Ugggggh

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There is nothing more frustrating than being a student in a field that requires strong skill sets, and not having the opportunity to enhance and develop those skills.  This is my situation right now.  Call this a “mini rant” if you will, but I am seriously beyond annoyed by my clinical experience at the moment. In the 114 hours of ride time that I have done so far, I have only had a whopping total of 20 runs.  I realize I can’t make people get sick, and that there are days that every truck no matter what, will sit motionless at the station, but it seems like this is the status quo for me.  Normally, I would take great pride in being the White Cloud, and being able to toss up a 12 hour no hitter.  But dammit, I’m trying to learn here and it’s hard to do hands on skill building, when the only thing your hands are touching is the table in front of you at the station.  Please, someone tell me this will change.  Convince me that at some point, I am going to get the chance to start doing some hands on learning here.  My Sanity depends on it

The End Is Near

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I want to start off by apologizing.  I started this endeavor with the hopes of posting frequent updates about my progress through class, and divulging anything interesting I may have learned or done in my clinical time.  I have found over the last 8 months, that free time is something I will hold very dear to me from now on.  I have had little to no free time at all since I began my Medic program, and any time I have had, has been spent trying to descramble my brain and avoid the “mental collapse” I had heard accompanies the pursuit of this cert.

I am officially a Senior.  Two semesters down, and one grueling 8 week session to go.  My final is scheduled for July 29th, and Aug 9th is when I will attack the practical portion of the National Registry testing.  I have to be honest, the course itself isn’t nearly as difficult as I thought it would be.  Yeah, some of the topics still have me reeling.  Renal and for some reason respiratory are the two that gave me the biggest fits.  But, for the most part, I feel I have a fairly good grasp on what is going on.  The Cardiology section was just as I had hoped.  I loved every minute of it, and I just wish that we would have had more than 8 weeks to go over it.  I couldn’t seem to get enough.  I still have a few issues with 12 leads, and I know over time I will become proficient at being able to read a STEMI through a Bundle Branch Block, but for now, I think I am where I should be ability wise.  And besides, any medic that says they know everything to know about this field, should probably find themselves another job, right?

I’ve been lucky, or maybe unlucky, in the fact that I haven’t really had the chance to see anything major call wise during my clinical rotations.  I guess you could call me a white cloud as far as my ride time has gone.  ER time was a different story.  I could have been labeled a CVA magnet, as most of my major problem patients were seen for just this reason.  My proudest moment was being able to get a line started on an unresponsive patient that my instructor brought in.  And the fact that he wasn’t able to gain access made it even better for me personally.  Looking up at him and seeing him nod his head and smile was one of the greatest feelings I have had so far during class.

My last shift of ride time changed everything for me.  All I needed was eight hours, I honestly didn’t care if I got to do anything or not.  I was ready to back off for a while and the Medics I were riding with felt the same, as most of my classmates that had ridden with them opened the gates of Hell when they set foot in the station.  I had about 2 hours to go, staring another No Hitter square in the face, when the shrieking bells of the pager interrupted my looking over 12 leads. “Respond with your First on an unconscious person”.  My preceptor looked at me as we were walking out to the bus and said “You’re probably going to get to drill on this one.  I’m willing to bet it’s an OD”.  We climbed in, and set off sirens blazing to respond to the call.

On the way to the call, I was going through my usual en route checklist of possible scenarios and how I would treat them.  It’s my way of getting myself ready for whatever I may encounter.  My thought process was interrupted by the chimes coming from the MDT.  That’s when he turned his head towards my position in the back of the bus and said “CPR in progress.”  Instantly, my thought process stopped.  I hadn’t prepared myself for this. All the times I have responded to a call, I always prepare myself for the worst case scenario.  This was the one time that I hadn’t. Four years as an EMT, almost 10 before that as a First responder, and this right here was the first time I had EVER heard those words uttered on any call I have responded to.  After I was able to swallow the lump that had worked it’s way up into my throat, I was able to collect my thoughts and get myself ready.  I flashed back to every lab we have had for the last 4 months. They drilled arrest scenarios into our heads.  Good compressions until we can get the Lucas on.  Tube with Res-Q-Pod and capnography in place.  ICE protocols as soon as we start working it.  Remember your H’s and T’s. Megacode after megacode prepared me for this very moment. I was ready for this.  I heard JZ’s voice from the front again. “Open the cooler and get the kit out.  Grab the Lucas and unplug the portable suction.  You take that stuff in.  Don’t worry about the board, we can have one of the First’s get that if we end up needing it.

