First Paramedic Call

I would like to believe that with every newly graduate comes a sense of eagerness and sloth. One being excited to move on after working so hard to reach the common goal of a particular degree, knowing all the doors of opportunity are now open; yet, in the same way, have a sense of wanting to quit and relax for a semester or two with no intention to do anything except wade in one's own accomplishment. As for myself, I was obvious pulled between the two options. At least until the student loans continue to show up in the mail.

Whenever anyone would ask, "So Kellie where do you plan on working?" or "So Kellie what's your next step?" My simple reply would follow, "I'll figure it out once I test out of becoming a paramedic." Well after the self-doubt, stress, pretest after pretest, and run down skills review - I did accomplish my personal goal of passing my National Registry and getting my state certification processed less than two months after graduation. With that said, I am now a Licenses Paramedic and I still haven't 'figured it out'.

No less than a week after my state was processed; I had the nerve wrecking opportunity to practice my new skills and responsibilities. Where I worked part time in the beginning since I received my Intermediate, was in a rural area just north of Abilene that covers an entire county called Fisher County, home based in Rotan TX. A normal day working with Fisher County, the EMS call volume consisted of 2 calls a day, but of course there were days that can be considered much more busier. My first 48 hours as a paramedic was "one of those days".

During those 2 days spent as a fresh paramedic, we had about 9 calls within the 48 hours. Mind you when I say 'we', there are two trucks on per day and usually switch every 12 hours to be on first call. For the most part all the calls I received were pretty basic with a transfer. But, of course, my first call of that day was dispatched as a patient who fell and might not be breathing. In my mind I strongly questioned, "how could the patient MIGHT not be breathing?" Needless to say after hearing that I STOPPED breathing. Honestly, in my head was thinking 'okay we need the airway bag, stretcher, cardiac monitor, and LBB.' As I'm sitting in the passenger's chair I want to repeat list out loud to my partner, but my mouth could not open and form words...literally! Come to have it on scene, the patient was laying on his right side and was in fact breathing. Apparently the poor guy was just discharged from the ER and when he got out of the car at his home, he slipped and fell. Yet it was greatest sigh of relief in my life.

Ending with the Clinical Book

It may have been just due to the fact that I am lactose intolerant from drinking a latte or maybe it was both, but once I finished that last Patient Care Report for my clinical book I felt sick. Within this binder of checklists, tabs, and signatures held my journey of skills perfected and people I have touched and those who have touched me. I have written in, carried, cursed at, and protected this clinical book during this Spring semester as if it were a sacred grail. Knowing if I lost or misplaced this clinical book, my entire last two semesters of paramedic clinicals meant it never existed. Those people I watched, preformed on, conversed with meant to the school that it never officially happened.

I have written a total of 128 PCRs. Among those 128 patient reports recalls several people with complaints of chest pains or palpations, difficulty breathing, abdomen pains, weakness, nausea with vomiting, broken or sprain extremities, headaches, attempted suicides, car accidents, painful urination or constipation, low blood pressures and high blood pressures, strokes, fever, babies being born, people needing intubations, altered behaviors, unresponsive people, and one dead on scene. All these patients I have met, observed, assessed, and documented ranged from the moment they were born to 99 years old.

Of course this not my first clinical book, but it sure will be my last. Also me having to turn in all these patient care reports doesn’t mean I will never have to document another patient I meet again, honestly when I start working besides assessment and treatment, it’s all about documenting and paperwork. But overall my last semester clinical rotation has showed me how much I feel ready to become a paramedic. What especially verified that conclusion was during an ambulance ride out at Mineral Wells.

LeAnn and I arrived at the clinical site with two Basic students from another school. As all of us were checking off the truck that morning, the alarm suddenly came on for EMS. The lead paramedic decided for all four of us students to come along, so we all sat in the back of the ambulance. So as we are driving to the scene, I’m sitting in the captain’s chair while LeAnn and the others are sitting on the bench, all of us were quiet. I guess LeAnn and I were not aware of our composure, the call came in as a behavioral call so after thinking what needed to be assessed and what possible treatment the patient might need, all we could do at the moment was sit back and enjoy the ride. Now I obviously couldn’t speak for the two other students, but once one of them said “I can’t believe you guys, are you not nervous at all? How can you seem so relaxed?” It was pretty much at that moment I believe LeAnn and I realized this had to be their first ride out.

