Beginning wanderings OR: The tokens I love so
I guess I'm about to start. I'm gonna kick things off nice and boring like so I don't set expectations too high. Heh. This is the beginnings of my EMT blog. I'm going to try to update at least twice a month, and even more if I manage to find the time. I've been reading a lot of other medical/EMS/that-sort-of-thing blogs and it keeps reminding me that, as safe as I probably am from sheer lack of people reading this thing, I should probably still remember to be careful about all that fun HIPAA (Health Insurance Portability and Accountability Act, the law that controls what can and cannot be shared about people's personal health information) stuff. So, in that vein, a little reminder that anything I post on this thing about people and organizations I run into, treat, or otherwise generally interact with in any way will probably be cleverly altered to the point of being unrecognizable. Fake names and altered descriptions will abound. No attempts will be made to keep things true to life, but I will rather try to make my future posts impressionistic-style, presenting things as I see them rather than how they may have actually occurred. Shouldn't be too hard, as that's basically how I've been doing things up until now. Also, since the world of medicine somehow seems to just LOVE having it's own little language with it's own quirks and idiosyncrasies (ye Gods the number of abbreviations used in medicine...) and since I want people to actually be able to understand what I'm saying (I know they've never really understood what I'm saying and so it's kind of a silly goal, but hey, I said I was taking this thing in a new direction...) I'm going to have a lot of explanatory parenthetical notes (and besides, in case you couldn't tell, I LIKE parenthetical notes... heh).
And finally, I want to talk about the format I'm going to try to do this in. In an attempt to keep things moving more smooth-esque and to maintain more order in this blog (read: bring my general wandering meaningless ranting level down from 11 on a scale of 10 to a respectable 9) I am going to try to adopt a more set kind of format for my posts. I'm going to start things out with any random weird/special introductory goodness, such as these first coupla paragraphs here. This could be anything from fun quotes to random rantings and/or musings to silly anecdotes to God knows what else. It's sort of my RDA of random wanderings so I can get it out of my system before I really start writing. Then I'll have a quick little intro section on how I'm feeling and how that whole life outside of work things is going. I know, it sounds like more ranting, but I think it's necessary (mostly for me... the original point of this blog was to give myself a journal so I could look back at all the things I've been through and learn from the past, don't want to completely eliminate that...) and different enough from the ranting bit to deserve its own section. After that a little description of all I've been through in terms of EMS (Emergency Medical Services, basically the umbrella term for anyone and anything involved in treating and transporting patients in emergency situations) action that's been going on since my last post. This may also contain my trademark ranting, raving, and wandering on towards the end, but I'll try to keep all of that as related to the subject at hand as my very underdeveloped ability to control myself allows. Of course, this format will change with time as I see what works and what doesn't and maybe even what people like and what they don't (as if anyone actually still reads this thing...). So yhea, I guess that's about all she wrote in terms of introduction... off we go.
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Alright... I guess it's about time to get this show on the road. It's tough to do though, just because I know it's yet another undertaking. Recently I've had mountains of new plans and undertakings, but I make progress on so few. Many of them I basically don't even really start on. I have dozens upon dozens of books to read. I have plans I want to fulfill. I have jobs I want to work at for at least enough time to get a real taste of the profession. I have classes I want to take. I have certifications I want to earn. It just goes on and on. Recently the world is making me feel like there's just far too much to it all. Sometimes realizing this makes me feel great, knowing that there's always more to experience and enjoy. But sometimes, and this is how things have been seeming like more recently for some reason, I just feel overwhelmed and for some reason generally... somehow... inadequate. But I press on. I think the biggest thing bringing me down is how difficult getting through the sea of misfortunes that is brought on by the bureaucracy of getting a job in EMS. Douglass Adams sure knew what he was talking about the several times he decided to take a jab at the mountains of red tape that seem to hold the modern world together. But hopefully soon I'll be out there working and all will be well. I'm really expecting a lot from EMS, but I still don't think it's too much. It's such an exciting profession and there's so much to it that I just can't wait to delve into.
