Clocks and Maps

Today (well yesterday, technically) made one year that I have been working at my current place of employment.

When I realized the date and stated this to my co-worker, she said, “Yay! Let’s all go to the party they’re not going to throw for you!” Rude people burstin’ my bubble.

It certainly hasn’t been the worst year of my life, but it’s definitely not where I expected I’d be right now. After college, my plan was to go to EMT school and work full-time as an EMT while getting myself ready for graduate school. As you know, that didn’t work out, and I found myself back in the midwest working in a psychiatric hospital and part-time as an EMT.

If things had gone my way, right now I’d have submitted my applications to various Ph.D programs in clinical psychology and would be nervously awaiting their decisions in the coming months. I’d go off to grad school this fall, spend the next 5-6 years becoming a clinical psychologist and focusing my research and practice on disaster mental health, and end up traveling the world responding to disasters or a professor at a well-respected institution (I can dream.), or something like that.

Instead, this job has turned me on to the field of nursing. I love what I do and I’m damn good at it, and with this experience and the right education, I could be a damn good nurse. I have not turned my back on EMS, nor have I forgotten that it was my first passion. I’ve just discovered a different path to achieve many of the same goals and involving all of my interests—EMS, patient care, evidence-based medicine, public health, clinical psychology, disaster mental health, patient advocacy, and education—and melding them into a career somehow. 

I hope to become a paramedic someday in the future, but a year working part-time as an EMT in a small, boring town leaves me ill-prepared for that right now. However, a year working as a CNA at the facility I work at has done well to prepare me for a career in nursing. Therefore, over the next year, I will be working hard to earn the required prerequisites for nursing school and will be sending in my applications by this time next year. I have an idea of what the course of my life will look like after that ,but I won’t reveal that to you yet. Just know that I’m pressing forward down the path that is right for me and the one that will allow me to help the most people in the best way.

It’s amazing how much differently the past looks with a year of hindsight behind you. You realize that what seemed like the end of the world at the time was actually the best thing that’s ever happened to you. Regret fades and transforms into relief, and despair into hope. Where there was once uncertainty, there is now a plan, better and more fitting than the one before. And someone who was once a reject is now on top of her game, ready to set the world on fire.

“The only point of clocks and maps, the only point of looking back is to see how far we’ve come.” –Dawes, How Far We’ve Come 

This is how far I’ve come in a year. I look forward to looking back again a year from now to see how far I’ll have come (wow, what a weird sentence, but yeah…).

2012

Left home

Moved to a new state

Started over

Got a good job I love

Bought a car

Got another good job I love

Got my own apartment

Visited my alma mater several times (which wouldn’t have been possible if I stayed home)

Went to Harvard

Reunited with college friends in the “Land of Opportunity”

Lost my kitty

Went to my first EMS conference

Neglected my blog (I even forgot to celebrate my blogiversary on 12-19!)

Many, many other things I am forgetting…

Ah well…2012 was definitely a good year for me. This time last year, I was in a crisis, not knowing what I was going to do, where I was going to go, or where I would be right now. Yes, the end of 2011 was rough, but 2012 was good to me. I have a year’s experience at two awesome jobs that I know will take me to where I want to go, I am (mostly) happy with my life, and I am financially stable. I cannot ask for more than that. I look forward to what 2013 will bring. I plan on working towards my goal of taking the next step in my career and going back to school.

Happy New Year to you all! Hello 2013! Cheers!

 

 

EMS Expo Review

A month has passed since EMS World Expo 2012 concluded in New Orleans and I’m just now finding myself able to give a brief update.

This month back in the real world was certainly rough after such an amazing vacation, but the conference has given me much food for thought (just what my hungry mind was looking for) and actually may have actually changed the course of my life…

First, I attended the pre-conference session entitled, “Beyond the Basics” given by Limmer, Mistovich, and Batsie. I can honestly say that this was the most rewarding part of the conference. It was a two-day session which covered many topics on a BLS level, but with deeper explanations of common topics often “skimmed over” in EMT school and with the added thought exercises and a scenario-based learning approach designed to empower EMTs. I wish I could have spent more time with these guys! I really did feel so much more knowledgeable and empowered after leaving their class. Now I’m left with the challenge of trying to apply the knowledge I gained there to my practice while remaining within the boundaries of my services’s protocols (more on that some other time).

