28 August 2008

Hurricane preparedness

Today the ambulance co. asked for volunteers to potentially deploy to the southern US if FEMA should request them for areas affected by the hurricane. I actually had to go search around for which hurricane we were referring to, the last one I heard about was Faye. But this readiness is related to Gustav, which is still at least 4-5 days from the landfall in the US.

I'm not sure how I feel about all this agitation over a storm that is difficult to predict. My family tried to evacuate per government orders for an oncoming hurricane (Rita) that missed their area but left them stranded on the highway, out of gas with a small child. After watching the limited and difficult disaster response to other natural disasters, I'm torn between get people out of the way and just get them as much help as quickly as possible. The US highway system is not designed for the amount of traffic it handles daily, much less when you try to evacuate a large metropolitan area.

I did volunteer to go, but the means of selection within the company are kept in a locked box in a mysterious smoke-filled room, so even if we get tapped to send people and/or trucks, who knows whether I'll go. I feel like I would want people ready and willing to come help my family so I should be willing to help others. Just thought you'd want to know, I'll try to post either way.

EDITED 8/29: Definitely not going, the selection process didn't go my way.

20 August 2008

Only in the movies, or maybe TV

In response to this post on things patients expect to happen because they see them in the movies. I had a recent interaction with a patient where I thought pretty much the same thing.

On scene of a two car accident, one car pretty smashed up, spun 180 degrees, cool skid marks on the pavement, the whole deal. Driver was fine but a bit unsettled by the whole thing. I was talking with her about how it happened when she suddenly stands up and looks at the rear of her car, "Oh my god! Look, he almost hit the gas tank. Oh that would be horrible. What would've happened then?" I promise, I tried not to laugh. "Ma'am, it wouldn't have exploded or anything. That only happens in the movies." "But, but...the gas tank!?" "Yes, I see it. It would've made a puddle and been kind of inconvenient, but no explosions or anything."

She still didn't believe me.

19 August 2008


In this lovely ambulance co, we have Road Safety. Essentially, a data recorder keeping track of everything that goes on in the trucks. How fast you drive, whether you're wearing a seat belt, how quickly you corner, how aggressively you accelerate, how often you stop abruptly, whether or not you have a "spotter" for backing up, whether your emergency lights are on, whether your headlights are on, I swear the list is nearly endless. As if it isn't aggravating enough to feel like you're being constantly watched, most of these criteria are also attached to an audible alarm in the truck so you know exactly when you are exceeding the recommended levels.

Some years, the six month summary is made available on each employee's driving record so you have time to "improve". The records are supposed to be anonymous so you can't find anybody's record but your own. The company sets acceptable levels of how many "naughty" noises you can receive and still be employed. That level amounts to one mistake every 8 miles, not a terribly stringent standard. And yet, somehow the standard is not the standard.

A supervisor, not the one who does my reviews, pulled me into the office to discuss my driving. Not based on complaints from anyone but based on the six month summary. I am meeting the standard, but not meeting his expectations. "You really need to do better. Just because you drive so many transfer miles shouldn't excuse this." Hmm, here I thought that was exactly the point of tracking miles per error because the more you drive, the more likely it is that errors could happen which don't entirely reflect your ability.

I suppose as a paramedic and a supervisor, it might be easy to forget a couple of key facts. 1. Many times when he is driving, the patient is not critical - I know this because he is driving. Many times when I am driving, the patient is critical and time is a factor so I am working to drive both safely and quickly. Lights and sirens on 911 calls where we run all the time is not too bad. The same through a large city with narrow roads, limited room to adjust, and the potential for getting lost is a challenging driving environment. 2. If the company sets a standard and an employee meets it, that should be the end of the official story. A constructive suggestion, maybe. Angry words and "disappointment", no.

18 August 2008

Swap, drop and schedule

In general, I like the freedom of working on the ambulance. Freedom in the sense that I work: Tuesday night, Thursday day, Friday day, and Saturday night. 48 hours a week. That means that all the days and nights NOT on that list are mine to spend like my last quarters into the snack machine of life, mmmm Reese's. I don't actually succeed in having quite as much entertainment as all that considering I work at the office job and studying my ever-growing behind off, but it is nice to think I have so many days to myself.

