Friday, December 4, 2009

Nothing new here...

Nothing new has been going on recently. The end of the semester is coming up, and with it, the final push for, well, finals. Next week is the last full week, and then finals. So far, grades are ok..I'm holding steady at B's, and a few borderline A's, which isn't as good as I had hoped, but better than it could be. At least I understand the stuff.

We are finally learning 12 -leads. The guy goes a bit fast, but it's more than I learned in EMT-I all those years ago, so it's something. A few take-home tests are due next week, and then it's just the tests. I'm excited for break, even if I am getting my gallbladder out just after New Year's.

On the station front, I am working with the new membership committee to help revamp the probie program. I really like this department, but it has a lot of things that make me say "WTF" On the other hand, Rockville was the same way. One of the things that makes me twitch about this station is the long-time officers. They're nice guys, but they have a bit of a warped sense of things, in my opinion. While working with one of the newer EMS officers, we decided that perhaps a solution to the 'lack of pride' issue we see in some of the kids and newer members (mostly the younger ones) would be to add a bit of history to the new member orientation. Nothing really in depth, but just a sense of where we came from. Things like when the department was started, maybe some pictures of the early days, stuff like that. The fact that we we had an LODD last year would be added in too, just to make sure that the newer members know and understand, and don't forget. When I asked an officer for help on the history (there isn't anything on the website) I was asked why, and when I said it was for the new probie book, the reply was "Why would you want to bore them with that stuff?"

I was floored. Why is the history of the department such a taboo issue? No wonder there are issues with people showing up and taking care of the station (we have to have 'clean-up weeks' to make sure that the station gets cleaned on a regular basis, and there are no dishes left in the kitchen cause no one cleans up after themselves and people just throw the dirty dishes in the trash after a few days). The officers bitch and moan about the 'young kids' and how no one has station pride and all that, and yet their attitude isn't helping. If the kids knew where they came from and had a little history to have pride in, maybe they would take more responsibility (then again, maybe not).

Some of us on the EMS side have instituted a buy-in dinner for anyone who wants on drill nights (Tuesdays and Fridays). Someone makes dinner, and then it's a $5 buy-in to eat. IOU's are accepted. Not a single one of the officers has eaten that dinner. I've seen some of them come in and ignore the invitation to eat, not even bothering to ask what is for dinner, and go out and buy something. How is that a good role-model to the new people? If the officers won't even sit around the kitchen table and eat with everyone else, what signal does that send to the new people? This place has to be the most disfunctional firehouse I've ever been a part of.

On the other hand, they do some things really well, and the disfunctional-ness means that they aren't uber-concerned with a lot of the Mickey Mouse bullshit I had to put up with at the other place. No 4 hour meetings because everyone is arguing Robert's Rules of Order, or spouting off just to hear themselves talk. Still there is a lot of growing room. And I like it there.

Monday, November 16, 2009


I can't say I was super-impressed with my clinical this weekend. Only 3 real calls (the others were crap calls that didn't really require us to be there, and the medic didn't even write a refusal). No IV sticks, and the medic I was with was not nearly as cool or nice as the one I was with last weekend. On the other hand, it did teach me how NOT to interact with my coworkers. In fairness to the medic, he was very good with the patients. Just not me or his partner.

Again, on the other hand, I ran an OB that actually gave birth, for the first time in my 11 years in this field. Thankfully, it was not in the back of the medic unit, but it was on the stretcher. The patient was a multiple pregnancy, multiple birth, and the kid just flew out. We did make it to L&D, but the nurses and doctors there were too busy arguing over which monitor to put on her and weren't quick enough in moving the patient over to the hospital bed. It would have been nice, since even though her water broke on our stretcher, I would have liked to NOT have to clean up after the actual birth. Still, it was nifty, but I am damned glad it happened in the hospital.

Nothing exciting happened after that, aside from the IV I missed because it was a crappy vein, and then got pushed out of the way by the medic, who was very easily frustrated. It made me mad, because her AC was a pipe, and her hand was a little spidery thing that you see in arthritic people. Irritating, because I wanted to go for the AC first, and he said that you had to do hand first, and when I couldn't get it, took the AC himself. Later he said 'You can put down that you did IV's if you want, I don't care.' I'm not so desperate that I'm going to cheat, jerk.

Hung at the firehouse for a bit after that, and then home. Lazy Sunday, though I did get some gardening done to clean up the yard for the winter (as noted yesterday).

Today was our last test before finals. It'll be very very nice to have several weeks without having to hurry and study for some test or another. Gotta check the schedule again...we start learning 12-leads in a few days.

Sunday, November 15, 2009

I can haz Christmas tree!

We got a Christmas tree today.

Yeah, I know it's early. See, I love Christmas. It's my favorite season (winter) and my favorite holiday, and not just because you get presents. It's because for just a few weeks out of the whole year, the majority of people act the way they're supposed to act, getting off the all-about-me bus and think about someone else for a change.

Anyway, we'd talked about getting a Christmas tree this year, but because C is in New Jersey over the holidays, we decided not to get one. We didn't have one last year, because he was in North Carolina. The year before, I didn't really have one, since I was in Antarctica. A tree, to me, is central to Christmas time. When I was growing up, it was a tradition for my mom and I to decorate the Christmas tree together, listening to Christmas music. When I was living at the firehouse, we had a tree that we decorated (albeit without the Christmas music). When I was living with Bee and Foo, we decorated the tree the day of the Christmas party, with all the people who came early, while Foo cooked for the party and Christmas music was playing. So yeah, Christmas trees have been rather central to my Christmas experience for a while. Not having one is hard. Not having C around is also hard, especially since we have not really spent 'holidays' together since we started going out. Yes, we are together for the actual holiday, but he's not around for the holidays, you know, the time leading up to the actual holiday when it's nice to have family around to listen to the music, see the sights, and so on. I keep reminding myself that it could be least he comes home most weekends, and he is not in a dangerous place (aside from the fact that it IS New Jersey). I have friends who's husbands are military, and are downrange for the holidays, so I know I could have it worse. It's still hard though, not to be able to share my favorite holiday with the one I love.

Anyway, we've discussed Christmas trees, and whether we should get one or wait till we have a house that will fit it. We've bought at least one ornament every year we've been together, so that when we have a tree, it's not naked. But when we went to the home improvement store today to get mulch, grass seed, and top soil to fix the yard(and how odd does it sound saying that 2 weeks before Thanksgiving?), I saw that they had little potted dwarf evergreens. We talked about getting a taller one to put in the corner of the yard where the hydrangea used to be (but died), and saw that they had cheaper one that were much smaller.

So we got one. It's only about 2 feet tall right now, and is outside now. C plans to build a small table to put it on in the corner of the living room, we'll leave it potted, and in the spring, we'll plant it. In the meantime, C, who has become enamored of the LED lights being advertised on TV, wants to put lights and ornaments on the tree while it's inside. Granted, some of the ornaments we have are bigger than the tree itself, but we'll figure it out. Maybe a bow for the top.

But for now I am excited. I have a Christmas tree, and although C will not be here during the week, he will be around on weekends, and we can do some decorating the weekend after Thanksgiving. The fact that the tree is potted means it won't dry out, and we can plant it in the spring.

So now I can have my dream of sitting in the living room, listening to Christmas music, the only light coming from the tree in the corner. The only thing missing is the fireplace.

One thing at a time.

Tuesday, November 10, 2009


When we last left our intrepid adventurer, she was asking cardiology questions. We actually did find the answer in pharmacology class later on (oddly enough).

At any rate, now that I am off antibiotics, my throat is sore again. A trip to the doctor today (since strep throat and I are such good friends, and I have no desire to have scarlet or rhuematic fever) I thought that was the prudent thing to do. According to my own personal Marcus Welby, I still have blisters all over the back of my throat and my tonsils, which is most likely the cause of the intense pain I have been having upon swallowing (but only on the right side). New antibiotics (Keflex) make me hope that I will kick this. A blood test to rule out mono has also been taken. However, the lack of fever and extreme exhaustion make me doubt it is mono.

This weekend was my first field clinical. I was in Baltimore City, and things weren't super busy, but they weren't really slow either. I did manage to get one IV on Saturday, and ran my first 'real' GSW. Yes, it took 11 years to get a real GSW. Most of them have been either 'it's not really a gunshot' or so much a gunshot that the cops cleared us before we got on scene. This one ended up being an organ donor, but still...Sunday was even slower than Saturday, with several 'man down' calls though there was one that might have been a dissecting aneurysm. I go back on Saturday for my last one, and I hope that I will get at least 2 IV's.

In other news, my back is still sore, though I suspect (read: hope) that today's extreme pain is due to awkward sleeping last night. I have a date with a heating pad later tonight, and perhaps even some more serious painkillers than Advil.

In the meantime...I have a pharm test to study for tomorrow.

Wednesday, November 4, 2009

Question for the masses

A question has been raised in my cardiology class that no one seems to be able to answer to the student's satisfaction.

What is happening, at the cellular level, that causes ST segment changes during an MI? I know it has something to do with repolarization changes due to dead and dying or ischemic tissue, but she wants to know the specific reasons behind the amplitude changes.

Any takers among my 2 or 3 readers?

Tuesday, November 3, 2009

It Lives!!!!

I am alive, no thanks to the strep throat I got last week. Just as things were getting together.

Still, I survived 2 tests during that time, one when I was sicker than a dog, so I can't be too upset.

