Noah.

His room was decorated with mementos of a former life.

Pictures of his friends and family are pinned to a bulletin board next to instructions for all visitors to take BSI precautions. Posters of his favorite band and a few concert t-shirts hung aside a calendar with this months activities at the nursing home. Not the typical decor of Jesus paintings and 60-year-old framed wedding pictures.

His Mother was sitting on a folding metal chair, her small frame enveloped in a yellow gown. She wears a blue mask similar to mine. I could see her eyes, tired and filled with worry for her only son.

The run came across our pagers as a patient with a capped trach going from a Nursing Home to a Wound Care appointment. As we approached his room we're stopped by a large sign warning to use Universal Precautions. There was a mesh barrier with a large stop sign draped across the doorway.

"What the hell...." Partner for the day checks her pager again to see what exactly our patient has. There's no mention of MRSA, VRE, or Acinetobacter. And typically they are very careful about making sure we have that information.

A nurse stops outside the room and gives us the once over. "Gown up ladies, he has massive decubes and acinetobacter."

Fair enough.

We climbed into our stylish gowns and masks and enter the room. The nurse wears the same plus a face shield. I give her a quizzical look.

"It's airborne" is all she says as she continues to get our patient ready.

Wait, it's airborne? I didn't realize that acinetobacter could go airborne. Apparently it can. Time to read up a little.

The first time I actually got a look at him I felt my stomach drop.

He was young. He was very young. Far too young to be in a Nursing Home. Everyone knows that Nursing Homes are for the elderly, right? This kid couldn't be older than 18 or 20. I would later ask his Mother what happened... How did he end up severely brain damaged and living in a nursing home?

She tells me a story I'm sure she's told a hundred times. A story about the worst day of her life. The day five months ago when her 19-year-old son decided to indulge in a massive amount of coke and heroin, and how his friends left him for dead. My heart breaks for her. As a Mother and as a human.

The ride to the hospital for his appointment was blessedly uneventful. They had given him a nice dose of Ativan at the Home to keep him calm for the drive. His Mother had informed us to watch out for his hands as he would likely swing if he became agitated.

When we arrived at the Wound Care office they take one look at my Partner and I BSI'd to the hilt and silently ushered us towards the "VIP Entrance". The VIP entrance is a back stairwell landing with barely enough room for myself, my partner and the patient.

Our Patient's Mother headed to the waiting room. She'd been through a few of these Wound Care appointments, and felt more comfortable out there. I promised her that we'd take good care of him. I can't blame her, given the size of his wounds and words being thrown around like debridement... She would be better off out in the waiting room watching Dr. Phil.

We stood in the quiet stairwell, I read my book while my Partner flipped through a two day old newspaper. It was quiet. Noah was quiet and calm. We didn't talk, we just took turns watching him, like nervous mothers watching a newborn baby sleep.

You know the saying It's always calmest before the storm? Well, it was starting to sprinkle at this point.

First his breathing rate increased. We both noticed immediately. I smoothed his hair down and whispered to him.


"Noah... it's okay baby... calm down."


It took a minute, but it did help. We continued to wait for the office staff to put us into a room. Five minutes turned into ten minutes which turned into twenty minutes.

We were doing our best to be patient, we both knew this was a busy office. All that being said I was growing frustrated when the RN opened the door to the stairway we were hidden away in to show us to our room. It wasn't her fault, I knew that. Still I felt my pulse racing.


My Partner and I found ourselves once again sitting in silence in the cramped room watching Noah. He started gurgling. He's gurgling and we're both Basics and as such in the State of Ohio we're not allowed to suction a trached patient. The Nursing Home staff and his Mother have all assured us that he does this and he is always able to clear it on his own. We're nervous. We sit... and we watch him. And we listen.

He's still gurgling after thirty seconds. I jumped to my feet and found the closest Nurse.

"Our patient needs to be suctioned. He has a trach."

All she could do was stare blankly at me. "So suction him then. Didn't you bring a portable unit?"

My mouth dropped. I didn't know what to say. Again, I tell myself it's not her fault.


"I'm sorry, we're not allwed to suction a trached patient as Basic's. The Nursing Home capped it and told us he rarely needs suction. He's having problems. PLEASE suction him." I was frustrated, sick of being “polite” and quickly heading towards being seriously pissed off. This should have been an ALS run.

Had I just passed Medic School.

********

"Can one of you flip him? I can't get to that sore on his hip." The RN was asking one of us, either of us. Noah was my patient, I stepped up.

"He's trached, I'm not sure you want to flip him on his stomach..."

"It'll be okay, just grab here and..." She grabs his leg and the foley and attempts to show me how to flip him onto his stomach. She ends up pulling on the foley which causes Noah to start swinging his arms. He's moaning.

"Okay, stop for a second. Let him calm down." It's more of an order than a request on my part. I admit that it came out in a tone much harsher than I had intended. I don't feel the least bit sorry about it.

We sat and watch him for a minute. Again I ran my fingers through his hair and whispered to him. "Noah, it's going to be okay... We'll be careful... We'll be careful."

I looked at the nurse and told her in no uncertain terms that given his earlier problems with clearing his airway on his own, I'd rather not flip him on his stomach. I wasn't comfortable with it.

"He'll be fine, we've seen him several times. Now grab him here...” She guided my hand to his hip and we flip him to his stomach.

And he does fine. Noah's head is resting on my left forearm while I hold his right hip so the Nurse can get access to that pesky decub. I was relieved that he was doing so well.

I knew he was severely brain damaged... I knew he probably wasn't processing anything that I was saying to him, but I talked to Noah anyway. He was sweating to the point of soaking my gown covered forearm, but his color was good. His rate was good. His pattern was good. I thought about my own son and how I'd want someone in charge of his care to treat him.

Then that damn Nurse ripped the wound vac off of his leg and all hell broke loose.

I let out a gasp. Noah started moaning and flinging his arms around. I worked with my partner to do our best to keep him still. The Nurse was completely oblivious. She actually left the room to argue with another nurse over which wound should be labeled what number for the pictures she still had to take.

And at this point, I damn near lost my mind.

I realize he's brain damaged. I realize he's another patient to you. I realize that you probably see TONS of patients in the same boat. But he is a HUMAN BEING.

Then he started choking. I yelled at the Nurse to come suction him. She ignored me and continued to argue over whether the sore on his right hip is actually number three or number four.

My Partner grabbed the Oxygen tank and a NRB. Noah's fingers were turning blue. After the longest minute and a half of my life he manages to clear his airway yet again. I consider becoming a practicing Catholic again.

The Nurse returned. "We need to get him on his back," I started. The Nurse completely ignored me and stuck a long q-tip into the wound on his hip. The wound that is exposing muscle and bone.

I considered jumping over our cot and physically attacking her. He started choking again. His fingers quickly returned to that dusky cyan color.


I looked at my partner and uttered the words that would come back to haunt me. “I'm going to lose it very quickly here. TELL her to get him on his back NOW because CLEARLY she is not HEARING me.”

A Nurse popped her head into the room, "Is everything okay in here?" She sounded concerned and all of a sudden I have hope.

"Could we have suction and a pulse ox?" I'm not asking, I'm begging.


It's been a good minute since Noah started choking for the third time. By the grace of God he managed to clear his airway once again. His respiratory rate increased to close to 30 and his color still sucked. We were still waiting for the Pulse Oximeter and for someone to suction him,

********

I could retype the last several paragraphs at least three times and still be accurate. The Nurse we had completely ignored me and put Noah at risk multiple times. I realize that he managed to clear his airway each time and I thank GOD for that. A patient should not be choking for close to two minutes while simultaneously turning blue before a Nurse intervenes.

