So my mediocre life as an EMT has included a handful of calls where I acted as the "in charge" person - all BLS calls, all leading EMT's and First Responders.
All of that has begun to change. Mr. Medic is throwing me at patients. And I'm failing.
He served an apprenticeship under his mentor in a large city system. Even after his stint in paramedic school, I think they made their medics ride with a preceptor for another year. That was standard for their system at that time.
We don't have anything nearly as official in place here, but Mr. Medic seems intent on grooming me for my new role as paramedic. In a year's time I will be expected to take care of people and it's time to step up my game.
Haven't killed anyone yet, but focusing on the fact that the guy has a 20+ year history of migraines and neglecting to check for stroke...oops. Talking insanely loud because you are nervous...oops. Spiking an IV slow as molasses... Seems like every call I go on I forget things. Just taking a good history (at which I thought I was decent) has turned into a bit of a nightmare.
I have a good rapport with Mr. Medic but I don't want to disappoint. I want to be perfect.
Truth
Bleeding
Friday, December 28, 2012
Wednesday, December 19, 2012
The Real Problem I'm not hearing about
Folks, I'm going to piss you all off.
SHUT UP ABOUT THE GUNS
The guns are easy to latch on to, and everyone has their opinion. I'm staying silent on that one.
Can we please have a discussion about mental health now?
Can we PLEASE have a discussion about mental health now?
CAN WE PLEASE HAVE A DISCUSSION ABOUT MENTAL HEALTH NOW?
The mental health "system" in the U.S. is dismal. I put system in quotes for a reason. There is no system.
Where do we take people who have mental problems? (I ask this in the context of EMS. Our coverage area is in 3 states, the closest mental health facility is in one of the states over an hour away, but we cannot transport to that hospital. We have to take them to the facility in the state where we picked them up, often a 4 hour journey.)
What do we do if we suspect a person is on the edge?
What does a mother do? A father? Sibling?
What can we do to make this better for all of us?
http://www.huffingtonpost.com/2012/12/16/i-am-adam-lanzas-mother-mental-illness-conversation_n_2311009.html
I have no answers. I just wish we could look at the big problem. No sane person would do something like this.
SHUT UP ABOUT THE GUNS
The guns are easy to latch on to, and everyone has their opinion. I'm staying silent on that one.
Can we please have a discussion about mental health now?
Can we PLEASE have a discussion about mental health now?
CAN WE PLEASE HAVE A DISCUSSION ABOUT MENTAL HEALTH NOW?
The mental health "system" in the U.S. is dismal. I put system in quotes for a reason. There is no system.
Where do we take people who have mental problems? (I ask this in the context of EMS. Our coverage area is in 3 states, the closest mental health facility is in one of the states over an hour away, but we cannot transport to that hospital. We have to take them to the facility in the state where we picked them up, often a 4 hour journey.)
What do we do if we suspect a person is on the edge?
What does a mother do? A father? Sibling?
What can we do to make this better for all of us?
http://www.huffingtonpost.com/2012/12/16/i-am-adam-lanzas-mother-mental-illness-conversation_n_2311009.html
I have no answers. I just wish we could look at the big problem. No sane person would do something like this.
Wednesday, December 5, 2012
Posting less often than I should...
OK, so I followed the EMS Newbie through EMT and Paramedic School by way of their weekly podcasts and blog.
I have no freaking idea how they managed to make that work. I cannot even get a weekly blog entry up!
Suffice it to say, things have been busy. In the past four weeks I have:
Attended the funeral of one of the best people you have never heard of (my grandfather)
Gone on "vacation" to warmer climes to visit with the family and suffered through a horrid cold/flu/plague the entire trip
Managed to keep up with paramedic lectures
Managed to keep up with paramedic exams
Gotten behind in reading
Making progress in my A&P course
Helping with the winter EMT class here in the mountains
Done nothing to work on the EMS program (my little projects)
Done next to nothing on my Master's course work
At last check, I am holding about a 95% in paramedic school. If there's one thing I wish, it's that I had a better work ethic to schedule more time to just do research on subjects. We are racing through the material, the instructors are excellent, but I still need to spend more time at it. Mr. Medic and I pulled out a few airway heads and began to put together my ALS airway kit. (I suck at endotracheal intubation at the moment.) Not just technique, but arm strength. So adding my scheduled strength training to "the list"...
And as usual, work trudges merrily along. Attempting to hit deadlines, deal with a computer crash and a new email system...
Bored yet with all the whining? I am!
So what do I do? Read more. Find a comfortable study spot that is NOT my office NOR my bedroom. I may have fallen asleep reading a time or two :-) Figure out how to fit in more exercise, preferably outside.
And, as always, wait for that pager to go off.
I have no freaking idea how they managed to make that work. I cannot even get a weekly blog entry up!
Suffice it to say, things have been busy. In the past four weeks I have:
Attended the funeral of one of the best people you have never heard of (my grandfather)
Gone on "vacation" to warmer climes to visit with the family and suffered through a horrid cold/flu/plague the entire trip
Managed to keep up with paramedic lectures
Managed to keep up with paramedic exams
Gotten behind in reading
Making progress in my A&P course
Helping with the winter EMT class here in the mountains
Done nothing to work on the EMS program (my little projects)
Done next to nothing on my Master's course work
At last check, I am holding about a 95% in paramedic school. If there's one thing I wish, it's that I had a better work ethic to schedule more time to just do research on subjects. We are racing through the material, the instructors are excellent, but I still need to spend more time at it. Mr. Medic and I pulled out a few airway heads and began to put together my ALS airway kit. (I suck at endotracheal intubation at the moment.) Not just technique, but arm strength. So adding my scheduled strength training to "the list"...
And as usual, work trudges merrily along. Attempting to hit deadlines, deal with a computer crash and a new email system...
Bored yet with all the whining? I am!
So what do I do? Read more. Find a comfortable study spot that is NOT my office NOR my bedroom. I may have fallen asleep reading a time or two :-) Figure out how to fit in more exercise, preferably outside.
And, as always, wait for that pager to go off.
Friday, November 16, 2012
What is the BEST stethoscope?
http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review.htm
Nice review page, and you can read it all if you like. Meanwhile the final results (partially subjective) are:
Wow. The second favorite is the $20 scope. Really? At least the one I got is in the top 3 (Littmann Master Classic II). I will be looking at that Cardiology III, though. I am not in love with the Master Classic.
Nice review page, and you can read it all if you like. Meanwhile the final results (partially subjective) are:
| Model | Photo | Price | Score | Rating |
Littmann Cardiology III Best Stethoscope |
 |
$160.00 | 32.9 | 1 |
Omron Sprague Rappaport
Best Buy |
 |
$19.00 | 30.7 | 2 |
Littmann Master Classic II |
 |
$87.95 | 29.5 | 3 |
| Littmann Cardiology I |
 |
Discontinued model | 29.3 | 4 |
Littmann Classic II SE
|
 |
$68.00 | 28.4 | 5 |
|
Welch Allyn Tycos Elite
|
 |
$136.00 | 26.6 | 6 |
Prestige Sprague Rappaport Stealth |
 |
$26.50 | 23.9 | 7 |
ADC Platinum Cardiology 615 |
 |
$43.13 | 23.8 | 8 |
Single Head Nursing Stethoscope |
 |
$6.78 | 23.3 | 9 |
ADC Adscope Professional 603 |
 |
$38.99 | 21.8 | 10 |
|
AllHeart Cardiology
|
 |
$22.99 | 20.9 | 11 |
DRG Puretone Traditional PT3 |
 |
$79.98 | 17.3 | 12 |
Wow. The second favorite is the $20 scope. Really? At least the one I got is in the top 3 (Littmann Master Classic II). I will be looking at that Cardiology III, though. I am not in love with the Master Classic.
Wednesday, November 14, 2012
Paramedic School - Week 5
I have been very bad in posting about my experience. I will attempt to do better, but just getting through is all I can manage at times for now!
We blitzed through Introduction to EMS and Pathophysiology...the latter being still on my list of things to re-read. We are moving forward into airway management and patient assessment, with a bit of a back-slide for an evening of Acid-Base. Our instructor thought that we needed more time for that one (thankfully) so tomorrow night I can really try and wrap my head around things.
I am managing to maintain a decent average (around 93% at last glance) and it's been nice to have near real-time grading of assignments, quizzes, and exams. The instructors are good so far - some much better than others - but it's nice to have a mix of folks with different backgrounds.
My plan of spending this weekend in intubation training has been scratched -- I have to go to a funeral out of state instead. But I will pack my books along and do my best to getahead caught up in the reading.
Is there, like, a book on tape that I can just play over and over to drill this stuff into my mind? Making flash cards just seems like so last century...
We blitzed through Introduction to EMS and Pathophysiology...the latter being still on my list of things to re-read. We are moving forward into airway management and patient assessment, with a bit of a back-slide for an evening of Acid-Base. Our instructor thought that we needed more time for that one (thankfully) so tomorrow night I can really try and wrap my head around things.
I am managing to maintain a decent average (around 93% at last glance) and it's been nice to have near real-time grading of assignments, quizzes, and exams. The instructors are good so far - some much better than others - but it's nice to have a mix of folks with different backgrounds.
My plan of spending this weekend in intubation training has been scratched -- I have to go to a funeral out of state instead. But I will pack my books along and do my best to get
Is there, like, a book on tape that I can just play over and over to drill this stuff into my mind? Making flash cards just seems like so last century...
Thursday, October 25, 2012
Paramedic, in a nutshell
So it's taken me this long to get it straight in my own head, and read through all the documentation associated with our courses. Ten months of courses, followed by clinical/field.