The semester is halfway done. I'm getting excited about being a quarter of the way done. I would like to be doing better, but I can't complain over much about B's.

Today was the H1N1 vaccine clinic on campus. I was supposed to be a runner, which meant that I was supposed to be taking filled syringes from the vaccine fill-up station to the various station giving the actual shots. I ended up taking care of a classmate who got sick, and walking her back to her dorm. When I got back, I made sure the stations had syringes, and spent the rest of my time there filling syringes with vaccine. Not the most exciting of 'clinicals' but good practice.

This weekend starts the first round of clinicals. I have 3 days of riding on a medic unit to get IV sticks before the 50 mile marathon in late November (yes, that was 50 MILES, not KM. A bunch of silly people run 50 miles up the Appalachian Trail in western MD, and the medic students have the responsibility of fixing the rampant dehydration and foot funk they will have by the end of the 50 miles.), so this Saturday, Sunday, and next Saturday will be spent in Baltimore. Hopefully my curse of no calls won't carry over too badly so I can actually get some calls. One of my classmates delivered a baby this week at her clinical. I don't really want to do that.

Drill tonight at the firehouse. I have some ideas I would really like to implement, but I haven't found the time to write them down to give to the Sgt. Also, have to study for my test tomorrow. Time to get cracking. There may still be time to pull A's out of my ass in these classes.

Tuesday, October 20, 2009

Still Alive

In the past few weeks, I have survived a CT scan (to check on the liver abnormalities found on the US for the gallbladder attack), been sick with allergies, thrown out my back, and given a presentation for class (I HATE giving presentations in front of a class).

On the other hand, I also got an A on that presentation, got an A on one test, and a B on several others. So, aside from the back pain and the limitations it's imposing (no riding the ambulance recently, no serious fencing), life hasn't been too bad.

Tonight is a drill night at the station, and then dinner with friends at Hard Times, where food is cheap and plentiful, and I will have leftovers for lunch tomorrow.

Tomorrow. Which reminds me, there are some phone calls to be made tomorrow, since the school saw fit to reimburse me for a not-insignificant amount of money that I didn't actually spend. At least, I don't think so. I knew that whole loan snafu would come back to haunt me.

Sunday, October 11, 2009

Making do

School is kicking my butt. Not in the 'study, study, study' way, though there certainly is a lot of that, (in fact, I have a test tomorrow), but more in the 'up early every day' way. Compounding the issue is the fact that C is in New Jersey for the next 6 months, which means I am chief cook and bottle washer for the dogs and the house. C does come home on weekends, but that's generally not enough time to get everything done. Basically, I'm still working out my schedule, trying to get to bed early at night (clearly a FAIL for tonight), and it's kicking my butt more than I expected.

Time to study. Maybe I'll have more to post about when we start clinicals....

Sunday, September 27, 2009


Nothing like chilling at home all day Sunday, working on homework and other stuff.

The house is relatively clean, including the dogs, which is good, since C leaves tomorrow for NJ for the next 6 months. Oh, he'll be home on weekends, but that doesn't count much when he'll be sleeping all day Saturday, and half of Sunday, and then have to either go to bed super early, or leave Sunday evening. One day, I swear, I will be able to spend a full calendar year with my love. By this, I mean that neither one of us is away for a significant period of time over the course of a year. Consider, we started dating in January of 2007, I left for Antarctica in October 2007-February 2008. In October 2008, C was sent to North Carolina for what was supposed to be 4 weeks, and ended up being 5 months. He came back in February 2009 when I got laid off. No he's being sent to NJ for 6 months. So yeah, one year we'll spend the whole year together.

In other news, I tanked a cardio quiz. Very disappointing and led to a brief crisis of faith where I doubted if this was the right move for me. I'm especially worried about the test from Thursday now. There is another quiz in cardio tomorrow though, so think good thoughts for me.

Add to all this money woes in regard to whether or not we'll be able to pay for everything for the wedding, and you have one lovely weekend. Granted, some friend's of mine have had a much worse week than I have, with people dying and finding out that others have serious cancer, so I should really count my blessings.

Which reminds me...appointment with the surgeon on Tuesday to see if I have to have the gallbladder out ASAP or if it can wait a bit.

Wednesday, September 16, 2009

Neat stuff

So last night I dragged my sorry butt to the firehouse, which I haven't seen in about a week (which I must rectify) for drill night. I've never actually been to a 'drill night' as every time I'm there on a Tuesday, I've either gotten the night wrong, and we don't have drill because we have a business meeting the next night, or I am on the ambulance and get sent out on a call that doesn't get me back to the station until drill is done.

This week was special. There is a gentleman living in our first due who has a Ventricular Assist Device (VAD). This is a little magnetic pump that is inserted into the left ventricle that, via centrifigul force, pulls blood from the ventricle and sends it through a shunt to the aorta. The atria are unsupported, but they do still beat. You will still get an EKG reading. It usually is associated with an internal pacemaker. And you will not get normal heart sounds. At all. Essentially, the heart is no longer really beating (though, if the pump fails, it can beat effectively enough to maintain life for a short period of time). The blood is being moved through the heart by this pump.

Here's the kicker...he has no pulse! Read that again. NO....PULSE. Also, no blood pressure, unless he is really super hydrated. This makes treatment slightly difficult, to say the least.

The interesting thing I found was that there are several hundred, if not thousand of people across the country who have different varieties of these things. Before last night, I wouldn't have known what to do if I had a patient present to me with no pulse or blood pressure, yet he was upright and talking.

The most important thing about the whole lesson was that he CANNOT be separated from his bag. The wire that controls the pump is connected to a computer in that bag. I shudder to think what could happen should an emergency happen (say, a car accident) and responders attempted to move the bag too far.

Anyway, these VAD's are mainly for people who have serious heart failure and are either waiting for a new heart, or aren't going to get one, and this allows them to have a much higher quality of life than they would otherwise have. I'm sure the nuisance of carrying around a mini-computer in a bag and having a wire come out of your side is much more tolerable than the nuisance of getting winded walking from your bedroom to the bathroom.

It's an interesting thing, and once more shows what technology can do. If you don't already know about these things, look them up. These people can be travelling through anyone's area at any time, and could have a problem.

Besides sounds wild!!! Like your standing near high tension lines or something. Seriously, if you don't care about anything else about this nifty bit of techology, look it up just to hear what it sounds like!

Thursday, September 10, 2009

The man is keepin' us down!!! it were...

Today I had a revelation of sorts. Our instructor climbed up on his soapbox about MAST trousers (a soapbox I share, given my hard science background and the overall lack of research that goes into most EMS decisions). Having come to the Promised Land of EMS (as the People's Republic of Maryland would have you believe) from a state that didn't believe in killing thousands of trees every year just to change 3 words in the protocols, I have viewed much of EMS here quite skeptically. From the insistence of people (who should damned-well know better) on flying patients based on their MOI to the hospital that is within visual distance of the accident scene,to new regulations every time the governing body gets bored, to in refusal of the state medical board to allow medics to use medications that are used every day in other parts of the country, I have become heartily tired of the stupidity that runs rampant in the EMS systems around here. Rogue Medic's recent posts have only provided food for thought.

I digress. At any rate, during the discussion of MAST trousers and why we are suddenly prevented from using them, he began railing against a certain segment of the medical community and why paramedics are the only licensed professionals in the entire country (that I'm aware of, please correct me if I'm wrong) that have a group of other professionals over-seeing, passing judgement and making rules for us. I think I've been slowly approaching this particular revelation, but today I got smacked in the head with it, and it makes sense.

To use the examples used in class today, sitting on the next computer over when we take our licensing test is a plummer, and next to the plummer is an electrician. Both of those professionals require a license, with the appropriate test, just as paramedics do. But neither one of those professionals has another person, say an electrical engineer, or a fluid mechanics physicist, sitting over top of them to give them codes and tell them what they can and cannot do, and what pipes or wiring they can and cannot use.

So why is it, that as a paramedic, I will have to defer to some guy sitting behind a desk somewhere, who hasn't touched a patient in decades, tell me that what I do for my patient is the correct thing to do? Why don't paramedics write protocols for paramedics? Why is it that doctors, who many times haven't the foggiest notion about what EMS is all about in the 'real world,' are the ones who say what we can do, what meds to give, and so on? (I admit that there are several exceptions to this, and I'm painting with a wide brush, but let's face the time many docs get to the point in which they are writing protocols, they are generally more politician and businessman than doctor). One person in the class answered that it was because paramedics usually only have a high school diploma, and because you are dealing with 'life and death' situations, which require the higher education of a doctor. He was challenged with the facts that electricians generally have high school diplomas and 2 or so years of education (same as most paramedics in this country), yet they are given control over their own domain. The argument of 'life and death' is a strong one, yet, if the electrician does a shoddy job, and the client's house burns down with the client inside it, is it also a life and death situation? Yes, there are shoddy medics, who do it only for the extra money or quicker promotion potential (in a FD run EMS system) and there are crappy programs out there that do nothing but teach to the test and just churn out as many medics as they can. Quantity, rather than quality, is often the idea.

I had an ER doc (granted, he wasn't a medical director, but in all honesty, what would stop him from becoming one if he wanted to?) once complain that paramedics only gave lidocaine for V-tach, when amiodirone was a much more effective drug. Here was someone who was giving paramedics drug orders via radio, who didn't understand that the state of Maryland does not allow amiodirone to be given under their protocols (not that I can blame them, given it's hideous expense).

