Seth412

I suck at thinking fast. I'm one of those guys who gets into an argument, then 20 minutes later a point that would have won it for me, or a totally new angle of looking at the Isubject finally comes to mind, but it's far too late. Or witty retorts, I just can't do it. i am a slow and methodical thinker. Given time I can dissect a subject, view it from multiple positions, and determine the best course of action and the best way to present it for discussion.

I'd be a good person for a Thinktank.

I've been in EMS for 35 years. As some have already said, given time this stuff will become second nature for you. I can remember how stressful my first ACLS megacode and exams were back in 1993. Today I can walk into a refresher course, write the exam and get into the mid 90s, use my megacode practice time to run through my exam, and leave the class in a couple of hours. It tends to make the docs and nurses in the class a little green with envy too as they struggle through their class. Sometimes I'll stay and tutor my classmates, just for the EMS brownie points.

My biggest problem now is that so much of this stuff has been ingrained into me that it requires thought NOT to do stuff. Last few asystole codes I've run I had to resist the urge to give atropine....and a couple of times I gave it anyways because I didn't have anything else to do.

I'm the exact same way. In a face to face debate, I can't think of anything to say. Over the computer, when I have time to think and formulate my argument, I'm quite a force to be reckoned with. I can approach any issue from a unique and thought provoking standpoint, even if I don't know much about the issue. In person, I draw a blank.

Have you got your anxiety disorder and OCD under control yet?

Yes or no.

First off, thanks for the replies all. Ugh I'm just stressing about the job. There's so much for me to improve on and it just is a bit overwhelming right now. I guess I need reassurance that what I'm experiencing is normal. Maybe the OCD talking

But yes, it's as under control as it's going to be. As far as I can tell, my stress reactions have been normal. Some buttferflies going out to the call, and like I said, difficulty focusing, but I think overall I'm adapting well for someone with these types of issues. Long term, I don't know. We'll have to wait and see. I'll let you know how it goes in the following months, to give you all some perspective on how someone with an issue like OCD adapts to this kind of work. So far I can tell you that I do seek reassurance and guidance probably more than the average person.

EMS teaches us things about ourselves, doesn't it? My employment background is mostly light industrial type stuff. Mostly it's procedure, and once you learn that, there isn't much thinking on your feet. Mostly repetition. So coming into the field, I did not know how well I do under pressure.

Turns out not very well. When I'm put on the spot in a stressful situation, I have a hard time focusing on even simple tasks. I feel I have gotten better since I started, but certainly not up to par with how an EMT should be. Is this something that can be resolved with effort and experience? If so, some tips would be very much appreciated.

A lot of folks experience this when first starting out in EMS.

Unfortunately EMT class is not good at preparing newbies for the reality of what we deal with on a daily basis.

It is more concerned about getting students to pass the exams, than real life learning.

I've always said it takes the average newbie a couple years to find their way and get comfortable with what we do for a profession. by then you get exposed to just about everything we deal with.

The DOA: no biggie, beyond anyones help. Don't let them bother you as you will see a lot of them in your career.

Be supportive to the family members and move on to the next call where you might make a difference.

Everyone learns at a different pace and we all make mistakes. Just learn from them and don't repeat them.

Good luck, we are here for you to vent to.

My mistakes are small and, in retrospect, kind of silly. On one call I failed to get the gurney out of the ambulance. Pressed the wrong buttons. I felt that I made up for it in the way I handled patient care in the back of the ambulance. I got a O2 sat, temperature, helped the pt remove clothing, and held a wet cloth on her head (temp was 102.8)

Thank you for listening. My first week was rough. Not used to being put through that kind of stress on a job. My background is manual labor. Generally stress free so long as you have a good supervisor. Does it get easier as you get used to it?

There is a huge difference between class and actual EMS. It's like, not even the same thing.

Don't sweat it. Medicine is a new environment that takes some getting used to. You will always have those calls/patients that will stick with you forever but in time you will learn that it is not your emergency and you get to go home to your family, which is all that really matters. Make sure you have someone in the field you can talk to. You can talk to those on the outside but they will not fully understand it (sometimes all you need is someone who will listen and be sympathetic even if they don't have a clue what you are talking about). Your "partner" is a douche and should not be listened to. We all learn at different paces and all start with a different level of knowledge on which to build. I'm not sure how you judge someone as a "below average" EMT as there is not much to judge an EMT on. Generally the "below average EMT" is someone who does it for the glory, the action and the lights and sirens. If you are doing it to help people (as cliche as that is) they you are already above a large portion of your cohorts.

