Monday, June 9, 2008

Perhaps I Have Become Insensitive...

I watched on the news today about a 23 year old state resident who while out enjoying the summer weather, trying to catch a break from the heat was struck and killed by lightening. The lightening strike also injured 4 others in the same pavilion that this gentlemen was seeking shelter in. Hundreds of people were around him, reports say people came to his aid including State of CT employees who work for the Department of Environmental Protection. His heart had stopped beating, he was in Cardiac Arrest, no AED's were readily available in close proximity, he lay waiting for minutes before the first AED would arrive on scene. He was transported to Shoreline Clinic and pronounced dead some minutes later.

In New Haven in the last 3 months two people have died in Pedestrian hit and run style accidents. In April a 27 year old Medical Student from Yale was struck and killed by a vehicle that fled the scene. Last week a 5Th grade student an 11 year old girl was struck and killed by a vehicle that was drag racing which also fled the scene.

These incidents have received local news coverage for a day or two and then have slipped into the forgotten events, to only be felt by the families and friends of the victims. However a recent incident in Hartford, one in which a 78 year old Male was walking across a busy street was struck by a vehicle that was chasing another vehicle on the wrong side of the street. Both vehicles subsequently fled the scene, leaving the victim lying in the busy street. This incident however was caught on camera, and in an effort to catch the eluding vehicles the Hartford Police Department released the video which would later spread around news outlets through out the world.

Hartford Police Department Video of Park Street Hit And Run

The media began running the story of how demoralized the City of Hartford had become, that pedestrians and traffic could just drive by and that no one came to the aid of the victim. The story gained national media attention, and even appeared on The Today show. The victims family spoke out against the community wondering why no one rushed to helped their family member. Now while I feel sympathetic towards the family, no one should go through the pain that they are feeling, of having a love run struck down and have the offender flee justice. While the video shows that no one immediately rushes to the aid of the victim, audio tapes have also been released from the 911 calls that came pouring into the emergency dispatch center at Hartford Police Department within seconds of the accidents. The video also clearly shows that people in fact did go out into the street to the victim, while no one immediately comes to aid the victim I have to ask, what good would it have done? The Police Department was on scene within 2 minutes of the accident, and EMS was on scene within 4 minutes of the accident with the victim being at Hartford Hospital 15 minutes after he was struck. The common person does not know how to properly aid an accident victim, I'm not sure what people expect from the community? Did they expect to the community to rush to this victims aid, a person who evidently had a serious spinal injury, to drag them out of the street to what they thought would be a safer place, to perhaps compromise their severe spinal injury even more? How would you feel if instead of doing very little they walked up and robbed him of his wallet and personal belongings as often happens in this neighborhood.

Perhaps I may come across insensitive, or uncaring in regards to this situation however it is the opposite. I know the family, I know the neighborhood, and I know the people and the way they act. I do not think this neighborhood is entirely uncaring as I have seen the exact opposite displayed on many occasions. I disagree with the way the media is covering this story, especially on the national level. It also disturbs be that this particular story is getting so much attention, and others are being left behind. This gentlemen had every resource available within minutes and has thus far survived because of such, where as a 23 year old has died quite possibly because of the lack of an available AED. Perhaps his injuries sustained from the lightening strike were so severe, but perhaps a readily available AED in such a public place with so many risks would have changed the outcome.

Then again this is only my personal opinion on these matters, and I'm sorry if I'm seen as insensitive, perhaps I am, perhaps the job has changed me.

Tuesday, June 3, 2008

Sitting on the bench

I am still very new, very fresh, the ink on my letter of medical control is still drying. I am ready for whatever may be thrown at me, ready to jump into the unknown, waiting for the big one, aching for another tube... instead I have found myself fighting pure boredom, listening to others do the "Good" calls.

I have been out on my own for just over a month and a 1/2 now and I have felt as If I have seen nothing and that I have accomplished little. Sure I have done the shooting, the stabbings, the acute MI, the acute respiratory distress, But I have been waiting for the Cardiac Arrest, waiting for the heart pounding anxiety, the dance around death, the indescribable feeling of a successful intubation except to those who have done it and yearn for another. I have listened to other Paramedics go out on Cardiac Arrest calls, heard of a coworker and classmate doing back to back Cardiac Arrests, and I felt as if I have been sitting on the bench and waiting for my chance to get in the big game.

