I've been having a lot of conversations recently regarding scope of practice, more specifically skills that are included in protocol. This has been a hot topic in VA recently, as it has been nation wide as well, due to the future changes that the national registry will supposedly be undergoing in the near future.
However, this discussion or protocol and scope of practice has always been a hot topic. Just check out one of the many blogs in the EMS blog-o-sphere (maybe AmboDriver or StreetWatch?) and you'll come across many posts that discuss the inclusion or exclusion of certain skills, drugs, etc. from protocol, and the merits of each.
But rather than focus on reforming the skills that EMTs around the country should undoubtedly have access to, I'd like to talk about several skills and pieces of equipment that I have found indispensable in my own experience while running at a rural rescue squad; in fact, I believe they are indispensable no matter where you run.
If you run with my service, you're looking at--unfailingly--at least a half hour transport to the nearest hospital, most likely closer to 45 minutes, maybe even an hour if you get sent on a mutual aid request. This exceedingly long transport time, potentially with a critical patient, is something that I don't think a lot of big city (or small city) providers fully understand the reality of. At my station, the majority of volunteer crews mark up at the basic level. Our medic level providers are few and far between, and as a result we rely heavily on a nearby county career-staffed station for medic-level services. QRVs are virtually unheard of, and if you have more than one crew in the building a shift, then you're the exception not the rule. While we do have access to a helicopter service for some of those calls that you know are going to be bad when you hear them go out, if you don't put them in the air immediately, there is a distinct possibility that ground transport may be just as efficient as flying them out. And you would be shocked to realize how long 30 minutes in the back of an ambulance with a patient who is seizing uncontrollably (and you have no medic-level rendezvous in your near future because they're on a call in their own first due) can feel.
So given that context, I want to talk about the merits of having the following three skills approved at the Basic level: 12-Leads, King LT Airways, and CPAP. In the following three posts, I will discuss some of my personal experience with these skills and pieces of equipment, as well as potential advantages and disadvantages. On the whole, I will be straightforward and say that I think these three skills are significantly more beneficial than they are problematic, but if you disagree, I would like to hear your ideas.
Coming soon: 12 Thoughts about 12-Leads.
Til next time,
CW
Tuesday, September 27, 2011
Monday, September 26, 2011
Some Calls You Never Forget
In EMS, there are just some addresses that you remember. Some of them may be associated with frequent fliers, some are associated with the most bizarre calls of your EMS career, and some are forever associated with those calls that leave ghosts behind.
In EMS, we all have those calls that we'll never forget. Over time, the may fade or blend into the memories of other calls, but they are never truly forgotten. In time, you are often able make peace with those ghosts left behind from tough calls, but in a small town EMS service there's a very good chance that you'll never be able to let them truly rest.
Small town EMS is an entity unlike any other. When you run those "oh sh*t" calls, they are to addresses that you may know; they are for family, friends, people you have grown up around, and maybe even members of your own department. That's not to say that you don't run those same calls in big city EMS, they just happen to be a bit more concentrated out here in the country.
I ran a call with a good friend of mine awhile back--ultimately, a fatality from an MVC (motor vehicle crash). The call was one of a series that we had that night (because where I run, when it rains it pours); this was our second response from the hospital, and as we were en route to the scene, we were advised that we were facing a potential code.
My friend and colleague happens to be small-town-born-and-raised, as many of my fellow providers are. Even as a transplant from the North, one of the first things you understand about this town is that it's a tight community, and when you hear a potential code go out over the radio you start fervently wishing that it's no one you know--that this time you'll get lucky and you won't be working a family friend or acquaintance. There was a look that flashed briefly over my friend's face, a look of desperation like I had never seen from her before.
Needless to say, she was not so lucky that night. Our transport for that call was to the hospital, but more specifically the morgue. The front of the truck was silent on the ride in, with few interruptions limited to the tones for the rest of the county dropping quietly in the background.
