A Lesson in Knowledge - Paramedic Skills Testing Day

Written by (Tray1)

It’s FINALLY here! Today is our National Registry skills testing day. For 2 school years we have worked toward this day. To become a paramedic, the skills testing day and the written testing day are the two most important days of the whole journey. Everything that our class has done up to this point has been geared towards these 2 days. Two days will determine if I am worthy enough to be issued a license to be a paramedic.

This morning I got up and everything was fine. I did everything exactly as I do when getting ready for any other day. Leaving the

I pick up my friend and classmate John and we are on our way. John was pretty nervous all the way to the testing site. I was pretty relaxed as he was keeping me entertained. We were early so we stopped at the coffee shop. We were both laughing hysterically because he was very nervous. Evidently his nerves have an effect on his GI system!

The impact of this day and what was happening didn’t hit me until I was doing my first skills station. It was one that I was good at. I stumbled. From there I fell and then the snowball effect had started and there was no stopping it. I kept falling on my face. My nerves were out of control. The nerves had an iron grip on every one of my body systems and wouldn’t let go. Every station I went into, the instructor told me to breathe. I kept forgetting to breathe? This was out of control. I did each station and can’t even remember most of what I did.

I asked one of the instructors whose PSA we were in and I don’t recall who he said, all that mattered at that point in time is that it wasn’t the service that I worked full time for as a dispatcher. I did not want to be the legendary dispatcher that tried to become a paramedic that passed out during her skills testing. Those stories tend to take on a life of their own! I told the examiner if I pass out; do not call the ambulance as I would come to in time. Hopefully before my time was up for that station!

I am nervous about passing both cardiology stations. Cardiology has been this demon that keeps trying to take control of my life. I struggled to learn it. I have spent more time studying Cardiology than I have on anything else over the last year and a half. I hated it prior to learning to love it.

I was having a difficult time controlling my nerves prior to walking into the cardiology stations, and it was pretty much over before I even walked in the door. I started the station, looked at the rhythm and convinced myself I didn’t know what it was or how to treat it. This black veil went down between my mind and the rest of my body. How in the world could that happen, how did I let that happen? It doesn’t matter. I looked like a complete idiot and the man testing the station was the demon. I don’t know how I walked out of that station and didn’t run away. I walked to the bathroom and just slid down against the wall. To emotionally exhausted to do anything. I just sat there in the darkness in my mind, knees up, arms on the knees and head down. To emotionally spent to even think of what just happened. There was just darkness without any emotion.

The veil lifted. My mind kicked in and I told myself to just get through this and not think about anything else. So I walked out of the bathroom back into the room, that room, the room that was the epicenter of everything bad that was happening in my life at that moment. I see people that I know, but I look right through them, to lost in what was happening to me. I couldn’t look at them, I couldn’t feel, I couldn’t do anything. My body was fighting too hard to breathe and stay conscious, there were not enough cells left in my body to deal with my emotions.

I couldn’t adapt to what was going on. I was trying to control the raging nerves that were taking control of every fiber of my body. Every cell of my body was fighting for its very livelihood and as hard as the battle was fought, I just couldn’t do it.

In the middle of the afternoon, waiting for my name to be called, I just sat there in my own zone with my classmates and I was totally spent, exhausted. We all sat there unusually quiet, we were all just there. Nobody was saying anything.

How much damage did I do? I knew the damage had been done and I was too exhausted to even worry about it. So I sit on the floor in the hall watching my classmates called into the closed door room of doom, one by one. Each one coming out with horrible looks on their faces.

They call my name, I look around like I am expecting to see another person with the same name stand up and enter the room. Nobody’s moving. It must be me. I will my body to walk towards the room. I was almost having an out of body experience. I am not scared, I know I had a bad day and now they were going to give me the score card to prove it.

I enter the room and EMSRB rep asks if I had any issues with the equipment or the stations. I manage to give her a knowing smile and respond, “nothing that we haven’t already discussed”. She shows me this little card and it takes me longer than normal to focus on it. All the stations are listed on it and there are 4 people’s initials on it. I look at her for an explanation. Did I only pass 4 stations? Whatever it means, it wasn’t registering in my tired mind at that point. She tells me I have 4 stations to retest. She goes into an explanation of what this little piece of paper means to me and at that point I am only seeing her, nothing she is saying is going into my head. My mind is racing and wondering how in the world did I managed to pass all the other stations? Every system in my body was in mass confusion. I didn’t know if I should cry, smile, jump up and down, vomit or just faint. I took a deep breath, smiled and said thank you and calmly walked out of the room.

