A Few Things…

Posted in Miscellaneous on February 17, 2011 by medic61
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Alright, so it’s been a while since my last post, and even longer since my last post of substance! I can’t say that this one will be much better, but I can tell you that I’ve been a busy bee these past few months.

First, I’d like to say thank you to the fine folks at MedGadget for sponsoring the Medical Weblog Awards! I was a nominee this year for “Best Literary Medical Weblog,” and it was an honor just to be nominated! Also, I was listed as one of the top 10 “Paramedic Student and Learning Blogs” here, and one of the top 50 overall! Lastly, I was voted as the “Best (female) Student Tweeter” by the readers of Dani’s Blog. Just wanted to take a minute to say thank you to everyone for the kind mentions and thoughts. Also a reminder to the HR software outsourcing people that BPO can be a great stratgy.

Secondly, I am gearing up for EMS Today this March in Baltimore! I am so thankful to have been a recipient of one of this year’s scholarships to attend the conference itself, and while this is my third year going to Baltimore, it will be my first actually being able to take classes! Thank you so much to JEMS for making this possible. If any of you are going to be in Baltimore during the conference, I’d love it if you could come out to the meetup on Thursday night! It should be a blast; I can’t wait to meet new people and see all my friends from the previous years! Please drop me a line if you’re going to be there so we can make sure and see you!

I am also very excited to announce that GenMed Show will be live podcasting from the exhibit hall Saturday morning. It’s going to be a great show with some awesome guests, so please stop by and experience GenMedigras on Saturday! Natalie and I will be handing out some really cool prizes! I know we’ve been sort of absent from the podcasting world for a little while, so the-little-podcast-that-could can use all the support it can get now! And, on the whole, be sure to stop by the ProMed booth and check out all the other great shows that will be going on throughout the week!

So, that’s it for now…I have some stuff in the works, though! I’m having to send my poor little laptop off for repairs, but once it’s safely back in my hands, I’ll be back to blogging in no time.

Stay safe out there, and see you in Baltimore!
Sam

Blog of the Year

Posted in Miscellaneous on January 11, 2011 by medic61
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It’s that time of year again! The Fire Critic is hosting this year’s Fire and EMS Blog of the year competition sponsored by Black Diamond. You can read more about it here, but it’s pretty exciting because there will be two winners: Fire blog of the year, and EMS blog of the year. So please, go check out the contest and nominate your favorite blogs! I’m submitting my nominations at the moment, and can’t wait to see how it turns out!

And please, if you have any favorite bloggers that I don’t have linked, let me know in the comments! I love being introduced to new writers!

Stay safe out there,
Sam

The Hospital is No Place for a Sick Person, Part 4

Posted in Miscellaneous, Nursing School on December 27, 2010 by medic61

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Before I move on to the fourth (and final) installation of my rantings observations on my stay in the hospital, I’d like to take a minute to introduce you to the blog’s newest sponsor! I am thrilled to welcome nursinguniforms.net to the blog, and want to thank them for their interest in the blog! Please peruse the site if you get the chance!

The final observation I’m going to make (for now) is on nutrition services. And before you jump to conclusions, this isn’t an “I hate hospital food” diatribe, I promise!

I found that the cheeriest, happiest, most obliging staff that I encountered were the nutrition staff. Every time they brought a meal, they had smiles on their faces, laughed, called me “sweetheart,” and wanted to make sure I didn’t need anything else. I didn’t actually get breakfast the first morning I was admitted, and when the lady came to take my tray, she asked if someone had already taken it. I said “Oh, no, I didn’t get anything to eat.” She looked shocked and rushed off to find me a tray. She wouldn’t stop apologizing, and I kept telling her not to worry, that I was really okay!

They always seemed so worried that I was going to be disturbed by their presence, and while I never was, it was sweet to know that they were worried about bothering me. They’d always say “I’m so sorry to bother you, but are you finished with your tray?” If I were sleeping or trying to rest, they would quietly come in and take it without waking me, and they were the only ones who made a point to try not to wake me up.

