Tips for Wilderness Patient Care Experience

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A reader wrote, “Any tips on what I can do to gain wilderness patient care experience? What would you want your co-instructors to know or have experienced before teaching WFR?”

My Experience as a WMA Instructor

I have been a Wilderness Medical Associates lead instructor since 2002. At the time of my application WMA generally sought instructors that had qualifications in three areas – patient care experience, teaching experience, and outdoor/backcountry experience. My observation of new instructors over the years was that instructors were usually strong in two of the three areas and were acting on a plan to gain experience in the third area. For example, at the time I was hired, I had a strong teaching and backcountry resume, but I was just beginning to gain patient care experience as an EMT-B. I have taught with RN’s, PA’s, and MD’s that had lots of backcountry and patient care experience but were just learning to teach.

Any Patient Care Experience is Good

It is hard to obtain “wilderness patient care experience.” A good trip leader/guide is constantly managing risk for their participants and actively working on injury prevention through use of safety equipment, like helmets and PFDs, and hygiene, like handwashing. Fortunately, injury and illness is relatively rare in the backcountry.

Instead of focusing on “wilderness patient care experience” seek out any patient care opportunities. The process of assessment and most treatment is the same, regardless of your location.

Urgent Care – I cut my teeth as an EMT working at a busy urgent care clinic. In each shift I would collect vital signs and patient history information on 20-30+ patients of all ages, health conditions, and complaints. The frequent assessment and treatment of kids was especially helpful. I also got to clean and dress wounds, splint injuries, and assist with other procedures. The urgent care was adjacent to an emergency department so I also had opportunities to assist on care with severely ill and injured patients. The constant assessment of lots of patients was really helpful for learning to distinguish between “sick” and “not sick.”

Urban EMS – If you want lots of patient care experience, and quickly, apply to an urban EMS system. My tours for a private ambulance service in Milwaukee, Wisconsin were non-stop patient assessment, care, and transport. We almost always had our next call waiting as we cleared the hospital, clinic, or nursing home we transported to. It was normal to run 8 to 12 or more calls in a 12 or 16 hour shift. My urban EMS experience exposed me two patient types – geriatric patients and patients that failed to manage chronic health problems. Being able to see the progression of disease states and the worsening effects of problems not managed well and early was a great addition to my paramedic knowledge and experience.

Mass Gathering Events – anywhere lots of people gather, especially if there is exertion, heat, toxins, and gravity will provide lots of patient care experience. Seek out opportunities to work or volunteer at special events like music festivals, marathon runs, adventure races, or church festivals. Patient problems can span the range from cuts, strains, and sprains to chest pain to intoxication to cardiac arrest. Be ready for anything because you just might see it. But the best experience you might gain from these events is just talking to people and helping them out with simple first aid. Being a friendly face in a time of need, no matter how trivial, is a great EMS skill.

Co-Instructor Traits and Experiences

This is what I appreciate in a great co-instructor:

  • Willingness and ability to follow the course curriculum
  • Ability to listen to student’s questions and answer questions succinctly while always bringing students back to important points and concepts
  • Only telling anecdotes (war stories) that reinforce student learning objectives
  • Being prepared to lecture, set-up a patient care scenario, and facilitate a debrief
  • Encouraging students to learn more and take appropriate risks while learning
  • Honest conversations with students about their performance and likelihood of passing the course
  • Passion for taking excellent care of patients, regardless of where, when, and how we encounter them

Your turn. What would you suggest for acquiring “wilderness patient care experience”?