For those of you who missed the original post-
http://medicdani.blogspot.com/2009/10/level-62-care.html
If you took the challenge feel free to step up and brag- I would love to hear about everyone and what has come easily and what hasn't. Here is my report card:
This week I focused on the little details with my patient care. Generally speaking the hospitals are all about saving money, so when the patient is admitted, the less you give them the better for the hospital. Instead of just giving them the incenstive spirometer, big yellow bin, kidney basin, mug and tissues- I added lotion, comb, toothbrush and toothpaste, an extra pair of socks and deoderant. This not only helped the patients want to do nightly and moring cares, but they felt better about themselves and their care.
Another trick I tried was focusing on snacks. Usually my patients are all regualr diets and can eat anything they desire, so I made sure they got dinner and a snack of their choice. One patient even disliked his supper, so we let him have food ordered in.
One thing I have noticed is that rules sometimes just dont exsist. Like overnight guests. I thought it was against the rules, til I asked. Now that I know better I actually take a cot from the pre-op and recovery area, make it up like a bed and bring it into the patients room. This makes both patient and visitor more comfortable.
However I still need to work on being compassionate about everything. I still sigh when the patient who has peed twice and hour every hour rings her bell. I still treat her kindly, but I need to stop the whining in the hallway.
Showing posts with label learning. Show all posts
Showing posts with label learning. Show all posts
Sunday, November 1, 2009
Saturday, October 24, 2009
Level 6.2 Care
EMS 2.0 is taking off in an amazing whirlwind around the medic blogospheres. It's amazing how a simple idea is going above and beyond. I have loved reading about this great idea and about how we as EMT's plan to change health care for the better.
The CEO of my hospital sends out many e-mails, most of which I don't read. I must have been exceptionally bored or in a go-getter mood because I read one of them today that talked about level 5 care in a hospital setting. All I could think about was 'what on earth is level 5 care supposed to mean?' and 'I thought we were a level 1 trauma center- is level 5 care good or bad!?' So I did some research in and around all the hospitals in my state. The scale is 1-5, the lower your score the worse you are. Aiming for level 5 is aiming for the highest. This got me thinking.
During nurses week we had a comment on our poster that said 'thanks for the level 5 care.' Another scribbled message said 'enough of this level 5 crap- I got level 6.2 care here!'
That poster is still sitting in the hallway, staring us down, reminding us why we do what we do. I have no idea what level 6.2 means, but it's much better than level 5!
So folks, I am issuing another challenge to us all. Let's all give level 6.2 care.
The standards that all the hospitals I looked up had in common were:
1. Compassion: As stated in yesterdays post, I am the first to admit that sometimes I am not as compassionate as I need or want to be. Let's all try to genuinely listen to our patients, knowing that everyone lies, but acting towards them as if this rule never existed. Synonyms of the word compassion are; sympathy, empathy, heartfelt and caring. All traits we should work on.
2.Responsibility: Being on the bottom of the food chain is easy. Being at the top is hard. Either way we are loaded with responsibilities for another human life, and sometimes its a life we aren't fond of. It's easy to love your child and care for them, but it is very hard to have a psych patient and keep calm around them. Stepping up is the hardest, biggest thing any of us in a hospital can do, and its a rare occurrence when anyone does it. I personally am vowing to always do my glucometer checks, fridge checks and take the equipment out of the rooms on Friday nights, even though that's not my job to do.
3.Diversity: Everywhere I go there is little to no diversity. I live in a VERY white state, and I am not just talking about snow and minerals here, I mean to tell you that in my high school there were roughly 2500 students. 300 were Hispanic and 5 were African American. That leaves 2295 white kids. Diversity comes in many different packages, in skin color, in religion, in political beliefs and so many other ways. It wasn't until I got my second job that I got to dealing with different kinds of people. Until then I had never met anyone who spoke Somalian, Iranian, dialects of Chinese and heaven only knows how many other languages. I had never seen anyone wear a turban in real life and thought that I would see so many different forms of religion through clothing choices. Each day I see and learn more and more about the world I live in, but I cannot become a better health care professional if I don't try to learn. Let's all try to talk to our patients about their lives, their beliefs and themselves, which will not only lead to better care, but more comfortable relationships with their caregivers.
4.Quality: When we play the alphabet game we always look for this word, and are always so sadly disappointed when it becomes a hard word to find. It's a hard word to find because its a rare thing for anyone to have or to give. Quality. We work in a devastating field. People who should live, die. Children get incurable diseases. Families are torn apart. We see this happening right before our eyes, so who am I to ask you to give more quality of care? I know I'm asking for alot. But the patients deserve it.