My only complaint was that although I was on a full, unrestricted diet, and should have gotten to choose my meals from a set menu, I never did. I don’t know whose responsibility that was, but I kept wishing that I had gotten to choose chicken instead of pork, or tea instead of coffee. I know that I could have asked the nutrition staff if I could get something else, but because they were so nice I actually was concerned about bothering them! Don’t get me wrong; I’m not a hugely picky eater, and would eat the majority of whatever they served, but it would have been nice to choose.

And yes, the food wasn’t stellar; I wouldn’t choose to eat that food again, but to be honest it could have been a lot worse. I was actually in the hospital for Thanksgiving, and they brought up a turkey dinner with mashed potatoes, carrots, cranberry sauce, and stuffing. It wasn’t the best Thanksgiving feast I’ve ever had, but it made me smile. They had made the effort to give those of us who were sick and in the hospital on a day we should be with our families a little bit of comfort and tradition, and that was all I could really ask for.

So to everyone who works behind the scenes in patient care…whether you’re working in nutrition, environmental services, registration, maintenance, or housekeeping…thank you for what you do. Giving me a Thanksgiving meal, leaving a flower in my room after cleaning it, and trying not to disturb me while I was resting are all small things, but they did not go unnoticed, and they will be remembered.

I suppose that the moral of this story is that…things don’t always go as planned in the medical field. Not every patient is treated the “textbook way” by the doctors or nurses, and there is certainly no rest for the weary as an inpatient. But I can certainly say that the things I have experienced during my time in the hospital will make me a better provider. I know that years from now I may become tired, a bit cynical, and maybe even jaded or burnt out; but I do hope that I can remember what it feels like to be a scared, anxious patient who only wants some answers, some rest, and to go home to her own bed.

As always, thoughts from your perspective as a patient or provider would be much appreciated! Thanks for reading and keeping up with this whole series, and I can’t wait to hear your feedback!

Stay safe out there,
Sam

The Hospital is No Place for a Sick Person, Part 3

Posted in Miscellaneous, Nursing School on December 16, 2010 by medic61
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Alright, after a brief hiatus so that I can focus on my final exams, we’re back at it! Here is my third observation from my recent hospitalization after surgery. If you missed them, you can read part 1 here and part 2 here. So, let’s get back to it.

3) Physical Assessment?
In nursing school this semester, we devoted an entire unit to the physical assessment. We learned what a full assessment entailed, we had to learn how to perform each individual part of the assessment from head to toe (along why it is done), and we even had to do one on a partner and be evaluated by our teachers. We were told in no uncertain terms that “a full physical assessment is done on every patient who is admitted to the hospital, regardless of the reason for admission.”

While I was in the hospital, yes, I was assessed. After shift-change happened, a nurse would come in, listen to my heart and lungs, and a CNA would get my vital signs. Once, a nurse listened to my bowel sounds. But never was I asked the questions to check on my level of orientation (Do you know what day it is, do you know where you are, do you know what happened to you, etc.). No one ever shined a light in my eyes to see if my pupils were equal, round, and reactive to light. My stomach was never palpated, my skin was never assessed, and no one ever measured the angle of my nail beds (hah!).

I understand that the physical assessment is not always applicable. I was awake, alert, and had appropriate responses, so of course the nurse could check a few things off right off the bat without having to walk through them step by step. Other things, such as measuring the angle of my nail beds, were excessive. I had no difficulty breathing, I am not a smoker, and I have no history of any major respiratory illnesses aside from some minor asthma. So, clearly, there’s no reason to suspect clubbing of my nails, as I have relatively normal lung function.

I want to point out that this is not a criticism of the nursing staff, it’s simply something I noticed. I’ve been hospitalized before, and noticed different things around this. For instance, when I was admitted for a concussion following a bad car accident, I was neurologically assessed every shift, but that was not the case when I had appendicitis or had my parathyroid removed. Another thing I found was that when I was admitted from the emergency room, rather than from surgery, I did get a full assessment. From the ER, I went to a pre-admit holding area where they did the full assessment. They asked about my religious preferences, dietary preferences, inspected my skin, looked in my eyes, etc. They provided a baseline assessment for the floor nurses to refer back to, but when coming from the operating room, this was never done.