UNIVERSITY
CLASS CREDIT
COURSE HOURS HOURS
A&P for Paramedic Practice 64 3
Introduction to Advanced Practice 64 3
Emergency Pharmacology 40 2
Patient Assessment & Airway Mgmt 64 3
Cardiology 112 4
EMS Operations 64 3
Trauma Management 64 3
Medical Emergencies 66 3
Special Populations 64 3
2243 Assessment Based Management 48 2
Clinical – I 250 2
Clinical -II (Field Internship) 250 2
1150 33
The A&P class is taken "on the side" throughout the rest of the courses. Ideally, we should use it should follow along with what we are doing in regular class. Meaning that we should be ahead on the A&P reading (I am as yet, not ahead in this reading). Speaking with one of the advisors, he said that in the past some people have left it for last. We cannot start clinicals until it's done, so they seriously crammed at the last minute. I get tachycardic just thinking about that (and getting through the rest of class will be much easier if A&P is done).
With classes on Tuesday and Thursday, I really cannot think about doing any “extra” reading between Monday and Thursday, so I guess A&P will live on the weekends. I’m attempting to be a better student – actually setting up a schedule for studying – but that’s a constant struggle for me with my ADD/procrastination learning style. I usually end up reading and doing quizzes on my breaks at work.
So, what does “Introduction to Advanced Practice” entail? So glad you asked. My life looks like this:
Class Topic(s)
1 Orientation and Course Overview
2 Being a Paramedic
3 Illness and Injury Prevention
4 Legal Issues and Ethics
5 Life Span Development
6 Pathophysiology 1 (Cells and Tissues, Role of Electrolytes, Acid-Base Balance)
7 Pathophysiology 2 (Genetics, Hypoperfusion, Types of Shock)
8 Pathophysiology 3 (Immune System, Inflammation, Stress and Disease)
That’s a ton of work. And about 300 dense pages of reading. In four weeks.
I can totally do this.
Wednesday, October 17, 2012
Phase 3 Clinical Trial - Mag Sulfate for stroke
http://www.fastmag.info/index.htm
This is the cool stuff I get to hear about in paramedic class. We have people all over the country (and a few outside) in our course, so they are practicing in very different environments.
Might be the next thing in stroke care.
Overview
The FAST-MAG Phase 3 trial is a multicenter, randomized, placebo-controlled, double-blind, parallel group trial of intravenous magnesium sulfate initiated by paramedics in the field within 2 hours of symptom onset in 1700 patients with acute stroke. The primary objective of the study is to evaluate the efficacy and safety of field-initiated magnesium sulfate in improving the long-term functional outcome of patients with acute stroke. Patients with acute stroke will be identified in the field by licensed paramedics who have received training in basic and advanced cardiac life support, stroke recognition, and specific procedures relevant to the proposed study. Physician-investigators will approve each patient for study entry after cellular phone contact with paramedics. Physician-investigators will also by phone elicit explicit informed consent to participate in the study, from patients when the subject is competent and from on scene legally authorized persons when the subject is not competent.
Paramedics will initiate a loading dose of 4 grams magnesium sulfate iv over 15 minutes or matched placebo, followed after hospital arrival by a maintenance infusion of 16 grams magnesium sulfate iv over 24 hours or matched placebo. Follow-up assessments will be performed at ED arrival, 24 hours, 48 hours, day 4, day 30, and day 90. The sites involved in the study will be EMS system rescue ambulances and receiving hospitals in Los Angeles and Orange Counties, California. The Clinical Coordinating Center and the Neuroimaging Analysis Center will be at UCLA Medical Center and the Data Management Center will be coordinated through Stanford University.
Study Hypotheses
The central aim of this study is to demonstrate that paramedic initiation of the neuroprotective agent magnesium sulfate in the field is an efficacious and safe treatment for acute stroke. The study design is a multicenter, randomized, double-blind, phase 3 clinical trial, using intention to treat analysis, of magnesium sulfate versus placebo among ambulance-transported patients with acute stroke, with study agent initiated in all individuals within two hours of stroke onset. Successful conduct of the trial will serve as a pivotal test of the promising neuroprotective agent magnesium sulfate in acute stroke, and will also demonstrate for the first time that field enrollment and treatment of acute stroke patients is a practical and feasible strategy for phase 3 stroke trials, permitting enrollment of greater numbers of patients in hyperacute time windows.
Primary Hypothesis:
Treatment with magnesium sulfate improves the long-term functional outcome of hyperacute stroke patients.
The primary study endpoint analyzed to test this hypothesis will be the difference in distribution of scores between magnesium sulfate and placebo groups on the modified Rankin Scale measure of global handicap, assessed 3 months poststroke.
Secondary Hypotheses:
Treatment with magnesium sulfate improves the long-term outcome of hyperacute stroke patients on measures of activities of daily living, neurologic deficit, quality of life, and mortality.
The secondary study endpoints analyzed to test these hypotheses will be the difference in distribution of scores between magnesium sulfate and placebo groups on the Barthel Activities of Daily Living Scale, the National Institute of Health Stroke Scale (neurologic deficit), the Stroke Impact Scale (stroke-specific quality of life), and in mortality, assessed 3 months poststroke.
Treatment with magnesium sulfate improves the long-term functional outcome of each of the following subgroups of hyperacute stroke patients:
Patients with ischemic stroke
Patients with intracerebral hemorrhage
Patients with ischemic stroke treated with conventional intravenous tissue plasminogen activator
Patients with ischemic stroke not treated with conventional intravenous tissue plasminogen activator
Patients with ischemic stroke treated within 60 minutes of onset
Patients with ischemic stroke treated within 61-120 minutes of onset
To test these hypotheses, the primary study endpoint, differences in the distribution of scores between magnesium sulfate and placebo groups on the modified Rankin Scale measure of global handicap, will be separately analyzed in each of these subgroups.
This is the cool stuff I get to hear about in paramedic class. We have people all over the country (and a few outside) in our course, so they are practicing in very different environments.
Might be the next thing in stroke care.
Overview
The FAST-MAG Phase 3 trial is a multicenter, randomized, placebo-controlled, double-blind, parallel group trial of intravenous magnesium sulfate initiated by paramedics in the field within 2 hours of symptom onset in 1700 patients with acute stroke. The primary objective of the study is to evaluate the efficacy and safety of field-initiated magnesium sulfate in improving the long-term functional outcome of patients with acute stroke. Patients with acute stroke will be identified in the field by licensed paramedics who have received training in basic and advanced cardiac life support, stroke recognition, and specific procedures relevant to the proposed study. Physician-investigators will approve each patient for study entry after cellular phone contact with paramedics. Physician-investigators will also by phone elicit explicit informed consent to participate in the study, from patients when the subject is competent and from on scene legally authorized persons when the subject is not competent.
Paramedics will initiate a loading dose of 4 grams magnesium sulfate iv over 15 minutes or matched placebo, followed after hospital arrival by a maintenance infusion of 16 grams magnesium sulfate iv over 24 hours or matched placebo. Follow-up assessments will be performed at ED arrival, 24 hours, 48 hours, day 4, day 30, and day 90. The sites involved in the study will be EMS system rescue ambulances and receiving hospitals in Los Angeles and Orange Counties, California. The Clinical Coordinating Center and the Neuroimaging Analysis Center will be at UCLA Medical Center and the Data Management Center will be coordinated through Stanford University.
Study Hypotheses
The central aim of this study is to demonstrate that paramedic initiation of the neuroprotective agent magnesium sulfate in the field is an efficacious and safe treatment for acute stroke. The study design is a multicenter, randomized, double-blind, phase 3 clinical trial, using intention to treat analysis, of magnesium sulfate versus placebo among ambulance-transported patients with acute stroke, with study agent initiated in all individuals within two hours of stroke onset. Successful conduct of the trial will serve as a pivotal test of the promising neuroprotective agent magnesium sulfate in acute stroke, and will also demonstrate for the first time that field enrollment and treatment of acute stroke patients is a practical and feasible strategy for phase 3 stroke trials, permitting enrollment of greater numbers of patients in hyperacute time windows.
Primary Hypothesis:
Treatment with magnesium sulfate improves the long-term functional outcome of hyperacute stroke patients.
The primary study endpoint analyzed to test this hypothesis will be the difference in distribution of scores between magnesium sulfate and placebo groups on the modified Rankin Scale measure of global handicap, assessed 3 months poststroke.
Secondary Hypotheses:
Treatment with magnesium sulfate improves the long-term outcome of hyperacute stroke patients on measures of activities of daily living, neurologic deficit, quality of life, and mortality.
The secondary study endpoints analyzed to test these hypotheses will be the difference in distribution of scores between magnesium sulfate and placebo groups on the Barthel Activities of Daily Living Scale, the National Institute of Health Stroke Scale (neurologic deficit), the Stroke Impact Scale (stroke-specific quality of life), and in mortality, assessed 3 months poststroke.
Treatment with magnesium sulfate improves the long-term functional outcome of each of the following subgroups of hyperacute stroke patients:
Patients with ischemic stroke
Patients with intracerebral hemorrhage
Patients with ischemic stroke treated with conventional intravenous tissue plasminogen activator
Patients with ischemic stroke not treated with conventional intravenous tissue plasminogen activator
Patients with ischemic stroke treated within 60 minutes of onset
Patients with ischemic stroke treated within 61-120 minutes of onset
To test these hypotheses, the primary study endpoint, differences in the distribution of scores between magnesium sulfate and placebo groups on the modified Rankin Scale measure of global handicap, will be separately analyzed in each of these subgroups.
Sunday, October 14, 2012
What have I gone and done? (or Paramedic class 1)
I'm a fairly busy person. Work close to full time. Master's degree seeking. Volunteer for EMS in local town. Volunteer for gov. doing EMS administrative stuff. EMT on call.
So why not add paramedic school to the mix?
I found a hybrid class - online "live" classes with a skills component where I will be flying to Massachusetts for skills training next year.
We had our first class on Thursday and I had my first (of what will likely be many) OMG-what-have-I-done? moments.
Well, maybe not my first. The first came when I signed the loan papers for the class. I will be paying this one off for 3 years.
Couldn't find a microphone with a mute button. Running around like a headless chicken for 30 minutes on that one. Got logged into the class web site. Over 40 people signed in. It's hard to tell the actual number since several people were logged in multiple times.
40, though. That's a lot of students.
I thought back to some other courses I've heard about - 50% or more don't finish. Yikes. I have to make it. I cannot fail this.