The rest of the conference was good as well. I attended so many wonderful, educational, informative, and insightful lectures and made a number of professional connections with people I met there. I even met a couple of EMS celebrities, most notable of which being Kelly Grayson (the one who gave me the free pass), though I only got to say “hi” and “thank you” very briefly at the end of his lecture. Mistovich is actually one of the writers of my EMT textbook, which I thought was kinda cool, and Limmer and Batsie are textbook authors as well. Also, I know for a fact (from stalking his blog) that I was in the same room more than once with Rogue Medic, but since I don’t actually know what he looks like (he’s the ninja of the EMS bloggers I read), I didn’t get to talk to him.

Now about the course of my life: Some of you may remember my impossible dilemma regarding me going to graduate school for clinical psychology. Yes. Well, that is on the back-burner now because a couple of months ago, I decided that I wanted to go to nursing school and become an RN first. That’s all fine and good. But now that EMS Expo has rekindled my original passion for EMS, I am now thinking about going to medic school! I will go to graduate school eventually, but the decision I need to make right now (and I mean now—applications are going to be due soon) is whether to go to medic school or nursing school. I have a list of pros and cons of each in my head and for the last several weeks have found myself unable to make a decision. I change my mind a dozen times a day and each time I do, it feels right. I’m going out of my mind and am making myself sick with the stress of figuring this out. I can’t convince myself that it will be okay no matter which way I go—I want to make the right decision!

So that’s my life right now. Feel free to share your advice/buy me a drink. I’ll let you know what I decide after I flip a coin spend many more hours thinking, reflecting, and planning.

 

EMS Expo

I’m writing this from my cozy hotel room in New Orleans, flipping between episodes of Law & Order: SVU and the Saints game, and biting all of my fingernails off. This can only mean one thing: EMS Expo begins tomorrow!

This is my first conference, and it happens to be in my city, therefore in order to get the most out of the experience, I decided to attend a preconference workshop as well. I’m super pumped and ready to spend the week filling my curious mind with more EMS knowledge. 

I expect to attend many insightful and thought-provoking lectures, meet some amazing people, and walk out of this conference a more informed, more competent EMT.

Come on, EMS Expo, show me whatcha got!

Expect daily updates.

Examination of Conscience

There were 15 patients on my unit when I left work the other night.

I expected there to be 14 when I returned the next day (one was scheduled for discharge in the morning).

Instead, there were only 13. I scanned the board and discovered right away who was missing. It was a patient who had been sick the last couple of days.

“Oh so they finally decided to send Mark* to the ER huh?,” I asked the staff. One of the aides looked at me grimly and said, “No…he passed away.”

I was utterly shocked.

I mean, yeah, the guy was pretty sick when I left him the night before—I did mention to the nurse my feelings that he should have been sent to the hospital—but I never expected that he would die! But sure enough, he just dropped in the day area this morning. Staff witnessed it and did everything they could—started CPR, called a code blue, called EMS—but without success.

I’ve never lost a patient this way before. It affected me in ways that I never would have expected. All day, his time at our facility, particularly last night, kept running through my head. Did I give him the best possible care? For those that don’t have experience with this kind of thing, that is a scary, dark place to let your mind go. You want to assure yourself that yes, you did give the best possible care that you could, but what if the answer is no? What if there was something more you could have done to make your patient’s last hours more comfortable?

The truth is, I do honestly believe that I would have done nothing differently had I known that he would be dead the next morning. I was always professional, respectful, empathetic, even, despite how difficult he was being. I checked in on him, monitored his vitals,and offered him fluids, as ordered by the nurse and maintained a caring tone even when he removed his oxygen (again) and ripped out his I.V.

So why do I still feel this way? I guess because this is the first I’ve had to deal with this. I’ve lost patients as an EMT before, but that’s different, at least for me. I’ve worked with this man for quite some time now, seen him improve from agitated, aggressive, and delusional to a calm person actually capable of speaking a polite word to staff. He was almost to the point where he was ready for discharge. Even though he had definitely been one of the most difficult patients I’ve ever had, I had a connection to him. And it’s just a different kind of tragedy when someone you have treated and cared for over a longer period of time dies unexpectedly.

Don’t worry, readers, I’m fine. I’m just still shocked, that’s all. And I’m reminded to always give each and every patient the attention and care that I would want to be given to myself or my family—it’s the right thing to do and you never know what will happen. You do not want the guilt of knowing that you could have done better for your patient on your conscience.

My conscience remains clean, though my heart is still a little heavy.

How did the death of your first patient affect you?

*Names changed to protect confidentiality

6-Month Update

Hello, loyal readers!

Remember me? Well, I’ve been in Middle of Nowhere, USA for over 6 months now and it’s been almost that long since I’ve written a blog post (yikes!) so I thought I’d amend that right now.