One of my classmates asked how I did. I can’t even remember who the first to speak was; all the cells in my body were still in a state of mass confusion. Then somebody asked if I was going to retest today. I said “I don’t know” and walked away.

I walked into the epicenter of my destruction as my personal belongings were there. I sat down in the chair. I put my hand on my purse like it was the comforting teddy bear from my youth.

As I sit there. I try to reflect on what had happened today. It wasn’t working. My mind kept going back to the black veil coming down and shutting down my brain. I found the strength to tell myself to let it go. If only for now, let it go.

People are coming and going in the epicenter of destruction. I sit there and come to the slow realization that I have a decision to make. I don’t want to make the decision. This could be the end. I don’t want it to be the end. I don’t want it to end like this.

I needed to find something to calm myself down. I needed to find something familiar. I need to get into my head and get past the veil. I need to think. My mind takes me to the song Kryptonite.

I took a walk around the world to ease my troubled mind, I left my body lying somewhere in the sands of time. The tune and the one sentence keep playing over and over in my head like a broken record.

I need to make a decision. So I have a come to Jesus meeting in my head. I am thinking that with the knowledge I have, I am a damn good EMT. What’s wrong with being an EMT? Nothing is wrong with it. All of a sudden, something kicks me in the ass and says “You didn’t go through all this, just to be a damn good EMT. Get out of this chair and finish the job!”

Is this what my mid life crisis is all about? Is this my moment of truth? I quit my management job to follow my heart’s desire and mix things up. With a new job, I also started school. It took me twenty years to go back to school and here I sit. I couldn’t even tell you if this was my moment of truth. My head was beginning to hurt from all the thoughts and emotions.

Finally, in what was probably only minutes, but seemed like a lifetime, I made the decision to retest. That’s all it was, it was a decision. I couldn’t rationalize or analyze it at that point. I was glad that I had enough brain cells to make the decision.

I walk up to the queen of the epicenter and tell her I want to retest. She informs me I have to retest all the stations today and can’t just pick what I want to retest. I told her that I would like to go do cardiology.

Every system in my body started to scream. What just came out of my mouth? How did my mouth betray the rest of my body? What was going on? Deep breathe, it’s to late, my feet are going to the cardiology station and nothing is stopping them. Oh God, what is happening? As I walk down the hall, John is sitting on the couch. We make eye contact. I tell him to come with me. He gives me a questioning look and I tell him to come on. My feet keep moving, they aren’t letting my body stop this forward motion. John is right behind me. We get around the corner and I turn to him and say, “Help me!”. The look on his face tells me he doesn’t know what I need. I tell him to convince me that I can do this. He quickly goes into his usual self. “You can do this; you know the material, slow down and take your time.” Just then the instructor emerges from another classroom. He gives me a questioning look and I say emotional support. Again, my feet betray me; they follow the instructor into the room. I don’t look back at John, I can’t.

The instructor gives me the choice of doing static or dynamic first. I tell him to choose. In my mind I am thinking I just made the decision to walk into this room and at this point, am not fully capable of making another decision.

I take a deep breath. The station starts. My treatments are very short sentences, sometimes one word. I have to stay focused. Concentrate on treatments. It’s all about ACLS. If I keep it short and sweet the veil won’t come down. I complete the first station and go on to the second one. Same thing, keep it short. Don’t waste your words. I hand the last card back to the tester, inform him I am done and look blankly at his face. He gives me a smile. At that moment, it was like baseball, the batter knows it is a homerun the second the ball comes off the bat and that is what it felt like. I put my head down in my hands and start to cry.

He asks if I am OK and I told him that I was not crying about whether I passed the station or not. I was crying because I made it through. The weight is now off my shoulders. The morning had been a total disaster and I had froze and looked like a fool. He informed me that he couldn’t tell me if I passed or not. At that point, passing didn’t matter. All that mattered was that I tested my cardiology stations with a complete stranger and the black veil did not come down over my brain. This tester was not the demon.

After a day of every cell in my body being in complete turmoil, I am starting to settle down. I go re-test the IO and start to feel like I have some control over what is going on here.

I have to go test my drug administration for a second time. The reason I didn’t pass the first time is that I do not remember a single thing that I did in that station. The black veil from the cardiology station followed me into the IV/drug administration station. Nothing to reflect on when you can’t even remember your actions!

