Well-earned complaint

Shaq and I are running a non-emergency for a female who is weak. Which means there is absolutely nothing wrong with this woman. This is the same county that requires emergent response to ear aches, so use that when assessing the severity of this call.

According to the notes, she “doesn’t feel good.”

Call me a library book, because I’m already checked out.

We find this lady sitting in a chair in her living room. I wish I could say she was watching Maury, but the television was off. Shaq does all the talking, and we learn that she “doesn’t feel good.”

Chalk one up for the call-takers. Good job, everyone. Strong work.

We move the stretcher a little closer and Shaq asks if she can stand up to sit down.

“Oh, no, I’m just too weak.”

“Well, ma’am, forgive me for asking, but how did you get in that chair in the first place?”

“Oh, I walked here, but that was several hours ago.”

Mind you, I’m still checked out, and I only have vague recollections of what transpired next, but it ended with us lifting her out of her chair and putting her on the stretcher.

“Which hospital would you like to go to, ma’am?” he asks.

“Oh, I have to go to North County, they have my records.”

“That certainly won’t be a problem. C knows how to get there.”

“You guys aren’t going to put me in that…that…room with all those Mexicans, are you?”

“Well, ma’am, I’m not really sure what you mean. We don’t have anything to do with room assignments at the hospital.”

“Well, I don’t want to be in that room with all the Mexicans.”

Then he lets loose. “That hospital takes care of all sorts of people, ma’am. They take care of Mexicans, Indians, Canadians, Africans, Jews, Catholics, Asians, Russians, Italians, Australians, Caucasians, Muslims, Christians, and everyone in between-”

“-that’s not what I meant-”

“-they will even take care of bigoted American women. Now let’s go.”

The rest of the ride was real quiet. And then we got to sit in the supervisor’s office for a little while.

But it worked itself out.

Imagine this

Imagine if you will, an ambulance service decides to make every “patient contact” require either a refusal signature, or a transport. Imagine there is no more “false call,” or “no patient found,” or “no EMS needed” options for call disposition, only a patient refusal or a transport to an emergency room.

Imagine that the service ignored their definition of a patient, which used to be “a person who is ill or injured who requests, or would request, emergency medical attention.” Imagine if that new definition included:

  • People sleeping in cars
  • Accidental medical alarm activations
  • People in car crashes who didn’t request EMS
  • A guy changing a flat tire
  • Passengers on a school bus which struck a mailbox

Imagine being told by dispatch to chase down a guy in a grocery store who was sleeping in his car, waiting for the store to open.

Now, imagine if you will, the ambulance service issues “report cards” to their employees, and one of the categories in which they are evaluated is their “Transport/Refusal Rate.”

Imagine that your yearly raise is directly tied to your “Transport/Refusal Rate.”

Imagine how angry you might be.

It worked

The drug overdoses (that either aren’t dead, or are awakened) always go the same way: Shaq and I stand around with between four and six firemen, and at least two police officers for upwards of an hour trying to convince this guy to go to the hospital.

And they always wind up going. But we waste a lot of time.

The cops can’t threaten these patients with arrest, because the state has an amnesty law. Basically, if a call for help is made, then a cop can’t arrest for drugs that are found out in the open. I think that is a bit ridiculous, but it is what it is.

Doctors won’t commit these patients involuntarily, so we can’t threaten them with that.

Usually it is just a matter of wearing the person down.

And it gets tedious.

So we ran one of those today. A guy in his thirties relapsed, and shot some heroin after being sober for two years. This guy can’t help that he’s an addict, but he certainly has to take responsibility for shooting heroin into his veins. It turns out his ten-year-old son found him lying in bed, not breathing, then called 911. The son woke the patient with a glass of water splashed on his face.

And enter Shaq and C.

There’s the requisite crew standing around: six firemen, two cops, one shirtless guy with dirty hands sitting on the floor, and one crying mother in the living room. Of course the patient first attempts to deny that he did the drugs, then admits to it when confronted with the full syringe in the bathroom. Then he says he is fine, and doesn’t want to go to the hospital. Shaq and I are standing kinda in the background when he nudges me: “watch this, dude.”

