21 November 2014

A Few of My Favorite Things

Last week, I got to go to the EMS World conference in Nashville, TN.  More on Tennessee later.  But, like every time I have been to an EMS conference, I was left wishing I had my own ambulance service as well as absolutely unlimited funds.  I liked a lot of the things.  I wanted almost all of the things...except those that were totally absurd.  I am sure that my employer will hate that I went because I will only make safety oriented and expensive suggestions at budget time.  Some ideas I saw there filled me with a sense of urgency and the desire to completely change every ambulance I encounter.  I'll give you the top 5, not including the fake blood that actually clots.

1.  Lifts
This thing may look really silly.  But, I believe that it fills a huge void in our care.  We've all been on those calls when an old or overweight or frail person has fallen out of or off of or just fell and can't get up.  Classic, right?  Here's my usual situation.  This patient has fallen, usually behind a door, or between a king sized bed and a wall.  They don't have clothes on.  I mean, do they ever?  They weigh 300 pounds.  We bend down, grab under each arm and heave them into a standing position, pop them on a chair or something just as useless and call the job done.  This, of course potentiates injuries for the patient and ourselves.  And something in the presentation this products representative got to me....our common practice has a complete lack of dignity for the patient.

This device goes under the patient, inflates with the touch of a button and puts them into a chair. Boom.  Done.  From there they can be slid back into bed, onto our cot or wherever they need to be.  I saw them used in the UK, and before I am accused of rampant anglophilia....Well, okay I have it.  But, this thing is awesome and is gaining traction in the US.

2.  Handevy System
I'm kind of hook, line, and sinker here. The real beauty of this, is that we can basically make it at home.  The beauty of that is that the inventor doesn't care!  This pediatric ER doc was tired of being afraid of sick kids.  He decided to help himself, his hospital, and his EMS providers by streamlining a system of pediatric resuscitation.  It looks a lot like the Broselow system...only better.  Only easier to use, customized to your service, and not a hot mess when you begin to tear that bag apart.  I can't explain it all here, so just check it out.

3.  Clean all The Things
One of my biggest problems at work is the one I can't even see.  Germs.  Ambulances are gross.  Tools are gross.  People are gross.  At least one company has come up with a way to solve this problem.  Here is a (ahem $14,000ish) system that sprays your ambulance with decontaminating magic stuff as often as you want!  Every call!  Every day!  Every all the time!  Must clean all the things!  This magic stuff sticks to surfaces without leaving residue or smell, but it does leave one thing...peace of mind.

4.  Safety Nerds Unite!
This wasn't exactly a product, but a mindset.  Why did I find virtually every ambulance manufacturer at this expo boring?  Because they all looked the same and they all looked dangerous.  Just one bloggers opinion.  If one of them could tell me how sitting sideways on a bench seat with a lap belt on is safe...I'd love to hear it.  The EMS Safety Foundation is trying to make headway in ambulance design safety.  They promote crazy ideas such as: forward facing captains chair instead of a bench seat!  No cabinets!  A desk!  Properly fitted seatbelts!  Not getting up while in a moving vehicle!  Supplies within arm's reach!  I know this all sounds crazy, but they gave me candy so whatever.

5.  This Australian stretcher. Thanks to the safety nerds, I saw this stretcher.  The only thing wrong with it is that it's Australian.  Just kidding.  Not really because I'm not sure we can get it here.  It can be loaded by one provider...without lifting...without batteries.  I also saw this amazing fancy-pants stretcher available on the US market.  I mean...wow.  I actually has a light bar on it.  What's not to like?  The thing is.  This Aussie one I found online starting around $3,000.  This American one costs upwards of $30,000.  What?  They both can be loaded by one provider...without lifting.  One uses batteries, the other uses physics.  One has a light bar.  You decide.  

05 November 2014

Step 2 of 1 Million

Last week I stayed up until midnight, on a day when I really didn't want to, in order to register for spring classes.  I have a vague memory of the first time I went to community college of waiting in line and hoping that the class you wanted and fit perfectly into your schedule would be open.  Now, I just have to remember a password (or let google remember it for me) and register in the comfort of my living room.  I am probably wearing the same outfit.

I've been taking medical terminology online.  This is my first and hopefully last foray into online class-taking.  From the beginning I felt very old.  It took me way too long to figure out how to get to the class, find assignments, and just figure out what the hell was going on.  Oh, my I felt old.  I did figure it out and I am just going to assume that every student in an online class is cheating.  Basically, especially in a class based on memorization, everything is open book.

