Accountability

Accountability.  It’s a strong word with multiple meanings.  Have you honestly sat down and thought about it, and what it means to you?  I’ve found in recent moments that many people have a very different route of thought versus me when it comes to this word.  As I sit here and eat my cheesy puffcorn, I digress….

When did jumping in to help fellow co-workers become a thing of the past?  When did admitting to doing something wrong or off protocol end up being the kind of thing you’d rather keep a secret?  I’ve seen too many times where people attempt to brush things under the table.  Here’s the thing.  We are human.  As much as we try to get things right all of the time, we are not Wall-E nor are we terminator.  Despite popular belief, we are going to fail.  It’s time to embrace this.  You will not get things right all of the time.  You will miscalculate a drug.  You will misinterpret a cardiac rhythm.  People will bleed a lot because you missed a femur fracture or internal injuries.  This will happen, and you are full of it if you think “not me.”  Own up to it and wear it like the ugly Christmas sweater that it is.  I promise you one thing in admitting that you are wrong: you will gain much more respect with all of your colleagues if you do just that.  I would rather work with someone who admitted that they made a mistake and went one step further and researched why it happened and what to do to fix it, than work with someone who has convinced themselves that they walk on water and can do no wrong.  Be accountable to yourself, and everyone that you make contact with.  It’s about that unspoken respect that we are to have for one another.

In the life and world of EMS, it’s so easy to want to brush this kind of thing off.  No one wants to admit that they caused a patient harm.  On a side accountability note, I think that it is important that we remain accountable to our fellow EMS’ers.  We owe it to each other to half one another’s back in any situation.  Especially when it comes to our mental health.  I’ve seen multiple blog posts and articles about suicides among our own.  We are human.  We bend and break.  Be the pool noodle for your fellow brothers and sisters when they are struggling to stay afloat.  I ask you not to be a psychologist, but to be a support system.  Know the resources out there.  Know that we are masters of hiding things.  I can attest to being numb to feelings and situations that I have encountered that should have enraged me or made me bawl.  It’s about having a person to turn to, to talk to that understands the way we work and what we are asked to do.  It’s like a quote I saw on Facebook posted by MedicTests.com that reads:

“It’s hard to explain to a non-EMS person how you are able to be woken up in the middle of the night and drive to someplace you’ve never been to take care of someone you’ve never met.” – Josh Pelonio, EMS World

This sums it up quite eloquently.  Be kind to one another.  Know that no matter what your struggles are, that there are people to talk to.  For starters, know that there is a specific resources for our family.  Please see the link below:

http://codegreencampaign.org/

Drive fast and take chances,

Coffeeandcoban

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Why I hate the medical field….

I hate the medical field. Now before I have a bunch of people pissy about that statement, let me explain.

If you’ve read my previous posts, you know that I’ve been dealing with two bouts of epiglottitis; one this year and one the year before. After this second round, the doctors have determined that it’s weird and maybe we should look into this a little more. So I got shipped off to a few doctors. (Strike that, 5 specialists.) Now after my most recent visit with the infectious disease specialist, I get told that it could be a few different things. One: I get to deal with it for the rest of my life with no treatment or prevention available. Just a pack of emergency antibiotics and steroids which I get to take and haul ass to the local ER for the tube and IVs and everything else. Not a matter of if, just a matter of when. Or, because my immune system is so crappy, they are very suspicious with how my labs have come back and think it may be pointing to leukemia. Fuck that I say. How can there not be answers?!?!

Fuck all of it because I’m 27. Fuck it because I had to cancel my wedding a month and a half before my wedding date because of choices my ex-fiancé made that made marrying him not an option (which is a separate thing but it’s my rant so there). Fuck it because I want a family and someone to stand by my side and treat me the way I deserve. Fuck it because I’m a damn good paramedic and firefighter and I’m not done with doing that yet. Fuck it because I’m not done teaching, not done making cookies with kids or eating Popsicles with my nieces and nephews. All it would take is a botched intubation attempt, or a failure to differentiate a simple sore throat and the onset of this crap again. It took a couple of hours for the onset this year vs a whole 24 hours last year.

