It's as easy as EMT

Nicole Castagno knew exactly what she wanted to be when she grew up. One thing she didn't know, though, was she'd be working 24-hours at a time to accomplish her goal.

On her way to a career in emergency medicine, Castagno is working as a certified EMT for the Rural/Metro Corporation and said she loves her job despite the intense commitment.

Castagno first reports to a base station in Mountlake Terrace to start each shift. She and her partner then prepare their ambulance and then proceed to the station they've been assigned to. Most often, they'll be assigned to a location with a low density of ambulances. Many times, these are houses that Rural/Metro has rented.

Castagno and her partner are on-call at their location until they get a case or are assigned to another station. To pass the time, she said there are things such as TV and video games set up at the houses to keep them entertained. Castagno works a 24-hour shift then gets 24 hours off. She repeats this cycle three times before getting four days off.

Because she works for a private company, the calls Castagno gets are often minor cases -- more serious and urgent cases are saved for the fire department and Medic One (the paramedics' ambulance). Although she has yet to encounter a case where it's a matter of life or death, Castagno enjoys the job because there's no predicting what will happen in a day's work.

"Ever since I was little, I wanted to be a doctor," she said.

Her first year at the UW, Castagno made a decision to go into emergency medicine, with hopes of working in a major emergency room like Harborview Medical Center. To reach her goal, the junior physiology major has taken a quarter-long class in emergency medicine at North Seattle Community College.

Aside from CPR, which is practiced on dummies, the class practiced their lessons on their peers. They would take turns acting out scenarios, and Castagno said she often had to play the patient. This was because she was the smallest student in the class and the easiest to strap to a gurney.

"I had a lot of duct tape on my forehead," she said.

Castagno said a lot of what's taught in the classroom is just common sense and the most beneficial part is learning how the system works, which is more complex than people think.

You don't just call 911 and people come, she said. There are a lot of in-between factors that need to be taken care of -- which hospital the patient will be transported to, whether or not the patient's insurance will cover the costs, and who will take the call -- just to name a few.

After completing the class, Castagno became certified as an Emergency Medical Technician, but has yet to become a legal EMT, a goal she is working toward at Rural/Metro.

"A certified EMT can't do anything more than what a first responder can do, such as CPR," she said, adding that when it comes to certification, every state has a different policy.

In Washington, in order to become a legal EMT, you must have reciprocation. This means working for either the fire department or a private company. Not many people know of the difference between the two.

When somebody calls 911 the emergency situation is assessed, Castagno said. If it's considered serious, they'll send in the fire department and Medic One. If it isn't as serious, such as a domestic dispute or a case of broken bones, they'll send in a private ambulance.

Rural/Metro is a private company, and the first one Castagno has worked with as a certified EMT. Though it has only been two months since she first started, she has already had a chance to apply what she learned in the classroom to real life.

Once she puts in her time in the field, more opportunities will open up for Castagno in the emergency medicine field. Her boyfriend, UW senior Benjamin Mason, spent two years on an ambulance crew before he was able to become an ER tech at Swedish Medical Center.

While a rewarding position, for the time spent transporting patients, Mason said his job isn't for the weak of heart.

"For most all of the patients, coming to the ER is one of the most scary days of their lives," he said.

According to its Web site, Rural/Metro is a "leading provider of emergency and non-emergency medical transportation services, fire protection and other safety-related services" in the state. Castagno said working with a private company is a great opportunity to see what it's really like out in the field.

She has answered many calls for car accidents and has even reported to an ice skating rink once or twice when spills have resulted in broken bones.

On these calls, Castagno and her partner will switch off between driving and staying with the patient in the back of the ambulance. The person in the back handles all of the paperwork, which she said can pile up.

Her job also includes a lot of inter-facility transporting, moving patients who don't have any other form of transportation from one location to another. A lot of this part of her job involves transporting psychiatric patients. Castagno said that these are the most interesting cases she's come across because she meets the most interesting people.

"One patient told me it was bad that I had him restrained to a gurney because he had to save the Space Needle from asteroids and the entire city of Seattle from global warming," she said. "He also thought he was God."

Aside from hearing out-of-the-ordinary stories, another perk transporting psychiatric patients is that you don't have to worry about them coding, Castagno said. Coding is when a patient stops breathing and has no heartbeat or pulse. The main part of her job is to get the patient to the hospital, alive and stable.

Once they get to the hospital, it's up to the technicians in the ER to take care of the patients, Castagno said. This is Mason's job. Mason is the only UW student who is an ER tech at Swedish. Mason considers himself very fortunate to have this job.

"I was in the right place and the right time, and got lucky for the job," he said.

His job is to make the patients as comfortable as possible, even though it involves "poking them with needles and catheters."

Though working as an EMT involves long hours and a lot of responsibility, Castagno continues toward her goal of working in a major ER. She said she loves her job and everyone is really helpful and enthusiastic -- and that it's obvious they love what they do.

She also likes that something different happens every day, and there is no predicting what situations she might have to respond to.

Castagno said her EMT work contrasts well with her job at the EMP in Seattle Center, which can get a bit repetitive and tedious.

"I need that variety," she said.