Some people were overly chatty - there's microphones, sure, but also a chat pane. This isn't twitter for chrissake! Some people would just not shut up. Having conversations while our instructor was talking, blah, blah, blah.
We went through the basics - introductions of the instructors, what is expected, how to access the online quizzes, assignments, and tests. The only pure moment of silence came when someone asked how much time outside of class would be needed to study. Brad (owner/instructor) pondered this for a minute and said, "probably 15 hours." SILENCE. It's about what I figured, but most people probably have been out of student mode so long they really didn't put much thought into it. Yep, folks. 2+ hours for every class hour.
I had forgotten the beginning of EMT class - it's all about EMS operations, ethics, and legal issues. Paramedic is no different. Not the most exciting stuff, but worthwhile. I've got to get back at it!
Here I go...
Saturday, October 6, 2012
one day down south
So I'm visiting my relatives in the southwestern US, enjoying the sun and 90+ degree heat while we get a sifting of snow back home. It's been a long time since I've been on what could be termed a vacation. Most of my vacations consist of driving to a relative's house to get some sort of work done. This one was really no exception.
Grandpa is not doing well. Dad needed help driving a truck and trailer south. Vacation it is.
Three days on the road with pops. Got to visit with my grandpa for a bit. Unloading the truck and trailer. Opening the house for the winter.
Today is my day. I have done nothing but sleep in, eat, play in the pool, play on the computer.
Back to work and reality tomorrow -- a ridiculously hectic week assisting with a conference. It will be 16+ hour days and little sleep. Paramedic school starts on Thursday.
But today is mine.
Grandpa is not doing well. Dad needed help driving a truck and trailer south. Vacation it is.
Three days on the road with pops. Got to visit with my grandpa for a bit. Unloading the truck and trailer. Opening the house for the winter.
Today is my day. I have done nothing but sleep in, eat, play in the pool, play on the computer.
Back to work and reality tomorrow -- a ridiculously hectic week assisting with a conference. It will be 16+ hour days and little sleep. Paramedic school starts on Thursday.
But today is mine.
Friday, September 21, 2012
Fun with books
So, we were supposed to order our books from Elsevier (publisher) in a package - cost around $500.
Paramedic Practice Today, Volume 1 and 2 Rev. Reprint
Author Aehlert, Barbara J Edition 2011 ISBN 978-0-323-08539-
Pharmacology for the Prehospital Professional - With Dvd
Author Guy, Jeffrey S. Edition REV 11 ISBN 978-0-323-08519-9
Pediatric Advanced Life Support Study Guide
Author Aehlert, Barbara Edition 3RD 07 ISBN 978-0-323-04750-0
12-Lead ECG in Acute - Text and Pocket Ref.
Author Phalen, Tim Edition 3RD 11 ISBN 978-0-323-07785-9
ACLS Quick Review Study Guide
Author Aehlert, Barbara Edition 4TH 12 ISBN 978-0-323-08449-9
I dutifully ordered them, though I already own the 12-lead book (figured I could give a copy away or sell it on Amazon)
waiting...waiting...waiting
2 weeks and the package is listed as "backordered" with no estimated date. 4 weeks until classes start. Emailed my school - "Oh, didn't you get the email? There has been some recent publisher changes that has affected textbook purchasing. In this email you will find a list of textbooks required for the Paramedic Program. Textbooks may be purchased new or used from a vendor of your choice; Online, Amazon, Ebay, etc."
Lovely.
Original price of package deal: $491
Price for textbooks (new) on Amazon? $369
Oops, don't need that extra book!
Total cost for books, new: $312
Saving me $179, about 6 hours of overtime!
Paramedic Practice Today, Volume 1 and 2 Rev. Reprint
Author Aehlert, Barbara J Edition 2011 ISBN 978-0-323-08539-
Pharmacology for the Prehospital Professional - With Dvd
Author Guy, Jeffrey S. Edition REV 11 ISBN 978-0-323-08519-9
Pediatric Advanced Life Support Study Guide
Author Aehlert, Barbara Edition 3RD 07 ISBN 978-0-323-04750-0
12-Lead ECG in Acute - Text and Pocket Ref.
Author Phalen, Tim Edition 3RD 11 ISBN 978-0-323-07785-9
ACLS Quick Review Study Guide
Author Aehlert, Barbara Edition 4TH 12 ISBN 978-0-323-08449-9
I dutifully ordered them, though I already own the 12-lead book (figured I could give a copy away or sell it on Amazon)
waiting...waiting...waiting
2 weeks and the package is listed as "backordered" with no estimated date. 4 weeks until classes start. Emailed my school - "Oh, didn't you get the email? There has been some recent publisher changes that has affected textbook purchasing. In this email you will find a list of textbooks required for the Paramedic Program. Textbooks may be purchased new or used from a vendor of your choice; Online, Amazon, Ebay, etc."
Lovely.
Original price of package deal: $491
Price for textbooks (new) on Amazon? $369
Oops, don't need that extra book!
Total cost for books, new: $312
Saving me $179, about 6 hours of overtime!
Thursday, September 13, 2012
Simplicity
I bet stupid ignorant underpriviledged people are really happy.
I could be living my life on unemployment/disability checks.
Subsidized housing. A check every month. Big screen TV, internet for gaming. No medical insurance to pay for, free government cheese. Pulling furniture out of dumpsters (which I do anyway). Living off the largesse of society. Spending my days watching whatever OC-Jersey Shore-MTV had to offer and loosing myself in the online world for my social interaction. Free books at the library. Public assistance. I could do it.
Instead I drag myself out of bed everyday and push myself into a job that slowly drains the joy from my soul. Spend my evenings and weekends on call with EMS just to feel normal. Study when I scare up an hour or two. Work on projects to improve a house and land I don't own. Work hard to repay endless student loans for degrees that really weren't worth it. Work harder to put myself through paramedic school, pay the bills for my extended family.
WTF am I doing?
I could be living my life on unemployment/disability checks.
Subsidized housing. A check every month. Big screen TV, internet for gaming. No medical insurance to pay for, free government cheese. Pulling furniture out of dumpsters (which I do anyway). Living off the largesse of society. Spending my days watching whatever OC-Jersey Shore-MTV had to offer and loosing myself in the online world for my social interaction. Free books at the library. Public assistance. I could do it.
Instead I drag myself out of bed everyday and push myself into a job that slowly drains the joy from my soul. Spend my evenings and weekends on call with EMS just to feel normal. Study when I scare up an hour or two. Work on projects to improve a house and land I don't own. Work hard to repay endless student loans for degrees that really weren't worth it. Work harder to put myself through paramedic school, pay the bills for my extended family.
WTF am I doing?
Thursday, September 6, 2012
Currently Reading...
I know you all have been just eagerly chewing your nails, wondering what the Ambulance Ranger has been reading, so here she goes:
Just finished Stephen King's The Wind Through the Keyhole: A Dark Tower Novel (AKA Dark Tower 4.5) and LOVED it! This was the first book I've ever pre-ordered as a Kindle book and it was well done. Beautiful tale within a tale inside a story. All I can say is, if you have never read the Dark Tower series, you truly have not lived. In my continuing re-enjoyment of the series, Wolves of the Calla is next.
Since I'm starting paramedic school in (gulp) 5 weeks, I'm reading a lot of medicine:
Capnography, King of the ABC's: A Systematic Approach for Paramedics [Paperback]
Troy Valente (Author) Found this book by accident - a very short tome on the pre-hospital use of capnography. Looks decent, will review later.
And then there's the course books.
Anatomy & Physiology text arrived yesterday.
The Human Body in Health & Disease - 5e by Gary A. Thibodeau PhD and Kevin T. Patton PhD
This is a self-study course, through the University of Texas, where you do video lectures, quizzes, and exams online. Supposed to be done concurrently with paramedic studies. I am going to try to be a few chapters ahead. Going to go ahead and order the study guide for this as well.
Still waiting for these:
Paramedic Practice Today, Volume 1 and 2 Rev. Reprint
Author Aehlert, Barbara J Edition 2011 ISBN 978-0-323-08539-
Pharmacology for the Prehospital Professional - With Dvd
Author Guy, Jeffrey S. Edition REV 11 ISBN 978-0-323-08519-9
Als-Entire Para Evolve (this is the online course component - quizzes & tests done through Elsevier's "Evolve" program)
Author Elsevier Edition 2012
Pediatric Advanced Life Support Study Guide
Author Aehlert, Barbara Edition 3RD 07 ISBN 978-0-323-04750-0
12-Lead ECG in Acute - Text and Pocket Ref.
Author Phalen, Tim Edition 3RD 11 ISBN 978-0-323-07785-9
ACLS Quick Review Study Guide
Author Aehlert, Barbara Edition 4TH 12 ISBN 978-0-323-08449-9
So here I go! I'll be chronicling the journey here, in addition to the usual chaos of EMS in my life, so stay tuned!
Just finished Stephen King's The Wind Through the Keyhole: A Dark Tower Novel (AKA Dark Tower 4.5) and LOVED it! This was the first book I've ever pre-ordered as a Kindle book and it was well done. Beautiful tale within a tale inside a story. All I can say is, if you have never read the Dark Tower series, you truly have not lived. In my continuing re-enjoyment of the series, Wolves of the Calla is next.
Since I'm starting paramedic school in (gulp) 5 weeks, I'm reading a lot of medicine:
Capnography, King of the ABC's: A Systematic Approach for Paramedics [Paperback]
Troy Valente (Author) Found this book by accident - a very short tome on the pre-hospital use of capnography. Looks decent, will review later.
And then there's the course books.
Anatomy & Physiology text arrived yesterday.
The Human Body in Health & Disease - 5e by Gary A. Thibodeau PhD and Kevin T. Patton PhD
This is a self-study course, through the University of Texas, where you do video lectures, quizzes, and exams online. Supposed to be done concurrently with paramedic studies. I am going to try to be a few chapters ahead. Going to go ahead and order the study guide for this as well.
