True Confession 2: Lifting and moving patients skills was fun! We finally got to our first skills night — a chance to get our butts out of the auditorium style seating and practice with equipment.
Our instructors broke us up into 2 groups and off we went to learn about the different pieces of equipment, how to place a patient on the backboard, and how to lift. Sounds simple, but strangely it is more sophisticated than it appears — there is a lot to remember.
The first time I am positioned at the head of the backboard, I give out the command. “Roll her on 3. 1,2,3,” feeling very official and smart sounding. However, I later realize I forgot to give the overview of what we were going to do first. If you know me, you know that is pretty typical — I just jump in and start giving commands!
I also had the strongest guy positioned at the feet and one of the smaller females at the head. There was some grunting and then laughing over that as the female is trying to roll the patient’s torso up onto her legs and the strong guy is hardly exerting effort at the foot end.
Then came the nugget that really hit me. In explaining the skills practice and the skill testing for the Registry, my instructor said this:
Skills are 80% preparation; 10% skill and practice; and 10% luck.
I saw some faces a little taken aback and others smirk at the word “luck.” Afterwards, I had a chance to talk with him more about it. He said it is important to acknowledge that there is a little luck involved. For example:
- Placement of the patient: Sometimes the patient is lying up against a wall or an embankment, and sometimes - if you are lucky - the patient is lying out in the open with no obstructions.
- Equipment: Sometimes — if you are lucky — the equipment you have is a great fit. Other times, you have to retro-fit it for your patient.
- Being left hand dominant: — While this is not something I need to worry about as an EMT, he said he is lucky to be left-hand dominant when it comes to starting lines in the ambulance. When he is sitting on the bench on the patient’s left, he is in a better position for both him and the patient when starting an IV.
Preparation is using your knowledge and elbow grease to have everything ready: which stretcher to use, buckles unbuckled, straps off to the side, and enough providers in the proper positions to help lift and move.
Practicing the skills over and over until they are routine will help to ensure that you do it properly and safely. I would also recommend when you are in groups that you don’t sit back and let the others do the work.
I got right in there and did some commanding, lifting and even got lifted in the scoop stretcher myself. That complete 360-degree view from provider to patient was key for better understanding and integration of the readings and lecture with the actual performing of the skill.
I am sure that this 80/10/10 rule could be argued, but for me it works. I feel that I have a strategy for attacking the skills stations — lots of prep and practice will help me pass these stations and hopefully I will not need to rely on that 10% luck!