Blur

The last few weeks have been a blur of almost continuous residence on an ambulance. I can tell you for sure I worked every day between 12/24 and 12/30, and I don't really remember anything before that. I'm sure there were good interesting calls in there somewhere, but I've been running on autopilot so nothing really sticks.

I had one call where I had to ask my partner at the hospital whether he'd started an IV because I'd been away from the patient for 10 minutes and honestly couldn't remember. Normally, I write all that sort of information down because it is important for the run form, important to tell the hospital and just generally good to know, but somehow I'd just lost it. I had a hard enough time writing the report because I was trying to explain what happened to the patient because we were the second ambulance on-scene and I got a lot of conflicting reports from the other ambulance, the firefighters and the patient.

I've actually had two days off in a row now because I took this weekend away for K's birthday today. We're having a low-key celebration and he's making prime rib for dinner since we didn't really do Xmas dinner this year (I don't think the mac and cheese counts). Next month is lighter duty on the ambulance according to the current schedule and K has asked that we try and schedule things a little differently to make sure someone's around for the hound so hopefully I won't be quite so insane and with any luck I'll actually get a med school interview sometime...

Have a happy New Year!

Holiday

On the overnight for 911 tonight, crazy busy so far. Day crews said it wasn't too busy for them, but apparently everyone was holding out for the overnight.

Checked my email tonight, got my first med school rejection - not even an interview for them.

Transferrific

911 from 0700-1700 on 12/20, ALS transfers from 1700-0700, BLS transfers from 1000-1800 on 12/21. Comatose on couch at 2030 on 12/21 while K is out playing bball and I'm on call for the FD - who thankfully don't get any calls. The overnight wasn't actually that bad, I slept from 2a to 5a and got a nap during the break between ALS and BLS transfers, so I'm not complaining about the schedule. I do have to say that I find my patience runs thin when I'm tired though, so here's two transfer stories. I do have a 911 story I'll try and share tomorrow.

0130 transfer patient from west-side hopsital ER to psych/detox center next to the east-side hospital. 23 yo female, depressed, not suicidal. Fine, fine, hop on board the sad bus and let's go. She's got an extensive list of meds and medical hx with her but nursing report indicates she's fine, normal vitals, so on and so on. Less than a mile from our destination, she looks at me and says, "I don't feel so good. My chest hurts and my jaw hurts." My internal BS sensor is screaming, but she does have a history of cardiac dysrhythmias, so I reassess vitals to find a slight elevation but still within normal limits, pulse strong and regular. She also has a history of anxiety, but denies that has anything to do with her current feelings.

When we arrive, medic is a little surprised that I head inside for a few minutes because we normally drop them off at the door. An aide and a social worker greet us, I hand over the paperwork and get the you're dismissed look just as I start to explain that she's developed chest pain and get their attention again. I try to accurately explain the situation and my assessment of her condition when the social worker looks at me and says, "Did you do an EKG?" Nope. "Do you want to?" I didn't answer that question because clearly, if I wanted to, I would've done it. The social worker finally turns her attention to the patient and eventually they agree to admit her for her fourth trip through their system. I left and had to explain the situation to the medic, who backed up my actions and assessment since she'd heard the nursing report and read the history documents. I worry that I wasn't being patient enough, caring enough, but everyone I talk with agrees that I was at least 10x nicer to the patient than they would've been. Just the fact that the medic didn't know there was an issue speaks to how nicely I treated her. I don't know how to feel about that, but I truly believe that there was no current cardiac issue with the patient.

1630 transfer patient from a nursing home to an emergency department, issued as a "go now" call from dispatch. Limited patient info enroute indicates 80's female with fever. Even though I'm on a BLS transfer truck, there happens to be a medic working with me so we treat this as a 910 (get it, 1 less than 911) call. When we get there, we head to the nursing station and are pointed down the hall to the patient's room - I leave them a parting shot asking about paperwork to go with the patient since they seem to be fairly ignoring us while continuing their social conversation.

In the room is the patient (and her roommate), her son and her husband. No staff. We start getting ready to move the patient to the stretcher and start asking questions of the family since they are the only ones there. An aide shows up and thrusts paperwork in my direction and is three steps toward the door before I look up. I ask her if she knows anything about the patient. Of course not. In a tone tinged with both annoyance and sarcasm, I ask if she could please send us someone who does know something about this patient. The family is looking at me somewhat slack-jawed at this point, so I apologize to them and explain that it would really be more realistic to have the nursing staff explain why they called us and what the patient's situation is than for us to continue to give the family the 3rd degree. They are in complete agreement and the son explains he's just surprised to see someone sticking up for his mom who has never even met her before.

I don't get into it further because the medic is working with the patient and I want to make sure I'm on top of what is going on and what he needs from me, but ultimately I just want to make sure that our patient gets our best help which means knowing what the heck is going on. Things clear up a little after getting some more information and we have an uneventful trip to the hospital. The ER is packed and they don't have a room for our patient, so we wait in the hallway with her for more than a half hour and I continue to chat with her and keep her occupied. I actually don't mind the wait because the ER staff is attentive to our patient even though they don't have a room for her, and the doctor who had seen her earlier in the day came down from the floor to take care of her specifically since the ER was so busy. That is the kind of care I can deal with and I will be patient all day if you can show me that you give a care and that I'm leaving my patient in a good place.

In need of body work

I was called a grandma the other day by one of the young punks on the ambulance. I turned up my hearing aid, shook my cane at him and threatened him with boxing his ears if he came over close enough to the couch. Everyone continued to mock the "old lady" truck, because I was riding with a partner who was 32. Ancient, I know.

While there are physical demands to being on the ambulance, I don't particularly find this job to be that bad for my body yet. I have more lingering issues from previous problems that ache and pain me on any given day. Knee surgery, ankle injury, wrist surgery, that weird pain that runs the length of my left fibula, the list goes on.

My tendency to fall down stairs only adds to my problems though. Three weeks ago, I slipped down the last 4-5 stairs in my house. I was, of course, carrying two bags and a lunch box so I didn't have a hand to grip the railing to try and stop my fall. Thankfully, one of the bags had my linens and pillow for staying overnight at the station so at least I hit my head on that and not the stair. But that didn't save my back or shoulder blade from bouncing down the stairs. It took less than a day for my back to give a loud snap and have my shoulder pain disappear. The lower back pain has been a whole other issue.

The spot I hit was just to the spinal side of my hip bone. Thankfully, not a place with a lot of muscular attachments needed for lifting patients, so I've been able to continue doing my job. But, it is a place that causes a fair amount of pain - when I sit, when I lie, or just when I reach the end of the day. No, I haven't been doing the appropriate ice and ibuprofen because I keep telling myself this is going to go away. That the large lunp is nothing, maybe just a knotted muscle. I've been to have my back adjusted twice, to no improvement. I had a routine physical last week and kept mum about the pain, although I did comment to the doc about having fallen down the stairs. Really, it will go away, I think.

I think what I need is one of those "Overhaulin'" type shows where someone hauls me away for a week, scrubs off the rust, lubes all the joints, fixes all the squeaks, and slaps on a bright, shiny coat of new paint. Anybody know someone?

10 hours of 911

0700: Truck check. Allow OCD tendencies to take over until truck is pretty on the inside. No time to clean the outside as the rotation of 911 ambulances has put us out next.

0830: Dispatched to chest pain. Transport high stress/anxiety patient with no cardiac history, unremarkable EKG. Medic takes 2 tries to get IV with patient screaming about how much it hurts.

1000: Dispatched to heart problem. Transport patient with confusion, mild chest pain, dehydration, extensive cardiac history, unremarkable EKG. I miss the IV, medic hits one.

1115: Dispatched to fall with head injury. Find patient who fell getting out of wheelchair and wants help to stand up and get back in chair. Find three adults and 4-5 kids in house not helping patient, wife hollering "I told you the next time you fell I was going to call the ambulance!!" Help patient up, quick assessment, no transport.

1200: Lunch.

1230: Finally get chance to wash outside of truck. Medic finds me just as I'm finishing up and complains I didn't ask for help. Unenthusiastic response to earlier request for truck washing made me fairly sure asking for help was going to cause ill will. We are again next out before I can finish washing, but the EMS gods are good to me and I finish before our call.

1300: Dispatched to medical clinic for heart problem. Ask if medic is bad luck for cardiac calls today. Find tachycardic patient (155 bpm) with "palpitations". FD assists moving and loading. In truck, medic asks for patient to be hooked to defibrillator pads and gives adenosine. Patient's heart rate slows to below 30, before running back up to 130. Drive lights and sirens through city. Patient's heart settles down to 108 before we clear the hospital.

1415: Fuel truck. Settle in to couch to watch TV, read, play on internet as we are still 3rd in line for calls.

1630: Dispatched for motor vehicle accident. Find 2 cars in front-end collision, one car with woman and baby, other car with no driver. Police say driver went to get her purse from building. Medic assesses woman and baby, no injuries and no transport. Other driver reappears, I assess, no injuries and no transport. Clear the scene, head back to station for paperwork.

1720: Finish paperwork after begging times from dispatch. Get lecture on how we're supposed to wait for them on the computer, but the call wasn't over because the fire engine was waiting for a second tow truck. Out only 20 minutes late.

So there it is, a reasonable day - not too many calls, not too few, and really only one patient that needed an ambulance, others that just needed the reassurance that comes with being evaluated by trained professionals.

Slack-tastic

So, yeah, I've been slacking off again with writing. It seems to come hand in hand with either being crazy busy or entirely asleep. If I'm busy, there's stuff going on and no time to write. If I'm not busy, there's time to write and nothing going on to write about. Only when I hit that sweet spot in the middle do you hear anything here. Nothing too exciting lately, no word back yet on the cardiac patient, so just a reflection here on my changing role as an intermediate...

