I’m feeling exhausted. I just want to plop into my bed and sleep instead of going to the work dinner tonight where me and my coworkers have to dance to High School Musicals for the volunteer appreciation dinner. Its not that I don’t appreciate the volunteers at work, its just that it has been a long day.
I just finished my EMR practical exams for EMA licensing, 08:00-16:30. I can’t even remember how many calls we did, must have been at least eight. Funny thing was that I was the only EMR doing testing that day, so I was always paired with a PCP student and got to assist them with their calls, which for the most part were the same except for different protocols.
Oh, I think I forgot to mention the most important thing: I passed 🙂
Hmmmmm, I was hoping I’d feel euphoria when I typed those two words but I just feel relief and exhaustion.
The examiners were really nice and all my calls went super smooth except when one examiner kept on bugging me by asking me why the patient was having a seizure. I listed all the possibilities of him having a seizure that I could think of on the spot: OD, diabetes, epilepsy, heat stroke, infection, poisoning…except he wouldn’t relent and throughout the whole call kept on asking me the same question:
What do you think is causing the seizure?
I couldn’t figure out why he kept on bugging me about it and it got me pretty frustrated, especially since I was trying to run the call and answer the questions at the same time. Sure I couldn’t diagnose the patient (since none of the reasons for seizures that I could think of seemed to make sense), but I dealt with the airway and lack of breathing just fine. I treated the patient fine. Even the examiner said the treatment was perfect. So why was he bugging me so much?
I found out at the end of the call when we chatted. Alcohol intoxication resulting in seizures. The patient was in withdrawal.
I felt like smacking myself in the head. Well of course! When I talked to the bystanders earlier on scene they mentioned he drank. I remember a light bulb flickering on in my head with the words: ETOH possible cause. I didn’t write it down (stupid me) and got caught up in other things because the patient was having airway and breathing problems, so by the time I did have time to think about it, I had totally forgotten what the bystander had told me.
I guess the examiner was really pushing me. He said I ran the call perfectly, but if I was a PCP student he’d fail me because I failed to note alcohol as a possible cause. Well I think he might be taking it to an extreme, but none-the-less it was a good reminder for me to write down the histories the bystanders tell me in the primary before I forget and take the patient away. Especially a patient who can’t respond to me or tell me any of their histories.
On a brighter note. At the end of the day, during the final debriefing with one of the examiners:
Examiner: “Well, I don’t really have anything to say to you. You did great.”
Me: “Thank you…”
Examiner: “You must do the PCP program. Your train of thought and level is way beyond the EMR level. You’re the people they’re looking for.”
Me: “Yeah…if I pass the interview next month.”
Examiner: “Oh yeah, you’ll pass.”
She said that with so much conviction that I just stared at her to see if she was joking. She wasn’t. She said that so confidently and genuinely. I didn’t feel like I deserved such a compliment.
As I went to leave…
Examiner: “I’ll see you out there on car some day.”
I don’t know how some people can believe in me so much, I wish I could believe in myself as much as they do.
Two more exams left: Written exam on Monday and jurisprudence exam (which was supposed to be on Tuesday but I still haven’t gotten the link!). I got the most stressful and difficult one out of the way today. I’ll keep you updated on how the other two goes.
For those who are curious about the calls I got for licensing today:
1. Status epilepticus
2. High fall trauma–Spinal with chest injuries, GCS 7
3. Burn patient (assistant)
4. Trauma with Fxs (no spinal)/penumothorax/subcutaneous emphysema (assistant)
1. IV Maintenance
3. Spinal Rolls (Assistant)
Other scenarios that day which I didn’t help with:
1. Heat stroke
2. Femur Fx Splinting with wooden splints
Calls not done today but is likely on the exam:
3. Cardiac CP
4. Flail Chest
6. CPR/AED (Adult/Infant)
7. Choking (Adult/Infant)
**NOTE: These are not the be-alls and end-alls to the many possibilities of what you’ll get. But it is to give you a general impression of some of the calls you may get for EMA licensing.
PS You can bring a calculator to the exam for drug dosage calculations.