Again, I’m not trying to say that this is something where the nursing staff failed me or anything like that. It’s just that as a nursing student, and having had an entire unit devoted to the physical assessment, I find it interesting to see that as a patient I only ever experienced a partial or cursory assessment during this admission.

What about you? If you’ve ever been admitted, do you remember the assessments that were done on you by the nursing staff? Nurses, on which ward do you work, and do you always do a full assessment on every patient? What criteria make you do a partial assessment versus a full one? I’m truly interested in learning more about this, as hopefully I’ll soon be doing this on a regular basis! Can’t wait to hear your feedback!

Stay safe out there,
Sam

The Hospital is No Place for a Sick Person, Part 2

Posted in Miscellaneous, Nursing School on December 11, 2010 by medic61

Alright, moving right along, I bring you the second installment of my observations as a patient on the general medical floor of my local hospital! If you missed the first post, you can read it here.

2) Judgment.
During the chapter on Pain Management in nursing school, it was repeatedly beat into our heads mentioned that pain is whatever the patient says it is. If you ask them to rate pain from 0-10 and they say it’s a 9, then it’s a 9. If they say they are in extreme pain even though they are laughing and have no signs of pain showing on their face, then they are in extreme pain. As the nurse, we have been taught that we treat the pain that the patient reports.

Now, I have worked in the ER and on the ambulance and seen patients say they are experiencing “the worst pain of my life” while texting on their phones or filing their nails. I know it’s difficult to hear what they say and make it mesh with what we observe, but when I start to get frustrated I try to take a step back and remind myself of a few things. I am not feeling what they are, I have no knowledge of what their experience with pain is, and I usually have little-to-no clue what their cultural background is like. Once I can bring these things to the forefront of my mind, I come back to the situation refreshed and ready to treat my patient the way I was trained.

But this was not always my experience during my admission. I had some nurses (such as the nurse in the PACU) who charted what I said for pain, and got me the medicine that was ordered without question. They would try to figure out the best schedule for medicine, the best way to position me, how to adjust my bed, if food or drink would help me in any way, and other ways of helping to ease my pain. The nurses on third (overnight) shift were the best as far as pain control went. Maybe it’s because they weren’t as busy because other patients were sleeping, or maybe it was something else, but when I said I was in pain, they did everything they could to help me.

I had other nurses, though, who seemed frustrated, skeptical, or annoyed whenever I would ask for pain medicine. They’d say things like “you just had your pain medicine two hours ago,” (even though my medicine was ordered for every two hours) or “is it really that bad?” I’d be reminded that “it is normal to have pain after surgery, you know,” or “overuse of narcotics can lead to dependency.” So whenever I had these nurses, I would get so embarrassed to push the call button because I didn’t want to hear the judgmental words or see the eye rolling. I decided it was better to put up with the pain than have to deal with their comments. But as a future nurse, I can say that what I experienced is not the kind of environment I want for my patients. I am sure that some of these nurses have seen many drug-seekers, narcotic-dependent patients and “frequent fliers” who may have changed their perception of pain management, and I understand that. However, it does not change the fact that their preconceived notions about my pain led to embarrassment and shame on my part.

What about you? Have you ever felt judged as a patient when you request medicine, or get a prescription filled at the pharmacy? Alternatively, providers, have you ever caught yourself judging a patient for one reason or another? I’d definitely love some more input on this and maybe we can get a good discussion going!

Stay safe out there,
Sam

The Hospital is No Place for a Sick Person, Part 1

Posted in Miscellaneous, Nursing School on December 9, 2010 by medic61

Over Thanksgiving this year, I had the unfortunate experience of having emergency surgery and spending two nights in the hospital. On Tuesday night, I called my doctor about some complications I was having from a surgery I had had two months prior, and when I went to see him Wednesday afternoon he asked, “when’s the last time you had something to eat or drink.” My heart sank, as I knew this was the “surgery question.” In one fell swoop, I had gone from thinking he’d give me a some medicine or tell me I was fine to having unexpected surgery the day before Thanksgiving. I wasn’t a happy camper.