I walk in to retake the drug administration and my eyes send my body back into the complete turmoil it has been in all day. I am surprised that I did not have a full blown seizure at that point. Oh no, it is him. The guy that tested me originally on cardiology was sitting in the IV station. Here we go again; every body system starts to go insane for the millionth time today. The cardiology demon has resurfaced in the IV/drug administration station and we already share the secret of the black veil of my mind. This time my feet want to turn and run away. My brain won’t let me. I convince myself to do this. I tell myself just to get through it.

I do the station feeling like there is no way, I am going to pass, and this guy knows I am a complete idiot. He was the only witness to my complete melt down this morning. He represents the black veil of my mind. He is the demon that brought the black veil and here it comes again. Poor guy is probably really nice, but today he is the mortal enemy of my mind. I complete the station and walk away.

I go back and sit against the wall in the hall waiting for my name to be called again. There is only the feeling of being done that gives me comfort. I can’t even reflect on the events of the day. My friend and classmate reaches over and puts her hand on my back. The tears start to flow again and come way to easy. We don’t say anything, she knows. I just put my head down trying to hold back the tears.

John’s name is called. John at the tender of age of 25 has been my mentor, one of my best friends. John has held my hand, kicked my butt, and made me believe that I was good enough to do this. As he is in the room of doom with the closed door, I reflect on our relationship over the last 2 years. I didn’t talk to him much today and I know he isn’t mad at me about it. We both had a job to do and came and did it. At no point did it ever cross my mind that John would not be successful today. John is good, he is very good. I manage to stand up against the wall. I am going to give him a congratulatory hug. He deserves it. He has not only managed to take care of his own studies, he has helped me and his success is very important to me. He is young and has goals and has everything in front of him.

The look on his face as he walked out of the room of doom, said it all. Something had gone horribly wrong for him. We made eye contact, I didn’t approach him. I knew by the look not to. I see the glisten of a possible tear on the ridge of his eye lid. I gave him my best empathetic mom look as he walks by. He put his head down and I let him go to be by himself.

My name is called a second time to visit the room of doom. I go in and the EMSRB rep tells me that I did not pass my drug administration station on the second try. This time, I almost pass out.

The realization of what just happened hit me like a ton of bricks. I failed one of the easiest stations of the skills. I could have walked out of there today passing all my skills. She is handing me her card with dates and locations written on the back of it. I walk out of the room of doom, completely lost. Again, somebody asks how I did and I reply by saying I have to retest one station, not offering anymore information than that.

I find John and we agree it’s time to go home.

The day isn’t over. We have to call our instructor with our results. Our instructor is another big reason that I am here today. He has put everything into our paramedic class. He seemed nervous for us last night. Calling is the last component of this day, so I dial his number. I don’t even know what I am going to say. He answers and sounds like somebody ran him over with a very large truck. I say hi and he responds back. I asked what he was doing and he said he was in his office making a noose. For lack of a better response, I told him that wouldn’t solve anything. He asked how I did and I asked if he wanted the good news or bad. He chose the bad first. I told him I had one station to retest and the good news was that it wasn’t either one of the cardiology stations. He asked about John. John was still upset about the controversy over the station that he failed and didn’t want to talk about it. In my crabby mom voice I told him to talk, handed him my phone and they conversed about it. Now the day was complete.

With the help of my friends and loved ones, all my body systems have reached homeostasis and I am able to take in the events of the day. I am able to return to my optimistic self. I have one station to retest. My friends didn’t let me be alone and sulk, they were there convincing me that I had the necessary boot straps and the ability to pull myself up from this and they were there to help me.

In reflection, I have kicked myself because somewhere on the way to the testing station, I lost my self confidence. I had the knowledge; our instructor made sure we had that. He did his job very well. I studied and knew the material. Having the knowledge is the one thing that got me through the day. The knowledge didn’t fail me. It was there, that is why I was able to do as well as I did. I failed the knowledge.

The knowledge alone wasn’t enough. The missing element was that I didn’t take care of myself. I forgot to make sure my self confidence was in check. I was not mentally tough. I didn’t prepare myself for how stressful the day could be. My body didn’t know how to react to the situation. I was not able to adjust or adapt. I didn’t have any back up systems in place. I got lost in myself and the betrayal of my nerves and my whole body revolted against it.

In the future, as I walk into the next testing site, I will smile and know that I survived the first one! It will not be as difficult as the first time. I will have the key in place (the knowledge) and I will not forget to take the lock (self confidence, mental toughness, adaptability) that the key fits into!

The National Registry maintains that your testing day is not a day for education; you are there to test your knowledge. I agree with the statement. But, on this particular day I received an education that can’t be taught in the classroom, it can only be taught by having the experience. Today I learned that there is so much more than just having the knowledge; just as there is when you are a paramedic.