What if he hadn't been able to clear his airway?

I realize I'm just a Basic. Somewhere they taught me that we were to be an ADVOCATE for our Patients. I've done my best to be that.

Noah went back to the Nursing Home in one piece. I guess someone decided that suffocating during a Wound Care appointment because his Nurse didn't see him as a human was not the way he was meant to go.

I guess I'm just a little frustrated. I realize that this Nurse was probably a touch burned out. I just wish she had seen him. I wish her eyes had been opened.

1(800)SUICIDE


1(800)SUICIDE needs your help.

Some of you may know that I've recently had a family member attempt to take her own life. I can't even begin to describe what a family goes through during a time like that.

Should you find yourself in the position to help with a donation, please do. Even a dollar will help.


Yes, that's me...



That's Your's Truly... in a skirt and sandles, in a batting cage.

I'm not right.

By the way, I missed more than I hit. And this coming from a girl who played on a boys team for four years.

They Don't Want To Know...


This post is part of a new collaborative writing effort by EMS bloggers all over the country. Go to Normal Sinus Blog to check it out!

“So, Epi... How's work going?”

My family is sitting around the dining room table. The chatter has stopped as they wait with baited breath. My one drunk Aunt even sets her wine glass down.

What do I tell them?

Do I tell them how five, yes count them, FIVE of my regular dialysis patients died this week? Do I tell them how I now read the obituaries on a daily basis at the age of 32?

Do I tell them about the 22-year-old quadriplegic former football phenom? The one who has to go to wound care appointments every two weeks for the massive decubitus ulcers on his backside?

Do I tell them that I did compressions for the ninth time in my EMS career this week? Do I tell them about the patients' Granddaughter who had to be restrained at the door of the room? Do I tell them how I am still having nightmares about her screams? Do I tell them that nine out of nine times I've helped to work a code the patient has died?

Do I tell them how exhausting it is, mentally and physically, to work 50-72 hours a week for barely above minimum wage. Do I tell them that we do anywhere from six to ten runs a day? Do I tell them how I want to cry when they tell us to “Grab the Bari-Cot”. Do I tell them that most of us eat Flexoril like they're candy thanks to cots that at times don't function properly and morbidly obese patients?

Of course not. I don't tell them about any of that.

The room is still silent. My Mom looks concerned. “Epi?”

“Oh, it was great. Got to see some cool stuff. A structure fire, and a car accident. Everyone was fine, but there were some HAWT firemen in turnout gear.”

Everyone laughs. I do too, but it's not real. I change the subject by asking my Brother about his job. He regales us with a story of a couple committing insurance fraud and his part in their prosecution.

They don't want to know.

Later on that night my partner text messages me. “How was dinner with the fam?”

“Typical.” is the only response I can come up with.

“Still having those dreams?”

“Yes” I respond. I think he can hear me exhale from two miles away.

“Come on over and talk it out.”

There are some things only a Partner can understand. And a family can't begin to.

You want me to what?

"You want me to what? Are you serious?"

Yes, Epi is not amused.

Sometimes I really believe I don't get paid enough to do the job I do.

20 Out Of 10: Change of Shift


20 Out Of 10: Change of Shift

Change of Shift is up! Guess who contributed? :)

Thank you so much Braden for including me. It meant a lot!

The Elephant In The Room...

Dear Nurses (Floor Nurses, ED Nurses, Nursing Home Nurses, etc.),


Hey everyone! It's your friendly neighborhood EMT. I'm writing because I've been feeling a little bit of... well, tension in our relationship lately.


A wise person once said, “If there's an elephant in the room, introduce it.”


Well, meet the elephant. The EMS and Nursing relationship. We have become the equivalent of two rivaling cliques in high school.


It's high time the tree-hugging hippy guidance counselor comes in and we all sit down and talk things out. Unfortunately, our resident hippy is busy making his own granola, so you're going to have to settle for me. I don't own any tie died shirts, but I do rock a wicked pair of BDU's at work, and own more than one pair of scrubs. Oh, and I make a phenomenal pot of coffee.


You know, we have a lot in common.


We both do our fair amount of complaining about each other. Some of it is warranted. Most of it isn't. I don't expect this to change. There are just as many bad apples who are burned out in EMS as there are in Nursing. This is not going to be one of those feel good posts where I say, “Hey, we're all on the same team, folks! Why can't we just get along?” That would be unrealistic and ridiculously cliched. (Although the Utopian idea of all of us treating each other with at least the minimum level of professionalism does appeal to me.)


My background is in EMS and my story is typical. I left a great job with great hours and benefits to become an EMT-B and work at a private ambulance service. I took a 50% reduction in pay, and I work 50-72 hours a week. I miss holidays, I miss school events, and I miss a lot of the every day stuff going on in my kids lives. I decided to further my education by becoming a Paramedic, and I just started school (again) to do that. It's a 12 month program that in addition to all of my regular hours at work is going to equate to over 5000 hours away from my kids over the next 52 weeks. I could make more money doing something else. Hell, I could make more money working as a greeter at Walmart. I choose to do this job because it makes me feel good to know that I've helped someone.


Some of this probably sounds familiar to you. Nursing and EMS are both tough jobs. We both work long hours, we all get stressed out, and we all miss the same family events. You get just as frustrated as we do. We both have management entities that put unrealistic demands on us. We both have drunks who are angry psych patients who can be physically violent. We both hold a lot of hands and comfort a lot of people. We both put up with exorbitant amounts of BS.


We have a few things in common. At our core, we all want to help someone who needs it.


I realize that I said I wasn't going to turn this into a pep rally. I'm not. Speaking as an EMT, my hope is to shed a little light on why we do some of the things we do. I want you to understand us a little better.


We might bring in a patient who has absolutely no need to be on an ambulance or in the ED. We know this when we bring them in. We know that we're just adding to your work. None of us enjoy the fact that we have to do it. As an EMT I'm not allowed to tell a patient “No. Drive yourself to the ED, or here's an idea, go see your Doctor!” Believe me, most of the time I have to bite my tongue. It's amazing I still have a tongue.


When we come in at three in the morning and we're sweaty and looking a little unkempt, it's extremely possible that we've done eighteen straight runs with barely enough time for a bathroom break.


If your vital signs don't line up exactly with ours keep in mind that ours are done with primarily a stethoscope and a manual bp cuff in the back of an ambulance with a Powerstroke diesel engine. I promise you we do the best we can.


When we ask you for a face sheet/billing sheet/charge sheet, it's not because we want to create more work for you. Particularly in the Nursing Homes. We need that information for our run reports and at least at my company, not having that information is grounds for a write up.


When I ask you at the Nursing home about your patient, it only benefits the patient if you can give me some history. I realize you are stretched thin, and that you might have to look through the patient's chart. Remember this helps the patient, it helps us as EMT's in the continuation of care, and it helps the ED Nurses when I transfer care to them.


A lot of EMS folks complain when you call us Ambulance Drivers. There's some truth to that title. We do, at times, drive an ambulance. That being said there's a skill set here that we have that you might be unaware of. We carry and utilize O2, monitors, defibrillators, vents, and suction. Paramedics can administer a number of drugs, including cardiac and narcotics. They can intubate, put in IV's, IO's and can even cric someone if it comes to that. Even though we drive an ambulance, it's unfair to lump us all into a group and label us “Ambulance Drivers”.