Still waiting for these:
Paramedic Practice Today, Volume 1 and 2 Rev. Reprint
Author Aehlert, Barbara J Edition 2011 ISBN 978-0-323-08539-
Pharmacology for the Prehospital Professional - With Dvd
Author Guy, Jeffrey S. Edition REV 11 ISBN 978-0-323-08519-9
Als-Entire Para Evolve (this is the online course component - quizzes & tests done through Elsevier's "Evolve" program)
Author Elsevier Edition 2012
Pediatric Advanced Life Support Study Guide
Author Aehlert, Barbara Edition 3RD 07 ISBN 978-0-323-04750-0
12-Lead ECG in Acute - Text and Pocket Ref.
Author Phalen, Tim Edition 3RD 11 ISBN 978-0-323-07785-9
ACLS Quick Review Study Guide
Author Aehlert, Barbara Edition 4TH 12 ISBN 978-0-323-08449-9
So here I go! I'll be chronicling the journey here, in addition to the usual chaos of EMS in my life, so stay tuned!
Wednesday, August 29, 2012
What does distance-learning paramedic school cost?
Yep, you've always wondered, so here we go...
(All in US dollars)
$200 Non-refundable Application Fee
$1500 Non-refundable tuition deposit (to accept your seat in the class)
$6000 Tuition payment, due one week before class starts
$800 Distance clinical fee - due when clinical paperwork is signed
$70 Anatomy & Physiology book/self study class through the University of Texas
$500 Paramedic book package
~$2000 2 Week trip to Massachusetts for skills "boot camp"
~$1000 gas/incidentals to travel to clinical location - not sure exactly where this will be, but it's at least 100 miles from my home and I've got 500 hours to put in...
$110 NREMT Paramedic Exam
$500 Travel to NREMT Practical (probably will need to fly somewhere for this)
What am I forgetting?
Drum roll...
Total estimated cost: $12,680
<gulp>
I'm going to keep a running log of what I buy/spend money on for this, just in case anyone is interested. Maybe I should track my hours spent as well. Could be interesting.
(All in US dollars)
$200 Non-refundable Application Fee
$1500 Non-refundable tuition deposit (to accept your seat in the class)
$6000 Tuition payment, due one week before class starts
$800 Distance clinical fee - due when clinical paperwork is signed
$70 Anatomy & Physiology book/self study class through the University of Texas
$500 Paramedic book package
~$2000 2 Week trip to Massachusetts for skills "boot camp"
~$1000 gas/incidentals to travel to clinical location - not sure exactly where this will be, but it's at least 100 miles from my home and I've got 500 hours to put in...
$110 NREMT Paramedic Exam
$500 Travel to NREMT Practical (probably will need to fly somewhere for this)
What am I forgetting?
Drum roll...
Total estimated cost: $12,680
<gulp>
I'm going to keep a running log of what I buy/spend money on for this, just in case anyone is interested. Maybe I should track my hours spent as well. Could be interesting.
Tuesday, August 28, 2012
I'm in
Paramedic school.
Accepted.
Loan taken out.
Books ordered.
Freaking out that in a mere 18 months or so, I will be the one people are looking at for the answers.
Nothing has felt more correct than this decision, not in a long time.
Classes start in a month - join me on the journey?
Accepted.
Loan taken out.
Books ordered.
Freaking out that in a mere 18 months or so, I will be the one people are looking at for the answers.
Nothing has felt more correct than this decision, not in a long time.
Classes start in a month - join me on the journey?
Tuesday, August 14, 2012
Waiting
Had my interview last week for paramedic school.
Now just waiting for the acceptance/denial.
And I'm not freaking out.
Really.
Well, maybe a little.
If it happens, it happens. If not, I can always re-apply.
Right?
Now just waiting for the acceptance/denial.
And I'm not freaking out.
Really.
Well, maybe a little.
If it happens, it happens. If not, I can always re-apply.
Right?
Thursday, August 9, 2012
We've got the runs...
Busy.
In the village fire department, we're all volunteers. We call ALS from the park as needed, but really it's a handful of EMT's and EMR's that keep things going. An unusually well-oiled machine perfected through years, sometimes decades of working together.
We all have day jobs. Some have more than one.
But when the pager tones us out, we go. Sometimes 3, 4 EMS runs a day. Each trip to the hospital takes a minimum of 3 hours.
I respond when I can, but with the single-lane road choked with tourists it can be 25 minutes 'till I'm on scene. Clear road at night? I can make it in 12.
But the others are already there. On scene, figuring out how to get the patient out. Taking history, vitals. Packaging, moving. They are pros at this.
Our small town swells with tourists in the summer. And the seasonal help that goes along with tourism. Cooks, river raft guides, bartenders, housekeepers. Every bed in town is full.
10 motels, dozens of vacation rentals, 8 bars, 20 restaurants, 3 gas stations, a couple grocery stores.
And one little fire station.
Two dozen volunteers with pagers and radios, ready to roll when needed.
In the village fire department, we're all volunteers. We call ALS from the park as needed, but really it's a handful of EMT's and EMR's that keep things going. An unusually well-oiled machine perfected through years, sometimes decades of working together.
We all have day jobs. Some have more than one.
But when the pager tones us out, we go. Sometimes 3, 4 EMS runs a day. Each trip to the hospital takes a minimum of 3 hours.
I respond when I can, but with the single-lane road choked with tourists it can be 25 minutes 'till I'm on scene. Clear road at night? I can make it in 12.
But the others are already there. On scene, figuring out how to get the patient out. Taking history, vitals. Packaging, moving. They are pros at this.
Our small town swells with tourists in the summer. And the seasonal help that goes along with tourism. Cooks, river raft guides, bartenders, housekeepers. Every bed in town is full.
10 motels, dozens of vacation rentals, 8 bars, 20 restaurants, 3 gas stations, a couple grocery stores.
And one little fire station.
Two dozen volunteers with pagers and radios, ready to roll when needed.
Tuesday, July 31, 2012
Decision made: Paramedic
Yep. Bailed on the AEMT class.
Was chatting with my sister about the 6 week plus clinical AEMT class.
She listened.
"Why are you doing this?"
"Doing what?" I replied.
"Screwing around with EMS. You want to be a paramedic. Find a class and go be a paramedic."
Darn it if, she's not right on.
Why take the time and expense of getting certified as an AEMT when I can just kick ass at paramedic school? So here I go. Looking around for a course ANYWHERE nearby. Closest university course is 200 miles each way...
My Background:
I have a B.A. degree, two actually. And an A.A. degree. And I'm working on my M.S. I don't need to take Math and English 101. (I am, however, doing self-study medical terminology on http://www.free-ed.net/free-ed/ I'm also working through two A&P textbooks)
WFR (not current)
WFA (not current)
EMR for a year
EMT for 6 months
My Requirements for a Class:
Not an extremely "compressed" class - I need a decent amount of time to absorb, ponder, study, practice (we have an assortment of training equipment at our location so I can practice skills - no "sim man" but plenty of disembodied parts lying around.)
Distance learning (need to keep my job)
Excellent recommendations/reviews from students and professionals
Not too pricey
OK with the Pit Boss (our EMS Director) = a place to work as a paramedic once I finish
Somewhere local to do clinical hours
Try doing a search for "online paramedic program" - OY! I sorted through mountains of "Paramedic to RN online. Fast! Cheap!" ads, looking for a gem in the gravel. I found a couple.
Jems had a list of accredited paramedic programs, which I went through for all the surrounding states:
http://www.jems.com/resources/directory/Accredited_EMT_and_Paramedic_Programs.html
Unfortunately, no brick-and-mortar program within commuting distance.
Also kept getting referred back to the Commission on Accreditation of Allied Health Education Programs (CAAHEP):
http://www.caahep.org/
But didn't find much good info on programs.
New York Methodist Hospital looks promising:
M,Tu,W 1830-2200 EST
518 didactic
572 clinical
3 trips to NY (8 days each)
Tuition: $9,750
http://www.nymahe.org/about_ems.php
National Medical Education and Training Center (NMETC)
Tu, Th 1900-2200 EST
??? didactic (10 months, about 42 weeks)
500 clinical
1 trip to MA (100 hrs skills training & evaluation)
Tuition: $7,995
http://www.nmetc.com/index.php
PERCOM - looked OK, but clinicals have to be done in Texas - might work for someone who lived closer...
Unknown days
??? didactic
??? clinical
Unknown number of trips to TX
Tuition: $4,500
http://percomonline.com/index.php
Found several more sites, but most required either too much time on location, or seemed kinda shady - like diploma mills. I realize I will get out of whatever class I decide on with the skills and education I push myself to learn. So here I go.
Mr. Medic is good with this.
Pit Boss is fine with it. He's looking into local options for clinicals.
NMETC it is.
Searching for a way to raise $8,000 tuition in less than 2 months. Wish me luck.
(too bad I'm not prettier - hookers make good money, don't they?)
Was chatting with my sister about the 6 week plus clinical AEMT class.
She listened.
"Why are you doing this?"
"Doing what?" I replied.
"Screwing around with EMS. You want to be a paramedic. Find a class and go be a paramedic."
Darn it if, she's not right on.
Why take the time and expense of getting certified as an AEMT when I can just kick ass at paramedic school? So here I go. Looking around for a course ANYWHERE nearby. Closest university course is 200 miles each way...
My Background:
I have a B.A. degree, two actually. And an A.A. degree. And I'm working on my M.S. I don't need to take Math and English 101. (I am, however, doing self-study medical terminology on http://www.free-ed.net/free-ed/ I'm also working through two A&P textbooks)
WFR (not current)
WFA (not current)
EMR for a year
EMT for 6 months
My Requirements for a Class:
Not an extremely "compressed" class - I need a decent amount of time to absorb, ponder, study, practice (we have an assortment of training equipment at our location so I can practice skills - no "sim man" but plenty of disembodied parts lying around.)
Distance learning (need to keep my job)
Excellent recommendations/reviews from students and professionals
Not too pricey
OK with the Pit Boss (our EMS Director) = a place to work as a paramedic once I finish
Somewhere local to do clinical hours
Try doing a search for "online paramedic program" - OY! I sorted through mountains of "Paramedic to RN online. Fast! Cheap!" ads, looking for a gem in the gravel. I found a couple.