Shaq makes his way to the shirtless guy on the floor, and stands all of his 78 inches over the guy on the floor. Kneeling down to get somewhat on his level, he delivers an excellent oration:

“Hey, dude. Check this out. You’re going to wind up going to the hospital with us today, that’s a fact. You say you don’t want to, but you’re going to. These guys in light blue? They’re from the fire department, and they get off at 7 in the morning. These guys in dark blue, they’re cops. They won’t arrest you, but they won’t leave until we tell them it is okay for them to go. Your mother out there in the living room? She’s calling your wife at work, and she already called your father. They are both on the way over here. Between the twelve of us, we will wear you down like a cheap pencil, and you will walk down those stairs, and you will sit on our stretcher, and you will go to the hospital. So what my partner and I are going to do now is walk outside. We are going to go outside to your front door, lower our stretcher, raise the head of it up, and undo the seat belts. And then we are going to stand there, and stand there, and stand there, until you walk outside and sit on our stretcher. It’s up to you how long that takes, and how much bitching you want to hear from your parents and your wife. When you’re ready, we’ll be outside.”

Then he stands up, turns to me, winks, then walks out.

I’m dumbfounded. I just witnessed a sentinel moment. So, I turn on my heels, and follow Shaq outside.

We barely make it outside before he’s trying to sit on our stretcher.

We’ve been on scene for less than five minutes, and now we’re leaving. On a call that would typically take at least half an hour.

I can’t wait to try that again.

Dispatching Wolf

“Med four, call radio please.”

Sigh. I hate when they want us to call on the radio.

We have radios. They are called ‘radio’ (or dispatch, depending where you are, whatever) for crying out loud. We have multiple channels that we can talk on, and they have the ability to contact us directly through our radios.

They can even send messages to us through our MDTs.

But they want us to call them on the phone. I hate talking on the phone.

And it’s never for anything important that couldn’t be handled some other way. It’s always crap like “hey, you guys have a call coming out soon,” or “do you have a phone number from that lady from that wreck six hours ago?” or “did you guys see a purse/license/keys/stuffed animal in the back of the truck? A patient from two days ago is missing it.”

  • I don’t care. Just dispatch me when it’s time to go.
  • What lady? No, I don’t have her number. It’s on the PCR.
  • Yes, I found it, and I sold it on eBay.

I cannot stand talking to radio on the phone. Well, frankly, I don’t like talking to them on the radio either. Shaq and I came up with a new strategy:

“Medic four, can you call radio?”

“No, ma’am, we can’t. Neither one of us have a cellphone. But we can switch over to private.”

Burn

Shaq and I are dispatched to a suicide attempt by carbon monoxide poisoning. The MDT says someone has been in their running car in the locked garage all night. The caller says the person is still alive, and that they have turned the car off, and opened the garage door.

PD has us staging down the road.

It’s barely 5 in the morning.

We didn’t get breakfast this morning.

And I haven’t tucked my shirt in yet.

PD clears us to come in to the house. They gave me just enough time to tuck my shirt in.

As we get close, one of the cops stops us in the street.

“This guy is being a jackass, and he might have a weapon in the car or something. So just hang out here for a little while, cool?”

You don’t have to tell me twice. “Cool, bro. Just let us know when to do what.”

So Shaq puts the ambulance back in park. I start to wonder what the hospital is serving for breakfast in the cafeteria. Maybe they’ll have those cheese grits again. Or the hashbrown casserole. My culinary contemplation is interrupted by a knock on Shaq’s window.

Some guy in a bathrobe obviously needs some attention.

“Yes, sir, can I help you?” asks my partner.

“Yeah. What’s going on up there?” pointing at the house in the cul-de-sac. “What happened?”

“Nothing, really. The police are taking care of everything.”

“Well why is the ambulance here?”

“I’m not really certain, sir. I imagine that someone is sick.”

“Well, what were you dispatched to?”

“I’m not really certain I can tell you that.”

“Don’t you know who I am?”

Shaq looks at me. I shrug. I’ve only halfway been paying attention to their conversation, anyways. “No, sir. I don’t believe we have ever met.”

“I’m one of your medical directors, Doctor Bathrobe.”

This just got interesting.

“Well, Doctor Bathrobe, you should certainly be aware of the fact that I’m not supposed to share any information with the general public. That could possibly be a HIPAA violation. If you would like to call dispatch, I am certain they would be happy to give you any information you desired.”

Lame excuses

My employer runs a paramedic program. When I say that the company runs a paramedic program, what I want you to take away from that is that the company supplies a physical location for a paramedic program, and students to fill the chairs.

But, they attached the words “EMS Academy” to it, so maybe it is sorta-kinda-official.

Whatever. It’s a moot point.

My employer runs a paramedic program.

Being one of the company’s Field Training Officers, I get to see the aftermath of the paramedic program, when the newly graduated paramedics spend several shifts riding with me. Some of them aren’t prepared, but most are.

I was having a talk with another FTO, Tony, while at the hospital a few days ago. This must have been early in a shift, because I actually cared about the topic.

