Monday, July 20, 2009


Yesterday was a long, busy, tedious day.

The monthly National Registry practical exam went off up in Concord yesterday. Evaluators needed to be checked in by 8:00AM, but it was not possible for me to do that because of my travel time. I didn’t leave Boston until almost 7:30, and I had about a 90 minute drive to the Fire Academy. All things considered, it wasn’t a bad drive, and I did well to get there when I did.

When I arrived I was assigned to one of the Oral stations. I know – some people would say that this sounds obscene, but it truly isn’t. But I should give a little bit of background about how the practical is done.

First, Paramedic candidates are tested in 12 skill stations – some combined with others. For example, there are multiple airway stations that a candidate has to show competency on: endotracheal intubation on an adult and on a pediatric patient, and placement of a secondary adjunct like a Combi-Tube or an LMA (stands for “Laryngeal Mask Airway”). Those are three separate skills that are evaluated by one evaluator. Another is IV access on an adult with medication administration and intra-osseous access on a pediatric patient. Again, three separate skills tested in one station. Other stations include patient assessment, static (identifying rhythms and verbalizing assessment and treatment) and dynamic cardiology (the dreaded mega-code), the random skill station (an obligatory station for demonstrating skills like immobilization – a common skill many Paramedic candidates fail), and the Oral station, where the candidate is given a scenario and they have to talk their way through it from beginning to end.

I can’t really give details, but the different scenarios include all manner of medical emergencies. The candidate has 15 minutes to talk their way through the situation, basically showing the evaluator that they understand what they are supposed to do from the time they are sent on a call to when they go back into service once they’re done. And there is a time limit of 15 minutes to get all of this done.

I saw 10 candidates yesterday. All of them got through the station without failing, but a couple were incredibly close on time. Some of them forgot that while they had to demonstrate attention to detail they had to do it quickly in the interest of time. It’s a fine balance to maintain, but that’s the way it is in the real world.

It’s not easy.

I’ve been an evaluator for almost three years, and the only station I haven’t worked on is the Cardiology station, simply because I am not an ACLS instructor. At some point that will change, but for now I’m happy not having to deal with that. I enjoy the variable nature of being put in a different place each month. It keeps things interesting.


Karen Brook Westhaver said...

Loved your post! Not just because of the wonderful detail of a HUGE day, but because I saw it as a metaphor of living an intense life where the pace is always shifting w/ much beyond one's control. Can totally relate. The "fine balance to maintain". I look at it as finding a comfortable "cruising altitude" to be able to deal with things as they come, never knowing what/when they will be but maintaining a pace which meets the needs but does not drain you of all your energy/resources. All while being intentional and conscious of taking time and space to enjoy the ride :) "A fine balance to maintain"...tricky, that! Thanks for the good read I always find when I check in on your blog.

40lizard said...

Just went through the Basic NREMT's- I feel your pain from my side of the world and can only imagine from the evaluator's stand point! I was exhausted both mentally and physically after each test!