Archive for the ‘EMS’ Tag

Eating Elephants, Round 2

There is an elephant on my plate…again.

I’m not going to pretend like I mind. I’m very busy, yes, but I usually work better under this kind of pressure. It’s stressful, but it’s motivating!

Between working two jobs, taking classes, book club, and studying for the GRE (again), I haven’t got much extra time on my hands, which is exactly why I’m in the mood to write. ;)

You read that right: I am back in school and studying for the GRE—very similar to the situation I was in two years ago. Except last time, I was preparing to apply to a ph.d program in clinical psychology while this time I am preparing to apply to master’s entry programs in nursing. I am currently taking prerequisite classes for nursing school at the local state college, then I plan to go on to earn an MSN specializing in nurse midwifery.

I can’t emphasize enough that I have NOT lost interest in EMS or psychology or any of the other things I’m interested in—I’m simply going down a path that is true to my heart and I will continue to pursue this and other interests for the rest of my life. And if you think about it, pursuing nurse-midwifery is not really a divergence from those other interests—all revolve around my passion and commitment to patient advocacy and to providing better healthcare to people in this country.

I’ll leave you with that for today. Thanks for reading (even though my posting is scarce these days)!

And when you’re stressed out and faced with a seemingly impossible task such as eating an elephant, just remember, the only way to do it is one bite at a time.

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.

 

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. ;)

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!

Clinicals: Things I Learned on the Amberlamps

So I had my clinical ambulance ride time on the ambulance last weekend. I did two 12-hour shifts on two trucks in two cities near where I live. I didn’t get to see anything crazy (no major trauma or medical calls, no combative psych patients, or anything like that), but I had a blast and I would say that I still learned lots.

First of all, I’m STILL a bad omen for car trouble. The first day, we were in three different trucks because we kept having problems! We operated most of the shift in the most ghetto ambulance I’ve ever seen, complete with wood paneling lining the walls and dim, flickering lights overhead. The second day, on our first call (a transfer to New Orleans), the family (who was following behind) informed us that one of our inner tires in the back was flat. Sure enough when we got to the hospital we discovered it was completely shredded and had to go to the nearest station to have it changed. So yeah, that was pretty exciting.

This particular ambulance company has ambulances designed so that the front cabin and patient compartments are separate, with only a tiny window for communication between the two. This is not what I was used to from when I did my ride alongs in Minnesota, so needless to say I was a little lonely sitting back there all by myself! I didn’t get to talk with my preceptors as much as I would have wanted to and certainly didn’t get to have all of my questions answered. Hmm…maybe that’s why they created the ambulances that way! Aha! They told me it was so that an out-of-control patient couldn’t make it to the driver and cause an accident, but I bet the real reason is to keep the students from aggravating them too much! Touche.

We do not spinal immobilize, or provide oxygen to, nearly as many patients as we’re taught to in school. I had 10 patients in those 2 days and the only one that had oxygen was a man with a broken hip who we were transferring between hospitals. Granted, none of the patients we had were critical and didn’t really need oxygen. It was just weird because it’s one of those things that’s done drastically different in the field than you’re taught in the classroom. Same with spinal immobilization. My instructor pushes this “cover your ass” medicine and advocates that any type of trauma patient “bought themselves a ticket to the spine board.” But thankfully, I learned that this service’s policy is that you don’t have to immobilize if the patient denies back or neck pain. Also, we had a patient that fell and was throwing up—I’m pretty sure if this scenario appeared on a test, the answer would be to spinal immobilize and “be prepared for vomiting” by turning the spine board on the side when the patient vomits and having the suction ready nearby. But in this real life scenario, the medic decided against immobilizing her because of the vomiting…and I’m so glad he did! That just wouldn’t have been a good situation to have to deal with had we immobilized her—for anyone. It’s difficult (and messy) to simply turn the spine board over when they start to vomit. (Now, you may have to do that when your unresponsive patient begins vomiting on you, but when the patient is responsive, alert, and oriented, why make things 10 times more difficult just because the patient might—and probably doesn’t—have a spinal injury?) And imagine if you were a nauseated patient and the EMTs forced you to lie supine and strapped to a board for the 20 minute ride to the hospital. How much would that suck? Anyway, the point of this rather longish semi-rant is that I think as EMT students, we’re taught so much to “cover our asses” that we forget that our jobs require us to, first and foremost, care for and comfort our patients. I’m so thankful that I was able to learn early on (thanks to other bloggers sharing their stories) that the best treatment according to the textbook may not actually be what’s best for the patient. And I’m really glad that the service I will (probably) be working for allows for some freedom in making these judgments.

Hmm let’s see. I also learned that I really suck at taking blood pressures in ambulances. Well actually, my first shift, my preceptors didn’t have me take ANY manual vital signs, for some reason. I really don’t know why, but for every patient we had they told me “We’ll just get an electronic blood pressure for this one.” So I’m really good at putting the non-invasive blood pressure cuff on people, but not as good at getting a manual. The second shift, they had me do it on every patient, and my first two I couldn’t get at all. The first time we were rolling along a bumpy road. It was hard enough to hear as it was but then the needle jumped every time we hit a bump! I missed the first one completely and the second time I was able to get a systolic of 118 but couldn’t hear when it stopped. The next patient was a really old lady who had bat wings hanging down from her arms. I’m guessing that was the problem that time rather than the noise. But I’m telling you I wanted to cry when I deflated the cuff and had to look up and tell my preceptor that I couldn’t get it. I swore that he looked so disappointed and was going to give me “below average” ratings and tell my instructor that I sucked. But he tried and couldn’t really get it either and after we got to the hospital he said their machines were having trouble getting it as well. So I felt a little better that I couldn’t get it not because I sucked but because it was just one of those difficult patients. I was able to get all the rest of them (And am SO thankful when I’m able to get one on scene before we get in the ambulance! It’s so much easier!).

GI bleeds are just as nasty and smelly as I have always heard. Lovely.

Finally, I learned that I’m really gonna have to learn my way around A LOT better. In just those two shifts, I was in at least 10 different cities all across south Louisiana. And the thing is, it’s not just running transfers to all of these unfamiliar cities no, no, no. You see, when you’re in a certain area, this company considers it fair game for you to run 911 calls if you happen to be there when they come in. I didn’t complain about it for my clinicals because the most interesting call we got all day was when that happened right after we dropped off a transfer. But I’ve never been to many of these cities and even the ones I’ve been to (like New Orleans) I don’t go to often and certainly don’t know my way around without precise instructions from google or mapquest (and god help me if those directions are wrong due to construction or something like that because I would not be able to figure my way around!). I know that ambulances are equipped with GPS nowadays but I was just reading a blog post the other day about how we can’t totally rely on them because they only work 90% of the time. I hope I am able to learn my way around very quickly. Otherwise I am so screwed.

All in all I had a good time and can’t wait to be a real, live, certified, working EMT! Shouldn’t be but a couple of months now…

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