We pulled up and grabbed what we needed and headed in. Two flights of stairs was all that kept me from my first code in the field. The crew on the Squad were calm.  They both have been doing this for a minute or two, and have done this very thing hundreds of times between the two of them.  I think that rubbed off on me.  I was surprisingly calm.  We walked in the door, and I was honestly surprised by what I saw.

She was laying on the couch.  I looked around and saw nothing abnormal about the apartment.  Nothing scene wise that I needed to worry about.  They had fast patches hooked up, and let us know she was in Asystole. There was an EMT Basic student standing at the far end of the couch using a BVM, and she had that OH MY GOD look on her face. One of the first responders said “Unwitnessed arrest, caregiver left her about 80 minutes ago and she was fine.  Also, we don’t know the code status.”  The patient has some signs that she had been down for a bit.  Hands were becoming cyanotic, but no signs of Rigor. I stood there and waited for it. Is she a DNR, or a Full Code.  That’s when JZ leaned around the corner and said Code status was confirmed.  Start working her.

We moved her down to the floor and started compressions immediately.  My preceptor looked at me and said “It’s showtime.  You ready?”  He handed me the drill and explained how everything was going to pan out.  I placed the cath, flushed the line, and established access.  Just like we did in labs, I yelled out “line in and patent”.  My first I/O.  Nailed it.  He then looked at me and said, “This one is all you.  Let’s get the tube”.  I went up to the head and got everything ready.  King Vision on and working…check.  Tube lubed…check.  Preoxygenate…check.  I had the Basic student pull the bag and the OPA and got at it.  Insert the blade, visualize the chords…Holy Shit the cords….there they are!  Advance the tube and visualize it through the chords….check.  I inflated the cuff, grabbed my ears and listened.  Both lungs good, nothing over the stomach.  YES!!!  Res-Q-Pod and capnography please. I freaking nailed it.  My first field intubation.  (And I didn’t chip the teeth Dr. S)

I walked down and started pushing drugs.  They would throw questions at me as far as what we are giving and why.  I remember at one point, when they asked what we are going to give next, I paused for a second and thought,  “ALL THE EPI”.  (girl I hope you read this, because only you will appreciate the magic of that statement) JZ was lingering in the background.  He was the writer for the day, and he was trying to get as much info as he could in regards to what was going on.  We pushed Vaso, 3 rounds of Epi, Bicarb and half an amp of D50.  We tried our hardest for 25 minutes.  We granted her wishes, but ultimately, it was all in vain.

Two things stood out to me during that almost 30 minutes we spent trying to bring that woman back.  I always envisioned my first arrest being not chaotic, but loud.  People screaming out directions, and people running around trying to get lines, and push drugs, and do compressions.  It was the total opposite  Not much was said.  It was relaxed to the point that the voices in my head could have whispered and I would have heard them.  Secondly, I realized that at no point was I scared, or nervous, or wanting to run from the room screaming and waving my arms like a mad man.  That right there was the one thing that I took away from the event.  I could do this.  I knew my stuff.  Granted, it was an asystole arrest.  We didn’t have to shock, or push Ami, but everything I have been taught, has stuck.  The first time jitters didn’t set in.

I’m hoping that this is a springboard for the rest of my class.  I’m not saying I want every shift to have a code, not in the least.  I do, however, feel that I am ready to start having those major events come at me. It’s almost like all the doubt I had about being unleashed to do this left my body with that one call.  Someone very close to me has told me from day one that I will rock this.  And even though I have never doubted my ability, there was always that little voice in the back of my head that had me thinking I rushed into this.  I can truly say now, that I whole heartedly made the right decision to do this.  I do have this.  Man, I love my job.

Honor

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“We fight with COURAGE, We stand with PRIDE, We HONOR those who have lost their lives”

Seems like a pretty good way to live your life.  It would be fitting to be stenciled into a wall in an Army Barrack, or plastered on a poster above an Armed Service Recruiters desk.  Pretty self explanatory it seems.  The stuff that pushes Armies to conquer their foe.

