Taylor S.

January 7th – January 14th (0 hours) – I did not go to my internship site these past two weeks due to my mentor being on vacation. I plan to go back on Friday, but I will write about an experience I had last semester. Last year, I had the privilege of sitting in at the 911 communications center. I got to meet Captain Greg Hoffman who gave me the tour and taught me about the new City Public Safety department. After the tour I got to sit with several dispatchers as I learned how a call comes in and exactly what happens after. I first sat with Kate where the initial call comes in. Her job is to determine whether to reroute the call to police or fire. Next, I sat with Nina who was in charge of dispatching the fire engines and ambulances. Finally, I got to listen in with Fabia who answered fire drill calls and life alert calls. I had no idea that certain dispatchers took all the calls north of Broadway and the others took the calls south of Broadway. Tucson Fire and Tucson Police were sharing the same room since the building is being renovated and whenever something “big” happened, they would flash a light so that everyone would be quiet. I learned so much that I didn’t know before and that helped me the next time I called 911 because I knew exactly what information the call takers are looking for.

I have learned so many technical skills with my experience at Tucson Fire, but my favorite skill I have learned is how to bandage an arm when the skin is pulled off and there is no surgical tape. I developed this skill because the two paramedics I was riding with were focusing on one patient and they instructed me to take care of the other patient (by bandaging his arm). I knew how to bandage an arm because of my practice in JTED, however this case was different because the skin was pulled off. I had to pull the skin back into place. I continued to wrap the arm like I knew how to do, but there was no tape to secure the end of the bandage. I asked the paramedics and they showed me how to tie it so that the knot doesn’t stick out. I thought that was the coolest thing because it looked so professional. Since my mentor was not with me (she was on a different call on the ambulance), when we got back to the station I went over the situation with her and I recall her saying “good girl” because I did exactly what she would have done. Even though she was not physically with me, I could hear her in my head telling me to put the skin back in place. I can continue to practice this skill on my ride-alongs where I get to bandage things for the crew.

Now that I have learned this skill, I can perform it in the field feeling brave. The crews will have confidence that I am able to do it on my own and they will be able to focus on another patient if needed. Since I want to go into emergency medicine, I will constantly be wrapping appendages and I believe that I will be using the new method of tying instead of taping. I can use this skill to teach more people how to make the knot pretty. The crews gave me confidence that I can do it effectively and I believe that it will carry over into my career, where I will know that I am doing it the right way. I have learned to think outside of the box with my treatments, I will be able to think outside of the box when it comes to every situation. I don’t believe I will use this in college until I get into my nursing program.

I was in a Pima NREMT training when I learned the term occlusive dressing. An occlusive dressing is an air and water tight bandage that is often clear so that the paramedics can assess the wound. For example, in my situation I had a fake stab wound on my ribs that was supposed to be gurgling blood. The correct way to treat my wound would be to use an occlusive bandage to stop the bleeding and to see if it was still leaking air.

January 15th – January 28th (3.75 hours) –  These past two weeks, I worked on the STEMI project at Tucson Fire. It was different going back to working on the project after having so much time off from it. In the project, I have to look at medical records and pull out small-but important- bits of information to put into a datasheet. The datasheet will be used to publish a report that goes out to all the important people in the city and around TFD. It is especially exciting that my mentor said that my name would be put on the report because I conducted the research for her. I had done it before so I understood all of the terms and got more work done, since I did not have to ask as many questions. I felt more confident and that really helped me when asking questions on small items. I have to look at the charting that the EMTs completed and since I already knew how to chart (from JTED) I am starting to recognize the difference between good and bad charting.

The industry specific vocabulary word I have learned is “turnouts”. Turnouts are the gear that the firefighters put on before leaving the station. It can be described as a “one-piece fire resistant suit”. This help protects the firefighters when they need to go into a building or are dangerously close to a fire. I learned this by going on ride-alongs and watching their preparation before leaving the station.

January 29th – February 11th () –

February 12th – February 25th () –

February 26th – March 11th () – 

March 12th – March 25th () – 

March 26th – April 8th () – 

April 9th – April 22nd () – 

July 20th – August 12th (18.33 hours) – One meaningful experience I had in the past two weeks was attending the Pima Community College Paramedic training. There was a group of 37 students that were practicing for their national exam on August 18. I got to act like a patient and help the paramedic out. I had to pretend like I was an 8 year old patient who was playing soccer when she had an asthma attack. After the situation was over, I got to talk with their teacher and help access what they did well and what they needed work on. It was such a cool experience to get loaded onto the stretcher and seeing how each paramedic did each step differently. After a few students, I was able to recognize the right and the wrong way to treat a patient having an asthma attack. I really enjoyed seeing all of the equipment a paramedic uses.