As I empathized with these two new students, it was a conscious awareness to me of how much I have grown with confidence and routine. It was so eerie to imagine myself as student on a first clinical ride-out like these two students, but I was there at a time with them. Naturally after knowing that this was the students’ first ride out, LeAnn and I gave whatever comforting words and friendly advice to each of them throughout the rest of the day. My clinical at Mineral Wells had to be the most interesting experience as I talked to the new students about there career dreams, witnessing their excitement, them wanting more calls, seeing them unable to fully relax waiting for a buzzer, and overall made me glad I still shared their passion as a student about to graduate.

With my spring semester involving mostly clinical hours and frequent visits to the school to prepare for National Registry paramedic skills, I was able to receive a part time job with Fisher Co. by the help of our head instructor. Working as an Intermediate with their EMS has allowed me to be the lead medic at times and with that helped me become more confident with not just medical skills, but also people/professional and radio skills that you can’t really take from school. Moreover as a small 4’11 female, I was just happy that I was able to reach the ambulance foot pedals while seeing over the steering wheel when it was time for me to practice driving on transfers.

Even so, here I am completely finished with my clinicals and overall my entire school profession as a TSTC student. When I turned in my clinical book to our coordinator, it was an odd sense of release. I wasn’t scared, nervous, or remorseful – I was done. So until then I wait for my course completion sheet so I can test out my written and skills for paramedic, and evidently wait another three to six weeks for my state license by mail.

Unfortunately for my spring class being able to walk across the stage for graduation has been postponed until August 2009 due the Swine Flu pandemic; however, once I’m an official paramedic I don’t know where I’ll be in August, but I will sure try and walk. For me, it is disappointing because as a 6.5 year professional college student the event would be a fitting closure, but the cancellation may just fit itself.

Sometime during my Spring semester as a friend and I were discussing how much effort – physically and emotionally – it is to move to one place for school, work hard, make friends, and then just leave. Overall the conclusion of the debate came to the fact that it’s the journey. I have made many friends from classmates to instructors, and although it is sad to accept the fact that the old elementary ‘friends forever’ is just a cliché. The people and city I feel close to now may eventually fade out; in truth they were there for my journey and vise versa. No one may ever get a prefect closure, but just to have the knowledge of receiving your degree in the mail and the wisdom that was taught by people who care, with friends who stood by your side for a moment in time, and actually enjoying your job…isn’t that all what matters once college is through?

Final Exam

The comprehensive final had a little over 80 questions entailing not only the entire Pharmacology semester, but also Cardiology from the past summer semester. Now 80 some odd questions for a comprehensive final seemed like nothing compared to back in the day of the Basic final consisting of exactly 200 questions, but the consequences of failing held fatal. Fatal not like “if you fail this test, you die”, but fatal in a way of “if you pass this final it’ll be you’re last one for a long time, but if you fail just put graduating in the Spring on hold and retake the final again this upcoming July” kind of fatal. Between the four of us, the two boys had the mind set of There is no ifs, I’m going to pass no matter what kind of attitude, unlike me and the other girl who were nervous wrecks before the test.

In preparing and bracing myself for the comprehensive final I experienced something very similar to the Kübler-Ross model – the five stages of death. But instead of death, it was over the upcoming final. I was in denial how close the day was coming. I was angry over how this stupid final could postpone me from finishing the program. I actually tried to bargain with prayers to pass the final. Yes, I even hit depression thinking Why bother even try? There’s too much stuff…I don’t care anymore. Finally, when the day of the final arrived I advanced to acceptance with my favorite outlook of Well I made it this far. If I don’t know it by now, then I should retake the class. And after an hour and a half of turning in that final test and waiting for the results, a sigh of relief was all that could be formed. I passed, all four of us passed our last semester of lecture, and we each only had to finish our last clinical requirements in next spring. It’s been awhile since that last day of class, but I’m still amazed we four did it – Kent from my original Basic class, Leann, Miguel, and myself.

