FlightEMS.com

Okay, I am a CSI junkie. Fueling my addiction? TiVo, which means CSI minus the commercials. Life is good.

Today, one episode really made me nostalgic. For those of you who don’t know, I spent time in the Army as a flight medic, stationed at Fort Irwin, California. This base is 35 miles north of Barstow, in the middle of the desert and, for the most part, boarders I-10 from Barstow to Las Vegas.

Although we couldn’t ‘compete’ for calls from the local MEDEVAC company or the CHP flight crew, we would occasionally be called in during periods of bad weather, (we were IFR capable) or for assistance in mass causality situations (we could carry up to 7 patients). One mission was a bus that had flipped.

The interesting thing about this episode, besides the bus roll over, was their use of ‘live’ victims. Although you can never replace the chaos of a real mass cal., I was impressed with the little details that made it across. Katherine, after finding a victim still alive in the mangled wreckage, stood and stared at her bloody hands as the man was carted away by paramedics. Gil Grissom had an encounter with another live victim the day after at the crash site who couldn’t tell him why she was there, her entire face screaming disbelief. Both brought instant feelings of familiarity to me.

Two minor pieces of dialog also surprised me. The first was a discussion over the driver’s body in the ME’s office regarding Type II diabetes and the possible symptoms. I was especially interested in the comment made by the ME about the prevalence of obesity in this country. Strange place for a stance on obesity? I thought so. The second, which probably only matters to me, was the comment about the McDonald’s in Barstow. Nick clarified it’s identification by saying something like, “You know, the one with the train.” I was thinking it right before he said it. All the tourists at that place used to drive me nuts.

The other interaction that really surprised me surrounded the victim that Katherine found. Katherine was having a difficult time understanding why he would sign a DNR prior to emergency, potentially life saving surgery. The victim happened to be a resident physician at UCLA.

I will never forget my favorite resident, Dr. V, standing outside an ICU room explaining what DNR meant to the family of a very, very ill 80 something woman. He stood there, in all of his 27 years, and told the family that he would never, ever want CPR done on himself. I later inquired to his sincerity because of his serious, but honest demeanor and the fact that he had echoing my thoughts, as well as the thoughts of many people who live and breathe medicine.

Do not do that to me.

The victim’s girlfriend gave that exact explanation to Katherine and Nick from her own hospital bed. I never would have expected this glimpse of health care provider reality to show up on one of the most watched shows on television.

My last comment has to do with this article I found while cruising my MSM sources. How many times have we, as health care providers, sat watching a TV show, or been in a movie theater and let out a cry of disbelief when they screwed something up? Okay, so it has completely annoyed everyone around us to the point that we shut up, but damn if it didn’t just get ya where it counts, huh? I found it very amusing that the real life CSI people were catching the same backlash. Welcome to our world, boys!

This type of technology would be an incredible advance for my patients, but in the back of my nerd girl mind, all I can see is visions of Darth Vader!

Medgadget.com — Internet Journal of Emerging Medical Technologies

I don’t want to take them. Okay, no one wants to take them, but I really don’t.

The pressure is on for me to get the Acute Care Nurse Practitioner boards over with. It has been 6 months since I finished my MSN program and all I can do is think about the stuff I didn’t learn.

Oh, don’t get me wrong, my education was unbelievable. I accepted an NP position in a hospital that has never had an ACNP on staff. Can you say a challenge fit for someone with experience? The great thing for me is realizing that my student loan payments (Which come out of the grace period this week!) were worth accumulating. I have definitely been prepared for the trail blazing that is ahead of me. Instead of intimidation and panic that I should be experiencing, I am instead in the midst of a semi-adrenaline, semi-competitive haze (or maybe it is denial!)

Nope, it is definitely excitement.

What the heck am I afraid of then? The details. I am weak with remembering the details. Pharmacology in particular. Cardiology? Scares the shit outta me. If something isn’t broken or gaping I don’t like it so much. Chest pain? Yeah, I am thinking PE, not MI. It is the trauma girl in me. I recently found my feelings of inadequacy eloquently echoed in MadDogMedic’s entry about his paramedic education.

I have come to realize, however, that the adult student fits somewhere on Maslow’s Hierarchy of Needs. There are some who are down at the basic level of ‘Safety’ attempting to keep their head above water, get enough sleep to function, and learn what they must to get by. Survival is the name of the game.

Others (the ones I hate) have their papers done the week they are assigned, and challenge every question they happen to get wrong on an exam because they KNOW they are right. If it isn’t a 4.0, it just isn’t good enough. ‘Actualization’ appears to be their goal, but it is nothing but a shallow farce.

Educational ‘Actualization’ comes not from hours with a book, but with the ability to apply what one has learned at the bedside. The hours of research, ridiculous papers, and ‘busy work’ homework are not just something to be suffered. They are not meant to impart details to remember for eternity. The ultimate goal of higher education is to teach the learner how to learn. Teach the student to respect what they do not know and give them the tools necessary to find the answers they seek. Most importantly, the goal is to humble them into accepting their knowledge gaps and drive them to be ever diligent in searching out answers.

MadDogMedic has yet to realize is that his fear of not knowing makes the good, great. When I dial 911, I do NOT want the highest grade in the class to walk through the door. I want the one who is ever diligent, ever fearful and ever passionate.

Shortly after finishing my training as a flight medic in the Army, I asked a mentor if he still got scared when the mission bell went off.

He looked me square in the eye and said, “Emily, the day you aren’t scared is the day you need to quit.”

I am still scared.

I just recently stumbled across Medical Grand Rounds. This week they are hosted at Sumer’s Radiology Site.

For those new to MGR as well, Nick at Blogborygmi was the originator. Archives can be found here.