Monday, September 5, 2011

Monsoon of the Midwest

I'm finally back on the streets!  It's been such a long week.  I've been working basically 12 hour on 11-12 hours off since Wednesday last week.  I haven't gotten adjusted to working nights yet, which I should be as I always work nights on 24 hour shifts, but my body isn't having it.  Usually I'm able to catch a couple hours of sleep at work, but I couldn't sleep for the life of me on any of my shifts yet.  It's awful.  And two of my shifts were out of our south station that is twice as far from my  house as the one I normally work out of, and the traffic is absolutely awful as I have to go right through the city on the interstate to get there.  Some days it takes as long as two hours to get there, and it's 30 miles.  At least I'm back to my normal schedule as of next week.  I haven't been able to sleep when I've been at home between shifts either.  The most sleep I got was yesterday, and that was for two hours.

It hasn't been especially busy except for last night.  I was basically cross-towning it for the entire shift.  We had a multiple stabbing initially; the guy had two stab wounds to the head, and his lip was cut open, one stab wound in the middle of his chest, two on the back of his shoulders and two to his lower back.  He was a mess-chest tubes and everything.  We also took a guy with multiple drips, some of which we need a nurse to take, across the city and into another town.  The worst was that we were way out west, had to drive basically as far south east in the city you can get (almost) to pick up the RN, then drive to the far northside to pick of the patient, and then take him way out of city limits to another hospital...then take the RN back, and then go to a post on the west side again.  Way too much driving.  Besides that we had a seizure patient.

The best part of shift was the random rain storm that came through.  It was completely out of nowhere.  There was a tiny blip on the radar, and even the weather channel continued to say it was clear with a 10% chance of rain all night.  I swear that little cell was hanging over the city and going nowhere.  We were driving up along the lake and the waves were massive.  There have been rip current and riptide warnings out, but seeing it was wild.  It was raining so hard that you couldn't see anything and the streets were getting flooded.  The waves were crashing together and getting pulled back into the lake.  It seriously looked like one of those toys where you can make waves in it...I wish I could explain it better.  They were crashing up against the shore so hard that the spray was coming onto the highway.  And everyone says the midwest doesn't get hurricanes!  I disagree.  Maybe it wasn't a hurricane, but it was like a monsoon.  The city literally looked like the videos you see of hurricanes blowing through coastal cities.

I almost fell asleep on shift last night, but my partner was driving me nuts.  First he turns on the air conditioning when it's like 55 degrees outside, then he changes his mind and turns on the heat.  He falls asleep and is snoring like crazy.  We kept getting diversion/bypass pages for different hospitals around the city.  I know well enough that when one goes on bypass at least 5 others will as well, so I always clear my pager every time it goes off.  Him-not so much.  He'd sleep right through the page and wouldn't clear it, so it would beep every two minutes or so, and his damn phone kept dinging with emails and crap.  I swear every time I started to doze one of the two would ding or beep again.  I told him multiple times to put his stupid phone on vibrate and clear his pager.  Of course he didn't.  The stupid pager was STILL beeping on our way back to quarters at the end of our shift.  And he kept saying "it's not my pager."  Well unless we have another fucking person on our rig with a pager, it's YOURS!  UGH.  So annoying.  I couldn't wait to get the hell off the rig.

Heading home was interesting.  I guess the lack of sleep finally caught up with me.  I was pretty much falling asleep at the wheel.  I was guzzling coffee, chain smoking, and had the windows down freezing myself, or attempting to, to stay awake.  I made it home thankfully.  I finally got some sleep today, but I'm still tired.  I pray I get good sleep tonight.  I'm so sore from being in the damn ambulance-I can never get comfortable.

Back on the streets tomorrow night.  I have no clue who I'm working with.  I hope they're cool or at the very least somewhat competent....

Sunday, August 28, 2011

The runaway

It's been quite a week...or few weeks I guess.  I'm finally done with service car!  Last week was absolutely crazy.  On Monday I had a psych run away on me (and I couldn't do anything about it because I had two other patients...and it's not really my responsibility at that point), on Tuesday the car I was in died while I had a patient to transport, on Wednesday I had three different medi-vans before I got one that started, and when I went on a call the lift wouldn't work so I had to have to psych patient sit up front with me....Thursday and Friday were just really busy.  I can't remember all that I ended up doing but I think my mind is blocking it out haha.

