NREMT-B Practical

Yay! I passed my NREMT practical yesterday on the first try for everything. Now I just have to pass the written/computer-based test.

I honestly thought I was going to fail the long spine board station... it was a disaster. It's a skill I'm definitely comfortable with (last week I taught it to 30 probationary members!) but I'm more accustomed to working with a particular type of board with spider straps. In the exam I had to use a particular type of board that I despise and seatbelt straps which I really, really despise. They get stuck under the board and malfunction and get in the way and get stuck up patients butts and are generally a pain in the ass (figuratively for me, literally for the pt).

So I get started on the long spine board exam with one of the more intimidating proctors watching my every move. CSMs go well. I start applying the c-collar but I'm struggling because my "patient" is wearing a massive hoodie and the hood is getting in the way of the collar at every turn. Finally I get it on and it's sized wrong. So I take it off and start over, again struggling with that damn hood. This time I get it right.

Finally he's collared and I'm ready to place him on the board. The proctor and I log roll him and I pull the board up to his back and we roll him back down. He's barely on the board. Okay, let's try it again. We roll him again and I try to get the board up against him but it's really stupidly-shaped so when we roll him on to the board, he's barely on it. At this point I'm sweating, humiliated, and getting into that nervous death-spin cycle, but I know that I just need to do it again until I get it right. So we log roll him one more time, and this time his body and the board cooperate and he is neatly centered on the board.

I immobilize his thorax, pelvis and legs with no trouble, and then I get to the head. I place the head blocks and start trying to tape his head down but the damn tape sticks to my gloves like crazy. Now I'm really frustrated. So I spend all this time fumbling with the tape as it rips my gloves and turns itself into a twisted mass of worthlessness.

Finally I figure it out and place the forehead strip, folding it to be nice to my "patient". As I start taping the chin down I look up and notice that the forehead strap has slipped down conveniently right over my "patient's" eyes. At this point, I want to cower out of the room and sit in a corner for a while, but I don't. I move the tape out of his eyes and apologize and finish the job. I leave the room confident that I had failed and really angry that everything seemed to go wrong and I couldn't seem to get anything right.

The other stations went smoothly but that experience in the long spine board station definitely dropped my confidence a little. I was shocked when I learned that I passed that station, although my instructor did comment that I had stepped over my "patient", which I don't remember doing at all but probably did.

At first I was pissed that all of the equipment "malfunctioned" and all of the circumstances seemed to be stacked against me, but then I realized, hey... that's EMS for you. It's rarely pretty and perfect and things are not always going to go the way they should. Equipment is going to break. Partners are going to be stupid. Patients are going to be difficult.

Anyone can backboard someone in a nice clean little room with plenty of light and a calm patient and all this perfect equipment and a bunch of hands, but EMS will ask you to backboard a screaming, bloody patient who is upside down surrounded by a crumpled vehicle in a ditch while it's raining at night after you have gone without sleep for 2 days and you really, really need to pee.

That stuff cannot be taught in a classroom and while it's intimidating it's also something I'm anticipating. It's a challenge that I want to match my resourcefulness and stubbornness against. I hope I can stand up to it.