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I’m a racist

May 21, 2013 by 2 Comments

Working with a new lady today. Somehow politics came up. I tuned the radio to Rush while I was driving her to the hospital. She seems mad, and I can see a chip developing on her shoulder.

“Who did you vote for in the election?”

That’s kinda personal, and not something normally asked, but whatever. “My guy didn’t win.”

“Romney?”

“Actually, no. My guy lost in the primaries. But I think Romney would have done a fine job.”

“Why didn’t you vote for Obama?”

“I believe in personal freedom and responsibility, not handouts. He and I disagree on the role of government.”

“You just don’t like him ‘cuz he’s black.”

—-

Look, if a person votes for a guy who gives him a check, I get it. It makes sense. People tend to like other people who make their lives easier.

But if you are voting for a guy based on his skin color, that is racism, and it makes you no better than the person who votes against a guy based on his skin color.

The latter is called bigotry, by the way.

Filed Under: Co-workers, Politics

That duck can pull a truck

May 9, 2013 by 2 Comments

The call is for a middle-aged man with “altered mental status not breathing normally.” I’m responding with the ambulance crew and a fire crew to the apartment complex address listed on the MDT.

I arrive on scene as the ambulance crew is making their way inside. I know the medic fairly well. He did all of his intern rides with Slimm and I, and he is good at his job. I know he won’t need me, but I would like to see him working on his own. The fire crew has been there several minutes.

I walk in to see the fire crew taping down an IV in the patient’s arm. “It’s a white-out, C” says Ashley the medic, with his thick drawl. “Suggah is thutty.”

(Think Kevin Bacon in JFK. Not Costner, because his attempt at a southern accent was piss-poor.)

I see Ashley and his partner spiking a bag of saline while a fire crew member is reaching into his bag for the D50.

“Hey, b’fore y’all go ‘head and push that dee-fifty, let’s mix it up in this bag right here.”

“But he needs the sugar. His glucose is really-”

“I know, I know, but we should mix it up in this right here bag instead’a givin’ it straight in the vein.”

“That doesn’t make any sense-”

“Look, now. If I tell you that duck can pull a truck, then hook that duck up! Lemme show ya’ ” Ashley replies, grabbing the syringe, attaching a needle, and mixing it into the bag of saline.

“Now, what we got here is dee-ten. It’ll wake’em up just tha same, but it’s just less shockin’ to tha system” he explains.

I know exactly what he is doing, because that is my preferred method of dextrose administration.

The patient wakes up quickly, and I glance at the bag. About 100ml are in so far. Somebody repeats the glucose stick. “Eighty-nine.”

“Now see, he’s had a hunnid of dee-ten, and he’s already awake. Ain’t that suggah better’n givin’ tha whole amp and jackin’ it up to tha three hunnids?”

Apparently, when a Southerner tells you that a duck can pull a truck, you are supposed to shut up and hook that duck up.

Learn something every day.

Filed Under: Case studies, Co-workers, Education, Patients

First things first

May 1, 2013 by 2 Comments

I’m responding to assist on what was dispatched as a “possible overdose.” Really, I’m just bored, and this sounds like it might be slightly amusing.

I arrive shortly after the ambulance, and make my way into the decrepit house. I overhear the medic talking with someone in the house. This seems to be a regular occurrence at this home.

Around the corner I find the other medic fiddling on the ground next to an unconscious person. The monitor is on the floor, and off. The jump bag is on the floor, not open.

The medic on the floor has a tourniquet around the patient’s arm, patting the antecubital.

The patient is an interesting shade of blue. And I don’t see chest rise.

“Hey, maybe we should grab that airway first, and bag this dude or something” I suggest.

“Thanks, man. We got this.”

Yet somehow, I’m the asshole.

Filed Under: Case studies, Co-workers, Emergency

I don’t like to take riders

March 10, 2013 by 12 Comments

I don’t like to take passengers in the ambulance with us to the hospital. They are a distraction to me in the back, the patient, and to my partner, who theoretically could be referred to as an “ambulance driver.”