Once I figured everything out, I learned why everyone likes online classes. I'm practically finished with the whole thing and it's only the second week.  Self paced, for the win!  Hopefully it will serve as a good review of A&P, which I'll be taking in the spring.  That class in itself should be a review, though I last took it (gasp!) 10 years ago.  I did not realized that sciences expire.  I think that I've figured out what to do to be ready to apply to the PA program in April (2016!).  There's an information session later this month that will hopefully confirm my suspicions and solidify my plan.

Until then, work, work, work.  

04 October 2014

New Wild-Ass Plan

The trouble with this plan is that it has so many fail points that I am afraid to advertise it.  It is also a very long-game type of plan (at least four years to completion).  I also don't want to build it up too much because I think I did for my parents whom almost deemed it not wild-ass enough.  Though I'm sure left to come up with one, had me feeding penguins in the Antarctic, or taking a trip to the international space station.

Basically this plan has me going back to school.  Shocking, I know.  Firstly, going back to my good old community college to take (and retake) prerequisites.  Retake because my Anatomy and Physiology classes were over 10 years ago.  How did that happen?  And we've arrived already to the first of many fail points.  I need to take five prerequisites and maintain basically straight A's.  This includes microbiology and organic/biochemistry.  I barely made it through basic chemistry, so I am justifiably worried about trying again.  B average is probably possible, but...you know, may be difficult.

So, get those classes done, borrow some money, write a winning essay, win over some killer references and apply to PA school in 2 years.  That's the plan.  I can't even tell you why at the moment (wait for the winning essay), but I was suddenly struck with a desire, and epiphany of sorts.

I've been a paramedic (my life dream) for eight years.  If all goes according to plan, I will have a solid 10 years in.  I will have moved on academically, but not to nursing school (because if I did, I'd really have to put my foot in it), and I may have something to retire on in 35 years.  That's an important one.  I can then better advocate for a paramedic masters program, or the use of PA's in the field in their stead to carry out wellness checks and the like.  You can take the girl out of the ambulance, but not the ambulance out of the girl...as they say.

Quiet goals fail.  Blogged goals cause me to succeed just so I don't have to look back at this post in 10 years and regret not trying.  So, here's to the next wild ass plan...may it succeed within the next decade.

08 September 2014

So, I'm afraid of bats.

I just finished brushing my teeth when I heard a weird noise down the hall in my bedroom.  Noises themselves are not unusual, bedtime is a typical period for the cats to decide to run amock around the house.  But there was something about this noise.  Ready to yell at the cats, I peeked in my room to see a bat, alive and well, on the floor surrounded by two curious cats.  "Oh, **** there's a bat in here." was all I had to say as I did an immediate aboutface and went dowstairs. 
Now, I am no stranger to domestic crises, but this was different.  Realizing that this bat was now between myself and my phone, and on the floor, I grabbed a sheet and bravely headed back upstairs.  But the bat, being a winged creature, afterall, had regained altitude and was now clinging to the wall somewhere where my cats could see it, but I could not.  They were beside themselves, presented with a moving, alive toy, I could barely get their attention.  Before I made my attempt to 'get' the bat or whatever the hell I thought I was going to do, I did grab my recently liberated phone and called the boyfriend.  I crept toward the bat with the phone propped on my shoulder, sheet between my hands when suddenly the bat remembered again that it was a winged creature and it flew toward me.  I also grew wings, dropped all of my armor and flew down the stairs screaming in a most unlady-like fashion.  Leaving the boyfriend perplexed and amused, I am sure. 
Somehow I managed to lure the cats away and into the bathroom with treats and promises.  I opened the front door, and 'Bruce Wayne' was at it again circling the hallway, sneaking down the stairs, then he might have detoured but I'm not sure as I was running all the way into the street.  I watched as it found it's way out of the door, though I was far from declaring the house safe.  Flashlight in hand, I inspected every nook and cranny before being able to go to sleep.  A ritual I kept up for the next week.  I worry that now that security as relaxed, I may meet Bruce again.

