04 January 2016

Calls

How about a good old fashioned call round up?

A pleasantly confused old lady with a fever. 'Would you tell me your birthday?' Huge, mischievous smile 'No.' 'Alright, you do what you do.' 'Thank you for a great dinner.' 'Anytime.' 'I'm so glad that's over.' 'Yes. Me too'. (Continues to hospital).

A kid that ate iron supplements. PS. this can be VERY bad for adults but especially children. But in the first stages, all I had to deal with was another kid whom didn't quite like me.

A kid who stabbed themselves with an adult epi pen. PS. I don't really know how bad this can be especially when everything is fine after 45 minutes. Poison control agreed in this instance.

A delightfully bright elderly lady with basically nothing wrong with her. When I stood her up from her chair she was about a head and a half shorter than I am. There was a pregnant pause before she said. "That's as high as I'm going to get!" "Hey, I wasn't going to mention it." I said innocently. "You wanted to. I could tell." I want more patients like her.

A patient with flank pain called at midnight. Within the last week they'd been seen in the ER three times for the same thing. No primary physician.

Someone with a pulse of 35 and a BP of 70/p. Both very not good. But a patient I can treat?! Amazing. Lots of generic chest pains and sick people: aspirin, zofran, yay yay yay!

08 December 2015

Expectations

I had a recent encounter with a family who had expectations for me that I didn't meet. They called for their unconscious family member.  Having met this patient before, I work very hard to not fall into 'The boy who cried wolf' mode.  I take every call seriously until otherwise informed. 
This person was unconscious.  Or were they?  It is my job to figure out why they're unconscious.  I see they are breathing sufficiently, I pry open their eyelids and look at their pupils. I feel their pulse on their wrist.  I pull out the glucometer to check their blood sugar.  This is when the yelling started.  "Why are you doing that?!"  When I fail to match their anger, they get angrier.  "I don't know why you're doing that.  [they] don't have a sugar problem!"  Again, my answer is too calm.  I continue my assessment, take their blood pressure, and wait for my partner to return with a device to get their limp body out to the ambulance.  More abuse comes my way "I don't even know why we called you." and "You know what?  I don't like you!" is shouted at me.  Meanwhile they were refusing to answer any of my questions, produce medications the patient was on, or tell me anything of any use including the patients birthdate. An observer may have thought that I stood there with my arms crossed and did nothing.  They may have thought I was smothering the patient.  They may have thought I was requesting unreasonable things.

The whole thing really took me aback.  I really didn't know what to say, knowing that anything I did say would spark more anger, so I landed on "I'm sorry I'm not meeting your expectations."  But really I meant, "Please tell me what you want me to do?"  "This is standard assessment and treatment for the unknown unconscious person (who isn't dead)."  "There are only two of us, I'm here assessing this patient and my partner is getting ready for transport, this is how it works." 

But are these people thinking "I wish that the people I called to help us were as hysterical as I am."?  Did they want me to throw the patient over my shoulder, carry them down the stairs, across the yard and into the ambulance?  Did they want me to inject a miracle elixir?  I really don't know, and frankly, I don't think they did either.  Somehow, even though they call us for our expertise and experience, that isn't good enough unless they hear what they want to hear.

So where does the solution begin?  I wish I could tell you that I counseled these people and they came around and we all held hands and skipped through a field.  But I don't know how to fight such unearned anger. They don't know that their expectations are skewed, but I am certainly not telling anyone that in the heat of the moment. 

Patients are usually non medical folk, they're scared, they're at the end of their rope with chronic illness. There is certainly a lot more heartache and trouble in their lives than in mine, but does that mean I have to answer for that?  All medical providers are just the patsy, the scapegoat.  We are people who can be blamed for problems larger than ourselves.  We are in a society where more emphasis is placed on the temperature of a drink than the quality of patient care; it's hard out there! An individualistic society that blames all problems on everyone else.  A society that forgets that there are 6 billion other people who are all trying to be the lead in their on life story. 

Okay, I'm sorry.  I rant.  I think I only wrote this down to make me feel better.  I guess I do.  The problem still goes unsolved. On this small scale, I decide to fight anger with kindness.  Maybe one day it will work.