Whether it be giving a patient an extra can of soda, or taking five minutes to help them apply some lotion to their back, the little things are the things that our patients like the most. I am vowing to take 5 minutes of free time on shift to spend with each patient, talking with them, fetching them odds and ends, even straightening up their rooms for them. I am vowing to hold more hands, pass more tissues, sit at more bedsides and to listen to more stories. If I was a patient that person would be a quality aide, and that is who I want to become.
5.Trust: We work with them from anywhere between 4-16 hours. We may or may not see them again the next shift we have. There is no consistency in the hospital, but we can still gain trust with a patient. Trust is an incredibly hard thing to gain, the world is full of mean, horrible people and whats worse, the media makes doctors, nurses, even aides out to be the bad guys. In television shows the nurses are the mean grumpy ones, the aides are ditzy and worthless. We need to fight barriers to gain a patients trust. I have no idea, no advice and no words of wisdom as to how to accomplish this, I just hope that as level 6.2. care givers we can.
I am taking a vow to be a better caregiver and to do a better job. To focus more on my patients and to see what we can do to not only save a life, but to change a life.
If you're with me, leave me a comment and set yourself a goal as well. We may be thousands of miles apart, but that doesn't mean that we can make a difference inside the hospital while these Paramedics are making a difference on the streets.
The CEO of my hospital sends out many e-mails, most of which I don't read. I must have been exceptionally bored or in a go-getter mood because I read one of them today that talked about level 5 care in a hospital setting. All I could think about was 'what on earth is level 5 care supposed to mean?' and 'I thought we were a level 1 trauma center- is level 5 care good or bad!?' So I did some research in and around all the hospitals in my state. The scale is 1-5, the lower your score the worse you are. Aiming for level 5 is aiming for the highest. This got me thinking.
During nurses week we had a comment on our poster that said 'thanks for the level 5 care.' Another scribbled message said 'enough of this level 5 crap- I got level 6.2 care here!'
That poster is still sitting in the hallway, staring us down, reminding us why we do what we do. I have no idea what level 6.2 means, but it's much better than level 5!
So folks, I am issuing another challenge to us all. Let's all give level 6.2 care.
The standards that all the hospitals I looked up had in common were:
1. Compassion: As stated in yesterdays post, I am the first to admit that sometimes I am not as compassionate as I need or want to be. Let's all try to genuinely listen to our patients, knowing that everyone lies, but acting towards them as if this rule never existed. Synonyms of the word compassion are; sympathy, empathy, heartfelt and caring. All traits we should work on.
2.Responsibility: Being on the bottom of the food chain is easy. Being at the top is hard. Either way we are loaded with responsibilities for another human life, and sometimes its a life we aren't fond of. It's easy to love your child and care for them, but it is very hard to have a psych patient and keep calm around them. Stepping up is the hardest, biggest thing any of us in a hospital can do, and its a rare occurrence when anyone does it. I personally am vowing to always do my glucometer checks, fridge checks and take the equipment out of the rooms on Friday nights, even though that's not my job to do.
3.Diversity: Everywhere I go there is little to no diversity. I live in a VERY white state, and I am not just talking about snow and minerals here, I mean to tell you that in my high school there were roughly 2500 students. 300 were Hispanic and 5 were African American. That leaves 2295 white kids. Diversity comes in many different packages, in skin color, in religion, in political beliefs and so many other ways. It wasn't until I got my second job that I got to dealing with different kinds of people. Until then I had never met anyone who spoke Somalian, Iranian, dialects of Chinese and heaven only knows how many other languages. I had never seen anyone wear a turban in real life and thought that I would see so many different forms of religion through clothing choices. Each day I see and learn more and more about the world I live in, but I cannot become a better health care professional if I don't try to learn. Let's all try to talk to our patients about their lives, their beliefs and themselves, which will not only lead to better care, but more comfortable relationships with their caregivers.
4.Quality: When we play the alphabet game we always look for this word, and are always so sadly disappointed when it becomes a hard word to find. It's a hard word to find because its a rare thing for anyone to have or to give. Quality. We work in a devastating field. People who should live, die. Children get incurable diseases. Families are torn apart. We see this happening right before our eyes, so who am I to ask you to give more quality of care? I know I'm asking for alot. But the patients deserve it.
Whether it be giving a patient an extra can of soda, or taking five minutes to help them apply some lotion to their back, the little things are the things that our patients like the most. I am vowing to take 5 minutes of free time on shift to spend with each patient, talking with them, fetching them odds and ends, even straightening up their rooms for them. I am vowing to hold more hands, pass more tissues, sit at more bedsides and to listen to more stories. If I was a patient that person would be a quality aide, and that is who I want to become.