Finally, I realize there are some of us who are arrogant and cocky and who think of themselves as Gods. At least on the EMS side, the good EMT's and Medics... We want to knock those folks down a peg just as much as you do.


We're not Nurses. But we work just as hard as you do. We're out there in the trenches, in our patient's homes and sometimes even in that bar you would never set foot in doing our job. We're human and we care about our patients just as much as you do. We're someone's Wife, Husband, Mother and Father. Most of us respect the hell out of you for the job that you do, and a lot of us aspire to do that same job. Believe it or not, for the majority of us, our number one priority is our patient's well being. Sometimes that comes before our own well being, despite what we've been taught.


I hope that maybe I've given you a glimpse into a profession you may or may not have been familiar with.


All my best,

Epi

Sometimes it's good news...

More often than not we as EMT's spend time with our patients when things are going horribly wrong.

Someone is having chest pain... We're there reading the EKG when there's ST elevation.
On the scene at the car accident when our patient can't feel their legs.
Taking the Grandmother of 15 to Hospice.
Taking the two time Breast Cancer Survivor with two broken legs to her Oncology appointment to "Discuss the results" of her last mammogram...

It's uncomfortable. It's stressful. It's heartbreaking.

It's also what we do. We chose this path in life.

All of that being said, it's wonderful to get some good news once in awhile.

Today McHottie and I took a 33-year-old female to an Ortho appointment. She was in a car accident a little over a month ago and has spent the last several weeks on total bed rest with a broken hip in a particularly unpopular (I don't know a PC way to say "crappy") Nursing Home.

She's been miserable. A once vibrant High School volleyball coach and Art Teacher is now being treated for anxiety and depression. Her family is mostly from Texas and what few friends she has in town have stopped coming to visit now that school is out. She wants nothing more than to get back on her feet, literally.

We took her to her appointment where we waited for an hour and a half to be seen. She spent that entire time on her back on our stretcher. (I think I might have mentioned in a prior post that our cots really aren't built for comfort.)

It was our privilege to be with her when her Orthopedic Surgeon told her that not only was she off of bed rest, but she could check out of that Nursing Home today.

The joy, the excitement in her face... It made up for at least 100 bad runs.

We assisted her in procuring some crutches, and even helped her get on her feet. Once again, literally.

I love my job.

NSR is up!!!

I realize I'm a little late with this...

The first week of Normal Sinus Rhythm is up and running!

NSR is a collaborative writing effort of sorts from EMS writers across the country.

The Nurses have Change of Shift.
The Docs have Grand Rounds.

Now we have our outlet. NSR.

Go give it a read!

A Basic Lesson

"Ohhhhhhh we're halfway theeere.... OHHHHHH LIVIN' on a PRAYER!!!!" My voice cracks as I sing at the top of my lungs.

Somewhere a coyote howls.

It's a long drive home from my Cousin's house, but one I'm very familiar with. The traffic is light at this hour, but the roads are slick. It's been raining most of the night.

I'm absolutely exhausted. I can feel my eyes getting heavy, burning, closing...closing...

I shake my head in an attempt to stay awake. I roll the window down a few inches and turn up the radio. "Living On A Prayer" has never sounded so horrible coming out of someone's mouth. I really shouldn't sing. I giggle out loud.

Only ten more miles, I tell myself. Ten more miles.

I find myself staring at the tail lights of the Mustang in front of me. My eyes are getting tired again. I yawn. I'm alone in the car, just me and the music. I take a long sip out of my Diet Pepsi bottle.

Without warning the taillights I've been watching disappear. I'm now seeing the headlights. Without warning the car goes off the road and into the trees of Suburbia State Park.

I slam on my brakes and pull off the side of the road. I put my hazards on and look for my cell phone.

Where in the hell is my cell phone? I can't find it anywhere. I look up ahead at the car, it hit a few trees pretty hard, there's some impressive damage. There's smoke coming from under the hood.

Well, I'm wide awake now.

I look behind me and ahead of me to see if any cars are coming. I grab a pair of gloves from the box in the back seat and cautiously exit the car. There's no movement coming from the car. I can feel my heart racing. I pray that another car stops so they can call 911.

I slowly approach the driver's side of the car. I call out, "Hey... Sir... are you okay?" I'm still fifteen feet away when I hear footsteps approach from behind me. I nearly jump out of my skin. A truck driver has pulled over and is running across the four lane road.

"Jesus Christ you scared the shit out of me, do you have a cell phone?" I laugh nervously.

"I saw the whole thing, already called it in," he grunts. Something tells me he's seen this before. "Let's get him out, the car might go up."

I can't believe this.

We work together to pull the half conscious man out of the driver's side of what was once his absolutely beautiful Ford Mustang. I'm guessing he still has several years of payments left to make.

The driver's eyes open suddenly, "WHOA WHOA... I'm okaaaay. I was taking a nap!" He slurs, swatting at an imaginary insect. His Harvard hooded sweatshirt is covered in blood that is pouring from his nose and the side of his head. He can't be more than 20 years old, and something tells me he has never attended class at Harvard. We set him down on the ground.

"Do you know what happened?" I ask him. I'm kneeling on the side of the road in the gravel.

"Fuck yeah I know. That fucking tree jumped into the road duuude!" He's trying to stand up.

"Hey, sit down, the ambulance will be here soon." I start, "You could have a --"

He cuts me off, "THE AMBULANCE? Did you call the COPS???" In a heartbeat the driver has jumped to his feet. He stumbles a few steps. I stand and put a hand on his arm to steady him.

That's when it happens. He swings at me. His fist misses the side of my face by at least six inches, but I'm shocked regardless. The up-until-now silent Truck Driver springs into action. In one fluid movement he has the patient restrained with an arm bent behind his back.

"Sir, you do NOT hit a woman. Especially if she's trying to HELP your sorry ass. Now SIT DOWN AND SHUT THE HELL UP!"

I'm simultaneously terrified, relieved and extremely grateful. The patient is sitting on the ground whimpering. The Truck Driver stands over him, his arms crossed. I thank him. I thank him again.

"Ma'am, excuse me for saying, but a pretty girl like you has no business stopping in the middle of the night by yourself. Anything could have happened."

I feel a lump form in my throat. He's right. What was I thinking???

The first thing they teach you in Basic school (well, the first thing they teach you after BSI) is something that is drilled in your head for the duration of the course. You may at some point dream about the words...

Scene Safety, Scene Safety, Scene Safety. Is the scene safe?

In my case, obviously it wasn't. And the Truck Driver/Good Samaritan was absolutely right.

I was wrong to stop. I was very lucky that nothing happened to me. I'm extremely lucky. (Yes, I've beaten myself up a fair amount over this in case you couldn't tell.)

I'm in Medic School for the second time now. Maybe it's time to review the basics.

Be safe out there.

Say some prayers...

Send some prayers and good thoughts to Sam (Medic 61) from On the Clock. I have it on good authority that she needs them.

Call me, girl.

Things are not always as they seem...

"So I have sixteen pages of notes that I can't understand, and the only thing I clearly remember from class was a reference to a water molecule resembling a legendary cartoon character." I close my notebook and shove it behind the passenger seat, and instead choose to reread the chapter out of my book.

