Paramedic who took the first National Registry test still on the job

Try this one-question pretest about paramedic Roger Swor:

Roger has been in EMS so long that …

1. He used a LifePak 2.
2. His National Registry number is only three digits.
3. "Emergency!" was still on the air when he started.
4. He couldn’t become an EMT right away because there was no such thing in his state.

You’re right if you picked A. You're also correct if you picked B, C or D.

If only the Registry were that easy — not that Swor needed any help when he took their inaugural paramedic exam in 1978. He got a 96.

"It wasn’t as structured as it is now," Roger recalls. "The preceptors were sort of making it up as they went along because there was no syllabus. We had to take different modules at different hospitals."

Career correction
Swor’s entry into EMS three years earlier was mostly due to some strident career counseling.

"I’d been a police officer since ’72," the 64-year old native of Duluth, Minn. says. "My first wife told me to either plan on being single or quit being a cop. I ended up doing both."

Like so many of us who came of age in the 1970s, Swor was intrigued by the fast-paced, antiseptic view of EMS portrayed by the TV show "Emergency!"

He’d also noticed that ambulances responded to all the "good" calls. "That seemed a lot more exciting than writing traffic tickets," he says.

By 1977, Swor was a paramedic with Duluth’s Gold Cross Ambulance, a 911 and inter-facility operator serving 250,000 residents of eastern Minnesota and northwestern Wisconsin.

He’s been there ever since. Along the way, he’s established skills review sessions to help colleagues prepare for practical testing.

"Supposedly, wisdom comes with experience," says Swor. "I figured maybe I could share some of that wisdom with new people who have a 'deer in the headlights' look when it comes to the real skills of their jobs.

"During the five years we’ve been doing these sessions, the first-time pass rate on practical exams has gone from 70 to 99 percent."

Medic and mentor
Swor cites patience and empathy as important traits for EMS educators.

"You have to relate to the people who are looking to tap into your experience and knowledge," he says. "Some skills evaluators come across like Marine drill instructors, which causes more stress and makes it even harder for students to remember what they’re supposed to do.

"My way of teaching is to interact with students and redirect them if I see them going down the wrong path. I might say to them, ‘What if we did it this way instead"’"

Swor doesn’t limit his mentoring to the classroom. He monitors students’ progress on the streets as well.

"When I see coworkers freeze, I tell them, ‘I’m not going to ever let you fail on a call. If I see you doing something wrong, I’ll help you retrace your steps and figure out how to do better next time.’

"Helping others makes my job easier, too, because I don’t have to work as hard when people I’m with get comfortable doing what they’re supposed to do."

One call at a time, one patient at a time
Swor says Hollywood’s version of EMS is partly to blame for anxiety that many novices feel, both in the classroom and on the streets.

"Emergency shows like 'Chicago Fire' make everything seem so stressful and critical. Everybody’s life is on the line all the time.

"You can’t afford to think that way. Just remember your ABCs and focus on one call at a time, one patient at a time."

Paramedic Roger Swor greeting Vice President Al Gore

Swor offers an example from his own history to illustrate methodical prehospital care.

"I’d been a medic for about a year when we answered a call at two in the morning for a van full of cheerleaders that flipped over after getting broadsided by a Jeep. There were eight girls in there, some still belted upside down, some with broken hips and legs, some with back injuries.

"I didn’t have any experience in multi-trauma, but I remember triaging without even knowing that’s what I was doing. Just take the worst ones before the less bad ones. No one panicked; everyone survived."

Being methodical isn’t always going to save lives, though.

"One morning in 1980 or ’81," Swor says, "a mother was driving her two kids when their car stalled on the train tracks. She was able to get the four-month-old out of the back seat, but was still trying to undo the seatbelt of her two-year-old when the train hit.

"When we got there, I could see what was left of the car upside down next to the tracks, and in front of that, the mother, dead in a snowbank. I asked this big lumberjack on scene — the kind of guy you’d never mess with in a bar — if anyone else was involved. He just looked at me, never said a word, but opened the door of his truck and pointed to the dead four-month-old he’d found on the ground.

"The two-year-old was still in the car, squashed between the console and the front seat."

Swor says two rules he borrowed from another 1970s TV show, "M*A*S*H," help him deal with calls like that.

"Rule number one is people die. Rule number two is paramedics can’t change rule number one.

"If you’re going to do this job, you have to find a way to keep smiling. Don’t get mad when an alarm comes in; bad feelings accumulate over the years and lead to burnout. Enjoy the calls you run. Try to learn from each of them."

Maybe the Registry should add that to their syllabus.

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