I'm finally back on the streets this week!  My first shift is on Wednesday.  I can't wait.  I've been crazy being off the rig.  This has been a very very long 4 1/2 months or so...

Thursday, August 18, 2011


Today was interesting to say the least.  It started off slow, then I got one patient, dropped them off, and went back for three more.  All of them schizophrenics.  And I didn't have a medivan today.  I had a car.  Go figure.

One lady was loud and always pissed off.  The other couldn't shut up for the life of her and couldn't keep to herself so she was pissing everyone off.  And the funny part is that I can't leave any of them in the car when I go into a nursing home or anything, so to drop one off, I have to bring them all inside.  It got crazy to say the least.  I dropped the first two off without a problem.  Then when I cleared to take the last patient, my dispatcher called and said they changed where he was going, and he was supposed to go to one of the places I had just gone earlier...of course on the other side of the city.  I take him back there, the whole time he's flirting with me and I was disgusted.  He kept calling me "Peaches."  I just kept turning the radio up so I didn't have to hear him.  We get there and they tell me they aren't taking him, to take him to the original destination.  I call dispatch and they have to call the hospital and straighten things out.  I had already been half way to the original facility he was supposed to go to-a good hour or so out of the city.  The change in destination nursing home called the patient's doctor and the doctor said he was supposed to go to the out of city nursing home.  I called my dispatcher to figure out what to do.  I waited at the second nursing home for nearly an hour before it was figured out.  He went to the place in the city.  I had to rewrite paperwork 5 times.  Four because of the mix-up with the destination, and the fifth time because I had the patient sign, and instead he writes his phone number down and says, "call me, I'll be waiting for you.  I love you Peaches."  And he tore the page in half so of course I couldn't turn it in.  But when I got back to base my operations' manager definitely got a kick out of it.  All I wanted to do was take a hot shower.  Needless to say, it took forever!  The worst part was when I took him up to the floor.  He went to the north wing with a staff member to his room.  I went to the south wing to go to the nurse's station.  I got my signature and went to the elevator.  I'm waiting there and it's taking absolutely forever, and guess who comes up beside me with no warning?  My damn patient!  Before I knew it he came way too close for comfort, grabbing me in a hug and not letting go for what felt like forever, then starts kissing me on the cheek and trying to get my lips!  I'm freaking out and trying to get out of his hold, which he finally lets go of.  Then he says, "when are you going to come visit me?  Are you going to bring pop and chicken?"  I just said I go to that place all the time-end of story.  The elevator comes and he's like, "I love you peaches.  You look like peaches and cream." *shudders*  So not how I wanted to end the day.  No way in hell.

Then as I was driving on the south side (not such a nice place), I was on a major street, but it also runs straight through the ghetto.  I was at a stoplight, and I mean for the area, there are always people standing on the street, throwing up gang signs, wearing their colors, etc., so I didn't think much of it.  Well the next thing I know a group of guys are running across the street, I hear the "POP POP POP" of gunfire, and I hit the gas and blow through a red light.  If I wouldn't have blown the light, I would have been shot.  They continued firing back at each other while I was in the intersection trying to get the hell out of there.  I'm truly considering buying a bullet-proof vest.  I know I'm a medic and not a cop, but seriously we go into places that are just as bad as the cops do, and I DON'T have a gun.  Ugh.  I'm not going to risk getting shot in the ghetto again.  I'd rather wear a damn vest.

I'm so glad to be done with the day today.  It was too stressful and I'm still shaken up.  I wish my neighbors were home because I'd go smoke with them and have a drink.

Wednesday, August 17, 2011


I can't wait until I'm finally back on MY rig with MY partners!  This whole being alone for an entire shift is getting extremely lame.  I can only entertain myself for so long.  Blah.

Today was slow to add to it.  At least yesterday was busy.  I only did two transports in 8 hours.  I read an entire book and took a nap.  Oh well.