So, as I sit here and pour out my feelings while watching SONS, all I ask is for the handful of people that actually read this, to send some good thoughts my way. I want guidance for my doctors and an answer to all of this.

Cheers and Merry Christmas

Beginning Again

Hello blog world. It’s been awhile….

The past year has found me in many different places. I have gone from planning a wedding to single, with a dog and many more bills. I have gone from dreaming about a family and kids to a second hospital stay involving a tube down my throat and the realization that those who claim your friendship aren’t always in your corner.

Life as paramedic has been rather swell however. My year has thrown many different challenges, and has forced me to become a better healthcare provider as well. My hope is to take more classes and get closer to flight medic status. I feel very privileged to be a paramedic in a rural community. The 20 minute transport time forces me to think outside the box and treat my patients for an extended period of time. It makes me almost feel bad for those that don’t get that opportunity.

My recent hospital stay has had me thinking about my career quite a bit. I can’t help but wonder if my epiglottitis isn’t compounded by my job. But I have a team of 5 specialists working to figure things out. Appointment on Monday, woo! :-). Here’s to getting some answers on my reoccurrent bouts of epiglottitis…..

It’s been a while….

So I have realized that it has been a while since my last post. I have found that my P90x ritual was insane because of the schedule I have with my job. But I have continued with running 45-60 minutes a day and lifting weights. Hoping this will help guide me in the right direction!

Speaking of jobs, I had a breakdown at mine a week ago. I had been feeling overwhelmed for quite some time and finally decided to talk to my boss about it. He was great, listening to my concerns and giving me guidance. I finally feel ok with not being at the office every day from 8-5 among other things. I think I just needed that verification that I wasn’t expected to be there all of the time on top of doing my shifts. So I am much relieved and feeling renewed. Has anyone else felt that way? Have you had a boss that was willing to sit down with you and just talk about things? I do feel blessed to have that in my job.

We have also been struck with difficulty getting medications for our ambulance service. Many have no idea that this is even an issue. Has your service run into this as well? What is your contingency plan for it?

Here’s to some awesome shifts!
Heather

It’s the little things….

This week has been a rather long one.  To start off, I am taking a recovery day today from my P90x workouts.  With as sore as I am feeling and the ibuprofen and heat not really helping, I figure it’s warranted.  Besides, I work tomorrow and don’t want to be completely worthless!  It’s been really tough, but it’s starting to stick.  I feel like my soreness is an indication of all of the right things I am doing.  I have also taken to adding more protein to my diet and limiting carbs.  Hopefully this will help as well, despite my vegetarian tendencies!  Has anyone tried the shakeology shakes, or a meal replacement shake with their workouts?  I am very curious as to how they taste and if you feel that they help.

 

A sad, sad week for our EMS people in Iowa.  A medical helicopter based at Mercy Medical Center – North Iowa crashed Wednesday night, killing the pilot, flight nurse, and flight paramedic.  I have had the great honor of having Russ teach me during my paramedic class.  I learned all I needed to know about PALS from him.  He loved to ask hard questions and make you sure of your answer, whether they were right or wrong.  Shelly was a nurse that I encountered many times during my EMS career.  Those two were an amazing team.  They will be missed greatly by everyone that they had encountered in their short lives.  It definitely makes you take a step back and look at your own life.  Hopefully you have found a job that makes you feel like it’s not work, are surrounded by wonderful friends and family, and can honestly say that you are proud of what you have done.

 

Be safe my fellow brothers and sisters in firefighting and EMS.

The somewhat pudgy paramedic.