Let’s look at it a little closer though.  Courage is defined as  “ mental or moral strength to venture, persevere, and withstand danger, fear, or difficulty”. Simply put, it’s having the balls and intestinal fortitude to face your fears, or even the fear of others, head on without turning and running the other way. For some, they are so loaded with it, it almost seems as if they can never be rattled.  These are the men and women that come back from a tour overseas with a chest full of medals and honors.

Pride is a feeling that you respect yourself and deserve to be respected by other people. Pride many times goes hand in hand with courage. Getting the hero’s welcome as you step off the plane, watching your teenager walk across the stage and receive their diploma.  It’s a state of mind.  A feeling of self respect.

Honorrespect given to someone that is deserving of it.   It’s something this country has done for years.  President’s Day, MLK Jr Day, remembering Pearl Harbor, are all ways we have honored those who have helped shape our past and made this country the great place it is today.

Less than one week ago, my little corner of the world was shook by one word, “MAYDAY”.  Two Toledo firefighters who had walked onto the scene of a North End fire, thinking it was just going to be another job, ended up giving the greatest sacrifice.  They lost their lives.  One, a 16 year veteran, who was once quoted as saying “I can’t believe we get paid for this!“.  Someone who loved what he did, and did it well.  The other, a 10 year vet, but who had only been on the department since September. This was his dream job.  He had always wanted to be a Toledo Firefighter.  He was still in the Academy, but drew an assignment only because he already had the certifications  that allowed him to do it.

 “We fight with COURAGE, We stand with PRIDE, We HONOR those who lost their lives”, is not just any old phrase or saying though.  This was the motto of the current recruitment class for TFRD.  It’s a motto that stands true for the fire service just as much as it does for the military.  Courage is running into that burning building, knowing that there may be someone in there that needs your help.  Pride is being able to back the truck into that station knowing you have just given a family another day with their loved one, or saved some of their memories by putting that fire out.  And Honor….that’s what we did last night. We honored the memory of those two from House 3 that gave their lives because they were over flowing with Courage.  And here’s the thing…this class motto, was penned by the one member of that class that lost his life.  

I was amazed by the turnout.  Detroit, Washington DC, Toronto, Orange County California, Chicago and even FDNY were in attendance last night to pay their last respects.  And it left me speechless.  I have never experienced anything like that in my life.  It was my first LODD memorial, and I could not imagine any other way to thank these courageous men and honor them for the service they provided to their community.  Having been a fireman before I decided to go into EMS, I had always believed in “The Brotherhood”, and thought I had a pretty firm grasp on exactly what it meant to be a part of it.  But standing there waiting to go in, and watching what seemed like an endless number of firefighters parade in wearing their dress blues, and seeing conversation after conversation between guys that were on departments separated by hundreds, if not thousands of miles, really put a whole new spin on what the Brotherhood meant.  There is no denying that this is a very tightly knit group.  When one guy is hurting, when one department is down, there is no end to the number of brothers that will come to support them.  And it gave me an even bigger sense of pride knowing that I was once part of that.

I want to take just one more minute of my time to address any of you reading this that are firefighters.  Thank you so very much for doing what you do. Being in EMS, and even having been involved in fire before, you often hear it from random people on the street.  But, it isn’t often you hear a brother say it.  Thank you from the bottom of my heart for putting your lives on the line everyday to save others. Your service to your community doesn’t go unnoticed.  Please everyone, Be Safe.  Because everyone needs to go home.

Dawn Petranek                                          JJ Greulich

A little Update

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I know it’s been a minute, but as I am sitting here, listening to the sound of rain and the crackle of thunder, I find myself with a lot of things going through my head.  It’s been roughly a month and a half since I started school.  So far things have gone well for me.  My grade is fairly decent, although I will say there is room for improvement.  I have learned so much up to this point though.  It is almost overwhelming at times actually.  The funny part of that, is we are just now starting to get into the “meat and potatoes” of the program.  My instructor has managed, almost unknowingly I would imagine, to teach a few tips and tricks that I can use everyday when I am on the road as a basic.  That is the one thing I have found most helpful about all this, being able to take some of this low-level Medic skill stuff and use it within my scope of practice. I have become quite proficient at intubation.  On a mannequin anyway.  Very rarely do I find myself unable to get one.  Even when they try to stump us a little by putting a C-Collar on it, or any other type of distraction they throw at us.  As far as IV’s go, I’m getting there.  I know it will take a lot of practice to master it, but there is only so much you can do as far as feeling for veins and what not on a simulated arm.