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Savin' Babies: Certification, rounds 1-15
So obviously I wanted to start working as soon as I possibly could after finishing my EMT-B (Emergency Medical Technician Basic; i.e. the guys in the ambulance that are one big step below being an EMT-P [i.e. Emergency Medical Technician-Paramedic, or just Paramedic to the layperson, or just plain ol' medic to EMS folks] and one decent step above a first responder). However, at every step I made it seemed as though there was just another person waiting with a very tough to complete form that needed to be filled out in just the right way in quintuplicate before I was granted the privilege of waiting 2-5 weeks for it to be processed. Okay, so I'm exaggerating a little, but things are intense. I had to travel back and forth between my house, the local DMV office, and my doctor's office no less than 5 times over the course of two days before my medical examiner's form was in an acceptable state for the DMV. Anyways not going to go down the path o' rant... gotta brighten the mood up a bit... lemme take my mind off of all of that and talk about the process I went through to become an EMT-B.
To become an EMT-B in California first you need to get your shots and get your CPR cert. I am fully vaccinated against MMR (Measles, Mumps and Rubella), HepA (Hepatitis A, a liver disease), and, thanks to an overzealous doctor, even against HepB (Hepatitis B, another liver disease). Most people outside of healthcare fields and since most EMT-Bs don't have prior medical work experience usually they have to get their series of three HepB shots, which takes six months to fully complete. However, one of my previous primary care docs was really intense and decided to give me mine when I was a teenager for no real good reason, so luckily I didn't have to worry about that. I had my TB (tuberculosis) test and it came out negative. I didn't remember weather I had my shots for some of those and didn't realize that I had a record of what shot I've had and when online though, so my doctor ordered that three or four blood titers be taken. I forced myself to watch the insertion of the needle and the drawing of the blood into the nifty ready for testing titer tubes so that I could get a quick and relatively painless introduction to the kind of things I'd have to start getting used to as an EMT. I took a really simple and easy CPR for the healthcare provider course that taught me to give CPR to adults, infants, and children in various different situations and how to use an AED on different age patients under different combinations of conditions and passed the easy test at the end to receive my certification. After assembling paperwork showing that all of these prerequisites were in order I set off to my obscenely expensive (well, for a poor college student at least...) UCLA EMT-B class. I got my books, got my parking permit, and I was off.
It's an extremely odd class experience as there's some very bad communication shaping how things progress. The way this class was taught we had about 5 different paramedics that would lecture, often giving us conflicting information on how to do things and about 15 different people that would then apply the knowledge we learned in lectures to practical laboratory experience meant to mirror the real world through simulations. The laboratory instructors would also all have a different view on what should be done and what shouldn't and how things should be done. It could definitely get pretty infuriating, but in the end I guess I have to admit somehow we all managed to come out pretty well prepared to deal with whatever may come up, despite it all. At least the course material was straight-forward enough. We never really learned anything too in depth about how the body works or how drugs work or the mechanisms of injury and disease. Really in a lot of ways it seemed like getting to be an EMT-B was less about learning to save lives and more about showing that you were good with dealing with mountains of red tape properly, that you could be a good boy and follow instructions, and that you could understand the bare bones fundamentals of packing up a patient and getting them some real medical help, because as much as you may want to give a patient some sort of treatment, as an EMT-B your best medicine is diesel and burnt rubber. It's not that they don't want you to help, it's just that the people out there with between 2-15+ years of training in medicine (weather they be medics or doctors or nurses or surgeons or what have you) are just going to be able to do a better job and it's more practical to teach you to get a patient to people with more training safely in a short period of time than it is to teach you to try to save someone by yourself. And by practical I mean it just saves more lives. However at the same time the instructors are responsible for teaching the students that even with the little they're allowed to do they could really kill people by failing to provide the right care, which really helps gives things a more serious air and helps keep you focused. Add the fact that this is most people's first exposure to the disgusting injuries that they'll have to grow accustomed to seeing , touching, and smelling in order to be a good EMT to the possibility of being responsible for someone's death and despite the ease of the material we are learning we stayed pretty serious about things. We still really had to focus because we knew what we were learning, as elementary as it was compared to what other healthcare providers could do, was vital. Luckily, the paramedics teaching the course were generally good people, and their enthusiasm kept one sane through it. Their excitement about EMS and about medicine in general helped us learn more through the extra information they gave us in lecture, helped break the monotony and agony of being forced to cram tons of really basic and mostly non-applicable information into our heads because it would be tested on even if it would never be used, and generally brightened the day when things got tough in those weekend-killing back-to-back nine hour days. Their stories kept us entertained and their enthusiasm about EMS was contagious. So we survived and we moved on.