So, I headed over to the hospital with my mom and saw some familiar faces. Not only had I been there for surgery related to this two months prior, but exactly one week earlier I had been there to have my tonsils out. I was so frustrated to be there that I had tears in my eyes, but the nurses were so reassuring and joked along with me about knowing exactly where to start my IV and things like that. It was really calming to be around smiling nurses who knew I was scared and did their best to put my fears to rest.

They took me to the pre-op holding area, gave me some Versed, and I got to speak to my doctor. The surgery was simple, he said, they just needed to drain an abscess that had formed at the surgical site and I’d be home for a late dinner. He patted my leg and said, “you’re going to feel so much better when you wake up.”

But I didn’t. No, not only did I not feel better, I felt much worse. I’ve been through surgeries before, and I know what is normal post-op pain. Hell, less than 24 hours after the original surgery two months before, I was off pain meds, upright, and I was at my first nursing school clinical. So yes, I know what it feels like to have pain from surgery, and I knew that something wasn’t right. The nurse in the PACU (post anesthetic care unit) was one of the kindest nurses I have ever met. When she asked me to rate my pain, she took me seriously and would say “okay, let me get some more medicine.” When I started itching all over from the medicine, she didn’t brush it off; she checked me all over for any signs of a rash or hives, and called the doctor to get an order for Benadryl.

Because I had had surgery so late in the afternoon, they transferred me to the general medical floor to finish recovering once the PACU closed. I was left in the care of the floor nurses, and everyone still seemed confident I’d be going home that night. It gets a little hazy from here on, because the Benadryl made me really sleepy. All I know is that I woke up at midnight still in the hospital, because my pain was uncontrollable.

Now, I’m not telling you this story just to update you on the goings-on of my life, this post actually has a purpose (I swear). During the time I spent in the hospital, I had some eye-opening experiences that I hope will help me during my time in nursing school and once I head out to work in the field myself. So, without further ado, here is my list of reasons that (in the words of a very wise friend) “the hospital is no place for a sick person.”

[Note: This started out as a small list of "things I learned from being a patient" but quickly developed into a several-thousand-word diatribe. For this reason, I've decided to break this into several posts over a few days so as not to write a totally overwhelming post!]

1) Sleeplessness.
What’s that thing you always say to sick people? “Get some rest,” or something, right? Yeah, that’s what they all said to me, too, and I would have been happy to get some rest had that been at all possible. To start, narcotic pain meds don’t make me sleep. They make me irritable, nauseated, and totally restless. So when I woke up at midnight, I literally only got five more hours of sleep over the next 36 hours, even though I spent each of them in bed.

The next morning, I asked the nurses if when the on-call doctor came we could see about getting me a sleeping pill due to the fact that the meds were messing up my sleep. They said sure, but that never happened, even when I asked the doctor myself. I was prescribed Zofran for my nausea, and I went so far as to ask the doc if I could have Phenergan since it tends to help me sleep. Inexplicably, she said no and I was continued on Zofran. That was problem #1, as far as my sleepless nights were concerned: no one was worried about my insomnia other than me.

Problem #2 was far more frustrating. On my second night in the hospital, I was up until 0500 but finally felt like I might be able to fall asleep. I closed my eyes, and drifted off until there was a knock at the door. I checked the clock and saw that it was only 0600. Rather than narrate the rest of the morning, let me list the times and reasons people entered my room:
0600: Time for my antibiotic
0630: Time for vital signs
0700: Shift change, RN and CNA introduced themselves
0730: Nutrition came to drop off my breakfast
0745: CNA wanted to let me know my breakfast was there, and asked if I needed help eating it.
0800: Time for pain medicine
0815: CNA wanted to help bathe me/do bed change. (By this time, I had stopped trying to sleep)
0830: Doctor came to do rounds
0900: Nutrition came to take my tray away
0930: Vital signs
1000: Pain medicine
1030: CNA wanted to know if I needed anything
1100: Discharge instructions

That’s thirteen times that someone entered my room in five hours. I was so frustrated; I wanted to say to them “listen, can you please, please, PLEASE just leave me alone to get some sleep!? I promise I’ll push the call button if I need you.” I understand that some things have to be done on a schedule. Vital signs, medicines, rounding etc. are all things that they don’t have much control over, and I get that. But things like the bath, bed change, welfare check, etc. could have waited, especially since I expressed to both the RN and CNA that I was exhausted due to not sleeping normally during my admission.

