Career Links Vol 4 No 4 May 2005
Responding in a New Career:
An Interview with Denny Kurogi, Assistant Dean,
Emergency Medical
Science
Interviewed by Kit Gorrell Frankenfield
Responding anywhere, anytime. . .to give a helping hand.
Illness and injury are a part of life. People who are in the field of
emergency medical services often enter people's lives during these times
of crisis. Their ability to act knowledgeably, compassionately, quickly
and calmly can stabilize otherwise chaotic, frightening
situations.
JCCC has several options for learning the skills of emergency medical
science. In addition to the first responder, EMT and paramedic programs,
the EMS program at JCCC offers classes in National Registry Refresher,
recertification and continuing education, basic cardiology and ECG,
American Heart Association CPR and AED, EMT-Intermediate, and Training
officer certification.
JCCC's financial aid program includes scholarships, grants and loans for
eligible students. Financial aid is particularly important for students
in the paramedic program, since long hours usually prohibit them from
holding full-time jobs.
For more information about the EMT program, contact Denny at (913)
469-8500 Ext. 3841 or by email at dkurogi@jccc.edu. The department
website can be accessed at www.jccc.edu/home/depts/001254.
Career Services Center: What is your role at JCCC?
Denny Kurogi: My role at JCCC has evolved in the 27 years I’ve
been here. When I started here, I was a one-person department, teaching
EMT classes. My main job now is being the administrator for five
full-time faculty, 50 lab clinicians and three medical directors for the
First Responder, EMT and paramedic programs. I do a little classroom
teaching, mainly in the areas of the history of the EMS, the roles and
responsibilities, and the future of the EMS.
CSC: What do you like about working here?
DK: Working with the people that I do. Once we get students into
our program, our staff keeps them involved and nurtures them, from the
beginning classes up through the paramedic level. I work with a staff
that cares about people and the profession. The other nice thing about
working here at JCCC is the administrative support from the college that
we have. I don’t know of any other EMS program in the country that has
the administrative support that we do.
CSC: Why did you get into EMS?
DK: I grew up in Honolulu, Oahu, Hawaii. When I was 18 years old,
I joined the Air Force to get away from the islands, get my education and
get exposure to the continental United States. The Air Force gave me a
battery of tests which indicated that I should go into the cryptography
field. I would never have chosen this field on my own. When I was in
basic training, I got a bloody nose that wouldn’t stop, so I was put in
the hospital. Because of this, I missed the beginning of cryptography
school. I was then assigned to medic school. If I had been given a
choice, I would have gone into meteorology.
CSC: What was it like being an EMT in the early days?
DK: That was the beginning of when they recognized our role. Viet
Nam had just started. They recognized that service medics could be
utilized in lots of ways. I was stationed on a military base and worked
in the emergency department. The base was part of the community, so we
responded to all types of emergencies like car accidents, heart attacks,
etc.
CSC: What do you remember most about your first calls on the job?
DK: What I remember most was different people’s reactions. For
example, I remember a kid who broke every bone in his body in a car
accident. All he was concerned about was who was going to call his date
to tell her he couldn’t go out. Sometimes in grave situations people act
very calm and in minor situations people act off the wall.
CSC: When you finished your duty with the Air Force, what did you
do?
DK: I went back to Hawaii and was going to work for the post
office. My family had a long history of working for the postal service.
It was a very good job and they assumed I would work for them also. Since
I had the training as a medic, I decided to continue working as an EMT
instead, much to the dismay of my family. I felt that I had four years of
training and experience in EMS and I knew I was breaking into a new field,
so it was getting exciting. From 1967 to 1974, I returned to Hawaii and
worked for the city of Honolulu Emergency Medical Services. Then I moved
to Wichita, Kansas because I wanted to attend Wichita State University to
become a physician’s assistant. They were interested in starting an EMS
program there, and when they found out my background, I ended up being the
instructor/coordinator there from 1974 through 1978. I started their
EMT/Paramedic program. In 1978 I came to JCCC to do the same thing, and
I’ve been here ever since—27 years.