5.Trust: We work with them from anywhere between 4-16 hours. We may or may not see them again the next shift we have. There is no consistency in the hospital, but we can still gain trust with a patient. Trust is an incredibly hard thing to gain, the world is full of mean, horrible people and whats worse, the media makes doctors, nurses, even aides out to be the bad guys. In television shows the nurses are the mean grumpy ones, the aides are ditzy and worthless. We need to fight barriers to gain a patients trust. I have no idea, no advice and no words of wisdom as to how to accomplish this, I just hope that as level 6.2. care givers we can.
I am taking a vow to be a better caregiver and to do a better job. To focus more on my patients and to see what we can do to not only save a life, but to change a life.
If you're with me, leave me a comment and set yourself a goal as well. We may be thousands of miles apart, but that doesn't mean that we can make a difference inside the hospital while these Paramedics are making a difference on the streets.
Tuesday, August 18, 2009
The Chain of Command
When we were kids in school we learned about the chain of command. As the students, we were the peons and had to have permission to even use the bathroom. The teacher had all the power we could see over us, but she didn't have all the power she needed to help her do her job, this is where the principal came in, who had to determine if the teacher was as crazy as we thought or not. No matter what kind of child we were, each of us defied the rules, and at least once, the principal took our side. But sometimes the chain of command gets screwed up, and then problems arise.
The nurses station was buzzing with phones ringing, voices yelling and white coats creating a blur as they passed. As they walked, the interns, brand new from med school and our own batch of young doctors, griped. "I cannot believe the nurse wouldn't give my patient denture cream!" A blond, skinny doctor said in disbelief to her colleagues. She wore high heels and too much makeup, and looked much younger than she probably was.
"I cannot believe it either, I mean what the hell is her problem, the woman needs denture cream!" Another doctor, a short brown haired-boy said. He also looked too young, but was wise enough to wear scrubs. The third doctor, looked to be about thirty years old, he stayed quiet and watched his colleagues intently. He held the patients chart and laughed to himself, but said nothing to the others.
As they entered the patients room to discuss this mishap they stopped and stared at the patient speechless as the elderly lady they were worried about smiled at them, showing off a full pair of natural teeth, complete with a gold tooth on one side.
My pager buzzed endlessly in my pocket, but I couldn't seem to escape from a certain patient. She had something wrong with her, but no one could identify it. I kept thinking back to a scrubs episode where a patient kept thinking everyone was a clone of themselves and trying to hurt her. Her lip trembled as she rambled on and on about going upstairs to a unit that didn't exist. She kept talking about promises that doctors made, and kept talking about doctors screwing up her care. I approached the nurse as soon as I escaped, who rolled his eyes. So I took action. Wearily I walked over to the case managers desk and sat down next to her. She looked over at me. "What?" She grumbled, looking back to her paperwork.
"I need your help." I said, my voice shaking and knowing full well that I could get in a lot of trouble for doing what I was about to do. The case manager looked at me and took off her glasses, studying me. I took in a deep breath, then continued. "I have this patient, who hasn't had a psych consult, and I think she needs one. Also, her nurse seems to think she is crazy, so none of her needs have been met yet. And I am not sure who can call for those or what can be done, but I know you are a patient advocate, and so am I. Can you help me?"
She nodded and put her glasses back on. "I need a patient name and medical record number."
"So you can help me?" I asked.
"You bet your ass I can." She replied.
Thirty minutes later a psych team came to her room and new labs were drawn. The patients needs were met, and she felt better about her care, even if she was crazy, and without a doubt she had some psychological issues. No one knew it was me that told on the nurse about the patient. No one knew that I had overheard the interns arguing over something ridiculous, but the aide that I had to tell on knew that it was me, and for once, I regretted the chain of command, for this information getting slipped.
"I'm not taking report from you, your a bitch." She said, her acne scarred face sneering at me as she scratched the table with her dirty nails and chipped nail polish.
"That's fine." I said, handing my report sheet to one of the male aides. Anger and despise came over me and I felt meaner and nastier than ever as I watched her. Finally my eyes turned to the aide I had handed my report sheet to. He looked at my report sheet and a smile crept across his face.
"You even have their medications on here?" He asked. I nodded. "And their place of work, and their stories?" He looked at me and smiled. "I'm gonna switch shifts just to get report from you." He said. I smiled and clocked out, without a report to give I was burning time.
As I walked out the charge nurse tried to send me back to the break room, but when I explained the situation to her she sighed and apologized. I smiled at her and thanked her for her hard work, then walked out of the hospital, which seemed to be empty.
As kids we never realized all the things we did until it was bedtime, when mom and dad tucked us into bed and asked us about our days. It wasn't until we laid awake wondering what problems tomorrow would bring because of today's actions. As adults, we do the same thing, but our problems don't include apology letters or time out. As adults the repercussions of our actions are much, much bigger...