I received a letter this week from a Patient I had recently treated. While I won't go into details of the call for confidentiality reasons. This was one of those routine ALS calls, where I felt I barely made a difference. I put the Patient on the monitor, ran a 12 lead, started an IV which I think I even missed the first time, and gave them some oxygen. I felt like a machine on this call, I felt that I was doing what an EMT could do with less training then I had. What I hadn't realized is that during this call, the way I talked to my Patient and explained everything, the calm cool demeanor in which I performed my skills, and the simple act of giving up the pillow from my stretcher to this patient made all the difference in the world to them. They didn't care that I wasn't pushing medications, performing life saving interventions, I did a job that they respected and thought was under recognized. They appreciated what I had done and they made it known by writing a letter to thank me for the treatment I had given them, because to them I did everything right and the best I could and made them comfortable in the midst of their emergency.

This letter has adjusted my outlook and feelings at work, I am trying to embrace the routine. Another local Paramedic recently asked how one can learn to deal with the routine and asked for other Paramedics input and advice:

Baby Medic: The Routine

For me a simple thank you has worked wonders, I realize that as minor and boring as the routine may be, to our patients it is a significant time in their lives, and the way we treat our "routine" ALS patient makes a difference in their lives and their perspective of EMS. While yes I still yearn for the "Big one" for now I am just grateful for the opportunity to make a difference in a life as little as it may be, even if its just a warm hand to hold. It is these moments that I got in this job for, to make a difference.

Tuesday, May 27, 2008

The Sunrise

Through our experience's on the job we often learn to appreciate new things. Some time these are simple things that we once enjoyed and have long forgotten about, sometimes its a new experience. Often times its a little thing in life that we took for grant it and never gave it much thought. I had what one would call an "Epiphany" today and realized that the things I see on the job have changed me, have made me older, and as I'd like to hope wiser to the joys of life.

Not too long after I was cleared I had a call that makes a new paramedics heart kick up a notch. While covering one of our suburban towns that we provide 911 coverage for I was dispatched to the elderly female down, not breathing, possibly a presumption. Now I'm sure a seasoned paramedic might not even blink and just go through the motions, but not me not today I'm still fresh. I never did a presumption while precepting, we talked about it, went over the procedures but never put it into practice. So here we are racing through town expecting to arrive on scene and find the police department first responders performing CPR, I'd have to go in and stop them and determine if she was in fact deceased or viable, a position I have never been in. Much to my surprise we arrive on scene first and I see a gentlemen my age standing on the front lawn. Much use to the typical scene in Hartford where this gentlemen would be doing the jumping jacks to wave me down and rush me into the house, I am caught off guard by how calm he acts. He walks to the ambulance and says they found her on the porch, he relays she's healthy with no known medical history and leads me into the house. Inside I find 4 generations of this middle eastern family standing around going on about life as if nothing has happened. The calmness puts a pit in my stomach and makes me wonder what I'm walking into.

She's lying on her back, fully clothed including a traditional Turkish scarf, wrapped up in two blankets with her head laid peacefully on a pillow. It's hard to believe shes not sleeping, however as I unwrap the blanket off of her as peacefully as possible and reach for her wrist I know at that moment her fate. I place her on the monitor and run a 12 second strip for my personal assurance, I reassure proper lead placement as my monitor runs quite possibly the flattest it can possibly go. I mark down the time and notify my dispatcher so its taped the time of pronouncement. I pull the blanket back up to the position I found it in, and leave the women in peace, the way I found her.

I now for the first time walk over to family and have the undaunted task of telling them what they already know. I am new to this, I have never done this before, and no training I have undergone could prepare me for the task of telling a family that their loved one has died. I try to be as compassionate yet straight forward as I could and stay in the house long enough to assure that the family does not need medical attention. I gather my gear and I walk back to my ambulance to be stopped on the way by this womens daughter. She thanks me for the job I have done and I feel guilty inside, I didn't do a job, I came and told them what they already knew. I think she sensed that perhaps I was uneasy or nervous and shared with me the story that had taken place.

