Well hello again…

We met almost two years ago in your room. Your sister found you hanging from the pull up bar in your closet. Your face would enter my mind from time to time, but it’s been awhile. Ironically enough, today as I sat in class my blue water bottle kindled my memory, it’s dark blue almost a perfect match of your skin. Moments later Captain started talking to us about the horrible things we would see in our career. Some of my classmates have no prior EMS/Fire experience, they have yet to experience this feeling, the memories that randomly come from deep within your brain to the forefront. As I think this, Captain, almost as if he is inside my head echoes my thoughts. He tells the story of a hostage situation from his PD days. He, unlike me was able to keep his composure retelling the story of one of his ghosts. Then again it’s been almost 2 years for me, and over 13 for him.

  As I pushed on your chest, knowing we are fighting a losing fight, I noticed the cluster of small cuts on your arm. I am sure no one really knew how bad you where hurting. I hope you are in a better place young man, but you put your family through hell. I am sure we will be seeing each other again. I am still new to this profession, and I have lost other patients, but something about you won’t leave me. So here is to a long healthy career, I am sure soon you will have some friends. 

When probie bashing goes too far

So this did NOT happen to me. This happened to a friend, who works for an agency that I am in no way associated with. His name will be “Cliff” for this story.

Cliff, an EMT-Intermediate arrived for one of his first probie shifts. He was on as a third with a full time paramedic and a firefighter EMT-Basic. The medic, Steve was welcoming and had a great attiutide. The firefighter EMT-B, Brad asked Cliff what his last job was. When he replied, Brad asked if his old job would have him back after he failed this job and got fired. I think we can all agree this was a shitty thing to say to a new employee. The morning carries on as such and the medic finally gets a call.

Medic 5 is dispatched for a chest pain. The crew arrived and Cliff starts his assessment. It is obvious the patient is having a cardiac event. ST elevation in lead V2-4. The patient is taken to the medic and Cliff starts to set up for an IV. Brad, right as Cliff brings the needle to the patient’s arm shouts, “Hey, have you ever even done an IV before?!” Cliff ignores the comment and sinks the IV. He then hands the patient ASA and instructs the patient to chew. Brad asks if Cliff has ever given ASA before.” Cliff gives the patient nitro, again Brad asks aloud if Cliff has ever given nitro before. Cliff draws up morphine, again, Brad asks aloud if Cliff has ever given morphine before. This is all done in front of a patient who is having an active heart attack.

I understand it’s kind of tradition to bust on the new guy. But to second guess a caregiver infront of any patient, especially a critical patient is unacceptable. Not only is this an unprofessional act, but it angers me that someone in my profession would dare to be so reckless. A patient who is having a heart attack has enough to worry about with out an unprofessional, moron EMT-Basic second guessing every move the ALS provider makes. Cliff did not go to the acting officer with this issue. This story angered me to no end. Had it been me, I am sure I would be out of a job, as I am sure I would have walked in to the chiefs office and gone on a screaming rant. It sickens me that a dip shit EMT can be allowed to act like this. Not only is this bad for the patient, who has enough to worry about, like will I live through this, will I ever see my family again and so on; this is horrible for our profession.

So if for a moment I can talk to this waste of space, and anyone else who would ever do something so reckless….. GET THE HELL OUT OF MY PROFESSION! If I ever see something like this happen infront of me, I will see to it you lose your certification, and will never be able to practice health care! What’s that? You want to be a firefighter and not an EMT? Well guess what Jack, EMS is 80% or more of your call volume, and it is what pays the bills. So go work in fast food with your shit attitude!

My Rock&Roll Day’s

So this is way off the topic of the blog.
I’m posting by our office in the middle of the night listening go music on my iPhone (RIP Steve Jobs) and this big chorus comes in and since my partner is inside, I can’t help but sing along. It flashed me back to my touring days.

A quick back story, I used to play drums in a metal type band. We never got famous but we made some great friends and had a ton of fun. I lived with my guitar player for a while, then because of a broken transmission on one tour, and far fewer paid gigs than we planned on I moved back in with my parents after our lease was up.