Now it's off to the gym to get my butt in shape.

I'm praying I'll be back on the streets for real by the beginning of September or I just might go mad!

Tuesday, August 16, 2011

Time flies when you're having "fun"

Well it's been an interesting week for sure.  I worked on the service car for several days last week.  On Friday I started on the service car but ended up being pulled onto a critical care ambulance so it wouldn't go out of service.  One of the partners called off, and it's our only critical care ambulance.  I switched into it around 0900. That was nice because I would prefer to be actually doing my job than acting more or less like a taxi service.

It was interesting during the day because we had to have a 3rd rider at all times since I'm not supposed to be lifting that much weight yet.  We switched out four times.  We only did a few calls during the day, nothing too major.  They asked me if I could stay until 1900...I was supposed to be off at 1600.  I said sure because I needed the hours.  We went back to base to switch out the 3rd rider again and so that I could get off, so I turned in my paperwork and was ready to head for my car.  My manager was like "where are you going?"  I said, "um...home, where I live."  She proceeded to tell me, "oh, he didn't tell you?  You're on until 0600."  What the hell?  So I figured whatever, the overtime is good and the chance to get some more money making calls.  And I got a gift card and made upper management happy because they didn't have to worry about not having a critical care rig up for the day.

Night time was interesting.  We got called way south for a patient on a ventilator needed transport to a children's hospital.  We got there, going lights and sirens for 50 miles...the kid was on a drip that we couldn't of the very few we can't take.  We had other options to give them, such as giving boluses to keep the patient sedated but they didn't like the options.  We went back and forth and eventually didn't end up taking the child.  I'm glad I risked my life for that.  Whatever.  We had to wait there for the ambulance crew with an RN and MD from the hospital to come and we handed off care.  I couldn't sleep for my life that night, and I spent most of it driving anyways.

I ended up getting off an hour late, so 0700.  I came home, picked some stuff up and went to bed.  I couldn't get up for anything.  Mind you I haven't worked shift work in over three months, let alone 4 days in a row....8+10+8+25=a lot of hours.  I was supposed to go see family but ended up cancelling.  I seriously stayed in bed through the day on Sunday.  Then it was back to work on Monday.

I've been back on service car.  Joy joy.  Yesterday I had two smelly psych patients at once going to a facility 9 miles from where I picked them up...and mind you this is 9 miles through the city.  Not cool.  I was gagging.  It wasn't too busy of a day but I was still really tired when I got home.  I still had to run errands, do laundry, and cook dinner.  Thankfully my boyfriend did the laundry so it wasn't as bad.

Today I was on service car again.  It was crazy busy.  I did 9 calls in 5 hours...nonstop.  I had time to grab a coffee at Starbucks at one point.  That was it.  I went to go pick up uniforms since I don't have enough (they only take up half of my closet), and when I got there, they weren't done.  The patches weren't put on.  And I ordered them on Friday.  Apparently they're overnight shipping them to my station.  Yay.  It still cost me almost an hour of my time driving there and back in rush hour.

By the time I got home I was beat, but still ended up going to the gym, baking fresh bread, making rice, and brownies, cleaning, and packed lunches for tomorrow for both my boyfriend and myself.  Yesterday I made Jambalaya in the slow cooker, so we had that for dinner.  It's nice that I really didn't have to cook much today.  Now it's off to  bed for another long day tomorrow.

Honestly I don't know how people work 9-5 jobs five days a week and don't go insane.  I hate it!  I just want my shift work back.  I have no life working like this.  I like working two days a week!  I'm counting down the days until Saturday like a mad person.  Two work days down, three to go.  *sigh*

Thursday, August 11, 2011

RANT: Let's be completely CLEAR on this subject

I just came across a blog that more or less said this, "paramedics that work for a private sector or company are only working there because they couldn't get on a fire department, and are therefore not as good as fire department affiliated medics."

First I have a few choice words for this person, but I will keep them to myself.  I also have several questions to ask of anyone who thinks the same.

Have you ever worked for a private ambulance service?
How long have you been a paramedic?
How many calls do you average a day?  A week?
What kind of calls do you get?
Do you have any special training above and beyond your paramedic license?
How many paramedics do you have on a call?