Accordingly with only having to finish twenty-four days worth of clinical skills in the total Spring semester, I’m not going lie, it’s different. The only focus during that semester was to excel on those clinical hours; there were no requirements of going to class twice a week, no more tolerating that well-known stress over new materials, no chapter quizzes, and especially no more end-of-semester finals. Do I miss it? No, but I will say I do miss the atmosphere with engaging with other students.

I’ll admit my journey through TSTC for EMS, like any other college or university, it wasn’t as clean cut as I had made it seem. One should expect that with such a small number of students per semester seeing each other every other day there should be drama and conflicts, my class was held no exception. So there were some drama between classmates and clashes with instructors, but not often. We all also had our own struggles and responsibilities outside the EMS program whether it had been work, families, or personal health. But even with our differences or outside conflicts, we in some way pulled it together and came to school every Monday and Wednesday or Tuesday and Thursday. Really that’s what all that mattered.

And so with Spring clinicals the only thing that’s holding me back from graduating and testing out to be a License Paramedic, I’m nervous. There isn’t a class on how to transition from EMT student to field paramedic. No one will be looking over your shoulder and coaching you through how to treat a patient, you’re not just working under someone’s supervision anymore, up until then your were just a student, but now everything that you have done to be a paramedic is entirely your responsibility. It’s funny because I have researched this issue online, and out of all the results apparently all say that from student to paramedic rather happens by one’s own time.

For now I’ll depend on the infamous reminders beginning from my Basic semester. BSI and provide O2. Advanced skills or not, ABCs first and let go the tourniquet. Seeing pictures on the monitor are pretty cool, but treat the patient not the equipment. Even trauma victims could be due to medical, get SAMPLE history. One can never be too old to use notecards. As a final point, respect and make the most of on your teammates when you’re in a pickle, as said before, we each need each other whether any of us like it or not.

Official Paramedic Semester Part 2

Now what can I say about my last classroom semester for the EMS program from TSTC? Before I start on my last paramedic course, I need to digress over how each course leading up to this point did hold a different kind of challenging milestone starting from Basic all the way to Cardiology. The issues could have been remembering to give oxygen to the patient, knowing a particular chapter front to back like 8 or 13 in Intermediate, differentiating your heart blocks, or knowing both adult and pediatric cardiac drug dosages. It could have been anything that seems so simple now, but, in the past, it was one of the hardest things to comprehend. Equally, this paramedic section was no different.

In my last part of paramedic lecture, as like the other previous lessons, the three main divisions were Pharmacology, Medical Emergencies, and Assessment Based Management. As a whole, this semester had to be one of my greatest challenges; a challenge because of two primary reasons – my own competence in math and a case of ‘senior-itis’. Pharmacology played a significant battle on my weakness towards math. Fortunate for me, I wasn’t alone, but it’s scary to think that one of the necessities of being a paramedic needs to be capable in determining drug calculations in which many in my class struggled. My instructor during this semester also confessed how hard it was for him to become accustomed with drug calculations, thus offered any tutoring to the willing. Although memorizing drug dosages, class, indications, contraindications, routes, and special considerations took up a bunch of gray matter in our brains, I swear learning how to calculate these medications brought some of us to literally tears of frustration. Somehow we all survived pharmacology without any head explosions, but while I did pass that section I still know I need much practice throughout my life.

The Medical Emergencies section consisted of fourteen chapters in about eight weeks, naturally that’s loads of in depth critical information packed in for a soon to be paramedic student. Somewhere the each of us did hit a road block while learning theses fourteen chapters, I was no different and toiled with the neurology and endocrinology portions. As a team we all tried to play our part in helping each other either by sharing flash cards, using different tips of memorizing such as Beta 1 equals one heart and Beta 2 equals two lungs, or just discussing over the last lecture of the week. Even our instructor helped us by creating scenarios related to a specific medical lesson to learn while doing. I still remember playing 20 questions with a classmate while waiting for our food trying to guess the patient’s medical emergency. As said before, there was a huge amount of information in this section, but after utilizing every technique available the class moved forward to the last section of the fall semester.

