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Calls that changed your perspective


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I think the calls involving the elderly give me a different perspective. We have a high population of folks 70 and above. They really hate calling for the ambulance, and most often or not convince a family member to take them to the hospital. They hate to bother us with their problems is a common theme. We had one yesterday, where an 88 year old fell and broke his right ring finger, it was an open fracture and the digit was dislocated behind the pinky, plus a pretty deep laceration nearly encircling the finger. We were more concerned about the injury than he was. He just wanted us to patch it up and he would go home and his wife could run him to the Doctor when she got home.

He kept saying that he sure did not want to bother us and have us go to all this trouble , after all it was just a broken finger. No big deal.

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So, Friday we did a transfer from our local hospital to one of the metro hospitals. Our patient was an elderly male with an unstable IV site and several meds being infused. He was extremely anxious about the 60 mile ride in the ambulance even after a sedative was given. My partner and I took the time to visit with him and his family before we left only to find out that not only were we all if Czech heritage but he also knew my grandparents very well. He also knew my partners aunt and uncle. He seemed to be much more at ease knowing that we were almost like family. My partner, who was in the back with him, visited all the way up to the hospital which helped things go faster. Once we got him to his room and transferred care to the ICU we stood in the hall to get our things in order. His nurse came out and told me he wanted to see me. When I went into his room he put his arm around me and told me "you know, for a girl, you're a pretty damn good driver". I smiled, gave him a little squeeze and said, "thank you! I had to be careful, I had precious cargo." His smile was from ear to ear.

It's the patients like this one that make me feel like I am making a difference. I like to help people and the ones that show they appreciate it make me want to continue what I do. They by far make up for the sh*t patients.

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It would have to be the ones where you do the hand-holding, but definitely the ones where you help bring someone back and they thank you.

I've had 2 cardiac arrest saves. The first one was someone in cardiology, and he didn't believe us until we showed him the strip. He looked for us at the station for 2 weeks to thank us for saving his life.

Little old ladies and war vets are the ones I'm suckers for. While working in Newark, and I was precepting, we were called out for a CVA. As I'm doing my assessment, I see a picture of a WWII soldier in the room. I ask his wife if that's him. She explains that he was a part of the Red Ball Express. At that moment, my crew and I stood up, saluted him, and shook his hand. While he was having a CVA, you can see that he was at ease with us.

Just Friday night, my partner and I got dispatched for chest pain. While the 12-Lead didn't show a STEMI, I felt something was wrong. My partner and I sat with her for a half-hour to convince her to go to the hospital. She gave in, went with us, and couldn't thank my parter and I enough for helping her, and our bedside manner.

I would rather take care of a little old lady any night, than someone who has gotten shot, stabbed, or crashed. The little old ladies seem a lot more appreciative.

Long story short: be nice to your patients, even in the big-bad city. It will help them feel better, and will not burn you out in this field.

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Many years ago I worked on a vol ambulance and was in the middle of a big job when we were called for a transport of an elderly man with cancer. I figured no big thing we will just get it done and I can get back to my "busy" life.

My attitude was bad from the time the call went out and then when we arrived the man wanted this and that and stalled us loading him on the cot. This only intensified my attitude. After a big deal we loaded him on the cot and as we went through his living room he asked us to stop so he could take one last look around his house before he left. We did and as I looked at the man and realized that this would be the last time he would see his house nothing in my day was that important. He died that night.

That was 18 years ago since then I have never allowed a call to get in the way of my day I treat every patient with respect and give them my full attention no matter how small I may think their complaint is. I am full time now and we run a tremendous amount of calls and it does not matter if I am on duty or off and do a call-back the patient gets my full support.

Best first post ever. =D>

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This was good reading tonight. I admitt I am guilty of a bad attitude on the street lately. I'm taking a leave of absense from the truck durring the next semester of paramedic school becasue I think I'm coming dangerousely close to burn out. I thought it would take 10 years before I lost faith in humanity, but I guess if you do anything 6 days a week 12hours a day it will start to wear on you.

Thank you to everyone who's been doing this longer than I've been wearing big girl panties who shared their perspective.

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Um, Rankin, if you're coming dangerously close to burnout, why are you taking the medic class? There is little in EMS scarier to me than a burned out medic. If it's that bad, you should talk to your employee health department.

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Um, Rankin, if you're coming dangerously close to burnout, why are you taking the medic class? There is little in EMS scarier to me than a burned out medic. If it's that bad, you should talk to your employee health department.

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This was good reading tonight. I admitt I am guilty of a bad attitude on the street lately. I'm taking a leave of absense from the truck durring the next semester of paramedic school because I think I'm coming dangerousely close to burn out. I thought it would take 10 years before I lost faith in humanity, but I guess if you do anything 6 days a week 12hours a day it will start to wear on you.

Thank you to everyone who's been doing this longer than I've been wearing big girl panties who shared their perspective.

You need to RUN don't walk and visit with a stress debreif counselor. I have been through burn out and every step they talk about except death. It took me two years to get things back into perspective and my career back on line. Don't mess with burn out do the things they tell you. Go have fun, exercise, eat right and most important TALK to people who have been there and find out what they did to get back. You are important to the EMS world and your first priority is to take care of yourself.