There's always a downside. In the case of this ambulance company, it is the current shortage of actual working per diem employees and an extreme shortage of overtime approval. These two things together equal a whole lot of "vacation denied" messages when you want even a single shift off. Unlike the office job, if I stay home sick, someone has to fill my seat. Instead, you find yourself wheeling and dealing for trades. I'll work X day if you'll work X+2 day. People monkey with the schedule to build themselves 24 hour shifts and cut down commutes. People switch around for semesters at a time to get the M-W-F or T-Th time they need to take a class. Some just dislike certain partners or supervisors.

This company has an on-line scheduling program, leading to multiple daily emails on currently available shifts, and multiple telephone calls from people looking to fill shifts. You need a strong disposition to say no but enough flexibility to help people out for an exchange at a later date both individuals and supervisors. Very political, very annoying.

17 August 2008

Things I probably shouldn't have said

Patient had just wrecked BMX bike on a large curb.

Pt: "What happened? I don't even know what happened."

Me: "Apparently, you aren't very good at riding your bike."

Shouldn't have said it because the paramedic burst out laughing in the middle of his assessment. Oops. Patient not very hurt and will never remember.

05 August 2008

Whatchya gonna do when they come for you?

Saturday nights are unparalleled for their entertainment value. Many folks go out, drink, carouse, and then cause trouble for themselves or others. Not all of these calls are entertaining, but some of them make up for the idiot 22 year old drunks vomiting all over themselves.

Dispatched for a "man down" outside a residential address. The FD arrives just behind us and everybody hops out. No man down, no men at all. Local resident pops out, "He was just layin' there, wouldn't wake up. Then these two guys, they picked him up and carried him off that way. I was afraid they was gonna mug him or something." We do the best we can to get a specific direction from him and head off in search of this sleepy drunk who has likely been located by his friends and taken into an apartment unknown. We receive an update from dispatch that they have received a report of shots fired at an address less than a block up the street. A fair amount of searching leads to a whole lot of nothing and we prepare to clear.

As we're walking back to the trucks, a young woman and a boy come running up screaming and crying about a baby being hit and where are the police and ohmigodohmigodohmigod. She wants us to follow her and check out the kids she states are being abused and immediately heads up the street, directly to the address with the reported shots being fired. Internal monologue, "Well, crap. I don't want to go to this address when there are no cops and somebody shooting. The damn firefighters are all charged up and heading off, and damn it, you don't need your tools for protection. If you think you need protection we shouldn't be going. At least there haven't been any shots since we've been on the block because nobody's interested in the fact that going up here is completely ridiculous." I try to stay in the middle of the group on the general principle that it might be the safest area, blending into the pack like zebras and lions and whatnot on the nature channel.

As we walk up, several more people come piling out of the house yelling about a gigantic black man who was beating his pregnant wife and throwing a 2 year old and a 10 year old against the wall and they called the police 40 minutes ago and nobody comes, nobody cares, oh that poor baby, ohmigodohmigodohmigod. One man gets particularly aggressive and comes charging at the fire officer and manages to be restrained by family just before something really bad starts to happen. As the family is pulling him away, I get the Lt.'s attention and point to the parade of cops coming around from the back of the house. No less than eight police officers file around the house looking pissed and ready for a fight.

This is when the first resident makes a mistake. The police ask about who reported the gunshots and the guy states, "I did but that was a lie. Nobody cares about that little kid." I miss most of the rest of what he says as the senior police officer comes unglued and the whole thing turns into an episode of COPS. It was one of those scenes where you didn't want to watch but you just couldn't turn away. In the end, two people arrested, one for the false call and one for getting a bit too aggressive with the PD. As they are sitting on the curb waiting for their ride to the station, the aggressive man continues screaming about how long ago they called and still nobody checking on the baby, just arresting people who are trying to do the right thing. Then, more screaming from inside the house, mama just found out her son is getting arrested. Police all pile back into the house, more scuffling and someone finally gets her under control. Paddy wagon arrives and hauls the two off. The neighborhood crowd is getting a little restless about the whole thing, and I'm not sure which side they are on, so I'm glad to see the loudmouth leave.

Finally, there are enough officers free to go investigate the original complaint. They stop by to make sure we're okay to hang out in case some one really is hurt, which was the whole point of us coming up the street in the first place. I don't know the story of what the PD found in the second house, but they were inside less than five minutes when they waved us off that everyone was fine. Forty-five minutes on a scene with no patient found, better than an hour of television.