I worked a 24 at the ambulance co. recently and ended up doing calls with three different medics. Two of those were "stay and play" medics as opposed to "load and go" medics. The stay and play medics are those who want to do nearly everything on-scene, or at least in the ambulance at the scene, so they have everything together and organized by the time we're rolling. I can understand it because a lot of the transport times in the city are short so if you want to have time to double-check yourself, you have to finish most of it before you roll.

Before this shift, I've been mostly with load and go medics - ones that want the patient in the truck and on the road as quickly as possible, with everything accomplished en route and if we don't get time to do something, well that just leaves the hospital something to do. These have also been the medics of the mindset that if you aren't going to use an IV for something specific, then don't start one. Goes back to efficiency because if you don't have to wait to start an IV, then you are that much faster to transporting.

I'm not yet falling in support of one side or the other, just noticing the distinct dichotomy first-hand and the difference it makes in the turn-over time between calls and the pacing of the day. Stay and play medics spend longer with each call making the break between calls shorter, but you really do feel busier all day. Load and go usually falls in line with getting the patient to definitive hospital care quickly when they need it, and getting them out of the truck quickly when they don't need it. I think both methods can be appropriate for specific patients, and I've seen people who tend towards one type utilize the other when a specific situation calls for it. I'm learning how to cooperate with both methods and how that changes my role on scene, so hopefully I'll be able to blend smoothly with anyone I work with.

Witnessed arrest

FD Dispatch: "Truck A, Ambulance X respond to [address] for a fall. Caller was hysterical and hung up on 911."

That's gotta be some fall for someone to be that hysterical. Enroute I hear the truck and ambulance sign out on scene with no further update. Scene was less than 3 minutes from the station, but more like 8-9 from my house.

Arriving on scene, I walk in to the kitchen to find a average-sized middle-age woman on the floor, shirt cut off, one medic intubating, one FF doing chest compressions, and the other medic adjusting leads and preparing to defibrillate again, calling out meds and rhythms for the other medic to discuss. I wait for an opportune moment to see what I can do because everything looks like it is being done, and get assigned to bring in the drug box, then the backboard (already in the house) and prep the stretcher outside. On my return, I find her boyfriend standing very close to everyone, crying and freaking out (understandably). I gently move him away a bit and start pumping him for information on the patient, name, DOB, meds, allergies, history.

After he's able to calm down a little because he's got something to help with, he fills me in, 43 years old, negative history, negative meds, just engaged 2 months ago, they were working on the garage and she went into the house to get something they forgot. Patient was in the house with her daughter, reported feeling dizzy and went down like a ton of bricks. Bystander CPR started before FD arrival. At this point, he is crying again and asks me if she's alive, does she have a pulse? I take a quick look over and see active chest compressions, electrical activity on the heart monitor (when they stop compressions), and see the seriousness with which they are continuing to work and not prepping to leave and tell him that she does not currently have a pulse but they are still aggressively working and we'll do everything we can for her.

The medic decides he's ready to roll, so out we go, compressions in progress, into the ambulance and the additional meds. They keep working on her in the truck, including starting her second IV in the external jugular (a great big neck vein). I'm sent back in to clean up the mess - wrappers, paper, saline, plastic, all the debris of a working code. I finish up quickly and find the ambulance still outside, so I'm back in, and get handed the BVM to maintain ventilations. Second medic is out and we're off.

I'm ventilating, chest compressions are going every time we can't find a pulse because she's back and forth as to whether her heart is beating hard enough to create a pulse, and drugs are going through the IV or on a drip. The medic exhausts the supply of 2 of the 3 drugs he's been pushing and eventually there's nothing left to do but keep ventilating, watching the monitor, and checking for a pulse. We see a little V-tach, some V-fib, something nobody recognizes, and even a few sinus beats from time to time. Patch to the hospital goes by phone instead of radio to prepare them for what we're rolling in with, but there's no way to summarize the massive amount of work that has gone on, so the medic hits the highlights - her current state, the meds in and the shocks delivered. Another ambulance at the hospital sends out crew to help us get inside with the assortment of attachments and the doctor starts checking for the all-important pulse. He gets no radial pulse. Possible faint but intermittent carotid pulse, he isn't convinced. He listens to her heart - and hears it, we haven't lost her yet.

I don't know right now how she fared. I wasn't feeling optimistic when we left the hospital because they had the lights off in her room and were looking for her finacee. I may find out tomorrow because that crew is on duty again. This was the first working cardiac arrest I've ever been a part of, and I have to say that it was pretty near how I imagined it. Heart-wrenching to interact with the family, but otherwise too busy to have emotion in the way of getting the job done. The ambulance was on scene for half an hour, which was much longer than I would've expected. My role was minor, and I expect the scene would've affected me a lot more if I'd been ultimately responsible for her care rather than following the medic's lead.

Transfer of care

I had a discussion last night with K about something that has been bothering me for some time - I promise, he brought it on himself, I didn't offer to talk about it. The problem is especially highlighted in a combination professional/volunteer department like the FD where not everyone arrives on scene at the same time because the volunteers respond POV rather than from the station. When everyone arrives at the same time, the process is basically this:

1. Gather information about what happened from what you can see,
2. Initiate patient contact, begin to set up rapport and patient trust,
   
3. Gather information from patient and/or bystanders,
4. Provide patient care and/or transport,
5. Transfer patient care to hospital by radio patch and then verbal report to the nurse/doctor.

Seems reasonable enough, yes? Where the problem occurs is when steps 1-3 are completed by somebody else before I arrive and I'm expected to take over at step 4 with little to no information. (It isn't just me, I'm just going to speak to my own experience.) Patients are confused by this sudden "abandonment" of their providers and why they have to re-answer questions, and frequently, answer questions that didn't need to be asked initially because people could see what was happening.

I do NOT think that anyone should delay patient care to wait for everyone to arrive on scene. I DO think that treating a transfer of care between FD personnel on scene with the seriousness and detail that transfer of care to the hospital is treated would be valuable. Why is anyone detailed with the hospital? Because they can't see what happened and they lose all that information unless EMS or the patient provides it to them.

I would like to think that even if a medic on scene has decided that a patient isn't critical, it would be good experience for whomever is taking over patient care to have enough information to understand how he reached that decision. Here's the incident that sparked this conversation with K:
Dispatched to a SNF for a patient who had fallen and was bleeding from a head injury. I arrive on scene and find the patient sitting on the stretcher with bandaging just being finished on her head. I help carry equipment back to the ambulance and get in to help with whatever else needs to happen before we transport. Everyone else stays outside, the medic on scene hands me the demographics and medication list from the facility and tells me the patient is all mine - simple "fall down, go boom". I catch him before he closes the door and ask a couple of questions (including whether they took vital signs inside), which are grudgingly answered and he hops up front to drive before the other volunteer even arrives on scene. I start talking to my patient, taking vitals, history and so on and I discover that I'm not sure she's as okay as everyone makes out. I start her on O2, hook her up to the heart monitor and see something that looks like maybe atrial fibrillation or flutter - which she has NO history of. We get to the hospital without any issues and I'm trying to talk to the nurse about what I saw and the medic interrupts with, "Yeah, she's 80, who doesn't have atrial fib?" When I'm trying to write my report, I have to chase him all over the emergency department to get answers about what happened before I got there. Very frustrating.

Memorial

As always, it was nice to see K's family - not the circumstances, but the time spent with them. The funeral related time was difficult, it is hard to see people you care about in pain. I'm not a big fan of viewings and there was seven hours straight on Wednesday with a lot of crying and mourning. K's grandfather didn't look much like I remembered, but several people who had seen him last week said the same thing, so I think it was a matter of the missing glasses and the makeup that masked all the age lines that make such a characteristic part of his face. K seemed to hold up fairly well, he had done a lot of his mourning after his last trip out there.

The service was fairly short, but it was hard to hear him eulogized by church people who had only known him the last four years and only really interacted in that one facet of his life. He had rediscovered faith in his last decade or so and many of the stories I had heard over the years did not quite jive with sermon we heard at the service, but if the spiel brought comfort to someone there, then I suppose it was worth it.

As a family, we relived a lot of memories, K's grandparents coming as Raggedy Ann and Andy to K and my halloween wedding, fishing trips and times in Florida, compassion and friendliness - this is a man who didn't really have any strangers in his life, only people he hadn't met yet. The first time he met my parents, he reassured them about my moving to Michigan because no matter what happened with K and I, they would be there for me. We will all miss him greatly, but are relieved to know that he no longer has to struggle with the pain and confusion that have marked his last time with us.

Quick updates

In chronological order:

1. I had a DNR patient die during transport last week and that was a rather awkward situation. We loaded him into the ambulance and my usual procedure is to have whoever is driving get moving and then take vitals and such. This patient was baseline unresponsive and in bad shape, so it wasn't like he suddenly quit talking to me or anything terribly obvious to realize he had died. When we were in the ambulance and I couldn't get a pulse, I realized that I think he quit making the nasty gurgling sound that was accompanying his breathing sometime in the elevator or short hallway out to the exit. We had to turn around and take him to the emergency department of the hospital we took him out of (we only got 2 stop signs away) so they could pronounce him, but there really wasn't any doubt. I'm glad I double-checked to make sure the DNR paperwork was in his file before we left.

