Wow you guys, your comments made me cry and I'm trying so hard not to cry! Stop being so nice to me: ) I haven't cried in front of J (yet?) but I broke right down at the hotel reception when the nice Romanian lady tried to comfort me.
Halfway through the week Guiseppe came up to me and said, "You're really having a hard time with this stuff aren't you?" and I replied, "I simply don't have the years of experience you guys have."
When I think of it, I have 3 months of experience, but spread out very widely over the last 2 years. It's ideal to do your training more compressed so you don't lose what you learn over time. But more importantly, the people in charge of training you during your internships (hospital and ambulance) need to be invested in it, and I didn't get much support from them. A few of them were really good and out of sheer compassion (not obligation) they would take me aside and teach me things. Most of them were uncomfortable with the language barrier and didn't waste their precious time on me. I feel bitterness because I wasn't given enough chances to learn, and this week it was apparent to everyone.
What surprises me is that I passed the written and oral exams. My book knowledge is not bad. However, I did much worse than I expected on both - I got a D on my written and a C on my oral. That's hard for me to admit as a lifelong B student. But there were many questions that I just couldn't work out the language, "What on earth is this question actually saying?"
My CPR grades make my head spin. My 2-person CPR was a C and my 1-person was a D! Last time I got an A on 1-person CPR and I did it exactly the same, so WTH. I felt really good about both CPRs yesterday, but apparently I am wrong. And they don't give you feedback so you never know.
OK now it gets sad.
I've already told you about my partner, Alexia. She has been doing this for 6 years (!!!) and seems to know it all. In our practice this week I was forced to take the role of team leader, because we all need to practice having that role. Every time I played team leader, she switched roles with me and took over! I was flabbergasted, what's going on here, we discussed it, planned it, and now everything is backwards, she's in charge! The first time she did it she felt bad and put her hand on my arm and said, "I'm truly sorry for that." The second time she didn't apologize, nor the third. Talking to her about it doesn't seem to work. She apparently has very little confidence in me and cannot stand to be in the assistant role.
We literally had to flip a coin before our practical exam to see who would be the team leader. It was me.
That's fine, I've rehearsed in my mind each potential emergency scenario. We discussed our operating procedure beforehand.
We walk into the room and there is a real-life actor lying on the ground simulating a motorcycle accident. (Does that sound familiar? I've never drawn any number other than 4 on all my tests with these people!) But this time the helmet was already off, showing a make-up hematoma on her forehead.
I immediately stabilized her head and told Alexis to start basis monitoring. Then this other actor steps up and says he's a rescue assistant and if he can do anything. I asked him to call the emergency doctor. He said, "I can do more, I can hold her head for you." I was surprised but said OK and was very careful not to move her head at all during the transfer - that's a fail right there.
I told him to hold her absolutely still and told the patient the same. I asked her about her pain and prepared the stiff-neck immobilization device. And this is where things started to go awry.
Alexis told me, "That's too big, make it smaller." I said, "It is on the smallest setting." (WTH Alexis) and then I realized it was not exactly centered on her, but I didn't want to risk moving her head so I left it (oops). I told Alexis to call the doctor.
It's OK that we communicate and that she helps me and gives me ideas, but she was clearly taking over the lead role.
I wrote down her values on my glove and started to do a body check, which I'd practiced a lot so I felt pretty good about (how wrong I was!).
Suddenly the emergency doctor arrived, one of our teachers. He was in a horrible mood for some reason and started shouting at us and Alexis didn't even have the chance to finish fixing the O2 to the patient, he shouted at her to get the spine board and the vacuum mattress. He shouted at me to hurry up and prepare a vein catheter so he could get meds in. He told me to hurry up he doesn't have all day. I'd never seen an emerg. doctor act this way so I was pretty stressed but did as he said. Then our time was up.
We left the room kind of confused but I felt OK about it because I thought I made the right decisions.
Then it was Alexis' turn to be team leader and you won't believe the case she got.