I honestly believe that had I been able to get some real sleep I would have been able to leave the hospital much sooner.

Stay tuned (I know you’re absolutely riveted!); tomorrow I’ll continue the list! And as always, I’d be thrilled to hear your input as a provider, patient, or third party on any of the points!

Stay safe out there,
Sam

Guest Post: Flaws in EMS Education

Posted in EMS, Guest Posts on December 1, 2010 by medic61
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Tonight’s entry is a guest post from @MattTheMedic, an off-shore paramedic who has recently started his own blog. He’s an incredibly intelligent and witty guy, so if you aren’t following him on twitter you should check him out! After you’ve read, please head over to his blog and say hi, and feel free to comment on this post to let him know what you think!

—————

To draw an objective conclusion about the flawed state of EMS Education you first have to admit there is a problem. Unfortunately I was unaware of the problem because I thrived in the earliest (and easiest) stages of said training.

The EMT-Basic program is a class designed for the lowest common denominator.

Good at memorizing things? Great.

Have half an ounce of common sense? Even better.

Willing to unquestioningly accept that 2 + 2 = 5 (90% of the time)? Awesome.

Medical directors are gonna love you.

At this point we’ve stumbled upon …
Problem #0 *: The EMT-Basic program is a watered down course that most 8th graders could pass with a little help. As long as you’re capable of memorizing and making your hands do what you tell them, you’re in. You’ve also just met the criteria to work in fast food.

I did not understand this problem due to the relative ease in which I negotiated the class. And this is not to say that I’m a rocket surgeon, by any means. I consider myself of average intelligence and had the benefit of running for 6 months on my local volunteer ambulance prior to ever stepping foot inside the EMS classroom. But, if you can remain calm, remember a few simple mnemonics (SAMPLE, DCAP-BTLS, AVPU, etc.), and memorize the practical sheets, you are the new Golden Child of EMS.

Please do not take this as a dig on my EMT-Basic Instructor. He was a wonderful teacher with too many students, too little time and a long list of things (mostly silly things) that the state required him to talk about. He was, and still is, one of my EMS heroes, an awesome Paramedic and a genuinely great person who I consider myself lucky to have had the opportunity to work with.

Also, please do not read this and think that I’m taking anything away from being an EMT-Basic. I was one for nearly 8 years. I bought into the “BLS before ALS” concept with my whole heart. I believed “Paramedics save lives; EMTs save Paramedics.” I was certain that I was better than 95% of any “Para-God” out there. I used to honestly believe I was the greatest thing to happen to EMS since Johnny Gage and Roy DeSoto. I was a genius and all you had to do was ask me. I’d tell you how badass I was. I’d give you the contraindications for a traction split while doing a keg stand. You could wake me up from a dead slumber and I’d rattle off how many CCs of air the blue balloon took to be fully inflated on a Combi-Tube. Need a pro Bag-Valve-Masker? I was your man. I was the master of all that was the BLS Craft. Life was so much simpler back in those days.

Then came working in an Emergency Room for 2 ½ years. At the same time I was working for a private ambulance on a 911 ALS truck. Then, ultimately, it came time for me to go to Paramedic School.

After about 2 days working in the ER, 2 weeks of working on an ALS 911 truck, and 2 months upon entering Medic School I had 3 minor epiphanies that equaled one coherent though:

“What I don’t know is not only dangerous, it’s nearly criminal.”

It was the perfect storm.

It was like I was Jake Blues screaming “YES! YES! JESUS H. TAP-DANCING CHRIST… I HAVE SEEN THE LIGHT!”

But, it turns out; I’d only recognized there was a problem. Not a solution. Yet.

To be blunt; I didn’t know D.I.C.K.

