# Failed NREMT Again



## MedicSlayer (Apr 23, 2014)

Welp, after failing my 4th attempt at the NREMT, I think it is time to reconsider my career choice. If I am being honest, I have had 4 chances to learn the MINIMUM competency to practice proper medical procedures and there is obviously something to say for that. Any suggestions from some like minded individuals who have possibly considered or done the same?


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## NomadicMedic (Apr 23, 2014)

Remediate with a refresher ... Or ...






What do you want us to say? Rah rah you can do it?

Not everyone gets a jersey.


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## Rin (Apr 23, 2014)

Sorry to hear that.  Think about what drew you to EMS and what other careers might fill some of those desires.  Best of luck in the future~


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## Chewy20 (Apr 23, 2014)

To be blunt, I don't want a medic working on my family that is having a hard time keeping up with the MINIMUM standards. I don't buy into the whole bad test taker thing either, you either know the material or you don't. I do feel for you though, you spent the time and money for medic school. Either your school failed you, or you just may not be cut out for it. You have 6 attempts (God knows why) so use them or don't.


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## joshrunkle35 (Apr 24, 2014)

I passed on my first try...I re-read the entire book, did probably 100+ hrs of JBLearning, did 2 different company's podcasts that "guarantee" a pass, spent a lot of time doing FISDAP. Any questions I missed in JBLearning or FISDAP, I re-read in the book. Any that I didn't understand, I wrote down and asked my instructor about. I spent 25-30 hours at the end of class with a study group before the test (people that will order pizza, but not beer...people that are there to learn). Then I bought NREMT-P flashcards and went over them all a few days before I took the test. During the class, I bought 5-10 extra books to learn certain concepts from a different perspective, like ECGs, etc. 

People surely pass on their first time doing much less work. I wanted to guarantee a first time pass, and beyond that, I knew that I had a moral responsibility to my patients to do as much as possible to help them. 

You likely have one of three problems:

1: If when you read my test prep, you said, "Cool. Me too." Then preparation or putting the hours in is not your problem. If, on the other hand, you haven't done all of that, you need to. If you haven't studied that hard and keep failing, you need to learn how to study. Mostly, it's about using a variety of sources and variety of methods: listening, writing, reading, games, etc. Then, you need to put the time in. Not 25 hours before your next test, 200 hours. 

2. If you've really hammered out the study hours, and you're telling yourself that you have 500 hours of study but keep failing, then it could be a problem of either not absorbing the material or not understanding how to apply the material or how to do "critical thinking". If you're not absorbing the material, then vary your study habits with other methods. You should be able to test this by taking a "non-critical thinking" test...something that just tests facts, like: What do narrowed pulse pressure, muffled heart sounds and distended neck veins indicate? If you get all of these right, you may be absorbing the material, and might even understand how to apply it, but may not understand how to "think critically". If it asked, "What does....indicate", well, it does indicate Beck's triad (especially if narrowed pulse pressure were replaced with low arterial blood pressure). If it asked, "What can....indicate", well it can indicate Cardiac Tamponade. Knowing how to differentiate between what the question is specifically asking is key. Knowing how to select between answers is equally as important as the information. 

3. If you have the study time, know the material inside and out and know how to apply critical thinking...if you're acing your practice tests but keep failing NREMT, you might have test anxiety, in which case you should see a doctor for a diagnosis and should contact NREMT to see if they have a way to work with you.

If, on the other hand, you're putting in bare minimum time and making up excuses like you "work 40 hours a week" or whatever, then know that while some people ace the test while barely studying, most people that I know who passed didn't sleep for a month and did nothing but study for the NREMT-P exam. They knew it was important to them. They wanted it bad enough that they wouldn't let anything, even sleep, get in their way of passing.


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## joshrunkle35 (Apr 24, 2014)

And...sincerely...I hope you figure out whatever you need to in order to pass. Even if you decide EMS isn't for you, pick yourself up, figure out what you need to do, ace that thing and then decide if you want to do the job or not. You've already made it this far. Don't go through life with regret or leave feeling like you we're beat by something. 

You can do it. Diagnose yourself. Create a treatment/action plan. Make it happen!


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## MedicSlayer (Apr 28, 2014)

I have read your post multiple times, trying to find the right words to say to you. I understand you may or may not be looking for a pick-me-up, but I thought you may need at least a little confidence boost!

You put in roughly 3 years of training to get to this point, and while this test is difficult, it is not impossible. Look at not the knowledge base, but rather the testing format and your reaction to testing- I know many people who have a difficult time testing and need to learn HOW to take a standardized test. Try going to the library and finding some reference material on test taking- forget about all the medical knowledge and focus on learning how to test; give yourself a month to refocus and then go back to the medical readings.