Gasp. I said it.

But yeah, I prefer not to take riders. I don’t really mind if a husband or wife wants to ride along, or a parent of a young child wants to ride along, but that’s pretty much where I draw the line.

So we get called to an office tower for a “female in her 20s with difficulty breathing.” I know what you are thinking, and no, it was not a panic attack. Turns out the office was painted or something, and the fumes triggered her asthma.

Poor girl. (She is better now.)

Her boss approaches, wearing an ill-fitting pantsuit with an air of attitude about her.

“I’m going to ride to the hospital with her in the ambulance.”

“Actually, we only take riders if they are family. You are welcome to follow in your car if you would like. Maybe you could give her a ride back to her car when she gets discharged?”

“No. I’m going to ride in the ambulance with her.”

Now, in general, I don’t appreciate when people tell me what they are going to do, I prefer that they ask me. Unless it’s vomit related. Then a person is free to tell me they are going to vomit.

“Well, actually, we have a policy that says only family members can ride to the hospital in the ambulance, I’m really sorry.” I catch the eyes of the patient during this conversation and I can see her trepidation. Something is on her mind, and I have the feeling that I am doing the right thing for the patient.

“I want your supervisor’s phone number!” she yells at me.

“No problem” I say, handing over a business card with the requested phone numbers.

After loading the patient in the ambulance and giving her some medications to start fixing her situation, I ask the patient about her the medications she takes aside from the asthma. She is a healthy appearing woman, so I don’t expect too much.

She starts rattling off medications that sound familiar, but that I don’t hear often. I stop writing, and look at her as her office building begins disappearing from the rear windows.

“So what kind of medical problems do you have?” I ask her.

“I have asthma.”

“What else?”

She hangs her head a bit and her voice cracks. “HIV.”

“How long have you known?”

“Only a few months” she replies, and her eyes begin to water.

We spend the next twenty minutes checking vital signs, talking about what she does at work, and (seriously) the sequestration crisis.

As we pull onto the hospital ramp, she looks at me, her eyes asking the question.

“You aren’t going to tell my boss, are you?” she asks.

“I wouldn’t tell your boss, even if I was allowed to. Nobody here will tell her anything, and they will keep her out of your room if you want.”

She seems relieved, and I am glad that I could comfort her in some way.

—

Somebody tell me that she would have felt comfortable telling me such private information with her overbearing boss ten feet away.

It wouldn’t have happened.

So only family rides.

 

Filed Under: Co-workers, Customer Service, Patients

Do your time first, hero

February 18, 2013 by 8 Comments

I can remember the day I first started in EMS like it was yesterday. It was a brisk November morning about 15 years ago. I was really excited to save lives and be a hero and get on the news, and all that. I had a fancy stethoscope that I bought at the College’s bookstore (for like $10! What a deal!) around my neck, a neat black glove pouch on my belt, and a nice trauma shear/bandage scissor combo that I had in my right leg pocket.

I was a hero.

I was also too young to buy alcohol, so cut me some slack, okay?

As I strode into the station, I admired the sharp creases that I had spent countless minutes and an immeasurable amount of starch ironing into my patches. Then I saw him: my new partner.

He was about six-three, and easily weighed three hundred pounds. And it wasn’t necessarily “fat” pounds, either. This guy was built like a defensive end. And his face was mean, too.

“Damnit. Another new kid! They always put me with the new kids.” were the first words out of his mouth. He sounded, in a word, angry.

“Hi, I’m C” I introduced myself in an effort to break some ice.

“I don’t care who you are, or what you think. Keep your mouth shut and do what I say, and you will do just fine.” was his reply.

While his reply was gruff, I listened to it, and heeded his advice. I kept my mouth shut, and I did what he said, and we got along great. He taught me a lot, and I am grateful for his tutelage. I didn’t get my feelings hurt, and I wasn’t offended by his manner. I was really okay with it. He was the veteran, and I was the rookie, so I knew he could teach me a thing or two, perhaps even three.