So why is it that paramedics are forced to subjugate themselves under doctors? Because the AMA refuses to allow any profession that may challenge the all-knowing doctors. They don't allow nurses to diagnose..instead, nurses are relegated to 'nursing diagnoses' which say nothing important when they say 'the patient is having ineffective breathing' rather than stating the obvious 'the patient is having an asthma attack.' I've had doctors pitch a fit on me for 'diagnosing a patient,' which, given the lack of proper letters after my name, I am prohibited from doing. I have seen, over the past 10+ years, the progressive 'dumbing down' of EMT and yes, paramedics, due to the reluctance to do such revolutionary ideas as 'diagnose.' EMT's are now taught to pass the test, and not question the information they are given. No thinking...just treat.

And yet, what is the solution? Surely the 'dumb paramedic' issue could be solved with more programs that offer a bachelor degree in Emergency Medical Services. It leads (in my not-so-humble opinion) to better providers, as a provider who has been taught to think can better treat the patient. Even now, we are moving in that direction with the influx of Associate degree paramedic programs. I think that, much as nursing has, gradually we will move away from simple 'certification' programs, then away from the Associate degree programs and into the realm of bachelor degrees. Nursing, physical therapy, and several other medical related jobs have traveled the same route. But the problem is how to break free from the over-seeing doctors? They won't ever let EMS go willingly.

I know there are several arguments, but I have to go and will deal with them later...

Friday, September 4, 2009

Week 1 down!

Well, week 1 is in the books. I am sitting in the Commons, a kind of 'town square' thing that houses several eating places (ala carte, really), the bookstore, and several other things. Had this been King's, my former place of higher education, I would call it the Student Center. This place, being much bigger, has this, and another student center type place.

I've forgotten how much fun it could be on campus. Seeing other students walking to their dorms and apartments, seeing people playing frisbee (and croquette, even) in the quad, and in general relaxing after a week of classes brought back a strong nostalgia of what-has-been. I miss being able to just walk down the hall, or up a set of stairs, or even just across campus to see my friends. Getting together on a Friday night to role-play, or watch a movie. Getting up late on Saturday and going to the park to play Ultimate. Watching football on Sunday with the whole group of friends.

I find myself wondering what might-have-been had I had this radical idea of medic school (rather than medicAL school) and had come here 13 years ago. Would I have met the same people eventually? Would I have met C? If I hadn't met C, and decided to come here now, would I opt to lie on campus rather than at the Crofton house?

These things go through my mind, but I know I wouldn't trade those years for anything. There are things I would do differently, but I can't complain about the track my life has taken overall. I have friends who have been with me through thick and thin for 13 years. Not many people can say that they've remained friends with people from college for this long after college, at least not with as large a group as we have maintained. And now, S will be having a baby in a few months. 13 years ago last week, S and I met for the first time, along with R, who has 2 children now. I am continually amazed that, even though some of us have moved away, we have remained friends enough to keep in contact with each other through more personal means than facebook.

In other news, I'm sitting here because C is picking me up. The Gnome-Mobile is safely stashed in a parking garage on campus, and we will be heading north to the Poconos for a visit with parts of my family. This weekend will be full of good food, family, and lots of catch-up reading for school.

This flexi-keyboard is working ok, although the harder keystrokes make it harder, as does the necessity of hitting the keys perfectly square. Still, I'm getting better at it.

Speaking of things I'm getting better at, actually going to the gym is getting easier. I'm getting back into the swing of things, and I'm learning more about form vs weight. And today I can actually move. The diet is a harder thing for me, but even if I eat 'bad stuff' I'm learning to eat less of it, and I hope that eventually I'll just phase that nonsense out of my diet. It's a process.

Thursday, September 3, 2009

More on school

While I'm thinking about it, and have some time to breath, another few notes on school.

Our main instructor is rather kick-ass, and reminds me of Rogue Medic, in that Why is nothing in EMS based on research??? sort of way. Can't say I blame him (either him, that is), given my hard science background and the fact that if any of the sciences I've ever dealt with did things that way, nothing would have ever been done. Pharmacology is a beast, in the evenings in the middle of the week after 2 other classes, but at least it's taught by a guy who has a good sense of humor and can make as light as possible from a heavy and dry subject.

Other than that, the netbook is working well, though I find I can't type notes on it like I had planned. But it is good for pulling up the slide presentations we use and following along. I am one notebook short, which will have to be rectified this weekend. I have more reading to do than I did for my first degree, and, given my inability to read for long periods of time (at least, when it's dry and boring material), this is rather nerve-racking. The other problem I'm running into is the battle of over-confidence. Much of this I have done before...not so much in undergrad the first time, but rather in the 11 years I've been doing this, in nursing school, and then the EMT-I class I took. I find myself reading sections and saying I know this stuff, and I am tempting to skim past that bit, or not pay attention. But I have to, lest I miss some important tidbit of info that will pull the whole kit-and-kaboodle together. It's a new sensation, and I'm not much for it, really. But I'm terrified of missing something that will come back to haunt me on a test somewhere down the line. I find myself being completely anal-retentive and hyper-vigilant. I can only hope it lasts.

On the good side, in one of the hardest classes we have, we had the first of our daily quizzes, and I (am pretty sure) got 100%. Yes, it's only a quiz, and no, they will not always be this easy. But it's a start.

In other news, I am heartily tired of being called by work. I told them time and again that I can't work during the week, due to my schedule, the work load, and the commute. Yet I get a call asking if I can come in on Tuesday, or Wednesday, or Friday. I finally emailed my schedule to my supervisor, since he wasn't there the day I brought it in. Hopefully I won't get asked to work wonky shifts like 2p-midnight. Once C heads out of town, I'll have to get home to let the dogs out and feed them. I really am beginning to wish I had a different part-time job.

Tuesday, September 1, 2009

First day of school

Today was the first day of paramedic school. An easy day, as they go, with only 2 classes, running from 0800 till about 1200. Which is good, since my lazy ass took itself to the gym yesterday for the first time in about 4 months, which, in turn, led to some fairly incredible muscle soreness today, mainly from squats, but a little bit from the push-ups.

The good news is that my 0800 Tues/Thurs class is now mostly only on Thursdays. The bad news is that Wednesdays are my late nights, with class running till 8pm. I'm wishing he had opted to have classes on Tuesday, but I'll take what I can get. The other bad news is that I find myself behind the 8-ball as far as reading goes, thanks to a company that shipped the wrong book, and then forgot to ship the correct one after I called them to fix things. Good thing I read fast, eh?

The other good news, however, is that all loan issues have been straightened out, and while I still need to electronically sign things, once I do, the money will be in the system for the school, and all I need to do is contact the FA director, who said she would request the withdrawl of the late fee from my account. I'm not sure how good a 'request' from her is, but it's something.

In the meantime, today, I need to run some errands out, and then come home and read. Lots of reading. Lots and lots of reading.

Tuesday, August 18, 2009

NIMS is boring

So tonight I found out I've been laboring under a serious misconception. I thought I had all the ICS/NIMS classes I needed. Turns out I only had one.

So, since I'm not doing much in the next few weeks, I will be spending some serious, quality time with the ICS websites, taking -200, and -800 (just did -100) this evening. How fun!

On Facebook, I'm reading about all the people who are going back to the Ice, and finding that I really want to go back. Impossible now, what with school starting shortly, but someday. Perhaps after the wedding?

On the school front, loan has been applied for and sent to the school, which has to certify it. Arguments have been made with the registrar over the status of my Eng Comp class, which I took, and can't prove, since not even I keep a syllabus for 12 years, and King's doesn't have the course description online (it seems that class is no longer offered). So I'll be making some phone calls in the coming weeks to see if the department chair has something to help me out.

I seem to be in a strange place at the fire house. I'm a probie, and therefore subject to all the normal rules regarding probies (curfew, no staying overnight, no hanging out in the lounge, etc), which is just fine by me. I need time to get acquainted with these people and learn my way around THIS particular station. And I'm not flaunting my long-time certification fact, I'm trying to downplay it. But I've been cleared to ride as OIC by all the EMS officers, routinely asked to help out on probie nights, and other things that seem to belie my probie status. It's a tough position to be in, and I'm still trying to work it out. I really am trying hard to remind people that I do still have probie status, but it's hard when you are so far ahead of some of the other newer members. And it's hard to have to keep reminding the officers that I haven't been shown how to sign in on the log book, given a passcode to get in the door, or gotten the ability to sign on to the station computers.

Though I guess that could be taken as a good sign....

Monday, August 17, 2009


This summer has been nutty.

Between working 10+ hours/day, 5 days/week, trying to get stuff in line for school in the fall, getting things together at the fire house, and getting stuff ready for vacation, I've barely had time to breath.

I dropped to part-time at the ambo company, and actually haven't been back since just before vacation. Last week wasn't good, what with getting things back together at the house after vacation, and with C's parents coming up for a visit. They left this morning, so I can relax a bit again. I like them a lot, but they are very...MidWest, and I am not, so I feel as if I always have to be on good behavior. No swearing, that kind of stuff.

Fire house stuff is going well. I got excused for the meetings and such I missed due to work, and have already been signed off as an OIC. Which is funny, since I still don't know what the hell is going on, and everyone kind of just assumes that I know what's going on since I've been doing this so long. But I've hashed things out with the EMS Captain, who was in my refresher course last year, and he's on board with everything that's been going on, so no worries on that front. Tomorrow night is drill, and the first one I'll have been to, so it should be interesting. The only things I have to do between now and then is get an account on the state's online reporting system, and make sure I'm up-to-date on the new protocol updates, and I should be good to go. Aside from that pesky 'probie' status of course.

