27 February 2006

Slow times

I actually have a minute today to stop and blog, so you can tell it must be a slow day. Yesterday, I only did 3 calls, and all of them were mentally out of it, so there wasn't much conversation (although one lady did ask me the same 6 questions 8 times in a 3 mile ride). Today, I'm riding with a paramedic, so we probably won't get hardly any calls at all.

It is weird to be here and be less than busy because I have a million other things to do. If I had my laptop I could be getting some other work done. As it is, I can study (I'm taking the MCAT in April), but there is only so much physics my little head can manage at once. I didn't enjoy it the first time, and I'm not especially enjoying it right now. Now that I've cursed us by complaining that we're slow, we're probably going to sit around until about 4 and then have 5 calls which take us way past shift change (at 6).

**EDIT** Just for the record, we sat around until 4 then did 3 calls which took us until 7p. But at least the one that kept us late we were asked really really nicely to take and thanked profusely by our dispatcher - and it was a nice older woman who had been sitting in the ED nearly all day and really wanted to go somewhere else.

23 February 2006

Yesterday I met a delightful woman who was to be taken to a skilled nursing facility and she asked a hard question. Specifically, "is the place I'm going nice?" I didn't know how to answer that as she was going to a place I do not find especially nice, but telling her that isn't going to accomplish anything because clearly the decision has already been made, and since she was heading to the county facility it might have been the only option her family could afford. I don't know anything for sure about the place, just the couple of times I've been there with other patients, it gives off a negative impression and the staff aren't especially friendly.

I ended up telling her that I thought they would take good care of her, but it still didn't feel right. Too much like a lie. When we got there, I wanted to sink through the floor. They didn't seem to be expecting her as no one on her unit knew where to put her and nobody wanted to help us. It took us almost 5 minutes to find a nurse. Our patient was somewhat forgetful and occassionally had trouble finding her words, but seemed mostly together, talking about her past and her family, and quite on top of the ADLs (activities of daily living). We may have been seeing her on a good day, I know that not every day is the same for patients like her, but this unit did not seem like a good fit. It was locked down, which is not uncommon and not a big problem, and the day room we had to go through the middle of was full of the other residents sitting mostly in wheelchairs and drooling or talking incoherently. 2 nurse assistants and about 15 residents. When we got around the corner, there was a woman sitting 6" from the TV and moaning/screaming constantly, another trying to go through the closed half of a glass door, and a guy rolling his wheelchair repeatedly into the counter.

Our patient can see as much of this as we can and began to looked panicked, as though she was searching for an exit and I didn't blame her for a minute. We left her with 2 of the only 4 staff I had seen on the unit, so I worry what was happening with all the residents we didn't see. It was the hardest place to walk out of and if she had asked us not to leave her, I probably would've broken down and cried because I didn't want to leave her there. The guy I was working with that day didn't seem to get it; the woman I worked with today didn't seem to get it either when I tried to explain it. Everyone looks at me as though it is because I'm new, and maybe they're right, but I prefer to think it is because I can empathize with feeling a little lost and confused in your own mind and then finding yourself in a place like that, with nowhere to go but down.

21 February 2006

Try, try again

We receive most of our dispatching through alpha-numeric pagers. The page generally tells you where to pick up the patient, what their name is, whether they need oxygen or anything else, and where they are going. Sometimes you get 10-15 letters worth of what's wrong with someone, but usually not.

Recently, my partner for the day (J) and I received a page to pick up a patient at an ICU and transport him 45 minutes to the state mental hospital. The page also included a note to stop at the nurses station first. J called in and found out that we were stopping at the nurses station so we could meet up with the sheriff's department as they were going to escort this patient with us. Since we alternate who drives and who rides with the patient, this one happened to be my turn. J asked whether I was comfortable taking the patient. I told him we should wait and see the patient and get a little more information as to what exactly is going on. I'm thinking if the guy is 6'2" and 250lbs and grumpy, maybe J should ride with him because I'm not in the mood to be pummeled or groped.