Okie dokie then, where to start?

1. I made it past the probationary period at my (counselor) job last week! Translation: Before, they could fire me without reason or notice and I didn’t have access to my vacation time. Now, they’d have to go through hell to fire me and I haz vacation!

2. Speaking of vacation, I’ll be using all of mine to spend a week in New Orleans for EMS World Expo!! That’s right. Thanks to the never-ending awesomeness and generosity of Kelly Grayson, a.k.a. Ambulance Driver, I’ve got a free pass to the conference! I was planning on going anyway—y’all know what a nerd I am. I can’t resist going to a conference where all of the greatest minds in EMS congregate annually to share their knowledge and experience with us newbies (and oldies alike)! But now I have $385 less that I need to earn in overtime. That translates to about a gazillion more hours I have to not be at work, stay home, and focus on other things.

3. Speaking of other things, graduate school is probably still happening in the near future. Like in the next couple of years. After attending a conference geared toward helping young Native people like myself with the graduate school process, I have a ton more confidence in myself and my grad school potential. I have been energized and am SO READY to go to grad school RIGHT NOW. I just still need a bit more time to prepare. My current timeline has me ready to apply and to start in the fall of 2014. That’s IF I can make the most of these 2 years until then and put together a kick-ass application to get into the schools I want to go to.

4. I became a real EMT this week as well. I know, I know. I became a real EMT when I passed National Registry. Then when I got my registry certificate/patch in the mail. Then when I got hired for an ambulance service. Then when I started working for that ambulance service. And now I’ve become a /real/ EMT again now that I’m off orientation and on my own! I work part-time as an EMT, meaning I only work a couple of shifts per week, so it took about 4 months for me to complete my 4-step orientation packet. But I’m done now and had my first (half) shift on my own on Sunday! =D The main thing I struggle with now is learning my way around this town (gimme a break! I’ve only lived here 6 months and I basically just drive to and from work every day…). Of course, I continually strive to become a better EMT—you know, someone who is capable of actually assessing and treating a patient rather than being just a medic’s bitch—and will continue to develop my clinical skills with each and every call. I love the medics at my service and they’re all pretty good at throwing tips and advice my way to help me grow into the truly kick-ass EMT I know I can be.

And that’s my current life in a nutshell. I promise I’ll make my grand return to the blogosphere very soon! My absence has not been due to lack of material—I’ve just been so busy. I work an average of 64-72 hours per week between my two jobs and I just needed a break. (Hey, blogging takes up a lot of time and energy!)

No, no, no. Don’t y’all worry. Ms. Katie B., B.A., NREMT, CNA, Badass Bitch will be back in full force very soon! Look forward to it. ;)

Lessons in Counseling

They call me “counselor.”

…But I’m not.

But I am…

Confused? Let me explain.

I had a good day at work the other day. I work in a psychiatric hospital and my title is “counselor.” But I have no (zero, zilch, nada) training in counseling. That usually requires at least a master’s degree in counseling, whereas I only have a bachelor’s degree in psychology. Sure, I may know a thing or two about many of the different illnesses that my patients are diagnosed with and maybe a couple of the medications that they’re prescribed, but nothing whatsoever about counseling.

But what would you expect if you were a patient in a psych hospital and someone worked there was called “counselor”? You’d probably expect them to be someone trained in counseling techniques who’s job it is to listen to your problems and help you fix them. That’s why when patients need someone to talk to, they ask for the counselor on duty instead of talking to other staff. That happened the other night. It was strange because my counseling skills were really put to the test (remember, I have no training for this), but it was also really nice because I was able to connect with my patients in a way that I never had before.

I like spending time with my patients. I spend my shifts walking around outside, tossing a frisbee in the small courtyard right outside my unit, playing cards, painting the windows on the unit, coloring, watching tv, or just sitting and talking with patients (when I’m not doing charting and paperwork). I like getting to know them, but I also like to think it’s therapeutic for them too—it helps them develop coping skills to deal with their issues and also reminds them that I am in no way above them just because I am staff.

