Thursday, June 26, 2008

RN vs EMT's, my coments to crzegrl.

RN vs Medic

Emily I hope you don't mind. I pulled the following off of crzegrl.net. My response is below that. Maybe if we can get more communication between hospital and prehospital providers we can work to resolve this problem.

" When working in the ICU as a nurse, I would tell people that I would have been a paramedic had it paid better. Of any profession in this world, it is the medics and EMTs who I respect the most. EpiJunky and Medic61 have put forth the topic of RN vs Medic—why don’t we get along? My simple answer is that it is based on lack of understanding. But, I digress. I will save that for my post for next week’s NSR.

Where I was I going with that? Oh yes. My interacting with others professionals in my job.

I deal with physicians, medics, firefighters, police officers, nurses, medical assistants, medical secretaries, not to mention the patients and their families. The helicopter and flight suit bring an instantaneous aura of respect, but being able to interface, not offend, and play politics is such a huge part of what I do. The flight suit only goes so far. I still have to be on my game each and every day."

again, the above is from crzegrl.net.



Let me give you my thoughts why we don't get along. This is coming from an 8 year firefighter EMT. A great deal of nurses I have had dealings with treat us like we don't know anything as road crews. I had a nurse on the floor tell me that I didn't need to know a patients history because I was just an ambulance driver. That kind of treatment of EMT's is what creates that hostility between us. Nurses tend not to trust our assessment skills. I hate it when an er nurse doesn't read my run report, ignores me, and ask the patient all the same questions I just asked, and it tends to upset patients being asked the same thing over and over again. I guess the bottom line is nurses tend to get from EMS what they give us. Not all nurses are like this. I know some ER nurses at a couple of trauma centers that are awesome. But this seems to not be the norm. They make us do ER clinicals, maybe nurses should do rotations with us on the road. We work in there world and try to respect it, It would be nice if nurses could wonder into our world from time to time. You are a hybrid in your job, so maybe it doesn't seem as cut and dry to you. Sorry Emily. Just my thoughts. Miss you. Shepp

We start next week.

So I go to the mailbox and find a letter for me. It is from a major city fire department in my area. I was hired with this department some time ago. I have been in limbo waiting for a start date. I got my start date. I start next week, I seem a little rushed. I went to the uniform store today and found that they have nothing in my size and will have to order my uniforms. This could be a problem if I do not have them by my start date. I have to go to this city's academy. I am little worried about this, and hope I will pass. Being a fat guy, I'm worried about the physical training. Wish me luck. JS

Tuesday, June 24, 2008

I'm sleepy

I remember reading a brochure for a local community college that just started offering public safety classes. It said "learn to be a hero". That sounded like the job for me. I thought, I could be a hero, and I thought it would be fun. Now almost 10 years later, I still wouldn't consider myself a hero. What I do think of myself is that, I am overworked, underpaid, and sleep deprived. But I never saw these thing advertised in the brochure. Don't get me wrong, I love the world of public safety. I like being able to make a difference in someones life. However, Nobody told me I would have to get up so many times in one night. I hardly slept at all list night. Every time I feel asleep we would get a call. Now today, I am really dragging ass. Don't get me wrong, this is nothing new to me. But I wish I could get a full nights sleep once in while. Oh well, that's the price we pay. JS

Wednesday, June 18, 2008

He is lucky the ambulance was close!

My partner and I are sleeping in the front seats of the ambulance. It is about 3am. We are posted in a parking lot in an urban area. I wake up to the sound of a crash. I see a van in the middle of the road with it lights on. I don't think much of it, people do the strangest thing in the ghetto. So I go back to sleep. About 15 seconds later someone is banging on the window of our rig. I roll down the window and ask "whats up?". He tells me he just hit a guy in the road with his van, and he is still laying in the middle of the street. I was working with a rather new EMT. I woke my partner up and drove the 100 feet to the middle of the street. Sure as hell there was a guy in his mid twenties not breathing and bleeding all over the street. My partner gets out of the truck and freezes. I do a quick IPS on the patient and find that he has a good strong pulse, is bleeding from the top of his head, his legs are twisted like a pretzel, and is still not breathing. My partner is still frozen. I tell him go to the truck and get a BVM, pulse ox, backboard, and C-collar. He returns quickly with the requested materials. I was able to get a pulse ox on him and it read 67%. I give him a few breaths with the bvm and after a couple a seconds he is up in the high 80% range. So I have to talk my partner and a cop through helping me, it is just the three of us on scene. I give some breaths and we board and collar him. We quickly get him in the back of the rig and I insert an oral airway (opa). I tell my partner to call dispatch and make them aware of our situation and tell them we are transporting priority one to the closest trauma center (prior to calling them, they thought we were still sleeping in a parking lot.). I have no real vital signs on this patient other than what the pulse ox is telling me. A was able to bring him up into the high 90% range with the opa, bvm, and o2. He had good color and I was able to make a half ass attempt at dressing his head wound. My partner says dispatch will call the hospital with report. (I think the dispatcher just wanted to know what we had.) I give my partner the information I had to relay to her to give to the hospital. The dispatcher scorns my partner for not having a blood pressure on the patient. I tell me partner to tell her that I am to busy trying to manage his airway to get a B/P. then told him to ignoring her, and said I would call the hospital from my cell phone. So, I call the charge nurse directly from my cell phone and tell her what we are coming in with. As we pull up to the hospital we see the trauma team is outside waiting for us. I'm getting tired working this patient all by myself. We unload the patient and rush right into the trauma room. The docs and nurses take over care from me. After they get the patient tubed and on a vent, the charge nurse comes out to me and says "you guys did a great job, and he is luck the ambulance was close!". I believe that patient lived with out much problem after a long hospital stay. It is runs like that, that keep me coming back to work day after day. I wish I could tell you what hospital it was, but I can't. Those guys in the ER did a great job and are awesome to work with. JS

Saturday, June 14, 2008

The paragod


I want to vent about the paramedic that think they are gods gift to medicine. You know the one that bitches about everyone Else's care but has awful skills themselves.I was on scene a few weeks ago with such a person. We were starting a line and he insisted that he would do it and pushed us away from the patient. It took this medic 3 tries to get the line. The patient had garden hoses for veins. But he had to be in charge. It was like the rest of us were not there. He thought he was a one man trauma team. Don't get me wrong he is a great person to hang out with and drink with, but he is not any better than the rest of us. Don't tell him that. His way is the only way. He is not a very good practical teacher. I believe in letting students do all most everything. I just answer their questions and give guidance. He thinks that students get in the way and should be in awe of his skills. It is quite funny to watch. I was just thinking about this and wanted to share it with everyone. JS

Thursday, June 12, 2008

Hey Probie


So I recently started with a new fire fire department. It is strange being a probationary firefighter again. It has been a long time since I have rode back seat in an Engine. The good thing is I don't have to be incharge of anything, and I don't get stuck as a pump operator watching the fire. Now I'm back on the pipe, I get to put the water on the fire. I like it, but it doesn't feel like I'm living up to my full potential. We had an elctrical fire the other day. I was inside doing overhaul and the chief walked in and shouted "probie" and nobody answered, then he did it again, still no answer. Finally he yelled "Shepp", I turned and said yes. He told me to go back to my engine, we were picking up to head into quarters. The reason I didn't answer is I have not been called probie in almost eight years. I just didn't think to respond. The chief was not upset and understood why I didn't answer him. But I got alot of shit from the guys when we got back to quarters. JS