Jems had a list of accredited paramedic programs, which I went through for all the surrounding states:
http://www.jems.com/resources/directory/Accredited_EMT_and_Paramedic_Programs.html
Unfortunately, no brick-and-mortar program within commuting distance.
Also kept getting referred back to the Commission on Accreditation of Allied Health Education Programs (CAAHEP):
http://www.caahep.org/
But didn't find much good info on programs.
New York Methodist Hospital looks promising:
M,Tu,W 1830-2200 EST
518 didactic
572 clinical
3 trips to NY (8 days each)
Tuition: $9,750
http://www.nymahe.org/about_ems.php
National Medical Education and Training Center (NMETC)
Tu, Th 1900-2200 EST
??? didactic (10 months, about 42 weeks)
500 clinical
1 trip to MA (100 hrs skills training & evaluation)
Tuition: $7,995
http://www.nmetc.com/index.php
PERCOM - looked OK, but clinicals have to be done in Texas - might work for someone who lived closer...
Unknown days
??? didactic
??? clinical
Unknown number of trips to TX
Tuition: $4,500
http://percomonline.com/index.php
Found several more sites, but most required either too much time on location, or seemed kinda shady - like diploma mills. I realize I will get out of whatever class I decide on with the skills and education I push myself to learn. So here I go.
Mr. Medic is good with this.
Pit Boss is fine with it. He's looking into local options for clinicals.
NMETC it is.
Searching for a way to raise $8,000 tuition in less than 2 months. Wish me luck.
(too bad I'm not prettier - hookers make good money, don't they?)
Tuesday, July 24, 2012
Already thinking about the next step?
So Mr. Medic surprised me the other day. Mr. Medic, Van and I were having a chat after class, cleaning up the room, washing coffee cups, etc. We were discussing the potential lack of ALS support in the area. One long-time paramedic passed nursing exams and turned in notice. An EMT-I is retiring. Last year we had a summer season paramedic on staff, this year not.
So here's the stats for our area:
~1,000 square miles covered (500 road miles)
3 ambulances (plus 2 local volunteer)
1 Paramedic
5 AEMT (2 don't go on calls much)
~20 EMT (maybe 10 are actively responding to calls)
I brought up the question, "Since our EMS service is largely law enforcement based is there a precedent for someone who works in another department, say, making maps, who also was an ALS provider..."
"Funny you bringing that up." said Mr. Medic, stretching his arms up behind his head, "But I've been meaning to talk to the Pit Boss about that very thing. There's an AEMT class supposed to be scheduled next winter and I want to get you in it."
"I'm sorry, what did you say?"
Shock.
Surprise.
Disbelief.
I mean, I'm not the smartest kid in class. I'm (relatively) old. And loud. Out of shape. And a pain in the ass. I constantly feel dwarfed by my fellow EMT students' skills and total recall of inane crap out of the book.
I have to read, and read again, and research when there's not enough information given.
I need to know why something is happening, and why what we're doing is fixing it.
My original plan consisted of finishing up EMT class, getting through exams, hitting my graduate school classes hard (while working and running with EMS) then re-evaluate in two years when my comps and thesis are behind me. Should I then go on to Paramedic, at least I wouldn't be trying to do that along with grad school.
I never considered the middle ground.
According to the new scope of practice, AEMT is 150 more classroom hours, and 100 or so clinical/field Doesn't seem like much, but it's double what I've just gone through.
Now my original plan is pushed to the back burner. I could do a 6 week AEMT course all in one go. Plus clinical/field hours. I'd have to take leave from my job, travel 1000 miles out of state, but it wouldn't cost me any tuition.
So what's the down side? It's not being a paramedic. But at this stage there's no class close enough to my home anyway.
What's the next step? Convincing my boss that me being out of the office for 6 weeks will work. Gulp!
Stay tuned...
So here's the stats for our area:
~1,000 square miles covered (500 road miles)
3 ambulances (plus 2 local volunteer)
1 Paramedic
5 AEMT (2 don't go on calls much)
~20 EMT (maybe 10 are actively responding to calls)
I brought up the question, "Since our EMS service is largely law enforcement based is there a precedent for someone who works in another department, say, making maps, who also was an ALS provider..."
"Funny you bringing that up." said Mr. Medic, stretching his arms up behind his head, "But I've been meaning to talk to the Pit Boss about that very thing. There's an AEMT class supposed to be scheduled next winter and I want to get you in it."
"I'm sorry, what did you say?"
Shock.
Surprise.
Disbelief.
I mean, I'm not the smartest kid in class. I'm (relatively) old. And loud. Out of shape. And a pain in the ass. I constantly feel dwarfed by my fellow EMT students' skills and total recall of inane crap out of the book.
I have to read, and read again, and research when there's not enough information given.
I need to know why something is happening, and why what we're doing is fixing it.
My original plan consisted of finishing up EMT class, getting through exams, hitting my graduate school classes hard (while working and running with EMS) then re-evaluate in two years when my comps and thesis are behind me. Should I then go on to Paramedic, at least I wouldn't be trying to do that along with grad school.
I never considered the middle ground.
According to the new scope of practice, AEMT is 150 more classroom hours, and 100 or so clinical/field Doesn't seem like much, but it's double what I've just gone through.
Now my original plan is pushed to the back burner. I could do a 6 week AEMT course all in one go. Plus clinical/field hours. I'd have to take leave from my job, travel 1000 miles out of state, but it wouldn't cost me any tuition.
So what's the down side? It's not being a paramedic. But at this stage there's no class close enough to my home anyway.
What's the next step? Convincing my boss that me being out of the office for 6 weeks will work. Gulp!
Stay tuned...
Tuesday, July 17, 2012
Tiredness
The summer drags on.
Thankfully temperatures have cooled off 10-15 degrees, and are nice and crisp overnight (woke up and was actually COLD this morning - yay!)
Still have our share of calls - people hiking for hours without water in 85-95 degree heat , chest pain, shortness of breath, abdominal pain, several car and motorcycle accidents. Just working a ton and still not getting very far. The summer seems to fly by. Need to get out, take some days off and enjoy myself. But as the saying goes, I've got to make hay while the sun shines. We have ambulance runs aplenty in the summer, not so much other times of year. So for the sake of my paycheck and skills advancement I continue to work through.
And I'm tired.
Going to get a cup of coffee now...
Thankfully temperatures have cooled off 10-15 degrees, and are nice and crisp overnight (woke up and was actually COLD this morning - yay!)
Still have our share of calls - people hiking for hours without water in 85-95 degree heat , chest pain, shortness of breath, abdominal pain, several car and motorcycle accidents. Just working a ton and still not getting very far. The summer seems to fly by. Need to get out, take some days off and enjoy myself. But as the saying goes, I've got to make hay while the sun shines. We have ambulance runs aplenty in the summer, not so much other times of year. So for the sake of my paycheck and skills advancement I continue to work through.
And I'm tired.
Going to get a cup of coffee now...
Thursday, July 5, 2012
Last week's schedule
Sunday: aka "the day of rest"
0530 - wake up to new dog needing to go out
0700 - back to sleep
0730 - wake up to new dog wanting to play, given up on sleeping in
0800 - sister decides that "we" need to get a ton of yard work done, build a fence and gate, and clean house (sigh)
1700 - try to catch a nap despite oppressive (for us) heat
1930 - pager tones - ALS for chest pain
2300 - back home
0200 - sleep
Monday
0530 - wake up to new dog needing to go out (really? again?)
0800-1800 - work regular job
2000-2200 - driving EMS supplies around, restocking
2330 - sleep
Tuesday
0200 - wake up to hacking noises - sister's cat is vomiting in my room...
0220 - pager tones for allergic reaction
0530 - back home
0600-0730 - nap
0800-1700 - work regular job
1900 - collapse to sleep
1920 - pager tones (I think) May have had a phone call with Mr. Medic in my sleep...did not respond to this call
2330 - wake up thinking "crap, it's almost midnight and I'm awake" take dog for walk, eat a snack, read, feel tired enough to try sleeping again
Wednesday
0210 - pager tones for pediatric diabetic emergency
0545 - back home
0600-0730 - nap
0800-1700 - work regular job
...
I really don't remember what the "rest" of the week was like - it's all a blur.
Summer in paradise. There aren't enough hours in the day.
Monday, June 25, 2012
Busy, again
Suddenly, it's summer. In the alpine, in the meadows. It's here.
Normally when the rest of the Northern Hemisphere is experiencing triple-digit weather we are still bringing our tomato plants in at night.
Calls, constantly inconsistent, but calls keeping us busy. In particular Mr. Medic has been running crazed, as have EMT-I's George and Sid. In our surrounding area many of our ALS providers (half, or more) are not in service - on vacation, sabbatical, out on medical or family leave. And the people are here, having their medical issues despite that!
Some crazy calls...my first "real" pediatric patient for instance...but that will just have to wait for a bit.
Will type more later, promise.
And I'm doing OK with the loss of my buddy. Getting better every day.
Normally when the rest of the Northern Hemisphere is experiencing triple-digit weather we are still bringing our tomato plants in at night.
Calls, constantly inconsistent, but calls keeping us busy. In particular Mr. Medic has been running crazed, as have EMT-I's George and Sid. In our surrounding area many of our ALS providers (half, or more) are not in service - on vacation, sabbatical, out on medical or family leave. And the people are here, having their medical issues despite that!
Some crazy calls...my first "real" pediatric patient for instance...but that will just have to wait for a bit.
Will type more later, promise.
And I'm doing OK with the loss of my buddy. Getting better every day.
Tuesday, June 12, 2012
Losing a friend
He was in pain, there at the end.
We knew that the pain meds he took for chronic arthritis were taking a toll on his liver. That, and surgery made the pain tolerable for years, but not forever.
Over the last few weeks we watched the changes. Urine turning orange, increased thirst, loss of appetite, nausea and vomiting, finally jaundice and acites. Liver failure. It came on too quick.
I had to make the decision for him, my good friend. He couldn't say the words, but his eyes told me. There would be no transplant, no saving him.
Ten years was not long enough. He died in my arms, on the grass, listening to the water play along the creek bed. Under the clear blue sky.