2. K has had a cold and I've just come down with it, so we're pushing the limits of the household kleenex supply.

3. I didn't have to work Turkey day, so K and I had a quiet meal at home and watched football all day, interspersed with liberal napping. I do have to work Xmas day though, and K is working Xmas eve (until 0800 Xmas morning), so it sounds like we'll be doing presents sometime around 1800 Xmas night which is going to be torture for K as he still likes to be up around 0600 for presents!

4. I worked a cheerleading competition yesterday, it is highly disturbing to watch more than a thousand cheerleaders, both on the floor and in the stands, doing the same dance to a song. I saw a wide assortment of strangely dressed and oddly competitive parents as well. Several other ambulance folk working said that most of the concerts are less crowded than this was. Most of the calls while I was there were TGS (teenage girl syndrome).

5. K's grandfather died this morning - I'll try and post some further information, thoughts or reflections as they come to me, because I don't think a quick update is an appropriate last word.

Technical issues

I blame part of my lack of posting on computer issues, which were supposed to be solved yesterday. My laptop has been having issues with charging and running on AC power, so I've been babying it and trying to get as much real work done on the battery life as possible. Yesterday was the scheduled service day for a technician to come replace the motherboard (since that is where the power connection is). Surprisingly, the connection had finally given up the ghost 3 days before the warranty expired, so it was being repaired free of charge.

Tech shows up, parts in hand and proceeds to tear the laptop into a hundred tiny screws and plastic pieces. Swaps the board out and begins reassembly. Here is where things went wrong. He had to remove the keyboard off the top to get to some other pieces, and when he goes to put it back, I hear a "hmmm" noise. I head over and see him holding some tiny plastic pieces and trying to put them back onto a connector. No dice, the plastic connector that links the keyboard to the rest of the computer is broken beyond repair.

He calls the company and asks them to send a new keyboard. They tell him my machine is now out of warranty and I'll have to pay for it or the service company will. I manage not to blow a gasket as he calls his supervisor and gets told that the service company isn't paying for a keyboard and I have to take it up with the company myself. Approximately 1/2 second after the tech leaves, I'm on the technical support chat trying to type without punching the keys so hard that I break my external keyboard too. The company tells me that there is a keyboard on order, billed to the tech, and they'll be in touch to replace it.

So now, I have to wait another week for the part to arrive and service to be scheduled before I can use my laptop as a laptop. I'm hoping the service group doesn't procrastinate just because they got billed. Until then, the laptop is permanently mounted to my desk.

Ooo, that smell.

The smell was almost indescribable. Decaying flesh, infected pus, oozing nastiness. The patient was in a room with glass doors, in an area with no other rooms with doors, that was the first sign. The nurse looked at us and asked, "Have you ever taken this patient before?" When we said no, her face kinda fell, that was the second sign.

Brief report from her included that the patient had a bandage on his face because he was missing a large area and a little information about his cancer, but nothing about the smell. She opened the door to let us in and before anyone moved, the smell hit like a tidal wave. At first, I couldn't quite figure out what it was, but when I saw the wound there was no question. I honestly don't know whether there was anything he could've done about it, but I have to think he's grateful that most of his nose is gone because it probably doesn't bother him much.

In the ambulance, we have an exhaust vent to try to eliminate the smells, but there was no way it was going to keep up. We had the heat fan blasting, the windows open in the front, but still it was thick enough you could almost see it. I made the 17 miles without retching and eventually we dropped him off. We did as much covert decontamination as we could in front of his place, and when we drove back to the hospital we continued cleaning and by the end of the day you almost couldn't tell (or so I was told). I had that smell in my nose the entire day and just the memory of it now makes my stomach flip-flop a little.

Politicking

The FD has had some major upheaval this year. This spring the anti-tax crowd converged on town meeting, slashed the town budget, and elected anti-tax candidates to the town council. Since then, department heads (except the police who seem to be exempt) have been fighting an uphill battle for control of their own departments and the money to keep them running.

FD started the budget year by cutting their budget almost 3% before town meeting. With the level funding from last year translating into another 3.5% cut, the chiefs sat down to make some major changes. Overtime call-back - time that off-duty and call ffs come in to cover the station while the on-duty crews are out on calls - was slashed to nearly nothing, the engine from the south end of town now drives to central station to cover when that engine goes out instead of off-duty ffs coming in. The department had capital funds for a new rescue truck this year and had spec'd it out, gotten all the estimates, and just needed final approval from the council. Instead, they were told to slash 10% off the truck, and when they did, they were told just to scrap the plan and wait until some other budget year because the truck was "not necessary".

This environment encouraged the chief to retire, with about 5 weeks notice, and allowed the council to appoint whomever they wanted as the acting chief while a "search" started. They promoted a captain (over three chiefs), posted the position with the publicly stated intention of not spending a dime to find candidates and stating that they weren't going to hire anyone who wasn't willing to work to continue to reduce the budget. I don't have an opinion on whether the captain is qualified or a good candidate because I just don't know enough about it (opinion through the department seems mixed), I just find the process to be very strange when you take someone with no experience and thrust them into a position of authority in the late stages of the critical budget process for next year.

What does this have to do with me? Beyond K's overtime salary cut, the department is now looking to have call ffs and ambulance volunteers fill regular shifts when full-time people are out sick or on vacation because they will not be earning overtime, just regular pay. The council is of the opinion that more volunteers is the solution to the budget problem because everybody wants to work for free (or cheap at most). K honestly came home and asked me whether I would keep volunteering with the department if these changes happen. I told him I didn't know. I know I would not go in and work a shift to cover a full-time person so the town doesn't have to pay overtime. I'm not qualified or interested. Apparently the word is out among the call ffs though that there will be a mass exodus rather than helping the council slash the budget like that.

There are several critical facts the council is forgetting. Many of the volunteers/call ffs are paid ffs somewhere else, so they are all part of the same union and they aren't going to undermine the union here in town. All the EMS volunteers and call ffs have other full-time jobs, so it is unlikely they would be available to pick up shifts when called at 0700 for an 0800 start time. And most importantly, the department has been actively recruiting for new volunteers/call ffs for years and very few people have the time and commitment to work for free for an extended period of time, so there isn't a huge pool of people to pick from and those that are here are (as a general rule) much less experienced than the full-time members.

Right now, I'm falling on the side of wanting to keep doing what I've been doing (at least until I get into school) and let other people hash out the bigger issues. No covering daytime stuff, just one night a week and every fifth weekend. I'm concerned about getting even more crap about not supporting the union and such, like I did when I started volunteering, but until and unless K specifically asks me not to volunteer with the FD, this is the way I'd like to make a contribution to my community.

One day at a time

That is what it should say on the sign outside my padded room because that is how I'm going to drive myself insane - one day at a time. This week, I picked up over 30 hours of work on ambulances for the next six days - above and beyond what I was originally scheduled for. Each individual request from full-time people looking for a day off didn't seem to bad, but when I really looked at the calendar this afternoon, the weight of all those shifts suddenly seemed a little more real. I didn't even realize Thanksgiving was already next week - I mean, I knew it at one point, but not recently. Thank goodness though, it is the only day I have off next week.

EMT quote of the day (from a staff member on transfer truck leaving the station to pick up a patient for transfer to the local mental health/detox facility): "All aboard the sad bus! Don't make us come back for you, just pile in! Non-stop service to [facility], trips leaving daily!"

Ahem

Um, yeah, I forgot yesterday. I worked my first ALS transfer shift, was tired, hungry and cranky by the time I got home, argued with K, had dinner, went for exercise, baked cookies, and crashed in bed. I remembered about writing somewhere around cranky, but since I didn't do it right then, all was lost. Still though, twelve days in a row is a personal record. Maybe next November I'll make the whole month...

Reading

I read a lot, which you may notice by the rapid turnover in titles on the sidebar. Primarily, I read for entertainment, but every now and then I like to pick up something different. In this case, K bought it for me because I'd talked about being interested after the author appeared on the Colbert Report. The book is The God Delusion by Richard Dawkins. Although I don't necessarily agree with all of it, the basic idea is that it doesn't make logical sense for there to be a supernatural power in control of the natural universe and that there are rational arguments against it and against most of the claims that a belief in some type of god or religion are strictly necessary for humans.

I also found it interesting to read a non-American's opinion on how an American's social standing suffers just for denying a belief in a supernatural god. When you live in a society where such a large proportion of people are believers in at least their public persona, it can be difficult to know when to express opinions to the contrary. While I've never had the personal experience of friends and family turning their backs on my because of my lack of belief, it has certainly been a problem at different points which I'm not going to go into.

It is also something that has come up a few times on the ambulance. EMTs are all taught about patients who may refuse care because of a variety of religious beliefs, and that isn't even what I'm referring to. Patients have asked me to pray for them or with them, sometimes on the spot. Since I'm in a professional capacity, I generally defer with some vague indication to "do what I can later". I try to reinforce to myself that I'm not actually lying, because what I can do is exactly what I do, nothing. I don't think it is appropriate in the back of an ambulance to try and explain/defend why I have come to the conclusions I have about god and religion, nor the place to try and "convert" anyone else, but my patients seem to have no such issue. I treat the situation like any other piece of extraneous information on a call, but every now and then it is hard to bit my tongue so it is fun to read a book where someone doesn't pull their punches and attacks the superstitious religiousity head on.

Well-supervised

I made it out of the kids football around 1530, so I actually had enough time to stop at home and drop some things off before heading to the overnight shift. No major injuries at the football thankfully, because I really don't want to see what a parent willing to paint his face for a 9 year old's football game would do if the kid were actually injured! Top three teams went home with trophies, and for the New England fans - you'll be happy to hear that the Patriots won.

