NR written...

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HorseHauler

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Well i'll be taking my NR written on this wed the 14th for paramedic on the new computer based testing. Anyone recently taken this new CBT test? Also are there a lot of odd ball questions they like to throw at you? I'm trying to freshen up on as much stuff as I can before Wed and was kind of wondering if there is anything I should really concentrate on that NR and DOT likes to ask? Just like everyone im nervous as heck and know this is an extremely tough test, so just trying to prepare as best as I can...

Any words of wisdom is appreciated.
Thanks
Eric
 
Well just got back from taking my test, not sure how I feel about it... It cut me off at question 150, so I think I interpret that as I was pretty much riding the fence the whole time, pass or fail.... I don't know... Some others were cut off at 80 so that pretty much meant they blew right through it or bombed it. wish me luck...
 
I hope everything goes well for you! Keep us posted! :)
 
Yay!!!!! I'm A Paramedic!!!!!!!!!!!!!!!!!!!! Woo Hoooooooo
 
THAT IS AWSOME!!! LET ME BE THE FIRST TO TOAST! :beerchug: :) :) :)
 
thank ya, thank ya!!!
 
The next the that Eric will say....... CLEAR!!!^_^
 
Knew you could do it!!!! I am soo happy for you!!!!! Congratulations!^_^ ^_^ ^_^
 
Congrats. Now that was quick.
 
Airwaygoddess said:
The next the that Eric will say....... CLEAR!!!^_^
Click to expand...


clear.jpg


hahahaha
 
Eric that is pretty dam good!!!!!!^_^
 
Congratulations Eric. Tough test I've heard though never got NR myself.

With that I'd like to open up a little discussion on your qoute. Let me preface this by saying, nothing against you or what you have accomplished. This is purely for discussion sake, because of how I looked at my own career.

"Yay!!!!! I'm A Paramedic!!!!!!!!!!!!!!!!!!!! Woo Hoooooooo"

My question is... when are you/we/anybody a paramedic? Certainly the NR pegs you as one. Obviously the powers that be do as you get assigned to a rig. But, when are we truely medics?

I remember the same feelings as Eric 25 years ago as I was handed my white shirt and was told "Congratulations, you made it." This after 13 months of class, clinical time and evaluations by the "older guys". My first day I offered to take the first call from my partner who for 13 months had been breathing down my neck and questioning every move I made. It was a respiratory call, which I hate. I felt nervous but this guy did the worlds best thing, he turned his back on me and walked away to let me do it myself. No pressure. Well, there was still pressure, but not the artificial kind brought on by having your work critiqued all the time. He obviously felt I was a medic.

In those days I mostly worked alone anyway ( I mean without another medic) , at least for the first 7 years and about 4000 to 5000 patients. I spent many a day questioning myself more than he had ever done. Was I any good? Should I have been certified? Do I know what the hell I'm doing? One day after about a year, in a hurry to leave the ER for lunch, I whipped out a chest painer report like I had done them forever. As I flaired my signature across the bottom I stopped and thought to myself, "hey, that call was easy." I didn't even think about it. It just got done.

Of course this wasn't the first call that went easy just the first one that dawned on me. At five years I was talking to a buddy who had graduated at the same time as me. I felt he was way better than me and was shocked to find out that we both , at this time, felt that we were just really feeling like we knew what we were doing. What do you know, it wasn't just me. At ten years we both said to each other, " you know I finally think I've really made it. "

There's plenty of guys smarter than me. Many that raced through the class faster. Lots that can spout the protocals blindfolded. But since I am second senior medic and have seen all the guys below me work their way up, I can say that certifying and running those first few years of calls sometimes made me laugh and wonder" did I look that lost when I started?" I'm pretty sure the answer was YES!

My point is that getting a certificate from an agency saying your a paramedic , while a huge accomplishment and an incredibly proud moment ( I remember) , does not a paramedic make. To me, all it says is, here's a guy we don't think will screw up too bad. Let him work toward being a paramedic. We think he's going to make it.