Two things I hope to learn from my time in the internship program is how to make myself look as professional as possible and how to treat basic injuries. I understand that I can never be perfect when it comes to looking professional, but I hope that Mrs. Wahl can teach me as many skills as possible to seem presentable. Some more skills I would like to learn are how to dress professionally for different situations, and when it is necessary to use someone’s personal cell vs work, etc. It is important to understand how the job system works when we get out of this program, so I would also like to learn how to make yourself stand out from others. From my mentor, I hope to learn how to treat basic injuries. Like the professional skills, I realize that I will never know what to do with everyone. I already learned how an asthma attack is treated and I would love to learn how to treat concussions, broken bones, excessive bleeding, etc.

As a student, I have learned that if there is a subject that I like, I get things done early and I do not procrastinate. I find myself getting excited for the next assignment and paying attention during the meetings. This makes me realize that I am actually where I want to be, and I can do better in school because of it. As a professional, I have learned that I can put together a business casual outfit really well. I also find myself accounting for traffic and giving myself a buffer zone just in case something happens. I try to be early and make myself be as professional as possible so people enjoy working with me.

August 13th – August 26th (16.18 hours) – One meaningful experience I had recently was my first ride along. I was down at Fire Station #14 (the one by the airport), and the firemen really took me under their wing for the day. I experienced the opportunity of switching between the fire engine and the medic truck. My favorite call was the first one where a man had a small laceration on his knuckle, and a woman had lacerations under her tongue. The Fire Chief- Chief Parris- walked up to the man and said “this is Taylor, she is one of our students, and she is going to be taking care of you today”. I was in absolute shock because this was my first ride along and first call. I had to remain confident as I cleaned the wound and bandaged it up for him. I loved this experience because it made me feel like I was one of the firefighters, and made me feel pretty special too. It taught me that even though you may not have years of training, you can still make a small difference in someone’s life. By the end of the day, I had gone on 8 calls.

August 27th – September 9th (22.64 hours) – One meaningful experience I have had recently in the internship program was completing a ride-along with station #8. Each station gets to design their own logo and have their own phrase, and station #8’s was “The House of Love”. It was interesting to see the crew’s dynamic which was drastically different from station #14’s. I got to go in 7 calls, and the rescue truck even let me bandage a person’s arm. My favorite call we went on was checking on two kids that had been locked in a car. It was my favorite because I had never worked with pediatrics before, and they have a completely different way of being treated for injuries. I also had the experience of learning how the fire engine works, with the lights, sirens, and horns. Captain Sloan really took me under his wing and made sure I had the best experience possible. I learned the difference between ALS and BLS calls, and how to treat patients with different injuries.

The expectations for my conduct and personality really depend on which site I am at. When I am at Fire Central or the 9-1-1 call center, I am expected to wear business casual clothes and be very professional. I am expected to speak in a soft tone and address everyone by their full titles (i.e. Chief Paul McDonough). However, when I am on ride-alongs, the firefighters joke around a lot and can be a little rough sometimes. At the fire stations, I am allowed to joke around with them until we get to a patient. When we are at Pima, I wear clothes that I am not afraid to get dirty, and I act however the situation I am given tells me to act. Sometimes I cam quiet, or sometimes the story given for testing calls for me to freak out.

I do believe that this is a natural fit for my conduct and personality because I try to be as professional as possible. I am always organized with my binder, and I am able to help out my mentor before she even asks. However, I do need to work on letting go and joking with the guys sometimes. I think being able to access the situation and how I am able to act is a skill that I am still trying to pick up. I also need to work on memorizing the buildings and how to get around them because at a certain point, there isn’t going to be anyone there to walk me to each place I am going to. I see coworkers on their phone a lot, and I am working to try and not fall into that habit. I like to think that I am doing a good job of being professional because some of my mentor’s coworkers have complimented me on that.