Tonight I'm rolling with the shift supervisor, so I'll be getting lots of feedback on how/where/when/why I do things. On the first call the list of things wrong included: not having my radio in hand when the tones went off, leaving the ambulance door open, not being able to lower the back shelf on the stretcher to get it to fit in the elevator, not turning off the heat in the back of the ambulance so I was sweating when we got to the hospital, not having my cell phone on me, and missing a couple of boxes that I've never used before on the run sheet. Nothing critical, but by the time we got back, I was feeling like I'd missed a bit too much. A big part of the reason I'm rolling with the sup is to learn, so what I have to do today is survive the feedback and show improvement. I'm aiming to get to the point where the sups feel comfortable having me on the trucks so I stand a chance some day of getting a full-time shift again if I decide I want one.

Schedule snafu

Today is the start of a long stretch of hours for me between now and Sunday. I was supposed to be on an ambulance from 10-2000. I found out on Tuesday that I was going to be working with the paramedic Lt. I had planned to bring in cinnamon rolls as a thank-you for the crew I third rode with last weekend. I thought I had the day all figured out, ha!

Cinnamon rolls went as planned, making several city crews fat and happy. Shortly after 10, the Lt. shows up and tells me they moved him to a different truck that had to have a medic, because I was on a BLS truck. At 1030, I find out that they don't have anybody coming in for this shift at all, and if you don't know it actually is not possible or legal to work an ambulance by yourself. Around 1200, dispatch called and asked me to drive the ambulance down to the southern station and man a wheelchair van down there. But they didn't actually have any calls for me to do, they just wanted me hypothetically available instead of definitely not available. At 1500, they finally found someone coming off shift who was willing to stay until 2000 and work, so I actually did 2 calls this evening and now I'm about ready to call it a day.

The next two days will push my commitment to blogging every day. Saturday I'm working the kids football from 800-1800, then heading to a city shift overnight (1700-700). Sunday, I have a couple of hours off, then a BLS shift from 1000-1800.

Valued employee

I made a trip up for a meeting at the office job yesterday and while I was there, I picked up the mail I've been neglecting for a couple months. I got a hand-slap email from one of the administrative assistants for not picking up my mail, so I thought I better empty out the box before someone decided to stick all that garbage in an envelope and send it to my house.

There were really only two relevant pieces of mail, the benefits enrollment information and a letter about my status as an employee. Thankfully, I wasn't making any changes to my benefits because I completely missed the enrollment period while that information sat in my mailbox. The letter though, made me laugh. Since my position is funded by grant money, it isn't really permanent but rather contingent on someone with grant money being willing to keep me around and cover my salary. Also, as a "soft-money" position my job can be eliminated at a higher level without a lot of recourse for me. This leads to an entertaining letter every year. This year's was dated October 1, and stated that I have "been approved for reappointment effective July 1, 2006 through June 30, 2007" also I'm congratulated "on this appointment and thank you for your contribution" to my employer. I'm not going to like the year that I find out in October that I haven't had a job since July!

While I was up there I also ran into the FOB (see NSP) who thankfully did not want to have a conversation any more than I did, but it was still weird to even realize he's still alive beyond the abstract small bits of info I get from my sister. If I'd been expecting him, I would've had something probably insulting to say about his treatment of my nephew, but I just managed a surprised "hey".

p.s. K is home today and a bit wiped out. The rest of his immediate family is heading to MI tomorrow to be with Grandpa. They were able to arrange hospice care at the VA, so hopefully he will be comfortable and well-tended for as long as he has left.

In this corner...

we have the new EMT-I and in the other corner the reigning champeen, the big city. And this morning, one of the experienced EMT-Is snuck up behind me, grabbed my arm a la a heavy-weight title fight and declared to the oncoming staff in the garage that I had hearby survived my first city shift. Many folks laughed, and those that hadn't punched my new patch yet took the opportunity to do so.

The medic I rode with wished for an easy night because he didn't feel like working too hard, and he got his wish - which is probably better for me anyway. We ended with a total of just four calls, all dispatched as falls. Three of the four actually were falls. One patient had fallen but just wanted help up rather than a trip to the hospital. One patient swore there was a broken hip involved, but the symptoms seemed like it probably wasn't that severe. One patient spoke no English and the most information we got was from a child on-scene translating, who did not go to the hospital with the patient.

Overall, not a bad night, but I'm wiped out today because I really didn't sleep much - per usual in an unusual place. After 200+ miles in the car and taking the final test for Haz Mat, I'm going to call it a night.

p.s. K reports his grandfather seemed slightly better today (appetite was up a little and slightly more aware) and they are in the process of arranging hospice care for him.

Gray day

No major change in the condition of K's grandfather, but they were able to confirm the brain bleed. Doctors report he has 1-45 days left to live. Not a very helpful bracket for determining what we're going to do for travel. Today, at the request of his dad, K left for MI and will be there until Thursday. He was quite uncertain whether to go, but ultimately decided he wanted to be with his family when they needed support, even if it means he has to turn around and head back soon.

Fairly dreary day weather-wise around here, and my last patient personified this by being the saddest person I've talked with in a long time. He was fairly oriented for being demented and we had a pleasant conversation during the transport. The only way he seemed sad was that he kept saying he didn't have any reason to live, nothing left to do, no way to go anywhere. I tried to just talk about positive things with him and avoid disagreeing or supporting his negative statements. I also informed his nurses at the home, but I'm not sure that he hasn't just given up, so he definitely needs more qualified help. He actually thanked me for such a pleasant conversation and I was glad to have given him something good today.

Edited to add (20:04): Lucked into a spot in the big leagues tonight, hoping for a reasonably quiet night to get my feet wet...

Lazy

I can't tell you how positively wonderful today was. K is working his 24h shift. I have no where to be until 1830 and nothing strictly required of me today. So I did, nothing. Well, I did read a little - an interesting book I'll probably write more about when I'm done - but mostly, just lazed on the couch.

Sadly enough, I consumed 100% less halloween candy today - because there isn't any left here - so I think that I probably had less excess calories today by sitting still than I have the last several by moving from place to place with leftover candy. Mmmm, candy, droooool. This is the start of the overeating time of year. I find that from halloween to at least Valentine's day, I eat too much. I try and balance it out with exercise, but I haven't found a place to play basketball yet this winter.

Other news from an unfocused mind - I don't know who to vote for tomorrow. NH is having a gubernatorial election which I'm all set on, as well as a multitude of other state offices, some of which I have no idea what they are. What is an "Executive Councilor" and does it matter to me that one of the candidates is a lying, two-faced backstabber according to her opponent? Is there actually more than one person running for sherriff? Ugh. I may just go vote on the governor and the constitutional ammendments tomorrow and leave.

We may be making a trip to MI soon. K called this morning to tell me that his dad called and said grandpa is not doing well and had a significant decline over the weekend. The docs aren't sure whether they are seeing bleeding in his brain or some sort of calcification, but either way, he isn't a candidate for any sort of intervention to relieve the building pressure in his brain. This has been a bad year for funerals. I'm trying very hard to wish positive thoughts and keep my spirits up for K.

Patience

I have rediscovered my intolerance for idiots today. Some folks had been doing stupid things to annoy me, but I was still making it through by reminding myself that I only had to deal with them for a little while. Today, I think retarded monkeys would've been better company than the idiots I was forced to sit through class with. The majority of the people in the Haz Mat class are part of a firefighter 1 class, so many participants are young, over-testosteroned wanna-be firefighters. They can't keep their fat yaps shut and listen to lecture and they have no practical experience in anything, so the only thing they have to offer the class is their particular idea of humor - which involves inside jokes and guffaws at the expense of one of their own. If I'm ever on fire in the town they're from, I think I'll just keep driving until I get to the next town over.

I'm not entirely sure how K ever made it through a series of FF classes involving people like this. I asked him today, and he reminded me that his class was actually worse because there was one guy who couldn't even read and they were all volunteers who knew they were never going to be professionals. The guys in my class think they're going to be hired some day, so they have at least a small motivation to pay attention. It is very hard to sit and try to learn anything, and I'm about out of patience. Being one of only four women in the class means that saying anything will get me labeled a bitch (or worse), but I think that it may have to be done to avoid any further disrespect to the instructor.

Hazzzzz....

Out at Haz Mat Operations this weekend, learning all about the kind of scenes I never want to show up on. Apparently it is a FD requirement for all staff, but I would've avoided it if possible. Today was eight hours of powerpoint slides, following a night of poor sleep, that just about put me to zzzz's. The lecturer wasn't too bad really, just a total lack of interest in the material. We're starting earlier tomorrow so we can finish up by 1500, so I'm hoping to catch an afternoon nap.

Tonight I'm in the city, running on the 911 truck as a third rider. So far, one MVC who got collar/board/IV (which I stuck on the first try!! and I was nervous after over 6 weeks of no live sticks), and one call that was really a PD call and not an ambulance call so we cleared up quickly. I always feel guilty wishing death/dismemberment/illnesses on people, but hey, that's what I'm here for!

Five truths

Okay, tagged by NSP to give you five things that are true in my life.

1. I am scared. Scared to get into medical school, scared to not, scared that I will never even hear anything from them. A thousand and one negative scenarios swirl around my brain on a daily basis.

2. I am indescribably glad I am not 22 anymore. Not that I think I was ever the kind of 22 that is currently annoying me, but if I were young and single again, I would probably have to kill these boys.

3. I am addicted to Diet Coke and I don't care. I've gone through periods where I try and cut back for the sake of caffiene and irritated primary care physicians, but I rationalize it by the facts that I don't often drink and I don't smoke, so what's one little vice?

4. I do not hate my body. Sure, there are times I wish it could be more (or less), but mostly I'm glad that it gets me where I want to go and that it is quiet enough that I can usually take it for granted. This is probably a result of seeing a lot of people whose bodies don't get them where they want to go.