Tony mentioned that he rarely sees the same paramedic student more than twice, and that each student does at least twenty rides at our company. He thought it would be wise for a student in our paramedic program to be ‘assigned’ to an FTO for the duration of their preceptor rides.

While we’re on the subject…our program is putting paramedic students on ambulances for their preceptor rides after three months of school. They don’t know how to read a monitor, and they aren’t allowed to perform any ALS interventions. What the hell is the point of riding for twelve hours on an ambulance if you can’t do anything?

Anyway.

Tony made a good point. After ten rides or so, there should be a pretty good rapport between an FTO and a student. They should be able to communicate openly with each other, so the student can get the most out of their classroom time, and their ambulance time. After twenty rides, any bad habits should be corrected, and the FTO can feel confident in his evaluation of the student. Alongside the FTO’s confidence in his evaluation, the course director can feel confident in the evaluations he gets from the FTO.

But instead, the students just ride whenever, and wherever. Rarely more than once with the same paramedic, or even with an FTO.

So Tony and I brought it up to the director of the program.

“Assign each student to an individual FTO. We have twenty-five students, and eighteen FTOs. Surely we can come up with a list of seven competent medics to fill the roster of needed FTOs. Once a student is assigned to an FTO, that student does all of their rides with that FTO. It only makes sense.”

We got a reply:

“Well, that would just be too hard, and we don’t want to make it any harder on the students.”

This is why I don’t care.

Lame-ass excuses.

Smoothie

“Male assaulted. PD on scene” reads the MDT. It’s raining and traffic is heavy, so I have to actually pay attention to the roads instead of the book I was reading.

I’m reading the new Grisham book, Gray Mountain. I can’t recommend it yet.

We finally make it on scene to find a guy in his early thirties standing with local law enforcement in the living room of his apartment. He has blood streaming down his face, and he is holding a towel against his head.

Shaq is taking the lead on this one. He’s going to be in Paramedic school soon, and needs to get used to assessing patients. Plus, he is really good at it. Good enough that I rarely have any questions for my patients, or tips for my partner.

After sensing an opening in the conversation with local law enforcement and the injured gentleman, Shaq breaks in:

“Man, what happened to your head?”

“That bitch hit me with a smoovie!”

“A smoothie?”

“Yeah! A smoovie!”

A glance at the gentlemen with the firearms confirms the previous point: they have no idea what is going on either, and how a cold fruit emulsion could have caused such a wound.

“She hit you in the head with a smoothie?”

“Yeah! I said that already!”

“But how did it cut you like that?”

“Cuz it’s heavy, man! Damn!”

“But, it’s soft, and it’s in a styrofoam cup or something.”

“Naw, man! It’s heavy!”

“A smoothie is heavy?”

“Yeah, man. Heavy. One of them things you smoove your clothes with!”

“One of the things you smooth your clothes with?”

“Yeah!”

“But, I don’t really…I’m confu-oh! Do you mean an IRON?”

 

Shaq

I can’t think of what to name my new partner. So I came up with Shaq.

He’s like 8 inches taller than me, older than me, and likes basketball. He said he wanted his blog name to be Shaq, so it is.

So that settles it then.

I still miss Slimm.

But this guy is pretty cool.

Classy, mom.

I’m listening to my student talk to the mother of a child who fell and hit her head. Ain’t nothing wrong with the child, but everyone already knows that. We’re going to the crappiest hospital in the county to “get her checked out.”

Of course.

So student is sitting there just chatting away with this lady. Which is quite alright with me, because it gives me the ability to focus on Angry Birds catching up on paperwork.

This guy isn’t burned out yet. I can tell, because he is asking about stuff that I don’t care about.

“So she is your youngest child?”

“Yeah. We have two others. Two boys.”

“What are their names?”

“Well, the oldest boy is named ‘Rex’, because his daddy is Mexican, and ‘Rex’ is Spanish for ‘King.’* The next one is named ‘Prince’ because if you have a king, you have to have a prince, right?”

“Right. Well, I figured you might have named her ‘Princess’ since you already have a King and a Prince.”

“Oh, we didn’t think of that.”

“How did you come up with her name?”

“Oh, I named her ‘London’ because we were watching that fancy wedding on TV when we made her.”

This might be the classiest lady I run across ever in my life time.

 

*It’s not.’Rex’ is Latin, and this lady is an idiot.

Where are y’all coming from?

Lately I have noticed more and more traffic coming to my blog, and its Facebook page. Somehow, ‘likes’ on my Facebook page have more than doubled in the past few months.

Not that I’m complaining or anything, just curious to know where everyone is coming from.

I thought it was just Flash and my mom that were reading this blog, but I’ve been proven wrong again.