That night, I was coloring with some patients during snack time when another patient said she needed a counselor to talk to. I thought, “Oh great.” This patient is particularly needy—a frequent flyer at the hospital. I thought that she was summoning me only because I happened to be talking with another patient at the time and no one was paying attention to her. But I squeezed every bit of professionalism I had in me to the surface, put on my best counselor face, and sat down at her table. What started out as her usual sob story of “nobody likes me, everybody hates me, wah wah wah” turned into something a lot deeper than that—by then two peers had sat down at the table too and were sharing their feelings with me, and before I know it, I’ve got everyone sobbing loudly as they open up to me and share things with me that they’ve never shared with anyone before, not even the treatment team! I gotta say, I never saw that one coming…

I sat there with them for two hours listening to their stories. Life on the res is tough. These people’s families really do tend to treat them like crap. I’m not going to pretend that I understand the historical, cultural, and social complexities of the situation on the reservations, but I do know that that night, two patients whom I viewed as overly needy and annoying transformed into two people who have had very difficult lives and who have a lot of problems they need to work on. And I wish I could help them. But that is way beyond my “scope of practice” as a counselor, so to speak. It’s probably way beyond anyone’s—the counselors, the nurses, the social worker, and the psychiatrist can only do so much alone. Until there is somewhere else for the patient to go instead of right back into the same shitty situation that brought her to us in the first place, I think she will continue to end up back with us again and again.

And while my heart is bleeding all over the floor for these people, everyone who has worked there longer than me—counselors, nurses, and aides alike—are all rolling their eyes. They say, “Katie, you can’t believe everything a patient tells you.” But that’s my job isn’t it? I’m not going to be the one to “fix” them—I just listen to them because they have no one else to talk to. I don’t care what they tell me—I know that a lot of people lie and try to manipulate you—but it’s my job to listen and to be supportive, not to judge them. Sometimes all people need is someone to believe them. So I do.

I may not deserve the title of “counselor” but that’s what I am, and I take my job very seriously, thank you very much.

Aaaaand the next day it was like nothing had happened. They were back to their rude, demanding, obnoxious ways overnight. The girl even called me a bitch because I’m “supposed to be there to help her and I never do anything for her.” Say whaaaa?

*sigh* Such is life, I suppose…

=)

White Cloud No More

So, after only 2 days on the ambulance, they’re already calling me “Black Cloud.” How the heck did that happen so fast?!

Well, from my perspective, I’ve been a white cloud for way too long and I think it’s about time something changed. (I mean seriously, I’ve done a total of 3 ambulance ride-alongs before even going to EMT school and only had ONE call per shift. My 2 clinical ride-alongs during EMT school weren’t terribly exciting either. Even at my other job in the psych hospital I have this uncanny ability to avoid codes.) But seriously, I didn’t expect my white cloud to turn black on my FIRST call on my FIRST day on the ambulance!

Here’s what happened: As I’m pulling into the station parking lot, I see the garage door going up and the ambulance pulling out. They pull up behind me and shout “Get in! We’re going on a call!” I grab my stuff as fast as I can and hop in the side door of the ambulance. Now I have no idea what kind of call we’re going to since I had just arrived for my first day and hadn’t been assigned my pager yet. We arrive on scene and the EMT-I leans in and solemnly tells me, “This probably won’t be a good thing.” And sure enough, we get inside and the family stated, “We just found him like this.” I’m thinking, Oh no…he’s dead. 

Yes, indeed. My first call as an EMT was a full code! Not a very exciting one, mind you–I knew from the get-go that our efforts were futile. The guy had been down at least 20 minutes before we got there. It had probably been much longer than that, but since there was no rigor or lividity present and he was still warm, we had to run it as a code rather than a DOA. But  it was asystole on the monitor from the beginning, so we delivered no shocks. Just CPR and some medications for about 20 minutes before medical control told us to stop.

I’m told I set a record. Most new EMTs have to wait weeks or months before they see their first code. I got mine before I was even technically on duty! Then we got a transfer from the local hospital to a specialized heart hospital in the city with a completely unstable patient. She was not ready to go when we got there (in fact, she was saying that she wanted to die) and it took an hour to get everything sorted out with her. I seriously thought she was going to code in the back of the ambulance in the middle of the freeway (thank god she didn’t because some doctor who was nowhere to be found had her chart with the DNR in it). Then, as 20:00 is rolling around and my shift coming to a close, a call comes in for chest pain. I decide to go even though it will add another hour or so to my shift that I won’t get paid for. (What? I couldn’t pass up a good chest pain!) It was one of those load-and-go situations—we got on scene and the gentleman was complaining his chest pain was 10 on a scale of 1-10—so it didn’t last very long, but I got to help with a 12-lead ECG and administer nitro. I really wish I knew what came of this guy. I can’t believe that I may have actually witnessed a heart attack in a 25-year old, but that’s certainly what it looked like…

So this former white cloud can certainly scratch a few items off her newbie EMT checklist after only one day. My second day wasn’t too bad either. We got a call for a woman who cut her foot after her domestic partner threw himself through the glass door in an angry rage, I spent some time in dispatch which was pretty interesting and informative, a call for an unresponsive resident in a nursing home, and when we were in the ER dropping that one off, another call came in for an elderly woman “not acting right.”

