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....

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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....

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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...

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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

Dichotomy

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.

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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

FUNNY!!!

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, hail....it 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.