"Dispaaaatch to Unit XX" The radio has been silent for the last 45 minutes... Sleepy Partner (Welcome Back SB!!! Even if it's only for the day!) is studying for the GRE while I close my book and grab the mic.

Epi: "Unit XX, go ahead"
Dispatch: "Unit XX, head on over to Suburbia Nursing Home for a 1430 pickup... Heading to a Doctor's Appointment in Outer Suburbia."
Epi: "Unit XX is clear on Suburbia Nursing Home, put us enroute."
Dispatch: "Gotcha' Enroute Unit XX. 13:55."

Sleepy Partner puts his study book down and rubs his tired eyes. I yawn. "I know, SP... I was just thinking about a nap myself."

I pull the truck out of the parking lot where we've been posted and head towards the ECF where our patient is. It's only two minutes up the road. Sleepy Partner is already reaching for gloves. He hands me a purple pair.

Sleepy: "Where is the office we're going to?" He scratches his head as he examines the map book.
Epi: "Over in Outer Suburbia."
Sleepy: "I get that. WHERE in Outer Suburbia? The street isn't in here... And how come Outer Suburbia isn't next to Suburbia? I mean wouldn't that make sense?"

Wait a second, I think... When exactly did Sleepy Partner learn how to use a map book?
Sometimes I don't have all the answers. Most times, in fact. I decide to consult a higher power (at least in their own minds).

I pick up my trusty little pink phone and call the ones who will certainly know. DISPATCH! My HEROES!!! Please enlighten us!!! SHOW US THE WAY!

Dispatch: "Well, Epi... According to the map program the street should be 186 yards east of Suburbia Hospital."
Epi: "Well, let me get out my yardstick."
Dispatch: "You're not funny you know."
Epi: "Maybe not, but I'm cute. That makes up for it, right? By the way, you can put us on location. "
Dispatch: (Laughing out loud) Gotcha on. Call if you have a problem finding the office.
Epi: No worries, I have my yardstick.

It's a beautiful day to be outside. The sky is an amazing brilliant Carolina Blue (yes, Carolina Blue does in fact exist outside of the great state of North Carolina!) and there are huge white fluffy clouds scattered across it. It's one of those days that Bob Ross used to paint. Sleepy Partner and I joke with each other as we can't help but be in a good mood. We walk the cot into the building. We're still giggling as we approach our patients room.

I knock on the half opened door. "Miss Jones? We're here to take you to your appointment..." A nurse walks past us and into the room, pushing the door open and exposing our patient to us.

Sleepy Partner: (whispering) "Oh... wow."

My jaw drops. Our patient has the single worst case of necrosis I've ever seen. What the ECF told us was a case of simple PVD is a gross understatement. Well, PVD is a given. Gangrene was not what I expected.

This is getting close to what her feet looked like. The black portion ran all the way up to her knees.

Our patient was on the phone and thankfully oblivious to our reactions. The two of us managed to summon some professionalism in the meantime. Our patient puts the phone down and looks at the nurse. "I am not going anywhere until someone tells me what's going on."

Fair enough.

"You know what's going on, you have a Doctor's appointment, " The Nurse starts to explain. She hands Sleepy Partner the packet of paperwork that accompanies the patient to the appointment.

He quickly flips through it. "It's a wound care appointment, Ma'am, with Doctor Decubitus."

Our patient starts crying. "No one ever tells me anything, I don't know what's going on... "

Her Nurse is getting aggitated. She turns to me, "She does this EVERY SINGLE time she has a doctors appointment. She does this EVERY SINGLE TIME I have to give her drugs." She throws her hands in the air, clearly frustrated she leaves the room.

I know this nurse. She's overworked and stressed out. She's not a bad nurse, but she's clearly having a bad day. I understand that.

My eyes keep going back to her legs. Signs hang on ever wall in the room reminding the staff and visitors that she is to have no pressure on either leg.

For a few moments the only sound in the room is our patient crying. My heart breaks for her. I step up to her bed and place my gloved hands on the rail to her bed.

"Ma'am..." I look her directly in the eyes and wait for her to respond.

She chokes back her tears and nods.

"Ma'am... I'm sorry that no one told you about the appointment." I keep my voice low and calm. "You really need to see this Doctor," I motion towards her legs.

"Why does he want to see me? I don't even know who made this appointment!" she argues.

Sleepy Partner decides to try. He shows her the letter from the doctor's office outlining the need for the appointment and asking for confirmation. He shows her the date and the time and the doctor's signature. He motions towards her legs and hands her a tissue. He pleads with her to go to the appointment.

She finally nods and agrees to go.

Sleepy Partner has grown as an EMT since I last worked with him. He's proof that being an EMT, a good EMT, is more than working well under pressure. It's not just saving lives. At its purest level it's about helping people. A lot of the time it is helping them when they don't even realize they need the help.

I'm so impressed Sleepy Partner. Go take a nap, you've earned it with no teasing from me.

Three.

Three of my dialysis regulars in the obituaries today.

Two of them were unexpected.

*sigh*

Okay... So... Here we go all over again.

I can't believe I'm typing this.

Last night was my (second) first night of Anatomy.

Yep, that's right folks... I'm starting Medic School again.

My grades rocked last time, so as long as McHottie doesn't run me over with the ambulance in a fit of rage, one year from now I'll be rockin' that Glitter Badge.

Home Away From Home... Concluded.

Welcome Back Everyone!

Unit XX here... Epi's a little bit busy with some very confusing chemistry homework, so she asked me to take you on a little visual tour of the front of the truck. See that picture up there? That's me in my sparkling glory. Epi and her kids had just given me a bath. You have no idea how good it feels to have a weeks worth of grime and dead insects removed with a stiff brush and some industrial strength soap.

At the top would be those infamous flashing lights. The ones that you may have seen in your rear view mirror asking you politely to please move your vehicle to the right so that we might get past you.


This right here is my angry air horn. Should you be on your cell phone when I approach you from behind and choose to ignore the loud siren that is blaring and the very obnoxious lights and strobes, you might get to hear this.

It's loud. It's EXTREMELY loud. Here's a fun story... One time Epi was standing in front it on the phone when Sleepy Partner thought it would be humorous to blow the air horn. It didn't just scare the living crap out of her, it rendered her deaf for five minutes and sent her into a blind rage. Gosh I miss that Sleepy Partner!

Inside the front of the truck... You might find a partner.

...A Sleeping Partner....

...An insane partner... (He's the EMS Moose.. our new mascot!)

...A Partner you can't help but laugh at... (Hey, according to protocols if he's pulseless and apneic I can intubate him... Go ahead and leave that glove on!)

Then there's the all important dashboard. I know what you are thinking. The dash is important? It is! It holds many things:

It holds... Map books, Frequent Flyer books (filled with face sheets), magazines, novels, my tired feet... Not the best place for your feet if that airbag goes off...

Here's my rear view mirror. I know Epi mentioned it's importance in the past post. It's a vital enough piece of equipment that I'm going to give it a second shout out. When you're driving, this mirror helps you to keep an eye on your partner. Very important. It also helps by giving you a place to hang air fresheners from Yankee Candle. The Country Linen scent is my current favorite. It gives the entire front of the truck a fresh smelling aroma similar to dryer sheets. Anything smells better than that GI bleed or the burst colostomy bag.

Side mirrors. Vital for backing up, changing lanes, and for when Epi is trying to put her hair back together after a rough call. When utilized properly, these bad boys should keep you from hitting those annoying concrete posts while backing in to a spot. Not that Epi has ever done that.