Knowing Pharmacology and Medical Emergencies happened to play the biggest parts in the semester, it was nice that Patient Assessment just involved one whole chapter for the last couple weeks of school. What occurred during those last 6 class days in the end was playing scenarios inside and outside the classroom. The situations applied to all the knowledge we have gained throughout our time in the paramedic program, for the four of us about to be done with lectures, it went as far back to Cardiology. In a way forcing the four of us to realize nothing just stops after a passing a section in class, everything we were taught was for a reason to enable us to treat a patient as a paramedic. To reinforce that realization and proving to ourselves that we in fact did not forget our painstaking efforts, we had approached our comprehensive final.

Official Paramedic Semester Part 1

The Paramedic class at TSTC was divided into two semesters – Cardiology and Pharmacology. Once the Intermediate course was over and I received my Basic course completion, there was only a week break before moving on to the Cardiology class. The course took place on summer semester, and because of that many students from the Intermediate class decided to take that semester off due to personal reasons. I, on the other hand, was still adamant to at least finish the program with a degree in 2 ½ years even if it meant no vacation time. The cardiology class consisted of five students, including myself, 2 people from my original Basic semester and 2 people from the Intermediate class. Some may think that it must have sucked having such a small class, but I honestly think had to be my favorite semester due to that very fact.

Once the five of us students moved on to our first Paramedic semester, we were already comfortable with each other. As a group together we each knew each other’s weaknesses and strengths, accepted each other’s personalities and quarks, and most importantly we looked out for each other and gave confident reminders when one couldn’t find it within one’s self – at least that’s what they did for me. To make that particular semester the most extraordinary, we were very fortunate enough to have our instructor from my Basic class teach and follow us to not only Intermediate, but also Paramedic cardiology. As a result, he has watched us grow from curious Basic students to anxious soon-to-be field paramedics. Our instructor had the advantage to become close to us, students, and knew how to work to grow on our individual strengths. Likewise, we were able to understand and absorb his particular teaching pattern and regard as him as not just our mentor, but our comrade through our journey.

Similar to the Intermediate format, the main sections for the first part paramedic included Cardiology, Special Populations, and Special Operations. Throughout that paramedic semester, we had come to familiarize ourselves with new cardiac drugs, equipment, and, in turn, learned both the right and wrong way of treating a patient. I definitely know I killed our manikin horribly over a class scenario once. Even though it was a manikin I still felt pretty bad for him by misplacing the leads and not treating him for the correct rhythm. However we all made slip-ups like that towards the dummy, maybe not as bad as I did, but we did learn from them and I, since then, have became more aware of lead placement on each patient. Besides training on more intense scenarios, the only real addition from lectures, skills, and clinicals was the ability to bask in being a certified EMT-Basic. With that title we each had the capability to move forward on Intermediate clinicals and try out our new advance knowledge and skills to real patients who depended on it.

When my second part of paramedic came along in Fall, three of my classmates from the Cardiology class moved onward with me and, with that, an additional four people entered also making the Pharmacology class a total of eight. What made this Pharmacology section to be somewhat interesting was two of the newer students were from my original Basic semester being a semester behind us. It felt like my old group from the very beginning was reunited and able to work together again. The four students have just finished their Intermediate semester which made this to be their starting point of paramedic part one, and, in contrast, those with me during the summer-time made Pharmacology to be our last lecture class of our curriculum.

In a way the other four students had an advantage in the class by already becoming accustomed to our instructor’s teaching habits owing to he taught them during their Intermediate phase. But, in the same way, those who previously took Cardiology also had an upper hand as a result of being familiar with many of the popular heart medications. Actually, it did not matter whether this was someone’s first or last semester, neither of the eight of us had ever taken Pharmacology. We were all in the same boat and, thus, each member was willing to help the other succeed in any way possible.

