American Jobs Act Leaves Out EMS....AGAIN!!!

As any good citizen, I sat up last week and listened to the President go on and on and on and I've been blessed by seeing his sound bytes played over and over and over again.  So I did a little research because my dad always told me if it looks to good to be true it probably is.  Well dad's right.  I find it interesting that "it will be completely paid for" but where is this money coming from?  I still haven't found that out but it has to come from somewhere.  I think NONE of these credits are really going to do much to spur hiring.

 But what really made me annoyed was that EMTs and Paramedics were left out.  There is a section to save teachers, hire new teachers, cops and firefighters.  Well excuse me for not being brave enough to be a cop or a firefighter.  I wouldn't want to do their job.  Fire is hot and well people are crazy.  This has annoyed me because its a slap in the face that my job as a Paramedic isn't as important.  I have been threatened, had a knife pulled on me, been pushed around, dodging traffic, all while treating my patient who is near a burning car.  I've taken family members, my own child to be specific, colleagues and family of colleagues to the ED but yet my job isn't stressful.  I recently went to a patient's house only to find that he had a rifle, pistol and a banana clip in his room.  But hey my job is simple right?

 As providers we are becoming this generation's doc on wheels for lack of a better term.  I want my profession to be as respected as that of a LEO or FF.  I'm so sick of us being overlooked.  We put ourselves at risk in order to help our community just like my local LEOs and FFs.  I have a great deal of respect for what they do and the dangers that can come with their job but each day I suit up and go to work I can't guarantee that I'll come home.  I kiss my kids and my husband and hope that the unaware public don't take me out on my way to someone who needs my help from that MI, stroke or trauma they're experiencing.  I also hope that my patient or their family aren't in a terribly bad mood and decide to take out any aggression on me.

Its time that we as EMTs and Paramedics get squeaky.  We need to make those folks in D.C. and locally aware that what we do, no one else wants to do.  Talk to any MD and I'm sure they'll tell you that they wouldn't want my job and see what I have to see.  They don't want to see that toddler dead in the car seat that mom or dad didn't strap in, that high school senior dead in his car, that elderly man whose family has completely neglected them and I can go on.  I've had calls that have changed me forever.  The most recent was a 9 month old girl who died of SIDS.  I was a mess after that call.  I made my husband wake up my daughter and put her on the phone.  I needed to know that my baby was ok.  I cried for weeks and even now I can remember every detail of that call.  We have an emotionally stressful job and its time that we stood up and made the public and local leaders take notice.  When they have their medical emergency we'll be there and not always in the safest of places.

Dangers of Refusals

So as some of you know I live in NC. Last summer a football player died after a paramedic allowed him to refuse treatment. You can read the article here. After reading the call report that was available here I began to wonder what this medic was thinking. So after several months, the family has filed a wrongful death lawsuit. You can read it here. Its pretty compelling.

This whole situation got me to thinking about all the patients that I have let refuse. I try to transport every patient because I am not a doctor and they called me for a reason. I never like letting patients refuse because it is such a liability. This paramedic is in serious trouble if you ask me. First it is NEVER ok to let a minor sign a refusal....ever. Based only on the information available, I would have transported him to the hospital due to his presenting complaints, history of asthma and because I could not get a hold of his parents.

I think the take home message is simple, be careful when letting patients refuse your care. If you exhaust all options, then document the living snot out of your report.

Burn out my A##

Alright over at 9-Echo-1 there's a thread about a couple of FDNY EMTs that supposedly refused to help a pregnant mother who later died and her baby died, because they were on a coffee break. First I sure hope that this did not play out the way it sounds and my condolences go out to the family.

Ok so now that I got that out of the way lets address this "burn out" garbage. Apparently we EMTs and Medics get too tired, overworked, underpaid, etc. Well not to sound nasty about it but we all knew that was the scenario before we left EMT class so get over it. All of us chose this job and understood the sacrifices we would have to make. Burn out is an excuse to use when one is feeling overwhelmed. I've found myself feeling tired and all that before but you know what I tell myself, AT LEAST I HAVE A FRIGGEN JOB. I may get sick of the nonsense that goes on but I chose this job and I applied at my current employer because I WANTED TO. So basically its time for all the EMTs and Paramedics to MAN THE HELL UP ALREADY. This job isn't for everyone. You either suck it up and continue doing the job you were trained to do or go find something else to do. Either way quit making the rest of us look bad because you can't handle the stress of the job.

Good grief its like having a bunch of kids. I'm not your momma and no I don't want you to whine to me about how bad it is. Either do something about it or shut the hell up about it. I can't stand whiners, excuse makers, laziness or dumbass. If you're that unhappy then quit and go do something else but stop making excuses for this kind of behavior. The more of us that find this to be unacceptable then the better chance we have at changing the mindset.

1 year later

December 4, 2008 is a day I will never forget. AJ was still in the hospital and we were all hoping and praying that he would recover only to receive that horrible phone call. This morning I got up and thought of AJ. I thought of all the tears and hugs shared last year. I felt so helpless, so numb.