A few problems have popped up along the way though.  Issues in my personal life have made it very difficult to keep my focus from time to time.  Work issues, and financial issues among others have caused me stress, and I have tried my hardest to overcome them.  Also, I find myself at work stuck in that Medic mentality occasionally.  I realize that Basic skills are usually the most important, and most overlooked tools used on any run.  But I find myself at times thinking how I would treat this patient as a medic.  I am almost two steps ahead of where I should be in that run.  Although I believe this could be a good thing, due to the fact that what I am learning in class is obviously sticking with me, and my critical thinking skills are developing the way they should, it could also be detrimental in that I don’t want to be one of those Medics that gets “tunnel vision” and wants to stick the IV and push drugs before realizing the patient simply needs oxygen. But, it’s a work in progress.  I have at least 9 more months to work on these things, and get myself exactly where I need to be, God willing.

So Far…

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Well, it’s been a month since I posted last.  If I remember correctly, I was about two weeks away from starting Medic class, and worry was starting to set in.  I was worried I was making a mistake.  Maybe, just maybe, I had jumped into this a little prematurely.  Perhaps I needed to just hold off one more year longer, build up my skills a little more, and jump in feet first all over again.  To be totally honest, I wasn’t worried.  I was scared to death that I had set myself up to fail.  So much so, that I spent about 10 minutes sitting in my car, having an argument with myself about whether or not I should start walking into that building.  Fear had crept in, and was staring me right in the face.  Taunting me like a linebacker daring the QB to sneak across the goal line on him.  Failure isn’t an option at this point, and I was thinking I would just avoid the possibility of it happening all together

Nevertheless, I went in.  And 5 classes later, I am glad I decided to.  My instructor is amazing.  A man that has been in EMS almost as long as I have been alive.  His passion for this field mirrors mine.  “Always do what is best for the patient”, and “You don’t need to be nervous until you see I am nervous”, are words that are continuously coming out of his mouth.  He has the ability to take what is projected on the screen in front of us, and put it into real world scenarios.  That in itself is a huge bonus for me.  Every class session, he manages to teach us that little “extra” that isn’t included in the lesson plan.  He believes, and I am in strong agreement with him, that grades aren’t important.  All they are there for is to prove that he is teaching what he needs to, and that you are learning it on paper.  What he cares about, is the end result.  He wants to have 17 people, that he would have no qualms about letting walk into his house and treat one of his grand kids when it’s all said and done.  

My worry about my skills not being honed enough have been squashed here in the two weeks of class as well.  He is a firm believer that ALS means nothing without a strong BLS background.  And without solid basic skills, you will never be a great medic.  So we have worked on those skills.  Twice a week, for 3 hours each day.  Basic skills…the funny thing is, although they should just be refreshers for me, I have learned some things.  Different techniques and way to use those most basic of skills. 

I can’t promise when I’ll be able to post again, but I thought I would give a brief update to keep you all up to speed on how things are going.  Until that time, be safe everyone.  

Wishes

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I started this blog as a way to chronicle my journey through Medic school.  It was supposed to be something I could use to look back and see  how far I had come in my journey, and maybe jog the memory as far as a few funny or memorable moments.  So far, I have followed the plan.  I have poured my feelings, worries, and emotions onto the pages for others to share with me, and to keep myself from imploding in a ball of emotion.  I think I am going to change things up a little bit on this one, as the activity we had in the sky tonight jostled a different type of memory for me.

Back in November or December of last year, I was a bumbling mess.  My inner demons had taken control of me and mentally I was far from okay. A trip to Kentucky came up for work, and I jumped all over the chance.  Not only would it be a way for me to get some solid hours on my check, but it would give me the chance to get away for a while.  Far away from all the distractions and bad energy that had been surrounding me.  And maybe, just maybe, I could find a way to get my head on right, or at least get it started in the right direction.