I will miss my friend.
We knew that the pain meds he took for chronic arthritis were taking a toll on his liver. That, and surgery made the pain tolerable for years, but not forever.
Over the last few weeks we watched the changes. Urine turning orange, increased thirst, loss of appetite, nausea and vomiting, finally jaundice and acites. Liver failure. It came on too quick.
I had to make the decision for him, my good friend. He couldn't say the words, but his eyes told me. There would be no transplant, no saving him.
Ten years was not long enough. He died in my arms, on the grass, listening to the water play along the creek bed. Under the clear blue sky.
I will miss my friend.
Thursday, June 7, 2012
on irrigation and irritation
OK, I'm all done whining...for now.
Still very few to no calls going on - how can this many people stay so healthy? We need a good lightning strike, or emu attack, or...
So we had our weekly training night and 'cause I was the idiot who brought up the subject of wound irrigation last week, Mr. Medic said, "well great! Next week, Ambulance Ranger will be doing the teaching on the wound care protocol."
Should have kept my big mouth shut.
Actually, though, we had a ton of fun. We kinda McGyvered what we thought would be the best pressure-irrigation setup out of what we had - syringe, 18 guage IV catheter, IV tubing, and normal saline. Floyd will no longer go on any runs unless there's a wound to irrigate.
Actually, the whole thing became a lesson in 'how to spike an IV' - something I was pretty sure everyone already had done several times. Apparently not. I think we got it down by the end of class.
We took the last 15 minutes to play with the ring cutters. Found out that only one of them actually worked. This is the stuff we need to do more of. Every week we work on moving patients, backboarding, c-collaring, KED use, etc. Which yes, we do need to practice. But we gotta do the 'fun' stuff too, or people get bored.
On call this weekend, so no beers for me :( - just hope those tones go off and I'm actually needed and wanted on a call.
[crossing fingers]
Otherwise I swear, I'm going back to playing World of Warcraft...
Still very few to no calls going on - how can this many people stay so healthy? We need a good lightning strike, or emu attack, or...
So we had our weekly training night and 'cause I was the idiot who brought up the subject of wound irrigation last week, Mr. Medic said, "well great! Next week, Ambulance Ranger will be doing the teaching on the wound care protocol."
Should have kept my big mouth shut.
Actually, though, we had a ton of fun. We kinda McGyvered what we thought would be the best pressure-irrigation setup out of what we had - syringe, 18 guage IV catheter, IV tubing, and normal saline. Floyd will no longer go on any runs unless there's a wound to irrigate.
Actually, the whole thing became a lesson in 'how to spike an IV' - something I was pretty sure everyone already had done several times. Apparently not. I think we got it down by the end of class.
We took the last 15 minutes to play with the ring cutters. Found out that only one of them actually worked. This is the stuff we need to do more of. Every week we work on moving patients, backboarding, c-collaring, KED use, etc. Which yes, we do need to practice. But we gotta do the 'fun' stuff too, or people get bored.
On call this weekend, so no beers for me :( - just hope those tones go off and I'm actually needed and wanted on a call.
[crossing fingers]
Otherwise I swear, I'm going back to playing World of Warcraft...
Monday, June 4, 2012
Useless
I'm just another EMT in the bin of EMT's.
Working on the paperwork - senseless paperwork where databases that should work well with each other...do...not...relate. Checking credentials. Hand-entering NREMT data (how stupid is that?)
Between one and two hundred providers in our system, maybe a double handful of them are actually good at their jobs. Who want to do medical calls. Who care.
Studying, training for the big calls. Not getting called. Budgets are down, people are circling the wagons. We don't need all those resources, you see. Don't bother paging out the call.
So I sit. Waiting. Working. For what?
We are broken. EMS is broken. Why am I putting my time and energy into the ridiculousness of this?
Working on the paperwork - senseless paperwork where databases that should work well with each other...do...not...relate. Checking credentials. Hand-entering NREMT data (how stupid is that?)
Between one and two hundred providers in our system, maybe a double handful of them are actually good at their jobs. Who want to do medical calls. Who care.
Studying, training for the big calls. Not getting called. Budgets are down, people are circling the wagons. We don't need all those resources, you see. Don't bother paging out the call.
So I sit. Waiting. Working. For what?
We are broken. EMS is broken. Why am I putting my time and energy into the ridiculousness of this?
Wednesday, May 30, 2012
Read this, read it now
What I really wanted for EMS Week
The Captain says it all - exactly the way I would if I had the eloquence to write.
And if you don't read the captain on a regular basis, you should.
The Captain says it all - exactly the way I would if I had the eloquence to write.
And if you don't read the captain on a regular basis, you should.
Thursday, May 24, 2012
'Mellow' update, call volume, and navigating certification
"Mellow Yellow" has been sent back to the Mountain District for some TLC from their expert mechanic - try as we could, Mr. Medic and I could not get the heat and power issues fixed. Our ambulance is set up. What do I do now that I don't have linoleum floors to sand down?
Calls have been sporadic at best - clusters on the weekends at either the Village Ambulance Service or ours. A few "real" calls, though - chest pains, abdominal pains, shortness of breath.
I have been putting together a checklist - "how-to" guide - to get certified in our service and in the Village Ambulance service. A good overview was lacking and I found out the method I had used was wrong! So, I think we've got it nailed down. Sent the final draft to Mr. Medic, the Pit Boss, and Tess for their review.
This example gives you an idea of the stupidity of national, state, and local certification:
(This is just for our little neck of the woods. And only for EMT's. This is relatively simple, compared to most!)
Calls have been sporadic at best - clusters on the weekends at either the Village Ambulance Service or ours. A few "real" calls, though - chest pains, abdominal pains, shortness of breath.
I have been putting together a checklist - "how-to" guide - to get certified in our service and in the Village Ambulance service. A good overview was lacking and I found out the method I had used was wrong! So, I think we've got it nailed down. Sent the final draft to Mr. Medic, the Pit Boss, and Tess for their review.
This example gives you an idea of the stupidity of national, state, and local certification:
(This is just for our little neck of the woods. And only for EMT's. This is relatively simple, compared to most!)
First Steps - Everyone
Pass EMT Class
Register with the National Register of EMT
website and create “initial entry application”
Pass NREMT Practical Exam
Pass NREMT Written Exam (Cost: $70 online, credit
card)
Our Service Certification
Talk to the Pit Boss or Mr. Medic about joining the Our EMS
crew – if you are not an employee, you will need to fill out volunteer
paperwork
Fill out the “EMS Credentialing Form” - contact
Mr. Medic to initiate this process:
o
Bring copies of NREMT and current Healthcare
Provider CPR cards
o
If you do not have a photo on file, you
will have to get a digital picture taken
o
This process gets you input into the ePCR, and
credentialed with the National EMS office
Attend Our Service EMS Endorsement (10 hours)
Schedule EMS orientation and ambulance driver
training with Mr. Medic
Attend weekly EMS training at Division Training
Center, Mondays 7:00-8:30 pm
State EMT License
State licensure is needed for those who
volunteer with the Village Ambulance Service or any other provider in the
state.
Fill out Village Ambulance Service Application
(Contact Tess for application)
Provide 2 copies of NREMT and current Healthcare
Provider CPR cards, one for VAS Application, one for State
Perform a Self-Query of the National
Practicioners Data Bank (Cost: $16 online, credit card)
o
You will need to fill out a form online, print
two copies, have one notarized, and send the notarized copy to the data bank –
be sure to check the box in your request to send a hard copy to your
address. DO NOT OPEN THIS COPY! Include with your State Board of Medical
Examiners EMT Application (next step)
Fill out State Board of Medical Examiners EMT
Application (Cost: $45 application fee)
Attend EMS training at Village Ambulance Service, 2nd and 4th Mondays of each month 7:00-8:30 pm
Wednesday, May 16, 2012
on faith and forgiveness
I admire people of faith.
How they can go about their lives, certain in the knowledge that there's ultimate good in the world. They seem keenly aware of their place, and where they are headed in this world or the next.
But that's not me.
I grew up in a semi-Mormon household.
Dad went to church a bit, but his folks didn't really integrate faith into their lives. He lost his mom early to lung cancer and dad just did not keep up with church-going. My mom's side of the family are the Mormons. Big time. My grandfather is not god, but he plays him in the temple. Really. (When the Mormons do their ceremonies to seal families together into infinity, they have people stand in as substitutes for those not in attendance, like dead people. Most temples use projected images, but there are a couple of "live" temples out there where people stand in. And my grandpa stands in for god.)
Flashing forward, my family wasn't altogether religious. We went to church sporadically, but didn't have family home evening or anything like that. My parents both worked. They only had a couple kids. The missionaries would visit from time to time to try and pull us further into the fold, but nothing much came of that.
I asked my dad once, what he believed in. We were standing out in the forest, scouting for the perfectly seasoned pine we could fell, buck up into rounds, and take home to stoke the wood stove. He looked thoughtful for a minute, smiled, and said, "This is what I believe in. Being out here in the woods on a hot autumn day. Or planting flowers with your mom in the back yard. Fishing. Being in nature. Working hard."
Yup, that's my pops in a nutshell.
And I've subscribed to that same philosophy most of my life. From the time I was eight and decided to live in a tent for the summer. Or the time when I was nineteen and hit the road in my pickup truck for a year. My decision to work in a national park rather than remain a well-compensated rat in a cubicle. We get paid in sunrises and sunsets, so it's said.
But I am sometimes jealous of that faith that others seem to have, that surety.
That thing, whatever it is, that has always eluded me.
How they can go about their lives, certain in the knowledge that there's ultimate good in the world. They seem keenly aware of their place, and where they are headed in this world or the next.
But that's not me.
I grew up in a semi-Mormon household.
Dad went to church a bit, but his folks didn't really integrate faith into their lives. He lost his mom early to lung cancer and dad just did not keep up with church-going. My mom's side of the family are the Mormons. Big time. My grandfather is not god, but he plays him in the temple. Really. (When the Mormons do their ceremonies to seal families together into infinity, they have people stand in as substitutes for those not in attendance, like dead people. Most temples use projected images, but there are a couple of "live" temples out there where people stand in. And my grandpa stands in for god.)