The nurses station was buzzing with phones ringing, voices yelling and white coats creating a blur as they passed. As they walked, the interns, brand new from med school and our own batch of young doctors, griped. "I cannot believe the nurse wouldn't give my patient denture cream!" A blond, skinny doctor said in disbelief to her colleagues. She wore high heels and too much makeup, and looked much younger than she probably was.
"I cannot believe it either, I mean what the hell is her problem, the woman needs denture cream!" Another doctor, a short brown haired-boy said. He also looked too young, but was wise enough to wear scrubs. The third doctor, looked to be about thirty years old, he stayed quiet and watched his colleagues intently. He held the patients chart and laughed to himself, but said nothing to the others.
As they entered the patients room to discuss this mishap they stopped and stared at the patient speechless as the elderly lady they were worried about smiled at them, showing off a full pair of natural teeth, complete with a gold tooth on one side.
My pager buzzed endlessly in my pocket, but I couldn't seem to escape from a certain patient. She had something wrong with her, but no one could identify it. I kept thinking back to a scrubs episode where a patient kept thinking everyone was a clone of themselves and trying to hurt her. Her lip trembled as she rambled on and on about going upstairs to a unit that didn't exist. She kept talking about promises that doctors made, and kept talking about doctors screwing up her care. I approached the nurse as soon as I escaped, who rolled his eyes. So I took action. Wearily I walked over to the case managers desk and sat down next to her. She looked over at me. "What?" She grumbled, looking back to her paperwork.
"I need your help." I said, my voice shaking and knowing full well that I could get in a lot of trouble for doing what I was about to do. The case manager looked at me and took off her glasses, studying me. I took in a deep breath, then continued. "I have this patient, who hasn't had a psych consult, and I think she needs one. Also, her nurse seems to think she is crazy, so none of her needs have been met yet. And I am not sure who can call for those or what can be done, but I know you are a patient advocate, and so am I. Can you help me?"
She nodded and put her glasses back on. "I need a patient name and medical record number."
"So you can help me?" I asked.
"You bet your ass I can." She replied.
Thirty minutes later a psych team came to her room and new labs were drawn. The patients needs were met, and she felt better about her care, even if she was crazy, and without a doubt she had some psychological issues. No one knew it was me that told on the nurse about the patient. No one knew that I had overheard the interns arguing over something ridiculous, but the aide that I had to tell on knew that it was me, and for once, I regretted the chain of command, for this information getting slipped.
"I'm not taking report from you, your a bitch." She said, her acne scarred face sneering at me as she scratched the table with her dirty nails and chipped nail polish.
"That's fine." I said, handing my report sheet to one of the male aides. Anger and despise came over me and I felt meaner and nastier than ever as I watched her. Finally my eyes turned to the aide I had handed my report sheet to. He looked at my report sheet and a smile crept across his face.
"You even have their medications on here?" He asked. I nodded. "And their place of work, and their stories?" He looked at me and smiled. "I'm gonna switch shifts just to get report from you." He said. I smiled and clocked out, without a report to give I was burning time.
As I walked out the charge nurse tried to send me back to the break room, but when I explained the situation to her she sighed and apologized. I smiled at her and thanked her for her hard work, then walked out of the hospital, which seemed to be empty.
As kids we never realized all the things we did until it was bedtime, when mom and dad tucked us into bed and asked us about our days. It wasn't until we laid awake wondering what problems tomorrow would bring because of today's actions. As adults, we do the same thing, but our problems don't include apology letters or time out. As adults the repercussions of our actions are much, much bigger...
Saturday, June 20, 2009
Once Upon a Ride-Along
" Ambulance 5 report to a Female unknown. Ambulance 5."
The Intermediate jumped into the drivers seat while the Paramedic radioed with dispatch. He opened the side door on the ambulance and pointed for me to jump in, and I gladly did so. The Intermediate was a young guy, who couldn't've been older than 25 years old, with sunglasses, a farmers tan and a god complex. The Paramedic was an older guy, with the beginnings of balding patches, a hearty laugh and with a big smile.
"Buckle up." The paramedic said through the little window between the compartments, then with a lurch I heard the tires squealing against the wet asphalt and we headed down to the scene. As we drove I was jerked around and finally I found it easier to just hold on rather than stay buckled up. I heard the Paramedic yell to the Intermediate about taking the 'long way around' and then getting rather angry, I looked out the little window just as the Intermediate turned on the sirens and I felt my jaw drop as we headed into oncoming traffic. The road was under construction and only had one lane.
Cars swerved in and out of the way and we quickly made it on scene. The paramedic looked back to make sure I was okay and smiled, then we all climbed out of the rig. As I clambered out of the side door I saw that the fire department had beaten us there and I started to follow the EMT's inside.
"Stay put." The intermediate said, then they walked inside, not saying a word, let alone looking back to see what I was doing.