If you want to survive in this field you will need tough skin and will need to learn to say, "Fuck them," even if it is just in your head. You sound like you have a good head on your shoulders and are doing it for the right reasons, just keep doing what you are doing.

Thank you. I told him he was wrong and that I'm going to prove it. I've never been subjected to this level of stress before, so I think you're right in that it will take some getting used to. When I think about it, I'm coping better than I give myself credit for. I'm reaching out to people and I'm avoiding alcohol. Even a single beer with dinner. I'm going to stick with it. I got into EMS for a variety of reasons. I believe I will be good at it as soon as I get the hang of it, and I want to do something that matters. Something that gives back, you know? The lights and sirens are a cool plus, but that's not my primary reason.

So my first week on the job has been pretty eventful. I've had a variety of calls, the most stressful of which being a DOA and a possibly septic patient (fever, tachycardia, low blood pressure). In the moment, I do okay as far as coping with stress. I do what my partners ask me to do to the best of my ability and I certainly don't freeze up. However, the stress that I put myself through seems to sink in after the shift. I experience anxiety, depression, fatigue, and loss of appetite. It's my first day off and I'm feeling not so good. I'm hoping that it gets better with time. I've made the decision to stick with it and teach myself to cope with it the best I can. Any advice is appreciated. If you don't feel I'm cut out for the field, let me know.

Also, something else that has me a bit stressed: I'm a slow learner. Every new job I take it takes me longer than average to get comfortable and learn the ropes. One of my partners told me that I'm I'm a below average EMT and that I won't last in the field. Given the nature of the work and my delayed learning, I saw it coming. Still not a nice thing to hear :/

Some courses, such as Mari's, are longer. However, for EMT-B, that is rare. Most courses are of the two week accelerated course to three month standard length course variety. Some classes may be four months if they stretch it.

Why are you under the impression that EMT-B is a two quarter sequence?

When you say you're having trouble getting yourself going what do you mean? Like depression kind of motivational issues? Laziness? Stayed up too late drinking beer and playing video games? Shift work doldrums? Something else?

What's up?

Figuring this out now before getting into EMS, a profession known to have moments of intense emotional stress, might be a good idea so that you've got some good coping mechanisms in place before making the switch.

Let us know. We may be able to help.

Thank you for your support. I really appreciate it.

It's nothing of the depression/emotional distress variety. It's more of the just not a morning person variety. It always helps if I have something in the morning that I have to wake up for (work, school, events, volunteer stuff, whatever), because afterward the feeling is gone and I can proceed with my day. What it amounts to is lighting a fire under my own a** when I don't have anything going on, because that's when it takes me until noon to get myself going.

As far as my current situation, some unanticipated days off have given me enough time to get caught up. So I'm going to give staying caught up another shot with my time management issues in mind. Speaking of such, time to get off the comp and study.

I'd say it's more of the time management variety. I have trouble getting myself going on my days off. I wouldn't say that my job is making me second guess EMS. Definitely not something I can see myself doing long term. The plan is ultimately to quit as soon as I land a job on as an EMT.

But I was under the impression that normally, an EMT course was a two quarter sequence.

It's a 3 month course.

Thank you. For the record, I reside in Clark County, WA. Not much in the way of EMT jobs here unless you're in Fire, as the Medical director doesn't want anyone on the ambulance who can't run an IV. That means at the minimum one has to be IV tech. Very close to me in the Portland, OR area, which is where i currently work and includes a few counties within it. AMR and Metro West operate here and hire EMTs. This is where I'd work if I were to do it locally.

I have an aunt and uncle who live in Seattle, WA, (King County), and they would let me stay with them temporarily if I have a job lined up, which means I can look there as well.

Those are my options.

This whole UPS thing has turned out to remedy itself. All of the new people are temporarily laid off from work on low volume days (goes by seniority), so this past week I've only had to work two days, so I've gotten caught up somewhat. However, once the holidays start rolling around, it will be high volume every day and I'll face this problem again.

Thanks for the replies, all. It isn't that I'm having trouble with EMT-B, I'm catching on fairly well. It's a matter of having enough time in the day to do all of the reading and assignments on top of working hours which vary widely depending on workload (sometimes I work next to nothing, other times WAY too much).