26 November 2015

Take the time

The other day we went for a medical alert call.  The good ol' "I've fallen and I can't get up." call.  These are some of my favorites.  Sometimes they are over fast.  The patient is embarrassed, we pick them up, put them in a chair and they thank us but want us to leave before the neighbors see the ambulance outside.  Sometimes we get to break stuff.  If all the doors are locked and the patient can't get to them to open them, things get broken which is always good fun.
And, sometimes we get to stay a while.
In the last year I've picked people off the ground many times, but one lady about four times alone.  I don't mind going to her house because she is fiery, funny, and likes to talk.  Boy does she like to talk.  The last time we were there we picked her up, cleared away the mess she had inadvertently made, took trash out and whistled at her new pet bird. 
On this occasion, one of our volunteers who works in a big town was rushing things.  He couldn't wait to leave, which he was free to do at any time, but I sat at the kitchen table with our patient.
Because I knew her and he didn't, I wanted to take the time, be sure she was okay, be sure she felt safe, be sure she was wearing shoes instead of slippers which is why she keeps falling.
The rusher did leave but made me think about this aspect of the job. I think it is as important as anything else we do. 
I have been having difficulty recently connecting with humanity.  These calls have become my primary way to do just that, and taking time is the key. 

Some of the only calls I can remember of late are these social calls.  A woman who couldn't work her new portable oxygen tanks.  She was an old immigrant, full of energy and, once we got her oxygen working busied herself trying to get us something to eat.  I called her doctors office, her son, and gave advice to her neighbors.  We fixed her a coke and went on our way.  15 minutes of our day where I actually felt like I did something.

My old partner and I picked a guy up off of his kitchen floor.  His thankfulness broke my heart.  A retired marine with an ailing wife in the nursing home.  He had struggled for ages to get up before calling.  We picked up the trash he had upset, vacuumed coffee grounds from the floor and petted his cat. 

I am retelling these to remind providers that we are working with humans.  If there is no need to rush out, what is the big deal to take a few minutes and make sure these people are squared away before we leave?  No, this isn't medicine.  It isn't saving lives, but it is doing what we had set out to do when we sat down in EMT class:  to help people.

I know being able to take this time might just be a luxury of working in a small town, but sometimes people just need someone to take the time for a chat, or to solve their menial but real problem.  Maybe all they need a cold coke and to know that someone cares.
 

17 November 2015

Yeah

Yeah, I haven't written since June.  Not here at least.  Yeah, I don't really know why.  Yeah, I've kind of waited to get over my crisis of hating the job before I wrote again.  Yeah, sometimes I hate the best job in the world.

It's kind of my biennial problem of getting a little burned out, working a little too much, and encountering a few too many people that just make me wonder where the world is heading.  Although, now I've feeling far more Zen about it  than I ever have.  Because, for the first time, I talked to people about my problem.  Not a professional (maybe next time) but I felt other people out about my misgivings and low and behold, it worked.  I found that I am certainly not alone in my feelings.  Also, if I need to benchmark myself against the best people, I have a few in mind.

It's easy to lose sight of hope in this business of EMS.  At least I think so.  We do see a lot of silly things.  Sad things, gross things, dumb things.  It's the dumb that's been worrying me.  How can these adult people really not know how to function properly?  Can they ever get out of their desperate situations?  Why do they keep dragging innocent children into it? 
I get tired of waiting for that 1 in 100 call that makes me feel anything but frustration, makes me work, makes me use the skills I have.  But I reached a conclusion and have decided to put the energy from that one call I'm waiting for into all of my calls.  Everyone deserves to be helped, even if their crisis is not a crisis, even if their house is unclean, even if it's 4am.

Yeah, there are more important things in the world than their problem.  Yeah, they could have driven themselves.  Yeah, staying home can prevent spread of illness.  Sometimes, I have to put these thoughts behind me and just complete a task.  Not because I want to, but because it's my job.  Someone's asked for help and I'm the one who showed up. Sometimes, yeah, they are alone.  Yeah, they don't know what to do.  Yeah they should know better but they don't.  People don't know what they don't know and a shitty attitude isn't going to help them change their ways.   

I know this is a little disjointed, but I'm rusty.  I'm just trying to say that I still like my job.  I like to help people.  I wish that I could change myself to be able to say that sentence without putting a 'but...' at the end. I'm trying.



 

03 June 2015

3 June 15

My bricks came in.

02 June 2015

01 June 2015

31 May 2015

30 May 2015