Day of good deeds

Recent shift consisted of:

• Help a half-naked man (not the socially acceptable half) back to wheelchair after falling on the floor.
• Search for a person slumped over the wheel of a parked care (not found).
• Transport the least injured person from a car accident.
• Carry an elderly woman upstairs after the FD got her out of the broken elevator.
• Bandage a kid with a head laceration, then lead his mom to the hospital so she didn't get lost.

Weird day, only 1 transport and the rest just driving around helping people. Not bad, just odd.

Also, favorite diagnosis from an ED doctor recently "Acute exacerbation of chronic crazy."

Lobotomized lab rats

are smarter than my last two patients today. I'll just tell you that they were passed out in somebody's front yard (at 1500!) and leave you to fill in the rest. These are the days that make me wonder why I decided to do this.

Also, we now have Ativan, Zofran, and Toradol on our trucks and the medic student even got to use one today.

Updates

• I addressed the salary question with HR and they "investigated" and decided to up my salary to $x+0.30/hr retroactive to April, then $x+0.92/hr after my evaluation this month. Because I'm a "valued employee". And I'm now sworn to the confidentiality of my new salary to help support morale...ha!
  

• K and I decided to buy the new microwave now and rig up a temporary set up to use it until we can officially install it. We aren't using the convection oven settings now because I'm not sure how the heat gets vented, but I'm guessing that 3" of space underneath probably isn't enough.

• The home equity loan isn't closing until next Wednesday, so we're trying to figure out whether we're missing out on any good sales if we wait that long.

• I've been sick for the last two days, achy and miserable. Strangely like the flu I'm not supposed to get because of my flu shot. No respiratory symptoms though, and that is usually the first thing I come down with when I get sick.

• I checked in with the school I interviewed with in September and I'm still on the no decision made list.
  

Recipe for confusion

Ingredients:
1 dispatch, "Meet PD for psych problem"
1 caseworker outside building
1 naked patient
2 unhappy cops
3 people on the ambulance (1 student)

Apply dispatch to EMTs, stir gently for 3 minute response time while student verbalizes potential patient scenarios. On scene, add caseworker. Allow complaints of patient medication non-compliance, conditional discharge, and other caseworker jargon to saturate EMTs, eventually requiring them to be rude and ask for entrance to the building to assess patient. At apartment, add 2 cops to a separate dish, laughing at EMTs and being grumpy for getting dispatched to a medical call where they had to request an ambulance. Add sweaty, naked patient, breathing heavily, answering "yes" to all questions. Wait patiently while EMTs stick to floor, seek clothing, dress patient, continue to be mocked by PD, attempt to get non-jargon information out of caseworker, and walk patient down stairs. Place PD aside for potential use in different recipe. Place mixture in ambulance, find out patient is schizophrenic with violent hallucinations, caseworker knows nothing further about medical history, knows nothing about what medications patient takes. Continue assessment, find blood sugar reading "HIGH" on glucometer. Agitate gently for 4 minute transport to hospital. Remove from ambulance and deposit mixture into ER room. Serves 6-8.

Sounds tasty, no? This entire call left me completely confused. The patient was trying her best to do everything we asked of her, so I was fairly irritated with the caseworker complaining about "non-compliance" when there was clearly a bigger problem going on. No known diabetic history, but this patient was in DKA (diabetic ketoacidosis). We missed it initially because there were so many funny smells in the apartment and we had been focused on psychiatric issues. At the hospital, they intubated her immediately. We later found out that she was also in renal failure and had some sort of fungus in her blood.

It figures

K and I are currently a bank check away from starting a kitchen remodel. And by "starting" I mean actually ordering the cabinets and such and waiting the 4-6 weeks for them to arrive so we can start my personal hell of home remodeling. So of course, yesterday the counter top microwave decided to shoot blue sparks and try to burn down the house. Being the good firefighter he is, K decided to shut it down and unplug it so there wasn't actually a fire. After reconsidering, he kinda wishes he'd let it go a bit and burn some of the ugly cabinets so that the insurance would cover some of the remodel, but I'm not a big fan of insurance fraud nor potentially out of control fires so I think he did the right thing.

The new kitchen layout includes an over the range microwave to save some counter space. The current cabinet over our range is too big to install a microwave there. No other cabinet in the kitchen is actually 30" wide and NOT over the only available counter space in the kitchen. As far as I can find on the internet, it is verboten to set an over the range microwave directly on to the counter top.

I'm the type of girl that really can't go 8-10 weeks with no microwave, my favorite food is anything K already cooked that I can just zap quickly. So I guess I'm going to have to take the Asian up on his offer of one of their spares at a reduced cost. Just figures that it would break now though.