I think frustration coupled with anxiety may trigger body stresses when you go to test. Try finding some calming musics and drink some green tea before you test again.


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## MICP (May 4, 2014)

*Don't Quit*

PM me and we can set up a time to talk.  There may be more to it than knowledge.


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## amanda30 (May 19, 2014)

Sorry to know about your score here are some tips for NREMT which you should follow 

1. Determine what the question is asking
2. Look for signs of criticality
3. Pay attention to respirations and the airway. 
4. Know the nooks and crannies
5. Read the question well--but don't read into it.

rest all depends on your hard work and dedication


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## sublimaze (May 28, 2014)

I found taking thousands of multiple choice questions over and over again was the way for me. I learned that when I took the EMT class. I can't just sit down and study a book. The information doesn't stick like that for me. Find a bunch of websites, apps, books, etc with multiple choice questions. When you come to one you don't know, look up the answer. I get to a point where I take the same questions over and over and start memorizing the answer. Yes, it's memorizing an answer, but it's also memorizing a fact. And answering a question is not as simple as just answering it, it makes you think about all aspects of what the question is asking and really work those critical thinking skills. 

These websites can also shed light on exactly what areas you're struggling in. There's no sense in studying a topic you're good with when you could be using that time to study a topic you're weak with.


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## sublimaze (May 28, 2014)

And don't listen to Chewy, he's that partner nobody wants.


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## TransportJockey (May 28, 2014)

sublimaze said:


> And don't listen to Chewy, he's that partner nobody wants.



Actually I find Chewy's and DEmedic's statements to be spot on. Not everyone passes. No everyone gets a patch. This isn't youth soccer. We need to move away from the lowest common denominator


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## sublimaze (May 28, 2014)

TransportJockey said:


> Actually I find Chewy's and DEmedic's statements to be spot on. Not everyone passes. No everyone gets a patch. This isn't youth soccer. We need to move away from the lowest common denominator



And when he fails it six times then you can say he didn't make that cutoff. But until then, maybe the kid has some test anxiety. Maybe he works better in the back of an ambulance than in a silent room sitting in front of a computer. Maybe EMS is more than a multiple choice test. Maybe that's why they have the practical part. Maybe he works better when it's not his life on the line. Maybe one day, you're on his stretcher. Maybe it might as well be youth soccer because it's definitely not as prestigious as you make it out to be, TRANSPORTJOCKEY.

Or maybe not. But what do I know. I'm just a third generation medic in one of the busiest 911 systems in the country.





So RA RA RA bro, get out there and go pass that test. You got it. I know you do. Some of the best partners I've ever had didn't pass the first go. Or second. Or third. My wife didn't pass her NCLEX first go either, and she's an amazing nurse now.


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## Medic Tim (May 28, 2014)

sublimaze said:


> And don't listen to Chewy, he's that partner nobody wants.




Not everyone is cut out to be a medic. Passing a course means nothing if you can't pass the licensing exam. Love it or hate it , the NR test is what many must take. 
Just because you put the time in does not guarantee you success.


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## sublimaze (May 28, 2014)

Post #5 so I can email this kid.


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## Mellowdnb (Aug 11, 2014)

Hey duder.

It all comes down to 1 thing. Do you honestly think YOU can pass? If not, then you won't. It already sounds like you have thrown in the towel by thinking of another career choice.

On another note, what helped me is to read all the specific conditions in your book. Pay attention to all the signs and symptoms. Next write down the TX you would give. Last write down what each specific condition could present as. Tension Pneumothorax COULD be confused with Pericardial Tamp. By knowing the signs and symptoms of each condition will allow you from choosing the wrong choice.

Look at other books to study. Mosby and Brady books differ. I prefer Mosby because it gives better clinical signs and symptoms. Mosby and Brady suck for Trauma. ITLS is good. PHTLS gives a better lecture of MOI.

Take an ACLS course, PALS course, ITLS course before you try to take it again.


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## Akulahawk (Aug 11, 2014)

One of the difficulties in the NREMT-P exam is that it's adaptive. In that respect, it's very much like the NCLEX and that exam was nowhere near easy. You have to slow down, read the question, read the answers, read the question again while looking for key words and phrases, and then look at those answers that actually fit what the question is asking you for. These adaptive exams aren't the "regurgitate the answer" type of exams that we're used to. You have to think your way through them. You have lots of knowledge, now you have to be able to apply that knowledge to a situation. So, these adaptive exams require you to be able to analyze the question and come up with the correct answer, given your knowledge base.

