#paramedic chronicles

[parastitch]

Paramedic Chronicles - Self-help

[paramedicchronicles]

Incomplete history

One of the most frustrating thing we encounter as paramedics is that patient who tells you they take no medications but once you get to the hospital, the nurses bring up their chart with 4 pages of medications for their disease riddled body.

Me: "I thought you said you werent taking any medications and had no medical conditions?"

Patient: "I dont"

Me: "well then why are you prescribed all of these?"

Patient: "oh yeah I take that for my high blood pressure, and that for my diabetes, oh and I take that for my hyperthyroidism"

Me: "THOSE ARE MEDICAL CONDITIONS"

A recent patient of mine denied any medical history except for an injury they had 2 years ago that landed them in the ICU for a month. They denied any medications stating they refuse to see doctors now because "all they do is push drugs and you can lower your blood pressure by just thinking about it" their blood pressure was 180/110.

I asked them many times in every different way possible if they had any medical conditions, like diabetes, hypertension, asthma, COPD, etc. But every time, they said no. I even worded it like "when you were seeing a doctor did they diagnose you with anything that required a prescription?" Had to be worded that way or else they'd go on their rant about how they don't believe in doctors anymore. Still I got nothing out of them.

We get to the hospital and the nurses bring up their recent hospital stays and med records. Not even kidding, the medical history and medications chart were each 3 pages long. The nurse looks at me frustrated because I said that they has no history. How am I supposed to know they have every single disease on the planet if they don't tell me! They told me they were super healthy except for their bad back. Never once did they mention they had renal failure!

[paramedicchronicles]

The pager..

Its terrible screetching that goes off at 3 am waking me from a dead sleep and leaving me gasping for air means someone somewhere is either dying, thinks they're dying, or are sadly, already dead.

As a rural paramedic working on an on-call car we have to call dispatch and confirm we received the page within 2 minutes of the pager going off. Usually we're pretty quick to call in. Our day room has a radio so we can listen to what's going on in our region and we can usually guess when a call for coverage in a different area is about to come in. Or we'll hear them say "paging" and our tones drop, and of course being millenials, we have our phones in our hands at all times so we get call within seconds of the pager going off.

Not this night apparently. I'm a fairly deep sleeper, but I will still wake up to a page.. at least I usually do.

The night goes like this; we were out on calls for a good chunk of the day, swap to nights and get paged out early. Get back to quarters, hang with the other crew, binge watch more of The Musketeers, go to bed around midnight. 3 am rolls around and the pager goes off. But I was apparently quite adamant I was going to continue sleeping. I quickly flipped over from my right side to my left and had the pager completely turned off before it even stopped beeping. Luckily there was a second pager in the room going off still. But the thing is... I was completely asleep during all of this. I woke up to the noise of me fumbling around to put the pager back on the charger. Then my partner asks "was that a page?" I immediately said no and rolled over to try and fall back asleep but I heard my partner call dispatch to ask if we had been paged to which they replied "Yes, for coverage please".

Obviously my partner is just chuckling away. He said hes never seen someone flip over that fast, and the fact I shut the pager off had him laughing pretty hard. Laughter at 3am is a good thing. After that we decided it would probably be best if we had the pagers out of my reach. So now I'm no longer trusted with pagers... better for everyone this way!

[paramedicchronicles]

Me: so have you been sick at all recently?

Drunk Male patient who likes to joke around with us: just a little morning sickness.

Me: uhm you have something to tell me?

Patient: yes, I'm pregnant and guess what! it's yours!

Me: uh yeah pretty sure that's not how this works!

[paramedicchronicles]

Interfacility transfers.... Interfacility transfers with Doctor and nurse escorts for the critical patient...

It's quite the experience. A stat transfer out of our small local hospital with 8 beds to a much bigger hospital an hour away with a critical patient attached to all sorts of monitors and pumps and on and on and on. I've had transfers where you're alone with the patient literally taking them home. I've also had it where you have an RN, Doctor, and a resident doc in the back with our patient attached to 2 separate IV pumps, a ventilator, and the cardiac monitor hoping that all this keeps them alive long enough to make it to the higher level of care where they can see all kinds of specialists.

Even though every transfer is different and vary in seriousness one things for sure, every time you have a nurse or doctor in the back with you, they're always and I mean ALWAYS surprised by the amount of equipment we have in the back and what we can do in such a small space. Which is why I am a firm believer all nurses and doctors, or more importantly those nurses and doctors working in the ER NEED to do at least 2 shifts with an ambulance crew.

I can't count the number of times I've had nurses or doctors question why I didn't do something enroute to the hospital. They don't understand that when you're in the back with a patient that's being ventilated and you're alone, there's no time nor the need for an IV. Especially when the hospital is less than 10mins away.

Today during a transfer the doctor that came along was just in awe of the amount of stuff we had. Anything he asked for I was able to tell him exactly where it was, something he seemed shocked to hear... which is weird. Do most people not know where all of their equipment is? How are you supposed to tell a fire fighter who's on scene with you to grab something for you if you arent able to tell them where it is? They obviously wont know so if you cant tell them then its wasting their time, your time, and precious time your patient may not have. So yeah, I know where everything is.

My favourite transfer ever was for a elderly woman who's pacemaker was misfiring and needed to be recalibrated. The only hospital in the area with a doctor available to do it was over an hour away in the city. She was super stable but due to it malfunctioning she needed the cardiac monitoring and a nurse escort just in case, because you never know what will happen during the drive. What made it so awesome was the fact this woman was so outspoken and highly opinionated about very obscure topics. The nurse was also amazing. He was incredibly personable and we joked around the whole ride there. We came to the decision that our patient needed her own talk show because everyone needs to learn from her. If there were more people in the world like her, we wouldnt have so many problems.

Transfers like that make up for all the bad ones you'll have throughout your career; nurses getting upset they have to do a procedure because you refuse to work out of scope, restrained patients who manage to actually get out of restraints, 4hour long transfers in the middle of the night through a snow storm, and the generally unpleasant patients who make you question why you do this job.

But even after all the bad transfers where you're ready to quit, you'll get that one patient who is so thankful for you and your partner, so thankful that they'll make sure you know it. Ones that remind you why you do your job and why you love it.

And man oh man do I ever love it!

[mashupofmylife]

It irritates me to no end when people talk about their ~*#tRaUmA#*~ and it turns out to be something like "my boss was mean" or "my coach yelled at me." Not invalidating those experiences. But they're definitely not formal "trauma," or capital T-Trauma, and they don't need to be to have an impact on you.

As a result, I'm very hesitant to use the word "trauma" to describe the whole situation with the fire department. But I guess I now have proof that its done something to me. I made a few mistakes and was told that a run was going to be reported to QA. No big deal, right? Except that I spent the next several hours feeling sick to my stomach, wondering when I was going to be pulled from the field, if I should cancel all of my upcoming shifts, and if I'd get sent back to a training status. Spoiler alert: none of that happened. I still haven't gotten any follow up about the situation. But based on the way my previous agency handled QA, I was waiting to be told that I was a shit medic who intentionally did wrong and I needed to do hours of re-education.

So yeah, maybe I got some little t-trauma from this whole thing. Or maybe I'm just hella anxious and perfectionist and hate to make mistakes?