19 August 2014

Presentation

There's been some of discussion lately around work about wearing shorts on scenes in the summer.  Some providers argue that 'if they are truly sick, patients won't care what I look like when I show up.'  But let's be honest, how many patients are truly sick?  Sick enough to not look at you with even a slightly critical eye.  Let's not forget that our patients are rarely alone, accompanied by friends, family members, or staff of a medical facility.  They can see us to. Our immediate appearance must build trust with them as well. 

When you walk into the home of someone whom called for your help, everything matters.  They are the ones about to put their lives ino the hands of strangers.  Appearing professional can come down to having your boots tied and your shirt tucked in.  No, these things do not directly affect patient care.  But, they do affect how your patients respond to you.  Trust must be built from the first moment you walk in the door, mostly because they invited you in. 

Professionalism is a compilation of a ton of things on an EMS call, but right from the start it is measured by your greeting, demeanor, and interactions with colleagues.  All of this has, even if it is subconscious, an affect on how much your patient trusts you, and, indirectly, how well your care will help them.  I've seen anxieties melt away from a patient with a professional greeting, introduction, and warm handshake.  I've seen patient trust fall incrementally as providers enter a home with their shirts untucked, fail to greet the patient, and immediately ask which hospital they want to go to. 

Whether I agree that shorts or appropriate attire, or if tattoos should be covered, the conclusion is the same:  professional appearance matters.  It puts us in a position of authority, builds trust and rapport, and ultimately facilitates quality patient care.  

28 June 2014

Dream Job

When I was a kid, I wanted to be a paramedic.  Almost every year in my school books I said I wanted to be a firefighter, EMT, or paramedic. The evolution was easy.  Once I realized that I was afraid of things that were on fire, paramedic was it. 

There is little I am more passionate about than a good education.  "Think education is expensive? Try ignorance."  As those elitist say.

I went to college, followed the path I was 'supposed to', and no one ever talked about money.  How much money will you make in your career of choice?  Everyone knows the careers that would technically make a lot of money, and it's all but guaranteed that without a college education you will have no hope (so the guidance counselors would have you believe).  Equally passionate about education, my parents saved and scrimped to send me to college.  Other paramedic students have long term loans, crippling debt, or second mortgages.  No matter how they arrived at being a medic, it was hard fought.

Like you do in college, we discussed the ideals of our profession.  Typical collegiate musings of perfect world scenarios.  We're going to save the world one person at a time and love it every day.  How to make the best better, to be the most professional, to do the best job possible.  Maybe we weren't that idealistic, but you get the idea, and I loved it.  Making and keeping EMS a profession is also one of my passions.  But I digress.  In all this talk, in all the raised standards of eight point grading scales, quality assurance, and over-the-top prerequisites, no one ever mentioned how much money we could make.  I guess it's tacky.  But the general idea of college is to get this wonderful education, and the rewards will be 100 fold. 


That may be true, but not as a paramedic.  We were set up for management, education, and administrative jobs, under the awesome guise of saving lives. 

I am having a constant crisis because I think I need to decide what to do with my life.  But my problem has never been what to do when I grow up.  I have always known.  I have my dream job, and the only problem is that it is letting me down financially. 
What I'm doing now brings me so much satisfaction, but does not bring me enough money to live comfortably.  No paramedic should have to sit and wonder what to do with their lives because we are already members of an honorable profession.  I followed my dream, and somehow, despite being a tangible, useful dream, I find myself struggling.

I've always said that no one gets into this business for the money, but that doesn't mean that we shouldn't expect to make a fair living wage, and I guess I've arrived at my real problem.  That is that I don't know what to do about this.  Unionize, picket, starvation protest, none of it will get action.

I am sad to realize that in 10 years, I'm not really going to make anymore money than I do now.  I will not have a fancy pension, and I cannot do this career until I am 65.  Or 60, or 55, for that matter.  Every paramedic I know has more than one job.  So what is my contingency plan?  Why do I even need one?

Four years of education and preparation for real life, and eight years later I don't have enough money to donate to the alumni association.  Something isn't right here.

I'm sorry, rant over and searching for suggestions.  And not suggestions like 'go to med school or go to nursing school'.  If I wanted to be a doctor or a nurse, I would be a doctor or a nurse.  I was led to believe that this was a worthwhile career, (which it is and and nothing compares to it).  But I feel fooled into thinking I could live off of it.  Disillusioned into thinking that I could work just one job, just 40 hours a week, and buy a car, pay a mortgage, and raise a family. 