It turns out that this patient is in a halo (screws in his head, attached to a ring, with support bars going down to a vest) because he has at least one cervical fracture and he also has compression fractures in his thoracic vertebrae. When you're in a halo, you can walk and do most daily activities on your own, you just can't move your neck. Normally the sheriffs take involuntary admission patients in their van, but they've never dealt with this kind of medical equipment and obviously don't want to be liable if something happens and the guy ends up paralyzed. As we're all having discussion with the nurse, we find out that this injury occurred when the guy tried to commit suicide by throwing himself head-first off a building (obviously not tall enough). When he woke up in the ICU, the nurse told him he had to be careful with his neck or he could injure himself and he promptly threw himself head-first out of bed. He was there a week and tried at least three separate times to run off the ward and refused to tell anyone where he was intending to go and so got himself chemically restrained. So the sheriffs were there because he was considered a "flight risk". I'm not sure where they thought he was going to go from an ambulance on the freeway, but having the sheriff there seemed like a good idea to someone.

In the back of the ambulance, it was obvious the ICU had given the guy some good drugs. He was pretty out of it and rather pleasant, after complaining the whole way through the hospital that he didn't want to go in the ambulance and he'd rather just go with the sheriff. The receiving hospital staff really rolled out the red carpet, sending about 6 people to walk the stretcher in with us because the sheriffs aren't allowed on the ward with their weapons. We delivered him with no incident and I sincerely hoped they'd be able to help him since he obviously needed it.

I found out yesterday that he once again threw himself at someone or something head-first and this time succeeded in giving himself "cervical compromise", which likely means permanent paralysis and an end to throwing himself anywhere. I only heard because they were sending another unit from our company to pick him up from the mental hospital and take him to a trauma hospital and those providers couldn't believe it when they heard someone in a halo had injured himself like this. I probably won't ever hear what happens to him in the end, but I hope someone can find the right mix of therapies to at least give him some peace of mind.

19 February 2006

Will work for nothing

Well, I think I can say that I'm now connected enough that any lack of posting is due to sheer laziness. The DSL is in. The wireless works so I'm lounging on the couch on my laptop. The cable is even up so I can watch something other than figure skating on the Olympics. Normally I'd be at work today, but the co. filled most of my shift through the end of the month, so I don't have to go until tomorrow and then I'm going to work on the ambulance 6 days out of the next 7, in addition to finding 20 hours to work at my old job.

I'm thinking of volunteering for the ambulance where K works because I could get emergency experience instead of just transfers, but I'm concerned. Not about time - I can weave time from thin air (or at least I seem to think so lately), and it would be one night a week and rotating weekends. K works at a union shop. The union rep was one of the guys who came over and helped us move in. Mr. Union doesn't want me to volunteer. And has told K so the last two shifts in a row, and told me so this morning when I brought cinnamon rolls as thanks for helping with the move.

I asked him why today, but his answer was "isn't my word enough?". I told him I didn't know him well enough for that, and he declined to explain his reasoning. K thinks it is because if the dept didn't have volunteers, the union would be able to push for hiring more guys. I don't find this to be helpful to my cause. 1. They aren't going to hire EMS-only people, or if they do, it will be paramedics not basics. 2. They aren't likely to hire a woman. 3. I don't especially want to work there (although getting paid for calls like the volunteer ffs do would be nice), I just want to help the people who live in my community and I think volunteering is a good thing that more people should do. The only explanation Mr. Union has given K directly is, "think of the trouble at home", implying that we're going to bicker and fight while on duty and then carry that over to home, oh - and that he should tell me to "volunteer at a soup kitchen if volunteering is so important to her."

I'm worried that someone will make it their task to make life uncomfortable at work for K, or for me when I'm volunteering if they don't want me there. The management seem okay with the idea as long as we can behave ourselves when working together. We've worked together on an ambulance before and it hasn't been a problem. Simply put, K has more training and seniority = he's in charge. End of story. If I wasn't willing to accept that, I wouldn't be suitable to be there. Besides that, I trust him - more than anyone else I would be working with (at least before I get to know people) - and he's a good patient advocate, trying to do the best for people - so what's there to argue about?

