My NREMT

[emtCstock]

I took mine for the first time 2 days ago. I was stopped at 120, and I wasn't sure what to think because I know people who have passed at 120. The class I was in was an extremely tough class (even the medics in the agency were looking at the test question puzzled why they were giving us them), there were 62 people to start out at the beginning, come graduation there were 21 of us left, so graduation felt like a great accomplishment.

Going into the test I felt pretty confident. I'm one of those people though who look at all the negatives ahead, such as if I fail 6 times and have to retake a whole other class again, so I didn't want that to happen. I'm not the best test taker and I'm not the worst, I tend to over-think the questions. Ever since I found out I failed this first attempt today it's got me down, I tried telling myself that I wouldn't be tripping if I failed the first attempt, but it still affected. I don't know what the first attempt percentage is that passed but i'm trying not to think about being a failure emt just because I failed it on the first try.

So now I'm definitely going to study a lot harder this time and try not to let the first NREMT fail get to me. I know this profession is for me and want to do whatever it is to pass and get my license. I figure if I just re-read my book I should be alright. I'm not one who likes to buy tools to help me but I did purchase the Fisdap study tools and I suppose I'll see how I do come next test.

 

[usafmedic45]

there were 62 people to start out at the beginning, come graduation there were 21 of us left, so graduation felt like a great accomplishment.

62? Seriously? The attrition rate is about where it should be but you should have started with the number you finished with and seen similar washout of people.

 

[emtCstock]

Yeah, we had 4 total tests, all over 100 questions. If you got below an 80% you failed it, then you got to retake it. If you failed the retake you were asked not to return to class and were booted from the program

 

[Handsome Robb]

62? Seriously? The attrition rate is about where it should be but you should have started with the number you finished with and seen similar washout of people.

66% attrition rate is where it should be? I agree the class needs to be more involved but that sounds like downright bad instructing....nothing against your school OP.

Don't over think the test, it's not hard. Just go back to the basics. Literally the entire test can be answered with Scene Safety/BSI, consider c-spine, ABC. Now in the real world you have to think for yourself but that's the way to pass the test.

 

[emtCstock]

Thanks. Like I said it was an extremely tough class, we learned a lot more than we needed too. I mean I'm not saying its a bad thing, more knowledge is great, but I figured I'll gain most of that through the years, but I would have liked to learn everything that an EMT should know, not both EMT/P, them cramming all that information into me is what made me over-think the questions.

 

[emtCstock]

I agree with you on "in the real life". When we had to do our clinical shifts, everything done in the field was so different from what we had learned.

 

[firemedic0227]

My class started out with 14 and we ended up with 6 people 4 of which were from the original class. So far 4 of us has taken the test and im the only one that has failed. The other 2 has not taken either test for NR yet. Our class also had the 80% rule. The sad part was that I had the highest grade in the class and I am the only one to fail the NR Exam.

The thing is now that I know what I need to study up on (Pathophys and Peds) that what I will be doing over the next month and re-taking the test in January. Studying never stops as a Paramedic ... Right? haha

 

[emtCstock]

If anyone was curious as to which test, it is the nremt/b, just saying.

 

[PAFSI]

It's my opinion that over teaching is what causes some of the issues once people hit the street. Basics attempting skills they were taught but not in scope can not only cost a certificate but a life. Working on the Federal level it is frustrating enough seeing people that don't know the difference between minimum required skills, DOT permitted skills and State permitted skills. Top that off, students studying for EMT-B have it hard enough with new skills, why confuse them with skills they aren't permitted? The instructor could also find themselves in trouble with State authorities for teaching outside of the scope of the students practice. Its like me teaching basic first aid and covering IV's. A student gets sued and they recall the syllabus and find that he/she was taught more than they were permitted, I would be open to liability lawsuits that Good Samaritan would never cover. Just my 2 cents, which won't get you a Falafal in Kabul.

 

[usafmedic45]

It's my opinion that over teaching is what causes some of the issues once people hit the street.

Any evidence to back this up or are you just talking to hear your head rattle?

Basics attempting skills they were taught but not in scope can not only cost a certificate but a life.

Come again? I think I see what you're getting at but I think that speaks more to the immaturity or unsuitability of individuals for the field rather than a problem with "overteaching" as you say.

Top that off, students studying for EMT-B have it hard enough with new skills, why confuse them with skills they aren't permitted?

Who is teaching skills that aren't permitted (or at least aren't required knowledge for the exam)? The problem is a lack of knowledge, not a large number of BLS providers being taught ALS skills.