Differential Diagnosis: I’d never even heard of this until I entered Paramedic School. Hell, the only thing I’d ever heard was “We don’t diagnose in the field.” And I believed that. Thus, a systematic approach of figuring out what was the matter with my patients never occurred to me. Sure I’d been taught to get a SAMPLE history, but no one ever explained how to formulate a plan of how to use said information.

Intravenous Access: Although I knew Medics could start IVs, I had little idea of why they could do it. And I was mostly unaware of the fact that ability to start an IV was not a treatment. It was a means to an end. The act of starting an IV itself has never once saved a person. All I knew was that it was damned cool and I wanted to be able to do it. Many people want to be paramedics solely to “do cool stuff like IVs and intubate.” And likely half of them couldn’t tell you why they want to do those things.

Cardiology: I knew two things about the heart to be true: If there is no pulse start CPR. If there is an AED available get the patient naked and slap that puppy on. I was clueless as to the “Why” and “How” of AEDs. Sure I picked up little pieces of the puzzle here and there, but no one sat me down and explained V. Fib or V. Tach to me in EMT class.

Ketoacidosis, Kalemia, Kussmal, K (Potassium): Some of these words I’d heard of, some I had not. Sometimes I just pretended to know what they meant so I didn’t appear stupid. Regardless, I was not prepared to describe, in great detail, any of the things above. In all honesty the only thing I knew about K (Potassium) was that there was a cereal I liked called “Special K.” And even at that, I still wasn’t sure if I was eating flakes of Potassium or just some corn flakes with really awesome marketing by the Kelloggs Corporation.**

The solution to problem zero seems relatively easy:
Make the class harder, to better prep EMT-Basic’s for Paramedic School.

• Teach Differential Diagnosis early. Let’s stop pretending that our students will remain EMT-Basics for the rest of their lives.
• Increase time spent on Anatomy and Physiology.
• Introduce Pharmacology earlier and more extensively (For starters, focus on the drugs these EMTs will end up handing their Paramedic partners)
• Teach them basic cardiac rhythms so they don’t feel overwhelmed later on in life. Or, at minimum, explain the concept of a P, a QRS and T waves.
• Give an intro to medical terminology (Or at the very least commonly seen EMS terms)
• Add more required Ambulance ride time and more ER clinical time.
• And lastly, institute an entrance exam to weed out the people you don’t want in the back of an ambulance taking care of your loved one.

Why don’t we stop pandering to the lowest common denominator? Just because you’re capable of passing a state mandated test does not prove you are ready to hop in the back of an ambulance.

To rectify this problem would be to kill a large sub-section of EMS, since many people are fine with staying Basics (especially in more rural/volunteer areas). The EMT-Basic may not be the backbone of EMS in the United States, but they most certainly are the legs. Sadly, making the course harder would eventually just be a case of shooting ourselves in the foot. I don’t have a perfect solution, but doing just a couple of these things could certainly help. EOR. – MW

*Problem 0 due to it being a problem before you even get started in your EMS career.

** Side note: The first thing I tell anyone interested in going to Paramedic School is to enroll in a medical terminology class at their local community college.

Women in EMS

Posted in EMS on November 15, 2010 by medic61
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I went to career day at an elementary school two weeks ago and got to talk to the entire second grade. I got a lot of great questions about what it’s like to work on the ambulance and treat patients, and I really enjoyed talking to the class. I got to show them a bunch of pictures of me with Drew, Eric, and other partners, and they really seemed to enjoy that.

Each class, however, astutely picked up on one common theme of the pictures: I was the only woman in each photo. Each class asked why there weren’t more women in EMS and why all my partners are male. I didn’t really have a good answer for them, to be honest. I told them about people who had told me that I couldn’t do EMS or fire because I was a woman but how I showed them by doing it anyway and being *good* at it. I used it as a teaching opportunity for the idea that you can do anything you want when you grow up, as long as it is within your means. (Sidenote: when my mom told me that I could be anything I wanted to be when I grew up, I asked her if I could be Christopher Columbus. Not sure why, but I thought that would be pretty awesome.)