No words were needed that night, at least not immediately. The talking will, and does come, and the support of other providers can help you reconcile your actions as an EMS worker and make peace; yet the question remains, how do you grieve? Because it these kinds of situations you are not just a provider, you are a friend, a loved one, an individual who shares more common ties with the patient than just a singular call.
It's a question that I'm not sure a lot of small town providers have yet answered; in fact, I think that there are many answers to this question that are as unique as the relationships between patient and provider themselves. But I do know this: there are just some calls that you never forget. And that's okay.
In EMS, we all have those calls that we'll never forget. Over time, the may fade or blend into the memories of other calls, but they are never truly forgotten. In time, you are often able make peace with those ghosts left behind from tough calls, but in a small town EMS service there's a very good chance that you'll never be able to let them truly rest.
Small town EMS is an entity unlike any other. When you run those "oh sh*t" calls, they are to addresses that you may know; they are for family, friends, people you have grown up around, and maybe even members of your own department. That's not to say that you don't run those same calls in big city EMS, they just happen to be a bit more concentrated out here in the country.
I ran a call with a good friend of mine awhile back--ultimately, a fatality from an MVC (motor vehicle crash). The call was one of a series that we had that night (because where I run, when it rains it pours); this was our second response from the hospital, and as we were en route to the scene, we were advised that we were facing a potential code.
My friend and colleague happens to be small-town-born-and-raised, as many of my fellow providers are. Even as a transplant from the North, one of the first things you understand about this town is that it's a tight community, and when you hear a potential code go out over the radio you start fervently wishing that it's no one you know--that this time you'll get lucky and you won't be working a family friend or acquaintance. There was a look that flashed briefly over my friend's face, a look of desperation like I had never seen from her before.
Needless to say, she was not so lucky that night. Our transport for that call was to the hospital, but more specifically the morgue. The front of the truck was silent on the ride in, with few interruptions limited to the tones for the rest of the county dropping quietly in the background.
No words were needed that night, at least not immediately. The talking will, and does come, and the support of other providers can help you reconcile your actions as an EMS worker and make peace; yet the question remains, how do you grieve? Because it these kinds of situations you are not just a provider, you are a friend, a loved one, an individual who shares more common ties with the patient than just a singular call.
It's a question that I'm not sure a lot of small town providers have yet answered; in fact, I think that there are many answers to this question that are as unique as the relationships between patient and provider themselves. But I do know this: there are just some calls that you never forget. And that's okay.
Entre'act
Before I post my next musing, I feel like I should give a quick rundown of the rules that I will be following for discussing actual EMS calls on my blog. I'm borrowing liberally from Peter Canning of StreetWatch, one of EMS' most prolific authors and bloggers (and also, a personal role model of mine), so I will direct you to the following page:
I will try my best to convey the heart, or the essence of each story, but to protect my patients, fellow providers, the service I run for, and myself, there will be several alterations of superficial details.
I hope you enjoy the posts to come,
CW
Band Wagon
I have now joined the masses. Follow me @CountrySpark_CW on twitter.
You can blame my Teaching with Technology class for this one :)
Thursday, September 22, 2011
Role Models
I've come to the conclusion that when the going gets tough, the tough find role models that can provide that extra bit of incentive and support to achieve one's goals--and then they get going. Recently, I've been feeling kind of overwhelmed by life, particularly by the demands that my academic pursuits have been making on my time.
For those of you who have been around since the beginning, the fact that I am simultaneously pursuing both an undergraduate and graduate degree comes as no surprise. For those of you that know me personally, the fact that I am on an accelerated track for both degrees is also not new information. For anyone with a bit of common sense, the fact that I am struggling and under some pretty intense stress should not blow you out of the water.
As a result of this academic (and many-other-factors induced overload), I've been floundering a bit. For most of my life, I have been largely intrinsically motivated. I choose to do and pursue things that I am passionate about because accomplishing those acts makes ME happy. There was a substantial period in my life where I struggled with the lose-lose reality of pursuing not-quite-passions because I believed that they would make other people happy, and thereby make me happy; it turns out my theory was horribly wrong in that regard.