After the course was over we went through various private and public organizations, filling out forms, paying fees, giving various bits and pieces of our identity out in order to jump through the right hoops. We waited for things to be sent around, things to be processed, for the machinery of business and government to groan on towards where we needed it to be. We waited a lot. The DMV needed fingerprinting, a background check, a heath inspection from a doctor, and lots of patience as the employees tried to figure out how an ambulance driver's certification went since it was something that came up so rarely. The National Registry (the National Registry of Emergency Medical Technicians, or NREMT, is the nation-wide certifying agency that determines if someone is qualified to provide a given level of care as an EMT) needed a lot of our personal information, needed recognition from our instructors that we had indeed passed the course and the written and practical tests associated with the course, and needed lots of time to set things up for our NREMT-B test (NREMT-Basic test, one of the major tests given by the NREMT to determine if someone meets the basic national standard required of all EMT-Bs). We needed to go on a ride-along shift with an ambulance company (that was definitely one of the more enjoyable parts of all of this and I'll definitely have a post about that later). After waiting for a week for UCLA and the NREMT to communicate sufficiently for the NREMT to be sure that I had completed my class and all of the prerequisites for taking the NREMT test, I had to deal with Pearson Vue, the private testing company that handles NREMT-B tests. I handled interaction between them and NREMT and worked to get a reasonable test day and place. Then came one of the easiest parts, actually taking the test. It's an adaptive test that asks harder questions if you show that you know your stuff and easier questions if you show that you're in over your head. It takes your performance and compares you to the national standard. It can take as long as 150 questions or 2 hours to decide where you fall on the curve of knowing your EMT stuff, or, as I discovered, it can take as little as 70 questions and just under half an hour. I had been studying like a madman for that test for so long I breezed through it. Probably the second most I've ever studied for a test, right behind the final for my survey course in advanced physics. Passing that test was one of the major boosts that helped me deal with the mess that is the certification process.
After taking the test I had a nice week-long vacation around Trinity lake. I went fishing, drank far too much beer, and just relaxed and enjoyed the beautiful scenery up there out in the middle of nowhere. I got great pictures, mostly of the river flowing by and the mountains at dusk. I recovered to some small extent from the insanity and running around only to fall back into even deeper. I came back to deal with helping my sister handle not just my now 2-year-old nephew, but also my new less than 2 week old nephew, all while my mom was relying on me to help her while she was overwhelmed by the planning required to deal with my other sister's wedding preparation and the housing, feeding, and care of the dozens of relatives that are going to be coming to America to attend the wedding. On top of that I still had EMT business to attend to. If it weren't for that packet from the NREMT containing a fancy looking certificate, a letter of congratulations, and that NREMT-B rocker (i.e. circular patch for the upper arm of a uniform) I may not have had the juice I needed to keep trying to get a job ASAP. But those little tokens mean a lot to me, and they helped give me the drive I needed to keep going. I dealt with more and more paperwork, started to fill out applications, make phone calls, try to get into fast track employment programs that according to some employees exist and according to some other employees don't exist, went through fingerprinting (again) and background checks (again) and dealt with a lot of people on the telephone who at times almost seemed as if they wanted to make things less clear, to throw more obstacles in my path towards certification than already were there. But finally, today, I went to the Los Angeles County EMS offices in City of Commerce and handed in my stack of papers, and after paying the last of what seemed like a never-ending string of fees, received my shiny plastic California/Los Angeles County EMT-I (EMT-I and EMT-B are basically interchangeable terms) license. I know it's just a silly card and that it's not the card itself but everything behind it that makes it important, but man it's nice to have that card. I'm big on tangible tokens. A "good work, pal" from a colleague and a pat on the back are nice, but somehow cards and rockers and certificates are what really make me feel as though I've accomplished something. So there it is, I am officially accredited and licensed. It was a long and difficult path and it took a lot out of me, but I feel very accomplished now. Now I only have to worry about interviews... I have one Friday and I'm hoping to set one or two more up as soon as I can... wish me luck.