It was a simple healthy patient transport from a hospital to home. Freaking the simplest thing you can do, of all the tasks. And we'd practiced so we had it down.
I got the roll board and we carefully set up the gurney (what do you call that thing with the wheels that patients ride around on?) and transferred the patient. And that was IT. All of our gear lay neglected in a corner, we never even had to open our bags.
No freaking way. And at one point I even helped her, when the nurse asked where the health insurance card was, and Alexis stood there speechless, not having thought of that, I jumped in and said, "This patient is privately insured." The teacher smiled at me and said, "Super answer!"
That was it, we were done.
We had to wait FIVE HOURS to find out if we passed.
I was told I failed the practical exam and when I asked why, they said I didn't act like a team leader, and Alexis took over the role. I asked if it was possible that they didn't hear me directing her, because I'm very quiet, but they said they heard me and it was inadequate. And that my treatment was wrong, my procedure was disorganized. Also that my freaking body check was too gentle! WHAT? I practiced this, and I know this, how could I have been too gentle? I honestly cannot believe that.
Then the teacher said, "You had really rotten luck when we flipped that coin and you drew team leader for THAT case."
At least he was honest enough to tell me that. Because seriously, in my case, we used practically every piece of equipment possible in an emergency. O2, drainage, EKG, Sp02, BP, spine board, vacuum mattress, stiff neck, etc. OK we didn't check her sugar or temp.
I can't help but wonder what would have happened if I'd had another partner.
It all comes down to a lack of practice/experience on my part. Even when we stayed after class to practice, it's never enough because teachers can only watch one team at a time and there are a lot of students, so most of the class time you spend observing others. It's one of the biggest design flaws of the class - the teacher to student ratio, and not enough time to do the tasks to achieve competence.
Now I have to figure out how I can get that experience before I'm expected to re-take the tests. I have to re-take the emergency case, the transport case, and both CPRs.
The only good thing is I do not have to repeat either the written or the oral tests. Thank God for that.
11 comments:
Thats rough. And getting less support for training and experience because of the language barrier is no doubt true. Most people just dont want to put in that much effort. And there seem to be some unique particularities in your part of the world.
In failure there are so many lessons. I see some of them embedded in your two posts. If you are ready to learn from them and make some changes you will succeed next time.
Meanwhile there are some animals that need hugs and kisses.
Oh I’m sorry it didn’t go well. The knowledge is there though and next time you’ll know what to expect. This is your test and your life don’t let anyone come in and steal that from you. Next time if your partner starts to take over stand up for yourself and take charge!
I'm sorry, sis. I know you're doing a good job, the best you can with the tools you have. You'll get through this.
What everybody else said--they are right! You know what the weaknesses in the system are, you know your own personal weakness (the language), and NOW...figure out how to fix it. That should keep you busy for a while, right?
What is really needed is somebody to start a school to teach this to non-native speakers. Maybe THAT is what you need to do--start the school!
I dunno. You've got skills, you need help to employ them, I wish there was more help for you.
ND, funny...before I saw your comment I was out there in the deep snow trying to find poop and wondered to myself, "Lesson in failure." Hrm!
Becky, I'm so glad you took the time to read this. BTW ,during my 5 hour wait period before our results, I went through all my photos of your visit here and had to smile at Elise and Christian's antics, expressions.
Aarene, wow, that's weird, cuz the school I'm working for, the secretary took a liking to me last year and said, "You should just TEACH these classes, in ENGLISH!" Cuz they have a lot of foreigners and a lot of different types of classes. I had to tell her, "I am not a teacher, have no qualifications, and I've tried teaching (Business English) in Germany and I feel inadequate because I believe students deserve educators who have been trained in educating." You know J is a teacher, so I'm especially aware of my lack of education in this area.
But since you mentioned it, and the secretary of the school said the exact thing, I cannot dismiss it.