And I'll be honest: history and teaching do make me happy. In fact, they are two of the things in my life that I am most passionate about (if there is confusion on this point, I refer you to why I started the blog in the first place...); however, lately I've realized that my personal fulfillment in the pursuit of an undergraduate and graduate degree is hardly cutting it anymore. I feel as if sometimes my workload is isolating me from the relationships that will make my eventual achievement of these goals enjoyable. Sometimes I feel like Hermione Granger.
No...I'm not kidding. If you want a better understanding of why I identify with a fictional character, read this; maybe then you'll understand. To me, Hermione Granger is an inspiration of sorts; the girl who didn't let anything get in the way of her voracious academic pursuits; the girl who wasn't afraid to fight for her dreams and what she believed in; the girl who valued her friendships above all else; the girl that I grew up idolizing. Yes, Hermione Granger has been and always will be a role model to me as a still-trying-to-find-my-way, at times graceless, yet well intention-ed young adult. With some of the stuff that I have been dealing with in the past few months, having a role model like Hermione has provided me with a model of how to keep on in the face of adversity and challenge.
That's not to say that all of my role models exist in the fictional realm. I am so unbelievably blessed to have an extraordinarily high number of impressive and commendable individuals in my life after whom I can model my own actions and choices, as well as rely on for support. And since my life has kicked into high gear recently, that support has been indispensable. So I would like to say a thank you to a few people whom have remained steadfast in their support, compassion, love and inspiration in recent months. Your companionship and dignity with which you live your lives continues to amaze me, and makes everything that I am working towards that much richer.
To my mom: I love you and you are truly one of the strongest women and supporters that I know. I don't know where I would be without you in my life.
To my adopted grandfather and mentor: your kindness helped a very lost little girl find her voice and her way, and I look up to you in more ways than you will ever know. Thank you for taking this fellow Yank under your wing, and teaching by example that a little bit of compassion, humility, laughter and common sense can take you far in this world.
To my beautiful cousins and sister: each of you have inspired me in unique and varied ways to try and be the best person that I can be. Each of you are veritable fonts of strength, grace, compassion and fun, and I am constantly amazed and humbled by the women you have turned out to be.
To the three musketeers: it always comes back to you. You are the rocks at the center of everything I do, and I know that we can face anything together and come out stronger for it.
To the family that I have chosen: friendship does not even begin to cover what I have with each and every one of you. Celebrating life's little moments and pleasures with you, whether it is a rich cup of coffee, or one another's triumphs and achievements, has left an indelible print on my heart.
It is with and because of each of you that the stress becomes manageable and the rewards become richer and the memories become stronger. You are the true role models that are helping me get through the overwhelming stress that enable me to keep my head in the game, channel my inner Hermione Granger, and face each challenge head on with no fear and the sweet taste of satisfaction. Thank you, and I love all of you.
For those of you who have been around since the beginning, the fact that I am simultaneously pursuing both an undergraduate and graduate degree comes as no surprise. For those of you that know me personally, the fact that I am on an accelerated track for both degrees is also not new information. For anyone with a bit of common sense, the fact that I am struggling and under some pretty intense stress should not blow you out of the water.
As a result of this academic (and many-other-factors induced overload), I've been floundering a bit. For most of my life, I have been largely intrinsically motivated. I choose to do and pursue things that I am passionate about because accomplishing those acts makes ME happy. There was a substantial period in my life where I struggled with the lose-lose reality of pursuing not-quite-passions because I believed that they would make other people happy, and thereby make me happy; it turns out my theory was horribly wrong in that regard.