A little P.S.: sorry about how long that discussion on certification got, but it really was that difficult and involved. It took a lot of my time and effort and sanity, and I really wanted to try to show how much it can wear on a person. I figured the best way to do that is to explain every time I was told to jump and had to comply and how much weight kept being strapped on after every jump to make it more difficult to comply no matter how much I wanted to. (Yikes, just thought of this... if this is what it takes to become an EMT-B... I'd hate to see what it takes to become an EMT-P... yipe...) Anywho, I plan to make future posts more to the point-ish as far as the last section so that the talk of EMT zaniness should be a lot shorter and more interesting.
__________________________________________________
And finally, I want to talk about the format I'm going to try to do this in. In an attempt to keep things moving more smooth-esque and to maintain more order in this blog (read: bring my general wandering meaningless ranting level down from 11 on a scale of 10 to a respectable 9) I am going to try to adopt a more set kind of format for my posts. I'm going to start things out with any random weird/special introductory goodness, such as these first coupla paragraphs here. This could be anything from fun quotes to random rantings and/or musings to silly anecdotes to God knows what else. It's sort of my RDA of random wanderings so I can get it out of my system before I really start writing. Then I'll have a quick little intro section on how I'm feeling and how that whole life outside of work things is going. I know, it sounds like more ranting, but I think it's necessary (mostly for me... the original point of this blog was to give myself a journal so I could look back at all the things I've been through and learn from the past, don't want to completely eliminate that...) and different enough from the ranting bit to deserve its own section. After that a little description of all I've been through in terms of EMS (Emergency Medical Services, basically the umbrella term for anyone and anything involved in treating and transporting patients in emergency situations) action that's been going on since my last post. This may also contain my trademark ranting, raving, and wandering on towards the end, but I'll try to keep all of that as related to the subject at hand as my very underdeveloped ability to control myself allows. Of course, this format will change with time as I see what works and what doesn't and maybe even what people like and what they don't (as if anyone actually still reads this thing...). So yhea, I guess that's about all she wrote in terms of introduction... off we go.
__________________________________________________
Alright... I guess it's about time to get this show on the road. It's tough to do though, just because I know it's yet another undertaking. Recently I've had mountains of new plans and undertakings, but I make progress on so few. Many of them I basically don't even really start on. I have dozens upon dozens of books to read. I have plans I want to fulfill. I have jobs I want to work at for at least enough time to get a real taste of the profession. I have classes I want to take. I have certifications I want to earn. It just goes on and on. Recently the world is making me feel like there's just far too much to it all. Sometimes realizing this makes me feel great, knowing that there's always more to experience and enjoy. But sometimes, and this is how things have been seeming like more recently for some reason, I just feel overwhelmed and for some reason generally... somehow... inadequate. But I press on. I think the biggest thing bringing me down is how difficult getting through the sea of misfortunes that is brought on by the bureaucracy of getting a job in EMS. Douglass Adams sure knew what he was talking about the several times he decided to take a jab at the mountains of red tape that seem to hold the modern world together. But hopefully soon I'll be out there working and all will be well. I'm really expecting a lot from EMS, but I still don't think it's too much. It's such an exciting profession and there's so much to it that I just can't wait to delve into.
__________________________________________________
Savin' Babies: Certification, rounds 1-15
So obviously I wanted to start working as soon as I possibly could after finishing my EMT-B (Emergency Medical Technician Basic; i.e. the guys in the ambulance that are one big step below being an EMT-P [i.e. Emergency Medical Technician-Paramedic, or just Paramedic to the layperson, or just plain ol' medic to EMS folks] and one decent step above a first responder). However, at every step I made it seemed as though there was just another person waiting with a very tough to complete form that needed to be filled out in just the right way in quintuplicate before I was granted the privilege of waiting 2-5 weeks for it to be processed. Okay, so I'm exaggerating a little, but things are intense. I had to travel back and forth between my house, the local DMV office, and my doctor's office no less than 5 times over the course of two days before my medical examiner's form was in an acceptable state for the DMV. Anyways not going to go down the path o' rant... gotta brighten the mood up a bit... lemme take my mind off of all of that and talk about the process I went through to become an EMT-B.