But nowadays you can’t get away with that. You have to treat the kids with the “kid gloves.” You have to be all tactful and mindful of the self-esteem of the new kids. Especially when they are kids.

Saying something like “I’ve been doing this since you were in Kindergarten, and we need to do things a certain way” can’t be said. Because the new kid runs to the supervisors and tattles on you, saying “he was really mean to me and hurt my feelings, and I need to cry about it a little bit, but he needs to get in trouble!”

There is a lot that the new people could learn from those that have been around for a long time. It’s just too bad that I have to be concerned with someone’s feelings. Especially when I have been in EMS since they were in Kindergarten.

Filed Under: Co-workers, Students

The fine line between personal and professional

February 15, 2013 by Leave a Comment

I can appreciate concern for another coworker’s well-being, I really can. Bad stuff happens to the good guys.

And it is a nice gesture to offer an ear to listen or a shoulder to lean on or a cold beer to drink followed by the other two. But demanding someone talk to your ear or lean on your shoulder or drink your beer is going a little too far.

People deal with their own demons in their own way.

There is a fine line between being concerned and being to nosy. When someone tells you that their private life is none of your business, they probably mean it. When someone can continue doing their job like they always have, without their private lives impacting their work, then the offer of the ear, shoulder, or beer is enough

We can’t demand that people talk to us about their problems. All we can do is offer to listen.

Filed Under: Co-workers, Psych

False competence

January 23, 2013 by 6 Comments

Double-ALS-night-shift-overtime. Half good, half bad. I don’t know why I agreed to work a night shift.

It’s going easy enough until around 3 in the morning. Diabetic call at the local premortuary sepsis factory decubitus plant nursing home. Easy enough, right? Throw some dextrose up in there and be done with it, right?

Wrong.

The staff says he must go to the hospital to be evaluated because the doctor says so. To complicate matters, we can’t get a line on this guy, who I swear, must have served in the first World War, and he has a long history of dementia, so who is to say what his normal mental status is, anyway?

Fine. No biggie. Stab him with a bit of Glucagon, move him to the stretcher, and drive him to the hospital. No big deal, right?

Wrong.

It’s my turn to drive. It’s going just fine. I’m listening to George Noory talk about aliens over the Pacific Northwest. It’s an easy drive over two lane roads dappled with houses. When all of a sudden…

“Hey, C, light it up, okay?”

“Dowhatnow?”

“Turn on the lights and sirens.”

“Huh?”

“Let’s go emergency!”

“Why?”

“His mental status isn’t improving.”

Taking a glance at my watch and doing some quick calculations, I realize ten minutes isn’t necessarily enough for Glucagon to work, and this guy has dementia anyway.

“Umm, you want me to get back there and ride this call?” I ask.

“No, I’ve got it. We should just get there faster.”

“I have faith in you. And the next three traffic lights won’t hold us up too much.”

—–

I’ll stop the story here, because the conversation became fraught with animosity. Suffice it to say, I don’t believe in traveling emergency to the hospital, except in extreme circumstances. I won’t judge someone who chooses to use the lights and sirens during some calls, but during a hypoglycemic episode, when there hasn’t been enough time to allow the drug to work, and the vitals are better than mine? No way does that warrant lights and sirens.

Especially not at three in the morning.

Let’s not trick ourselves into thinking we are heroes by running people off the road to get to the hospital.

Maybe services could review the calls in which the medic decided to utilize lights and sirens during transport. I bet there is some interesting information out there.

Filed Under: Case studies, Co-workers, Emergency, Lame, Partners, Patients, Things that bother me

Not a cop

January 16, 2013 by 1 Comment

I don’t take people to jail. That is kind of the opposite of what I do. Although I will admit that my uniform can certainly make me look like a police officer to the uninitiated or inebriated.

“What’s this guy here for?” asks the nurse with the voice and demeanor of someone who could only be described as ‘bitchy.’

“He had a little too much to drink last night, and was taking a nap at the bus stop. He was trying to catch a bus down to the Catholic Church for the free breakfast, but he missed it.”

