cotjockey

4.Your idea of fine dining is anywhere you can sit down to eat... 5.You get an almost irresistible urge to stand and wolf your food even in the nicest restaurants... LOL...a friend and I just finished taking PALS. The second day of class, everyone in the class and the instructors went out to lunch together. The nurses in the class took twice as long as the EMS people did to eat...you could almost tell who was EMS and who was a nurse just by watching us eat. Sometimes I think I need to work on my table manners...

I usually turn the radio off...I like to hear what dispatch is saying and now and then, someone on the fire department says something important when they get on scene. We also have a bunch of citizens out there in scanner land who have called the fire chief to complain that they heard a radio in the background when the ambulance personnel were on the radio. With the radio off, I miss less, I don't get as many citizens all fired up, and I don't have people looking at me funny when I sing along with the radio.

I'm not sure how becoming a paramedic will help you become a physician. Most of the classes don't apply toward pre-med, the clinical experience is very different, and if you want to go for the MD, it makes much more sense to start with the medical classes right away...paramedic school takes a lot of time and dedication, which if you truly want to be a doctor, could be better spent. (I hope the grammar police don't come after me for the run-on sentence!) My paramedic class was full of people who said they were taking it to bring them one step closer to the RN...NONE of the medic classes applied toward the RN program. If you truly have the goal, go for it...but, don't take baby steps that won't benefit you in the future.

It's not that I didn't appreciate what the RN did...it was just time for people who had crazy things like glucometers and IVs and meds to take over. It seems to me that once you have more definitive care, bystanders or EMS or whatever needs to step out. There was nothing more she could do. If a nurse doesn't promote someone to a charge position simply because that person blew them off once, they are wrong. She should have realized that she was out of her element and he was in his...just like I wouldn't walk into L&D and try to run the show, nurses with no EMS experience, should not try to run the show on an EMS scene. Once I get my patient to the ER or L&D or where ever, they are no longer my patient...in the field, once EMS shows up, the patient belongs to EMS. In my case it was obvious that the RN either didn't know what she was doing or simply had one of those moments where she just wasn't thinking...she asked what I was going to do with the D50 and then questioned whether it was OK for us to do what we were doing. Again, it makes us look bad when someone who is well known in the community as a medical professional questions our practices. Before I knew better I would have put more faith in the RN than the EMTs if it were my family member...if she questioned what they were doing I would wonder if the EMTs really knew what they were doing. I don't deny that I could have handled it differently. Every few years the fire department / rescue service runs an article in the newspaper telling what we do, what kind of training we have, how citizens can help...I think it is time some someone to write an article.

I have to wonder what the reaction would be if the story were told from the RN's point of view. I was walking out of Burger King, when I heard someone screaming for someone to call an ambulance. I went over to investigate and found a lady slumped over the steering wheel of her car...she was barely responsive. As I tried to talk to her, someone came up to me and said, "Hi Kelly, what do we have?" I told her that the lady was very sick. She asked me to move and I told her, "I am a RN." She countered with, "But I am a paramedic." I again informed her that I am an RN and she told me, "OK...but I have D50." What was she going to do with D50? They got the woman into the ambulance and I went over to see what they were going to do. They pulled her coat over her head even though it was freezing outside and they began their search for a vein. When they finally found one, they inserted the line and started pushing D50 without even calling the doctor to ask permission. I asked them if they had called to get orders and one of them said, "No, we don't have to." Another one said, "You'll need to move so I can shut the door." I stood there for another minute or so when she said, "I'm shutting the door...move." How rude! I am an RN...I used to supervise the one who told me to move when she worked at the hospital...and now she is telling me to move? And these EMTs are telling me they don't have to ask permission to give meds? What is that about?

I knew the patient was diabetic because we pick her up every other week or so. I did ask the RN what she found and she said, "This lady is sick." I then asked if she could move out of the way so I could start getting vitals and things when we started the "But I'm an RN" conversation. I'll admit I should have handled it better, but sometimes the only thing that works is saying "You need to move so I can close the door" instead of "Excuse me." "Excuse me" doesn't always work. I really think she was out of line to be questioning what we were doing...again, I don't walk into L&D and ask her if she checked with the doctor before she increased the pit...I know that L&D is her world and I trust her to do her thing. If we were doing something obviously negligent, sure she would have the right to intervene, but we were doing exactly what needed to be done. I don't have an issue with nurses in general...just a few that I never really got along with in the first place. When I worked at the hospital, I got along with everyone pretty well...sure I did the head butting thing on occasion, but everyone else did too. This particular RN is generally awesome...more than anything, I think she wasn't thinking Saturday afternoon. I also think that a lot of them forget that when I step outside the hospital doors, I have a totally different scope of practice...I can do all sorts of things that I can't do as an LPN. It's pretty rare that I will pull the cocky paramedic bit with people, but occasionally, it needs to be done...just like they sometimes need to do the "because I'm an RN" bit with me. This was more a vent than anything...sometimes I think we all need to spout off a bit about the things and people we encounter. I'm sure she would complain about me equally if I wouldn't get out of her way while trying to provide care for one of her patients.