We just got home from a short tour. It’s 6 or 7 am and we drove overnight from Albany. We had a blast, it was only 6 or 7 shows but we got to see some old friends and we made a few new ones. This is actually just 3 or 4 days off before we go back on the road for 3 weeks. A bunch of shows fell through so we decided to just stay home rather than try to find shows last minute.
I’m exhausted so I take a couple hours of sleep, enjoy a nice shower and stuff my face with food I didn’t pay for. I hop in my 1988 Toyota Celica (It’s 2004 or 05) with the flip lights stuck half way open, and the string hanging out of the drivers side window that acts as my door handle and I’m driving to the show. We are playing in a small bar that we play at ALL THE TIME! Last December we played every show that came through. That means in 31 days we played something like 18 shows, it was some of the best days of my life.

We all meet up at the show, we are playing with these two Christian bands. Haste The Day, who we booked their first show in this area a couple of years ago, and have played with maybe 3 or 4 times before tonight. The other band is called Still Remains and they are really new, I haven’t really heard them before. Haste The Day has a new CD out and are starting to get a lot of attention. This bar is very small and the capacity is 80 people. Well once you count 5 bands with 5 people, 2 “sound guys” and the 5 or so staff members, and each bands 1-3 “merch guys/girls” you have almost 50 people, oh and then there is the promoter! That only leaves room for about 30 more people. Well tonight there are many more than that who want to see the bands. Luckily tonight the fire marshall doesn’t pay us a visit and the show doesn’t get shut down.
A brand new band opens the show and I don’t watch them because I’m chatting with a cool Christian cat covered in tattoos. His name is Jeremiah and we became friends because we met at a Sick of it All show and I had a No Innocent Victim shirt on. NIV is another Christian band, I’m not a christian, but they where the very first hardcore band I saw play live and they killed, so I became a fan.
We go on and we SUCK!! we always do when a band we like and respect is playing with us! Everyone says we did good, but by our standards, it was a bad show. But the sting of failure dissipates quickly as we are surrounded by friends, many of who feel more like family.
Still Remains comes on and kills it. So much energy. Places like this, small, cramped make for great shows. The bands play on the floor, you can look them right in the eye. While everyone was going nuts, my friend E knocked the keyboard players keyboard over! It was like a $2000 keyboard/sampler. The music stopped dead in it’s tracks like in a movie when someone walks in to the country/biker bar. Turns out it was ok, and the show continued.

Our friends in Haste the Day went on and we went off! Everyone was having a blast, dancing, just going ape shit. It was one of those nights when the band was on fire, playing as tight as they ever did, the crowd was having a blast, full of positive energy, the room almost glowed with the energy and the excitement of the assembled. The band played song after song and didn’t seem to tire. The band played one of their newer songs that had a very melodic bridge, and did a round. One of the guitar player starts singing and we all rush the singer and start singing along. “I never should have let you go, I never should have let you slip through my arms” we sing our lungs out. After a few bars the other guitar player starts his part, singing in harmony, but different words, and the crowd, my friends and I on cue split almost as if we had rehearsed in to one of the two lyrics. “As the sun sets tonight, I’ll hold you with all that I have!” Half of us now sing with every breath we can draw in. Then after a few bars the lyrics become a combination. “I never should have let you go. Promise me, you’d stay with me forever!” We all sing, then the big sing along ends and the band explodes in to a breakdown and we all go ape shit! They continue with a few more songs and they thank us for coming out and say how much they enjoyed the show, but we keep shouting “One more!!” They decide to play one of their older songs called “Substance” and the room explodes with energy. Another big sing along approaches and we surround the band, arms over each others shoulders as we all sing with what’s left of our voices “I want you to know what I’m going through!!!!” The hair on the back of my neck is on end, goose bumps rising like mountains and a feeling of embrace by the whole room wraps around me. The song ends and we go out side to get some fresh air. It’s after 1am and the show ran long and no one wants to leave. We have all shared a wonderful moment and no one can bare the thought of it coming to an end. My band, Haste the Day & Still Remains stand around talking while the crowd slowly filters out. Still Remains has made arrangements to stay with a friend they know, while Haste the Day still hasn’t found a place to crash. Since I am staying at home I debate with my self if I should offer them a place to stay. I decide these guys are all cool, we have played a handful of shows together and I can’t pass up a chance to help a touring band, because it sucks sleeping in the van, without showering for several days in a row. I offer to let them crash at my house and they gladly accept. We drive to my parents house, along with one of my other band mates. I show them to the den where there is a couch, recliner and plenty of floor space. I snaked down the hall and opened the door to my parents room, I whisper-shouted “Don’t be alarmed, there is a rock & roll band sleeping in the den. They’ll be on the road by 9.
I offer them use of the shower, towels and any of the food I didn’t pay for they’d like to eat. They say they’ll just have some cereal and are very grateful. They make good on their promise and they eat every last crum of the cereal. Before going to sleep we talk a little bit, they say they heard I had quite the collection of body piercings, we discussed tattoos and piercings and they headed to bed shortly after each doing a bunch of sit ups and push ups. It was kind of funny to watch, but what ever helps you stay healthy on the road. We all retired to our places of sleep, putting the amazing show behind us, in the past but forever in our hearts.