27 June 2014

Not an Alien

It was a necklace.  A necklace of tiny plastic purple beads. Yes, those are definitely tiny plastic purple beads, or maybe not.  Is that a sex toy?  No, that is more ridiculous than a necklace.  Well, then I guess it's an alien.  I've entered the twilight zone and I am about to witness an alien birth.  I'm not sure. I mean it's late and my first time but there was definitely something weird there, something weird coming out of this woman's vagina.

I composed my 3 am brain, willing out to figure out just what was happening.  She was in labor, at her due date, and assured me that everything was normal.  This may have been my first time, but it was not hers.  They just waited a little too long, that was all. And I was stoked, so excited to get a classic delivery.  A delivery that should go fast and smooth.  I am one of the few paramedics who want to deliver a baby.  We're 15 minutes out and she's ready to push.  This is going to happen, and I enter the mode of this plane is taking off, I'm on it, and I might as well make the most of it. At the very least; fake it 'till I make it. 

It took about two minutes for it to dawn on me.  So sure and ready to see an infant head, the options of toys and necklaces should have been further down on the list.  Certainly lower than the option of tiny purple baby toes.  Doing my best to maintain my patented neutral face of "everything's fine as long as I look indifferent and ask the right questions" I ask when she last saw the doctor in my most calm voice. 
The answer was buried in the next contraction, and from then on I didn't really get any answers at all, other than an exhausted nod.

I made eye contact with my driver and spun my finger in the air.  With a raise of his eyebrows and a jolt backwards, I knew he got the message that the speed limit was now a suggestion.  This seemed better that shouting, "The baby's coming out ******* backwards!!" like I wanted to.  Neutral face, neutral face.  I managed to explain in a potentially calm voice to the mother that her baby didn't get the memo that a dive the easiest way out of this mess, and I think she took it in stride.  What's worse than giving birth in a moving ambulance?  Giving birth to a baby that just might not fit out of the standard issue hole.

My phone rested tightly between my shoulder and my ear as I called the hospital back to explain our evolving situation.  For the next 15 minutes she pushed and I completely revamped my policy on touching patients' bathing suit areas.   Progress was slow and most of the baby didn't make an appearance until we were parked in the hallway of the ER, handing over to the maternity nurses.  I could tell from their faces that they didn't believe this until they saw it.  Like me, their faces changed from confident indifference, quickly to shock, and just as quickly back to what I will call the look of 'strictly business'.

I personally didn't push a breech baby out of me, the true star of this situation was the mom.  Breech delivery is kind of a commitment you can't turn back from.  Once little purple toes are visible, the system becomes irrevocably one way.  With a mighty push, most of the baby was out.  Neutral face, neutral face.  Everything's cool, except now we had to get the head.  For me, this was one of those magical times when a strange instinct takes over and does the right things for me.  Suddenly it was out and as I watched, all of my fears stood on edge, ready to be realized, when the little thing let out a cry.  Neutral face, neutral face.  It was finally okay to relax, to be happy, to show one moment of emotion at work.  It might have been a hideous baby, but for my memory, it was one of the most beautiful things I'd ever seen.

31 May 2014

1000th Post!

This lovely orchid plant was my grandmothers, who kept the finicky plant alive for several years. It is now under my care...I give it a week.

This, more importantly, as the title implies, is my 1000th post here on the old blog. Wow! This is also the 248th photo of the day, counting from May of 2008 plus a bonus month of October 2009

I don't have much to say on this occasion, it seems crazy that I've made so many posts.  Granted, a certain percentage of them are complete nonesense, but they still count.

It's funny to read those really old posts.  Some of them make me wonder just who was writing.  It's amazing to have a record of personal and professional changes one can go through in nine years.  My life in 1000 posts.  I do realize there are fewer and fewer posts about EMS.  Certainly there were a lot back in 2006-7.  But that was when it was new.  When I wanted to share every tiny thing I went on.  And I'm not saying I'm jaded now, just that my tastes and standards have changed.  I still love the job, but you don't want to hear about that abdominal pain that was going to the ER for the 3rd time in 18 hours, and I don't want to write about it either. 

It is worth considering though, adding more posts to just skim over what I've done at work.  I've noticed a lot of forgotten calls in the old posts, God knows how many I've forgotten in recent years, and have no record of. 

1000 posts.  Can't wait to say I have 2000, though that may take 18 more years at this rate. 

30 May 2014

30 May 14