But I couldn’t give them an answer as to why EMS was a traditionally male-dominated field. I tried to think it through a bit more, but came up blank. Medicine is a strange field for gender stereotypes, really. Physicians are typically thought of as being male, nurses are typically pictured as female, and EMTs are thought of as male. But, why?

In sociology we discussed that since physicians have to attend many years of school before being able to practice, it is something that many women do not wish to do. Since they bear the physical burden when starting a family it often isn’t feasible to take that much time off during one’s time in medical school. Of course, this isn’t always the case, but we talked about how this sort of set the precedence for doctors being typically male.

Alternatively, we discussed how nursing is a field that requires less time in school, which often lends itself more kindly to those who wish to start a family and still have time for school. Clearly more goes into it than just this for both MDs and RNs, but it’s a cursory assessment, I guess you could say.

But what’s the deal with EMS? I feel like the ratio of men to women is equalizing more and more, but that the stigma still exists for women in the field. I know that I, personally, have encountered many instances where I’ve been told that I wouldn’t make it as an EMT simply due to my assigned genitalia. But…why? I know that I keep asking this, and it’s because the more I think about it, the more it baffles me.

So I guess what I’m asking is for reader input. Do you see this gender stereotyping of the field the way I do, or do you perceive it differently? What is the gender ratio like at your station? Have you experienced any discrimination in the field based on your gender, or have you witnessed it? What are your thoughts on why this exists?

I’d just like a little insight, and figured you all would have some more ideas!

Stay safe out there,
Sam

Character Counts

Posted in EMS on October 27, 2010 by medic61
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Last week, I had the privilege to go to a local elementary school and talk to four classes of fifth graders about being an EMT. They were studying the pillars of character for “character counts week”, which include fairness, caring, responsibility, trustworthiness, citizenship, and respect. The teachers had found several people who have professions that embody these ideals to come in. A priest, a coach, and a firefighter also got the chance to speak to the eager children who were happy to have a break from the routine.

I got up in front of the first class and awkwardly started. “So, I’m an EMT…” I said, and wondered where to go from there. It was surprisingly great, however, because the kids seemed to fill all the silences with stories and questions. I finished my little talk and let them ask me more questions. There was a brief lull, so the teacher interjected.

“Sam, do EMTs make a lot of money?” She said this with a little twinkle in her eye because she knew that we don’t, and that the kids probably thought we were on par with physicians.
“Well, no, they typically don’t,” I said, “but I actually volunteer as an EMT.”
“So that means you don’t get paid at all?”
“Right, I give my free time to work as an EMT.”

I saw a little boy’s eyes get very big. His mouth dropped open in shock, and he started to clap. The rest of the class joined in. Immediately, tears came to my eyes, as I was completely caught off guard. The little boy kept this open-mouthed grin, and then said “oh my gosh, when I have free time I just watch tv or play with my friends!” I had told them about how I work two jobs and go to school full-time along with teaching at my church and volunteering on the rescue squad. He looked at me with pity in his eyes and said, “don’t you ever get to play with your friends?”

I know I’m busy, but I’m happy this way. I told him that even though I keep my schedule pretty full, I still find time to watch tv, play video games, and see my friends. He seemed relieved, and accepted this with some hesitation.

What I find interesting, though, is what each class had in common. Without fail, each class asked “what’s the worst thing you’ve ever seen?” I’ve had little kids ask me this before, but for some reason I was unprepared that day. The last time someone asked me about the worst thing I had ever seen, I just blushed and looked at my feet. They don’t really want to hear the truth, but think they do. And to be honest, I don’t really know how to explain to someone the nightmares that still come, or the times I collapsed in the shower with giant sobs sticking in my throat. You can tell them the event that is “the worst,” but you can’t tell them the aftermath. But, after an awkward pause, I came up with a response.

“Whenever anyone gets hurt, it’s always bad,” I fumbled. “I mean, sometimes it’s worse than others, but it’s never good to get hurt. I think that the worst things I’ve seen are car accidents, though, because they’re typically avoidable, and the injuries can almost always be avoided with the use of a seat belt. How many of you wear your seat belts every time you get in the car?”