"But-" I started after them, then stopped and I sighed, unsure about how to take it.
"Trust me darlin', you'll be glad you listened." One of the firefighters quirked up from behind me. I looked to him and nodded,knowing it was easier just to listen to their advice. I looked up to the fireman, and I assume that the look on my face showed my confusion. "Look around." He said quietly, leaning into me. As I did so I realized everyone around me were men, and all taller than 6 feet tall. I was 5'1, and a female.
"Aw hell we'll go in with her." One of the other firefighters said to the one standing next to me. I looked to him and smiled.
"Really?" I asked and he nodded, then instructed me to go inside and grab a disposable face mask and gloves. I did so and giddily followed on the heels of these two giants as we entered the building, face mask and gloves on.
The EMT's both looked to us and nodded us over. We walked over and I could tell where we were at by the smell alone. As we stood comfortably around a cot I saw the Intermediate talking to a young girl about my age, who looked to be in pain, but I wasn't sure what kind of pain. She held her abdomen tight, but held her bottom lip out and sat straight up, talking to us normally.
"Go ahead and sit on the stretcher." The Intermediate instructed the young woman and we quickly seat belted her in and started back out and into the rig, disposing of the face masks as we did so. The Intermediate jumped back into the drivers seat, and the Paramedic led the way for us through the back doors of the rig and we got the patient situated. After a moment I heard the Intermediate radio us to the hospital and we started on our way there.
"Alrighty Dani, you've been on a call before?" The Paramedic asked. I nodded and he smiled, ushering me to go ahead and do my thing.
"Do you have any allergies?" I asked her, she shrugged. "Are you on any medications, prescribed or recreational?" She nodded and handed us a large bag, that rivaled the size of a garbage bag from off her lap. I took the bag and opened it, looking at the medications. "Which ones do you take daily?" I asked her.
"Whichever ones I want to." She said. I tried to not let my jaw drop and question her mental capacity, but asked her if any were for medical conditions that she took on a daily basis. Again she shrugged.
"Do you have any medical conditions?" She shook her head no. "What was the last thing you had to eat or drink?"
"I don't know. Don't you get that?" She said, then faked a wincing pain. I looked at her, trying to hold an expressionless face, I looked to the Paramedic who shook his head and filled out the answers as she gave them.
"Alrighty then, what were you doing before the pain started?"
"I was sitting, just like this." She replied, the faked another pain. I looked to the Paramedic.
"Now, OPQRST works well." He said, "However, asking questions that work directly with this ...problem... work just as well." I nodded and turned to the patient, whose bottom lip was sticking out recordedly farther than before and her brow looked furrorwed.
"Are you pregnant?" I asked her. She shook her head no. "Are you sexually active, and if so, is there any chance you could be pregnant?" She just stared at me and the Paramedic looked to her, then to me, who was at a loss of what to do.
"Listen, the more you answer, the more I write, the more time you get at the ED."
"I was just sitting there and it hurt." She said, then faked a moan and looked to us.
The Paramedic set down his clipboard and explained to her that he was going to palpate her abdomen for any deformatites or abnormalities, we set the stretcher back and laid her flat and he palpated her abdomen. No reaction whatsoever, he sat back and wrote more information on his clipboard and then looked to me. From his look alone I could tell what it meant.
As we arrived at the ED a ER tech came running out excitedly, "What do we got?"
"Turkey Call." The Paramedic said quietly as we pushed her into the ED. I felt excited, being able to work with the patient, but at the same time sadly let down. You only get so many hours of clinical time on the rig and I wanted mine to be well spent.
I stood behind the Paramedic as he gave report to the Nurse, who sighed at the address alone that she was picked up at. The Paramedic nodded and kept on with his report, stating his finding and then turning to me, as I handed over the enormous bag of medications. The Nurse looked at me and noticed that my shirt said 'STUDENT' on it.
"Welcome to the game kid, get used to alot of this." She said, taking the meds, then walking into the patients room. The Paramedic looked at me and patted my back.
"Believe it or not, that was the best call I could've asked for you to go on." He said, showing me a big grin. "Lets re-stock the rig and get some grub."
As I helped the Intermediate re-stock the rig and played a short game of basketball with some ER Doctors, I had no idea why everyone thought that was a good call. We did nothing, not even an IV. But, the older I get, the more I'm starting to understand that the younger you learn it, the better you get at it.
The Intermediate jumped into the drivers seat while the Paramedic radioed with dispatch. He opened the side door on the ambulance and pointed for me to jump in, and I gladly did so. The Intermediate was a young guy, who couldn't've been older than 25 years old, with sunglasses, a farmers tan and a god complex. The Paramedic was an older guy, with the beginnings of balding patches, a hearty laugh and with a big smile.