Anyway, thats my story and I'm sticking to it. And again, no disrespect to Eric, just for discussion.

ffmedic -
trying to figure out should I retire before or after I actually start pushing those a$$#0l*s off the road who don't pull over. :P
 
I agree with you 100%. I know I have a long way untill I "believe I really make it, and really know what i'm doing". Classroom only teaches you book work. It takes years of real life patient care to really find out what your made of. This is why now that registry is over, you can forget quite a few things that you learned that will have nothing to do with working in the field, now you have to learn it the field way. My comment was purely happiness of passing the class.
 
Old School State to NR?

No offense to you, and I do understand what your saying, as to all the booksmart medics out there, who could diagnose a swallowed penny to which part of the gi tract its working through just by auscultation. BUT the piss themselves when they get the pressure of their first CPR where there in command. BUT DONT STEAL HIS THUNDER. I mean, you sound like a nurse trying to degrade an emt right now. And besides, talk to anyone who took their state test back in the day, and has any experience with dabbling with the NR. The most common answer you get: "I COULDNT HANDLE NR". Straight from a ccemt-p yesterday actually. Point being, a lot has changed since NR took over. Paramedics are given WAY more responsibility, and their knowledge is expected to be MUCH MUCH deeper, than Im sure anyone thought it would go. ANYWAYS, JUST LET MY MAN ENJOY IT. NR doesnt just "hand" you a shirt and say, here, your a medic. You have to earn it. I destroyed THREE duffle bags carrying my books from medic. And that was just walking about three hundred yards a day for six months.. HOW MANY BOOKS DID YOU HAVE?

ffmedic said:
Congratulations Eric. Tough test I've heard though never got NR myself.

With that I'd like to open up a little discussion on your qoute. Let me preface this by saying, nothing against you or what you have accomplished. This is purely for discussion sake, because of how I looked at my own career.

"Yay!!!!! I'm A Paramedic!!!!!!!!!!!!!!!!!!!! Woo Hoooooooo"

My question is... when are you/we/anybody a paramedic? Certainly the NR pegs you as one. Obviously the powers that be do as you get assigned to a rig. But, when are we truely medics?

I remember the same feelings as Eric 25 years ago as I was handed my white shirt and was told "Congratulations, you made it." This after 13 months of class, clinical time and evaluations by the "older guys". My first day I offered to take the first call from my partner who for 13 months had been breathing down my neck and questioning every move I made. It was a respiratory call, which I hate. I felt nervous but this guy did the worlds best thing, he turned his back on me and walked away to let me do it myself. No pressure. Well, there was still pressure, but not the artificial kind brought on by having your work critiqued all the time. He obviously felt I was a medic.

In those days I mostly worked alone anyway ( I mean without another medic) , at least for the first 7 years and about 4000 to 5000 patients. I spent many a day questioning myself more than he had ever done. Was I any good? Should I have been certified? Do I know what the hell I'm doing? One day after about a year, in a hurry to leave the ER for lunch, I whipped out a chest painer report like I had done them forever. As I flaired my signature across the bottom I stopped and thought to myself, "hey, that call was easy." I didn't even think about it. It just got done.

Of course this wasn't the first call that went easy just the first one that dawned on me. At five years I was talking to a buddy who had graduated at the same time as me. I felt he was way better than me and was shocked to find out that we both , at this time, felt that we were just really feeling like we knew what we were doing. What do you know, it wasn't just me. At ten years we both said to each other, " you know I finally think I've really made it. "

There's plenty of guys smarter than me. Many that raced through the class faster. Lots that can spout the protocals blindfolded. But since I am second senior medic and have seen all the guys below me work their way up, I can say that certifying and running those first few years of calls sometimes made me laugh and wonder" did I look that lost when I started?" I'm pretty sure the answer was YES!