One vocabulary word I have learned at my internship site is “vasoconstrictor”. A vasoconstrictor is something that causes the blood vessels to dilate, which in turn, causes the blood pressure to rise. I learned this term at Pima when the paramedics were treating me for a stroke. If they gave me oxygen, it would be a vasoconstrictor and could possibly be fatal for a stroke patient, because it causes the pressure to increase in the brain.

September 10th – September 23rd (22.61 hours) – One meaningful experience I have had recently in the program is a ride along with Station #9. While I have been privy to touring a few stations in Tucson, this Station was by far my favorite. In between calls, I got a tour of the ambulance and how to use all of the equipment in it. I also got to attend a class on SMR (Spinal Restriction Movement)- the crew at the fire stations have to give and attend a class each month. I enjoyed riding with the engine crew because they let me take all of the vital signs: blood pressure, pulse ox, respiration rate, and glucose. At the end of the day I got to take a picture on top of the ladder truck, which I have always wanted to do. I learned many valuable lessons from the firefighters- such as you should try to squat rather than kneel in someone’s home. I also learned how to be brave and take vital signs even when someone is talking to the patient.

While I was attending the Pima EMT’s class skills day, I learned the word traction. We were talking about the different types of femur splints and how they are used. One EMT is supposed to hold traction while the other ties all of the straps down. Traction, in this context, means to pull on the foot slightly to try and relieve the pain before the splint officially pulls the foot.

September 24th – October 7th (31.35 hours) – One meaningful experience I have had over the past week is completing fit testing with the firefighters. Every year, the firefighters have to bring in their masks and make sure that the masks are still a perfect fit for their face. We also checked to make sure that all of the straps were in place and the firefighters still know the correct way to put the masks on. Usually they stay the same, but sometimes their weight will fluctuate or the rubber will wear off. I got to instruct the men how to complete the testing with all of the 6 different exercises. I learned that a 500 on the machine is a pass, but the fire department strives to get above a 3000. After we had tested all of the masks, I got to put a mask on and complete the fit testing. I definitely did not enjoy it and it made me realize that I would not be able to be a firefighter. The regulator really controls your breathing and during the first test, the goal is to suck out all the air from the mask, making it seem like one is suffocating. While I did not enjoy the experience, I really got an insight on the conditions that the firefighters are being put through.

At my internship site, I mostly use in-person communication to complete my duties. I sit in a cubicle surrounded by offices, so it is very easy to get around to the people that I work with. For example, if I have a project that I am working on and I have a question, I can just walk to the person’s office that the question pertains to. So far at my internship, I have only found one person that replies to my emails, so if I am not there to talk to someone face to face, I will call their office phone. However, I text my mentor because she is never at her desk, and made it okay for me to text her. In-person is the most useful to me because I move around a lot, so when I am at a firehouse, I do not get contact information because I will probably never see them again.

I try to initiate communication as soon as I have a thought because I have memory problems and if I do not ask it right away, I probably will forget it. I also am working on a project that is very big and has a very strict deadline, so it would waste time if I wrote down the question and debated which form of communication to use. When I write emails or send texts that do not have a deadline, I usually sit down and think about the wording to make it as professional as possible. Like I mentioned in my previous answer, my main form of communication is face-to-face so it is not appropriate to review the communication before it happens. I feel that I am very comfortable in choosing the appropriate method and executing it well. I feel very comfortable talking to everyone including Captains and patients. I try to make myself seem as confident as possible because in the field, patients are trusting you with their life.

I learned the term STEMI when I was working on the STEMI project for TFD. STEMI stands for ST- Elevation Myocardial Infarction. It is a more serious heart attack that occurs when one of the major arteries is blocked. For the project, I am looking at all the reports of chest pain and am identifying if they were a true STEMI.

October 8th – October 21st (0 hours) – I did not spend time at TFD this week because the computers that I work on were being used. When I am not completing ride-alongs or working with Pima students, I am working on a project known as the “STEMI Project”. Every other year, TFD comes out with a report on how they are doing and the new technologies they are using in the field. It is my job to look at all of the reports of chest pain and transfer the key information into a spreadsheet so my mentors and the Captains can run data analysis. It can get very boring staring at a computer for 3 hours straight, but I understand how vital it is. I really like reading the narratives (where the EMS provider is able to explain the story of what happened and what treatments they performed) and looking at all of the different medicines and interventions that are given. I learned that when a firefighter or paramedic gets hurt, they have to be put on “light duty”. The duty can be short term, like a couple of days at the 911 call center or a couple of weeks working on the STEMI Project- or it can be long term. I met an EMT named Sharon who has been on light duty for almost a year due to a knee replacement. When they are too hurt to work in the field, they are usually pulled into Fire Central where they can help out with office work.