5. I'm outta truth today....gotta get crackin' on some w-o-r-k, so hopefully four will do!

Patched!

The store that does clothing for the ambulance company (and unfortunately also the FD) usually sews all the patches on our shirts as part of their "full-service" ordering. Bad enough the company only forks out for the cheapest shirts which drop buttons regularly and need constant trimming for lose strings but most of the time it takes 1-2 weeks per shirt and you have to take at least one patch per shirt back to be re-sewed within a month. I'm no professional seamstress, but I have not been particularly impressed.

With my new credentials, I get one new patch per shirt (I'll try and get a picture up). I went by the shop on Tuesday and asked for a patch to swap out because I wanted at least one of my shirts done for work today. I've never seen the woman look so happy as when told I wasn't asking for her to sew my patch right then - just to give me one so I could do it. Her husband came out to see what was going on and gave me a suspicious look, but they let me take the patch. The rest of the shirts are heading to them today. It took me over an hour, but I have to say that my unskilled job looks at least ast good as theirs and will probably last longer too.

Spooky

Halloween was a bit of a disappointment this year. I was working a vanbulance shift - in a real box ambulance - and nobody on day shift was even kinda costumed. We went around to hospitals and nursing homes as usual and there was a disturbing lack of both holiday spirit and CANDY. These are places that have had candy for a week or two now, and on the actual day, nada. The best I saw all day was a patient at one of the homes who had an orange vest with bats, a matching headband with stuffed bats on springs and bright orange garland with plastic bats wrapped around the wheels of her chair. I wish I had a picture for you, but this particular place wasn't a likely candidate.

Trick-or-treating is town-regulated to run from 6-8p only and my shift ended at 6p so I was home for most of it. I'll just say that there were so few candy-begging ghouls and goblins, we actually watched all of Saw from 7-9p and only had to pause twice to answer the door. So much for being in a better place for trick-or-treat.

Patient quote of the day, as we were lowering the stretcher so she could move to her wheelchair and I had just been hit by a n-a-s-ty wave of stink: "Oh, girls. You made me so excited I just farted. Sorry, I think it smells a little." I could only wish I had been at the head of the stretcher instead of the foot right then.

Dreary weekend

Why do people only want to do social things with me on the weekends I'm on call?!? I only volunteer one weekend out of every five, and yet nearly every time there is something going on it is a weekend when I can't leave town. And this has been a pathetic weekend to hang around. Nasty weather, low call volume, and K is on shift today, so I don't even have anyone to talk to while I'm sitting around all day.

Enough whining. Tomorrow is our 7th wedding anniversary. I can't really believe it has been 7 years, but I can't even believe I've been out of college for almost 10 either. For the first time in those years, we don't really have anything specific planned. The last two years, we've tripped to Montreal and just enjoyed being out of town and watching a little of Canada's national sport. This year, it's a Monday and there is NOTHING going on. No hockey, no football, no basketball, no performances of any type, so we've been at a loss for what to do. K is checking out places to go eat, maybe a day trip or something.

I've already given him his present - a new wedding ring to replace the one he lost in the snow in January. The new one isn't identical to the old one since the price of gold has changed dramatically, $1200+ to replace it. So we went with a titanium and gold one instead of white and yellow gold. The titanium is supposed to hold up better to wear and tear too, but we'll see. No, I don't know what he's up to for me, although I had to laugh at the jeweler we had sizing his ring trying very hard to sell him on something for me. They also resized my grandmother's ring for me so I can wear it on the ring finger of my right hand and get a little more use out of it. It was something I'd been meaning to do for quite a while now, but her passing this year brought it to the front of the list.

I'm going to try NaBloPoMo in November to try and make me think more about writing every day. I'm thankful they picked November because some of the changes in my life might actually give me something to write about next month. Of course, I haven't seen the ambulance schedule yet, so I may have to learn to blog in succinct sentences rather than blathering on, but we'll see.

Giddy-up!

Well, despite the annoyance of the man in charge of paperwork - who described me as "on his back" to a state official - my EMT-I license from the state is all taken care of. I almost took offense to the implication that I was unfairly riding him, but I can be quite a pest when I'm not getting what I want and your job consists of only doing what I am asking for.

The company submitted my reimbursement request to accounting today so I should be getting my money for the class soon. And I found out what I'm getting for a raise... $2.04/hr! Sadly enough that is about 15% and enough to make a difference in what I take home.

I'm toying with the idea of quitting the office job entirely and just picking up as many part-time hours as possible because if I can get together about 52 hours a week I can make the same amount as I usually do now. It is more plausible as an EMT-I because night shifts are 14 hours each, but I'm not sure whether to torment myself. Seems like six of one and half-dozen of the other whether I stay or go.

Workin' on the chain ga-a-ang

I've now worked five days in a row for the ambulance - pretty good for a part-timer, but it doesn't leave a lot of time for writing.

Saturday, I worked a shift for a guy who asked me three weeks ago to cover because he had other plans. I agreed to be helpful, but it turned out that Saturday was the officer's funeral, and I really wished I wasn't working so I could've stayed home and been upset there instead. Since I was on a regular transfer shift, I missed the whole thing but I can tell you it was extremely eerie to see so many police in one place. I didn't expect folks from MA to come up, but there were busloads from Boston and towns along the way, a motorcycle unit from Cambridge, and I think even some state troopers from MA, in addition to just about every off-duty police or trooper from NH. Every hospital we picked up or dropped off at had the TVs tuned to the funeral and it was a very somber day.

After shift, I headed to the southern station and worked a kids' football detail in the freezing cold. I have to say that after watching these slightly older kids, I have more respect for the coaches of the younger kids because they were actually much better behaved than these kids.

Sunday, I worked the circus detail, so I watched the first show for free and hung out in first aid for the second show. Apparently, I talked with one of the stars of the show in the parking lot, but I didn't know it at the time so I didn't know I should be awed or anything. I have to say that I didn't attend a lot of circuses as a kid, but I do believe that things have changed. When the tigers came out, the ring was completely enclosed in some sort of metal safety netting so that nobody in the audience got mauled. The trapeeze had a giant net under it and they only performed about 4 tricks. The high wire had big crash pads under it and some very silly looking boys with parasols on it. There were hardly any midgets and they didn't even have the midgets and the elephants out at the same time, so we didn't get to work any elephant tramplings. Overall, we barely did anything - one bandaid, some earplugs, and some aspirin was it.

Monday, Tuesday and today are back to working on the transfer truck. Supposedly my EMT-I paperwork was hand-delivered to the state office yesterday, so we'll see whether I actually get licensed any time soon.

Murphy's law

**I had this one almost ready on Friday and got distracted by other things...

Had an FD call this morning that left me chuckling - only because I wasn't in charge of anything other than driving. 84 yo man, difficulty breathing. When I arrive on scene, the FD has him pretty much loaded onto the stretcher and they're headed for the ambulance. I help get the stretcher outside and hop in. One of the FFs has already started getting the IV ready, the medic listens to lung sounds, the line is started with a large puddle of blood and it appears we're about ready to go. The medic gives the gentleman a nebulizer treatment of albuterol and turns around to get the solumedrol ready when he notices that there's something not quite right with the IV.

The FF who started it comes back over and they agree that they don't think it is blown, just leaking from the connection of catheter to administration set. So they un-tape everything (including the tegaderm, which the old guy whines about) but it turns out the connections are okay. The FF messes with the positioning a little and thinks he finds a good spot, but as soon as he turns around, the guy's bleeding again. I'm trying not to start giggling because this would suck if I was in charge of the line and the two of them are looking so serious about the whole thing. They decide that maybe it's the admin set leaking. Medic looks up and tells myself and FF #2 that he wants to spike a new bag and change out the tubing. FF #2 opens a new bag of saline, and looks up to see the me handing the old bag to the medic who is just re-spiking with a new admin set. Since I wasn't digging around in the cabinet, I heard the medic change his mind, FF #2 looks confused until I explain the change in plan.

New admin set does not fix the problem. Medic decides to have the FF hold the line until he can administer the solumedrol and then give up on it so we can get moving. He breaks out the drug box and grabs a needle and syringe. The first needle is too tiny and just about snaps in half when he tries to push it into the vial. Again, I'm holding back on laughing as he looks up at me and rolls his eyes. When he gets a needle that works, he somehow does not have a full dose in the syringe, so out comes vial #2 which provides the rest of the dose. The medic turns around and grabs the port on the admin set, screws the syringe on, and out goes the dose. Right onto the hand of FF #1 holding the IV because the medic injected it into the disconnected admin set which was still taped to the guy's upper arm. Here, I can't contain it and I laugh quietly - thankfully only heard by FF #2 who joins me. Patient's son now opens the back door of the ambulance and looks panicked, "Is my dad okay? Why aren't you going?" Medic manages calm reassurance that we were just finishing up and about to leave. Door shuts. Since there isn't any more solumedrol, the line is discontinued and patched up, and after a little haggling over who is going, riding, and staying, I drive us to the hospital.

After we drop off the patient, the medic finally lets out a little of the frustration about everything going wrong and has me laughing. We head to the pharmacy to replace the 2 solumedrol that we don't want billed to the patient and the medic has a brain fart where he can't remember what drug he wants and I bail him out. Heading downstairs, he tells me thanks because it would've taken him at least 5 minutes to remember the name of the drug he wanted. We had a nice ride back to town, still laughing over everything going wrong.