My point is that getting a certificate from an agency saying your a paramedic , while a huge accomplishment and an incredibly proud moment ( I remember) , does not a paramedic make. To me, all it says is, here's a guy we don't think will screw up too bad. Let him work toward being a paramedic. We think he's going to make it.

Anyway, thats my story and I'm sticking to it. And again, no disrespect to Eric, just for discussion.

ffmedic -
trying to figure out should I retire before or after I actually start pushing those a$$#0l*s off the road who don't pull over. :P
Click to expand...
 
mxjagracer said:
No offense to you, and I do understand what your saying, as to all the booksmart medics out there, who could diagnose a swallowed penny to which part of the gi tract its working through just by auscultation. BUT the piss themselves when they get the pressure of their first CPR where there in command. BUT DONT STEAL HIS THUNDER. I mean, you sound like a nurse trying to degrade an emt right now. And besides, talk to anyone who took their state test back in the day, and has any experience with dabbling with the NR. The most common answer you get: "I COULDNT HANDLE NR". Straight from a ccemt-p yesterday actually. Point being, a lot has changed since NR took over. Paramedics are given WAY more responsibility, and their knowledge is expected to be MUCH MUCH deeper, than Im sure anyone thought it would go. ANYWAYS, JUST LET MY MAN ENJOY IT. NR doesnt just "hand" you a shirt and say, here, your a medic. You have to earn it. I destroyed THREE duffle bags carrying my books from medic. And that was just walking about three hundred yards a day for six months.. HOW MANY BOOKS DID YOU HAVE?
Click to expand...

Okay, let's clear some things up... many of you realize I believe in the NREMT testing ideals such as a national test, and one continuity test, especially now since it is computer based. Now, with that said let's look at the educational value of NREMT. It is a shame the basic is written at a junior high level science level, what more is a shame is that it has a 64% fail rate. This itself proves that those that allowed to enter and exit EMT programs fail to have even a poor understanding of generalized science. This is why I am such a proponent of entry requirements, before one can ever enter an EMT program.

Face it, if you fail the NREMT more than once you either have a testing problem such as anxiety or you don't know your stuff. Any CCEMT/P that ever said NREMT was too tough confuses me, since NREMT cannot even test over any material higher than the current ACLS and NHTSA curriculum, apparently that states CCEMT/P was a joke. We have had at least 4 employees that just passed NREMT and barely understand dosages and especially barely any pathophysiology, this is why they are now in orientation longer than normal.

The current test is definitely a lot easier than it had been prior to five to ten years ago, the same as ACLS and other courses. EMS educators across the nation has made note of this to the NREMT to increase and strengthen their questions. Some of us who can verify this that have been involved with the NREMT over 25+ years. NREMT is not new, and many states that do choose to go with state in lieu of NREMT do so because of costs and yes they have poor pass rates. This is scary, because us in EMS education realize the need of a contiuity test system and even though NREMT has problems we (EMS educators) can complain and reform tests. Instead of "beefing up" their curriculum and educational and teaching systems, they much rather choose and spend thousands of dollars designing their own. It is a shame that those in charge in the state much rather run away from the problems than to correct them.

One cannot describe because they have "book knowledge" they will lock up any more than those that don't; in fact the opposite. The reason people "lock up" is people do not know what to do and how to perform. This can be reduced by more scenario based training and increased clinical time. The current basic EMT practical time is a joke. Courses that require less than 150 clinical hours should not really describe they really have clinical time at all. Now, some states don't even require basic clinical time! I know we laugh about the basics describing their whopping required 72 hour clinical time.. wow! A whole 72 hours.. We commonly refer to them as observation clinicals, since it is so short. No wonder newbies barely know what to do in the field.

Then again we require those that teach five year olds in kindergarten to have a baccalaureate degree and those that teach how to perform an emergency crich and shock someone with 360 joules only to have an GED... yeah, there is something wrong with our EMS education system.

R/r 911
 
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Along the same lines of what you said about "book knowledge" ridryder...

There seems to be this weird view in EMS, and I have heard this many times is that "The best medics aren't those that get As in class." And this is echoed over and over...