Vacation was wonderful, if a bit wet the first week, but it was everything I needed and more. If anyone is uber-curious about what I do in my spare time, check out my pictures.

As for school stuff, I have placed out of the computer class, thanks to a quick run to the bookstore to buy an 'Access for Dummies' book. The class just covered the Microsoft Office Suite, and it seemed rather silly to me to take a whole semester class just to learn one program. So I gave myself the quick, 2am crash course version, which seemed to work, since I found out today I passed the challenge test, and can remove that class from my fall schedule. Today was finding funding, which I did, and am just waiting because C has to cosign my loan. Tomorrow will be a trip to campus to argue with the registrar, who have muddled up my transfer courses, and are telling me that I have to take several credits-worth of classes that I have already taken. Parking permit has been obtained and will be mailed here (though it doesn't go into effect until the second day of classes, so I have to remember to bring quarters for the meter), and once the loan is fully approved, the only other thing is finding the money for books.

Which brings on a mini-rant. I know books are expensive...I remember my eyeballs bugging out at having to pay over $100 worth of books for one class. And I figured things would be more expensive now, given that it's been nearly 10 years since I last bought books. But seriously..nearly $1000 for books alone? And that's including the used price for those I could get used. Amazon, thankfully, has prices that are a bit more sane, and the chair of the program sent us a link to another place to get books a little more cheaply, but still. It's a bit ridiculous.

I do still need to get a bookbag and notebooks and so on. But things are slowly coming together. I'm beginning to get excited.

And on that note, a plug...For those of you who don't know, EMT-extraordinaire and far-more-prolific-than-I blogger Epi is also attempting medic school, and is having some financial difficulties. While my own adventures prevent me from helping her out right now, I'm asking all 2 of my readers to consider helping her our. She has a recent post up that explains all. Please, help an incredible EMT move up the ranks.

Wednesday, July 22, 2009

Talking to God

Several things on my mind right now, and it's hard to keep hold of any of them, given my level of exhaustion. It wasn't this hard to get ready for vacation and work last year, was it? Though perhaps the amount of prep time in the evenings had something to do with it.

I can't complain much though. So far this week, I've gotten off shift on time every night. I keep expecting it to change, but the EMS ghods are smiling on me. So far. I expect tomorrow will suck several big donkey dongs, but we'll see what happens.

After the horrible day that was yesterday, today was relatively good. I was back with Bald Partner, and the FNG (a new hire that we are training, who really is a FNG. He's been an EMT for 3 or 4 months...he's still all new and green and squeaky). We ran 2 patients, both of whom could walk. The second one was a psych patient.

I hate psych patients. Even given my ability to read people's body language and facial expressions, psych patients are just too unpredictable for me to feel truly comfortable. Today's patient was different though. Clearly suffering from some sort of psychotic break, her manifestation wasn't violence or random voices...she thought she heard God. I didn't read the paperwork (FNG did all the paperwork, thank heavens, because I would have been hard-pressed to give this patient the attention she deserved AND get my paperwork done at the same time), but she had been taken from her home from the police early in the morning, and, by her claim, had been left without food or water all day at the EEP facility. She claimed they hadn't let her read her Bible, took it from her, wouldn't let her pray, all manner of horrible things (including claiming that the Devil kept shutting her up when she tried to talk to the workers there). And all she wanted, she said, was peace. Life, peace, and to feel safe.

I felt sorry for her. She wanted help, but she was so afraid. It took me a while, but FNG and I got her calmed down. I got her to feel safe with us. Not hard when you consider we were taking her from a frenetic place with screaming people. She kept calling us her guardian angels that she had prayed to God for, and God told her that He sent her guardian angels. She cried when we left her at the psych hospital, and calmed down when we told her we would visit her if we could, and that she was safe here, and they would take care of her.

As much as I bitch about days like yesterday, when everything in the world goes wrong, days like today remind me why I put up with the shit from dispatch, and the disregard from the company BigWigs. Because I can take a patient who was terrified of the world, and make them feel safe. I can take someone who was crying from fear and turn them into tears of joy, and make them laugh. I can teach a person a very small way to assert some control over their fear, simply by teaching them to control their breathing. I made a difference in someone's life, if only for a very small amount of time. As cynical and jaded as I've become about people and life in general, patients like this really do remind me of why I enjoy this job so much.

And they very often come when I need them most. Like today, when I was questioning my whole plan to become a paramedic, and how could I survive years of dealing with crap like this, only with more letters after my name, and did I really want to do this, and how could I get out of having to do this even part-time. That, my friends, that is fate right there.

And faith. I may have a somewhat twisted view of the world, I may question my purpose here (really, who knows what their purpose is, anyway?), I may be more superstitious than is generally healthy, but I have a firm belief that everything happens for a reason. The fact that I get patients like this, who reaffirm for me that I am doing something right, after I've had days that make me question my continuation in this field, means that Someone up there is telling me that I'm on the right track. I'm doing something right.

I've been told by several people that I have a gift. The gift of empathy and understanding. I'm not sure how much of it is gift, and how much of it is humanity. I've worked with a lot of EMT's in the years, and with many of them, it's hard to believe they mean it when they tell someont to 'Take care.' Is it experience that seperates those with a 'gift' from those who just go through the motions? I don't know. I do know that Bald Partner has the same 'gift' as I am purported to have. He doesn't use his as much, since he drives on every call, but even though he tells just about every patient the same thing, he is sincere. I believe that he really does want them to get better. When we ran the code a few weeks ago, and said goodbye to the wife, he grabbed both her hands and said I'm sorry for your loss. But his words, though cliche, were sincere and you could tell she knew he meant it.

Bald Partner and I have talked about it, and both of us feel that it is a manner of treating every patient as if they were your family, and how you would want a member of your family to be treated. Maybe it is as simple as that.

In other news....a young member of my firehouse (early 20's maybe) who isn't an EMT yet had an exposure a few days ago. From talking to her this morning, there is no info on the patient who gave her the exposure, so they're doing the whole nine yards of prophylactic treatments, as far as I know. I know transmission rate is very low for most of the diseases we worry about, but it's still a scary time.

Tuesday, July 21, 2009


I am toasty. I feel like I'm in exactly the opposite boat as I was in with my last job. The last job was a case of love the company and the people (well, till they laid me off, at least), hate the work. This time it's love the work, hate the company and am ambivalent about the people.

I hate the fact that the employees that bring in the money that keep the company afloat are treated like crap, because there is always more where they came from. My supervisors are blowing sunshine up Bald Partner and my rear-ends, about what wonderful employees we are, and how much they value our hard work and initiative, yet, when we show initiative, the company does not recognize it.

Take this example...The other week, we stopped to get a bite to eat since we had some time. We parked in a parking lot for a college, that had a sign posted for the local bank for no parking. There was NO sign saying that this was for the college only, etc. In the time it took us to run in and order our food, our ambulance was towed. Luckily, a bus driver saw it, told us, and took us to the tow yard, where we met the tow truck as it was off-loading our poor ambo. My partner and I had a call waiting, so I ponied up the $200 to get the truck out of hock, and we went on our way. The fact that we were early for our assigned call is just icing on the cake.

Yesterday we were told that the company would not reimburse us (me) for the expense of paying for the tow. Let me just iterate....that $200, at the measly hourly rate I am paid, is almost 2 days pay. And I am in the highest pay bracket for basics! Yet I was told by my supervisor how much he values us for just doing it and getting the job done. Well, let me assure you, supervisor-man...should something like that happen again (and I will try my damndest to see that it doesn't) I assure you I will do just like all the other crews do, and wait for you to come down to pay for the ambo. Especially since you are so much better paid that I am, and because at the measly rate I am paid, and thanks to the company's refusal to reimburse me, I can no longer afford to do such a thing.

Hell, the company won't even reimburse the toll fees you may have to pay (for the privledge of travelling through Baltimore rather than taking the time to go around it) in the chance that the truck you're in doesn't have an EZPASS. That's pretty cheap if you ask me....Going through the city easily cuts off half an hour or more of time (much more if it's rush hour), and yet we have to foot the bill for the tolls if we dare try to make the company look good.

Today I was paired with a guy, who while very nice, is in a bit of a spot and is in one of those years where nothing goes well. I won't go in to details, but suffice to say, neither one of us was paying attention, and we nearly broke the ambo. Things were caught in time, but the ambo was put out of service, and we took the last, oldest unit left in the bay (everything is out of service). Which didn't have AC in the cab.

Hoping that we still had AC in the patient compartment, and not too worried because most of our patients are elderly and don't like the AC anyway, we took a call for an hour long transport. Again, no details, but the patient was very sick, got way overheated (as did I), and it was all I could do to keep her from vomiting all over my ambo. I tried ice from a cup in a glove (couldn't find ice packs), and water on a sheet to keep her cool, but nothing much was working. It was just to damned hot. I also endured evil looks, sighs, and eye rolls from the patient's family member riding in the back with me. I continually apologized, the entire trip. I apologized as we attempted to find the correct building and endured the snarky remarks from the family member about why an ambulance couldn't find a hospital (because, you know, all ambulances and their crews know every single hospital in every single city, and every building on every single large hospital campus). I continued to apologize as we tried to find elevators, and after we got the patient on the bed. And I meant it. Had that been a family member of mine, I would have been burning up the phone lines about why such a horrible vehicle was on the AC, and can't go faster than 60 mph without vibrating wildly in the back.