Personal Cell Phone. An essential tool for when one can't figure out how to unlock the truck phone (Epi's company restricted the truck phones to only call certain numbers, and then conveniently forgot to add some of those important numbers, you know, those numbers, like dispatch. If your phone is fortunate enough to be programmed with the dispatch number, chances are it takes five full minutes to navigate the menues to find it anyway.)

The Truck Radio. This particular radio allows the EMT's to notify dispatch of important things. It's extremely important to maintain a level of professionalism when using this radio. Here are a few examples of things you may hear on the air:

(All said in a pleasant tone)
"Unit XX to dispatch... We're enroute!"
"Unit XX to dispatch... We're clear on those instructions."
"Unit XX to dispatch... We're out, ending miles are 16.7."

Here's a few things you might hear, but shouldn't:
(Mostly said in an extremely agitated tone)
"You want us to what? There's like FIVE trucks there right now!!!"
"Yes dispatch, just to confirm, you want us to... NO, wait a second... Are you serious???"
"Negative Dispatch, We're going to have to turn down that run on the grounds that it's a minute and a half until we're off the clock."
"Negative, Dispatch, my partner is missing."
"Unit XX... report to the EMS Director immediately."

The Mic on the left is to talk to our dispatchers. The mic on the right is for the PA system management has yet to disconnect in our truck. Here are a few things you might hear through our PA system.

"Please...get...over...to...the...RIGHT!"
"Unit LMNOP, please move your ass!" (only said in the privacy of our massive ambulance bay, and typically at the end of a shift)
"Hey Baby... How YOU doin?" (Typically said by a friend of Epi's to Epi in an effort to simultaneously scare the hell out of her and embarrass her in front of other EMT's at the ER.)
"SWEET HOME ALABAMA!!!!" (Sung at the top of your lungs while driving through an empty downtown at four in the morning.)

Those ever important control panel. The bottom half controls the siren and allows for performing a symphony with it while approaching an intersection. When driving with the lights and siren on Epi typically prefers that the non driver operate the siren.

The top half controls the lights, the airhorn, and the power to the back of the ambulance. Nothing terribly exciting here.

It is suggested that you figure out what each of these knobs and switches do before ever setting foot on the ambulance to work as an EMT.

The FM radio. Often your only source of entertainment on those long shifts. Epi and McHottie have a tangle of wires, an Ipod, and an FM transmitter set up to supply them with a never ending supply of Bob Marley music and NPR programs.

Now... if only she could figure out how to play "No Woman No Cry" with the siren. Then I'd be truly impressed.

Okay, here comes Epi... I'm sure she has something serious and profound to say... I'll yield the keyboard to her...

Hey everyone, it's Epi. I'd like to thank my trusty truck for writing this post for me as I've been nose deep in studying. Okay, maybe I was taking a nap, but I'm definitely thinking about studying.

I know that we've poked fun at the truck today (and with my last post)... I want to make sure that everyone knows that even though I'm all for a giggle here and there, McHottie and I do take our jobs very seriously.

Our priorities are and will remain looking out for ourselves and each other, closely followed by providing excellent patient care.

Notice that nowhere in there is "Playing No Woman No Cry with the siren."

I'm not even sure it's possible. I suppose it could be. That'll be our project for a slow day.

Thanks for playing around ya'll... Be safe out there.


Another meme, this time from Hammer.

I know that a lot of folks aren't huge fans of memes. I like them when they're a little more creative and give you the opportunity to put thought into it. This is one of those.

I am : First and foremost a Mother. Everything else is secondary.

I think : People need to talk less and listen more.

I know : That the things I used to think were so important, really weren't.

I want : More than anything... Stability, honesty, and to laugh again.

I have : In the past made some horrible decisions, but I have no regrets. They're all learning experiences.

I wish : I had gotten into EMS ten years sooner.

I hate : Feeling like I have to apologize for insignificant things. I'm working on this.

I miss : The warm feeling I'd get whenever my Grandma would cook for my Brother and I.

I fear : Failing. Failing my children as a parent, primarily.

I feel : Right now, absolute exhaustion. Mental and physical.

I hear : That a 24-hour shift is coming my way soon!

I smell : Clean. Like soap, shampoo and soap. And like lilacs courtesy of Bath and Body Works.

I crave : Good Chinese food. As opposed to the crap I attempted to eat for lunch today.

I search : Most mornings for my keys.

I wonder : Where I'll be in five years.

I regret : Absolutely nothing. It's all a learning experience.

I love : My babies. And a few others as well.

I ache : At the end of most shifts. And pretty much any time I do yard work.

I am not : A shy person. Normally.

I believe : God put me here to do what I can for people, while I'm with them.

I dance : Like no one is watching. More often than not when no one is actually watching.

I sing : Cliche'd songs at karaoke. And at very loud volumes while driving alone.

I cry : More than I'd like to admit.

I don't always : Remember to sign my run reports. This gets me in a lot of trouble.

I fight : Like a rabid wolverine when my children are involved.

I write : Because it distracts me.

I win : At tic-tac-toe... If I'm playing my 3-year-old.

I lose : My mind when I encounter stupid drivers. Which unfortunately is often.

I never : Pass up a "teachable moment" when my kids are involved.

I always : Wear gloves when with a patient. Always. And if yesterday's events are any indication I'll do this for the rest of my EMS career.

I confuse : Colonel and Corporal. It made me a very sore Private in Basic Training.

I listen : To silence. It comforts me.

I can usually be found : Looking for a damn face sheet while at work. At home I'm typically found playing with the kids, doing laundry or typing on the computer.

I am scared : Of raging drunks and violent psych patients. But not *that* scared.

I need : More joy in my life. And significantly less stress.

I am happy : Just to know that my kids are happy. I'm happy when I feel like I've made a difference. I'm happy when I can make someone smile.

Meet Lucid...

Soon to be EMT, Pre-nursing major, and future flight nurse. Oh, and talented writer :)

Lucid, you rock.

Worst Camera Nightmare.

Tagged (via MASS tag) by David McMahon.

Please answer today's question on your own blog, any time until next weekend. Just link to this blog (or to this post) so I can follow the progress of the discussion.

The question is: What was your worst camera nightmare?

The Recipe for a Nightmare
By EpiJunky

1 very bright and overeager extremely young avid photographer
1 semi professional camera in good repair
4 lenses of various lengths
2 flashes with fresh batteries
25 plus rolls of professional grade film (yes, FILM folks! I actually shot FILM!)

and of course...

1 bride on a budget. (That's another post altogether!)

I can hear the groans from here.

Yes, I had no business shooting a wedding. I agree completely. I was young, and stupid and had a teeny tiny ego. After all when enough people tell you that "You should really do weddings!" you start to believe it. Unfortunately, most of those people were family members. I really should have ignored them.

It started out well enough. I was there early, list of required shots in hand. I had my newish camera, fresh batteries, for both the flashes and the body, plenty of film and my best friend to help me for when I had my temporary freak out. Oh, and to adjust the Bride's train, and help out in general. (Notice the fact that I had NO backup camera body. Thank GOD mine didn't die on me... That's more nightmare than I could have survived. I was SO stupid.)

Okay, so I tripped over a microphone cord and fell on my face pretty early (but before the actual service), it wasn't my most glorious moment... It did do a little to shake my confidence.

I actually made it through the wedding with no major issues. I did well at the reception. I was confident that my shots were going to be great. I was beyond excited when I dropped the film off.