K says screw them, if I want to volunteer I should, and he can take care of himself. I'm glad he's supportive of me, but I still have that lingering doubt...

17 February 2006

Rolling along

I think the library people are getting used to me...I'm here at least once a day and all these shiny acoutrements on my uniform definitely make me noticeable. The great thing about it is that I like libraries, I could hang out with books for an extended period of time and be quite happy. The equipment for the DSL connection finally arrived, but apparently the outside work for the line isn't done yet so we aren't hooked up. The wireless works in the house though, so that will be wonderful once we get it.

First real shift as a non-training employee at the ambulance went okay. We rolled all over the area covering a hundred miles or so. I was riding with someone else reasonably new, but at least she's friendly so it was a pretty good day. I joked at one point that we were out "saving lives" (which is a joke because the transfers we do are mostly people who are on the borderline of being able to have their family or a taxi drive them instead) and she scoffed, but our last call of the day was actually someone who needed help and would have benefitted from more care than we could provide.

It was a hard scene because the family was all there and all the women were sobbing. Since the patient was headed directly to the ER, we tried to keep things moving so there wasn't a lot of time for comforting anybody other than the patient. Definitely one of those situations that reminds me of people in my life that aren't necessarily in good health and the ways I would like them to be treated by professionals. Always a good reminder.

11 February 2006

Are we there yet?

Yes, mostly anyway. K and I loaded everything Thursday and two co-workers came and helped us unload on Friday so most of the big and/or heavy stuff is in the new house. I'm hanging out at the town library with their free wireless connection until the DSL is ready, so I'm still not really in touch yet. Current forecast is for large quantities of snow tomorrow, so I may be able to get back down to the library tomorrow and update further.

08 February 2006

Out of service

I've been away from posting for a while now, will be gone for a while more. Closing on the existing place went through today, got the final $$ total for the closing on the new place on Friday and we may even be able to eat when we're done (joking). Completed 30 of my 40 hours of on-the-job training at the new job, hopefully to start regular shift next week. Internet access may be spotty until "can you hear me now" gets their act together to send us the DSL connection equipment, so fear not if I appear AWOL.

04 February 2006

Learning the ropes

Okay, so I've been trying to learn about this whole "saving lives" idea, but I have to admit it is quite different as a job. Three days of in-house orientation consisted of a lot of "company policies" and cya insurance issues and big-brother methods of tracking everyone. Day 1 of riding along consisted of feeling as though I had no idea what was going on. The truck I was riding on was assigned to ALS transfers - which means there were two providers more highly trained than I am to haul people back and forth.

We were in the city in the morning and our first call was actually a 911 response since all the other trucks were busy and we were less than a block from the call. Lights and sirens, check. Patient requiring lights and sirens, no. Second call was actually a transfer for a patient with a heart condition at the local hospital who needed to go to a higher level hospital. Lights and sirens, check. Hour-long drive in pouring rain which included hydroplaning and dodging massive traffic, check. Realization that I think I might just kill someone if I had to drive in that traffic, check. Last call was to take an older gentleman to a rehab facility after being discharged from the hospital. No lights and sirens, lots of nurses with no idea what was going on.

I spent pretty much all day feeling stupid. I have no idea how to do all the paperwork that needs to be completed. I couldn't get their stretcher to work because it is different from the ones I've finally gotten to know locally (although the training officer did spend 15 minutes having me raise and lower and load and unload the stretcher in the afternoon, so hopefully that will go better next time). I couldn't find a pulse on one patient, couldn't get a second blood pressure on another. Hmph. And I don't even get to see the station I'm going to work out of until next week, and even then it will only be one day so I'm not going to have any idea where I'm going. Don't think I'm complaining, I wanted a challenge, I just didn't expect to feel like a moron.

02 February 2006


Conscious, alert, and officially oriented - I guess that's an adequate description of me right now. Able to rub two brain cells together into a coherent thought...not so much. Four hours round-trip every day is somehow completely exhausting and tomorrow is my first ride-along day and a 10 hour shift. Maybe I'll have something to write about over the weekend so everyone stay safe until then.