I am toast. I am burnt. I am tired of caring, and having no one give a shit about me. I am tired of doing my job, and getting nothing but shit for it in return. I am tired of being used and abused, and of having nickle and dime OT being the norm rather than the exception.

I have 2 more days on full time, and then I switch to part time after vacation. I'm hoping that moving to part time will allow me to take this more in stride, but I'm wondering if I am not permanently burnt on this. I like the job, but I know most of the other companies around here are the same way, so I don't know that I can escape.

Depressing thought...

I'll try for a happier post tomorrow....after all, I go on vacation in 3 days.

Saturday, June 27, 2009

Creepy Crawlies

I've been to some sketchy places in my time. There was the one house from my time in PA, that didn't have flooring through half of it (sub-floor only), and the people had more hamsters than I've seen in a pet store. I've had to disinfect my boots on more than one occasion simply because I stepped in patient's house.

Never had I seen more bugs than in this patient's apartment yesterday.

We had been warned, but the warning never really does it justice. Bugs everywhere...crawling on the floor, the walls, the furniture. All kinds of bugs too...bed bugs (mostly these), roaches, gnats, and I think I saw a few fleas, but I'm not sure. There were also bugs that I've never seen before, and had no idea what they were.

Luckily the ride wasn't too bad, as in long, and the patient was a pleasant man. Ex-Navy, who was so proud of his service that he said that if he hadn't been married, he'd have stayed in permanently. He didn't look his age, aside from the way he moved (arthritis in multiple joints), but was all alone in the world. No siblings remained, and his children and grandchildren were halfway across the country. He had a home health aide, but the apartment manager said they didn't do much, and given the state of the apartment, I believed it.

Still, it was all I could do to not scratch my whole body. The whole call I had the feeling of creepy crawlies all over me. Drove me batty. It didn't help that the building was generally warm, and I had sweat running down my back, which aided the creepy crawly feeling. It took us an hour to decon the unit. My partner just took the cot out and hosed it down, then wiped it down with bleach. I did the same with the stair chair, before we bleach mopped the inside and got the seats and walls with disinfectant spray.

Ugh...I still get itchy thinking about it.

I guess karma does work, because we got to base last night at 1901, and were able to head home. Amazing.

Oh, and for the record....There was never anything on fire. T just wanted to see what the reaction of the BossMan would be.

Friday, June 26, 2009

Funny things

Several funny snippets of conversation heard yesterday.

T come rushing into the day room at base: Anyone have a fire extinguisher?

Bossman, who comes in at that exact time:
Why do you need a fire extinguisher?

T: I can't tell you.

BossMan: Then I can't give you one. Will there be a problem if I can't give you one?

T: Well, if you don't give me a fire extinguisher, we might need something larger....


We found out Michael Jackson died yesterday as we were taking a patient to a stroke rehab place. When we got to the floor, we had to wait a bit, since they had just had someone code, and were taking that patient to ICU. As we were waiting, I asked the nurses if they had heard the news.

Me: Did you hear the news?

Nurses: Which news?

Me: Michael Jackson died today.

Nurses: No way! Get out! Really???

Unit Secretary: Oh My God! Oh!! Oh!! Oh!!!

Me: Are you ok? Do you need to sit down?

Short Nurse comes up and hears all the talking:
What happened?

Nurses: Michael Jackson died.

Short Nurse: Who killed him?

I was rolling. So was everyone else. She got mad that everyone was laughing at her. But come on! That's funny right there....


I called Mom to let her know about Michael Jackson.

Me: Did you hear Michael Jackson died?

Mom: No! Really? He wasn't that old. What happened?

Me: Heart attack, evidently.

Mom: Well, they say when you have a heart attack at that age, it's most likely fatal.

Me, thinking, As opposed to all the other heart attacks at any other age?: Well, it's a shame.

Mom: Yeah. Well he was a weird dude, but he had some good songs...


In other news, after several weeks of OT and working late, Bald Partner and I have gotten off shift early the past 2 days. Wednesday was a long distance trip to the outer edges of MD, which took just about all day. Yesterday was a 'busy day' (we didn't really see a difference), and we thought we'd be running late. After our last call, which ended about 1815 or so, they nearly sent us up to Baltimore, but someone must have had an attack of the smarts at dispatch, because we actually were told to disregard and head back to base.

I'm expecting today to be a late day, since we've been pretty light the last few days.

Sunday, June 21, 2009

Errr...say again?

So last week, my partner and I did a late transport that was made later by some crap at the hospital. We cleared the call at a few minutes after 1900, which is the end of our shift. The dispatcher got on and said I need to you do a pick-up at Hospital X. We looked at each other, and Bald Partner got on the radio and reminded dispatch that we were at the end of our shift. Her response? Well, I'm stuck with the call, so you don't have a choice.

We called our supervisor and asked for clarification, and decided to be nice (though the dispatcher had been snotty) and take it, since it was on our way home. The fact that we had other issues (the clipboard is a piece of crap that won't hold paper, and when we grabbed the clipboard some of the paperwork fell out, necessitating a trip back to the hospital and then back again to the nursing home) meant that I didn't get home until 2230. I hadn't eaten since 1300, since we aren't allowed meal breaks, and have to eat on the road on the way to or from a call. BossMan said that he would get back to us with the policy on taking calls after shift.

Two days later, BossMan gets back to us with the reply. As long as you are in a unit, and not at base, dispatch can put you on a call and you can't refuse. Since we don't ever get back to base before our shift ends due to traffic and other problems, this means that the only thing allowing us to go home in a timely manner is the good graces of dispatch.

Is this standard procedure for other companies? Because it seems pretty sketchy to me.

Thursday, June 18, 2009


As promised...a little late since tonight is the first night I got off shift at a relatively sane hour in several weeks.

A few weeks ago, we took a patient home from BMH (Big Military Hospital). It was hot and humid, and his apartment had a total of 25 or so stairs to navigate, from sidewalk to apartment. We used the Reeves, since he was weak and we weren't sure of his ability to maintain an upright posture long enough to get him upstairs.

So, before we leave any hospital to take a patient home, I make sure to ask the nurse if there is someone home waiting for them. I would hate to take a patient (especially one who can't really care for themselves) home and leave them alone. The nurse in question for this particular patient called the apt and got no answer. Several calls later, the social worker avowed that she had spoken to the wife, and that she was home. OK, so off we went.

My partner usually runs to the house to prepare the way for whatever form of transportation we are using for the patient. It took him a while to come down from this one. Mrs Patient had been asleep. Ok...

So up the steps we go, with the patient in the Reeves, and his wife chattering at us the whole way (btw...wife was easily 30 or more years younger than the patient. Not judging...just sayin') about how we have to be careful, and how much work she has to do with him, and so on. Again, temp is around 90, and there is no AC in the building. Bald Partner looks like he's taken a shower with his shirt on.

We get up and get him in bed so she can 'clean him up.' She's trying to clean him up, and is ignoring my attempts to get her to sign my paperwork. Then the phone rings, and she answers that, flopping down on the couch to argue with the daughter who is screaming at her that the man needs to be in a home (I'd say he does), and so on. She hangs up, and goes back to the patient, ranting all the time about the daughter, and how much work the patient is and so on. She talks to him roughly, and treats him roughly, pulling him around to work all the sheets out from under him.

I finally get my signatures (after she ignores what I'm saying about signing her own name because she's too busy complaining about how much work he causes her) and escape to the AC in the truck.

Compare that to this on the same day:

Elderly man from BMH, also going home. The call home is answered by the wife, who says that she is there and waiting anxiously for him. We arrive, and are met on the street by the neighbor who cuts their grass. He takes the bags of belongings for us, and my partner makes sure we can easily get around the house. We get the patient inside (less stairs, plus ability to use stair chair), and while he's debating where he wants us to get him to, his wife nearly pushes my partner out of the way so she can hug him. The patient decides to go to the bedroom, where he has a chair in front of the window AC unit, and can watch TV. We get him in there, admonishing him to be exceedingly careful when he gets up, get our signatures, and leave with the sound of the wife, patient and neighbor thanking us. As I'm leaving, I hear the wife asking her husband if he's hungry, and does he want a sandwich.

Amazing to me. Two families, just a few streets apart, just a few years apart in age (well, the patient's at least). And yet such a dichotomy of reactions, I'm left fairly stunned.

As an aside, we took the first patient back to the hospital this week. He was moderately stronger, so we used the stair chair this time. Thankfully, it was also much cooler. The ER at BMH knows him and his wife well.


In other news, my new netbook came today! I got it for school, so I don't have to keep removing our primary computer, and so that Fiance can have a computer when he gets home from work should I need to crash at school one night. Now all I need to do is switch out the hard drive in it for a slightly larger one. I don't think I'll be doing this on my own. Foo has great computer foo. I'll get him to help me tomorrow when we go to install the window AC unit in their house. Their HVAC went all kerflooey.

Monday, June 15, 2009

I had a post

I had a post, about the dichotomy of 2 patients who seemed similar enough to each other on the surface, and how different their home lives were. But it's late, and I need to go to bed.