Her mother wakes every morning at 5am no matter how late she was awake. She gets dressed and goes down stairs to the back enclosed porch and lays down on the carpeted floor, wraps herself in blankets to stay warm, props her head up on a pillow or two, and lays there watching the sunrise every morning. She tells me its what she loved, the highlight of her day, to watch the sun come up every morning and start her day knowing that no matter what happens, the sun will always come up tomorrow. Her family can take comfort in knowing that their loved one went perhaps in what she would call the most perfect way, enjoying the thing she cherished most about her day. And I take comfort in knowing that no matter what challenges i face through the day, the hard decisions and situations I encounter, the sun will always come up on another peaceful morning, and for the first time in years I no longer take it for grant it, and enjoy my morning cup of coffee watching the sun rise.

Wednesday, May 21, 2008

Blogging again

Well first off if anyone actually reads this I apologize that I haven't updated this. This "Blog" sort of became forgotten during the demands of precepting and it wasn't until recently that I was reminded of this venture. This blog was mentioned recently while sitting around playing Poker with my friends and yes I say friends referring to my Preceptor and his partner. Although I am no longer precepting and am a cleared Paramedic working on my own, I will always for the unforeseeable future refer to him as my Preceptor because I don't think I will ever stop my learning from him and the phone calls for advice. But I digress, I was told that I should really start "Blogging" again, as people enjoyed reading it and I was actually good at doing it. It was reassuring because while I suspected people had read what I had written no one had really come out and said so. So I apologize that I haven't updated this in months now, a lot has changed and I hope I can use my newly found and sometimes appreciated down time sitting in the truck to update this site and continue with my blogging and share some insight into my first year as a Paramedic as this blog was intended to do so. So check back within the next few days to find a few updates as I play catch up to where I stand now.

Tuesday, March 18, 2008

Coming Together

In the past 2 weeks I feel as if I've begun to make noticeable progress in becoming a Paramedic. I have been to Red Pod at HHED more then I remember and count, the staff is recognizing me as a Paramedic and not an EMT now as I continue to make the transition. I have continued to do routine ALS and BLS calls, and I have seen critical patients now. I have struggled with getting IV access and beat myself up over it to only watch the staff in the ED have to resort to Central Lines or getting a line with ultrasound. I got my first pre-hospital Adult Cardiac Arrest and my first field intubation and first intubation since my OR time last May. The feeling of that first Code, that first tube, the first time you shock someone, is indescribable, but those who have been there know it, and crave it as do I now. I crave my next tube, my next code, its still so fresh and new to me that it still excites me and I hope it will the rest of my career. The slim chance of making a difference, the feeling of getting pulses back and fighting to keep them, the chance to some day see that person walking down the street again, that is after all what we got into EMS for right?

I continue to gain more confidence and get more comfortable with my skills and knowledge, sure I have a long way to go still, more to learn, and more to do, but for now I'm happy where I am and where I'm going. Out of all the feelings and emotions I have gone through in the past few months as you have read, the best feeling was my preceptor giving me the chance to tech a routine ALS diabetic on my own while he rode up front, sure it was as routine as it could get, the nursing home pretty much fixed her believe it or not before we arrived, but it was still something I was doing by myself and I soaked it up and loved every second of it.

For now I will get in the truck and continue to do my best, continue to learn, crave my next tube, my next code, and hope for trauma the one thing I've yet to see while precepting.

Monday, March 3, 2008

Getting Comfortable

Growing up as a kid and learning to ride a bike your often told that once you fall off, you've just gotta get right back on and do it again, eventually it will come natural, and years later you can just get right back on after years of being off and still do it, a little shaky at first but you'll succeed. This idea rang into my head as i drove away from work Sunday morning after a busy Saturday night in the city. I realized that I had fallen off from precepting for a while, I had lost interest, I had doubted my career tract and the direction my life was going in. However I was determined to give it a go, I mean after all I just put myself through a year of medic school hell I can't give up that easily. I realized that now after a few shifts back on the road, I'm getting back into the game, I feel my head is in the right place again and its back to business.

