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What I know now that I wish I had known then...

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After a marathon 16 hour shift last night...in at 1430 and off at 0630 the next day, I have come up with a b*&%$ list that I'm going to share...

I wish I knew...

How much my feet would be hurting at the end of a shift

How much I despise the sound of call lights

How much I can't stand being asked for pain medication on the exact 4 hour mark for a q4 drug, only to go in and the resident is sound asleep

How much I dislike the smell of c-diff

How much my feet would hurt...omg

How much I feel like a drug dealer and not like a nurse

How crappy EMS treats me when I call them for a very sick resident

How much that really bugs me and makes me wish I were still in EMS

That's all I have now, time for a drink, a hot bath, and my hubby to rub my feet OMG they hurt.

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I dated several nursing home nurses prior to my getting married to my ONE true love (sappy I know).

Their biggest complaint in their job when it came to venting to me was how bad the EMS providers treated them when they called. I vowed that no matter how trivial I thought the call was, I would never take it out on the nurse or NHstaff when they called.

You would be amazed at how the level of your working relationship will grow with those nursing homes if you are nice and not a bunch of complete assholes. Not saying anyone here is an asshole but if the shoe fits, wear it I guess.

We are the face of our agency when we show up at a nursing home or any other place and if you are an ass or a not so nice person to a nursing home staff member then you probably are not a very nice person/medic/emt to the rest of your patients.

Just sayin,

And of course, there are times when you want to gibbs slap those NH Providers but try not to because it looks bad on a police report.

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I wish I knew:

1. How badly the govt was going to destroy the practice of medicine

2. How much I would rather work 12hr shifts instead of 8hr

3. How much someone could miss being out on the road, knowing whether it is day or night, sunny or raining

4. How important nights, weekends and holidays become when you have a family

5. How much you can miss 'home'

6. Student loans really do need to be paid back eventually

Edited by ERDoc

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I wish I knew:

1. How badly the govt was going to destroy the practice of medicine

Now now, but I want to know, If we like our ER Doc do we get to keep our ER Doc????

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Of course you do, becaue the govt says that your ER doc can't fire you.

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Kate,

I've found that my feet do much better if I wear calf compression sleeves (e.g. Zensah, CEP) while at work. My feet are still tired at the end of the day. But they aren't nearly as tired if I've been wearing the sleeves. It might be something to consider trying.

Things I would have liked to know or remember? My list encompasses much of what's already been listed. Although, I'm intrigued by the mental floss aspect of the question. It's had me thinking all morning. If I come up with anything insightful I'll share. For now, though, I'll have to be lame and add the con-contributory "ditto".

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Thanks for letting me vent and joining in guys :)

Our facility has vent patients and so we manage A LOT in house. We have a company that can come place a PICC line, we do a majority of the management in house so for us to call EMS is a big deal since we hate sending patients out. In this particular case my patient had quickly become septic and it wasn't something we manage in house because we don't have the 1 on 1 resources an acute ICU has.

That's a good idea Mike about the compression sleeves, I know a few nurses who use them and I might look into them. I have a hard time saying no so I end up working 60-80 hrs a week and last week worked 6 12's straight. With my crappy joints, awful hip, and now sore ankle, I think I need to cut back some.

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Kate : my wife started wearing compression socks a couple years ago after she would have wicked calf cramps and lower leg pain from working 12's on the hard tile floors. they make a world of difference. Also she found some merrill shoes with a really cushioned sole that help .

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Things I wish I knew prior to diving headlong into EMS:

1) The degree to which night shifts kick your rear end is directly proportional to your age.

2) Working targeted response advanced life support (ALS) isn't all gravy. Some nights I assess 15+ patients and don't transport a single one of them to hospital (BLS crews take those patients to hospital after I assess) When a call is dispatched as "highest level available" it just means I have to assess them. I only transport a patient when there is something I can provide that patient the BLS crew can not. I go lights and sirens to every single call because according to AMPDS If the call justifies my response it should be a lights and sirens response.

3) AMPDS (Advanced Medical Priority Dispatch System) is complete and utter crap. The old method where paramedic dispatchers assembled the caller's information and sent an ambulance according to their assessment of the priority level is documented to have had a significantly lower triage error rate. The triage error rate would probably be lower if we just let callers/patients decide whether or not we should show up lights and sirens. In fact, I would be all over a study to that effect.

4) Working targeted ALS in a high demand system does not mean you will have the best tools at your disposal. I would have significantly better pharmacology available to me if I worked in non targeted Alberta than what I have in BC. Being registered in both places is extremely frustrating when it comes to some of these items. What I can do in one place I can't in the other. Part of me wishes for a national practice standard, the rest of me is worried the overwhelming Ontario ethic would come into practice (I'm talking about calling for online medical control to give ASA to a STEMI patient level of ridiculous).

5) I would have fast tracked my education beyond being a paramedic a little sooner. I'm in the process of completing a bachelor of health science now. How far I go beyond that depends on my future relationship with admissions.

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I wish I'd known how much sleeping at night was taken for granted.

... and that when ERDoc said he'd take me out for dinner and a movie he really meant Dennys on Plainfield and back to his rent-by-the-hour motel on 28th St to watch something from the $1/day bin at Snuff Bunker; the adult subsidiary of Blockbuster.

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