Practice Makes Perfect

As people,

we're pretty bad at judging our own abilities. We are often under the impression that because we obtained a certain amount of required academic material, we have the ability to work in our field perfectly. In reality, we're probably way worse at things than we think we are. That can keep us from succeeding in the long term. Your argument may be that you're at the top of your game and have been doing better than ever before. While that might be true, I assure you that as a career and technical education (CTE) students, we do learn various amounts of information regarding our profession but it’s never enough. We can only learn so much through literature and standardized tests. This is why a crucial part of our class includes volunteering, shadowing physicians, and better yet clinical hours. Our CTE instructors and HOSA advisors also plan events and invite guest speakers to help further enhance our knowledge of our career interests. Both try to give us as much information and insight on how their day is and how they manage a high-stress job.

During our CTE course, we are taught certain skills needed to perform a crucial task. Take cardiopulmonary resuscitation (CPR) for example, you might have received a skills sheet and a PowerPoint on how to properly perform adequate compressions along with ventilation. You might have even been lucky enough to physically practice CPR on a Resusci Anne, otherwise known as a CPR mannequin. Let's also add a shadowing experience or two, following a physician around and watching them perform CPR in a hospital several times. Now after several lectures and multiple knowledge enhancement opportunities, you might be an emergency medical services (EMS) graduate student and think you’re ready for any emergency scenario, the truth is you aren’t. You are dispatched to a home in a rural area for a patient in cardiac arrest. You arrive at the scene and the patient has not been given any prior CPR. Considering the time it took you to find and enter the house, along with the time between the family’s 911 call and the time they have been down, you have limited time to begin CPR or there will be little to no brain function left. The patient is not in sight so you ask the family member where they are, they respond with “In the bathroom”. You see that the patient is stuck in a prone position between the tub and the wall, you don’t know if C-spine is clear so you can’t pull him up and out of the compressed area. You try to follow your skills sheet for a medical and possible trauma scenario, but all you’re thinking about is how you will give CPR to a patient in a compressed area.

See when you practiced and observed CPR, the patient was laying in a controlled area like a hospital where help could immediately jump in. Along with the patient always lying in a supine position. You are taught to look at your surroundings and manage with where you are and what you’ve got. You will not be given a scenario similar to this one on a standardized test, module exam, or at least not at the beginning. Like many of our HOSA members, I too am a CTE student enrolled in an EMS course. I attend the Area Career Center (ACC) in Hammond Indiana, and I had the opportunity to learn early on that the amount of academic training I now have is nowhere near close to how much it takes to efficiently work in the field. My CTE instructor,

Mr. Ryan Cogdill, took it upon himself to organize an event to help better prepare us for our clinical and the EMS work life. He called in a couple of his best connections and managed to get a greatly experienced ambulance company, InHealth Integrated Care, to bring an ambulance and walk us through the basic pre-clinical rundown. Along with the information, the Chief Operating Officer, Jeff Zielinski, let us practice a few scenarios using all the equipment including a stretcher and a Kendrick Extrication Device (KED). After Mr. Zielinski gave us a brief overview of the ambulance and all of its features, we familiarized ourselves with the placement of the equipment and removed all expired materials such as lubricant and oral medications. Once finished we began going through scenarios, he assigned everyone a role with specific orders. One of the students volunteered his car as a prop to make the scenario more life-like. The two students entered the car and began to play patients while two other students played the emergency medical technicians (EMT’s) arriving at the scene. Students were also playing the role of police and law enforcement along with basic bystanders. As two of the top students enrolled in the class began their patient assessment for a car vehicle accident, they froze. They were focused on following a skills sheet, which we are taught to do, rather than their surroundings and how they affect patient care.

In some cases, you will not be able to get a well-detailed patient background because the patient might have a speech impediment, not speak English, or simply unconscious. When it came time to put patients in the KED device then onto the stretcher, the students froze again. As I mentioned earlier when you practice these skills you are in a controlled environment where you can see the patient from all angles. When practicing applying the KED on a patient in class, you can easily stand behind to make sure it's fully secure because the patient is usually on a chair. In this case, the patient was in a car with the seat fully reclined back. Things as small as inclining the seat forward didn’t occur to the students because they were focused on following their skills sheet. This was a new situation that we were not prepared for, it’s almost as if all our instincts go out the door because we’re afraid to make the wrong move and cost the patient their quality of life. Take this as an opportunity to learn everything outside the box. For more information on the ambulance company, InHealth Integrated Care, and the ACC EMS instructor, Mr. Ryan Cogdill, please see the information below.