A grim way to Learn

One of the clear benefits of doing practicals in class is that it gives us a chance to learn from our mistakes. And overall.... as EMT students, we make lots of mistakes.

Most of them are small, like not thinking to put a sheet down on a Reeves stretcher to make it easier to move a patient to the ambulance stretcher later one, or tying bandages in such a way that the un-padded side of a splinting board ends up against the patient.

But then there are the big mistakes. The deadly ones. The ones where, as a student, you sit at the end of the exercise wondering "Do things really go bad that quickly in real life?" [The answer, by the way, is unfortunately 'yes'].

As we come to our final exams, it almost seems that the instructors are purposefully trying to have us kill our patients, because ... well, let's just say that they can be sadistic at times. They are absolutely giving us every opportunity to inadvertently 'kill' our patients as we role play through scenario after scenario.

The good news, of course, is that this is all pretend and no EMT students are harmed by our errors.

The bad news, unfortunately, is that all these scenarios represent real-life situations that various instructors have personally faced. As one told us, "After 25 years as an EMT, I still learn something new on just about every call."

As an EMT, one has to be comfortable with the concept of death and dying. The five stages of grief (anger, denial, bargaining, depression, and acceptance) are introduced early in the classwork, and throughout the course we touch on the medico-legal aspects of DNRs and Advanced Directives, as well as the more challenging emotional aspects of palliative care and how to respond and comfort family members affected by the death of a loved one.

Even the after-effects on ourselves as EMTs is touched upon, because while we are (hopefully) going to focus at the task at hand in providing care, the post-traumatic stress is something we individually have to work through as well.

I can directly relate to this, as I recently learned that one of the patients I encountered during my clinical rotation with our paramedic unit, a 7 year old child, succumbed to his illness later that day. As a father with a son of near this age, the death of this near-stranger hit me a surprising amount. 

So we keep trying to drill on signs and symptoms, focusing our 'index of suspicion' skills on possible underlying causes for injuries and illnesses, and learning to treat the symptoms before us while anticipating the worst of what might come, all the while hoping that we've not missed a critical piece of our assessment that will have the world come crashing down around us.

As I wrote earlier, we're not studying to pass the test, we're studying for those moments where we are the only thing standing between the patient and the grave.

As one instructor put it to me after one particularly challenging scenario: "Death one hundred twenty six, EMTs... zero."