The instructor could also find themselves in trouble with State authorities for teaching outside of the scope of the students practice.

Once again, are you just going off on a tangent for hypothetical argument here or do you have some proof if this? A lot of states have a rather open ended policy regarding protocols which allows providers to pretty much do whatever their medical director can prove he adequately trained them to do. Therefore, any "extra" education given isn't out of the scope because the scope appropriately varies from department to department based on the capabilities of each. Our EMT-Is were taught to a level that is more in line with most paramedics than the NREMT-I standards at the request (or I should say, demand) of our medical director. None of us who served as instructors nor our medical director heard from either state we were involved with about us teaching "out of scope". They were well aware of it too, since our medical director liked to play games with them about how far he could push the scope out. I think he enjoyed watching the more conservative folks at the state level squirm.

student gets sued and they recall the syllabus and find that he/she was taught more than they were permitted, I would be open to liability lawsuits that Good Samaritan would never cover.

Actually, no you wouldn't. The liability would be on the former student for not following either a prudent layperson standard (as a bystander/civilian) or the requisite medical knowledge inherent with their respective position. Poor education is not an excuse to pass the buck and it's not a proximate cause so the chances of you being successfully sued would be minimal at best.

Seriously....where do people come up with this crap?

 

[PAFSI]

USAFMedic45:
{Any evidence to back this up or are you just talking to hear your head rattle? }
An opinion is exactly that, opinions do not require evidence as they are theoretical in view.

[Come again? I think I see what you're getting at but I think that speaks more to the immaturity or unsuitability of individuals for the field rather than a problem with "overteaching" as you say.]

Providers are responsible for maintaining their roles in the scope of practice, but you teach skills a person is not permitted to use, they blur the SoP. Just the other day we fired an RN w/ 18D background because he performed skills he was not permitted. He argued his reasoning but in the end his training exceeded his scope and that cost him his job.

[Who is teaching skills that aren't permitted (or at least aren't required knowledge for the exam)? The problem is a lack of knowledge, not a large number of BLS providers being taught ALS skills.]

emtCstock said "Like I said it was an extremely tough class, we learned a lot more than we needed too. I mean I'm not saying its a bad thing, more knowledge is great, but I figured I'll gain most of that through the years, but I would have liked to learn everything that an EMT should know, not both EMT/P, them cramming all that information into me is what made me over-think the questions." So he stated he was being taught beyond his scope of practice. I am guessing you are one of those that would argue that EMT-B should be a 1 year class. They should get all of their experience in class before they ever hit the street. Then you would be the first to say that everything one learns in class is useless since it is different in the "real world". If the later is true, why require them to sit through classes that are useless? As emtCstock wished that he could learn the detailed stuff on the streets where he would learn the pertinent information.

[Actually, no you wouldn't. The liability would be on the former student for not following either a prudent layperson standard (as a bystander/civilian) or the requisite medical knowledge inherent with their respective position. Poor education is not an excuse to pass the buck and it's not a proximate cause so the chances of you being successfully sued would be minimal at best.]

So you base this on your Professional Legal Training? Before you teach your next class you may wish to contact legal counsel and ask them what their interpretation of the law is. Page, Wolfberg and Wirth (who represent me on EMS matters) would agree. But to suit your demand for evidence, right from the Emergency Care in the Street: Paramedic glossary "negligence- professional actions or inaction on the part of the health care worker that does not meet the standard of ordinary care expected of similarly trained and prudent health care practitioners and that results in injury to the patient" For the laymen, anyone that acts in a manner beyond what would be expected or permitted is negligent. If the DOT curriculum is not being followed, they are not providing training that is expected of similarly trained health care practitioners.

[Seriously....where do people come up with this crap? ]

Its called professional development and 20 years of experience on the street. I own my own business training multiple levels of EMS and have to keep abreast of current laws and legal trending. My knowledge and experience have been called on the stand and certified as an "Expert Witness" on several legal cases. So I recommend you pull out your Paramedic manual turn to chapter 4 and re familiarize yourself with your limitations.

 

[usafmedic45]

So you base this on your Professional Legal Training? Before you teach your next class you may wish to contact legal counsel and ask them what their interpretation of the law is.

You know I'm on the roster of expert witnesses for a malpractice attorney too right? Guess where I learned what I posted from....