When I bring a patient to the ER, I give report, help transfer the patient to the ER cot, and get out of the way. I honestly expect the same from bystanders...especially those that know they can't do anything for the patient when we, as EMS providers can. We couldn't have gotten the patient out of the car because she was standing right there in the doorway and wouldn't move...we couldn't even get close enough to check a pulse...and the passenger door was locked and she didn't seem to hear us when we asked her to unlock it. This RN is one that has no emergency experience, so I'm not sure why she wouldn't let us have access to the patient or why she was coming over to our ambulance to ask us if we had permission to do what we were doing. We have a protocol for what we do, so most of the time, we don't need to call for an order. When the patient is crashing and has a blood glucose of 24 and horrible veins, is not the time for us to explain that to another medical professional. Having someone who people in the community know is an RN (and a very good and respected one) question what we are doing puts us in a bad light...it makes people think we are just going off all willy-nilly and sticking needles into people and injecting medication. There are people in the community who will think that...we've had more than one phone call about it. She couldn't do anything for the patient...she should have backed off when EMS arrived. I don't interfere in her world, she shouldn't interfere in mine. As for my ICU experience...I am an LPN that worked in ICU, practicing under mainly my paramedic license. It was a disaster from the word go and looking back, it honestly seems like it was set up to fail. When I was in the hospital, I had to get permission from an RN to do anything with my patients (which is not unreasonable, since I am an LPN) many of whom had never titrated a drip, can't read an EKG, or whatever. A lot of the other nurses did not understand how my scope of practice differed from the other LPNs...it was explained a dozen times or more, but I consistently had other nurses telling me I could not start IVs, I could not document what I saw on an EKG, and that I did not have the knowledge to decide that the dopamine needed to be titrated up or down. I was always under the impression that I was good enough to do it in the ambulance, I was good enough to ask for advice when they wanted it, but I didn't dare go off on my own and tell someone their patient was in a complete heart block, because I am "only an LPN." But...when they asked me to interp a strip or weren't sure what to do with the rhythm, I was their person to go to. Yeah, it makes me angry...I thought this was a good place to vent. And the CPR class...we have a ton of snow and ice on the ground and I don't like driving in it myself...I certainly don't want to take the chance of getting in a crash with someone else in my car. I'm a bit paranoid about that. Even if I didn't feel that way, my car was in the shop, so my husband was stuck driving me around...he wasn't really happy about driving me up the street for the EMS call, he would have come unglued if he has to pick up one of my CPR students. I'm not sure who else I could have had her call...we don't have taxis, we don't have buses, and the ministers and church groups who give people rides for things only do it for medical appointments, grocery shopping, etc...their service is not for someone who wants to take a CPR class and ran out of gas or whatever happened to her car. This person has taken the CPR class from four other people and she ends up messing around all through the class...she'll sing during the videos, talk on her cell phone during lectures, make designs on the answer sheet instead of trying to fill in actual answers, and pretends to have sex with the manikins. She has made passes at two of the male instructors and since I am the only female instructor, they thought it would be best for me to try and get her through. Some of the other instructors feel like they have to put up with her antics since she is paying for the class...since I don't charge my CPR students, I would have been very comfortable telling her that if she was not willing to take the class seriously and do what needed to be done, she would need to reschedule for a time that she was willing to be serious. I honestly don't know what else to do with her...they don't teach you how to deal with students like her in the instructor class. I could have been more diplomatic and probably should have, but either way, I was not going to pick her up...I don't appreciate the sense of entitlement...I was already going to do the class fro free, I was already going to pay for her card, I was already giving up half of my Saturday to help her out.

We were once dispatched to a patient complaining of abdominal pain because of "sclerosis of the river."

LOL...it left me shaking my head. I don't think I could write a book...I do talk a lot though!