So many of us in this line of work tend to surrender themselves to the world of fast food and bad choices when it becomes to our health.  I have always struggled with my health and weight.  When I was in high school, my weight was very high.  In college I gained the freshman 25, and the weight ever seemed to come off.  Eventually I got fed up and started swimming for an hour every day.  I am very much a fish, and love the water.  This gateway totally opened me up to a new world of being active and I loved it!  I have lost over 100 pounds, and am very proud of that goal.  After my hospitalization in October, I have noticed just how weak I am again.  Plus a few pounds have creeped on.  Add on the fact that my fiancé and I are headed towards our wedding day in November, I’m starting to feel a pinch.  Now I am not necessarily looking to lose weight, as I am satisfied with where I am scale-wise.  I am however looking to gain my strength back.  I never knew how incredibly weak I would feel post hospital stay.  The doctor figures I won’t be back to 100% until March.  I am not satisfied with that, so here I am, beginning this journey!  I have done the P90x workouts before, but am starting the program again.  This time, I am focusing on pushing myself and gaining my strength back.

 

We have such a physically demanding job, and just “getting by” isn’t good enough for me.  I am looking to pack carrots and lots of protein and whatnot, and charge ahead.  If there is anyone who is looking to roll with me, follow along.  My goal is to post a little something everyday.  I like the idea of holding myself accountable, and having a place to piss and moan when I am sore, tired, and the pager isn’t cooperating with my workouts.  So, piss and moan away with me!  Lets kick the fast food bs, start packing lunches (and save money!) and forge ahead.

 

Day 1-Chest and Back, Ab Ripper X

Today was my wake up call with how weak I really am.  The first time I went through this, I was able to make it through the workout with decent weights and even did every single 25 count ab workout.  Today, not so much.  Chest and Back went actually decent, but when I made it to the Ab Ripper X workout, holy mother.  I couldn’t even make it all the way through.  That’s when I got pissed.  I am 26, how can I seriously not make it through?  But, thinking back to what the doctor said, I have to remember to take it a day at a time.  I will be stronger at the end of this, and that’s all that matters.  So tomorrow is a new day (actually a 24 hour shift, half with the fiancé) so here’s to Plyo!  Go kick some ass peeps….

Uh Oh…

Have you ever had a moment in your career that made you stop and go “uh oh?” I ran across a story today that made me realize how important it is to check and double check interventions and medications. Apparently there was a paramedic that gave a wrong medication to a patient. Has this ever happened to you or a co-worker? Think about this, how close in size are the medications D50 and Sodium Bicarbonate? When out of the box and put sde by side in a dark room, could you tell them apart? So say you couldn’t, and you ended up giving your patient the sodium bicarb instead of the D50? Now what happens? Do you record it in your report and notify the hospital or, since it’s just you in the back, do you “sweep it under the rug” and pretend it didn’t happen? Think about how easy that would be. No one is there except you or the patient….

Hopefully this wouldn’t be the case. Hopefully you check and double check your medications and give things a second glance before proceeding. In our line of work, when it’s balls to the wall and things are happening super fast, its easy for something like this to happen. Just goes to show you, you can’t ever be too careful. Watch your step, and don’t rely on your partner to catch everything.

Keep your IV catheters bevel up,
Heather

Small town EMS

It’s been a while since I last posted on here.  We have been mondo busy lately!  There has been an increase in transfers as of late.  Speaking of, how do you as an EMS provider deal with your job?  Especially when it becomes one that you aren’t sure you love anymore? 

 

Don’t get me wrong, I love my job and the people I work with.  I have a very unique situation in which both the call volume and types of calls I experience has helped me grow as an EMT and paramedic.  However, there are times when I feel trapped at my current job.  There isn’t much room for advancement, and the requirements (mostly unspoken ones) have become semi-constraining.  I am very blessed to have a fiance that understands my job seeing as he has basically the same one, but it still bothers me with how much I am “at work.” 

 

At my present job I am scheduled 10 shifts every two weeks, each shift 12 hours.  Sometimes that means working anywhere from a 12 hour shift to a 72 hour shift.  It all depends on our part time paramedic’s schedule.  I am always in the office Monday through Friday from 8-5 whether I am on call or not, because there are day to day things to be done.  Our service also goes out and speaks to local community groups, as well as teaches CPR to community members and other services.  My shifts can be during the day or at night as well.  Due to the amount of business that we have experienced over the last couple of years, our number of second unit calls have increased as well.  Which equals me doing calls when I’m not on call.  Please keep in mind this isn’t me “bitching,” it’s simply a representation of my job requirements.