CSC: What’s exciting about being an EMT?
DK: I think what’s exciting is being able to affect people’s lives
in hopefully a positive way. You see vulnerabilities—the most invincible
people are being put in very bad positions in a crisis. Probably what
makes it exciting is that every day is different. Every call is
different. If you were to ask a field tech now what is exciting about his
job, he would say that he doesn’t do the same thing every day. I can go to
a motor vehicle accident, and I can go to another one, and it won’t be the
same. Not having a specific routine. Yes you have protocols, but how you
handle different calls can vary.
CSC: So you stayed in EMS because ultimately you liked it?
DK: Yes.
CSC: Before EMS existed, who responded to emergencies?
DK: There’s always been an ambulance service of sorts, even back
to horse and buggy days. Before 1960, there was an ambulance service, but
the kind of care and service you got was not like it is now. Modern day
EMS really began in the early 60’s and became sophisticated in the 1980’s.
It’s only been forty plus years that EMS has been what it is
today.
CSC: Are all firefighters EMTs?
DK: Most of them are. Johnson County MED-ACT, a public ambulance
service, provides the ambulance service for Johnson County, Kansas. The
Overland Park Fire Department runs a joint service with MED-ACT in the
city of Overland Park. One person from the fire department and one person
from the ambulance service staff them. It’s a very unique service.
CSC: What’s the difference between an EMT and a paramedic?
DK: An EMT does what is known as supportive therapy—things like
bandaging, splinting, CPR (cardiopulmonary resuscitation), and AED
(automated external defibrillator). A paramedic does all that but also
more invasive and definitive therapies, such as putting in IVs and giving
medication. The paramedic has a higher level of responsibility and
academic requirements than an EMT. They are more able to handle
complicated emergencies. Anymore, an ambulance almost has everything on
their paramedic unit that an emergency department has in a hospital.
CSC: Why is there so much turnover in this profession now?
DK: Many people have been in EMS now for over twenty years. It’s
a physically and emotionally demanding job. It’s getting to the point
that we’re reaching a turnover phase. There are many factors. Some
people just get burned out after awhile. They can’t take it anymore
emotionally. Also, EMS has a unique kind of shift. Everybody who has
been in EMS and the fire departments love the shift work. It’s a 24-hour
work shift, and averages ten days per month. It’s not for everybody. You
work one day and then are off the next, work the next and off another, work
another day then off four days. Then it repeats. But it’s the fact that
you are there at work for 24 hours. That can get to some people.
Sometimes people decide to pursue other careers, whether they are medical
careers or completely get out of the field.
CSC: Can you speak to the emotional and physical aspects of the
job?
DK: In regard to the physical, ten years ago I decided to work
weekends with the Overland Park Fire Department. After working for three
or four months, I decided I couldn’t do it anymore because of the physical
demands. There are situations that are too demanding physically, like
lifting patients or carrying them up and down stairs. Many people in the
field have back injuries because they don’t use the proper lifting and
bending techniques. Sometimes in emergency situations, you compromise
your own safety because you’re trying to help someone else. We stress in
training not to compromise your own safety, but it happens. Physically it
gets to the point that you can’t lift and move patients who are several
hundred pounds up and down stairs, unless you have a lot of help.
If people were to get emotionally burned out, it’s because you see life
and death. It’s hard to watch kids get hurt and see abuse. Not many calls
are life and death situations, but you see people get hurt all the time,
and you see abuse and car accidents. When you constantly see injury, it
can take its toll.
CSC: Do EMTs or paramedics ever have to go through debriefing when
a tragedy occurs?
DK: Yes, they can go through Critical Incident Stress Debriefing
(CISD). Almost every department in the last ten years has some kind of
CISD team. Not everyone has to go through debriefing. Part of it is the
individual’s make up, the department you work for, and how much you love
everything about your job. There are formal processes now that when a
major disaster happens, you’re offered the opportunity to go to CISD.