To become an EMT-B in California first you need to get your shots and get your CPR cert. I am fully vaccinated against MMR (Measles, Mumps and Rubella), HepA (Hepatitis A, a liver disease), and, thanks to an overzealous doctor, even against HepB (Hepatitis B, another liver disease). Most people outside of healthcare fields and since most EMT-Bs don't have prior medical work experience usually they have to get their series of three HepB shots, which takes six months to fully complete. However, one of my previous primary care docs was really intense and decided to give me mine when I was a teenager for no real good reason, so luckily I didn't have to worry about that. I had my TB (tuberculosis) test and it came out negative. I didn't remember weather I had my shots for some of those and didn't realize that I had a record of what shot I've had and when online though, so my doctor ordered that three or four blood titers be taken. I forced myself to watch the insertion of the needle and the drawing of the blood into the nifty ready for testing titer tubes so that I could get a quick and relatively painless introduction to the kind of things I'd have to start getting used to as an EMT. I took a really simple and easy CPR for the healthcare provider course that taught me to give CPR to adults, infants, and children in various different situations and how to use an AED on different age patients under different combinations of conditions and passed the easy test at the end to receive my certification. After assembling paperwork showing that all of these prerequisites were in order I set off to my obscenely expensive (well, for a poor college student at least...) UCLA EMT-B class. I got my books, got my parking permit, and I was off.
It's an extremely odd class experience as there's some very bad communication shaping how things progress. The way this class was taught we had about 5 different paramedics that would lecture, often giving us conflicting information on how to do things and about 15 different people that would then apply the knowledge we learned in lectures to practical laboratory experience meant to mirror the real world through simulations. The laboratory instructors would also all have a different view on what should be done and what shouldn't and how things should be done. It could definitely get pretty infuriating, but in the end I guess I have to admit somehow we all managed to come out pretty well prepared to deal with whatever may come up, despite it all. At least the course material was straight-forward enough. We never really learned anything too in depth about how the body works or how drugs work or the mechanisms of injury and disease. Really in a lot of ways it seemed like getting to be an EMT-B was less about learning to save lives and more about showing that you were good with dealing with mountains of red tape properly, that you could be a good boy and follow instructions, and that you could understand the bare bones fundamentals of packing up a patient and getting them some real medical help, because as much as you may want to give a patient some sort of treatment, as an EMT-B your best medicine is diesel and burnt rubber. It's not that they don't want you to help, it's just that the people out there with between 2-15+ years of training in medicine (weather they be medics or doctors or nurses or surgeons or what have you) are just going to be able to do a better job and it's more practical to teach you to get a patient to people with more training safely in a short period of time than it is to teach you to try to save someone by yourself. And by practical I mean it just saves more lives. However at the same time the instructors are responsible for teaching the students that even with the little they're allowed to do they could really kill people by failing to provide the right care, which really helps gives things a more serious air and helps keep you focused. Add the fact that this is most people's first exposure to the disgusting injuries that they'll have to grow accustomed to seeing , touching, and smelling in order to be a good EMT to the possibility of being responsible for someone's death and despite the ease of the material we are learning we stayed pretty serious about things. We still really had to focus because we knew what we were learning, as elementary as it was compared to what other healthcare providers could do, was vital. Luckily, the paramedics teaching the course were generally good people, and their enthusiasm kept one sane through it. Their excitement about EMS and about medicine in general helped us learn more through the extra information they gave us in lecture, helped break the monotony and agony of being forced to cram tons of really basic and mostly non-applicable information into our heads because it would be tested on even if it would never be used, and generally brightened the day when things got tough in those weekend-killing back-to-back nine hour days. Their stories kept us entertained and their enthusiasm about EMS was contagious. So we survived and we moved on.