When working on the STEMI Project, I learned the term “nitro”. Nitro stands for nitroglycerin which is a medication that is recommended for treatment of heart attacks. When used, it dilates the blood vessels to help the heart pump blood. Many of the patients that had a STEMI took nitro before EMS arrived, but they were given more.

October 22nd – November 4th (31.01 hours) – One meaningful experience I have had recently in the internship program was going to an airway class with paramedic 7 and 14. I went to the PSESI (Public Safety and Emergency Services Institute) and was able to sit in on a class and even got hands on. Every year, all the crews are required to complete a certain amount of training in order to stay on top of their education. My mentor is very particular at who she lets teach the class, so, I was learning from the best. After the instructor went over the various tools and diseases of the respiratory system, we got to the practicum part. I followed crew 7 as they taught me different ways to intubate. Finally, in the end, I was able to practice intubating on pigs. The guts were put into fake mannequin heads that looked exactly like humans. It was very fun getting to put on all my PPE, such as gloves, goggles, gown, and mask.

When I was volunteering at Pima, I had to talk to an instructor named Sharon. Before that, I had always gone to my mentor when I had any questions. However, on that day, my mentor had not arrived yet, so I had to go to her for my questions. I talked to her in person because I did not understand the process of National Registry EMT. I also was confused about the layout of the building and I did not know where to go. I initiated the conversation and I believe it went really well. I was nervous at first but now I am able to talk to her freely without being nervous.

I frequently talk with the crews when I am there for social reasons. In between calls when we are waiting we try to get to know each other since we will be together for the entire day. When we are on the way to calls, everyone wears headsets so we can hear each other. They always engage me in the conversation since I am there and it is usually for social reasons. I feel very comfortable talking to them because I am basically one of them. I get to interact and help patients just like them, so it gives me confidence. Also, a lot of them are like kids and they like to joke around and be crazy, so it is easy to talk to them.

When I was at the PSESI, I learned the term “cricing”. The technical term is a “cricothyrotomy” which means to make an incision on the throat to access the trachea. After that, the crews can stick a tube in the hole to get a viable airway.

November 5th – November 18th (0 hours) – I did not go to my site during these two weeks because I am caught up on hours and I had a lot of homework. One experience I had a few weeks ago was volunteering for the 23rd annual Chili-Cookoff. I sold waters and sodas and floated around wherever they needed the help. This event was really fun because 100% of the profits go to the Tucson Firefighter’s Charities. This money will be used to make food boxes for the holidays, as well as buy toys for children. Each station had their own booth, as well as their own theme. It was cool to see the different crews who I have ridden with again and get to talk to them. I learned about the Fire Cadet program and had the opportunity to talk to one of the boys. He was testing with National Registry in December and I was able to answer some of the questions that he had about the program. I did not realize how much I learned from Pima until I was able to answer all of his questions with confidence.

At the beginning of the semester, my mentor and I worked to create a spreadsheet that was shared with all of the coworkers I was interacting with. They were able to go in and input times that my help was needed, or not needed. I would say that for the most part, I stuck to my schedule. In the end, I did not come in every week since I had already hit my hours. A couple of days over fall break I left an hour early, but my mentor was understanding. When I could not make it to my site, I emailed my mentor that I was not able to come in and explained why. I also went into my spreadsheet to mark it down that I would not be present. To succeed, I made sure that I was never scheduling things when I did not have the time. Once I committed to something, I did not go back on it.

I believe that I managed all of my tasks very successfully. I was worried at the beginning that I would not hit my hours due to my huge time commitment with JTED. I was successful because when I scheduled my internship days, I put my whole focus into them. I used Sunday’s to do my homework and the time in between JTED and school to get more work done. This was the first year that I used a planner and calendar, so I was able to exactly map out my time for everything. I think that next semester I can be even more successful by only going every other Friday just so I can study a little bit more. If I keep doing the same amount of activities, I will be able to get my hours even with the break.

I learned the term “KED Board” when I was playing a patient for the NREMT. Its official name stands for Kendrick Extraction Device. The board is used to stabilize patients who are in a sitting position (most often patients in motor vehicle accidents) until they can be moved onto a regular spinal board.