What is considered a victory

We in EMS arrive on scene to a patient and we have to figure out what is making them ill. Sometimes it’s plain for all to see. A knife sticking out of a chest, a body hanging out of a mangled car. But sometimes it’s not so simple. A sharp abdominal pain can be anything from gastritis, to a perforated bowel or ulcer, or even a tripple A. Sometimes feeling lethargic with nausea and vomiting is the flu, sometimes it’s an A typical presentation of a heart attack. We don’t have access to MRI and X-rays, blood work, or any of the things a doctor has in an ER. We have to use our knowledge, the tools at hand, our instinct, and our assessments to crate a working diagnosis so we can begin treatment.

This brings me to the subject, what do we consider a victory? A cardiac arrest save, a healthy baby delivered in the back of the medic, an OD reversal, sure these are all vitories, and they all leave you with that great, “This is why I do this!” feeling. Well sometimes, like in the case of one of my twitter friends a victory might be buried under the disappointment of a patient who didn’t make it out of the hospital alive. Did this mean EMS failed? No, no it doesn’t. Sometimes, sadly we are called to late. But we still arrive quickly, we bring all of our knowledge and experience to the patient’s side, and we use all the tools we have to give them a fighting chance. We all know somethings we are helpless to fix. A patient with a bad internal bleed, we can identify it, and do our best to get the patient to the hospital alive, but sometimes we are to far behind the 8 ball. We can’t view this as a failure. We identified the problem, and we did everything in our power, but somethings we just can’t fix in the back of an ambulance. I know it dosen’t feel like a win, but I sure as hell won’t call this a loss. Here is to a job well done.

 

‘Merica Healthcare

Dispatched via private for-profit EMS for a priority 3 (non-emergent) fracture. Arrive on scene at the nursing home to find a older male in a wheelchair with a recent right foot amputation. Staff says he keeps bumping it and reopening the wound.
Wound is dressed, clean, bleeding controlled. Pt is A&O to baseline and pt denies any complaints. No idea where the fracture idea came from, but the pt is loaded up and taken to unit. Transport w/o change or incident less than a mile to the ER.
On arrival of ER, pt is moved by sheet to bed. Crew starts putting a new sheet on the stretcher as the doctor takes a look at the wound, he tells the crew to wait, redressed the wound and tells us to return the patient to the nursing home. Pt taken back to room, put in bed in POC and turned over to staff.

It’s a hard job. Lives hang in the balance, some days it’s all you can do to keep from falling apart. But someone has to do it? Am I a hero? Well… Yeah… Maybe.