Mourning

I've never before worked a job with a badge, so I've never been asked to wear a black mourning band around my badge and felt the heavy weight of rememberance that brings to ordinary activity. I look around the station and all I see are the black bands. I don't normally even notice the badges anymore, unless somebody is missing one. I was at the station at 1700 shift change and watched everyone adorn their badges for the next shift.

Everyone was quiet and subdued around the station, with the exception of cranking up the TV every time another news report came on. I know all the public details about the death, the deceased and the killer because I've seen every report repeated every 10-15 minutes. I also know some of the private details from the folks who worked the scene. I indirectly know someone who worked on the trauma team at the hospital. I know that the patient was fairly deceased long before they pronounced him dead, or they would've sent for the helicopter to Boston.

I don't know how to deal with the situation. I did not know the deceased personally, hadn't worked with him like some other folks. I can't imagine the awful pain of the wife and children left behind. I'm glad the killer had been caught and will be subject to the death penalty. I don't know how to convince myself that K is safe at scenes. First, one medic I know was threatened, by a patient he transported, with a knife in the emergency department, now an officer shot.

It is hard because I know a lot of good people in EMS and the fire service, and I know that while the maxim is always personal safety, crew safety, and then everyone else, these people can and will put themselves into less safe situations with the intent to help. I know I can't adequately assess a scene to determine safety for presence of weapons/intent to harm. I'm supposed to rely on the police for that, but (with absolutely no disrespect) obviously that doesn't always work either. I need some time to process and understand, but everything else continues moving at the same pace.

Official results

I passed! I'm now officially an EMT-I and I can do fun stuff like stick you with needles. Any of you who have met Watson can now imagine the happy dance, involving jumps, twirls and generalized excitement!!!

Sent to scoring

Just saw my official status for EMT-I test: "Sent to scoring". Results will be posted in the next 72 hours according to the website. Fingers crossed!

Rough day

Chronologically, bullet-style:

• Drive to work. Notice large trailers implying a concert at local arena. Consider whether to try and squeeze car in alley or park (and not pay) at metered spot. Realize it is volunteer night and don't want to move 3 other employee cars when leaving, park at meter.
  
• Clocked in, did truck check, immediately paged for a transfer across town.
• Left receiving hospital to return to station. Upon return, sit down, read 2 pages of new novel, called on radio to "stay on post" at receiving hospital. Drive back to receiving hospital to post.
• Post for 3 hours doing nothing. Two other crews posted with us. Tell Ellie I've read her blog and link to it. Try and decide whether the look of panic on her face is because I know or who I might tell. Decide it doesn't matter.
• Paged out for another call. Drop off patient, return to station. Notice *$%!@#! parking ticket on car. Remember trailers of concert crap and golden rule of meter parking - never when there is something at the arena. Watch the insanity of shift change. Called on radio to next call - 20 miles away down a busy 1-lane each way highway at the height of "rush hour" in NH. Not happy about getting out late. Patient turns out to be very nice and talkative and improves my mood immensely.
  
• Return to station 1:15 after shift end. Find back garage full of trucks parked so our truck won't fit. Find alley full of cars for people working concert. Ask supervisor if we can leave truck in the alley.
  
• Sup blows a head gasket about parking situation both inside and out. Truck of worst offenders is photographed, documented and sup leaves mumbling about heads rolling. Realize one of the people on that truck is still on probation and I probably just got her fired.
• Spend 20 minutes rearranging vehicles until our truck fits with nearly everyone on shift helping tell me how to drive and/or watching.
• Get in car to drive home for volunteer shift. Find ANOTHER @*&%#!$ parking ticket on car, given at 1830! Spend drive home trying not to speed or do anything erratic because apparently my car is police-attractive today.
• Call ex-partner and make sure other worker on offending truck is off probation - she is.
• Slump on couch and try to get blood sugar and caffeine levels back within normal limits while not grousing at K about my day.
• Sleep fitfully all night because there aren't any calls with the FD but I'm always listening for something to come up.
• Awaken to a beautiful sunshine-filled Friday the 13th. Hope today is better.
  

Plunking along

No exciting news lately and nothing inspiring me to write.

Last two shifts on the vanbulance have been uneventful, although we did transport two hospice patients in one day and mine was by far the closest patient to dying I've ever had. He was the brightest yellow color I've ever seen on a living person and he would suddenly stop breathing for 15-20 seconds at a time as we drove 25 minutes to the hospice providers. The worst part was that he was coming from a family member's house and had a DNR, which the family did not have a copy of. So if he died in the ambulance on the way to hospice, I would've had to try and defibrillate him, do CPR, the works, until we got to the hospital - and we were transporting a family member with us who would've had to watch the whole deal. Thankfully for me, he made it all the way there without any extraordinary measures.

Clothing items from the yearly purchase for the FD are starting to come in, so I'm almost looking like everyone else now.

I applied for an open full-time slot as an intermediate at the ambulance co (even though I'm not official yet), and the boss responded to let him know when I pass. Not exactly an excited response, but not a "get bent" kind of deal either. I'm not entirely sure why I'm so insane as to think I could go full time again, but the schedule seemed amenable - Sunday night, Monday night, Thursday day and Friday day. Which would leave me Tuesday and Wednesday for the work-from-home stuff and Saturday completely off! Sad when working 6 days a week seems like a good deal. But if you'll check back a couple of posts, you'll see I'm coming to grips with the fact that I'm completely insane...which, come to think of it, probably explains the whole medical school deal too.

Unofficial

Unofficially, I passed the practical exam for my test. Woohoo!

Testing, testing

I finished the EMT-Intermediate test today. I left feeling pretty good about all the practicals and the written test, so hopefully that means I passed. Official line is 2-3 weeks for on-line test results and 3-4 for paperwork, but the last group in August got results back in 4 days.

Insanity

I had to admit it this week. I might just be insane. An ambulance supervisor called Monday and after a confusing few minutes trying to get us both talking about the same thing, he asked whether I would work the wheelchair shift I was scheduled for on Tuesday and then drive down to the southern station and work a transfer vanbulance shift. All together, working 8a-midnight. And yes, I did it. Partly because the guy who called is the scheduling supervisor and I'm still trying to be as accomodating as possible so I get some decent shifts after I get my next level of certification.

I'm also insane because I've picked up a large number of detail shifts this month working at things like hockey games and children's football games. The first hockey game last week was good because it was at a local ice rink instead of the big arena, so I got to sit right next to the glass and feel almost part of the action. This weekend is the season-opener, so I'll get to learn what it is like to work at the big arena too. I wish I could say that the money was good, but it isn't really, which is why I didn't do a lot of these things when I was working full-time.

Last night was my FD night and I was actually in town at the early call (I almost always miss 1 a week that happen before I get home from work). There was only 1 later call, and that was a no-transport, so the low-call trend continues. Today is also open house at the FD, so I may head over there this evening and see if they need any help. Again, insane - volunteering for things I've not been asked to do.

Forgive me if posting is slow as I work my way through all the hours I have piled up waiting for me. I'll try and update after the EMT-I exam on Sunday as I should have the results for the practical portion at least.

Office life

Once upon a time, I had an office at a place where other people worked. I didn't really like being there every day. Even further back in the dark ages, I was a cubicle dweller within a small maze of indistinguishable partition walls. I hated being there every day. These places had their problems like poor temperature control, bad lighting, annoying coworkers, complete lack of windows, inconsiderate people in large public bathrooms and so on. These places also had their positive sides like enjoyable coworkers to discuss work/gossip with, making me feel "adult" and "productive" because I actually left the house every day, free leftover meeting junk food, fastest internet connection known to mankind and so on.

Today is a work-from-home day, so I get to enjoy two large windows in my office, a cute office-mate who curls up by my feet and barks at the dreaded UPS and USPS delivery folks, an entire refrigerator full of food that is not labeled for someone else to eat (but also contains no free meeting food appearing a couple of times a day), good lighting, a comfortable desk, a private bathroom and so on. I'm also incredibly lonely because although my office-mate is cute, he's not so good with conversation and doesn't have any entertaining gossip about anyone.

I alternate between getting a million things done in an hour and not being able to concentrate long enough to get anything done in two hours. Sometimes, I see interesting things out my windows. Things like when the city crews came by and dug up all the manhole covers and replaced them with pavement. Weird because two days later, another crew came by and dug up all the pavement and re-paved, putting the manhole covers back in. Like when the city crew came by and painted little arrows and slogans on all the storm drains. Like the fact that the UPS man comes down this street and stops within 2 houses of us EVERY DAY. Like the day my much older neighbor, who usually walks around with a cane and a little rat-dog, came by on a scooter - with the dog riding along. (Why? Assuming he goes out partially for the exercise and partially for dog-related issues, why would you take a dog on a scooter? I'll never know.)

Sometimes, this quiet is a nice change from the vanbulance where I have to talk all day with a partner or patients, but right now it stinks because the low call volume lately means a lot of sitting around with nothing to do and my schedule hasn't been coinciding with the other ambulance people I enjoy talking to but rather with those that make me want to claw out people's throats so I'm not getting the usual social interaction at the station. Also, I'm kinda sad because D made it to the 911 trucks at the southern station starting next month so he isn't going to be around to talk to anymore either.

No point to all this, just feeling left out of the rat race in a weird way today and slightly overwhelmed by the big pile of work that a 19 page document can represent.

The rest of the story

So we had a couple of other ambulance calls with the FD on Sunday and suddenly our MIA third volunteer shows up. I, of course, made sure to get the story from his side on whether and why he was leaving. It's no good listening to the gossip when you could get the real story instead. Apparently, he asked for a leave of absence for this semester because he's taking 20 credits at school and didn't feel like he'd have time to respond as a volunteer. Management denied his request, so he submitted his resignation with 2 weeks notice instead. This was 2 weeks ago, so this weekend was his last shift with us.