It’s generally made up of people within the department, and counselors
from outside the department. A lot of it is handled by peers too. I’ve
always stressed that back then, forty years ago, there was no such thing
and people didn’t fall apart. They talked to each other. It’s now a
little more formal. Sometimes all it takes is being able to talk to
someone else who’s sharing it with you.
CSC: What tips do you have for students considering the paramedic
field?
DK: The first question I would ask is “Why do you want to be a
paramedic?” The typical answer is “because I want to help people.” I
would ask them what they have done to make them want to help people in
this kind of situation. If they have answers like working in the
hospital, then I take them more seriously. Sometimes they answer “I’ve
seen it on TV. It looks pretty exciting.” Then I tell them that five
percent of calls are like that, if that much. A lot of it is holding
Grandma’s hand, and telling her you’re taking care of her and taking her
to the hospital. You’ve got to truly want to help and learn from people.
There’s a lot you can learn. When I worked for the Overland Park Fire
Department, we did a lot of transfers. Some of the best times were when
you picked people up from nursing homes. It’s very enlightening to talk
to people who are older; they always teach you something. These were some
of the most rewarding calls—seeing the kinds of hope they still have, where
they have been. You’ve got to be able to do that—not just what you see on
TV.
Second, I also encourage students to volunteer with an
ambulance service or fire department, ride along and see what their day is
like, and ask yourself if this is really what you want to do. They may
never get a call while you’re there that will amount to anything.
Third, consider if you’re able to work with the same group of people 24
hours a day. These are the working conditions you’re going to have to
exist under. If you can’t stand to be around people, even one person,
then your life will be miserable in this job. Getting along with people
is important. We all know that if you have six or eight people in a
firehouse, there are going to be personalities that don’t get along. It’s
a matter of realizing that you are “family,” you do have to exist well
together. As it takes in any relationship, humor and compassion go a long
way.
Finally, can you handle this kind of stress? When emergencies occur, they
are very intense situations. Some people can’t handle the reality of being
near a dead person or a child who’s badly hurt. It’s not everything you
see on TV. You need to know what you are truly getting into. Another
incident that can be upsetting is when people take their own lives—you
never have closure on it. You generally don’t know why and you’re not
going to get into all the circumstances. It affects almost everybody, I
think.
CSC: What is involved with the application process for the
paramedic program?
DK: There is an interview with a consensus panel of five
interviewers for each applicant. It involves a full-time instructor,
three field professionals and an academic counselor. Between the five of
them, they select who the top 26 are who get in the program. Usually over
40 candidates are interviewed and on the last day of interviewing, the
panel comes to an agreement about the top 26.
CSC: It’s not unusual for over 40 people to apply for 26
positions?
DK: This is the first year that we’ve had the 40 plus applicants.
From here on out I don’t see that we’re going to have any less than
forty.
CSC: What are they looking for in candidates?
DK: If there was one penetrating question, it would be whether or
not the person can succeed academically. It’s a very intense curriculum
for one year. Given the fact that someone can do it academically, then
you are looking for other traits. Everyone wants to “help people,” but
in a five-panel interview, they are looking for how the student handles
stress and adversity. Sometimes there are questions that lead to other
questions, and it’s a matter of how they handle themselves, their
composure, and whether they’re able to act in a professional manner.
Students usually are not able to work during their program. Classes are
eight hours a day, three days a week. There’s a lot of classroom work and
the other two days a week are needed for review and study. People are
constantly busy. I give a talk to the paramedic classes called “A Year of
Balance” at the first of every year. Students will be so academically
stressed that they need to have everything else in their lives in order.
Some people say they lived and breathed paramedic training for a year, and
everyone around them knew it. Overall, the panel reviews all the
information before them including instructor and employer recommendations,
academic history and the interview.
