Oral Station NR practical Exam

Part of the National Registry Practical exam is two Oral Stations, I have discussed it previously here.

 I'm not sure but I have heard that the addition of these Oral Stations is a relatively new addition to the test.

Obviously checklist station scenarios do a poor job of assessing higher brain function in the paramedic student.

You can teach a monkey to pass Dynamic. What really separates a Paramedic from other level providers is their critical thinking skills and ability to control a scene.

The Oral station is suppose to test that.

I don't think I am suppose to discuss the specifics of my scenarios that were presented but I can say that they weren't that difficult to deal with.

 And that is what really screwed folks up.

 I am guessing that the reason so many folks failed the station was that they didn't ask all the SAMPLE questions and take a complete set of vitals.

Honestly, I only did it because during practice one of my instructors told me I should (when testing the Oral Stations).

Also, when I say a "complete set of vitals" I am talking HR, RR, BP, SP02, pupils, lung sounds, temperature, FSBG, skin color, temperature, and moisture.

I can tell you that one of the patients I flat out would not have taken FSBG or temperature if faced with that exact situation in the field, because I honestly don't think there would be enough time(it was an 8 minute transport time to trauma center)

I may very well may have not asked about allergies either, because in this case the patient really didn't "need" any medications.

But I did ask, and I passed. Folks I know didn't ask, and didn't pass.

This whole situation kind of goes against what Paramedic instruction presses.

Paramedics are taught to form a differential diagnosis, and ask pertinent questions regarding patient presentation and that underlying differential.

If it doesn't matter what the patient's temperature is, I really don't think that someone should be penalized for not asking about it.


 So future paramedic student test-takers keep that in mind....

 

Practicals

So I am done testing....I passed my practical.

I had to retest KED.

I just wanted to carry on the proud tradition of ALS test-takers failing the BLS station.


Parts of it were easier than I thought they would be...other parts were harder.

Now I'm just waiting for my cards to show up.

National Registry CBT

All I can say is that the most important thing to remember is to be the BEST answer...as the instructions at the beginning on the computer based test state. I have found that if this statement is phrased another way, it makes taking the test a whole lot easier....

Always pick the least wrong answer

Often, I found myself reading a question, and finding that the answer that I had formulated in my mind was not listed, not even a little bit, so I was forced to pick things like "don an air-purifying mask" before started triage at an hazardous chemical spill MCI, where the appropriate answer was "GET THE HELL OUT OF THERE!!"

But anyway, I passed. The test cut me off after 80 questions, so I guess I did pretty good.

There was a ton of scenario based questions for sure, so I would suggest getting very comfortable with those.

Only a few times (probably about 4) did I have to straight up just guess an answer.

Now, on to the Practical!!!

Taking Responsiblity

As Paramedic school was coming to a close, it became apparent which students were "getting it" and which really weren't. There is something that I can say that I observed about those that seemed to have more trouble than the rest.


They always had an excuse.

I never heard someone who was really having trouble with rhythm recognition say "I will take responsibility for my own learning"

Of course, that is a really strange thing for someone to say...but there always seemed to be extrinsic factors regarding learning, with the course, the teacher, the book, the tests, or the rhythms themselves.

To future paramedic students, my advice in regards to this is that when you crash and burn (you will). Learn from that experience and find ways for you to improve, don't just blame it on factors outside of your control.

Also, if banging your head against the wall doesn't help you retain material, stop banging your head against the wall.

Flash cards were the suggestion for learning pharmacology.

Flash cards didn't work for me.

I stopped using flash cards.

I didn't blame the flash cards, or the people who told me to use flash cards, I didn't blame the fact that we spent slim to nil amount of time on the material in class.

I found something else that worked for me.

What I learned about Hospital Clinicals (Part II)

Pay Attention to the Nurses that enjoy the help

There are going to be some nurses that for one reason or another will have no problem having a paramedic student start every single IV for them and push any medications that they need to.

These nurses are the best, but don't mess things up.

Keep your ears open to how you can help these nurses more. Changing sheets, taking vitals, whatever. That brings us to the next point...

Make sure the nurses that don't give you opportunities see how much (more) you are helping the nurses that are

Don't be obvious, blunt, verbal, or a jerk about it. But if the stick-in-the-mud nurses see how much easier you can make their job, they might open up more.

Graduated

Yesterday I took my finals (practical and written), and I passed.

I am officially graduated from Paramedic School.

My NR Practical Exam is scheduled July 8th, and I will be scheduling the Written Exam as soon as my Program gets the ducks in a row.


I will probably find some time to put some more posts up with my copious amounts of free time.

Ride time

The Harley is still shiny, there isn't any major damage, there is a small pool of blood approximately 6 feet from where the patient is lying supine, C-spine being held by a passerby that happened to be from a local squad. First Response Squad members are surrounding the patient....

"Hi, Whats your name"

"Cindy"

"Cindy, What happened?"

"I don't know"

Judging by her facial expressions she knowns that something is out of the ordinary and she isn't in any pain, there is a small laceration that appears to be bleeding from her chin, she bit her lips, all her teeth are intact and her airway is clear, she has a helmet on, no visible deformities and major bleeds evident. Pressure is being held on a wound below her knee by a first responder. A rapid trauma assessment confirms what I already figured. The lac on her knee must be from something on the bike and the bones underneath appear to be intact.
She says her neck hurts, but its probably not neck-neck pain.

No allergies, takes an ACE inhibitor and birth control.

She goes on a board, and into the truck, off to the hospital. 

Her pressure is slightly elevated, no signs or symptoms of cerebral hemorrhage.

I ask her numerous times if she is feeling nauseous.

18 gauge in her left AC.

Equal chest rise bilaterally, denies SOB, saturation at 100% on room air.

It was her first day riding, she had taken a safety course the previous weekend.

"If at first you don't succeed, don't try skydiving" goes through my head.