I can’t keep the lids open

So here I am, in the truck, posted at the office. It’s 0402 am and I have been here for 10 hours. We, after doing 6 calls have been posted for almost 2 hours. Sounds nice, however I am unable to close my eyes.
Why? Because it is company policy to write up any one caught sleeping. A supervisor in his office, with the door closed, probably asleep him self, is just a few feet away from me. If he catches me sleeping, I could lose my job. This is my first shift on nights. Every part of my body and mind are screaming, go to sleep! Besides the fact I haven’t gotten sufficient sleep to sustain my self, it’s the time our body’s are set to sleep. I love being an EMT, I really do. But when policies are enacted that are counter productive to overall moral, efficiency and safety, I find my self very frustrated. Sometimes, it seems as if some of the rules set by the company are designed to demoralize and wear down the crews. Almost as if they prefer tired and broken employes. I’m not sure what my point is, other than I’m tired, I wish I was asleep in bed with my lovely fiancé, and not under paid, stuck in an ambulance ruled by iron fists.
Oh yeah, by the way, well after a year of having my medic, I FINALLY got released with this company, and have been told the paper work… Blah blah blah…. You will be working a week and a half as an ALS provider at BLS pay. You’re welcome for us paying you for 9 trainee shifts after making you get released with a volunteer 911 agency before waiting months to start training you here.
Well this ate up like 10 minutes. Wish I was sleeping.

My sick mind

The scene: A nursing home room. We have a patient on our stretcher and the lady in the A bed is telling us we need to put the patient in the empty B bed. My partner says “I know, we can’t put her in this bed, your already in it!”
Me: That’s a video no one wants to see! I’m sure there is a market for it though.
My partner *red face dry heaving* “OH MY GOD…. that is… Oh God!”

Social Media The Death of a Career

In a day where social media is in every facet of society, it shouldn’t be shocking when problems arise. It started with friendster, then myspace, Facebook, twitter, tumblr, and countless others. Your digital person is all over the Internet and anything you say or do can and will be held against you. What you may view as a personal outlet for your opinions, or feelings, can be seen by others as a public loud speaker, no matter what your privacy settings.
How many of your “friends” do you really truly know? Are they people you have shared your whole life with? Or, like most people, are they work acquaintance? These “friends” may not be who you think they are. They may see opportunity in your musings. A chance to further their own career at the expense of yours. It’s important you realize who you are speaking to. What you may find funny, others find offensive.
Many people view their social media outlet as a personal party. You and your friends sharing ideas, stories, thoughts, and experiences. But with today’s big brother, watch dog attitudes, a few simple words can have long and far reaching consequences.
It’s not that uncommon to hear of people losing their jobs over a Facebook post, or a tweet. Many places of work do not have social media policies, and the few that do are vague at best. Many of those fired have successfully sued their formal employers. A post made in anger or a joke finds it’s way to management. A manager is offended, and angrily fires the employee, and things continue to elevate from there. It’s a shame a persons thoughts and opinions are under attack, and you have to censor your self. But, in this economic hardship, having a job is a blessing and if putting duct tape over your cyber mouth is what’s needed to keep your job secure, swallow your pride and grab a roll of duct tape.

Brahms’ Lullaby

So I was reading all the blogs I normally read and Ambulance Driver. He mentioned how some hospitals will play Brahms Lullaby when a baby is born. The hospitals in my area do the same. I have always said, we should continue this tradition. I feel it gives people a nice warm fuzzy feeling, and it celebrates the mericle of child birth.

However, I have also said we should play Queen’s “Another One Bites The Dust” when a patient dies. Just say’n.

Not in the mood for you ass hole.

Seizure at XXX Bar
En rout we get an update, Patient had stopped one seizure and has started another.
Find a 40 year old white male on the floor of the bar. Staff says he had a seizure there last night and was transported to the ER. Staff says he has only drank water, but has a long history of ETOH abuse. Witnessed seizure 2X. Pt lowered to the ground from bar stool. No head, neck, or back pain.
Pt is loaded up and taken to the unit. Pt states he has been a heavy drinker for 30 years. He first asks why the fire department was there. After we remind him he has had two seizures we get ready to go. Then he can’t recall how he got in to the ambulance while on the way to the ER. Vitals assessed, IV box pulled out. Pt states he dosen’t want an IV, I explain he has had two seizures back to back, he is at hight risk of another one, and is informed of the risks. He agrees, and as I wash the site he tenses up. As soon as I go to stick him he flings his arm at me and I miss.
Pussy. I toss the needle in to the sharps container and sit in the capten’s chair and ignore him until we get to the ER.

There he is short and shitty with the RNs and tells them he won’t be staying long, and he won’t be getting an IV.

Sign here ass hole.