I must say, when I first started in the field, I heard this sort of thing a lot.  When I was in EMT school everyone's goal was to get on a fire department and people were constantly debating which private ambulance service is better than the other.  It took me some time, but I came around.  I'll be the first one to admit it.  I didn't want to work in the private sector.  At all.  I wanted to be full time on a fire department.  End of story.

Once I started doing ride time and clinical time I spoke with a lot of paramedics that worked for private ambulance companies, and I saw first hand what they brought into the ER.  I also heard of some of the crazy calls they got.  I wasn't convinced, but I gave it a shot.  And I've been doing it for nearly 8 years now.  Sure, fire departments are great.  I'm not going to deny that.  I was on one for several years.  It was fun.  I loved being a firefighter and I want to stay current with my certification.  But I noticed some major differences in how "private ambulance medics" and "fire department medics" do their job and what they know.

I'm not here to say either side is bad, as I've done both, but to people that have comments like the one above, I would like to say a few things to clarify the differences.

People will typically say that "on a fire department you'll see patients of all ages, all medical conditions, a lot of trauma, you get more action, etc."

and that on a private ambulance, "you're basically a taxi driver, you just cart old people around."

That, simply put, is a JOKE.  First of all, on the fire department, yeah you'll get your trauma, you'll see an assortment of ages and medical conditions.  But not how some may lead you to believe.  Running traumas (outside of a broken hip or minor MVCs, and simple trauma) isn't all that common.  Maybe if you're in a very urban area you'll see the stabbings and gunshot wounds, etc.  In the suburbs, not so much.  Of course it's bound to happen eventually, but it's not an everyday thing, as I was told in school.  Age wise, you're looking at mainly elderly people, with young adults and adults mixed in occasionally, and the rare child or infant.  As far as medical conditions go, you'll see people with chronic problems like diabetes and emphysema and heart problems.  I'm definitely not denying you will see any of these things, as anything is possible.  At a fire department, the amount of calls you get varies constantly, and when you run a call you always have extra sets of hands, it's typically not just two people on a rig.  

Now, for working on a private ambulance.  Yes, you will do some calls where you're taking a patient for a dialysis appointment or a psych transfer, and some of them are boring.  That's just how it works no matter if you're working in public or private.  Trauma, no, we don't see a lot of live action trauma like the car wrecks you see on TV.  We get the broken hips, the falls, the lacerations.  What people don't seem to realize is that the people that DO have major trauma are commonly not taken to a hospital that can care for the patient.  Guess who takes them?  That would be a private ambulance.  Age wise?  We see a lot of old people.  But we also see a large mixture of all ages groups, ranging from neonatal transports on up.  Medical conditions...if someone has it, the privates have dealt with it.  We get the calls for people that are young with acute problems, people with chronic problems of all ages, and desperate emergencies that, guess what?  Fire department medics aren't trained to deal with.  I don't know any fire medics that are trained in peritoneal dialysis treatment, trach emergencies, LVAD devices, chest tubes, ventilators, or balloon pumps.  I could list a hell of a lot more but I think I've started to make a point...

If you hand the same list of medications to a medic in the fire service that has never worked for a private service, and one that has worked primarily in the private sector, I can tell you who would know the medications and could figure out the patient's medical history from it.

The people that I work with are AMAZING medics.  We can get a call, talk with the patient (and staff if necessary), take a look at their medications, review their symptoms, and have an extremely good idea what is causing them-NOT just treating what you see, but having the knowledge behind the cause and being able to treat the patient more definitively.  We also have the capability to take a patient to the most appropriate hospital, even if it's further away.  We are required to stay current (I can't speak for 100% of private sectors) on PEPP/PALS, ITLS, ACLS, and monthly continuing education.  A great deal of us are trained in ventilator operation and tracheostomy emergency care.  We also are required to be fluent in protocol for more than one system as our jurisdiction varies widely.  Call wise?  I would say an average day would be 5-6 (granted some of these calls can last hours due to where the patient is being transported), and there are some days where 12+ wouldn't be shocking.  And the amount of people you have to do these calls? TWO.  You and your partner.  One driving, one in the back with the patient.  Try running a full arrest all by yourself, now that's what I call fun.