In my two days on the truck so far, I’ve gotten exposure to a good variety of calls, learned some new skills, and am learning to work well as a team with the wonderful medics and EMTs at this service. I may not be Mz. Erudite EMT Extraordinaire just yet, but I’m getting there. And if this whole black cloud thing keeps up, I may get there sooner than I would’ve thought!

Just Call Me Sparky

I am well within my rights to have taken mostly a lazy day today—I think today may have been my last day off for the rest of my life!

I just got done with orientation at my first job (counselor in a psychiatric hospital) and will start orientation with “County EMS” (CEMS) next week! Exciting, but stressful. Pretty much every day that I’m not working at the hospital, I’ll probably be on the ambulance.

That’s right. For those of you that haven’t heard the news: I was hired by the EMS service! Freakin’ right! I’m starting to feel like my old badass bitch self again! It was a very intense interview too—that man definitely grilled me good—but in the end I think he was convinced of my passion to affect change. And so I was hired.

I’ve got my uniform (for the most part) and am just waiting for next Thursday to get here so I can sport it. All that’s left to do is slap a patch on my arm and call me “Sparky.”

Since I haven’t blogged in a while, I’m having a little bit of trouble getting back in the swing of things. Hopefully I’ll have some interesting stuff to share with y’all next time!

Orientation/Downtown Adventures

Yesterday was a super adventurous day in orientation! We were trained and certified in Non-violent Crisis Intervention, which was very hands-on and fun. We learned how to recognize different ways that a person might act out and then respond appropriately. The hands-on part comes when you learn various methods of physically restraining acting out people, and that was super fun! Our hospital really makes an effort to minimize the use of restraints (indeed, I’m told that the use of them has gone down 78% over the last decade), but they are sometimes necessary if a patient is becoming dangerous to him/herself or others, so we must know how to use them safely. Part of that training also includes how to block strikes and release yourself from various holds that a patient might try on you. It was a lot of fun but also practical. I’m quite certain I will have to use some of these techniques at this job.

(The other exciting thing about yesterday was that I got my flu shot and the nurse gave me a Scooby Doo band-aid! I know you’re jealous…)

Today was also really exciting (except for the fact that we were back in the classroom and I didn’t get enough sleep last night). You see, part of my training for this job includes CNA (Certified Nurse’s Aide) certification. Today, we thickened up various beverages with a thickener (for patients who can’t have thin liquids) and tried them. Here is the verdict: Water—eh, not too bad; Coffee—gross; Milk—couldn’t even bring myself to try; Juice—not too bad, actually kinda tastes like applesauce. Then we spend the afternoon learning a few skills. We did brushing teeth, denture care, oral care for the comatose patient, and partial dressing. They’re fairly easy and straight-forward, but I gotta tell you that each time my turn was up, I kept wanting to start by saying, “THE SCENE IS SAFE. GOT MY BSI.” It just felt natural to me that that’s how I should start. I mean, hell, those EMT skills were drilled into me pretty good. But I’ve got to get used to the way of doing nursing skills, which always starts with knocking on the resident’s door, introducing yourself and explaining the procedure, making sure the breaks are on the bed/positioning the patient, washing your hands, and putting on gloves. I’m sure I’ll get the hang of it soon.

The other really cool thing that happened today (besides going to ACE Hardware and getting an elastic band to keep my keys on) was that I went downtown to a bar with one of my classmates. It’s a really cool place right by the river that serves beer and wine. It was great to go out after work and do something with someone and try to make friends in this new town, but that’s not even the best part. The best part was that I had a Czech beer!

Isn’t that crazy? I thought I would go have a casual drink and bond with a classmate and sure enough, I end up in a bar in a beautiful location drinking one of my favorite Czech beers, bonding with my classmate, and learning more about my new city. I can’t wait until spring/summer! I think this is a nice place with some nice outdoor activities to do then.

So I’ve had a pretty cool last couple of days. There’s a good chance that I’ll have some more awesome adventures in the coming days as well because it looks like my internet will be cut off either tomorrow or Thursday (my roomie is in the process of moving out) and I don’t think I can afford to get it reconnected right away. So I should have plenty of time on my hands after work to explore the town, maybe get a hobby, and also, you know, a life. ;)

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