“Why isn’t he in jail, like he should be?”

“Because he is hungry, cold, and tired. Your hospital has food, warm blankets, and soft beds. He needs a nap and a snack, then I’m sure he will be out of your hair pretty quickly.”

“Well, he should have gone to jail.”

 

It’s not against the law to be drunk. It’s not against the law to take a nap at a bus stop. It’s not against the law to be homeless, hungry, cold, and tired. No cop I have ever met around here is going to take a guy to jail for sleeping off a drinking binge at a bus stop.

It is also not against the law to be a bitch. But being a bitch doesn’t get you anywhere.

Sometimes I wonder if particular nurses have a crappy attitude because they always get the stinky drunk patients, or if those nurses always get the stinky drunk patients because they have a bad attitude.

Filed Under: Co-workers, Customer Service, Things that bother me

Back pats

January 11, 2013 by 12 Comments

In the world that is EMS, write-ups, disciplinary action, whatever it may be called is to be expected. Usually, some goofus complains about something that is completely not important, or relevant, or even true, and a ‘paper trail’ has to be started.

Out comes the proof that management had a talk with so-and-so about how it isn’t appropriate to blow snot rockets on the hood of a car during an extrication.

I swear, you get one stuffy nose…

So yeah, the paperwork is expected. And it’s cool. But what is more important are the commendations. The ‘attaboys’ for doing a good job, or catching something that others might have missed, or for getting a nice letter in the mail to headquarters.

The attaboys are fewer and farther between than the other paperwork.

So, if you are in management, keep that in mind. If you find yourself slapping a lot of wrists, find something to pat a back for. If your employee never gets their back patted, and only gets their wrist slapped, maybe they aren’t the kind of employee you are looking for.

Praise is good.

Filed Under: Co-workers, Customer Service, Politics

IV access

January 7, 2013 by 2 Comments

Look, I’m pretty good at starting IVs. Seriously. No boasting about it. I was lucky enough earlier in my career that my Paramedic partners always let me get the ‘first stick’ on each patient.

I got a few, blew a few, and missed a whole lot more. But that’s okay, because the Paramedic was there with more experience and sticks to get the line that I couldn’t.

I do the same thing with Slimm; he gets to stick every patient first. And he is good at it, too. He gets easily 80% of his attempts on the first try. No kidding. There are the ones he doesn’t think he can get, so he defaults to me. We are working on him trying the harder sticks, but he is hesitant some times.

Between the two of us, when a person needs IV access, we usually don’t have any trouble getting it done.

I enjoy when a patient tells me they are a “hard stick” only to be surprised when I snake an 18 in their forearm on the first try. Blindfolded. Left handed. Going over railroad tracks. In a tornado.

Which isn’t to say that we attempt IV access on lots of patients. I don’t believe in the “if you are sick enough for an ambulance, you are sick enough for an IV” train of thought, though I won’t fault those who believe that.

We probably stick 25 percent of our patients. And between the two of us, I would imagine that we are successful 95-98 percent of the time. But we should be that good, right?

That being said, when we roll into the Emergency Room with a patient who is in need of IV access, that doesn’t have it, you can rest assured that A) we tried several times, and B) we weren’t successful for whatever reason. So the smug looks and comments really aren’t necessary.

Before anyone makes snide comments, they should probably do so after they get the stick on the first time, and before they call the physician into the room to put in a central line. Especially when the patient’s arms look like a pincushion after eight attempts.

On a similar note, when we roll into the Emergency Room with a patient who does not have an IV, and there isn’t any evidence of EMS attempts, then you can safely assume that we did not think stabbing a patient just for the sake of stabbing the patient was necessary. And when you look at me or my partner with a rude face and say “these patients really need to have an IV before they come in here,” don’t be surprised when we look back at you with the exact same face you are giving us and say “Why? To make your job easier?”

Have a nice day.

Filed Under: Co-workers, Customer Service, Hospital, Patients
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