And I'll be honest: history and teaching do make me happy. In fact, they are two of the things in my life that I am most passionate about (if there is confusion on this point, I refer you to why I started the blog in the first place...); however, lately I've realized that my personal fulfillment in the pursuit of an undergraduate and graduate degree is hardly cutting it anymore. I feel as if sometimes my workload is isolating me from the relationships that will make my eventual achievement of these goals enjoyable. Sometimes I feel like Hermione Granger.
No...I'm not kidding. If you want a better understanding of why I identify with a fictional character, read this; maybe then you'll understand. To me, Hermione Granger is an inspiration of sorts; the girl who didn't let anything get in the way of her voracious academic pursuits; the girl who wasn't afraid to fight for her dreams and what she believed in; the girl who valued her friendships above all else; the girl that I grew up idolizing. Yes, Hermione Granger has been and always will be a role model to me as a still-trying-to-find-my-way, at times graceless, yet well intention-ed young adult. With some of the stuff that I have been dealing with in the past few months, having a role model like Hermione has provided me with a model of how to keep on in the face of adversity and challenge.
That's not to say that all of my role models exist in the fictional realm. I am so unbelievably blessed to have an extraordinarily high number of impressive and commendable individuals in my life after whom I can model my own actions and choices, as well as rely on for support. And since my life has kicked into high gear recently, that support has been indispensable. So I would like to say a thank you to a few people whom have remained steadfast in their support, compassion, love and inspiration in recent months. Your companionship and dignity with which you live your lives continues to amaze me, and makes everything that I am working towards that much richer.
To my mom: I love you and you are truly one of the strongest women and supporters that I know. I don't know where I would be without you in my life.
To my adopted grandfather and mentor: your kindness helped a very lost little girl find her voice and her way, and I look up to you in more ways than you will ever know. Thank you for taking this fellow Yank under your wing, and teaching by example that a little bit of compassion, humility, laughter and common sense can take you far in this world.
To my beautiful cousins and sister: each of you have inspired me in unique and varied ways to try and be the best person that I can be. Each of you are veritable fonts of strength, grace, compassion and fun, and I am constantly amazed and humbled by the women you have turned out to be.
To the three musketeers: it always comes back to you. You are the rocks at the center of everything I do, and I know that we can face anything together and come out stronger for it.
To the family that I have chosen: friendship does not even begin to cover what I have with each and every one of you. Celebrating life's little moments and pleasures with you, whether it is a rich cup of coffee, or one another's triumphs and achievements, has left an indelible print on my heart.
It is with and because of each of you that the stress becomes manageable and the rewards become richer and the memories become stronger. You are the true role models that are helping me get through the overwhelming stress that enable me to keep my head in the game, channel my inner Hermione Granger, and face each challenge head on with no fear and the sweet taste of satisfaction. Thank you, and I love all of you.
Wednesday, September 21, 2011
What Exactly Is Social Studies?
So I realized that in my last post, I may have jumped ahead of myself. If you were to create a taxonomy of social studies (the field in which I am earning my Masters), history would fall under the heading of social studies. That is to say that before one can discuss history education, one must consider the greater category that it falls in. In order to correct such a massive oversight, I offer the following. Enjoy!
Welcome everyone. Get ready, because critical thinking time begins now. Today's lesson will examine the following question: what exactly is social studies? There are a few things that I would like you to think about as we make our inquiries today. They are:
Welcome everyone. Get ready, because critical thinking time begins now. Today's lesson will examine the following question: what exactly is social studies? There are a few things that I would like you to think about as we make our inquiries today. They are:
- What disciplines make up social studies?
- What is the "point" of social studies?
- Why do we teach social studies?
- How can we make learning social studies fun?
- Why is social studies relevant to your life?
To get you thinking, I present the following situation:
Your name is Harry Potter. You have been chosen and marked by the Dark Lord as his equal. Your mother died to protect you, and you have powers beyond your own that protect you as a result; these powers derive from love. You have twice faced Voldemort and and you know that a third meeting is imminent thanks to Sybill Trelawney's prophecy. You also know that there is a single remaining horcrux (remnant of his soul that binds Voldemort to the realm of the living) beside the one that exists within you. You have a choice to make. Sacrifice your life for the destruction of Voldemort, or let Voldemort reign once more?