"Buckle up." The paramedic said through the little window between the compartments, then with a lurch I heard the tires squealing against the wet asphalt and we headed down to the scene. As we drove I was jerked around and finally I found it easier to just hold on rather than stay buckled up. I heard the Paramedic yell to the Intermediate about taking the 'long way around' and then getting rather angry, I looked out the little window just as the Intermediate turned on the sirens and I felt my jaw drop as we headed into oncoming traffic. The road was under construction and only had one lane.
Cars swerved in and out of the way and we quickly made it on scene. The paramedic looked back to make sure I was okay and smiled, then we all climbed out of the rig. As I clambered out of the side door I saw that the fire department had beaten us there and I started to follow the EMT's inside.
"Stay put." The intermediate said, then they walked inside, not saying a word, let alone looking back to see what I was doing.
"But-" I started after them, then stopped and I sighed, unsure about how to take it.
"Trust me darlin', you'll be glad you listened." One of the firefighters quirked up from behind me. I looked to him and nodded,knowing it was easier just to listen to their advice. I looked up to the fireman, and I assume that the look on my face showed my confusion. "Look around." He said quietly, leaning into me. As I did so I realized everyone around me were men, and all taller than 6 feet tall. I was 5'1, and a female.
"Aw hell we'll go in with her." One of the other firefighters said to the one standing next to me. I looked to him and smiled.
"Really?" I asked and he nodded, then instructed me to go inside and grab a disposable face mask and gloves. I did so and giddily followed on the heels of these two giants as we entered the building, face mask and gloves on.
The EMT's both looked to us and nodded us over. We walked over and I could tell where we were at by the smell alone. As we stood comfortably around a cot I saw the Intermediate talking to a young girl about my age, who looked to be in pain, but I wasn't sure what kind of pain. She held her abdomen tight, but held her bottom lip out and sat straight up, talking to us normally.
"Go ahead and sit on the stretcher." The Intermediate instructed the young woman and we quickly seat belted her in and started back out and into the rig, disposing of the face masks as we did so. The Intermediate jumped back into the drivers seat, and the Paramedic led the way for us through the back doors of the rig and we got the patient situated. After a moment I heard the Intermediate radio us to the hospital and we started on our way there.
"Alrighty Dani, you've been on a call before?" The Paramedic asked. I nodded and he smiled, ushering me to go ahead and do my thing.
"Do you have any allergies?" I asked her, she shrugged. "Are you on any medications, prescribed or recreational?" She nodded and handed us a large bag, that rivaled the size of a garbage bag from off her lap. I took the bag and opened it, looking at the medications. "Which ones do you take daily?" I asked her.
"Whichever ones I want to." She said. I tried to not let my jaw drop and question her mental capacity, but asked her if any were for medical conditions that she took on a daily basis. Again she shrugged.
"Do you have any medical conditions?" She shook her head no. "What was the last thing you had to eat or drink?"
"I don't know. Don't you get that?" She said, then faked a wincing pain. I looked at her, trying to hold an expressionless face, I looked to the Paramedic who shook his head and filled out the answers as she gave them.
"Alrighty then, what were you doing before the pain started?"
"I was sitting, just like this." She replied, the faked another pain. I looked to the Paramedic.
"Now, OPQRST works well." He said, "However, asking questions that work directly with this ...problem... work just as well." I nodded and turned to the patient, whose bottom lip was sticking out recordedly farther than before and her brow looked furrorwed.
"Are you pregnant?" I asked her. She shook her head no. "Are you sexually active, and if so, is there any chance you could be pregnant?" She just stared at me and the Paramedic looked to her, then to me, who was at a loss of what to do.
"Listen, the more you answer, the more I write, the more time you get at the ED."
"I was just sitting there and it hurt." She said, then faked a moan and looked to us.
The Paramedic set down his clipboard and explained to her that he was going to palpate her abdomen for any deformatites or abnormalities, we set the stretcher back and laid her flat and he palpated her abdomen. No reaction whatsoever, he sat back and wrote more information on his clipboard and then looked to me. From his look alone I could tell what it meant.
As we arrived at the ED a ER tech came running out excitedly, "What do we got?"
"Turkey Call." The Paramedic said quietly as we pushed her into the ED. I felt excited, being able to work with the patient, but at the same time sadly let down. You only get so many hours of clinical time on the rig and I wanted mine to be well spent.
I stood behind the Paramedic as he gave report to the Nurse, who sighed at the address alone that she was picked up at. The Paramedic nodded and kept on with his report, stating his finding and then turning to me, as I handed over the enormous bag of medications. The Nurse looked at me and noticed that my shirt said 'STUDENT' on it.
"Welcome to the game kid, get used to alot of this." She said, taking the meds, then walking into the patients room. The Paramedic looked at me and patted my back.