Yesterday was a busy day for our small volunteer service...seven calls in 24 hours...we usually don't get that many in a week. Our first call was a woman who is very well known to us, she was sitting in a restaurant parking lot in a very nice hypoglycemic state. I arrived on scene first, since I was at the restaurant two blocks away. As I approached the scene, I saw an RN who I know rather well trying to talk to the patient. I identified myself (even though she knows who I am) and asked her to step aside. She looked at me like I asked her to get naked or something and stated, "But I am an RN." I sort of rolled my eyes and said, "I know that, but I am a paramedic." She again replied, "But I am an RN" to which I replied, "But I have D50." She again gave me that sort of dazed and confused look and said, "What is the D50 for?" At which point the police officer on scene told her to get out of my way. She watched as we moved the patient to our ambulance, tried to get in as we pulled her coat over her head so we could get to her arms and find a vein, and then stood in the doorway of the ambulance, asking if we had called for an order to give the D50...I told her to move and closed the door. So...we get the patient safely to the hospital and as we are finishing paperwork, I hear my name being paged over the intercom. Since I don't work there anymore and most people who know me know my cell phone number, I was a bit confused. I pick up the extension and hear a voice on the other end saying, "Yeah, will you pick me up?" "What?" I asked. "Yeah, this is Mary, and you are supposed to do my CPR class today, and I need a ride. Do you know where I live so you can pick me up?" "Umm...we generally don't provide transportation for CPR students." "But I'm going to pay for the class," she says. "I'm not picking you up...that is not part of the deal...besides, my car is in the shop and I don't think my husband should have to provide transportation for my CPR students." She starts to sniffle and says, "So, what time are you going to pick me up?" "I'm not," I said as I hung up the phone. Mary is an interesting duck...I'm pretty sure she has some sort of diagnosable medical condition that causes her to be a bit slow mentally, but I can't say for sure. She used to date three of our "civilian firefighters" (people who get to say they are members without training, fighting fire, etc...they usually make food runs and help us wash trucks) who are all mentally challenged. She has taken CPR from four other instructors and has not been able to pass the written or the practical. She just doesn't get it...and I was her last hope. She is a "comfort aide" (she passes ice water, empties trash, visits with residents) in a local nursing home and says she is going to go to RN school. I suppose I could have picked her up...I'm just postponing the inevitable, because I know I am going to have to do a one-on-one class with her eventually, but I was in no mood to do it. She makes designs on the exam paper instead of answering the questions or tries to make all of the answers 'C' or something every time she takes the written test. She sticks her tongue in Annie's mouth and makes moaning noises when she tries the practical. I am enough of a witch that the other instructors felt she wouldn't pull the games with me. Sigh...I am off to pray that she finds someone else to do her class...and that she never takes care of me if she makes it to RN school. Thanks for listening to me whine / complain / vent / etc...

OK...I am terrified of zebras...not a bit of logic behind that, but I still just cringe when I see them on TV or in the zoo or whatever. I don't like zebras at all. I also don't like dragon flies...I just know that one day a big dragon fly is going to bite me adn chew all of the flesh from my body and cause a very slow and painful death.

Dustdevil is very wise...

The one time I went to a CISD, I walked out of there feeling more angry than I did when I walked in. For one thing, one of our lieutenants kept telling me I was violating the patient's right to privacy and breaking confidentiality rules...I wasn't saying anything that everyone there didn't already know. The first person on scene, who ended up seeing most of the horror was crying so hard she was literally screaming and shrieking at the top of her lungs...it scared me to see how upset she was. And then...when I had to pee, one of the leaders wanted to go with me...I guess that is pretty standard practice, but I had no desire to pee in a 3' x 4' bathroom with someone staring at me. They also told us we were not allowed to swear...I know swearing isn't nice and it isn't that big of a deal, but I had some choice words for one of the people involved and somehow calling her a mean lady just didn't feel the same as calling her a F****** B****! LOL.

One other thing we did...had a volunteer that was a HUGE know it all punk...drove everyone nuts. So...one weekend, he went out of town for training and took a department vehicle. We have sort of an unwritten rule that you are not supposed to leave your vehicle at the station overnight unless you are pulling a shift, but he didn't care. He parked his truck right hear the door and told the paid guy to "watch it" for him...also gave the shift guy a nickel and told him to have it washed and waxed when he got back. The shift guys that were on from early Friday morning until late Sunday night went out every few hours and gave his truck a light spray of water...this was the middle of January and it was COLD. By Sunday night, there was a huge coat of ice all over his truck...I don't think he could get into it until Tuesday or Wednesday. I doubt that he will ever leave his truck there overnight again.