The issue is, if I drop the EMT course, I'm about $1000 in the hole. Money which I saved up specifically for the course. And I have to do it all over again if I start over with another course.

I don't need the job for the money (parents have no problem helping with expenses so long as I'm in school full time. I have excellent parents). I need it for the reference. It's looking like the choice is going to have to be quitting. I'll go over it in my head a few more times, though. Do I want to save up 1000-1500 for another course in order to keep this reference?

Thanks again, everyone.

I posted a thread not too long ago regarding some of my concerns about becoming an EMT. I'd like to thank all who replied.

Another thing that has been eating at me: I recently landed a job at UPS in addition to my EMT course. This job is my first real job outside of working here and there for temp agencies and under the table. Needless to say, my resume doesn't look too impressive.

I love this job, but unfortunately I may have to quit. I'm in one of those accelerated EMT courses and I just can't keep up. I'm about 5 chapters behind, and I can only salvage the course if I drop the job.

This means that my only solid reference is gone. I'm really stressed out about it. Can one have any hope in landing a job anywhere in this field without a steady work history?

I suppose I could drop down to four hours of sleep a night and catch up that way.

Dude, I already gave you a scenario that was nearly my breaking point. Car into the water -5 dead. As long as there is a support system in place for you or that you have that support some other way, then you can do this but with teh OCD how well will you cope with the obsessing part is entirely foreign territory for you and for me to determine.

I can't even imagine running a call like that, especially being the only medic and having to make a decision.

I'm giving myself until Monday to make a final decision on whether I'm going to take the class this fall or not. If not, it's plan B, back to acquiring credits for an accounting degree. It's funny, EMS and accounting have to be polar opposites. I've also put some thought into being a CMA or a Radiology Tech.

Thank you. Yea it's really hard for me say how I will react to the buildup of stress. I imagine, due to the obsessive nature of my mind, that the big difference between me and others is that my breaking point will come a lot sooner. Do you ever get used to the job, seeing people dying and suffering? Or does it suck every time you see it?

Just bumped up my SSRI dose. Higher doses are supposed to work better for OCD, so we'll see if there's any improvement.

I was more concerned about the cumulative stress and how it will affect my mental health.

I'm getting things under control as we speak.

I think everyone just wants you to be informed of the decision you are making. I wish I had heard half of what this board has to say before I became an EMT, just because when I started I wouldn't have been so surprised at what we actually do.

I recently ran a hard call and because of that I want to tell you to run away, because right now I want to run away. We do things that change people's lives. Even when there is nothing we can do, we still become the person that tells someone that their mother is dead, or their child is dead. We become the person that the family hates, or loves. It is a huge responsibility for anyone.

So, don't take their advice as an insult, take it as some people with quite a bit of experience trying to help you make the most informed decision you can.

Thank you. I was never offended by triemal's posts (although through his obvious frustration it appears he was offended by mine). I was offended by a post a few pages back, and perhaps I should not have been. Saying that if I need medication for day to day life, I'm unfit for EMS. I guess I took it like somebody with no history of mental illness looking down on me without even a shred of understanding, like I'm inferior. That's why I reacted the way I did, because it was such a black and white response.

To be truthful, I'm 23 and I have no idea what I want to do with my life. EMS has for a long time been an idea on the back burner. I've always found it fascinating. I think I'm going to give the class a shot and see for myself. I guess the biggest dilemma now is, could I use that money more constructively?

There are certain people on this thread that won't be satisfied until they hear me say "I quit, I won't pursue this as a career." I think it's totally reasonable that I give it a try, all advice considered. Worst case scenario, it will be a bit much for me and I'll go to plan B.

For the record, It's better that I get a realistic view of what I'm up against and I appreciate those who have provided that. You seem to be upset that I'm not following the "you should quit now" advice, and you seem to think that because I have made a different decision that I have disregarded it altogether. You've invested a lot of energy into expressing your views and your frustration has been more than noticed. No need to worry. I have considered everything.

Because I've decided to do something other than what you've told me to do, doesn't mean I haven't been listening. Although you misunderstand my illness (questioning my ability to separate the important from the unimportant out in the field, not how my illness works. I ruminate obsessively after the fact. It would be more like going home and obsessing about whether I did everything right) you have given the best advice i've heard as of yet and I assure you it's taken into account. Can we end the hostility?

Because I say I'm going to give it a shot does not mean I'm not listening. Would you rather me say "okay, I won't do this."

Yeah...that was pretty pathetic. Try again.