Also entertaining was a spate of "suicide attempts" Sunday afternoon. Somebody blamed it on the football game(s), but who knows. It wasn't just our town though because we went to 2 different hospitals who were both complaining of the same patients.

I got to tech one attempter to the hospital who tried to run a garden hose from the tailpipe to the window of the car. FD measured carbon monoxide in the car and found no elevation at all. I had to work at it, but I was able to keep a straight face when the patient looked at me with the sad-puppy eyes and said, "I guess I didn't do a very good job, huh?" Yeah, not so much. The doctor at the emergency department actually complemented the FD for measuring the CO and me for reporting it because it cut down quite a bit of what they were going to have to assess the patient for at the hospital. I made sure to take no credit for it, because I didn't really have anything to do with that decision - but when you get updated from "suicide attempt" to "carbon monoxide exposure" by dispatch en route to the call, checking the levels is definitely on the to-do list.

Monday was pathetically slow at the ambulance co, my truck did 1 lift-assist for another crew, 1 transfer and 1 truck shuffle in an entire 8 hour shift. I did get some other work done and a little reading in so it wasn't a complete loss, but it is frustrating to feel like you spent the whole day just wasting time.

On-call weekend - random thoughts

I've been on-call for the local FD this weekend. Saturday we did not get any calls. None. A whole town of people completely safe and healthy, or at least taking care of themselves, all day. Today we finally got a call - and I missed it. I was sitting next to my pager and somehow it didn't alert to the call. The first I heard of it was the ambulance signing off on scene, so by the time I called dispatch and found out where and what it was, then got dressed, in the car and headed the right direction, they were ready to transport. I was at the station for the second call, which was really nothing interesting, but at least I didn't have to take all the harrassment for missing another call.

Yesterday, we did training for how to hook a hose to a hydrant, how to use the radiation detectors, and helped one of the other volunteers learn to use the stretcher more efficiently - and all together it took more than 5 hours. But now I'm wise, or maybe just wiser, or a wise-ass, I'm not sure.

I also found out this weekend that one of the two guys that is on my "shift" as a volunteer has quit. Nobody quite knows the whole story, but he certainly hasn't been around today and word came from the chief that he was done...so I guess we're down to 2. Kinda sad to lose someone young like that who could've contributed for a long time, but for the particular guy in question, I'm not entirely surprised.

Fiction snob

I've learned something about myself this weekend. After long thinking that grammar wasn't that important and reviling instructors who cracked down on me for little things like semi-colons...I was wrong. I'm no perfectionist but if you're going to publish something on paper that will linger indefinitely, you should at least try and master the basic rules of the English language.

Maybe someone noticed a recent increase in the pace books are turning over in my recently read side bar (probably not). I've been saving $$$ and borrowing books at the library. This is the first time in many years I've had both time and a library to do so. And I was suckered in. The library had a table full of books out by the front door with a cute little sign "Summer Picks!". I assumed this meant that someone in the library had read them and thought they were pretty good. Within the first chapter, I was looking at the book to see who in the world had published it...and couldn't find any information. This leads me to believe that it was a self-published deal which would clearly explain the inability of the author to write in proper English. In order to publish you should (at a minimum) have:
1. A story to tell.
2. A firm grasp of the difference between "your" and "you're".
3. Some idea of where the quotation marks go when several characters are engaged in dialogue.
4. The ability to write a coherent sentence.

The book I'm currently reading has 1, and sometimes 4. But it is entirely aggravating to read a book when I feel like I should bust out the red pen, mark it up and send it back for a re-write. It's too bad because the story's pretty good and it is set in the city I work in, so it is kinda funny to read about characters driving 110mph through the toll booth I pass through every day. I'm about halfway through and I will finish because if I can finish a book about WWII, I can certainly finish this one!

Hard day's work

Well, actually the hardest thing about it was not getting myself in trouble - but that's not an uncommon problem for me. I picked up a detail shift on Sunday, which are things like the baseball games, races, and in this case a kids football game. 40 or so 6th, 7th, and 8th grade boys on each team smashing into each other with great joy and enthusiasm. Coaches seeming a little strung out, shouting at the kids about what play was called and where they are supposed to be. And four referees, one of whom was rather overweight and seemed the most likely candidate for needing medical assistance - until I saw that he doesn't take more than 3-4 steps during any play so he's hardly even breaking a sweat. Add in a few handfuls of parents and siblings for each team, a beautiful 80 degree, low-humidity, light breeze day and you have the makings of a delightful 4 hours of sitting around doing nothing while getting paid.

So how did I almost ruin the nirvana of EMS? I was posted in the front row of the stands, which meant being near a number of parents. After the first "varsity" game, some of the kids came off the field so the rest of the kids could play in the second game. The home team's center was apparently the son of the woman sitting closest to me, and he was talking with his mom after the game. Another toothless, redneck yokel (who I sincerely hope was not a parent, but probably was) came by to throw his two cents in.

"So XX, do you feel like a loser?" [nod from kid] "Well, you should. You and the whole rest of the team are a bunch of losers. You're twice the team those other kids are and you just stood out there and let them walk all over you. You guys weren't even trying. I hope you remember what it feels like to be a loser like this." [kid looking more hurt at every insult. mom just sitting there doing NOTHING]

At the first question, I was just stunned. As the yokel went on, I had to hold on to the arms of my seat to keep myself from getting up and saying something. I realized that there was probably little more embarassing to a 12-13 year old boy than having some woman he doesn't know stick up for him (since it implies he can't do it himself), but I don't condone child abuse, verbal or otherwise, and I'm saddened to think that the kid left thinking that it is okay as an adult to act like that because nobody told this yokel he was being inappropriate.

As an EMT, I'm responsible for patient advocacy - but I'm not sure where the line is for children who aren't my patients when I'm being paid to represent my company in full uniform. The first rule of detail work is don't rock the boat unless it specifically involves your patient or your safety. But isn't there some value to being a good citizen? Am I really going to just sit there if there's physical abuse? Shouldn't his mom have stood up for him?

Real world overlap

So it finally happened...I think I found the blog of someone I met in the "real world". Sorta weird to think about reading someone's thoughts and opinions that I wouldn't normally be privy to in the course of the day. I don't know her personally and she's still fairly new at the ambulance company, but there are some unmistakable signs that this is the same person...first clue being the picture. I'm putting up a link because it might be interesting to anyone wondering what I'm in for if I ever get onto a 911 truck and because it's a good read. Enjoy.

And then...I die

I've checked all over my uniform, but I still can't find the place where it says "Kill me" on it. Two partners in two days have tried to make the vanbulance one with another vehicle. Large other vehicles.

Partner #1 tried to get us killed by two separate semis. One he tried to pass in the right lane when the truck was making a right turn from the left lane. One just tried to run us over on the freeway.

Partner #2 tried to put a Yukon in my lap by turning in front of it. I swear to you, we were turning onto a 1-way road and he NEVER LOOKED the direction the traffic was coming. I was on the radio with dispatch and I thought I'd help him look since it was probably hard for him to see. Just as I turn to look, he starts to pull out, I shouted a naughty word and he looked at me like I was a crazy psycho and then FINALLY saw the 40 mph Yukon that was about to smash into my door. The worst part about it is that the guy is a total dink and spent all day bitching about all the other drivers and cutting people off, including commenting that he wished he were on his motorcycle so he could just cut between all the cars that were so annoying him.

Yes, I put my life on the line every day in this job - and it may have nothing to do with the patients.

p.s. And yesterday, I put my head on the line too because we transported someone with lice. L-I-C-E! I didn't realize anybody past 3rd grade got those, but ewwww, and they were sending her back to the same nursing home. Just for the record, we left the pillow there.

Stupid call of the day

"Dispatch to 28. 28, head to [hospital X] to meet up with 6 and take staff back to [southern station]."
"28 to Dispatch."
"Go 28."
"Any additional information on where in [hospital X] we might find these people?'
"6 to 28, we are at the emergency entrance, meet us there."

Ooookay. So I get to drive 20 minutes each way to take a nurse back to her hospital because, why? Oh yeah, because 6 ends shift at 1700 and it was 1630 and dispatch doesn't want a paramedic truck out of service long enough to return this person they agreed to transport with a patient without thinking about how she's going to get back. Bad enough to be a taxi service for the patients, now we taxi staff too? Gotta love it.

Roll bounce

K and I were up early Saturday morning because we needed to insulate the attic. While going out to pick up supplies, we witnessed exactly the kind of incident that caused me to get my EMT certification in the first place. K and I riding together seems like an excuse for everyone around us to decide to wreck.

We were waiting at a stop light when a motorcyclist with the green light made a left turn into the right lane in front of us. Deciding to show off, he thought it would be a good idea to accelerate hard before he was even halfway through the turn. Bad idea. The rear tire slipped, gripped again for a heartbeat, and then slid out from under him. The motorcycle continued to slide down the road and off to the right shoulder. The rider hit the pavement on his left leg and quickly separated from the bike, and proceeded to bounce - left hip, head, chest, right shoulder, back - then slide to a stop. I'm sure he was very grateful that he was one of the few bikers in NH wearing a helmet and full protective gear.