Yes, this may be true, but the opposite is probably more often the case. The "average" medics [academically] probably lock up more than those who were above average academically. It seems that every other guy in EMS feels that an "A" medic is somehow inferior to the others when it comes to street sense, which is ridiculous...
 
=ffmedic;

My point is that getting a certificate from an agency saying your a paramedic , while a huge accomplishment and an incredibly proud moment ( I remember) , does not a paramedic make.
Click to expand...


I was a paramedic after I passed the nremt-p exam; it's a shame you never got a chance to do the same. Now, you could argue that the test should be harder (I recommend taking it yourself before making this argument), but the fact remains that once you pass, you have every right to call yourself a paramedic. At every level and every point in my career, there has always been someone who has argued "you're not really a paramedic until _____." I think this is BS. The confidence you described after 5 years is something I felt after 4 months in my system. The point being, this really depends upon the system you're in and many other factors, not just time on the street. Lastly, I'm always offended when people belittle "book smart" paramedics. I made straight A's and was a "book smart" paramedic. This doesn't show that I'm necessary smarter than anyone, just that I put more effort into learning the material. How does this hurt patient care? I've never heard anyone request a doctor who barely made it through medical school. Everyone wants the book smart doctor. Why isn't ems the same? Why don't we value formal education? Let me end by giving you the profile of those who complain about book smart paramedics. They tend to be the ones who barely made it through their paramedic class and wonder how others seemed to get it so easy. They tend to put more emphasis on experience because truthfully, they couldn't get it the first time around in the classroom. Many, belittle the nremt-p without ever having taken the exam. And, there is a good reason for not taking the exam because most of these people would fail miserably. These people tend to belittle new paramedics who are slightly unsure of themselves because they are brand new ALS providers. Book smart or not, any smart new paramedic is going to be cautious at first. Many times in fact, the book smart--really just plain smart--paramedics are more cautious because they better understand the risks involved.

PS, to any straight A paramedics out there, watch out for these bozos because they will try and bring you down to their level every chance they get.
 
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I do understand some of the feelings of "booksmart" as those that can't comprehend clinical judgement. This sometimes is perceived as "lacking" of common sense, however; let's not confuse the issue of being smart and being able to provide good care.

Let's compare Paramedic curriculum to other professions and we can find out that it is definitely not organic chemistry level or neuroscience; mainly it is still at a basic level of science with a large emphasis on the art of clinical judgement and skills.

As an educator for many years, I know when one discusses "grade" levels that it is irrelevant in EMS. I can write a test where most can score a 98% or one over the same material, that no one can pass. Since EMS has no consistent curriculum and educational values there is too much variations and fluctuations for basing a score on how well someone can perform. This is one of the multiple reasons EMS needs to be taught in a collegiate setting, so a standardized grading and value setting can be established. I do worry though when people describe they had difficulty with EMT course since this is just above a first aid level. Either poor instruction, poor study habits or reading skills usually can be the major contributors.

Ironically, we are one of the few health care professions I see that ever "bad mouths" those with higher grades. In fact to be allowed into any other health care program, one would need a high score to be considered even to apply. Compare nursing, most base GPA and entry level tests on point based system for entry, the same for PA-C, medical school (which to be a surgeon, one has to be upper 10% of the class).

So why do we in EMS criticize those that have better academic ratings? Should we not encourage being "above average" in knowledge and skills? Do we want our profession, to be comprised of "average or below average" technicians ? Why do we not have entry requirements requiring at least a B average or above before applying for EMT school as well as requirements of entry tests such as HOBIT, AHPAT, etc.. to be sure the student has enough basic knowledge and skills to successfully complete the program ?

Until we quit placing EMT as classes and move it into a program format, we will never get accomplished education.

For curiosity I am wondering, while you were in your EMT or Paramedic class were your grades averaged or was it required to pass all tests with what level ?

R/r 911
 
Thanks! good luck to you in the rest of your medic class!!!
 
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