We stopped about half way to our destination to top the rig off with fuel, and do the usual long distance trip pit stop stuff.  I was pretty quiet up to that point, as I had a million things running through my head and I really didn’t want to stop the thought process.  As my partner was filling up the truck, I was enjoying a smoke off to the side.  It hit me at that point that I was up in the mountains, in the middle of nowhere, in complete silence.  There were no street lights other than the ones that illuminated the parking lot of the gas station.  The hustle and bustle of city traffic was nowhere to be found.  Complete, and utter silence.  That’s when I looked up and noticed the sky…it was like something you would see in a movie.  Stars as far as the eye could see.  It was almost as if a million more had been created just for me.  So close, I felt like I could reach up and grab one and put it in my pocket.  I just stood there in amazement and could not stop looking around.  It was honestly, the most beautiful thing I had ever seen in my life.

it almost looked like this….

night_sky-9030_0

That’s when it hit me.  This was exactly what I needed.  Time away from home, a little peace and quiet, and the fresh mountain air was the right combination of things to get my mind right.  As cliché as this is going to sound, I had this overwhelming feeling of peace and calm surge through my body.  It was something I had not felt in a very, very long time.  I took the driving duties for the first leg of the almost 8 hour ride home.  I felt like a new man.  Gone was the worry, and the fear and depression.  I had convinced myself that even if it was for that one day, it was a welcomed feeling.

This wasn’t just any ordinary night though. We happened to be making the trip during the peak of the Leonids Meteor Shower.  As I was driving along, I couldn’t help but notice the immense number of falling stars I witnessed sailing through the star filled sky.  So, partially because I was feeling like a new person, and mostly because the caffeine levels in my body were seriously low, I started to wish on them.

I’m not a believer in the whole wishing on a star thing, but I’ll be damned if the one wish I kept making didn’t come true.   My life turned around after that trip.  Things improved greatly over the next nine months.  And it only took until the beginning of January for it to happen. Sure, there have been some ups and downs.  But it is nothing like what I dealt with before.

That brings me to the whole point of this post.  This weekend was the Perseids Meteor Shower.  I find myself a little stressed here the last few weeks.  I am losing my “bubble”, so to speak.  As I was outside having myself a breathing treatment earlier, I happened to look up and that’s when I saw it.  Two stars shooting across the sky.  This time, there was about 75% fewer stars in the sky, and there was a Q siren blaring off in the distance, but it didn’t stop me.  Hopefully, once again it will come true and all the stars will line up for me again.

Twelve Months

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One year, twelve months, 365 days.  To some, it seems like an eternity.  Think back to when you were a kid.  It seemed like forever until the next time Santa visited.  When you became a teenager, time seemed to speed up a little.  It seemed that high school flew by.  There are so many things I wanted to do, but it seemed like I never had enough time.  And then adulthood set in.  The phrase, “so much to do, and so little time to do it”, can almost be the universal motto for anyone with a career or a family.  This is how it has and hopefully will work for me.  I know I have mentioned before how I fell on some hard times in the last year.  Well, in case you were wondering, I think now is the time to get some things off my chest. What better time to cleanse myself of my past, then when I am about to embark on the most strenuous 12 months of my life.

At this time last year, I was one day removed from being told I had been fired from a job I had held for almost 15 years.  A place where everyone knew me.  Even the guys with 40+ years in knew me because my grandfather had roamed the same buildings I had at one time.  I was completely destroyed mentally.  I had finally been able to get myself settled financially after six years of struggling through the effects of a terrible divorce.  Everything that I knew, everything that I had fought so hard to obtain and cherish was ripped from me once again.  I started that trip that cost so many people…the trip towards hitting rock bottom.

I filled out so many applications.  Jobs similar to what I was doing…..jobs I was almost guaranteed to get because I had the experience and the skill sets they needed.  Jobs that paid decent, but took me in a different direction career wise.  I figured why not, I have nothing to lose.  And then there was the very first app I filled out.  It was for a small private ambulance company very close to where I lived.  At the very least, it would allow me to maintain my EMT Cert, and hold me over until I found something better.  Two months after I had filled it out, almost to the day, they called.  I had completely forgotten I had filled it out to be honest.  I went and took my interview and was told to go take my drug test.  I was hired.  Little did I know that interview would change my life.

I started the job with all the enthusiasm one normally would when accepting a new position.  I have to admit, I was a little worried though.  Even though I had been an EMT for 2 years, any experience and skill sets I had were based on having at least 3 people in the back of the rig when transporting.  This was going to be a real test of my abilities.  If it had to be done until something better came along, I guess I had to try my best.