I have a few that might be funny...I thought they were, but after reading this, I think I may need to go back to grammar school! One of our paid firefighter EMTs was a bit of an unpleasant person...I don't know if he thought we were cute or easy or desperate or what, but he gave three of the female volunteers a key to his room, hoping we would visit him during his shift. Well, he didn't get so lucky. He did get his bed, baseball cap, shampoo bottle, and dresser sprinkled with glitter...the really fine almost powdery stuff that sticks to everything...three years and two firefighters that have used that room later, there is still glitter in that room. On my birthday last year, one of the paid guys filled my bunker boots with Jello...the kind that sits on a shelf in the grocery and doesn't need refrigerated. LOL...I got to walk around a fire scene for four hours with my feet squishing in Jello...and my boots are still pink on the inside. One of our paid guys had a "friend" that liked to visit him at night. One night while she was visiting, our assistant chief had dispatch set off a test page...I heard he got caught in the zipper while trying to get dressed as the tones went off. Another one that wasn't really a prank, but was sort of funny...we were sitting around eating cake one night and one of the guys thought it would be funny to put icing in my hair. (I have expensive pink highlighted hair). I was going to get him back and ended up chasing him all over the station, hoping to catch him and smear icing on his bald head. So...I was hiding under a brush truck and when he came by, I jumped out at him...caught my shoulder on the bumper and ended up getting a new shirt, 18 stitches, and a tetanus shot. Still haven't got him back for that one...will have to start planning.

I think it happens in all lines of work, not just the adrenaline types...teachers, accountants, grocery clerks. I think one of the reasons people notice is because a lot of the adrenaline junkies brag...we have a lot of down time and it eventually comes up in conversation. Also, police, EMS, firefighters, teachers, nurses, doctors, etc are held to a higher standard than the accountants and grocery clerks. People seems to think that because I have a sparkly gold patch on my shoulder and I carry a radio that I shouldn't do things like that or that I need to carry old ladies groceries or let men in suits ahead of me in the fast food line. It is amazing what people expect from those of us in the public eye. Its is wrong or right? Not for me to judge anyone else...I do often wonder why so many of us do it. Is it the risk? It is the adventure? Is it because we start to have those sort of feelings for people we spend so much time with? Or are so many of us so starved for physical contact that we will take it where ever we can get it?

What is your name? cotjockey (don't wanna put my real ID on line) When is your birthday? January 21 Eye color? Green Hair color? Brown with blond and pink highlights What nationality(s) are you? Polish, German, Swedish Any piercings? Three in the left, two in the right Any tattoos? Not yet You have three wishes, what are they? 1) Be debt free, 2) Get into RN school, 3) Lose 40 pounds What sound can you not stand? Our favorite drunk screaming, "Girl! Girl! Come over here and see what I got for you!" Special talents? Ummm... What is the first thing you do when you wake up? Go pee What is the last song you sang? "I Love this Bar" Do you play any instruments? Trumpet, piano, and kazoo Do you know any random facts? Yes BE HONEST- Do you listen to show tunes? Dear Lord, no... Do you want to go to college? Yes Whats the first thing you do when you get home from work? Take off my scrubs Is there anyone you are desperate to meet? Nope Do you dance around your house when nobodys home? Only if naked Favorite quote? "Growing old is mandatory, growing up is optional" Main source of exercise? Walking Yay or Nay Diet Pepsi? Nay Kids? Yay Bread? Nay Hair cuts? Yay Hiking? Nay Black and white photography? Yay Coffee? Nay What C.D.s are in your stereo right now? Toby Keith, Seether, Maroon 5, and 50 Cent Guilty pleasures? Pizza and whiskey If you had to eat one meal for the rest of your life, what would it be? Enchiladas made by the lady down the street Speak other languages? Enough Spanish to get me in trouble Favorite song (as of right now)? "Remedy" Favorite flower? Daisy Contacts, glasses, or neither? Both Hometown? Right here Favorite Drink? Jim Beam Have you ever been in love? (depending on what your concept of love is) Afraid so... Have you ever been skinny dipping? No Assertive or passive? Passive Sing in the shower? Nope Any regrets? Yes Do you swear? Uh-huh Do you have any pet peeves? Stupid people, people who know everything, and people who talk to much (you know the ones who always talk and talk and then they talk some more and never realize they talk too much because they just can't stop talking?) Favourite Ice cream flavor? Bubble gum Member of the red light club? More than once