Since I’ve been there since the very beginning, I talk about that with
students. I spend a lot of time with students talking about those areas
and also developing projects such as civic responsibility. I have a great
staff of people who teach students how to become a good paramedic. They
stress three areas: cognitive, psychomotor and the affective domain,
which is how to be able to handle stress, the professionalism necessary,
etc. We stress those three areas, besides just learning the “book smarts”
and the hands-on skills. You also have to be professional and be able to
handle stress.
CSC: How many students are currently enrolled overall in the EMS
program?
DK: In an academic year, about 125 students complete the First
Responder course, 65 EMTs and 25 paramedics, so there are over 200
students.
CSC: What is the First Responder, EMT and paramedic programs like?
DK: The First Responder is an 8-week class. A lot of people take
the First Responder course because they want it for their own knowledge.
It’s something that a citizen should take. But people will start with
First Responder and see if this is a career they are interested in
pursuing. The EMT is a one-semester class—11 non-credit hours, and the
paramedic is the 2-year degree program (Associate of Applied Science in
MICT). It begins every January for one full calendar year, and is pretty
much a full-time experience. Students need to apply for the paramedic
program by October for the next year.
CSC: Is an internship required for the paramedic program?
DK: Yes. The paramedic program is broken up into three areas.
The first four months is spent in the classroom portion. The next four
months is spent interning at a hospital. They get classroom and lab, and
then work in the hospital in various areas, such as the emergency
department, surgery and the surgical units, obstetrics and the children’s
unit. The final area is the field internship with an ambulance service.
They perform from day one as a student, but work their way up during the
four-month period to actually leading a call with other paramedics.
That’s part of where their affective domain is graded heavily (such as
problem solving, communication and working with people). We want to know
that they can reach a point where they’re able to function, not as a
student, but as a field paramedic, someone who is actually taking care of
a real patient.
CSC: Do faculty check with hospital and ambulance staff in an
internship situation to monitor students’ progress?
DK: We have evaluation tools for preceptors. Faculty also goes
out and meets with them to discuss student progress.
CSC: Do the ambulance services enjoy having students work with
them?
DK: They embrace us, because our students are their future
employees. There is a lot of shortage and turnover in the EMS field.
There’s no doubt that if you talk to Johnson County MED-ACT, they always
want our students. They sometimes hire our students before they
graduate.
CSC: Do students ever get all the way into field training and
decide that it’s not for them?
DK: We have had students in the last month of their training had
to be let go because of that. Generally speaking, these students usually
come back. We give them terms of remediation, what they need to
accomplish, such as more field experience, or work on skills, etc. Then
they can re-enter and finish their program. Generally it’s not the skills
that they lack, but not being able to bring the whole picture of an
emergency together and work it effectively. It happens very seldom, but
it does happen occasionally.
CSC: From the patient’s point of view, how important is that
person who comes in their home to take them to the hospital?
DK: Very Important. Once the chain of patient care begins, how
that patient is treated will dictate how he/she accepts care from other
health care providers. They will remember how they were treated
initially. It’s very important on the patient side. Given that all
things are equal, most ambulance services are going to hire someone nice,
because that is one thing they can’t teach—compassion. They can teach them
skills, but you can’t teach niceness. Most of your calls—95 percent, are
going to involve how nice you can treat people. Paramedics and EMTs need
to be compassionate, nurturing, patient and calm. Calm is a big thing.
That’s one of the very first things I address when talking about roles and
responsibilities. If everything else falls apart in your mind with respect
to the patient, remain calm and reassuring. Facial expressions are
important, as well as the manner you approach people who are in a crisis
situation. Initially you have to be as nice as possible. You are
courteous in people’s homes and respectful of their property. Treating
that person like you would a family member is very critical.
A good EMT/paramedic will always introduce themselves to the patient,
explain what they are doing and what they’re going to do. Open
communication is very important. There are always difficult questions,
like “Am I going to die?” or “Am I going to be all right?” We tell them,
“I’ll do everything I can to help you…we’re taking good care of you.”