How could an understanding of disciplines found within social studies allow you to turn the advantage in this situation? We will return to this question a little bit later.
If nothing else, I hope that at the end of today you take away this understanding: social studies is a series of interconnected disciplines that focus on human interactions with a variety of institutions, individuals, and places, and the study of these disciplines can provide individuals with the necessary skill sets to be informed and contributing citizens.
Now if you would, I ask that each of you take a moment to briefly consider what disciplines you believe would fall under the heading of "Social Studies". Some that come to mind for me, include but are not limited to: history, geography, human (cultural) geography, sociology, anthropology, archaeology, philosophy, political science, civics, religion, economics and psychology.
Have you ever previously considered just how diverse a field social studies actually is? If you were anything like me, you probably had a class that was called "Social Studies" in middle school but you never actually knew what they meant by that term. Did it mean history? Did it mean memorizing maps? Did it mean learning about other cultures? Was it ultimately a mixture of all of the above? Again, if you are anything like me, you would probably identify most with the latter of all those questions. But the question begs to be asked...why does this mixture of random subjects matter?
I posit this in response: social studies matters because it helps students learn essential life skills that force them to think beyond the scope of their individual existences. We teach social studies because we aim to prepare our students for a global, interconnected and complex world that requires them to understand the dynamics of cause and effect, the value of grounding logically based arguments in evidence, thinking critically about sources of information, and understand how past actions and decisions can influence present and future circumstances and events. Earlier, I argued that a social studies education "can provide individuals with the necessary skill sets to be informed and contributing citizens," and I stand by that claim. An effective implementation of social studies curriculum can produce an informed and engaged citizenry that is prepared to meet and overcome the challenges that your students will face and be saddled with in their lifetime.
But while this all sounds well and good in theory, I am sure that many of you would be quick to point out that with many, if not all, of the disciplines that I have listed, your experiences have been overwhelmingly less than stimulating; and this is the part that returns to my previous post on teaching a "dead" subject.
Unfortunately, it is exceedingly easy to fall back on the standard method of teaching social studies. For those of you that have enjoyed J.K. Rowling's masterpiece that is Harry Potter, I invoke the image of Professor Binns' History of Magic class: dry descriptions of facts, individuals and events, in a monotone voice, in the face of death or other such trivial happenstances. Thus, the alternative becomes the critical question: how do we not become the Professor Binns of social studies? This is a question that pre-service and in-service teachers alike grapple with on a daily basis. How can we "hook" our students into caring about social studies?
To this end, I would like to return to my initial question and situation (re: Harry Potter). For a child of the 1990s, that situation alone would have made devoting my attention to the subsequent lesson worthwhile. For a child of today, Suzanne Collins' The Hunger Games trilogy offers ample material in which to base a social studies lesson that will have many students hanging off their seats and eager to draw connections. There are many possible answers to the question I posed though; having a understanding of the past can better inform Harry about his present choices and the possible consequences; understanding the psychological condition of Voldemort can help him better plan his strategy to victory; understanding the political machinations of the Death Eaters allows him to better understand how to dismantle their reign. I could go on and on, and regardless of how far fetched this may seem, there is a legitimate connection that can draw in students. It is the art of finding those connections that social studies teachers must focus on and make a priority.
As I continue down my teaching career path, this question will arise again and again. And when it does, I hope to be able to provide additional answers and suggestions along the way. Additionally, if you have ideas or comments regarding this topic, I would love to hear them. Dialogue on this topic is welcomed and encouraged.
If nothing else, I hope that I made even the tiniest bit of headway in convincing you that there is much more to social studies than you ever believed, and that it is indeed "a series of interconnected disciplines that focus on human interactions with a variety of institutions, individuals, and places, and the study of these disciplines can provide individuals with the necessary skill sets to be informed and contributing citizens."