The top dogs of the paramedic food chain?  Those trained in critical care.  Not only are they trained in all of the paramedic basics, they are trained to work ventilators, to manage chest tubes, run IV medications on pumps, care for critically ill neonates, operate an LVAD to keep a patient's heart beating until they get a transplant, and transport patients that are so unstable they literally need EVERYTHING to keep them alive.  They have to do additional continuing education, keep up with NRP standards, read and treat patients based on 12-lead EKGs and transport them to definitive care-skipping the ER to go straight to cath lab, along with "regular" emergencies.  Even with all of these extra things they do, they still do almost the same amount of calls as regular ALS paramedics.  And can you guess how many of them are on the ambulance at once?  You guessed it.  TWO.  One drives, one is with the patient.  Nurses very rarely accompany patients as the protocol allows more freedom.

I've worked on both sides.  I have a lot of respect for paramedics on both sides-fire and private sector.  I've seen some pretty crazy stuff on both sides too.  But I can tell you this, I've learned a hell of a lot more being on the private sector than I did with the fire department, because I was constantly exposed to conditions day in and day out.

I have seen amazing medics on both sides, but I must say, I am biased.  The medics I work with, especially the critical care paramedics, I have mad respect for, and I would trust them with my life.  They are trained in so many different areas and have so much knowledge base.  I feel it's an honor to work with them, to have my partners by my side, and to be part of a critical care team.  They are my family.

To anyone that thinks private sector medics aren't "good enough" for a fire department, I tell you to take a closer look.  Live a day in the life, a 24 hour shift on a private ambulance, and your perspective will change drastically.  You just have to look beyond the surface and get over the fact that we don't have "FIRE DEPT" written across the back of our shirts.


for now.

A different perspective

In the past two days I have done things I am definitely not used to doing.  But I must say, I have gained a lot of respect for those that do it on a regular basis.

Once again today I worked a service car.  It's actually quite odd to me to work an eight hour day...I don't think I'll ever get used to that.  Today I actually only worked for eight hours...yesterday was ten.  But anyway.  I can't say this is something I would want to do all the time, but it is still rather interesting.  I still hate the lift...I had a different vehicle today and the lift had a seat belt...well my thinking brain wasn't on and I couldn't figure out how to get the lift back up and folded....DUH the seat belt has to be secured.  *sigh*  They really need to dumb this down a notch for me or give me an ambulance.

Other than mass casualties and other atypical events, I'm only used to having one patient at a time in my rig.  Even though I'm not providing actual patient care on the service car, it is definitely interesting when you have more than one patient in it at a time.  Typically they end up ranting and raving for the majority of the ride and are not especially pleasant (at least not so far).  I'm not sure why they will put two psych patients in one vehicle and expect them to behave appropriately.  Today I felt rather like a school bus driver constantly having to look in the mirror making sure they were behaving and not throwing fists.  It can also get confusing with multiple folders in a pile and making sure the right one goes with the right patient.

But I did get to go all over the place.  I was on the far north side, the far south side, out west, and way the hell out of town southwest was in the middle of nowhere (they didn't even have a Starbucks!).  I'm still quite amused with my dispatcher and I take every moment I can to confuse him or make him think.  For example, he asked me what my location was when I was on the way to a call and I told him "I'm on LSD"  He was like, "ummm....huh?"  It seriously took him about five minutes to figure out what I was talking about.

I'm trying to find the positives in a crappy situation.  I miss my partners like crazy.  It's hard not having a partner all day.  I especially don't like it when I have to drop someone off into a bad part of the city and I'm all alone.  I know I'll appreciate being back to full duty and having someone to harass....and of course cursing at taxis and honking the horn just aren't as fun when you're by yourself.

The main thing I enjoyed today: listening to whatever radio station I wanted, having the windows down and enjoying the beautiful day, and looking at the lake and skyline and realizing how much I love it here.  I also realized how much I don't truly appreciate my job and where I live...and I'm going to make it a point to stop and just observe more often.