Wow, I sort of fell off the planet there... Big changes since my last post. For starters, I've patched things up with my wife, she's moved back in and we're working through our issues, albiet slowly.
Work has been pretty hectic lately. Seems like our days are getting busier, even though the numbers don't really reflect an increase in call volume. I have also noticed that we seem to be running more intubated patients this month, which certainly isn't a bad thing, it just wears you down after doing so many in a day.
Had a run the other night from Podunk ER out in the West End. The patient had gone in for her first chemo treatment, developed sudden onset SOB followed by respiratory arrest. She was intubated in the ER and placed on Dopamine. Then... They found the Advance Directive. The part I was having trouble dealing with was just getting her saturations to improve, but didn't have very much to play with due to the advance directive. Pretty stressful situation on top of an already stressful day. Boy did I sleep like a rock when we finally made it back to the station.
I've completed my set of powerpoint slides for my airway assessment course I'm teaching and sent it out to the medical director, so we'll see what he thinks about that. It'll be back to work soon on the release exam questions that I put off a while ago.
I bitch a lot about this job and it's shortcomings, but I really do love the work I do. I just wish the business side of things would catch up to the rest of it and start really taking care of the employees. Right now, we're just being treated like cattle. Something's gotta give, and I just hope it's the company instead of more disgruntled folks deciding their time is better spent elsewhere.
Other than that, Taking a vacation to Indiana this weekend to go visit my Grandfather & Aunt, so should have fun there.
See ya.
Wednesday, March 18, 2009
Tuesday, January 13, 2009
Quality Assurance
So yesterday was our QA meeting at work... There's 6 of us on the QA committee, 1 BLS provider, 1 ALS provider, 1 Supervisor, 1 Critical Care Medic, 1 Dispatcher, and the QA Officer. Basically during the QA gig we sit down at the conference table, with a stack of 5% of the run sheets for the QA period, which in this case was 3 months worth, so there were probably close to ~400 call sheets there. After we go through those, we look at the runs for the QA period where medications were administered. Being that we're primarily a transport service, one would think we don't give much medications.
There's this provider, who we have been running into a lot in QA. Last period, he had a serious mishap that would be referred to as a sentinel event, in a hospital. I don't want to elaborate too much, but let's call it a horrific lapse in judgment that took a bad turn for the patient.
So there's three runs from this provider. They are escalating in severity in terms of poor judgment. The ultimate conclusion was that the provider hadn't learned anything since the incident and we voted to take away his controlled substance standing orders. It's really upsetting to me that people can be this way. We're not doctors, we're paramedics, and we must remember that we are not practicing medicine and need to display some restraint.
I don't know if it's an education problem, or if it's just the way some individuals are, but it really distresses the hell out of me. It's people like that who give medics a bad name.
But yeah, so that was my day yesterday. Back to work wednesday.
There's this provider, who we have been running into a lot in QA. Last period, he had a serious mishap that would be referred to as a sentinel event, in a hospital. I don't want to elaborate too much, but let's call it a horrific lapse in judgment that took a bad turn for the patient.
So there's three runs from this provider. They are escalating in severity in terms of poor judgment. The ultimate conclusion was that the provider hadn't learned anything since the incident and we voted to take away his controlled substance standing orders. It's really upsetting to me that people can be this way. We're not doctors, we're paramedics, and we must remember that we are not practicing medicine and need to display some restraint.
I don't know if it's an education problem, or if it's just the way some individuals are, but it really distresses the hell out of me. It's people like that who give medics a bad name.
But yeah, so that was my day yesterday. Back to work wednesday.
Saturday, January 10, 2009
A look into the job
One of the things that people ask me a lot is, "What is your job like?" or "Is it scary?" and I think... Hmm what can I say to really knock this person's socks off... And you know, sometimes I really have to struggle to find a good story because that's what they're looking for. I was the same way when I started out... Looking for the guts and glory. And it doesn't exist. Well at least not in the degree people expect it to. I guess I do have a part in an extraordinary job in that I deal with things most people wouldn't dream of, but if you think about it, I am just doing my job.