23 rolls of film.

To my former employer. My trusted local photo lab.

I went in to pick up my prints... The first several rolls turned out beautifully. My ego swelled.

The bride getting ready.
The bridesmaids.
Mother of the bride helping her get ready.
Oh look, the groom is trying to make a run for it!!!

The ceremony shots turned out beautifully, even with no flash. Who knew that 80mm 2.8 lens would work out so well in poor lighting!

Okay... Let's see the reception...

Where are the reception shots?

Okay... here we go... The wedding party enters... Good good good... Okay, that one's out of focus... Why did I take take a picture of the drunk Aunt? Okay...

Where's the rest of them?

Yep. It happened. Somehow the lab lost TEN ROLLS OF MY FILM.

In other words, MOST OF THE RECEPTION.

Gone. No trace of them with the exception of my eight tickets for the rolls that I had checked in.
No First Dance.
No speeches.
No toasts.
No garter toss.

GONE.

Oh HOLY HELL. I lost my mind in the lab that day. When I talk to Jeff (former coworker who was working the day I came in to pick the film up) he still laughs about it. Apparently my language alone was enough to make my former coworkers consider calling the police.

I don't find it funny at all... Even eight years later.

I don't even want to go into how horrifying the whole ordeal was for me... I'm the one who had to break it to the bride and groom (and the mother of the bride!) that the lab had lost the film. I feel worse for the family. They handled it better than I did, believe it or not. I was VERY lucky.

I was more than upset about it... I was physically ill. It gives me chills to this day.

So there's my nightmare, folks... Not my proudest moment by a long shot. Let's just say I've learned quite a bit since then. Thank God.

The view from the back of the ambulance

video

A little gift, from me to those of you who have never experienced the joy of riding in the back of an ambulance at 70 mph with no shocks.

For those of you on dialup... Save your time. It's loud, it's bumpy, and if you stare out the window long enough, it's extremely nauseating.

I Have Been Waiting... (Another possibly pointless post)



This song has been stuck in my head for at LEAST a month. I should have included it in my mega meme, but what can I say, I'm a bit distracted lately.

The lyrics say a lot. I'm big on lyrics.

In other news, today I was attacked by mayflies and I broke a nail closing the truck door :)

Post Secret


I LOVE the blog/website Post Secret.

You never know what you might identify with. The updates are once a week, on Sundays. For anyone who has ever had a secret... It's a way to know that you're not alone.

Happy Father's Day, Dad.

I've been tagged! HOLY CRAP :)

Twice in fact. Once awhile back, don't know how I missed that one, Sam. :)

So Sam from On the Clock and Kim from As The Pump Turns (who's blog I'm really growing to LOVE) have both tagged me with similar memes... I've decided to be a rebel and combine them (and tinker a bit with them... like I said... I'm a REBEL!!!!).

The rules:
Six word memoir. Write one.

Six pictures that best describe you. Preferably with a short explanation. Or something.

Six songs you identify the most with (Or have the fondest memories associated with... or something like that... Hey, I'm not big on rules right now)


Hrmm... six six six. Maybe I should name this hybrid meme "Mark of the Devil".

Don't mind me folks, I've got a load of benedryl on board thanks to my hellacious allergies. Okay, so here we go.

My six word memoir...

Don't dismiss me I'm not done.


And my six photos from the top left :

That's me with my third baby, my camera. We're seldom apart.

She Who Rules on her third birthday. My children are my oxygen. Every single thing I do is for them or because of them.

That's me with some friends at an EMS conference. My EMS friends are my second family.

From the bottom left:

Some of the tools of my job (yes, in toy form, but still). My job is part of my identity.

My son, Future Cardiologist. The boy who singlehandedly taught me about mutual unconditional love and adoration.

And finally, the last photo is meant to symbolize reaching for my dreams, no matter how impossible and far away they seem. That's me on the day of my buddy flight for LifeFlight in Toledo. Eight of the most amazing hours of my life. I'm going to be up there one day.

Finally, the six songs (All of which I've heard more than once in the last week:

Want To - Sugarland
I LOVE this song. It reminds me of how exciting it is at the beginning of a relationship, the uncertainty of it all, and how sometimes just giving in and not over analyzing every little thing can bring amazing results.
My favorite line: "Yeah we both got dreams we could chase alone, or we could make our own."

Three Little Birds - Bob Marley
I want to thank McHottie for reminding how much I LOVE Bob Marley. We had a patient this week (I'll post more on her later) who was singing along to this song when he played it. And she's nine years old. It was possibly the cutest thing I've ever seen.
My favorite line: "Don't worry about a thing, cuz every little thing is gonna be alright."

Save Me - Shinedown
I saw this band play at Rock on the Range, and they were AMAZING! The crowd was absolutely insane during this song, and I might have even had a nitrile covered fist in the air.
My favorite line: "How did I get here and what went wrong? Couldn't handle forgiveness, now I'm far beyond gone."

Better When We're Together - Jack Johnson
McHottie introduced me to Jack Johnson's music, and I've been hooked ever since. It's so laid back and calm, and it's great music to nap in the truck to. He proposed we use this song to put together a slide show of the partners at work for the Christmas Party. (It would not be the typical slide show I have a feeling.)
My favorite line: "Love is the answer, at least for most of the questions in my heart."

Forever and For Always - Shania Twain
I haven't been much of a fan of hers, but this song is one of my favorites. I can rock this one out at karaoke :) It's one those songs that just make me smile and feel warm and fuzzy inside :)
My favorite line: "And there ain't way I'm letting you go now, and there ain't no way, and there ain't no how, never see that day..."

Edited to add the song I forgot :) Thanks Sam!

Unwritten - Natasha Bedingfield
It's my new anthem. That's all I have to say.
My favorite line: "Drench yourself in words unspoken, live your life with arms wide open, today is where your book begins, the rest is still unwritten."

The Coffee Cup Meme...

Okay, since no one ever tags me to do anything (no worries, I'm not hurt or anything... Give me a minute... *sniiiiiiiffle*), I've self tagged myself.

The premise (for those of you unfamiliar with this one) is simple. Snap a picture of your favorite coffee cup and write a little bit about it.

Here it is... 24 blistering ounces of joy.


Thank Heaven for 7-11.

Coffee has been a part of my "getting ready for work" tradition for the last three years.

Shower, brush the teeth, hair, makeup, uniform, boots, coffee.

Any deviation from this results in disaster. Seriously, use your imagination.

Epi shows up to work happy and awake. Unfortunately she's still in her pj's and her hair is rivaling Don King.

Epi shows up to work looking fantastic, perfect hair and makeup, uniform pressed... Unfortunately she didn't get her coffee, so she shows up with an AK-47. Apparently I become a "raging bitch" (according to more than one of my past parters) when I don't have a significant amount of caffeine in the morning.

So I'm addicted, I'm afraid.

24 ounce cup, two splendas, two creamers. $1.29 when I have to pay for it, but more often than not it's free when I'm in uniform.

Good stuff.

Non Princess Emily

There actually is an upside to working on a transport truck.

I know, I can't believe I'm typing that out.

The upside is getting to know your favorite "regulars". Those patients who for one reason or another you look forward to picking up, even if it's just to go to a scheduled appointment.

Emily has quickly become one of those patients.