I will never forget my first Emergency run there.  Dispatch chirped us over the phone and all I heard was…

I Need you guys to start heading to Rural SNF. I’m still getting details.”

I remember having this huge adrenaline rush.  My first call as a “career” EMT and it was an emergency run.  Not knowing what we had, my FTO jumped in the driver’s seat, I climbed in the officer’s seat, and our Medic climbed in the back.  We started heading out normal traffic.  My FTO told me that it happens quite a bit.  They will send you that way while they are still getting info just to cut down on the ETA.  Just as we were turning onto the expressway, it happened.  They chirped us again.

“This is going to be on a possible stroke. Vitals are……”

To this day I could not tell you what those vitals were.  All I remember is my FTO lighting us up, hitting that gas pedal, and me almost coming out of my seat I was so geeked.  A CVA…..are you kidding me?  Two years as an EMT on a fire department and I am finally getting my first CVA.  I looked back at our medic and noticed he was sleeping on the cot.  Even though I knew he had been doing this since before I graduated high school, I was in shock….“seriously you are sleeping while we are heading to a stroke?” Everything else about that run….hell even the rest of the shift, was a blur to me.

I ran one more training shift with that crew, and was set loose to roam the streets as an EMT. Even though it wasn’t what I had in mind career wise, I had become what I always dreamed of doing when I was a kid.  I was an EMT.  It wasn’t quite at the level of my childhood heroes Randy Mantooth and Kevin Tighe, but it was probably as close as I would get.  I knew this was a different world than what I saw on TV.  Running 911 wasn’t going to be the norm, but yet the occasional break from dialysis runs and doctor appointments.  It would give me a chance to work on my skills though, and hopefully serve as a part-time gig once I found one of those well-paying factory jobs I was so used to working.

I began to develop that camaraderie with my fellow employees, just like I had at any other place I worked.  It was different here though. Because it was a small company, it almost had a family feel to it.  You had the ones that you felt so close to, they were almost like brothers and sisters.  There was the few that seemed to always be looking to stir up trouble.  Just like that annoying uncle that always got drunk at the family function and inevitable pissed everyone off.  More important than the bond I developed with my coworkers though was love I began to develop for the job itself.  I found I was able to really help people.  I was able to make that dreaded Dr appointment a little better by saying or doing something ridiculous to take their mind off it for a little bit.  I started developing bonds with the patients that were regular trips for us.  And to me, that was what this job is all is all about.

It took a little bit, but I started working shifts on ALS trucks.  Me being the sponge that I am, I was always asking questions.  I did it not only to learn a little bit, but also to make me a better EMT.  Knowing what that medic was going to do in certain situations would allow me to better help them.  Things magnified 10 fold when I started working with my Partner in Crime.  I would relentlessly pick her brain and test her knowledge.  She would never admit to it, but I know there were a few times that she was highly annoyed by it.  Every time we had a free minute, or even as we were running to a call, I would ask her things.  Play out scenarios in my head.  It was at that point, and with some encouragement from her, that I decided to become a Paramedic.

12 months….sure I left out a lot of detail.  I mean, who really wants to sit and hear about all the boring details of my life?  Hell, I would probably fall asleep if I had to sit here and read about myself.  So don’t feel bad if you are sitting there nodding off right about now…because I am right there with you.  The next year though, it’s going to be a whirlwind of action, stress, smiles, tears, and hopefully when it’s all said and done, I will be wearing that gold patch on my sleeve.  Twenty two more days and it will officially begin.  One last thing before I head out.  I just want to thank everyone that has given me advice, or an “atta boy” up to this point.  Without your help and support, I don’t think I would be getting ready to do this.  I especially want to thank my PIC.  You are the driving force behind my desire to do this. I know I’ve said it before, and I’m sure you’ll hear it a million times more, but I hope the end outcome of this is me being just as good at what I do as you are.  I know you kid about torturing me in labs.  But I hope you do.  I want you to push me to be the best.  Because you know I will accept nothing but as the end result.  Thank you, Thank you, Thank you.

One year, twelve months, 365 days.  That’s all I have left.  To me, it’s ironic how the same amount of time that has brought me so much pain and suffering, will also be the amount of time that is going to see me reach my dream, and get that gold.

medic patch

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