"Believe it or not, that was the best call I could've asked for you to go on." He said, showing me a big grin. "Lets re-stock the rig and get some grub."
As I helped the Intermediate re-stock the rig and played a short game of basketball with some ER Doctors, I had no idea why everyone thought that was a good call. We did nothing, not even an IV. But, the older I get, the more I'm starting to understand that the younger you learn it, the better you get at it.
Tuesday, June 16, 2009
Superstition, Evaluations and Learning
I have this insane superstition that if I see an ambulance or fire truck pass me on the way into work that it will be a good night, if i see an Air Ambulance or a ambulance with lights on, its going to be an amazing night. Crazy, let me be the first to agree with you on that, but somehow it seems to work out that way. When I was worried about taking my car into a repair shop, I passed an ambulance with its lights on as I pulled out of the shop, and without fail they have been the biggest help. When I made a moral decision over all else regarding my EMT classes, I passed a huge collision with multiple ambulances, and it has turned out for the best.
So when I passed three ambulances, a fire truck with its lights on and watched our local Air Ambulance land on the hospital, all before even clocking in, I knew it was going to be a fantastic night. Honestly its good to know that it lived up to the expectations I set out for it.
The hospital is so incredibly noisy during the first few hours that I am working there. Everything seems to make noise; call lights, IV pumps, phones, pagers, Sp02 monitors, bed alarms, visitors, patients, and us, as we are yelling to doctors, answering these phones and begging the Nurses to go see the patient already, even if they have been in there 10 times in the last hour. Throughout all of this noise I recieved my patients and grabbed the other aide for report, realizing how awesome my patients were going to be.
After last weeks respiratory precautions the staff was alarmed and although they had been fitted, didn't want to 'expose' themselves, so I got nominated to have a new patient with the same diagnosis. Same thing, different week; strap papper around my waist, put on blue gown, put on gloves, and finally put the papper on my head. Its a workout all in itself but after gearing up, I felt like a superhero jumping into action.
Gowning up to go into that room is very similar to going into surgery with all the gowns, gloves, shoe covers, and masks that you need. As I was pulling everything off before leaving the patients room I looked at my tennis shoes and smiled. I had bought these now old shoes the first week I started working at my primary unit, and had worn them every shift since. These shoes had gotten me in places I never thought I would; I have been into the OR's, in a recovery room, inside an ambulance. These shoes have tripped me into the laps of Firemen and have kept me walking that extra hour or so as we push through the last bit of the shift. These shoes have helped me run from the patients room to the doctors down the hall, and were the first thing I bought with a paycheck from the hospital. I smiled as I thought of my first pair of EMT boots that I will one day buy, and where those would take me.
Halfway into my shift I got pulled into the boss woman's office, where she informed me it was evaluation season at the hospital. (Apparently evaluation season is like tax season, but no one gets more money, just the stresses of another interview with what can be an intimidating woman.) Nodding, I told her where my red packet was located, on my primary unit, and we agreed for an evaluation later. However, as lucky as I am to have escaped that evaluation- I still have my other evaulation on my primary unit today. Wish me luck, I am nervous as ever!
One thing that my boss on last nights unit mentioned was that she loved that I tried to learn from my patients, and that she was glad that I am always trying to learn from the job, not from the textbooks. I laughed and nodded my head, little did she know a patient had found out I was an EMT and just sat me down and given me all of his 'best advice' as well as 'all the good info the world doesn't offer' before that meeting.
My favorite thing in the world while working in a hospital is when a patient asks you about your career goals. As a CNA, your the peon, the bottom of the totem pole, but there's so much room to grow and almost all CNA's become RN's. However, I'm different and I love to watch peoples reactions as they ask me, when I tell them I'm going to become a Paramedic, they tell me; "Your either crazy or an adrenaline junkie." Maybe their right, but I'm happy being both.
So when I passed three ambulances, a fire truck with its lights on and watched our local Air Ambulance land on the hospital, all before even clocking in, I knew it was going to be a fantastic night. Honestly its good to know that it lived up to the expectations I set out for it.
The hospital is so incredibly noisy during the first few hours that I am working there. Everything seems to make noise; call lights, IV pumps, phones, pagers, Sp02 monitors, bed alarms, visitors, patients, and us, as we are yelling to doctors, answering these phones and begging the Nurses to go see the patient already, even if they have been in there 10 times in the last hour. Throughout all of this noise I recieved my patients and grabbed the other aide for report, realizing how awesome my patients were going to be.
After last weeks respiratory precautions the staff was alarmed and although they had been fitted, didn't want to 'expose' themselves, so I got nominated to have a new patient with the same diagnosis. Same thing, different week; strap papper around my waist, put on blue gown, put on gloves, and finally put the papper on my head. Its a workout all in itself but after gearing up, I felt like a superhero jumping into action.