I have a blister on my hand, just inside the webbing between my thumb and index finger. You know, the place that gets all the pressure when you grab things. Yeah. It sucks.

Today was, thankfully, a light day, in terms of calls. One round trip (which technically is two calls, since you have to do the paperwork for the return trip) at 1300, and then one at 1700.

Unfortunately, the 1700 call was for a bariatric patient. Evidently, he wasn't bariatric enough to require the special unit, so all we needed was the wider stretcher. So we pick up the stretcher, run some errands, and head to the hospital.

Except the genius on dispatch at that time gave us the wrong room number...a number that doesn't exist in the hospital. Add 30 minutes to drive to a different building thinking it's there, and then back to the main building with the correct room number.

Anyway, we needed some extra hands on this one. Dood was 375lbs. Add the 50-60lbs of the wider stretcher in there, and you have me and my partner attempting to deadlift about 215lbs each. I think my max deadlift (one rep, max weight) is about 150lbs. I'm no slouch. But when I tried to pick up my end of the stretcher today, I didn't move it. I don't mean it moved, but I couldn't lift it to drop the wheels down either. I mean it was like a cartoon when the character strains and strains but doesn't move the boulder kind of thing.

But seriously...Dispatch really needs to arm us with the correct info. I mean, come on...this kind of weight is break-your-back-and-go-on-disability-forever kind of stuff. My partner, who is pretty damned strong and can lift a lot of weight, had issues lifting the back end to get the patient in the ambulance. And that was with part of the weight supported by the truck!

Friday, June 12, 2009


Bald Partner and I saw this on ESPN as we were waiting for lunch at a wing place today.

Flash mob

Some days...

...I love this job.

I was hugged by a patient's wife today after I brought him home and got him in bed, after Bald Partner and I made damned sure not to knock over any of her knick-knacks or put dents in her walls and woodwork with the stretcher.

Some days I love this job.

Even when I nearly punched a nurse today.

I really don't care how tired you are. I really don't give 2 shits about the fact that you are technically off-shift. I will even let the rudeness you showed me by not giving me report (when we showed up 5 minutes before the end of your shift but you were busy) and then repeatedly telling me that you were off-shift and trying to pass me off to your replacement (who had yet to get report from you). I'm trying to be understanding about you being tired at the end of a long day, and that you are probably way over-worked. You may even have to go pick up your grandkids or something, and the traffic is going to be horrible, etc...

But when you are brisk and rude to a patient, and tear her onion skin when taking out IV #1, and then wipe the open sore with an alcohol swap, I lose a lot of my understanding. When you roughly handle a patient and repeatedly dig at her skin, trying to pull off the tegaderm covering IV #2, and you bring tears to her eyes and make her cry, I start to get angry.

Constantly talking about how you're not supposed to be here and you're so late and you shouldn't have to do this IN FRONT OF THE PATIENT, while you're TEARING AT HER SKIN AND MAKING HER CRY makes me want to throttle you. Finding out later that the large bandage on her OTHER arm covers a wound ALSO caused by you makes me want to get you fired.

The fact that the patient involved is not only a veteran, but a fellow nurse, makes it even worse.

You clearly can't do much of your job anyway, since you had another patient who needed to go to radiology earlier in the afternoon, and you got him ready to go at 1700.

I said something to the charge nurse on the way out. Be thankful that the patient thought you were 'a good nurse,' because I sure as hell didn't think so. She requested that I not file a formal complaint, though I'm still seriously considering it. It's already written up. My partner is all on board with it.

Still, I made that very same patient smile several times, and even laugh as well. I made sure she was comfortable, especially since moving her to the stretcher caused her to cry from chronic pain. When I said goodbye to her, she said thank you, and meant it. I could see it in her eyes.

Some days I love this job.

Even when the social worker at the emergency psych clinic tells me I can't look at the notes of the patient I'm transporting because of 'patient confidentiality' (as if my partner and I are not fellow health professionals), and that WE were not the company she called, and this is how Other Company does it and that should be good enough for us. And she won't tell me the patient's medical history, medications, allergies, etc. She won't even tell me if this is a voluntary or involuntary commitment (it was involuntary, btw).

Even when the patient starts to get aggravated because we didn't take him to his house. He didn't start swinging, and he quieted down nicely when we told him we were stopping here for a bit.

The nurse at the in-patient facility thought the behavior of the social worker at the emergency center was extremely unprofessional and disrespectful, and was very nice to us, explaining many of the procedures she had to do while we waited with the patient.

And on top of it all, we scored 2 hours of OT.

It was a good day.

Tuesday, June 9, 2009

Too much of a good thing....

I don't mind OT, really I don't. After all, money is money. But 2 days out of 7 (so far) where I got off on time is beginning to become a bit ridiculous. I submit (once again) that dispatch really needs to learn about traffic in the DC/Baltimore Metro areas.

Today my partner was off, doing his interview for the Balt. County FD. Hopefully he did well. I got to work with someone else, which was nice, but I do miss my partner. It was nice to have someone driving who knew their way around though.

This morning we took a young woman from DC to Baltimore for in-patient psych treatment. She was deaf, and was able to read lips only if I spoke very slowly. I was able to sign a bit (I know the alphabet and a few things like please, thank you, sit, hungry, etc) but I felt really bad for not being able to talk to her effectively on the hour long drive up. I always wanted to learn sign language and just never have. Perhaps something to do when I'm in medic school?

Because, you know, I won't have enough to do.

We had some pretty gnarly storms here this morning and evening. The morning ones woke me up, and I realized just how scared poor little Kaylee is of thunderstorms. She's actually almost as afraid of the lightening as she is of the thunder. I really need to start working her. She's beginning to get those neurotic border collie characteristics, and that needs to be nipped in the bud.

The evening storms caught us as we were leaving Baltimore. Heavy rain (the kind you can't see through), winds, lightning, was crazy. Add that to the fact that the GPS took us through Baltimore (though I'm not sure the highway would have been much better), and the O's were having a game tonight, and you can understand why I got almost 2 hours of OT tonight. It makes up for the half hour I got off early last night.

I went to the firehouse last night and started getting stuff done for my 'probie book.' It's not hard, and the other EMT's find it amusing to be asking me things like 'change the O2 bottle,' or 'demonstrate use of the portable suction.' All I really need to work on is where things are on the ambo. I was planning on going tonight, but with getting home so late, I really didn't want to. Hopefully tomorrow night is better.

And now, bedtime. Got lots to do tomorrow before work.

Sunday, June 7, 2009

More stuff

A second post in a night, but mainly because I'm still quite irritated about the whole dispatcher thing the end of last week, and if I end on that note, I'll be too irritated to sleep well tonight.

Friday my partner and I picked up an hour of OT before our shift started. We were told it was a standby for a PSA against smoking. We figured we'd sit around for a few hours, listening to the radio and reading or whatever.

We were wrong. It was for a video against smoking, and my partner and I were playing EMT's. Three hours of pulling the cot in and out of the ambo, picking up a 250 lbs guy on the cot (about 7 times), and then putting him back in the ambo. In the rain. All in all, it wasn't bad, and it was an hour of OT.

This week I think I only got out of work on time once. Thankfully it was a Thursday (Thursday's are practice days). I'm a firm believer in OT, but it was a bit ridiculous. Then again, I probably won't think so when I get my paycheck on Friday. Which, I might add, is now on direct deposit, which means that my bank SHOULD be giving me an extra $75 for it. I'm not complaining.

I really like my partner, aside from his total inability to pay attention to the GPS, or my directions. His sense of direction is suspect, but he's a good guy. We agree on a lot of things. This week, while listening to news radio (around here, you live by 'Traffic on the 8's' on the local news network starting around 2pm) we heard the story about the couple who spied for Cuba for 30 years. My partner's repsonse? 'Fuck 'em! That's treason, and they should be killed for it!"

I do like the job, really I do. I like the patients, and talking to them, and learning about them and their life (well, at least the one's who can talk). I get infuriated at the often uncaring nurses and doctors that the patients and their families have to deal with, and I help when I can. But the stupidity on other levels of this job drives me up the wall. Such as being sent 50 miles out of town during rush hour an hour before we are to get off shift, and having the dispatcher say "ok" when we tell her that traffic will prevent us from getting out there in less than 2 hours. On our way, we are asked if we have a pulse ox (we don't...they are too expensive to waste on BLS units, so only the ALS have them due to the LifePack 12's). She gets back to us just as we get off the highway, to tell us that we are cancelled from the call, due to the fact that the patient 'requires a pulse ox, and that's an ALS skill." Insert massive eyeroll here. And here we have another reason why I like my partner...he shares my distain for the medical community's insistance that the pulse ox is required and valid no matter what. At any rate, we swung by an ice cream parlor before heading back, since it would be another hour back to base. Without traffic.

I do enjoy it, but I miss emergency calls. Waiting around all day in a truck, waiting to shuttle patients from one place to another is boring. I like the patients, but it's really not enough. I wouldn't mind doing this job as a second, part-time job, but to do it full-time, all the time...nah. I just don't have that temperment. I find myself repeating the mantra "just till August, just till August." Luckily, given that I have a lot to do between now and August, and that I have a 2 week vacation coming up in late July, early August, the time should pass very quickly. And I've joined up with a fire station near the house, so that might quell the boredom a bit.

I still have to talk to the bank about a loan for school, and pay my bill. I have to register for my classes and buy my books. I also have to get things made and fixed for my vacation.