Dispatcher: "Unit 19, One-Nine..."
McHottie: "Nineteen, go"
Dispatcher: "Unit 19, Got a run for you out of Local Ortho Clinic, taking them to a private residence on Wilson. I'm sending the page now.
McHottie: "Nineteen is clear on Ortho and enroute."

*BRRRRRRRRRRRRR* I jumped out of my skin at the noise.

McHottie was driving. "It's your pager vibrating against that pop can." (Yes, he reads minds as well ladies, what a catch!)

I read the details of the run to my partner. We're both familiar with the neighborhood the house is in... We grew up there. Steps outside, lots of steps. Not fun when you're carrying a stretcher with a patient on it.

"If there are that many stairs we'll use a stair chair or call for an assist. I'm not wrenching my back carrying a patient up a flight of stairs," McHottie said as he turned into the Local Ortho Clinic parking lot.

"Negative Ghostrider, the patient is in a full body cast. Looks like she's only 89 pounds though..." I set my pager down, grabbed two sets of gloves and headed to the back of the truck to get our cot out, McHottie was trudging into the lobby to try to locate our patient. It was getting close to the end of our shift and we were both moving at half speed.

I pull the cot out and begin to drag it towards the building... That's when I saw her for the first time. A young mother, she couldn't have been any older than 25, pushing a reclining wheelchair with a little girl, eight, maybe nine years old. The little girl was covered up in a Disney Princess fleece blanket to protect her from the biting wind. Mom wasn't even wearing a coat, she looked cold and tired. The little girl looked like she had just found the golden ticket to Willy Wonka's factory. Her eyes were huge and chestnut brown. Her smile positively infectious. She had gorgeous curly hair pulled up on top of her head in a pony tail.

Her mom spoke first. "Are you our ride?" She looked hopeful, shivering against the wind.

I get down on one knee and look at the little girl, a big smile on my face. "That depends, is this Princess Emily?"

"I'm NOT a Princess!!!!" She laughed so hard and for so long that I couldn't help but smile.

"Well we have it on good authority that you are, and your chariot awaits!" I motioned towards the ambulance. Her mother leaned towards me and whispered that the ambulance ride was Emily's favorite part of any Doctor's appointment. I nodded.

McHottie came out of the building looking defeated. He called over to me, "Hey, Epi... Our patient is MIA."

I pointed at Emily and smiled.

McHottie put on the charm. "I didn't even see you over here, I'm sorry... I'm McHottie, you must be our Princess!"

Emily and her Mom both laughed out loud... McHottie looked a little lost. Not something I'm used to, believe it or not. I explained that Emily had told me that she is "most definitely NOT a princess."

McHottie checked out her body cast. It was bright blue with half a dozen messages written from various people. He looked at Emily's Mom. "Do you have a marker?"

She whipped the marker out of her side pocket.

"Emily, can I sign your cast later on?"

"Yes you can!" I think she actually batted her eyelashes at him. She was GLOWING.

We loaded Non-Princess Emily into the back of the truck, McHottie was teching the run. I sat up front with Emily's Mom.

I couldn't hear most of the conversation during the transport, but I can tell you that Non Princess Emily laughed as hard as I have ever laughed during most of it.

I'm going to take a quick second to give my partner the props he deserves. For all the crap McHottie gives me, for all the teasing, for all the days where I want to attack him with my "glove-chucks", there is one thing that I will never deny him. This man is the BEST partner I've ever had. He's a PHENOMENAL EMT, and he's got an amazing bedside manner. His ability to develop a rapport with his patients is incredible. If any of you ever tell him I admitted that for the world to read I'll hunt you down.

We arrived at Emily's home just a few minutes later. Four steps leading from the street to the lawn, and four more to the front porch.

McHottie does the math, he can tell I'm doing the same. "Will you be okay, Epi?"

I survey the steps one last time. "Yeah... We'll be fine."

And we were fine... We carried Non Princess Emily up all eight stairs to her castle. And never broke a sweat. McHottie lifted her from the cot and placed her gently in her hospital bed in the living room. He raised the rails and cracked a few more jokes with her while I got the paperwork signed and started towards the door with the cot.

You know, it's amazing how tough kids can be. This little girl was in a BODY CAST for the entire summer and wasn't complaining about it. She impressed the hell out of both of us. We both hoped that if she had to be transferred again, we would be fortunate enough to draw that card. And we did... a few short weeks later.

***Which I'll write about tomorrow... It's late ya'll, have a good night.***

Welcome to my home away from home.

Welcome to my truck, Unit X. Don't mind the picture, she's shy. I spend more time in the back (and front) of this ambulance, than I do awake at my own home with my kids. I have issues with that statement, but this is supposed to be lighthearted, so... well, that's another post for another time.

I thought I would take ya'll on a little visual tour of my home away from home. For those of you who have always wondered what the inside of an ambulance looks like (I can only imagine why), this post is for you.

The Back

The back of the truck. This is where we spend time with our patients. It's also where Sleepy Partner takes the majority of his naps.

1. The hooks and the bolts.
These babies serve very important purposes, and endless amusement. First and foremost, the two lower black bolts (because I don't know what else to call them) are responsible for keeping the back doors of the ambulance closed. Very important stuff unless you like the back doors flying open at random moments while you fly down the freeway. The yellow hook above the bolts keeps you from dropping the patient on the stretcher while you load it into the back.

The three of them together provide moments of hysterical laughter to my partner as I am CONSTANTLY catching my boots on them as I climb out of the back of the truck. Nothing is more funny to him than the idea of me faceplanting on the asphalt as I attempt to exit the back of the truck. Well, it would be funnier if there were some hot firefighters in turnout gear watching while I do it.

2. The Stretcher/Cot
They're not built for comfort, that's for sure.

This lovely bright yellow contraption is where our patients relax while we take them to where they need to go. Dialysis appointments, Wound Care, Dentist, Optometrist, even to the ER!
It's also another comfortable place for Sleepy Partner to crash. A growing boy needs his sleep ya know!


3. The Bench Seat/Bench Compartment
The bench seat serves several purposes. Underneath we keep everything from body bags to spare linen to extra O2 tanks.

The bench seat itself is where a second patient can ride (typically on a backboard, strapped down to the bench). It's also where most riders accompanying a patient choose to sit if we allow them to ride in back. If I'm missing a pen, it seems to always wind up hiding somewhere along the bench seat even if it's not where I sit. We keep our "ears" (stethoscopes), BP cuffs, and glucometer here as well.

It's also yet another place for Sleepy Partner to catch a cat nap.

4. The captain's seat
This is where I sit when I'm in back almost 85% of the time. It's the seat with the best access to the airway. It's also the seat closest to the action area and the front of the truck. If I need to open the side window to let some air in (for any given reason, use your imagination and think c. diff, disconnected g-tube or GI bleed. yes, I'm a weenie), this is the best seat to do it from.

5. The "Action" area
What do we keep here... Suction. Lancets for the glucometer, Spare alcohol and betadine preps. Bandaids. and rolls of tape of every width.

On those long transfers it's also where we keep our 44 oz Diet Pepsi's and our reading material.

6. The rear view mirror
Yes, I realize that technically it's in the front of the truck, but don't discount it's importance to those in the back.

Things you can convey without using words just by catching your partner's eye in the rear view:
Drive faster. This guy looks like shit.
Drive faster... This guy smells like shit.
Drive faster...... This guy keeps grabbing at my chest!
Drive faster! This guy is grabbing HIS chest!!!!
Drive slower!!!!! You just tossed me out of my chair/made me spill my coffee/interrupted my nap with your bad driving!
Seriously, STOP THE TRUCK and get back here, this guy just grabbed at my boobs again!