Irritant

It is like a medium sized splinter under your skin on your index finger, just in that spot where you hit it every time you use your hands. It is too deep to pull out, you have to wait for your body to react enough to push it out where you can reach it OR you have to dig, poke and prod with a needle until you make a big enough hole in your skin to get it out. Red, inflamed, irritating. Yeah, just like that.

My current splinter? Salary. Specifically, what I'm being paid relative to other individuals in the company with similar levels of experience and seniority with the company. If I'm being paid $x/hr, there is a guy with approximately 2 months more experience who is being paid $x+2/hr. I've talked with a number of EMT-Is in the company, who have all been open and sharing with me, and the salary inequities are startling and upsetting. There is a woman who has 3 years of experience who is making $x+.50. Only 50 cents more than I got as a new EMT-I out of school.

In talking with a supervisor and some senior employees, everyone suggests that I should go to HR and ask them to evaluate what I'm being paid. And that if I'm not happy with what they suggest, I should go to the director of the ambulance co. So here's where I have the two painful options, my yearly evaluation is in November and they usually try to address salary issues at that point, so I could wait and see what they come up with. But evaluations are frequently not completed on time, and my official "evaluator" is out after just having a baby. Or I can dig and poke and try to get money from the company now so that any pay increase I get next month (which are usually percentages) will be based on a new salary, or they'll stiff me entirely because I just got more money.

I don't know what I'm going to decide, but I do know that it is annoying and I'm bumping into that sore spot every time I go to work.

¿Habla íngles?

At least 3 years of high school Spanish and one year in college aren't going to waste. I've had a string of patients lately that only speak Spanish, or little enough English to be unable to communicate. I'm able to remember enough to impress my ambulance partners and thoroughly confuse my patients. I knew a fair amount of conversational Spanish, and as I need phrases I've tried to learn them. But really, I don't think my high school teacher ever expected me to ask, "Does the pain move anywhere around your body or stay in one place?" K is also taking an introductory Spanish class because he's encountering patients he just can't communicate with and it is hard to help people when you don't know what is wrong with them. We do have access to language line, a telephone translation service, but it really is easier if you can just talk with the patient yourself.

Also inconvenient is the need for trying to ask questions in multiple ways. For English-speaking patients, I'll frequently ask a question, get an answer, move on with some other questions or information and then come back to ask the question with a different phrasing to make sure I'm getting consistent answers. When I come up with only one half-baked translation for a question, I'm unlikely to try it again unless I think of a better way to ask it, so I'm never sure I've gotten quite all the information.

The last patient like this had been working on his car when it fell off the jack and crushed his arm underneath the wheel (not the tire, the metal wheel). Nobody on scene spoke English. Myself and one firefighter spoke some Spanish. I was able to get enough information out of him to give a decent radio patch to the hospital and a reasonable report to the triage nurse. Unfortunately, they didn't have a translator available in triage, so I was trying to ask some of her questions too, "Have you ever smoked?", "Do you drink alcohol every day?", "Who is your primary care physician?" with about as much success as I had in the ambulance. What really made me laugh though - when I returned to registration to try and get his demographic information, there was a fluent Spanish speaker working with him on that and nobody thought to ask her to help us out in the back.

Quick points

I have so many things rattling around in my noggin to write about that I don't want to forget, so here's a quick update on the things I may write about later.

• Is there something wrong with you when the most jaded and detached people find you strangely unmoved by a difficult ambulance call? Call was for an unconscious infant, updated en route to CPR in progress, ultimately a death from unknown causes. I was on an overtime shift and we had a paramedic student with us who had never seen a code before, much less a pediatric one. Medic later told stu, "Don't worry, these are hard calls. Not everyone is as unemotional as she is." Thankfully, I'd already had a conversation with stu about the call, so I think he knew that wasn't really the case. I do seem to be attracting bad calls lately though.
  

• I don't normally give you much information about my reading choices, nor endorse or pan books I've read but "Isolation Ward" was great. I find that I enjoy novels, shows or movies that have characters I can relate to or ones I could imagine myself as and this book really hit the spot. I also enjoyed "Iron Ties" which is the second book in the series - as usual I read them out of order, so I just finished "Silver Lies" and I'm glad I started with the second one because it was much better.

• The fire station had open house on Friday and K was dangling from a rope as part of the big show to impress the kids. I'll try and post a pic later.

• We've got company in from out of town for a couple of days from MI, so we're hitting up some of the local highlights. Every time people visit, we come up with more things to see so eventually we'll actually be able to have suggestions for folks.