Gowning up to go into that room is very similar to going into surgery with all the gowns, gloves, shoe covers, and masks that you need. As I was pulling everything off before leaving the patients room I looked at my tennis shoes and smiled. I had bought these now old shoes the first week I started working at my primary unit, and had worn them every shift since. These shoes had gotten me in places I never thought I would; I have been into the OR's, in a recovery room, inside an ambulance. These shoes have tripped me into the laps of Firemen and have kept me walking that extra hour or so as we push through the last bit of the shift. These shoes have helped me run from the patients room to the doctors down the hall, and were the first thing I bought with a paycheck from the hospital. I smiled as I thought of my first pair of EMT boots that I will one day buy, and where those would take me.
Halfway into my shift I got pulled into the boss woman's office, where she informed me it was evaluation season at the hospital. (Apparently evaluation season is like tax season, but no one gets more money, just the stresses of another interview with what can be an intimidating woman.) Nodding, I told her where my red packet was located, on my primary unit, and we agreed for an evaluation later. However, as lucky as I am to have escaped that evaluation- I still have my other evaulation on my primary unit today. Wish me luck, I am nervous as ever!
One thing that my boss on last nights unit mentioned was that she loved that I tried to learn from my patients, and that she was glad that I am always trying to learn from the job, not from the textbooks. I laughed and nodded my head, little did she know a patient had found out I was an EMT and just sat me down and given me all of his 'best advice' as well as 'all the good info the world doesn't offer' before that meeting.
My favorite thing in the world while working in a hospital is when a patient asks you about your career goals. As a CNA, your the peon, the bottom of the totem pole, but there's so much room to grow and almost all CNA's become RN's. However, I'm different and I love to watch peoples reactions as they ask me, when I tell them I'm going to become a Paramedic, they tell me; "Your either crazy or an adrenaline junkie." Maybe their right, but I'm happy being both.
Wednesday, June 10, 2009
How Far We've Come
When I think back on it, it was always just the five of us, crazy kids, worryless adults, just trying to survive. We were four hicks and a chick, and we were instoppable, the world was at our feet, and we didn't even realize it, we just kept living like the world had already done us wrong by making us grow up.
-I have learned that there are times where its okay to follow the rules, but you will never forget the times you broke them for the first time.
It was always blue eyes and blue jeans. It was always busting our asses just to fix an old beat-up truck. Anything domestic besides beer was laughed at and we lived for Friday nights. Grades were a suggestion, homework an option and we made things work for us. Life was good.
When I realize where we are at now, its still just five of us, we are still crazy, but no longer kids. Our mudding trips have been replaced with movie nights. Grades are no longer an option and we aren't acting out, we are doing what we think we are supposed to in life. We used to crowd around campfires, now we are crowded around anything but. We used to save each other and take chances with our lives, feeling invincibile, now we realize how quick its going and that we will not live forever. However, I have learned a ton since then.
-I have learned that there are times where its okay to follow the rules, but you will never forget the times you broke them for the first time.-I have learned that regardless of what the weatherman says, it is always sunny, you just have to look past the cloud cover, its always there.
-I have learned that its not okay to always go with the flow, and its always important to listen to your heart in all matters.
-I have learned that people give second chances more times than not, and I have come to understand the importance of these second chances. Third chances don't exsist.
Those are just a few things that I have learned, all from personal experience. After re-reading a few of my posts and comments I got to thinking about life, the to-do list and whats next in life for me. I have conqured a ton of the little hills I set out for myself, but there's still more to do. I have gotten my piercings (and they meant something to me as well), I have ridden in an ambulance, I have changed a life, I have worked side-by-side with a doctor, just to name a few. You don't realize how far you've come until you step back and look at it.
Nothing exciting happened at work last night, I had a heavy patient load, but the nurses were excellent about giving me a hand, and everything ran so smoothly, it truly made up for all the drama on Monday. I cannot believe I have been working there 9 months now, but I have loved almost each and every day, (I honestly can only gripe about 2 patients, max) and I have learned so much. I have helped recover patients from surgery, I have assisted doctors with dressing changes, I have assisted the nurse with any and all invasive and non-invasive procedures, and most importantly I have come to learn more about life and myself.
In the blog heading, it says 'I never thought I would learn about life on the job.' I wish I could explain the feeling I get in my heart every time I think about everything I have learned from my patients, from their experiences. Working with them, learning from them has made me better, smarter and more compassionate. I have learned about the blue skies, about the love from a parent to a child, about addictions, taking a stand for yourself, and so many more lessons. We take for granted the beauty of our job, from time to time we gripe, moan and bitch, and with good reason! But I strongly believe that if we step back from time to time and see how much we've learned, we would be hesitant to bitch and moan.
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