Friday, December 10, 2010

It's the end of the semester as we know it....

Today is my last day of clinicals. I am spending my day in a firehouse in Smaller County (that I hope to possibly get hired in when they open applications this month), attempting to defrost my hands. Who decides it's a good idea to wash the ambo in sub-freezing weather anyway? My sleeve is wet where the water ran down from the hose. I miss the sauna in McMurdo's Station 1.

Anyway, as stated, it's the end of the semester, and I have a chance to breath. Facebooking has been possible, but that's about all I've been able to muster. While this semester hasn't had the intensive class time and tests of last year, it has been a study in time management, of which I am a poor student. Three days of clinicals a week, several papers, and a couple of tests thrown in for good measure have had me hopping around like a headless frog the past few months. I have had some interesting calls, which I will regale you all with once the semester is done for good next week and I have time to take a breath and actually think. Next Monday is ACLS class (finally!), and Tuesday is my final presentation for my research class.

I will say that I find myself endlessly frustrated by the seemingly arbitrary skills and the number of times we have to perform each skill in order to finish our ride-along time. In apparent direct contrast to the new AHA guidelines, we are required to record the number of patients we ventilate, (one patient=one ventilation) and we are required to ventilate 20 patients. However, we are not required to track or have a certain number of patient's we perform compressions on. I don't know about anyone else, but most working codes, where one would be performing ventilations, tend to come in late at night, generally after we are forced to be out of the firehouses. Not to mention that even as a live-in at a relatively busy, non-medic staffed station I didn't have 20 working codes in an 8 month period. So please explain to me how I am supposed to get 20 ventilated patients between September and December (and then again in February to April). I am quite frustrated.

Add to this that I seem to be the ultimate 'white cloud.' Medics breath a sigh of relief when I walk through the door, knowing that the next 8-12 hours will be easy. The most calls I have run on a medic unit in a 12 hour period was 5, and only one of those was an ALS call that required more than a bandaid and a bit of comfort. Not that those things aren't important, but as a student who is required to have a certain number of specific skills (IV starts, ventilations, medication administrations, etc) these type of calls do not really help, aside from the assessments (which, admittedly are also important, as I need assessments for things such as respiratory distress, chest pain, altered mental status, syncope, psych, OB, etc). Most of these I have, but we just don't run that many trauma calls (most of those being of the BLS type). Therefore, I find myself behind in trauma, psych, and AMS assessments. I have a plethora of respiratory calls, but very few chest pain calls. The OB calls will come when we do our L&D rotation next semester, and I find myself hoping that I will be able to get more hospital time next semester to attempt to check the appropriate boxes. However, even the nurses at the hospitals are happy to see my wander in, as my presence guarantees a quiet 8 hours.

All told, I am not unhappy. In fact, I have had several calls that were excellent teaching opportunities, both as far as assessments, skills, and interpersonal relations go. I've learned lots of what not to do, and some of what to do. How to deal with difficult nurses and doctors, when to treat and when to let it ride, and so on. Riding at my home station isn't quite as good, because I can't practice as an ALS provider, but the medics there know I'm in school and let me ride with them to work on my assessments. One of the medics (I seem to be the only one who likes her) is an excellent provider, and quizzes me on what to do next, and basically runs through the call with me, what I would do next, medication dosages and so on. It's very nice to have that extra help.

But I am very glad the semester is nearly over. Just 4 more short months, and I'll have my second BS degree, and be a licensed paramedic. Then it's just a matter of finding a job.