Page, Wolfberg and Wirth (who represent me on EMS matters) would agree

How long did it take you to google "EMS malpractice lawyers" to find that?

right from the Emergency Care in the Street: Paramedic glossary "negligence- professional actions or inaction on the part of the health care worker that does not meet the standard of ordinary care expected of similarly trained and prudent health care practitioners and that results in injury to the patient"

Show me where it says "instructors can be held liable". Better yet, point me to some case law showing that it was a successfully argued matter. The burden is on the provider to verify that their practices are in keeping with the current medical standards. Also, if you were really an expert witness, you'd understand that malpractice is not based simply on "negligence" and that several other factors come into play.

Providers are responsible for maintaining their roles in the scope of practice, but you teach skills a person is not permitted to use, they blur the SoP. Just the other day we fired an RN w/ 18D background because he performed skills he was not permitted. He argued his reasoning but in the end his training exceeded his scope and that cost him his job.

Which is it? Do you run a business training EMS providers, work in a setting with nurses, etc or are you deployed to Afghanistan?

But that's because he lacked common sense, not because he had the training in excess of what his scope is. I'm trained to do a lot of stuff (chest tubes, pericardiocentesis, surgical airways, etc) but it doesn't mean my standard of care is "blurred".

You're just looking to pick a fight and it doesn't matter if I march Ken Mattox, Bryan Bledsoe and Justice Scalia in here, you're going to continue with your belief that what you're saying is absolutely correct. Hopefully, the other rational members of this forum can see through your bluster.

Its called professional development and 20 years of experience on the street.

You know what they say about relying on experience alone....as for professional development, you're about as much an expert witness as you are an airline pilot.

My knowledge and experience have been called on the stand and certified as an "Expert Witness" on several legal cases.

Would that be here or in a foreign country? LOL

I own my own business training multiple levels of EMS and have to keep abreast of current laws and legal trending.

Really? Where?

For the laymen, anyone that acts in a manner beyond what would be expected or permitted is negligent.

It depends on what they did precisely. Under a prudent layperson standard, the definition of what one would reasonably be expected to do is rather vague so it's hard to make blanket statements.

If the DOT curriculum is not being followed, they are not providing training that is expected of similarly trained health care practitioners.

So then you're telling me that services that use thrombolytics, RSI, retrograde intubation, etc are somehow violating "the law"? Remember, the DOT curriculum is not a binding piece of legislation. It's not even a legal baseline. It's a suggested educational curriculum. The state standards are going to be what folks are held to. Besides the discussion isn't about dropping below the DOT curriculum, it's about going above and beyond it.

If you weren't talking out of your back side like you can't see straight ahead of you with both eyes well enough to read, I might be more inclined to believe some of the fanciful stories you're telling. Have a nice day and enjoy your stay here, however long it might be.

 

[PAFSI]

How did you know I was an Airline pilot? And now that I am at 5 posts, I can link to facts. I have read of few of your posts and watching House on AFN, you lack the true Cynical ability to be any more then another disgruntled poster that would counter that it took a mommy and daddy to make you if it gave you the chance to post one more time. But seriously, read Chapter 4.

 

[usafmedic45]

How did you know I was an Airline pilot? And now that I am at 5 posts, I can link to facts. I have read of few of your posts and watching House on AFN, you lack the true Cynical ability to be any more then another disgruntled poster that would counter that it took a mommy and daddy to make you if it gave you the chance to post one more time. But seriously, read Chapter 4.

OK, I'll go read "Chapter 4" if you agree to read the following before your next post. I'm all for people being well rounded when it comes to potentially useful knowledge and since I see you're already up there.....
http://en.wikipedia.org/wiki/Crucifixion#Nail_placement

This also might be interesting to you since we're on the subject of execution methods..... :lol:
http://en.wikipedia.org/wiki/Official_Table_of_Drops :lol:

BTW, welcome back.

 

[emtCstock]

Well on a side note from you both, I'm retaking it next week. So I hope for the best.

 

[PAFSI]

Wishing you luck!! Remember what you have in your book is what they will test you on, nothing else. Always stick with your first answer. And the test is based on "best answer" not the only answer. So don't over think it, just answer it with your best answer. You passed your prep tests to get this far and they shouldn't have been much more different. Looks like I am getting ready to go back to take the new Paramedic test and will be using the exact same theories, they got me through Basic and Intermediate already.

 

[emtCstock]

Thanks, I'm feeling pretty confident this time around.

 

[emtCstock]

Take 2 is on Wednesday. Feeling a little better.

 

[epipusher]

Has usaf ever been a civilian medic? I'm not so sure he has.

 

[emtCstock]

I passed!