I've had a couple of weeks now to reflect upon the completion of the EMT course, and my successful certification by the state of New Jersey. I want to again thank my wife and son for their patience with me, and to everyone that offered their support and well wishes.

The experience was both easier and more challenging than I had expected. In all honesty, the course material wasn't particularly difficult to understand, even with the use of medical terminology sprinkled throughout. The hands-on and practical skills weren't particularly difficult either, whether it was applying trauma bandages, inserting airways, performing CPR, or just moving and lifting patients.

On the other hand, I was challenged to overcome an initial desire to simply 'help' a patient with what appeared to be an immediate discomfort or pain, and rather to slow down and assess the entire situation, looking for those more hidden issues that actually posed a greater life risk. It took a bit of time for me to not just understand the importance of this, but to actually internalize it to the point that it became natural to slow down rather than speed up in times of crisis.

Not that I was always perfect at it.

The waiting is the hardest part.

Last night I took the NJ State certification exam, and to be honest, I found it easier than the class final.

75 hopeful future EMT's were given up to 2 hours to complete 100 multiple choice questions, which spanned the entire gamut of course materials from operations to anatomy, pediatrics to geriatrics, medical injuries to trauma care. 

So I was either really well prepared or clueless.

Results can come in as little as 48 hours, although the State only promises "3 to 6 weeks".

My wife asked me this morning if I was relieved it was all over, to which I snorted and responded, "This isn't the end of the journey, it's just the start."

Now I'm just waiting to hear the word "Go!"...

Today was our final practical exams, a requirement for graduation from the EMT course. Designed to test our knowledge and understanding of all things EMT, covering medical and trauma assessments along with key skills including airway management, bandaging and splinting, CPR and AED usage, and pharmacological interventions such as EPI-Pen and Nitroglycerin administration.

And although the final practical exams were designed to test the skills I have gained over the past 4 months, in the end it taught me perhaps the most important lesson of all -- a reminder that being humble and keeping an open mind may just be the most important EMT skills I can master.

While the EMT course has been challenging, especially for someone who has been out of the day-to-day experience of classes, studying, and test taking for almost 30 years, I felt that I had done pretty well for myself. My quiz and exam grades were always high, and while there was a lot of memorization to accomplish, my own life experiences often helped to put class material in context and perspective.  Eighteen months as a driver for the squad gave me an additional sense of how to interact with patients, and the experience of having observed other squad EMTs actually putting some of these skills in action in the course of our calls might have even offered me an edge in some scenarios.

Through the class, the practical exams had gone extremely well, with several instructors telling my that I appeared to have that special quality that would make me a good EMT. I passed through all the practical exams without requiring remediation or a second (and final) attempt to demonstrate a critical skill.

And then there was today. Final exams. And on the fourth and final skill station, I made a huge mistake, one that I won't quickly or easily forget.

And so it begins, not with a whimper or a bang, but rather with a 2-and-a-half hour orientation session last night. 24 hopeful future EMTs, split about 50/50 between men and women, from squads around Morris, Union and Somerset counties.

I'm taking my EMT course through Atlantic Training Center at the Morris County Public Safety Academy in Parsippany, although there certainly are many other training organizations offering EMT courses in New Jersey.

The key message last night was pretty simple: Becoming an EMT is hard work. Be prepared to put in the time, study, practice and study some more. Classroom lectures, reading assignments, online lectures and quizzes, in-class written and practical exams... plus 10 hours of clinical rotation in a hospital emergency department or with the Mobile ICU (MICU, aka paramedics). Clearly, this is not something you can coast through with some last minute cramming.

One instructor explained that they weren't there to help us pass the course. Their goals were to turn out the best EMTs possible, and while they'd be more than happy to help us when we need it or when we ask for help, but ultimately this has to be something that we, as students, really wanted to succeed at.

The goal, as he explained it, was to teach us to "act, not react".