Here's the thing...all the posts that have suggested you think twice about getting into EMS, not get into it, or that there will be huge difficulties for you...they've all given some very clear reasons why someone with your problem wouldn't be a good fit. The fact that you refuse to listen means that, yes, you are cherry-picking the answers you want to hear and ignoring everything else.

Whether you like it or not, you have been given several things you need to think very hard about before you try and get involved in EMS, or any other kind of medicine. For everyone it's not as simple as "I'm gonna do this no matter what and downsides be damned," and doubly so for you. Until you get your meds worked out and your condition under control you shouldn't even be considering this. Once it is and you've figured out how you well you will function, then you should take an honest look at what has been said and make a decision.

But you obviously aren't capable of doing that.

For some reason I highly, highly doubt that will ever happen.

And who says I'm refusing to listen? Did I not make it clear in my last post that I've been hearing all advice? Would throwing in the towel right now before I even begin qualify as listening to your advice? All responses will be considered. I'm working to get everything under control now. My class starts in a month and a half. I'm going to attend and see how it goes.

Yeah...that was pretty pathetic. Try again.

Here's the thing...all the posts that have suggested you think twice about getting into EMS, not get into it, or that there will be huge difficulties for you...they've all given some very clear reasons why someone with your problem wouldn't be a good fit. The fact that you refuse to listen means that, yes, you are cherry-picking the answers you want to hear and ignoring everything else.

Whether you like it or not, you have been given several things you need to think very hard about before you try and get involved in EMS, or any other kind of medicine. For everyone it's not as simple as "I'm gonna do this no matter what and downsides be damned," and doubly so for you. Until you get your meds worked out and your condition under control you shouldn't even be considering this. Once it is and you've figured out how you well you will function, then you should take an honest look at what has been said and make a decision.

But you obviously aren't capable of doing that.

For some reason I highly, highly doubt that will ever happen.

Pathetic? Dude, I've obviously struck a nerve. You're a Paramedic. Shouldn't you deal with stress a bit better than this? Relax, bro. Everything will be okay.

You've got points going for you already Seth.

Many folks come here and get the kind of responses your getting and fade away to never be heard from again.

+1

Thank you! Can't scare me!

But for real, I figure it's worth a shot. I have the class all paid for. I'll do a few ride alongs with the fire department, see how it goes. If it's too much for me, I'll do accounting or something. Already have a few credits toward that. I'll balance the books of an ambulance company and pretend like I'm part of the team.

Because being told something that you don't want to hear doesn't mean you were given incorrect information. Just because you don't like the answer doesn't make it wrong.

Now, you again have made it clear that you don't want any real advice and will only listen to things that confirm what you want to do, but hey, maybe somebody else will get something out of this.

No, you aren't. You may have a very general idea, but until you have done either for quite awhile you don't have a clue. You don't know what your responsibilities will be, what your reactions will be, how your body will react to different types of stress, how your mind and emotions will react to different types of stress, you don't know what your real role will be in various situations and how that will effect you, you don't know what you will see doing this, what you WON'T see doing this, you don't know how your view of all of these things may change over time, you don't know how your view of regular life may change over time, and so on and so forth.

It should be. You don't have any abilities yet. You may have been through an EMT class before, but that is not the same as actually practicing in the field.

Perhaps before you go any further you need to get your medications sorted out. Forget EMS, isn't this something that you should do so that you can improve your daily quality of life? Get that taken care of first, until it is everything else is moot.

There are lots and lots of "insignificant" things that you will come across that will have bearing on your patient care. There are lots of "significant" things that you will come across that will have bearing on your patient care. I'll ask again, if you are constantly worrying about these things and are unable to seperate what you should actually be concerned about from what doesn't matter, how will you be able to effectively treat your patient?

It's great you are worried about the cumulative build up of stress; that is something that everyone should worry about, but your bigger concern should be your other problems. As you describe them, and since you are currently not able to control these problems with medicine, you have issues that make you a poor fit for medicine.

Get them under control, and maybe that will change.

Or just continue blithely down your road of only hearing what you want and pretending that nothing else matters.

Sounds like someone is a little worked up about my responses. I'll have you know, I have been hearing all of the responses on this thread. So chill out. While it is true that because I don't like an answer, doesn't make it wrong. I happen to know the particular answer I responded to, the one you're so worked up about, is wrong. It isn't as black and white as "take medicine, can't be in EMS. Don't take medicine, can be." That was a garbage response, and I treated it as such. I'm a very comforting person, that's something that I believe will help me in EMS. If you need a hand to hold or a shoulder to cry on to help you through this thread, I'm here for you buddy. Thank everyone else for the replies.