Things are starting to come together and its starting to feel more and more natural to me, now I'm not going to sit here and say I'm no longer nervous that would be a lie, but its starting to feel more comfortable. I'm finding myself getting more comfortable with the "Routine ALS" calls and nervously waiting and anticipating the more mind numbing challenges of the aggressive ALS calls. My skills are improving, during my clinical time in the ED I was fairly successful with my IV's, I didn't have too hard of a time, this has not been the case so far in the back of the ambulance. My success rate has been poor and everyone trys to cheer me up except my preceptor naturally. Everyone talks about bad streaks of success rates and that everyones misses, sure its true but during precepting this should be my time to be successful and prove myself so its been a burden I've carried. I've sat in the back of the truck and tried to figure out exactly why I've been doing wrong with our catheters, these are a style I've never used before and I feel its all in my grip. So Saturday night I adjusted my grip, while it feels a little akward I pulled off 100% of my IV's, sure I may have caused a blood bath inside an Apt because of a poor tamponade technique but hey I got the IV and pushed the meds I needed to, now I just need to work on doing it cleaner haha!

So all and all things are on a much better track, In a sense of the analogy I have gotten back on my bike and I am peddling away, it feels natural, its getting comfortable, and I look forward to the challenges ahead, I look forward to finally becoming a good medic.

Friday, February 22, 2008

Two Weeks

As I sit here and catch up on all the posts I've missed, attempt to fill everyone who may be reading this in as to how life has been since "The Call" as I've come to label it now, I realize its been two weeks tonight. The comments and phone calls of people checking up on me have dwindled down, again I'm left saying thank you, the support of my co-workers, classmates, and EMS professionals from other companies has been tremendous and makes me proud of what EMS as a profession is becoming. I sit here still battling this plague that they call the "Flu", still feeling like crap, but I have become victim of my night schedule, even though I haven't worked in days, I still sleep during the day and am often up all night, I think this is adding to my stress. I unfortunately don't seem to be feeling better quick enough, I now am facing the fact that although I mentally feel better my lungs do not agree. I'm getting short winded a lot today, and find myself violently coughing, and now coughing up well I won't even tell you what kind of mucous. I'm not sure I'll make it back to work tomorrow, sounds like another call to the doctor tomorrow.

I have talked with my friends and my girlfriend, and we've all come to an agreement that my stress level and my emotions have been on the rocks ever since I went to nights, I've worked days for 2 years now and I don't think my body and mind is adjusting very well to nights, I'm beginning to think this may have contributed to my inability to deal with "the call" very well. I find that I was happy to be sick, happy to avoid going to work and facing stress again, I find it hard to face stress right now, perhaps because I have so much, I know its part of the job, but I need to lessen the stress in my life, I've begun debating if I'll be successful precepting on nights, I've contemplated asking my supervisors to switch me to a preceptor on days. Nothing against my current preceptor, I have the utmost respect for him and think he is an outstanding Paramedic, I just think that working nights is adding undue stress to my life right now, and perhaps I'd succeed more rapidly precepting on days, sure it'll be slower and take longer but I'll be healthier and a little less stressed. I also have started to doubt if this is truly what I want to do with my life, sure I know I don't want to work commercial EMS forever, but do I want to be a Paramedic, to have the stress of having someones life in my hands, perhaps on a regular basis?? I faced this same decision 2 years ago, when I decided I didn't want to pursue becoming a Police Office anymore because of the politics, did I make the right decision? Or have I again faced an obstacle that put me in a hard place, and rather then overcome it I chose a different path? One thing is clear, I am miserable in Connecticut, I hate this weather, facing yet another snow storm, another cold night, miserable people who have all chosen to live here complaining and driving like complete morons, I'm sick of the pace of life, I want it to all slow down, I want to enjoy life everyday, I want warm weather, warm people. I guess its time I really need to set my foot down and chase my real dreams. My dreams of moving down south, being happy and successful. In order to chase these dreams though I need to decide where my life is going to lead my career wise, and first and foremost I owe it to myself to finish precepting, I can't just throw this away right now, not yet, not this soon. I need to figure out how I can get through this, many before me have, maybe they haven't face the same obstacles I have this past year, the death of my aunt who raised me, the death of one our medic instructors, my life falling out from under me, and then such a shitty call so soon into precepting. The one thing I do know, is that if I make it through this, I truly will honor the ones I've lost, and hold myself on a higher pedestal. I need to get through this......