I really would like to take Krav Maga. Right now I just don't have the time, and when I'm in school I won't have the money.

I got invited to take the Phase 1 test for the FBI. Gotta take PTO for it, but I might be able to make it up with some OT on the weekend. I'm not sure how I feel about it, but I'm pretty sure that the process takes a long time, so school will likely be finished anyway. Although, given the current state of affairs at the DOJ, I'm not sure that it's something that I really want right now.

Random thoughts on a Sunday night...

A letter to the dispatcher...

I understand that you are 2.5 hours from us. I know that you have never had to drive in DC. I know you have a job to do to send us on calls.

But it's a rainy Friday afternoon in DC, when it's predicted to be a gorgeous weekend. We had to get from the top-side of DC to the middle, including getting fuel along the way. You did NOT send us a page for the call, you just told us to head to Virginia. You did NOT tell us we were going to be put on a call.

Therefore, when we are attempting to make our way through a mile long back-up of traffic, calling and copping an attitude with me is NOT a good idea. Telling me that you don't believe that it takes near an hour to get from where we were to where we are now (including filling up the tank with fuel) is an especially BAD idea. Then, when I request the page for the call, you say "Don't tell me that you're claiming now that you didn't get the page," really makes me pissed off beyond your ability to understand. You should bless my partner, who kept me from ripping you several new assholes over the radio.

This occurred a day after the same dispatcher got mad at us for 'taking too long' at the hospital because the patient was non-verbal, and we had to get information from the wife, who took a bit longer to get to the hospital. Then sent us to another hospital, but did not send us the page. We tried to call her for 20 minutes, and got no response. We had to call our supervisor and have him call dispatch in order to hear from her. And when we finally got the page, it was incomplete. We finally got the whole page, and found that it was wrong, and it took her another 20 minutes to find out where exactly the patient was. This of course was after she got an attitude with me again, wondering what we had been doing, and why we hadn't found the patient yet.

It seems that my partner gets a better response from her than I do, even when I really am trying to be nice.

I don't deal well with stupidity. I deal less well with it when it's coming from someone who is supposed to have the information I need.

I REALLY don't deal well with people calling me a liar.

She used to be on night shift, which meant that I only had to deal with her for an hour or two. Now, for some reason, she's on day shift, which means that I have to deal with her all day.

I'm letting my partner talk to her from now on. I don't think I can have another day like Friday, or I may drive up to Philly and try to smack some sense into her myself.

Friday, May 29, 2009

Heros and Villains

I met both a hero and a villain yesterday. First, the hero, because he deserves higher billing...

We took a patient to Military Hospital yesterday from his home, for some wound care. He is a WWII combat vet, and a holder of the Purple Heart. As he tells it, his unit was searching for some downed pilots in the jungles of some Pacific island when he was shot in the leg. His leg essentially had a hole in it, with all kinds of fun stuff hanging out of it. He says he got shot around noon, and his unit helped him splint the leg, and fashion a crutch out of bamboo, and they continued on. They were held up by a Japanese ambush patrol, but were saved by another unit who ambushed the ambush. He finally made it to the field hospital around 6pm, where doctors argued over whether or not they could save the leg. They decided to try, and just cleaned it out, put sulfur powder in it, and put a cast on it. Two months later, he developed an infection and they found that maggots had gotten into the cast, which is pretty gross till you think that the maggots cleaned out all the old, dead flesh, and left the new growing flesh. This soldier spent a year in and out of various hospitals until he was given a medical discharge.

This is even more impressive when you consider that this man had already served his time in the military before the war, and then decided to sign up again to fight in the war. Not only that, but he had to go to Maryland to sign up, because DC did not allow any of it's residents to be deployed (something about retaining a protective force around the nation's capitol).

Think about all that for a second. You are searching for some downed pilots, get part of you leg shot out, and walk for 6 hours in the jungle on that leg, avoiding enemy patrols, and ambushes. You finally make it out, and the doctors want to take you leg. They decide to let you try to keep it, but wait another 6 hours. That's 12 hours with a giant bullet hole in your leg, folks.

There are so few WWII heros left. I was lucky that this guy was completely coherent and able to tell me his story. So many of the other WWII vets we transport aren't that lucky.

Now for the villain...

We were in Big Government Hospital, waiting by the elevator to go upstairs to pick up a patient. We were waiting patiently, and had already been waiting about 5 minutes. One elevator was down, and it was a busy time, and with all the wheelchair-bound patients, the elevators were filling up quickly. A woman in a wheelchair came up to us, and said 'You're blocking the elevators,' (you know, because we were standing there for no other reason than to block the elevators) to which my partner replied, quite nicely, 'Well, we're waiting for the elevator.' The woman then went on to loudly complain about the elevators here at BGH, how they never worked right, etc etc.

Then she proceeded to make comments about us. I'm pretty sure she wasn't speaking to anyone in particular, but said 'These people think they're more important than the patients, but they're not.' Then she said 'If they think they're getting on before me, they better watch out.'

We didn't reply, because there wasn't much point in it, and because there was a huge crowd there, but it really irritated me. We had been letting patients and people go on before us for about 10 minutes, making us late for our pick-up, because we well know that a stretcher takes up a lot of space, and the area was very busy. The fact that she came up after we'd been standing there for 5 minutes and started making those comments was totally uncalled for and I really was tempted to say something, but couldn't think of anything sarcastic and nice enough to say that wouldn't leave us as the 'jerks verbally attacking a patient in a wheelchair.' But I just really don't understand the point in making those comments, and then continuing to make those comments. Which I think is what makes me the most pissed. Why be so mean and bitchy to random strangers who are trying to do their job and help your fellow patients? Do you feel that insecure in your position as a patient that you have to run down other people? Or did you just need that elevator THAT much?

Of course, this is the same person who would complain and bitch at us for being late to pick her up if she had needed transport, I'm sure.

Wednesday, May 27, 2009


I like my partner. Truly I do. He's a nice guy, despite his insistence that we listen to R&B all fucking day! We get along fairly well, and while I don't see us getting to the stage that Epi did with her partner, it's not a bad deal.

However, my one beef with him is about driving. He generally does all the driving, because, quite honestly, I have a hard time seeing over the dashboard in the driver's seat (it goes up a bit, which obscures my view of the front of the truck, which makes me uncomfortable). He brakes a little hard for my liking, and takes corners a bit hard as well, but that may also be the difference between an ambulance and a van-bulance.

But where I really get annoyed with him is his following directions. Or rather, not following directions.

To be fair, he does know his way around DC and some parts of MD much better than I do. And we do have a GPS for most things. But he consistently misses the directions the GPS gives, and we end up turning around because we passed the nursing home or whatever (usually with the patient on board). Today, we had to find our way out of a neighborhood. I set the GPS to head to the local hospital, telling him to just use it to get out of the neighborhood so we could get back to the highway. He called me to the window because he got turned around twice, taking my directions for getting on the highway, but then listening to the GPS because it was telling him to turn around. No biggy, as I knew where we were and easily got us back on track.

Then we were getting close to the destination hospital, and I knew exactly where we were going, so I told him what exit to get off at and so on. We ended up on a different road, totally lost, because he saw the hospital off to the side and thought that's where he needed to go. Fifteen minutes later, we finally made it to where we needed to go.

I really wouldn't have minded so much, except that the patient was having some respiratory issues, and we really needed to get where we were supposed to be.

All that said, I really do like the guy. He just really needs to listen to my directions when I say I know where I'm going.

All else is on the GPS.

By the way, I have joined the darkside and moved to smugmug for my photo needs. Picasa was nice, but I'm at 99% of my alloted space, and smugmug is unlimited. It also has some nifty features I liked, and it's relatively inexpensive, especially with a promo code from a friend.

Tuesday, May 26, 2009

Some of the people I meet

First some house-keeping....I finally saw that I got comments! w00t!!! Unfortunately, I can't seem to find the button that sends me a message when I get comments. Help, anyone? (I am so illiterate at some internet stuffs)

Anyway, a good deal of my patients come in vegetable form, but I do occasionally get those that are alert and oriented x 3. The other day I had a gentleman who had worked as a technician for the FAA, and had traveled all over the state testifying in various state courts for an organization against rape crimes. Not because he personally knew someone who had been raped and murdered, but because he heard about the crime against a bright, beautiful young woman, and felt so strongly that he just HAD to do something. He was bed-bound due to a previous stroke, and yet his mind was as sharp as any I have ever encountered. I truly believe what I told him...That he had experienced and forgotten more history than I had learned thus far. He laughed.

Then I had another gentleman with whom I had a very interesting conversation about politics. It started about 2A rights, and extended into politics in general. I gave him some websites to peruse, which he said he would when his wife wasn't home, since she didn't like him reading political stuff, as it made him angry all the time. (heh)

I had an elderly woman who had grandchildren and great-grandchildren in abundance, who were coming to visit her for Mother's Day. We talked about her children and them visiting her in the hospital. When we left her, she wished me a Happy Mother's Day. When I told her I wasn't a mother (aside to my dogs), she said that she wished it to me anyway, since she wouldn't be able to wish it to me when I did have children.

I had a patient who lectured me on my 'adventurous ways.' He countered my complaint that C doesn't want to come rafting with me because it's too dangerous with evidence from his friend (who fell out of a raft and hit his spine on a rock, becoming an instant paraplegic). It doesn't make me want to go rafting any less, and I felt horrible leaving him in the absolute HOLE of a nursing home he was stuck in.