 

I am curious as to how other people’s shifts work.  Being that we have increased in call volume and my job requirements have since increased, especially when I am not on call, I have lost a big chunk of my “down time.”  Which has honestly been eating at me.  While I am not sure that there is any real feasible solution to our current situation, What does an EMS provider do when they feel the burn out approaching?  Obviously this is a career that I have chosen and love dearly, and I don’t want it to become one that I hate and no longer do.  I am looking for thoughts and experiences from those that have gone down this road.

 

Once again, safe and warm thoughts during this holiday season!

Heather

Empathy….

Hello all, it’s been quite a while since my last post.  I never intended this blog to become anything huge, but I have a feeling that it will be a bit of a stress reliever for me today.  Today marks one week since I was intubated and sedated, rushed by my own ambulance crew, and spent a few days in ICU. 

The doctors have no idea what happened, what made me sick, or honestly really how to treat it (I get the feeling anyway).  The night before started out with a sore throat.  I was on call, and didn’t feel bad enough when I went to sleep to “call in” sick.  I awoke the next morning to my fiance coming in, and myself drooling and having obvious breathing issues.  We went to the local ER, where the ER doc came in to my room, looked at me, and said one word.  “Epiglottitis.”  Awesome.  As a paramedic, I remember that chapter in my book that covered this.  And how it said that you shouldn’t touch these people, make them comfortable, and that they end up being intubated.  Then he said the next magic phrase.  “Get anesthesia down here NOW.”  Crap.  It is at this point where things get fuzzy, because I had about 4 nurses doing different things.  Next thing I know I’m being wheeled into the trauma room, and my anesthesiologist (also a paramedic, rock on) was looking at me and telling me what was going on.  Then helloooooo Versed.

A tip here for you fellow medics that haven’t ever experienced this drug.  I felt bad.  It was this horrific ringing of the ears-mind numbing wash out.  But the anesthesiologist talked to me during this part.  His voice was the only thing that I remember, because he was telling me how I would feel, and what was happening.  Now, never underestimate the power of speaking to those patients that are seemingly unconcious, whether or not chemically induced.  My fellow crew members and great friends talked to me during the ride over too.  Now I obviously don’t recall any of it, but my low and steady heart rate, and calm blood pressure spoke for itself.

The next phase was round two of the ER, this time in a bigger city.  When I arrived, I apparently became VERY agitated.  Almost 30mg of Versed later, among other things, and I was vented upstairs in ICU.  This is where I become a bit agitated.  Here I am, a 26 year old paramedic, who was initially thought to be a drug addict due to my age and the fact that I was intubated.  After my family cleared THAT one up, my ICU care started.  I managed to have an IV drip of Fentanyl infiltrate, and nursing staff failed to come take care of it until over an hour after my family said something about it.  My fiance is also an EMT-Intermediate, and has been for a few years now, so he has some medical background.  And he was appalled.  It took my mother crying.  CRYING over how blue and swollen my fingers were becoming.  My engagement ring was still on, and sure as hell wasn’t coming off anytime soon now.  My family also got to experience watching my Propofol infusion run empty, and it taking yet an incredible amount of time for anyone to come take care of it.  After 3 days in ICU, I was extubated and moved to one of the floors.  Two more days, and I busted out of dodge.  Puffy, sore, incredibly tired and happy to have a cupcake after not having squat for a few days, I was glad to be out.

Moral of the story for me?  We have an incredibly invasive job.  We start IVs, give drugs, tube people, splint bones, etc.  The next patient you have; take a second and stop.  Ask yourself what you have to do for your patient, and what the best way to do it is.  Because I tell you from experience, its the extra pillow, the calm voice, and the extra warm blanket that makes the difference.  Always be vigilant to your procedures.  Check and double check, and talk.  Speak for those that can’t speak for themselves.  Be the ultimate patient advocate.

 

Warmly,

Heather