Do you need critical calls to enjoy your work?

[jsadin]

I've met both types of EMT...those that want non-stop blood/guts/high stress calls all day and those who would rather sit at the station and wear out the batteries on the remote. I personally prefer a nice, steady pace. Enough calls to make the shift go by, but not so many that I'm out straight for 24hrs. Both the systems I work in are fairly low volume, however, so there can be some long dryspells. I'll go with Dust and say I've seen enough trauma that it doesn't interest me much anymore. Not that I've seen anywhere near the volume that Dust has, but the treatment is usually pretty cut and dry.

[akroeze]

I like to do a call, get back to base for 30-60mins to eat/sit down/catch a show/check e-mail then go out again. Steady busy with a break between calls.

I wouldn't mind if I never had to do a trauma again.... I got into this job for the medical end of it

[DwayneEMTP]

Yeah, I can see it both ways.

Where I am now, most things are pretty mundane. But I've found that there is a lot to be learned in the mundane. I've become a fan of dermal issues. They are weird, and complex, and incredibly varied. They are so outside of our normal scope of concern (yeah, my new phrase) in EMS that each one takes me to new places...and there are plenty of derm issues in Afghanistan.

Do I get my blood pumping when we get the call for a trauma? You bet your ass, but they are almost universally disappointing. I think we get programmed for trauma excitement, but the bottom line is that there is very little A&P mystery to a severe trauma, at least to the point that we have control before transferring care at the military hospital. Most of my interventions are basic (by ALS standards). There is very little mystery, almost never do I come back from a trauma with some nugget of information I remembered from school that the other medics didn't think of.

I like the adrenalin..and we have it between 3-8 times/month, but the sneaky little skin problem, or headache, or unresolving hypertension is much more interesting in this environment. And that's what keeps me fired up.

So, do I need the drama? No...Do I want the drama? Yeah, a little drama keeps me a little nervous, on edge, feeling like maybe I better study harder because something I do might actually make a difference.

(NOTE: Just to be clear, this environment is a little different than normal EMS in that interventions need to be considered to pathology resolution as opposed to transfer of care at the hospital. So perhaps this doesn't apply to the original posting as I first thought it might.... :-( )

Dwayne

[Don1977]

I like a variety, sure, everybody wants that trauma, but i like a variety of calls, except the psych transferes, the system milkers that are so "depressed", please, gimme a break......

Trauma isnt everything....

[Timmy]

When I started my 3 month stint of placement in Aged Care I thought I would hate it with a passion, after all it certainly isn't trurma or a rush lol...

I was amazed at how much clinical knowledge is needed in such an area. Old people are so polypharmacy it's beyond a joke! Some of my residents are on 17 different medications per shift, its insane, a pill poppen party lol. It takes quiet a lot of study to even scratch the surface of the medications tree in there. I thought it was going to be full on in paramedic pharmacology until I started nursing, there has to be at least 80 different medications in our drug trolley that the medications nurse dish out. They all have a MIMs PDA thing so they can look up the medication information but after doing 5 shifts a week I'm sure you'd soon become pretty fimilar with the different types of meds. The organisation, planning, responsibility and knowledge of those medications is quiet huge.

In EMS you might only have a few patients per shift that need medications. Here you have a full 8 hour shift of medications with only two 15 minute breaks, all the ressies need there meds at a certain time and there's only 2 of you between 40 patients. There's soooo much room for error.

When you sit down and read though a residents medical history only to find they've got 6 or so conditions/diseases/syndromes that you've never even heard of let alone pronounce. I normally pick one per week and do some reading on it.

Have you ever nursed a patient with a decubitus ulcer? The amount of time that is spent on research into what dressing is best, how many times they need rolling, how you roll them and into what position, is there any creams that could be beneficial ect ect.

I haven't had an emergency patient or been on any EMS calls for about 3 months . Since I've been in aged care we've had a cerebral arterial bleed, a non diabetic resident go unresponsive from hypoglycaemia, a diabetic resident go DKA, an AMI and plenty of falls with injury.

