Well, I’m almost done my practicum… by almost, I mean I could do 4 more tours without having any patients I can use to sign off on my last 2 competencies- but I’m almost finished.
I think there’s something wrong with me. I actually asked one of my instructors; a self diagnosed adrenalin junkie, whether it was “normal” that I wasn’t getting all hyped up headed to calls. He insisted that there was absolutely nothing wrong with that and I had a lot of “maturity” (haha) and life experience to back me up, and staying calm is a good thing.
Even on the few Holy Shit calls I’ve done- I’ve looked around and thought “Geez, how come I’m not flipping out right now! This is NUTS!”. (the reality is, and I’ve said so before, I’m just not the freaking out kind of gal). But I’ve learned that I’m even better at it than I thought.
Anyway… I figure before it all falls out of my head, I should put out a list of Things You Will Learn out in the big bad world of practicum.
1. The definition of “Emergency” varies wildly depending on the person, the circumstances, and the time of day. For example- An elderly person living alone who has a nosebleed that won’t stop, might decide at 4am that this is in fact an EMERGENCY. The definition of “Emergency” as far as the dispatchers are concerned is all inclusive. The box to tick on the screen reads “Uncontrollable Hemorrhage”- Whether you have lopped off an arm, or you don’t have a spouse any more to tell you to stop picking your nose.
2. Sick people smell sick. It’s true that “Not Sick” people may also be… odoriferous, but not in the same way as Sick people. There’s also a difference in the smell of blood depending on the degree of severity. Nosebleed blood smells like blood. But when there’s enough blood that you’re looking around wondering how many patients you really have, the blood smells like Sick People.
3. A good sense of humor will take you a long way. In fact, it is the key to survival in EMS, and medicine in general. If you were to take every situation at face value and stopped to look at exactly what you dealt with on any given day, and couldn’t crack a joke… you’d lose your shit. Besides that, I have yet to find a patient that couldn’t appreciate being given a reason to smile. (ok, that’s not entirely true- I had one that was too busy not having a face). And you have to be able to get along with your crew. As a student, I have no choice but to expect a certain amount of shit and abuse (the good kind), and without the ability to see it for what it is, practicum would SUCK.
4. You might see Dead People. After an entire month I actually had to go out of my way to find one. I’ve never seen a dead person before! So in the wee hours of the morning there was a death on the long term wing at the hospital and I volunteered to go help pack up the body. I wasn’t sure what to expect- all I know about dead people is what I’ve seen on TV, and from that I’ve learned to keep away from their mouths and hope they don’t try to get up. Alas, dead people are pretty boring. There’s nobody home in there, and their faces look a little melty because, well, there’s nobody home in there. I’m sure it might be different if it were a traumatic death, or they die in your care, but dead people aren’t that big a deal.
5. Learn this phrase, and practice it in the mirror, and say it out loud to yourself a few times a day so you know how it sounds; “I was wrong”. This coming from the smartypants know-it-all girl who has spent her entire life preferring to be Right over Happy at every turn… Learn to be WRONG. I’m positive that there have been a few instances where my preceptor has pretended not to see me do something just so he could say “You did not ___insert task____”. And I would start to say “Uh, yes I di……you know what, you’re right, I did NOT do that, I was wrong”. Your preceptor isn’t (necessarily) an ass, but your place as a student is to do as you’re told, when you’re told, and absolutely not argue.
6. Don’t Judge. Probably the hardest skill to master- I know, you’re doing it right now! And that’s ok, but you have to save it for after the call is over. Trust me, the patients can tell. Whether you’re taking care of the uncontrollable hemorrhage (nosebleed) at 4am or driving the drug seeking “back pain” all the way into the city half an hour before you’re due to be off shift, treat them like they’re any other Sick Person, do what you can for them and be nice. Your preceptor might Judge, but so does he have the experience, and is already employed- he can do and say as he likes. When you get all judgey, you don’t do your best work anyway, and then it’s a missed opportunity to practice your skills. So you make your patient comfortable, start that IV if it’s “indicated”, ask your ever growing list of history questions, and make them believe you care that they want morphine.
7. Grow some balls. Yes, that’s actually a piece of advice I was given by another instructor. You have to not only delegate to your crew on scene and in the truck, but you are actually in charge of the scene altogether! When the police show up, they’re there to direct traffic and protect YOU. When the firetrucks show up, they’re there to make the scene safe, move stuff, lift stuff and help YOU! If you tell a firefighter to lay down in a muddy ditch and hold someone’s head for an hour while his crew lifts a car off of the patient, he will do exactly that. But when you get on scene and stand there with your mouth hanging open while everyone runs around- yes, someone will take over, but you will finish the call by saying “I was Wrong”. Get used to being assertive (and polite of course), and don’t be afraid to shout at firefighters- they cant hear you worth a shit with all their gear on, and YES, you get to boss the COPS around (heh heh)! (and for any of you cops and firefighters reading this- THANK YOU)
and last (for now) but not least, you will learn that everybody loves these cookies
No Bake Cocoa Haystacks
1/2 cup butter
1/2 cup milk
1/2 cup cocoa
2 cups Sugar
3 1/2 cups rolled oats
1/2 cup shredded coconut
Add butter, milk, cocoa and sugar to a tall sided pot and bring to a boil, stirring constantly. When it’s rolling, wait 2 minutes (keep stirring), then remove from heat, add vanilla, then oats and coconut and stir really well. Drop by rounded teaspoon onto wax paper. Allow to cool and package in a closeable container. Take to your station and watch the magic!
Well, I can’t speak for all of my classmates, but if I’ve learned nothing more important over the last month, it’s this- If you can’t picture doing what you do for free, for a potentially endless length of time, you’re in the wrong industry.