After the course was over we went through various private and public organizations, filling out forms, paying fees, giving various bits and pieces of our identity out in order to jump through the right hoops. We waited for things to be sent around, things to be processed, for the machinery of business and government to groan on towards where we needed it to be. We waited a lot. The DMV needed fingerprinting, a background check, a heath inspection from a doctor, and lots of patience as the employees tried to figure out how an ambulance driver's certification went since it was something that came up so rarely. The National Registry (the National Registry of Emergency Medical Technicians, or NREMT, is the nation-wide certifying agency that determines if someone is qualified to provide a given level of care as an EMT) needed a lot of our personal information, needed recognition from our instructors that we had indeed passed the course and the written and practical tests associated with the course, and needed lots of time to set things up for our NREMT-B test (NREMT-Basic test, one of the major tests given by the NREMT to determine if someone meets the basic national standard required of all EMT-Bs). We needed to go on a ride-along shift with an ambulance company (that was definitely one of the more enjoyable parts of all of this and I'll definitely have a post about that later). After waiting for a week for UCLA and the NREMT to communicate sufficiently for the NREMT to be sure that I had completed my class and all of the prerequisites for taking the NREMT test, I had to deal with Pearson Vue, the private testing company that handles NREMT-B tests. I handled interaction between them and NREMT and worked to get a reasonable test day and place. Then came one of the easiest parts, actually taking the test. It's an adaptive test that asks harder questions if you show that you know your stuff and easier questions if you show that you're in over your head. It takes your performance and compares you to the national standard. It can take as long as 150 questions or 2 hours to decide where you fall on the curve of knowing your EMT stuff, or, as I discovered, it can take as little as 70 questions and just under half an hour. I had been studying like a madman for that test for so long I breezed through it. Probably the second most I've ever studied for a test, right behind the final for my survey course in advanced physics. Passing that test was one of the major boosts that helped me deal with the mess that is the certification process.
After taking the test I had a nice week-long vacation around Trinity lake. I went fishing, drank far too much beer, and just relaxed and enjoyed the beautiful scenery up there out in the middle of nowhere. I got great pictures, mostly of the river flowing by and the mountains at dusk. I recovered to some small extent from the insanity and running around only to fall back into even deeper. I came back to deal with helping my sister handle not just my now 2-year-old nephew, but also my new less than 2 week old nephew, all while my mom was relying on me to help her while she was overwhelmed by the planning required to deal with my other sister's wedding preparation and the housing, feeding, and care of the dozens of relatives that are going to be coming to America to attend the wedding. On top of that I still had EMT business to attend to. If it weren't for that packet from the NREMT containing a fancy looking certificate, a letter of congratulations, and that NREMT-B rocker (i.e. circular patch for the upper arm of a uniform) I may not have had the juice I needed to keep trying to get a job ASAP. But those little tokens mean a lot to me, and they helped give me the drive I needed to keep going. I dealt with more and more paperwork, started to fill out applications, make phone calls, try to get into fast track employment programs that according to some employees exist and according to some other employees don't exist, went through fingerprinting (again) and background checks (again) and dealt with a lot of people on the telephone who at times almost seemed as if they wanted to make things less clear, to throw more obstacles in my path towards certification than already were there. But finally, today, I went to the Los Angeles County EMS offices in City of Commerce and handed in my stack of papers, and after paying the last of what seemed like a never-ending string of fees, received my shiny plastic California/Los Angeles County EMT-I (EMT-I and EMT-B are basically interchangeable terms) license. I know it's just a silly card and that it's not the card itself but everything behind it that makes it important, but man it's nice to have that card. I'm big on tangible tokens. A "good work, pal" from a colleague and a pat on the back are nice, but somehow cards and rockers and certificates are what really make me feel as though I've accomplished something. So there it is, I am officially accredited and licensed. It was a long and difficult path and it took a lot out of me, but I feel very accomplished now. Now I only have to worry about interviews... I have one Friday and I'm hoping to set one or two more up as soon as I can... wish me luck.
A little P.S.: sorry about how long that discussion on certification got, but it really was that difficult and involved. It took a lot of my time and effort and sanity, and I really wanted to try to show how much it can wear on a person. I figured the best way to do that is to explain every time I was told to jump and had to comply and how much weight kept being strapped on after every jump to make it more difficult to comply no matter how much I wanted to. (Yikes, just thought of this... if this is what it takes to become an EMT-B... I'd hate to see what it takes to become an EMT-P... yipe...) Anywho, I plan to make future posts more to the point-ish as far as the last section so that the talk of EMT zaniness should be a lot shorter and more interesting.
__________________________________________________