I now hate anyone who thinks aged care is boring, it's just a stereotype that its branded with and no body seems to look at the bigger picture. You can be a hygiene nurse or you can use your time in a more productive manner, there is certainly no shortage of clinical information and learning in such a place.

Although, I do admit, I miss the good old adrenaline rush and being under the pump, doing the front line care and dealing with all the uncontrollable and stressful situations in EMS.

[firedoc5]

I thought I had posted on this....

Take it from a former member of a company of hard-core trauma junkies, sorry to say, yes. (I'm so ashamed). We we would get "antsy" after a while. I won't go into details.

But I know not everybody is/was like that. Some prefer the transfer only type of calls and are quite satisfied. And that's alright.

[Eydawn]

To be honest, I thoroughly enjoy patient interaction and care whether the patient is acute or not. Maybe that's because I'm still newer at the whole 911 thing... but the same holds true for my wilderness/Boy Scout stuff... yes, the acute interventions and assessments are the calls my crew re-hashes and remembers, but the things that I really remember in detail and appreciate are the smaller things.

I think that all of us in some fashion NEED an acute call at least every once in a while to prove to ourselves mentally that we can still hack it. It's also good to be able to face a challenge. But I don't need acute calls to be *HAPPY* in EMS or satisfied with my job. Hell, I'm happy just being there around other people who understand my yen for acquiring medical knowledge- supervisors who won't chastise me this time for asking what inotropic means or using medical terminology in every day conversation.

You don't know how good you got it in EMS until you work for a really crappy job that doesn't satisfy your need for intellectual and environmental stimulation and medical interaction. Maybe that's just me... but I'm grateful for every day I get to spend at my new job and haven't looked back once.

Wendy

CO EMT-B

[firedoc5]

To be honest, I thoroughly enjoy patient interaction and care whether the patient is acute or not. Maybe that's because I'm still newer at the whole 911 thing... but the same holds true for my wilderness/Boy Scout stuff... yes, the acute interventions and assessments are the calls my crew re-hashes and remembers, but the things that I really remember in detail and appreciate are the smaller things.

I think that all of us in some fashion NEED an acute call at least every once in a while to prove to ourselves mentally that we can still hack it. It's also good to be able to face a challenge. But I don't need acute calls to be *HAPPY* in EMS or satisfied with my job. Hell, I'm happy just being there around other people who understand my yen for acquiring medical knowledge- supervisors who won't chastise me this time for asking what inotropic means or using medical terminology in every day conversation.

You don't know how good you got it in EMS until you work for a really crappy job that doesn't satisfy your need for intellectual and environmental stimulation and medical interaction. Maybe that's just me... but I'm grateful for every day I get to spend at my new job and haven't looked back once.

Wendy

CO EMT-B

Well said Wendy. :toothy7:

[Dustdevil]

Well said Wendy. :toothy7:

I second that.

And the Scout camp example actually reminds me of the military scenario. The guys tend to take you for granted every now and then when nothing is happening. There is no glory in treating rashes, headaches, sprains, and bug bites. The guys don't run around talking about how awesome the Doc is when that is all that's going on, no matter how good you are at it, and no matter how much complicated medical practice is involved in it. But let someone get seriously injured, and everyone's watching. It may be the easiest case you've handled all month, compared to managing hypertension and complicated internal medicine cases that you do every day. But to everyone else, it is the test of your abilities and worth. And, when you're all they've got, it is important that you occasionally get the chance to show them something that they understand. Trauma and heart attacks work well for that.

[Zach Smith]

I don't mind straightforward BLS calls (mostly that's what I am) but I do perk up and seem to be motivated by critical calls, especially code blues, because I'm actually able to assist someone that truly needs me and use my training to save a life, rather than giving out band aids all day. I do seem to need a true life threatening call occasionally to refresh myself and really feel like I'm serving my purpose.