Experience, Training, and Preparation

Ever show up to a scene, take one look, and immediately feel like your head was spinning? Maybe it was the sight of the person covered in blood or the size of the fire that made things seem to be going fast. Perhaps you were met as you stepped off the rig by people grabbing at you trying to get you to move quicker. It might be the sounds of the blaring car horn through the dust from the airbags or the roar of the fire as the windows self-ventilate that barrage your senses and start your mind racing.

I remember one of the first MVA’s that I responded to as an EMT. I don’t recall the type of cars, the time of day, or even the patient's injuries. I do recall vividly looking at my leg as I sat on the bench seat of the ambulance doing vital signs and wondering “why is my leg bouncing up and down?” My leg was shaking and bouncing all over the floor; it sounded like a woodpecker convention in the squad. I tried to mentally stop it and couldn’t; physically putting my hand on the knee did nothing either. Here I was, a brand new lifesaver (EMT) and I couldn’t even control my own leg!

What I now know is that my reaction was physiological. A part of the whole “fight or flight” thing. My heart was racing and my breathing fast as my mind was trying to process everything in front of me.

Why don’t I react that way now when I get to the scene of a “good” car crash? How can I remain calm and be able to think clearly? What changed?

Experience. I’ve been to more than one MVA now in my 25 years of Fire/EMS service. I have been there, done that. (I suppose I could have the t-shirt if I was into collecting them) I have made good decisions and poor ones; each decision I make gets filed away mentally for the next time. It allows me to anticipate things before they happen and see things that others don’t.

Training. I’ve read and studied articles on MVA's. I’ve gone to the junkyard and cut cars and pulled the rookie out dumping him unceremoniously on the ground. I’ve attended classes and training sessions to be more knowledgeable and skilled in the process. I’ve put in the time necessary to get better.

Preparation. This is different from training which involves theory and motor skills. This is the mental work that is done beforehand to prepare you for the sights and sounds of future events. Dr. Rich Gasaway has done some great work at explaining how the mind works and how the body responds accordingly. I’ve learned to think about thinking, to look inside myself and identify my natural qualities and characteristics and how I am wired. I understand a bit better my emotions, my thought processes, and how I communicate with others when I’m under stress.

Which do we need?

We need all three.

Training gives you concrete facts and the usable skills to perform a function. Experience is what synthesizes that knowledge and applies it correctly and efficiently to given situations. It’s what allows you to improvise, adapt, and overcome. Preparation gives you the internal confidence to make the correct decision when it’s game time.

Experience guys: you have no excuse to stop training. The industry continues to change rapidly and with each change, certain experiences cease to be relevant or applicable. Review your past experiences objectively and revisit the lessons learned.

Training attendees: going to training sessions does not make you an expert. Knowledge is good and necessary, but at some point, you must apply it in real-time. That’s called gaining experience. In the meantime make your training sessions as realistic as possible.

We must work harder on our preparation. Learn who you are. Notice what mental strengths you have and the areas where you can improve. Look at the people around you. Determine their motivators, their fears, their personal strengths. Think about thinking. Think about the physiological effects of stressors and how they will cause you to respond.

For those of you just starting out, don’t worry. Your shaky hands and bouncing feet will go away in time. Your mind will clear up and you’ll actually be able to focus on things. For those of you who’ve been doing this awhile, be patient. Not everyone may be at the same stage or speed as you. Remind yourself that you were once new.

Gain experience, spend time training, prepare yourself internally.