Because being told something that you don't want to hear doesn't mean you were given incorrect information. Just because you don't like the answer doesn't make it wrong.

Now, you again have made it clear that you don't want any real advice and will only listen to things that confirm what you want to do, but hey, maybe somebody else will get something out of this.

No, you aren't. You may have a very general idea, but until you have done either for quite awhile you don't have a clue. You don't know what your responsibilities will be, what your reactions will be, how your body will react to different types of stress, how your mind and emotions will react to different types of stress, you don't know what your real role will be in various situations and how that will effect you, you don't know what you will see doing this, what you WON'T see doing this, you don't know how your view of all of these things may change over time, you don't know how your view of regular life may change over time, and so on and so forth.

It should be. You don't have any abilities yet. You may have been through an EMT class before, but that is not the same as actually practicing in the field.

Perhaps before you go any further you need to get your medications sorted out. Forget EMS, isn't this something that you should do so that you can improve your daily quality of life? Get that taken care of first, until it is everything else is moot.

There are lots and lots of "insignificant" things that you will come across that will have bearing on your patient care. There are lots of "significant" things that you will come across that will have bearing on your patient care. I'll ask again, if you are constantly worrying about these things and are unable to seperate what you should actually be concerned about from what doesn't matter, how will you be able to effectively treat your patient?

It's great you are worried about the cumulative build up of stress; that is something that everyone should worry about, but your bigger concern should be your other problems. As you describe them, and since you are currently not able to control these problems with medicine, you have issues that make you a poor fit for medicine.

Get them under control, and maybe that will change.

Or just continue blithely down your road of only hearing what you want and pretending that nothing else matters.

By the way, I live in the great Northwest as well. With any luck, I'll end up working in your ambulance

Thanks for the replies everyone. I appreciate you offering me some perspective. All advice has been noted.

Are you ready or do you think you will be ready to be the only medic on scene of a car full of kids who went in to the water. Your backup is 25 minutes away and you have 4 firefighters on a single pumper there to help. 3 were pulled out, CPR in progress and you have two more kids in the water. Which kids do you work? Which ones do you call? Do you go into the water for the kids in the car or wait for assistance?

Are you ready for the family of the above victims to be screaming at you, threatening you if you don't work their kid? Which kid do you let die because HELL you are the only medic and your resources (YOU) are finite and you cannnot do it all.

Are you ready to face that kind of situation?

I don't think anybody is ready to face that situation, or ever will be.

Seth: everyone handles the cumulative stressors of this profession differently.

Some play the macho man "nothing bothers me and end up eating a gun barrel , or drinking themselves into a stupor after work, others cope by doing the very best they can according to their training & knowledge , then afterwards find a healthy release of those emotions.

Anyone who has been in EMS for more than a few years will tell you there are calls that affected them deeply.

It's all in how you let those demons out that will determine whether or not you can continue to do this for a long time.

In over 4 decades in EMS I've seen and dealt with things that would make many "normal" folks run away screaming and learned how to deal with my emotions in a healthy release that doesn't involve alcohol, drugs or other destructive behaviors.

no one else can predict how you will be able to deal with them other than yourself.

Thank you. I really want to do this, and I'm going to give it a shot. It's going to be especially important for me to find a healthy outlet for the stresses of this job.

I am well aware of what I'll be facing as an EMT/Paramedic. As I made clear, it wasn't the "doing the job" part that had me worried. I am confident in my abilities. It's the accumulated stress and how it will affect me. And why would I listen to the advice of someone who gives me a "better quit now" and "people with your problems can't do this job" response?

I am sorry, and I do mean this in the most sympathetic way, but if you need medications to just deal with normal day-to-day life, then EMS is not for you, unless you stay on the non-emergency transport side of the business. I know lots of folks who are on these types of meds and work in EMS, and I would say generally that they are not the medics I want to see when I look up from the ditch. I am sure there are some that do it well, but I have not met them. This is also not a good career for people who have to function in "black and white" structure, where everything fits a schematic (engineers). EMS is very gray a good bit of the time. Consider other medical careers where you are the follower and not the decider.

Your advice has been noted and will be promptly ignored. I've made my decision. This is what I want to do.