Thank you for that, I will do my best to find the help I need. And J came home just now and said he connected with a former student who is in rescue and might be able to slide me into their trainings. In the end, I need to end my training with the same agency I began with (Malteser) but perhaps now I can take advantage of other agencies.
I have no idea how these tests are supposed to run, but I am so angry for you: it sounds like Alexis sabotaged your test, repeatedly and on purpose. That is not okay!
With both of us in our house working in the ER and triaging emergencies and performing CPR with coworkers that are not always American, there is one common theme when you are the leader: assertiveness. If someone else tries to take over the role, ***you make them back down.*** You're the boss. Just like you would if it was a horse trying to go into your space: you claim that leader space and tell that person what they should be doing instead, because there is plenty to do other than trying to take away your role. (Sorry, I am so very mad for you! I want to shake Alexis for you!) It sounds like they are looking for assertiveness as part of that leader role, and that can be especially difficult when you are surrounded by people from a culture that doesn't care about politeness when it comes to giving orders...cultural differences aside though, it *is* something that you will encounter in the workplace, so I can understand why they're scoring for it. I learned assertiveness the hard way when I was put in a leadership position above a Russian man. He didn't like taking orders from a woman, but he learned real quick that that was the way things were now. Shy me would never have developed the balls to do something like that if I hadn't had the pressure to do it for the sake of our patients.
Both Carlos and I have encountered plenty of ER doctors like your teacher/ER dr. (I wondered if he was really having a bad day or if he was role playing? You *will* find drs like that sooner or later, usually with the most critical/stressful cases, and many will go as low as screaming and cursing at the staff. Vets and MDs.) They are incredibly intimidating to work with but you learn to do it. I'm surprised you had not come across it already, as it is incredibly common!
I agree with Aarene: you should just teach these courses in English. What is the minimal amount of training/certifications/qualifications you would need in order to teach in Germany? I would think that since this is a credential/certification course, you wouldn't need something like a Master's in education in order to teach it like you would college-level courses, no?
I really like the teaching ideas! In the meantime, you can hang out with your barn therapists.
I agree with what was said above. I wonder if they took your politeness as weakness. Next time treat the person as a horse. Who cares what they think.
Do not despair! You did an awesome job considering the huge language barrier issue. No matter what, you have learned much, and we are very proud of you!
Curious, did Alexis pass?
Saiph, I remember you telling me that some of the best doctors have little people skills: ) I will keep the teaching thing in mind, but don't feel qualified and I'm not really motivated to go back to school to become a teacher. I taught business English here and always felt my students deserved a teacher who was an actual teacher.
Camryn, why is listening to people eat often disgusting, but listening to horses chew hay is therapeutic?
Teresa, I'm determined that I can be a medic and be both polite and compassionate, if that is possible.
KB, Alexis passed, there was never any doubt of that. Wish I knew her scores, wish I knew if anyone else failed, but I literally ran out of there as soon as I got my grades because J was waiting in the car and it was snowing. As is typical for me, I did not say goodbye to anyone except the teachers, to whom I said, "See you soon" cuz I'll be back.
Don't give up! This stuff is brutally hard, but you will prevail, persistence is a big part of the equation. :) I thought of you, as I got an opportunity to spend 2 days at LA County Hospital ER observing recently. Holy cow, what a crazy place, just one. thing. after. another. Drug addicts, traumas, shootings, bizarre stuff, people with no insurance, no money, no English, no family... Cops everywhere. Way more patients than capacity could handle, dirty, gritty, chaotic. Eye-opening dive into the world of a "county" and a teaching hospital.
One thing that struck me was a behind-the-scenes morning with the students, residents and fellows, where they were reviewing cases. And screw-ups. And learnings. And nobody-in-the-room-knows-the-answer when the fellow asks them a question. So, *everyone* has a hard time at first, even baby doctors-in-training, even people who are innately brilliant. I think they make the tests killer hard on purpose, it's a psychometric test- as much about testing your technical skills as it is about testing your mettle! So let your chutzpah shine, and go kick ass in the 2nd round! You can do this!
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