Flashing forward, my family wasn't altogether religious. We went to church sporadically, but didn't have family home evening or anything like that. My parents both worked. They only had a couple kids. The missionaries would visit from time to time to try and pull us further into the fold, but nothing much came of that.
I asked my dad once, what he believed in. We were standing out in the forest, scouting for the perfectly seasoned pine we could fell, buck up into rounds, and take home to stoke the wood stove. He looked thoughtful for a minute, smiled, and said, "This is what I believe in. Being out here in the woods on a hot autumn day. Or planting flowers with your mom in the back yard. Fishing. Being in nature. Working hard."
Yup, that's my pops in a nutshell.
And I've subscribed to that same philosophy most of my life. From the time I was eight and decided to live in a tent for the summer. Or the time when I was nineteen and hit the road in my pickup truck for a year. My decision to work in a national park rather than remain a well-compensated rat in a cubicle. We get paid in sunrises and sunsets, so it's said.
But I am sometimes jealous of that faith that others seem to have, that surety.
That thing, whatever it is, that has always eluded me.
Monday, May 14, 2012
Ambulance Rehab - "Mellow Yellow"
The fact that this ambulance is striped in orange does not make a difference - her name shall be "Mellow Yellow"
She's a two-wheel drive, mid-nineties model who has seen better days. When Mellow came to us, fresh out of "winter storage" - read: sitting out in the snow for 5 months - she needed serious love. Every compartment was a mess, and filled with medical/non-medical items. C-collars next to tire chains, vacuum splints in with the transmission fluid, etc. I should have taken "before" photos on this one.
Mr. Medic wanted to re-finish the floors and through a little research, we found out that linoleum can be sanded down...you see where this is going! A palm sander, dust masks, and a shop vac were dredged out of my garage and we worked many hours. The result? One very nice looking floor! Took about 10 years of grime off the surface and we followed that with three coats of polish. Should work well for the next inhabitants.
Clean, sort, organize, toss, clean some more, re-organize...this rig is set up differently than the rest so a few exceptions to our standardization needed to be done. But she's beautiful now.
Just a few "minor" issues left - no patient heat, not charging on shore power, then we can send her off to the Southwest district and bring in the next one!
She's a two-wheel drive, mid-nineties model who has seen better days. When Mellow came to us, fresh out of "winter storage" - read: sitting out in the snow for 5 months - she needed serious love. Every compartment was a mess, and filled with medical/non-medical items. C-collars next to tire chains, vacuum splints in with the transmission fluid, etc. I should have taken "before" photos on this one.
Mr. Medic wanted to re-finish the floors and through a little research, we found out that linoleum can be sanded down...you see where this is going! A palm sander, dust masks, and a shop vac were dredged out of my garage and we worked many hours. The result? One very nice looking floor! Took about 10 years of grime off the surface and we followed that with three coats of polish. Should work well for the next inhabitants.
Clean, sort, organize, toss, clean some more, re-organize...this rig is set up differently than the rest so a few exceptions to our standardization needed to be done. But she's beautiful now.
Just a few "minor" issues left - no patient heat, not charging on shore power, then we can send her off to the Southwest district and bring in the next one!
Monday, May 7, 2012
Response and responsibilities
Been too busy. Too busy to write, too busy to think.
Working on ambulances, running calls. Trying to study protocols. Trying to study for graduate school.
Trying to get excited about going to work at my 'real job'. Finding out that my responsibility level may increase there and having a hard time caring about it. My boss may get a temporary promotion, then I would be doing more of the stuff I hate about my job. Great.
Not getting much done. Becoming an expert in procrastination.
EMS is my escape. Escape from the drudgery of data management. Escape from monotone webinars and useless "FYI" email messages.
When I'm on a call, the rest falls away. I'm taking care of a patient, grasping desperately into the recesses of my memory, focusing on the actions, what comes next. I'm in the moment. I take care of the patient to the best of my abilities, deliver them to the hospital, clean up the ambulance, then I'm done. It's never easy. Never goes EXACTLY the way I want it to. But I'm getting better every call. Learning. Enjoying the comradeship of my fellow EMS peers.
But it's the 'real job' that pays the bills.
Unsure how to keep my happiness quotient stable at this point. Maybe it will come to me.
Will post on the ambulance work when I can.
Working on ambulances, running calls. Trying to study protocols. Trying to study for graduate school.
Trying to get excited about going to work at my 'real job'. Finding out that my responsibility level may increase there and having a hard time caring about it. My boss may get a temporary promotion, then I would be doing more of the stuff I hate about my job. Great.
Not getting much done. Becoming an expert in procrastination.
EMS is my escape. Escape from the drudgery of data management. Escape from monotone webinars and useless "FYI" email messages.
When I'm on a call, the rest falls away. I'm taking care of a patient, grasping desperately into the recesses of my memory, focusing on the actions, what comes next. I'm in the moment. I take care of the patient to the best of my abilities, deliver them to the hospital, clean up the ambulance, then I'm done. It's never easy. Never goes EXACTLY the way I want it to. But I'm getting better every call. Learning. Enjoying the comradeship of my fellow EMS peers.
But it's the 'real job' that pays the bills.
Unsure how to keep my happiness quotient stable at this point. Maybe it will come to me.
Will post on the ambulance work when I can.
Friday, May 4, 2012
EMT
Friday, April 27, 2012
Currently reading...
EMT Protocols (what else?)
Also, for you Dark Tower fans out there, King's latest "The Wind through the Keyhole" aka The Dark Tower 4.5 is out. I just got my copy today, so protocols may have to wait a little while!
In the EMS blog world, I am still getting caught up on Siren Voices. If you're not reading it, you are really missing some fantastic writing.
Also, for you Dark Tower fans out there, King's latest "The Wind through the Keyhole" aka The Dark Tower 4.5 is out. I just got my copy today, so protocols may have to wait a little while!
In the EMS blog world, I am still getting caught up on Siren Voices. If you're not reading it, you are really missing some fantastic writing.
Thursday, April 26, 2012
NREMT
It was not simple. The questions were harder than I thought they would be.
It went too fast. About 35 minutes.
It didn't seem like enough questions - I last looked on #55.
Then it ended. Abruptly. It was done.
I had plenty of time to ponder as I drove the hour and a half home. Did I fail that miserably? I didn't think so, but it didn't feel like a slam-dunk either. By mile 50 I was convinced I'd failed and would have to pay, schedule another test, take another day off work, and drive another 150 mile round-trip to the testing center. I had told a few people it was my test day, they would be surprised if I tanked it. Mr. Medic knew, Taylor knew. Crap.
With the EMR class last year, it took a couple of days to post. How could I wait that long?
[And yes, I have heard the stories about "Back when I took my test we had to wait by the mailbox for weeks. Walked to it three times a day in 6 feet of snow, uphill, both ways..."]
It doesn't make the waiting any easier, folks.
So, fingers trembling, I logged in on the off chance it had posted.
Examination Scored
Congratulations on passing the NREMT National EMS Certification cognitive examination
And there it is. I passed.
Still waiting for the pshychomotor exam results to make it through the bureaucracy, but for now I'm done testing.
Time to start studying protocols.
:-)
It went too fast. About 35 minutes.
It didn't seem like enough questions - I last looked on #55.
Then it ended. Abruptly. It was done.
I had plenty of time to ponder as I drove the hour and a half home. Did I fail that miserably? I didn't think so, but it didn't feel like a slam-dunk either. By mile 50 I was convinced I'd failed and would have to pay, schedule another test, take another day off work, and drive another 150 mile round-trip to the testing center. I had told a few people it was my test day, they would be surprised if I tanked it. Mr. Medic knew, Taylor knew. Crap.
With the EMR class last year, it took a couple of days to post. How could I wait that long?
[And yes, I have heard the stories about "Back when I took my test we had to wait by the mailbox for weeks. Walked to it three times a day in 6 feet of snow, uphill, both ways..."]
It doesn't make the waiting any easier, folks.
So, fingers trembling, I logged in on the off chance it had posted.
Examination Scored
Congratulations on passing the NREMT National EMS Certification cognitive examination
And there it is. I passed.
Still waiting for the pshychomotor exam results to make it through the bureaucracy, but for now I'm done testing.
Time to start studying protocols.
:-)
Tuesday, April 17, 2012
EMT Class week 24 - The final chapter...and the beginning
We passed. We all passed.
Class practicals, class written, and NREMT practical. Done.
Clinicals? Done.
NREMT written? Scheduled for one week from today.
Funny, I feel less capable now than I did when I finished my EMR. Maybe it's just that there's so much more to learn. Two sets of protocols, master all the equipment for both ambulance services. Wanting to learn more, know more. I'm a bit lost at the moment, really. I need some direction. Set new goals. Learn to be the best care provider I can...
Class practicals, class written, and NREMT practical. Done.
Clinicals? Done.
NREMT written? Scheduled for one week from today.
Funny, I feel less capable now than I did when I finished my EMR. Maybe it's just that there's so much more to learn. Two sets of protocols, master all the equipment for both ambulance services. Wanting to learn more, know more. I'm a bit lost at the moment, really. I need some direction. Set new goals. Learn to be the best care provider I can...
Friday, April 13, 2012
EMT Class week 23 - Van departs, practice, and written test
First big shocker - Van our class coordinator got a nice job offer and had to leave earlier than anticipated. We are all stoked for him, but none of us got to say good-bye :(
So Tess and Mr. Medic are back in the hot seat to get us through these last few weeks.
I don't think any of us really took too much to heart that we should have been studying for practicals all along. This was a known entity, and we should have been preparing. Really. We all have our excuses. Family, job, life, ahem, graduate school, all the usual suspects. It's a good thing we built in a couple of practice sessions.
On to the test. I would like to say I breezed through it, but 270 questions (!) is a lot for anyone to 'breeze through'. Floyd kicked my ass by a couple points and I will never live that down. I did well. Missed a few stupid points, but overall I'm good with it. Everyone passed.
