including all aspects of scene management and patient care): Perfect X 2!!!!
IV start and medication administraion: Perfect!
I'm feeling pretty good. I'm thinking I've probably failed my dynamic and static cardiology. I'm delighted about my performance everywhere else but I won't know for sure until a National Registry official walks into the room, calls my name and takes me out in the hall to tell me my results.
The waiting? It kills me!
Finally, my name is called. The official tells me that I passed everything except IV.
WHAT!!! IV!!!! Wow! I must have made some dumb mistake! That means I passed EVERYTHING ELSE!!!! Woohooooooo!!!!
I'm delighted! I have this vision of leaving the testing center completely finished. Completely done!!! Wow! I just have to go back in and re-take the IV station (they're letting us take one of our two re-tests on the same day).
Ok! One more to go. No sweat. I review over and over again while I'm waiting for my name to be called. I'm going to nail this one and do it perfect!
My name is called.
I go into the station. I do it exactly as I was taught and perfectly!
I walk out of there feeling like a million bucks. Once again, I have to wait in the holding room for the official to call my name and tell me my results. This time, I'm not too worried. I pretty sure he's going to shake my hand and congratulate me.
He calls my name. I go out to the hall with him.
He's not smiling. He does not shake my hand.
I failed it again!!!!!
I'm outraged!! I cannot believe it!! What the hell! I did the station perfect! It's the most simple one of all!! I've started a bajillion IVs in the field and in the lab. What the hell did I do wrong???
Nope. Can't tell you. Thats now how national registry works. You're here to be evaluated, not trained.
I make noise.
I stomp my feet.
I almost make a scene.
Chief, the director of my program, comes to me to ask me how I'm doing. I tell him I failed when I should not have. He starts with the "well, that's how it goes..." speech but I stop him.
"No! I did everything perfect! I did it fucking perfect!" Yes, I drop the "f" bomb. Chief has never heard me cuss. He knows I mean business.
"I'll see what I can do." He says and hurries off.
The medical director for my program, my teachers and the head of the department are all present this day. Chief gets them to lean on the evaluators under the pretense that I may challenge the evaluator's ruling. A bit later, I'm asked to step out into the hall. I meet with Chief and my medical director, Dr. S.
"You violated the sterile field."
"You put a piece of tape around the IV tubing underneath the Tegaderm, or bio-occlusive dressing at the IV site."
"Of course I did! That's how everyone's taught me to do an IV. It's supposed to keep it from coming out. In fact, I practiced my ass off to be sure I could do it right!"
"Well, apparently, that's not the proper way to do an IV." Dr. S. tells me.
I turn to chief.
"Why didn't you teach me that two years ago?"
He just shrugs.
As you can imagine, I'm a bit pissed. I go outside, I call a friend and vent for a bit. Ok, I missed one station, I'll have to test it again (Not until june 13th at the earliest, goddamit!), but the upshot of all this is this:
I passed all the stations I was worried about! In fact, I passed them on my first try!!!
Ok, so I've got a slight delay in my process to certify for paramedic but, it's in the bag! I head downtown to meet with herself and a bunch of other people who have nothing to do with EMS.
Sunday, 5/21 to Wednesday 5/24: Played video games. Read crappy spy novels and murder mysteries. Stayed up all night goofing off. Went running and did a spot of beer-drinking.
Thursday, 5/25: I graduated from college!!!
Friday 5/26: I checked the National Registry website. Under "written exam" it says "Passed."
One more IV start and I'll be a paramedic instead of a pair-of-hands.
Posted by --maddog at 05:03