The patient's family is also very fun. When I was still 'training,' a patient's wife and I had a long conversation about anything and everything while we were stuck in traffic and then taking a detour to her house.

On the other hand, dealing with people all day, everyday, is taxing my poor, introvert brain. I had thought originally that C was the one who had a bit of a stabilizing effect on my temper (and the judicious application of the hormones from the birth control I started taking about the same time). Now I'm wondering if it was the lack of 'people' in my day. In the lab, I could escape people fairly easily, and most of my co-workers knew that I didn't like people much, and left me alone.

Now that I'm back in an ambulance, I'm finding that my road rage is back, although it is still somewhat less than it used to be. Perhaps I'm finding balance.

Do the Shuffle!

Though I may bitch and moan about doing the interfacility shuffle, I'm still thinking it's better than the lab job. I do like the patients. However, my tolerance for stupidity is getting less and less, especially in regards to dispatch.

See, our 'area of operations' is DC and Baltimore (more DC than Baltimore, truthfully, but we do venture up there about once a week). Evidently, years ago, we had our own dispatch, in DC, which makes sense, since movement in a vehicle around DC is only understood once you've experienced it. However, because it made sense, management decided that it must go, and dispatch was moved to Philly. None of the dispatchers in Philly have been to DC, let alone driven around here.

Are you seeing where this is going?

Now, I have to say, I totally understand the difficulty dispatch has. They have to send a truck, and while they try to be nice if we are coming to the end of our shift, sometimes they just don't have a crew to send to cover a call, and the board is full up for the next shift. And most of the time, I don't mind...Overtime is overtime, after all.

However, calling us at 1700, when we are well off the beaten path (meaning the Beltway) in VA, and telling us that we have a pick-up at 1800 up in MD, halfway to Baltimore, is not an efficient use of crew resources. In normal traffic, that trip would take about 45 minutes. However, in beltway rush hour traffic, that is a 2-3 hour trip. When dispatch then calls the crew at 1810 asking for an ETA, and the crew says 'We're sitting in pretty heavy traffic, and we haven't made it to MD yet, so probably another hour and a half to 2 hours,' it is not conducive to have a crappy attitude over the radio. The crew was not being snotty, and the sound of the dispatcher (who is 2-3 hours away, sitting in A/C, NOT in a hot truck in miles of traffic) sighing heavily into the radio and saying 'Well, just do your best,' is not in the best interest of crew morale. In fact, perhaps checking the internet for traffic in the DC area (which is easily found via several websites) would be a better use of time.

Or perhaps, when the crew says it will take another hour and a half or more to get to the destination, and it is close to the end of their shift, finding another crew who could get the job done in that same amount of time would be a better use of crew resources.

Or, as I've said before, perhaps having dispatchers spend some time in the field with crews, driving around in the traffic here, would give them an understanding of why it sometimes takes 2 hours to go 15 miles.

Or perhaps not...

Sunday, May 17, 2009

The new puppy

So, we adopted a puppy because I wanted to try working her in SAR. She is a 6 month old black lab and border collie mix. I'm not sure how well she'll work out though. She loves kids, and loves men, but she's very submissive to women, which concerns me a bit. She listens to both me and C equally, so that's not really an issue, but she just seems to be on guard all the time around women.

So far, she mostly knows 'sit' and is working on 'down' which is coming along. She's pretty good about her recall, although, like any puppy, she isn't really good about it when she's distracted by something (which is true of any of the commands...something we're working on). She is a bit of a jumper, and C and I really have to stop allowing her to jump on us, except when she's given the command 'up.' She's mostly house-trained, but if we don't notice her at the door to go out, she'll pee on the carpet. But she doesn't have a good tell, so it's hard. And annoying.

I go to my first SAR training next Sunday. Well, not first, but first in several years. I'm looking forward to seeing many of the people again. I had gotten out of it when I went to nursing school, because I just didn't have the money to drive all over creation. Plus, they didn't have any provisions for someone who didn't have a dog. Now I have a dog, so we'll just have to see if she passes their evaluations. If not, I'll just have to work as a walker until we move to a bigger house and I can get a dog that will work out.

Of course, we haven't payed for the new puppy yet (her name is Kaylee). I keep trying to get the woman in the rescue organization to email me her address, but she keeps forgetting. I need to call her again.

She and Kobe get along well, except when there is human food involved. But she is getting a bit better about that as well, and there is much less snarling when an event occurs.

Any way, here is a picture of Kaylee, and the bottom one is Kobe.

Thursday, May 14, 2009

It's raining again...

It's raining again. At least we had 2 or 3 days of spring, right?

Today was a rare day, and made the earlier (more horrible) part of the week seem like a distant memory. I made it a late start, but got there in time. MB, the supervisor, gave us his favorite truck, which was clean on the outside (OMG!!!) and mostly clean on the inside (double OMG!!!!) No crumbs on the floor, not a whole lot of trash inside. Wonderful.

Dispatch posted us to the VA. Of course, the day I bring my lunch. But we were able to go to my favorite deli in the city, and get lunch, which we then ate in our new favorite spot when posted to the VA.

I love the National Shrine. Easier to access than the National Cathedral, and they have a free parking lot across the street.

So, we got to eat lunch. Aside from a brief attempt from dispatch to give us a call (it was out of Virginia, and we are not yet certified as EMT's there), we were undisturbed for almost 2 hours. We got a call for the VA, but when we got there, the patient decided he didn't want to go (evidently, you can do that in the VA). So we left, and told the nurses to call dispatch back when they had convinced the patient that, yes, he really did want to go home.

So, back to our spot at the Shrine. We watched a collection of older middle school (perhaps young high school) students from Wisconsin get off their coach bus and head towards the Shrine. Which was interesting, considering there is a road between the lot and the Shrine. Not an overly busy road, mind, but not one I would like to cross with a butt-load of teenagers. Not to mention that buses usually drop off their charges in front of the shrine and then come over to park.

We got another call at a nearby hospital, for a patient to go to a place down in Virginia. At 1600. In DC. Needless to say, traffic was a bit of an issue, and, though we got off the floor in record time (all the paperwork was done and the patient was ready!), it still took us till nearly 1800 to get to the rehab place.

Dispatch decided to be kind to us, and let us head back to base. Considering the traffic, we made decent time, and got back to base EXACTLY at off-time.

My dogs are crazy. The puppy still occassionally attacks Kobe for sniffing at areas where she has eaten people food. She hasn't done it in weeks, yet she did it tonight. I have no idea why. Perhaps I could ask the vet when I take her in next week. Still, they have been playing and such for the better part of the last 30 minutes, so I can't complain. They do get along fairly well.

Company comes tomorrow. I have to finish cleaning. Unsure of what we'll do this weekend, but if the weather is as bad as they say (all rain, all the time) I'm leaning towards something inside. Perhaps climbing?

Wednesday, May 13, 2009

Insurance stupidity

I really wish I was better able to put my rants into eloquent words. I just always feel like I'm ranting aimlessly, not doing much to effectively put my thoughts into words. But whatever....I'm still doing it.

SO the other day we got a call to take a patient from the hospital to his house. I wasn't sure about this one as soon as I walked on the unit, and checked on the patient's room. I could hear him breathing from where I was in the doorway. Even the nurse's were saying that the man needed to stay in the hospital. No home health care, no home O2, no home suction....and only his equally elderly wife to care for him. The patient was bed-bound, and pretty much awake, but un-responsive. The nurse had taken off the O2, and the patient had developed what I call the 'fish-eye stare;' the stare of someone who doesn't have enough O2, and whose brain is shutting down due to lack of oxygen.

So why was this man, who so obviously needed to still be in the hospital, being sent home, especially to a home that was not equipped to care for him? Because his insurance had decided that they were no longer going to pay for his hospitalization, and had cut off payment at noon that day. Therefore, the hospital was sending him home. Our company would take him home, and charge the insurance company for it.

We managed to finally get him home (see previous post rant on nurse's not having the patient ready to go when we get there), to a house that was supremely unfit for a person who is constantly ill. His wife, a tiny woman who 'had a cold' apologized for the state of the house and how it had been built years ago, before anyone thought of disabilities. I had put the man on O2 on the way over, just to give him a chance at staying home a little longer, but I would bet my next paycheck, his wife called 911 not an hour after we left.

So, let's add things up. Insurance company pays for X number of days in hospital, and won't pay any more. Patient requires more hospitalization, but is sent home because insurance won't pay for more hospital time. Private ambulance company take patient home, and charges insurance company. Patient needs more time in hospital, so 911 is called, who comes to take patient to hospital and (most likely) charges insurance company again. Patient is taken to ER, who charges insurance more money to see the patient, and treat him, and bed him until another bed opens up on the floor. Patient goes up on the floor, and stays until insurance stops payment again. Or until the patient is healthy.

Or until the patient dies.

Rinse and repeat, ad nauseum.

So you can see my irritation here. I've ranted about insurance companies before, though not here, and their ridiculous policies that have no relation to reality. One example is my old insurance company's policy that physical therapy is limited to 30 visits, regardless of medical need. So, you know, don't have a stroke, or any other serious medical issue that may require extensive therapy to recover from.

It is my firm belief that anyone who works in the policy making department of an insurance company should be made to spend time with EMS crews (both public and private), and on the floors in hospitals and in ER's, so they can see what happens in the real world, as opposed to some mythical virtual world where everyone is magically healed after X days, and there are never complications.