--CW
Now if you would, I ask that each of you take a moment to briefly consider what disciplines you believe would fall under the heading of "Social Studies". Some that come to mind for me, include but are not limited to: history, geography, human (cultural) geography, sociology, anthropology, archaeology, philosophy, political science, civics, religion, economics and psychology.
Have you ever previously considered just how diverse a field social studies actually is? If you were anything like me, you probably had a class that was called "Social Studies" in middle school but you never actually knew what they meant by that term. Did it mean history? Did it mean memorizing maps? Did it mean learning about other cultures? Was it ultimately a mixture of all of the above? Again, if you are anything like me, you would probably identify most with the latter of all those questions. But the question begs to be asked...why does this mixture of random subjects matter?
I posit this in response: social studies matters because it helps students learn essential life skills that force them to think beyond the scope of their individual existences. We teach social studies because we aim to prepare our students for a global, interconnected and complex world that requires them to understand the dynamics of cause and effect, the value of grounding logically based arguments in evidence, thinking critically about sources of information, and understand how past actions and decisions can influence present and future circumstances and events. Earlier, I argued that a social studies education "can provide individuals with the necessary skill sets to be informed and contributing citizens," and I stand by that claim. An effective implementation of social studies curriculum can produce an informed and engaged citizenry that is prepared to meet and overcome the challenges that your students will face and be saddled with in their lifetime.
But while this all sounds well and good in theory, I am sure that many of you would be quick to point out that with many, if not all, of the disciplines that I have listed, your experiences have been overwhelmingly less than stimulating; and this is the part that returns to my previous post on teaching a "dead" subject.
Unfortunately, it is exceedingly easy to fall back on the standard method of teaching social studies. For those of you that have enjoyed J.K. Rowling's masterpiece that is Harry Potter, I invoke the image of Professor Binns' History of Magic class: dry descriptions of facts, individuals and events, in a monotone voice, in the face of death or other such trivial happenstances. Thus, the alternative becomes the critical question: how do we not become the Professor Binns of social studies? This is a question that pre-service and in-service teachers alike grapple with on a daily basis. How can we "hook" our students into caring about social studies?
To this end, I would like to return to my initial question and situation (re: Harry Potter). For a child of the 1990s, that situation alone would have made devoting my attention to the subsequent lesson worthwhile. For a child of today, Suzanne Collins' The Hunger Games trilogy offers ample material in which to base a social studies lesson that will have many students hanging off their seats and eager to draw connections. There are many possible answers to the question I posed though; having a understanding of the past can better inform Harry about his present choices and the possible consequences; understanding the psychological condition of Voldemort can help him better plan his strategy to victory; understanding the political machinations of the Death Eaters allows him to better understand how to dismantle their reign. I could go on and on, and regardless of how far fetched this may seem, there is a legitimate connection that can draw in students. It is the art of finding those connections that social studies teachers must focus on and make a priority.
As I continue down my teaching career path, this question will arise again and again. And when it does, I hope to be able to provide additional answers and suggestions along the way. Additionally, if you have ideas or comments regarding this topic, I would love to hear them. Dialogue on this topic is welcomed and encouraged.
If nothing else, I hope that I made even the tiniest bit of headway in convincing you that there is much more to social studies than you ever believed, and that it is indeed "a series of interconnected disciplines that focus on human interactions with a variety of institutions, individuals, and places, and the study of these disciplines can provide individuals with the necessary skill sets to be informed and contributing citizens."
--CW
Sunday, September 18, 2011
Stuck In My Head All Day
http://www.youtube.com/watch?v=v_yTphvyiPU&ob=av2n
Because this music video makes a girl's heart scream of adoration and cuteness, and it's a great song :)
Love, CW
Because this music video makes a girl's heart scream of adoration and cuteness, and it's a great song :)
Love, CW
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