I can only think off the top of my head of a few real hair raising calls, and most of them weren't really hair raising at all. I used to think that taking ventilator patients would scare the fuck out of me - and the first couple times, yeah, I was nervous about it. But after I learned about the physiology of it, it's just another therapy.
It's hard for me to grasp this concept at times, that people think my job is something special. I really love it, don't get me wrong, but I'm just another shlep out there doing what I have to do to make a living. Maybe what they see is the fact that I advocate for the patient, I don't know. I would hardly ever credit myself with saving someone's life. Maybe that will come along some day, but for now, I just keep the patient going between hospitals, cause that's my job.
At the same time, I can't resist glorifying it some days, because I like to see people's reactions. I occasionally will offer someone a ride-along to see their reaction, and mostly its always the same... "I couldn't handle the blood and guts." But you know the funny thing is, when I was doing 911 in Texas - there was rarely any blood and guts... The bloodiest call I had, ironically was a Hep B positive patient who got the shit beat out of him with a lead pipe. I just did the job, you know?
I think that I have a harder time dealing with the human tragedy and aftermath than the actual patient care, or poor outcomes... When I was an intern, I had a gentleman that was 18, in a shootout and he got clipped in the head... Well, we rushed him to the trauma center where he was promptly pronounced dead. I happened to be charting outside the trauma bay when the nursing staff brought the family back, and what got me the most was this guy's wife and 1 or 2 year old child bawling over the body. I was sad, but also raging. I was so angry that this fucker made such a poor choice in life to get his ass shot and killed, leaving his child to grow up without a father. Who knows - maybe the kid won't grow up to be a banger - Unlikely. That's the stuff that really bothers me. That, or the 2 year old that I took to a hospice clinic to die, because his parents didn't want to feed him anymore on account of some congential defects. I understand the concept of hospice, and do-not-resuscitate, and fully support them. But to look upon a 2 year old child and know that this poor defenseless thing is going to starve to death, is just too hard.
Those are the demons I deal with. It's never hard to deal with the adrenaline, the blood, the "guts" - It's the human demons.
I can only think off the top of my head of a few real hair raising calls, and most of them weren't really hair raising at all. I used to think that taking ventilator patients would scare the fuck out of me - and the first couple times, yeah, I was nervous about it. But after I learned about the physiology of it, it's just another therapy.
It's hard for me to grasp this concept at times, that people think my job is something special. I really love it, don't get me wrong, but I'm just another shlep out there doing what I have to do to make a living. Maybe what they see is the fact that I advocate for the patient, I don't know. I would hardly ever credit myself with saving someone's life. Maybe that will come along some day, but for now, I just keep the patient going between hospitals, cause that's my job.
At the same time, I can't resist glorifying it some days, because I like to see people's reactions. I occasionally will offer someone a ride-along to see their reaction, and mostly its always the same... "I couldn't handle the blood and guts." But you know the funny thing is, when I was doing 911 in Texas - there was rarely any blood and guts... The bloodiest call I had, ironically was a Hep B positive patient who got the shit beat out of him with a lead pipe. I just did the job, you know?
I think that I have a harder time dealing with the human tragedy and aftermath than the actual patient care, or poor outcomes... When I was an intern, I had a gentleman that was 18, in a shootout and he got clipped in the head... Well, we rushed him to the trauma center where he was promptly pronounced dead. I happened to be charting outside the trauma bay when the nursing staff brought the family back, and what got me the most was this guy's wife and 1 or 2 year old child bawling over the body. I was sad, but also raging. I was so angry that this fucker made such a poor choice in life to get his ass shot and killed, leaving his child to grow up without a father. Who knows - maybe the kid won't grow up to be a banger - Unlikely. That's the stuff that really bothers me. That, or the 2 year old that I took to a hospice clinic to die, because his parents didn't want to feed him anymore on account of some congential defects. I understand the concept of hospice, and do-not-resuscitate, and fully support them. But to look upon a 2 year old child and know that this poor defenseless thing is going to starve to death, is just too hard.