This morning another Raleigh FF was hurt in an off duty accident. I find myself reliving all those terrible emotions that I felt last year.

Stay strong Flip. You have a wife, 2 daughters and a whole family of emergency services personnel thinking of you and praying for you. Fight like you've never fought before. Dig deep and find the strength to return to your family so that they may tell you just how important you are to them.

I don't pray much but here goes:

God please help Flip and his family through this difficult time. Please surround them with your love and grace. Please send him back to his family to fulfill his job as husband and father. He needs you now more than ever.

Everyone please pray hard for Flip and his family. This is such an awful event for any family to experience and I sure hope that this story has a happy ending.

Grade Reports

Well this school year has been off to a rocky start. My nephew was struggling so much to get decent grades but he managed to get a decent grade card. He was missing some assignments in 1 class in which he ended up with a D but he got Bs in all of his other classes. Considering he failed last year its a huge step in the right direction and I couldn't be any prouder of him.

My son has also done great this time. He got all As and 2 Bs this quarter. Not to bad but school seems to come easy to him. Now if we can just get his behavior to match up with his academics...but then again I'd probably have a stroke if that happened.

As a reward we took the boys out to Andy's. I was hoping for Lonestar but we told them they could pick. They were so proud of themselves and it makes me so happy to see them succeeding. I'm still deciding on an end of the year reward for them. Of course it will involve good grades all year long but I'm not sure what to do for them. Any suggestions are welcome.

My Response to Anonymous' Comment

Well kiddies if you think that I'm some precious little fragile thing you've obviously never met me. I jumped into an Airway discussion on Rouge Medic and some person, who wishes to remain nameless, had his 2 cents to throw in. For those who know me, I am not going to just let it go. Anyway if you want to read the initial topic go to Rouge Medic and look for Teaching Airway-Part I. There is also a link from Rouge on my comment and his take. So here's what I had to say to Anonymous:

Let’s respond to some of Anonymous’ comments”

"Yes, you do need more practice and it's your fault for not banging on the door of your higher ups demanding more training and why do you need an MD to confirm your tube. Your training should allow you to know that way before."

First let me say this before you go judging have your house in order and know your job. With that said, I do the initial confirmation of my tubes but in my system it is not considered a "successful" tube until verified by a MD at the ER. As for training, the places that are best suited for this according to my medical director and training officer do NOT want medics there so aside from going to the college on a regular basis and tubing a simulator, my hands are sort of tied.

“The person I want treating my family is the person trained appropriately, assesses and performs appropriate skills when necessary, recognizes change better or worse to take appropriate steps to correct, and deliver them to the appropriate next level of care. They may need you to do that skill, I hope you know how.”

If my patient needs me to do a skill then it gets done. I never withhold a treatment that I know how to do when that treatment is indicated. I however am not a cookbook medic. I was taught to think without needing a script for every patient. Sounds like maybe you should try it sometime.

“You've never worked in a teaching hospital have you. Hold on to that dream.”

I have. UNC Chapel Hill and Duke University and you worked where for your training?

“An IV can be placed by most medic's without thought but we all still miss occasionally. Is that a reason to stop the skill? Do we need more practice? Or was it because that patient was a little more difficult then others? In an arrest do we not give medications because we blew the IV or do we try an IO next or vice versa?”

Ok so now if you fail to successfully obtain a skill it’s the patient’s fault? I’ll remember that next time I am unable to get my IV. That is probably the single most moronic statement I’ve heard and why are you even bothering with an IV in an arrest situation? IO is quicker and the quicker you can get medications to the patient, along with continuous chest compression, the better outcome potential for the patient or did you miss that part at the last ACLS class?

Is it so hard for you to imagine that you may not be the best provider to do a skill for your patient or does your ego get in the way of treating your patients?

Newbies in EMS

Alright so its been a couple of months since my last post. During this time I have started to help out teaching at the community college I got my degree at. Tonight I was there helping with patient assessment, vital signs and history taking. I must say that most of the students were ready to learn and listen to what I had to say but there were a few that felt as if they knew it all. Well those met their match tonight. I may not be super knowledgeable about things in EMS but I do know how to assess a patient. I noticed a couple of students rolling their eyes and so I posed the "ok you've been dispatched to an injured person" and I sat there. Smartie pants said well how did the pt hurt themselves. I said well are you sure this pt is hurt, did you make sure your scene was safe, oh yeah and how about you ask your 16 y/o patient the questions". Ok so you get the idea I was not all that nice. Reality is that if you are at week 2 of EMT class, don't act like you know everything that's going on and that this is all too basic for you. I've been in EMS for 4 years and I ALWAYS learn something from every call I go to and from every partner I have. I really like riding with seasoned EMTs and Medics because sometimes they ask a question I never would have thought to ask.

My advice to all the newbies out there is this: humble yourself before you make a big mistake and always try to learn from those who have more experience. You will NEVER know it all and the sooner you come to terms with that the better provider you will be.