I watched the hands shoot up in the classroom and smiled. “It’s so important that you remember to wear them every day, no matter how far you’re going,” I said with more confidence.

One little boy, who has my mother as a teacher, said, “your momma told us that she doesn’t leave the driveway until she hears all the seatbelts click. Is that true?”
“Yep,” I smiled, “she wouldn’t even start the car until I had my seat belt on.”
“What about you? What do you do if a friend doesn’t want to wear a seat belt?”
“I just tell them that it’s my rule that I don’t go anywhere without everyone wearing their seat belt, and if they won’t wear one, then they can’t ride with me.”
“Wow…that’s really cool!”

I was pretty proud of myself, to be honest. Never had I been able to turn that painful and awkward moment into a teaching opportunity, and as I saw a little boy mime the action of buckling his seat belt, I had to smile.

Tonight, my mom brought me the thank you notes the children had written me. Almost every one had a star of life, or an ambulance on it. I can’t truly explain how much this meant to me; the sentiments inside expressed that perhaps I had actually gotten through to them a little bit.

So I can share my happiness with you, I thought I’d post a few of them (a few fronts and a few insides) here on my blog. I just love the pictures!

Take care out there,
Sam






Ridealong

Posted in EMS, Miscellaneous on October 11, 2010 by medic61
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It’s been a long time since I’ve done a ridealong with another department; the last one I did was for my EMT class when we had mandatory ride time. I really enjoy seeing how other departments function and getting experience with providers more experienced than I. So, when Rhett (aka The Fire Critic) asked me if I’d like to ride with him, I jumped at the opportunity. It’s not every day that I get to do a ridealong, but it’s even less frequently that I get to ride with an internet celebrity.

Rhett and I met at EMS Today this past year (March 2010), and we had been friends on twitter for some time. I’ve been an avid reader of his blog for ages, so when I found out that we only lived about 45 minutes away, I was floored. We even had some mutual friends on the department, which I thought was pretty neat.

One fine Sunday morning this past month, I made my way up to the department. I had breakfast with the guys and got to meet each of them and hear about how amazing it is that Rhett is riding the ambulance; he usually sticks to the engine ;) I know with ridealongs it’s usually a day full of calls or a completely quiet day, so I was wondering what would happen. Rhett took me back to sign the release, and before I could finish my signature, the tones dropped for a house fire.

Now, it wasn’t anything major, but still, it was a house fire! We didn’t spend too much time there, and right as we cleared from the scene we were dispatched to “amputated toes.” At this point Rhett and his partner started shooting me dirty looks from the cab and mumbling things about busy days with ridealongs! It wasn’t a true toe amputation, but it was close…it reminded me why I’ve never mowed the lawn in slippers.

So after clearing up, we go about the day as usual and I get to hang out with the guys a little more. Things are finally settling down when we get dispatched to a diabetic problem. Dispatch notes state that the patient is “conscious and breathing,” so I expect to see someone with low blood sugar who is easily fixed with some juice or glucose. Yeah, right.

Rhett is getting things from the ambulance while his partner and I go inside. We find the man on the floor in the back room, unconscious. The partner touches him to try and rouse him, and then looks at me; his skin is totally dry, and we suddenly realize that this isn’t a diabetic problem at all. Rhett comes in right as we say “oh shit, it’s a full code.” To make a long story short, we work him all the way to the hospital when all we expected was a little low blood sugar. I couldn’t find my BDUs due to moving recently, so I wore jeans; during CPR I ripped a big hole in the knee, so they are now my “CPR pants” :)

We ran one more call, and it was a welcome relief to do something that wasn’t a huge call! I left after about eleven hours and I was exhausted; it’s not often that I work that hard in EMS! The guys tried to claim that it was me who was the black cloud, but I told them it could just as easily be Rhett, since this was only the third time this year he rode the ambulance!

I had an absolute blast all day, and hope I can ride another shift with them sometime in the future. Rhett also wrote up his account of the day here, so please go give it a look if you have the time! If you’ve never read his blog, definitely give it a read, and be sure to follow him on twitter

Be safe out there,
Sam