In the area I am in we often pick up friends and family and this leads to a lot of burn out and so we get to practice a lot on recognizing the steps of it and the steps to recovery from it. You are way tooooooo new in your career to be burning out. If you want to know more or you need to know where to go LET ME KNOW... true I don't know you but you are an emergency worker and we are all responsible to help each other as the rest of the world does not understand us on a good day let alone when things are not good. Heck most of them don't understand our rigs take gasoline or diesel like there cars they think they are magic and just keep running.

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Thanks Fireland,

So what are these steps? Is there a website or something I can visit? I've only been at this for a little less than two years. My system has a really great program for critical incident stress management, for after bad calls, but they're very demanding of our time and don't seem to take burn out seriousely. When I stumble into the station to start a 12hour shift just after leaving my 12hour shift at the hospital I get the world's smallest violin. Everyone else has been through what I'm going through and they somehow stuck it out, and the last thing they need to hear is the new girl whining. Not all of them have a little girl at home who stands at the door and cries becasue she doesn't know when her mommy will come home next.

I think my spark first started to fizzle when I experienced my first baby-code. She was 2 weeks old, she had a congenital heart defect and there was nothing we could have done to save her short of open heart surgery on the rig, but I'm sure you know exactly what I mean when I say I still felt like crap. We all did exactly what we were trained to do but sometimes it just isn't enough. I was pretty messed up for a while but I came out of it okay I think. I've seen some pretty gross things in my short career but I can honestly say that a dying baby is the ugliest thing that has ever exhisted.

Now, along with riding the ambulance and going to school, I work in a pediatric ER to pay the bills. About a month ago we had a really aweful day from hell. First a 2 week old came in for a "fever" but showed obviouse failure to thrive and turned out to have bilateral femur fractures and 4 fractures in his left humerous. Needless to say the social services and the police got involved, and may his mother rott in hell. Just an hour later I took blood from a 7 year old so she could be tested for STDs, then escorted a pregnant 13 year old to ultrasound. That's not exactly a typical day at work, it just all piled up. When I came home my husband had invited another couple over for dinner and everyone was talking pleasantly, but I just slouched like a defeated soldier and muttered synicle remarks.

the next week I did a shift at the hospital and then ran to the station, changed clothes and headed out for our first call and the calls just kept coming one after another. We didn't make it back to the station for the rest of the night. I was so tired and so frustrated after my shift that I went home with bags under my eyes all sweaty and frizzy haired from the heat and humidity and cried like an idiot. Ever since then I've been trying desperately to hold onto my compassoinate side. Last week at school, after running on the rig all day and rushing off to school 5 minutes late, one of my preceptors got on a tangent about responsibility as a Paramedic, and added that if your job makes you miserable enough to have a bad attitude you should quit becasue there are plenty of medics out there who love their job. I had been trying to ignore it, but that night I finally accepted that I was in seriouse burn out danger. I put in for a leave of absense. It was aproved but i still have to fill my obligation for august. I stopped and thought about it and realized that I'm always cranky at home, on the rare occasion that I am home, and while I used to love getting to know people at work I suddenly wanted nothing more than to be left alone. I hate showing emotion and the only reason I have the nuts to write this is becasue I'm tired enough to claim intoxication.

I do love EMS, enough to destroy myslef for it as it turns out. How do I get back to square one? I'm in the book-nerd pathophysiology phase of school and i can postpone my clinicals and ride time until my leave of absense is over. I think spending some more time with my daughter, working in the hospital and going to classes should be a more apropriate work load right now.

Come to think of it, I haven't had the energy to exercise or the regard to eat right for about 9 months.

So how did you "get out of it?"

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At the bottom is a link to one site with good information about burn out. However you need to go to your stress debrief team and see who the mental health professional is. Sounds to me like you have more than just an incident or just school. In emergency care we often get caught up in helping everyone else except ourselves and overtime it takes it toll. It does not matter if you have been doing this for 2 days, 2 months, 2 years or 20 years it can catch up with you if you don't take care of your self. We had one EMT that went off the deep end on a routine transfer. Come to find out the lady looked like her Mom who had SERIOUSLY abused her when she was a child and seeing this lady opened up the gate for her that she has never been able to close.

Find a good counselor I did not use the one our system provided, I found one that specialized in emergency workers while she is not one of us she knows how to help. I just felt the one we had with our unit was too much of a talker and I did not want everyone thinking I was weak, or could not handle the job. Never mind that in our small community I picked up 9 patients in 2 weeks that all died and the oldest was 12 and my best friends son. I just could not figure out why I was burnt out. It took about 2 years to get myself back to feeling good and like a productive member of society. If your proctor does not understand this then maybe it is time for him to do something different. when we loose the caring about each other or the students that are going to replace those of us who have been at it for ever then it is time for us to move along. let me know if this web site helps. I have all the papers that show this stuff but can not find it on line.

http://www.stressdoc.com/four_stages_burnbout.htm

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