This question is from the Nursing area, but it may help you figure this kind of question out:



> The mother of a 16 year old girl calls the Emergency Department, suspecting that her daughter’s abdominal pain may be appendicitis. In addition to pain, her daughter has a temperature of 100° and has vomited twice. What should the nurse tell the mother?
> 
> 1.  “Give your daughter a laxative to rule out the possibility that constipation is causing the pain.”
> 
> ...



Well, you'd see this question and answers and the right one might not pop out at you right away, but you know that while constipation may cause pain, it normally doesn't cause a temperature or vomiting. You also know that the appendix is in the RLQ and pressing on the LLQ therefore can't result in rebound tenderness from the appendix. You've learned that appendicitis can happen to people of any age. 

You see the fact that there's pain, an elevated temp and vomiting, and you suspect that appendicitis might be the cause and a burst appendix is not good... so you opt for #4. That's the best answer. 

I've highlighted the words I would key on in red and blue that would help me answer the question correctly. While this answer may seem like _duh, I know that..._ to many people, you would still have to have pull from information/knowledge that's _not_ in this test question to make answering this question relatively easy. Otherwise the test question is relatively straightforward. Just don't read into it because doing that isn't necessary for the test purpose of answering the question. 

I've not taken the NRP exam since it went to computer adaptive, but this style of question is right up that alley of the CAT type of exam. 

I would imagine that most exams you've taken in Paramedic School were of the traditional type of question where you can do well on simple rote memory. This just doesn't prepare you well to take adaptive tests where questions are like the above. 

Before you take your next exam, take a good, serious look at your test-taking strategies. With questions like the above, traditional strategies may not work so well. See if you can find some good test resources that might be able to help you figure out how best to tackle this kind of exam. You've had 4 cracks at it now and haven't done well with the methods you're using. Change it up.


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## MrJones (Aug 11, 2014)

The NREMT exams are hard, and one will inevitably a) guess at more than a few answers and b) walk out convinced of failure. It has long been my opinion, though, that  a) if you know the material to the appropriate level you will more often than not guess correctly and b) unless you were forced to take the test on a Friday or Saturday (no one would voluntarily do that, would they? ) you'll know your results in less than 24 hours, so there's no sense in worrying about it.

And put me on the side of "not everyone is cut out to be in EMS".


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## Akulahawk (Aug 11, 2014)

Not everyone is cut out to be in EMS. Of those that are, not all are cut out to rise above EMT. Some people, for whatever reason, just aren't able to put things together well enough to be able to safely function as a beginning Paramedic. They just aren't. Some people are great on the "clinical" side of things and just can't get the classroom stuff together. Years ago, I had a relatively new EMT partner that passed the exams, got certified, and even worked as an EMT for a while before he got his first really critical call. He wasn't able to handle that very well and slogged through with some hand-holding. His next critical patient just stressed him out too much. On paper he was just like anyone else. In practice, he just wasn't cut out to be in EMS. He made his own decision about that and went on to find employment elsewhere, in a different field. 

This is why I think that having some very entry-level experience is a good way to get your feet wet in seeing if you even _like_ healthcare or are cut out for it. You don't have to work very long at that entry-level position, but you should be there long enough for the novelty to wear off.


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## Mellowdnb (Aug 11, 2014)

I'll make the argument that if one has the will to learn, the desire to help others, the attitude of not quitting and always looking for learning opportunities, one can become an amazing Paramedic. The key is to always keep reading, take courses, go in to the ED and practice skills every chance you get. This field is a learned skill.

Too often this field will be quick to wash someone out but they will not be willing to help an individual succeed. When was the last time an experienced medic was critiqued on his/her skills? Throw an experienced Paramedic in a stressful simulation lab and the results will be not very good.  How many schools teach students leadership and how to become a rock star on skills? Not many.

 People CAN be taught to handle stress. It's called stress hardening. The USAF Pararescue utilizes it. So does some flight services. I was lucky and had a great preceptor who taught me this skill and how to utilize it. Staying organized and having a game plan is key to succeeding.

 1. Learn a skill. GO SLOW. Don't aim for speed. Take every step slow.

 2. Once you learn all the steps, and you can repeat it multiple times with NO MISTAKES. Train for speed. Time yourself. Keep working on this. Stay organized with your equipment.

 3. Once you have speed down, train for stress. Low lighting, people yelling at you, fog machines, tight space environments.

4. Record yourself. Critique what went wrong, what needs improvement and what went well.

Boston Med Flight utilizes the above methods and it works.


  I'll give you the fact that some aren't made to be in this field. It's the ones that have no desire to want to improve, the ones that ***** about con ed and the ones that are rude to patients.


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