About the time he stopped, we got the green light and pulled through the intersection to see if we could help. The other two left-turning cars also stopped, thankfully they were both far enough in front of him that nobody ran him over. By the time K got out, the guy was up and heading to pick up his bike. I stayed and called dispatch to send the ambulance, but before I could even finish explaining where we were and what happened, the guy was sitting on his motorcycle trying to start it. K said the guy swore he was fine, just a little road rash on the left knee, and refused to let anyone check him out. The guy then fixed his mirror and drove off. We were behind him down the road for a while, and he kept looking around at parts of the bike and himself, but he seemed like at least there was nothing too important broken. I'm fairly sure he ended up at the hospital some time that day because hitting the pavement at 25mph hurts, even if you're too embarassed about the whole scene to notice.

p.s. Yes, we finished the attic insulation and may save the $600 in heat in the first couple months this winter given the price of fuel and the fact that there was almost no insulation in the attic when we started.

Riding with boys

EMS is an interesting field because it has been all men for so long, they don't even bother to act like men instead of boys. In the last week I've had conversations about: the terrible blow jobs suffered by one man from his wife and his fond memories of his last great blow job; the relative hot-ness of various women wandering near; the tramp stamp tattoo and how it leads to the anal sex; and so on. I can't even remember them all, but most of them were inappropriate and if voiced within 2000 feet of a human resources person probably would've resulted in the immediate firing of everyone in the room.

I also spent 2 days this week riding with one of the biggest flirts in the company. When we go to the hospitals, he frequently disappears for 20 minutes or more and if you track him down, he's flirting with a nurse, an aide, admissions people, radiology techs, or pretty much any female under 40 and under 200 lbs. It doesn't bother me to ride with him as long as he doesn't make us late for calls, and even though I don't believe he was sincere, it was entertaining to be told you are pretty or beautiful 6-8 times in an 8 hour period. Yes, he's married. No, he doesn't do anything beyond batting some eyelashes and saying innocuous things. He's one of the people I was warned by some women about when I started at this company, but nobody has any suggestion of anything he's ever done to anyone. He's a Lt. at a fire department, so he's well aware of "the line".

It is interesting insight into the psyche of men though, and there is actually quite a diverse group at this company. Guys who are sports jocks to family men to crazy punk rockers covered in tattoos. The one thing they all agree on though, how much they like to talk about women and sex.

It's official

Just returned from getting the official sign-off on my class. I am hereby qualified to pay $145 to take the national registry exam to become an EMT-Intermediate. When I pass that, I will be qualified to send additional funds to the state so I can be licensed to practice.

Now that class is officially done, I'm going to vent a little. This was BY FAR the single worst class I've ever had the misfortune to pay to take. The lead instructor didn't give a rat's ass about us personally or the class as a whole, including not bothering to show up for several nights of class where things promptly went wrong. The outside lecturers showed up and flipped through the power point slides produced by the book editors (and you can guess how great those were) with no apparent preparation or thought going into the lectures. There were inconsistencies between information given out by guest lecturers and answers on quizzes/exams because those instructors had no input into what we were tested over. Lab instructors were not even trained, had no idea how we were going to be tested, and couldn't run the stations the way the exams were offered. When we got to the hospital and ride-along time, all the feedback about our class was negative and reflected how unprepared we were to be treating real patients. Our instructor claimed we had a "poor attitude", but for most of us, that developed as we realized the impossibility of achieving any actual proficiency from this class.

Ugh. The only thing good I can say about it is at least my job is reimbursing the cost so I don't feel like I was personally screwed out of the $700. Now, onward to learning what I should've been able to do as an Intermediate in 1985 since that is the national test I have to take.

Template changes

Don't be too surprised if the look changes every day or so until I settle on something new...feel free to give feed back on ones you like.

Final exam

Last night was the final in-class exam for Intermediate class. I passed the written test easily and felt good about all the practical stations. At the end of the night, I found out that I failed two practical airway stations (they were both completed at the same time) because I forgot to say that I would wear gloves. Stupid reason to fail because I always put on my gloves before I even get out of the ambulance, but a failure criteria anyway. So I get to go back next week and retake those stations.

I was going to go back next week anyway because our instructor conveniently "forgot" to have our course evaluations ready for us last night and he definitely needs the feedback. He needs it so much that several people have written to the state certification department about what the program needs and whether they should even be certified at all.

I also managed to get suckered in to an 8 hour shift on Saturday and covering half a shift on Sunday, so instead of having the whole weekend off, I really just have Monday off. I'm such a sucker for a sob story...

Last day of ride time

I finished my last day of ride time last week and now I just have to pass the final cumulative written exam and the practical stations and I am D-O-N-E with this class!!! Ride time was fine, it was my only day at the station I work out of, so it was nice to ride with people I'm more comfortable with. I think I did okay - definitely more performance anxiety because these are people that I need to have respecting my skills and wanting to work with me, or I'm still going to be stuck on a transfer truck regardless of my certification. I went on several calls with one of the supervisors and several with one of the other medics who let me start 2 IVs (successfully!) and push D50. Several people were reasonably impressed that I pushed D50 through a 22 gauge catheter (22 is a pretty small diameter and D50 is 50% dextrose solution which is about the consistency of molasses, not easy to push through a small opening).

Today is my first day completely off of work, of any kind, in quite a while. K is even home today and we've been taking advantage of some dreary weather to relax and take it easy inside. We were supposed to fix the hole in the ceiling today while there were two of us to lift drywall, and to finish the long-postponed shopping, but neither of us really feels like it. No big plans for the holiday weekend, just a softball party on Friday (we lost out of the playoffs this week) and then hopefully some med school apps to work on if they're here by then.

Cue Imperial March (Darth Vader's Theme)

If you know the song, then you know the feeling. I present you, my lord, with my puny medical school application and beg you not to crush my throat from across the room. (Yes, I'm entirely comfortable with being a nerd.)

I submitted my central application (AMCAS) today, along with the $250 fee for applications to 4 medical schools reasonably near my house and officially ended hours of agonizing debate over what to include, where, and how. I was expecting more of a feeling of relief, but instead it was more like the knot in my chest got a little bigger and tighter. Now I'm official. People know that I want to go to medical school and are going to judge everything I've said and done to decide whether to let me in or crush me like a bug. But first, they have to send secondary applications where I have to write more essays, get letters of reference and send them additional money. Always with the money - I'd think that schools getting in excess of $34k a year in tuition wouldn't need so many application fees, but apparently I'd be wrong.

I don't know how long the rest of the process takes, but most of the schools do interviews from October to January with the earliest admission decisions in January and the wait list decisions running until March or April. Apparently cooking a med school app takes about as long as creating a new life - but I'm really trying to create a whole new life for myself so maybe that's appropriate. At any rate, GULP! I'm good enough, I'm smart enough, and gosh darn it, people like me...I hope.

Slow

I'm going to invoke the word we do not say in EMS in the hopes of getting a few interesting calls today. Things at the FD have been slow. Very, very slow. Thursday we did two calls all night. This is my volunteer weekend and yesterday we had 2 calls (one was a lift assist) and a cancellation, and that was it in 24 hours. We've had one call today so far...slow.

The medic working today got bitten by some sort of bug on Friday and his arm is incredibly swollen today. Yesterday it didn't look nearly that nasty, but today it seems pretty clear he's going to need medical intervention. He showed it to one of the ER docs this morning, asking whether he should get it checked out and the doc's response was "Hell yes!" Kinda sucks 'cause he's one of my favorites and he might not be there if we get a call later. The other medic on this shift I've never really worked with, and from all rumors that sounds like a good thing - so maybe I shouldn't be hoping we get more calls, but I am anyway.

Edited 8/21: So, we did get more calls - all night long. Serves me right for wishing for more work. The medic came back after a dose of IV antibiotics and a prescription for more and he sent the volunteers (specifically me) with one patient of our own and one patient he worked with one of the younger guys taking the lead...exactly the reasons he rocks.

Time out

Just so you know, I haven't been ignoring you. I mean, it's just that I've been out of town and kinda busy, right? I've been thinking of you even if you didn't know it, that's gotta count for something...okay, maybe it doesn't count for much, but that doesn't make it untrue.

Monday through Wednesday this week I was away at a "conference retreat" with one of the groups I still do statistics for. This yearly gathering is held at a spectacular lake house where they serve gourmet food and give you free run of canoes, kayaks, etc. for enjoying the lake. But the payment is that you have to sit in presentations and meetings and actually accomplish some stuff while you're there. I've had several people comment on how miserable it must've been to go and listen to people all day, but really it isn't that bad. I enjoy listening to smart people talk about interesting things. It is why I like school. And smart people who think that I have something interesting to say - well, even better.

Thursday I turned down an offer to work an extra shift on the ambulance because one of the local hospitals was running a continuing education seminar on heart attacks brought on by illegal drug use. So I sat for another 4 hours listening to smart people talk about interesting stuff. I learned that you should NEVER NEVER NEVER give someone on cocaine and having a heart attack a beta-blocker because it will make everything worse and probably kill your patient, and you should give them some valium or something to settle them down a little. Good to know, but kinda useless personally since I can't administer any of those meds.

Last night was also my volunteer night and my two favorite paramedics were both working even though it wasn't either of their shifts. We only did a couple of calls, but one of them was interesting for me because there were two calls dispatched within a couple of minutes of each other. Meaning the ambulance was heading to the first one, and they were sending the engine from across town to the other and sending in an ambulance from another town. So I pulled a quick U-turn and headed to the second call because I knew the other 2 volunteers were heading to the first (one of them was right behind me). I was with the patient for almost 5 minutes before the engine got there, which would've been great if I'd had any equipment. The patient decided not to go to the hospital, so I ended up doing all the paperwork for the refusal - including the 40 minutes to enter all the info into the computer. The Lt. on the engine definately had some say on-scene as he had to decide whether to cancel the ambulance, which we didn't because we felt like she should probably go to the hospital and were trying to talk her into it. But this was pretty much my patient, all mine, and I'm greedy like that.