Since Van wasn't around, Tess decided to start class practicals right after the written. I was done early so I got through Medical Assessment, C-Spine immobilization, and Cardiac Arrest. Was nice to have those done and focus on getting through Trauma Assessment, BVM Apneic Patient, and "choose your own adventure" AKA long bone, joint, traction splint, OPA/Suction/NPA, bleeding/shock, O2 administration, or mouth to mask.
I miss Van, but it feels good nonetheless to be toward the end of EMT book work. Time to get out into the real world, deal with protocols, and get the job done. I hope!
So Tess and Mr. Medic are back in the hot seat to get us through these last few weeks.
I don't think any of us really took too much to heart that we should have been studying for practicals all along. This was a known entity, and we should have been preparing. Really. We all have our excuses. Family, job, life, ahem, graduate school, all the usual suspects. It's a good thing we built in a couple of practice sessions.
On to the test. I would like to say I breezed through it, but 270 questions (!) is a lot for anyone to 'breeze through'. Floyd kicked my ass by a couple points and I will never live that down. I did well. Missed a few stupid points, but overall I'm good with it. Everyone passed.
Since Van wasn't around, Tess decided to start class practicals right after the written. I was done early so I got through Medical Assessment, C-Spine immobilization, and Cardiac Arrest. Was nice to have those done and focus on getting through Trauma Assessment, BVM Apneic Patient, and "choose your own adventure" AKA long bone, joint, traction splint, OPA/Suction/NPA, bleeding/shock, O2 administration, or mouth to mask.
I miss Van, but it feels good nonetheless to be toward the end of EMT book work. Time to get out into the real world, deal with protocols, and get the job done. I hope!
Thursday, April 5, 2012
We lost one of our own yesterday
I didn't know him very well.
Of the 150 or so providers in our family, I'm just getting to know some of them.
And there are those I will never know.
We lost a good man, too young, too soon.
Rest in peace, Ranger Nelson. Your jump kit will be here if you need it.
Monday, April 2, 2012
EMT Class week 22 - Practice and Clinicals
Not much to report from class last week, we are running through stations to get ready for our practical exams. Given that our first written exam is on Wednesday, I would rather do more prep for that!
Taylor and I hit the "big city" for our ED shift yesterday. All I can say is - whew! I'm glad we're done!
Nothing like being in a place where you really have no idea where (or if) you fit in, what to do, and where to find things. We started our 10 hour shift at 0900 with a quick orientation by the the ER Tech. Here are the rooms, the board, no you don't write anything down on the chart - just jot vitals on a piece of paper, etc. And here's your vomit bucket filled with thermometer, BP cuff, PulseOx, and stethoscope. When you're not needed, stand here. Simple enough.
Yep, not so much.
Mr. Medic's suggestion rang in my ears, "You will be in the way. Leave the docs alone. Nurses you will just have to see how they react. ER Tech is probably your best bet. Try to shadow/emulate them. And keep an eye out for that little old lady/man who comes in without any family or friends. Spend some time with them. Ask them SAMPLE and OPQRST. The nurses will be happy someone is spending time with them and you will get a good history taken."
So Taylor and I are plugging along, grabbing vitals as asked. The first room goes empty and the ER Tech starts to clean and make it up for the next patient. "How can we help?" Irene gives us the scoop - "Grab the disinfectant, wipe down the bed, pillow cover, counters, tray, floor if needed, coil up any cables, any sterile, unopened equipment goes back, opened goes in the trash. New sheet on the bed, new pillow cases on the pillows. Trash taken out as needed."
Boom. We've got an assignment.
Any patient gets discharged, we are on that room like white on rice. Cleaning with passion. Not much different from working on the ambulance, really. Running to catch vitals when asked. Grabbing coffee, water, sodas, sandwiches for patients when asked. Otherwise just standing in our assigned space, waiting. Sunday is not a very busy day, apparently. There were almost always 4 rooms empty at any time out of the 20 total. Seemed pretty busy to me compared with our regular receiving hospital which has 5 beds! Taylor and I chatted quietly when we had the chance. The hours passed.
Abner arrived. 82 years old, shortness of breath. History of asthma and pneumonia, coughing, can't catch his breath. All alone. Dan was his nurse, and had a bunch of patients. "Can you give me a hand?" We were trying to get him to the loo. When Abner stood, I noticed the watery mess on the sheet. Then the smell. I mouth "I think he had a BM" to Dan, behind Abner's head. Oh boy. Short, slow walk to the toilet. We strip him down and begin to clean. Caught myself gagging and started breathing through my mouth, and trying to keep a smile on my face (apparently the smiling counteracts the gagging reflex...) Abner is embarrassed. "I'm so sorry. This is humiliating." I assure him that there are no apologies necessary and we are happy to help. Dan keeps rushing out for more supplies - wipes, a clean gown, an adult diaper. I'm looking around for an exhaust fan switch - there is no fan. He keeps talking. Never stops. His devoted family (none of whom are inclined to get off work to come care for him in the ER) his deep faith. Getting old. Living with a broken body.
We get him cleaned up, put together, and into another room. I check in on him. He asks for a blanket, something to drink, something to eat, a phone to call his daughter. I help. I listen. I sit with him while the ER doc goes over the instructions. Probably not over the pneumonia, here's some more antibiotics. Daughter can't come pick him up for two hours. Nurses move him to the hall 'cause we're running out of beds. A roll-over accident is coming in by ambulance. I make sure he has all his stuff and is comfortable. I check in every few minutes and go chat whenever his eyes are open, just so Abner's not under the impression he's been forgotten, shoved into this back hallway.
"You have sown so many seeds of kindness today. You will reap a bushel."
"I need all the help I can get." I replied "But being a heathen all my life tends to keep one out of God's graces. Well, maybe not a complete heathen, really a rebellious ex-mormon"
"I don't believe that. You've sown your seeds of kindness today."
"That's probably the nicest thing anyone has ever said to me. Thank you." And I meant it.
Abner's daughter showed up after work. We got him into the wheelchair with all his belongings. The daughter looks exhausted. Guess I can't just judge her too harshly - we all have lives to live and our own issues to deal with. She wheels Abner out the door.
We're on to the next patient.
Taylor and I hit the "big city" for our ED shift yesterday. All I can say is - whew! I'm glad we're done!
Nothing like being in a place where you really have no idea where (or if) you fit in, what to do, and where to find things. We started our 10 hour shift at 0900 with a quick orientation by the the ER Tech. Here are the rooms, the board, no you don't write anything down on the chart - just jot vitals on a piece of paper, etc. And here's your vomit bucket filled with thermometer, BP cuff, PulseOx, and stethoscope. When you're not needed, stand here. Simple enough.
Yep, not so much.
Mr. Medic's suggestion rang in my ears, "You will be in the way. Leave the docs alone. Nurses you will just have to see how they react. ER Tech is probably your best bet. Try to shadow/emulate them. And keep an eye out for that little old lady/man who comes in without any family or friends. Spend some time with them. Ask them SAMPLE and OPQRST. The nurses will be happy someone is spending time with them and you will get a good history taken."
So Taylor and I are plugging along, grabbing vitals as asked. The first room goes empty and the ER Tech starts to clean and make it up for the next patient. "How can we help?" Irene gives us the scoop - "Grab the disinfectant, wipe down the bed, pillow cover, counters, tray, floor if needed, coil up any cables, any sterile, unopened equipment goes back, opened goes in the trash. New sheet on the bed, new pillow cases on the pillows. Trash taken out as needed."
Boom. We've got an assignment.
Any patient gets discharged, we are on that room like white on rice. Cleaning with passion. Not much different from working on the ambulance, really. Running to catch vitals when asked. Grabbing coffee, water, sodas, sandwiches for patients when asked. Otherwise just standing in our assigned space, waiting. Sunday is not a very busy day, apparently. There were almost always 4 rooms empty at any time out of the 20 total. Seemed pretty busy to me compared with our regular receiving hospital which has 5 beds! Taylor and I chatted quietly when we had the chance. The hours passed.
Abner arrived. 82 years old, shortness of breath. History of asthma and pneumonia, coughing, can't catch his breath. All alone. Dan was his nurse, and had a bunch of patients. "Can you give me a hand?" We were trying to get him to the loo. When Abner stood, I noticed the watery mess on the sheet. Then the smell. I mouth "I think he had a BM" to Dan, behind Abner's head. Oh boy. Short, slow walk to the toilet. We strip him down and begin to clean. Caught myself gagging and started breathing through my mouth, and trying to keep a smile on my face (apparently the smiling counteracts the gagging reflex...) Abner is embarrassed. "I'm so sorry. This is humiliating." I assure him that there are no apologies necessary and we are happy to help. Dan keeps rushing out for more supplies - wipes, a clean gown, an adult diaper. I'm looking around for an exhaust fan switch - there is no fan. He keeps talking. Never stops. His devoted family (none of whom are inclined to get off work to come care for him in the ER) his deep faith. Getting old. Living with a broken body.
We get him cleaned up, put together, and into another room. I check in on him. He asks for a blanket, something to drink, something to eat, a phone to call his daughter. I help. I listen. I sit with him while the ER doc goes over the instructions. Probably not over the pneumonia, here's some more antibiotics. Daughter can't come pick him up for two hours. Nurses move him to the hall 'cause we're running out of beds. A roll-over accident is coming in by ambulance. I make sure he has all his stuff and is comfortable. I check in every few minutes and go chat whenever his eyes are open, just so Abner's not under the impression he's been forgotten, shoved into this back hallway.
"You have sown so many seeds of kindness today. You will reap a bushel."
"I need all the help I can get." I replied "But being a heathen all my life tends to keep one out of God's graces. Well, maybe not a complete heathen, really a rebellious ex-mormon"
"I don't believe that. You've sown your seeds of kindness today."
"That's probably the nicest thing anyone has ever said to me. Thank you." And I meant it.
Abner's daughter showed up after work. We got him into the wheelchair with all his belongings. The daughter looks exhausted. Guess I can't just judge her too harshly - we all have lives to live and our own issues to deal with. She wheels Abner out the door.
We're on to the next patient.
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