EMT-Intermediate Semester

As far as EMT-Intermediate classes went, I think that’s when I began to accept my peers as more than just a 9 to 5 schoolmates, but instead my friends and teammates. In a way I needed them for support and motivation throughout the lectures, skills, and an outlet outside of general school EMS – vise versa I would like to believe they needed me for the same reasons. There were about twelve students in our class overall, the four newer guys already had their Basic patch and didn’t have to do clinicals like the rest of us. Yet that didn’t prevent either one being alienated from our original group. Like I said, we each needed each other whether any of us liked it or not.

Obviously learning how to perform as an Intermediate required more advanced skills and in depth thinking of what happens to the body when one does this?…from Basic semester. Pretty much the lectures of Intermediate class involved a lot of medical terminology mispronounced, a lot of visual aides on the board, and a lot of questioning your acts of why and what happens when something is done to the patient. The three biggest sections during lecture were to understand the body pathophysiologically, advance airway, and trauma. Our instructor pushed us to grasp the importance of the information so we could all see why it was critical to realize quickly and perform crucial IV fluids and the need to intubate. Needless to say, we each depended on each other in hopes someone could translate in layman’s terms during study groups.

As far as skills I want to say that it was easy to learn, but to carry it out was a bit harder. Personally, my main issue with the skills was Trust. Do I really trust my fellow mate to stick me with that needle? Do I really know my landmarks? Do I trust my partner when he says “My veins never roll”? Even though I’m checked off this skill, do I trust myself? Am I even ready? But eventually all my doubts, probably like many before me, washed away after that first successful flash and the equal rise of the chest.

On top of being in class for lecture and lab during my Intermediate semester, I and a bunch of the other students were also doing clinicals. Because the TSTC EMS program requires students to pass the lecture class before doing any clinicals, I was executing my Basic clinicals during my Intermediate class semester. Clearly I enjoyed every bit of it, which fortunately in a way validated my career choice. My first clinical day was by riding out with the ambulance, I remember being so nervous and tense throughout the day going to calls that the next day my shoulder and neck muscles were tight all over. Even though I also enjoyed my hospital clinicals, it was nothing like the ride outs. On the whole completing my Basic clinicals did help confirm that I actually knew what I was doing and that I’m able to apply the knowledge I have acquired.

Yes, you do go to school to become a Paramedic

I was nervous. I graduated high school in 2003 and almost six years later I’m still in school without a college degree. My initial major was Nursing – straight out of high school I went to Colorado for that particular program spending two years there I found out that students making a 4.0 GPA were on a waiting list, so I came back to Texas to spend another two years in San Antonio adamant to get into their Nursing program. Come to have it my GPA was unable to qualify for their program and I don’t know how I came up with the information, but I eventually decided I’ll major in EMS to bridge over towards my goal of becoming a nurse. That of course was my initial goal.

I chose Abilene TSTC because it was only 2 ½ hours away from my hometown and they would accept most of all my transfer credits leaving me with just the EMS program classes needed. But since I’ve been in the EMS program the thought of once wanting to become a nurse has left. I believe the nursing pursuit left after the second month of my first EMT-Basic semester. Sure I may probably come back to nursing eventually, but at the moment it has to be EMS. It’s silly to think that with my initial goal, I planned on not building relationships with my peers – just wanting to do my time, pass, and leave. But of course it’s just not possible.

In the beginning of my Basic class we started out with over 20 students, two, including myself, will be graduating from that initial class as a paramedic this coming semester – following another two the semester after. It’s odd to think how far we all came, how far I came to reach this point.

Looking back I think in reality my Basic year had to be the most stressful time in my life. This is funny because those who have watched me grow through now may say different. But my basic year, like many others, I had really no idea what I was getting myself into, and with that, I started to fall in love with this career and its aspects for myself that failure was not an option because I didn’t want to lose it. It was test module after test module, chapter quizzes, research papers, extraction day, pass a comprehensive final to move onto clinicals or else retake the entire basic class, and when you thought you have done all you could do – you had to memorize and accomplish prefect performance of over 20 basic skills. I threw up at least three times during that whole semester just due to plain stress and nerves – first time in my life. Overall I’d like to think that maybe our EMT-Basic course was like some weird sick boot camp, because we started with over 20 students and ended with eight moving on to Intermediate.