Those are the demons I deal with. It's never hard to deal with the adrenaline, the blood, the "guts" - It's the human demons.
Checking out the truck (Starting up the blog)
Well, here goes... I've never been terribly great about blogging or journaling, but I feel like it could be beneficial. I'll start off by giving a little background.
I've been in EMS for almost 3 years now, having been a paramedic for almost 2 of them. I love it. I'm working as a critical care paramedic for an outfit that does interfacility work in the DC Metro area. We take a lot of bs patients, but also a lot of critical patients, and it is very stimulating work. Most of the time the patients are grateful for someone who comes along and will pay attention to them, instead of treating them like some shmuck in a bed. I'm also a shift supervisor at work, which adds to my stress level most days.
I'm currently involved in divorce proceedings. One of the hard things about this job is it doesn't exactly work well getting involved in it when you're in the middle of a marriage. I started my relationship home almost every night and ended it working 2 24 hour shifts a week, and I tell myself that this had to have played a part in things. Other than that, it's rough sometimes, and a relief others. I don't know if my Ex is reading this, but I'm going to say whatever cause this is my space. For the first time in a long time, I don't feel stressed out about life. I was out last night having a good time with some friends, not moping, or anything of the sort, so I really feel that this is a good thing, no matter how much it sucks.
In between working, I like to go out and drink / eat with friends, I occasionally play video games, or just plain sleep and watch tv. I have been meeting new people and maybe at some point, the kind of relationship I want will blossom out of it.
Any names appearing in this blog will be changed to protect the identities of the innocent. Before people comment to me about HIPAA - I'm not divulging any protected health information - and anything I write about a facility - well if they're doing something fucking stupid - they deserve to be called on it.
It's my intention to post just about anything here that I find interesting, or stories from my daily life. Sort of an experiment. I'd like to go back to the beginning at some point down the road, and see just how life has progressed. Sort of an objective look if you will.
Thanks for joining me and I hope that you all will learn something, or at least enjoy reading. I welcome all comments and thoughts.
Have a good shift!
I've been in EMS for almost 3 years now, having been a paramedic for almost 2 of them. I love it. I'm working as a critical care paramedic for an outfit that does interfacility work in the DC Metro area. We take a lot of bs patients, but also a lot of critical patients, and it is very stimulating work. Most of the time the patients are grateful for someone who comes along and will pay attention to them, instead of treating them like some shmuck in a bed. I'm also a shift supervisor at work, which adds to my stress level most days.
I'm currently involved in divorce proceedings. One of the hard things about this job is it doesn't exactly work well getting involved in it when you're in the middle of a marriage. I started my relationship home almost every night and ended it working 2 24 hour shifts a week, and I tell myself that this had to have played a part in things. Other than that, it's rough sometimes, and a relief others. I don't know if my Ex is reading this, but I'm going to say whatever cause this is my space. For the first time in a long time, I don't feel stressed out about life. I was out last night having a good time with some friends, not moping, or anything of the sort, so I really feel that this is a good thing, no matter how much it sucks.
In between working, I like to go out and drink / eat with friends, I occasionally play video games, or just plain sleep and watch tv. I have been meeting new people and maybe at some point, the kind of relationship I want will blossom out of it.
Any names appearing in this blog will be changed to protect the identities of the innocent. Before people comment to me about HIPAA - I'm not divulging any protected health information - and anything I write about a facility - well if they're doing something fucking stupid - they deserve to be called on it.
It's my intention to post just about anything here that I find interesting, or stories from my daily life. Sort of an experiment. I'd like to go back to the beginning at some point down the road, and see just how life has progressed. Sort of an objective look if you will.
Thanks for joining me and I hope that you all will learn something, or at least enjoy reading. I welcome all comments and thoughts.
Have a good shift!
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