7. Our GCS cheat sheet
I like this because for some reason I've memorized and forgotten the GCS scores twice now.


8. The vent from God Himself
It brings us precious heat in the frigid winter and can turn the back of the truck into a meat locker during the summer.

9. The "tagged" cabinet
Home to the AED (if you are fortunate enough to have one on your truck), the first in bag, and the airway bag.

Very rarely opened on a day car.

10. The rail
See that blue piece of latex free elastic tied around it? It's of no use to a basic truck. Well, if you tie the ends together it makes a nice rubber band...

The rail is what we grab onto when our partners take those corners too sharply while we're standing. Or if they break too suddenly, again, while we're standing in the back.

Legend has it that it has alternate purposes.... That's just gross. Use it for its intended purpose.

11. Diamondplate

I have no idea what its purpose is other than looking cool. Also, it's one more thing for me to have to scrub with a toothbrush before the state inspection.

12. The railing and the "escape hatch".

When you need to make a quick exit, the best way is through the side door. Make sure you grab the railing because (and I'm speaking from experience here), the more urgent your escape is, the more likely you are to fall out of the ambulance.

****** Tomorrow, we'll continue on to the front...******
I know you all will be waiting with baited breath :)

A quick conversation with McHottie

McHottie: Yeah, so I'm 33 years old, I'm not married and never have been, and I don't have any kids. I like kids though...

Epi: Wow. You're just like Jesus.

McHottie: (Doubles over laughing) THAT...was good. High Five!

Epi: .... (I can't even talk I'm laughing so hard)


Yep, that's right folks. McHottie. Just like Jesus.

A conversation with my three year old...

video

And the transcript for those who don't speak three year old...

She Who Rules: *GASP* See? *waves*
Epi: What's that?
She Who Rules: What?
Epi: What is that?
She Who Rules: What???
Epi: Did you hear that?
She Who Rules: *Gasps again* I see the bird!
Epi: Is it a bird?
She Who Rules: Yeah.
Epi: Is the sun in your eyes?
She Who Rules: Mom, look at it? See? Hot!
Epi: Be careful... Can you say "I Love You?"
She Who Rules: I love you.
Epi: I love you too, Sweetheart!
She Who Rules: What?
Epi: What???
She Who Rules: (Speaks three year old gibberish... All I know is she's laughing at me)
Epi: Yeah? What are you doing today?
She Who Rules: Nothin'
Epi: Are you playin'?
She Who Rules: Yeah...
Epi: Are you having fu--
She Who Rules: (Cutting me off) AIRPLANE!!!!!!!
Epi: What?
She Who Rules: (I dont know what she's saying here) I no see it! Airplane?
(Sound of train in the distance)
She Who Rules: (Shrieks) MOM CHOO CHOO!!!!!!
Epi: What is it???
She Who Rules: Mom Choo choo train... That's a choo choo train!
Epi: Where's the choo choo train?
She Who Rules: *gasps again and listens* Choo Choo train right there!
Epi: Where's it going?
She Who Rules: Nothing (this is her answer to just about everything she doesn't have an answer for)
Epi: Okay, say bye bye!
She Who Rules: Bye Bye!



McHottie meets Pseudo Dad

McHottie is my current partner. He's 6'3", never been married, no children and 33 years old.

Pseudo Dad was my partner at my last employer. He's 6'4", been married three times, has adult children (three if you count me!), and is 49.

McHottie listens to hard rock.

Pseudo Dad listens to Journey.

McHottie has a thick head of hair.

Pseudo Dad... well he's... Let's just say his hair isn't so thick anymore.

McHottie has been an EMT for a few years.

Pseudo Dad has been an EMT for a few decades.

They are quite different. That's probably understating it a bit. So imagine my shock today when we met up in a hallway of a local hospital and they BONDED. They bonded over stories where I make an ass out of myself.

************

Epi: PSEUDO DAD!!!! How ARE YOU?

Pseudo Dad: Hey Epi... That's a new look for you... Very Pollyanna! (I had my hair in pigtails)

McHottie: (To Me) That's Pseudo Dad?

Epi: Yes, Pseudo Dad, meet my partner McHottie. Hey, did you happen to notice my stellar parking technique down there? I can back that truck up like it's no ones business!"

Pseudo Dad: (looking at McHottie) Her parking's okay?

McHottie: She's doing okay actually! (He winks at me. Score one for McHottie!)

Pseudo Dad: So... You sick of her yet? Are you sending her back to us?

McHottie: Am I sick of her yet? Nooo... She's great, really!

At this point I feel the need to check him for a fever.

Pseudo Dad: She's a good kid. (He's smiling. He BETTER smile.)

Epijunky: Yeah, you BETTER tell him that... Sheesh. I was a good partner to you! Don't you dare sell me out!

Pseudo Dad: Hey, did she ever tell you about her first body donation run? (Edited to add: The original story is in the second half of that post)

Epi: Don't you dare...HEY... PSEUDO DAD... I WAS GOOD TO YOU!!!

McHottie: (Perking up) No, I don't believe she has... (He walks over to Pseudo Dad, who begins regaling him with the tale of the body)

I decide to retrieve my patients face sheet and talk to Pseudo Dad's new partner.

Epi: Are you sick of him yet?

Pseudo Dad's partner: (deadpan) Since day one.

We walk together back over to Pseudo Dad and McHottie. McHottie is doubled over laughing.

Pseudo Dad: And she's screaming PSEUDO DAD I'M GOING TO KILL YOU!!!! I've never heard so many four letter words come out of a woman before. We laughed for a good fifteen minutes, tears running down our faces.

McHottie looks at me. "I cannot WAIT to get a body run with you."

Epi: Oh shuuush.

I look at Pseudo Dad who is practically dying. "I won't forget this one, Pseudo Dad. You're gonna pay."

Pseudo Dad's partner starts laughing, "Ooooh YOU'RE gonna PAY!"

Epi: Well, as much fun as this has been, and believe me, it's been an absolute thrill, we need to get out of here.

McHottie takes the head of the cot and we start to head towards the elevator with Pseudo Dad and his Partner.

Pseudo Dad: You miss me, Epi, you know you do. Make sure you tell him about run with the dog and the firefighters.

Epi: I hate you. Shush. No more Epi stories.

McHottie starts laughing again.

Epi: Seriously, I hate you all.

Addition to the ever growing blogroll...

Please welcome Kim from As the Pump Turns.

Best of luck in Seattle.

I'm jealous ;)

Like a Fish Out of Water

"Unit X has a county run"

The disembodied voice echoes through our ambulance bay where we've been sitting for the last 45 minutes, stewing in our own sweat, pondering the idea of setting up a kiddie pool there. Surely it would help morale... Yeah, that's the argument we'll use with management! The board in dispatch has been blessedly quiet today.

A swell of adrenaline courses through me. We haven't done a large amount of 911 runs lately, and while I love my regular patients, my dialysis patients... Every once in awhile you need something different. Add to that the fact that I'm working with a Medic, and I'm positively giddy.

Yes, I have my geeky moments, and I'm not ashamed to admit this was one of them.

Myself and Medic Partner for the Day make our way to our truck. It's quite warm outside, and we chose to leave our truck run with the air on. I jump in the drivers seat and key up the mic.

Epi: "Unit X is on the air..." I pause and wait for dispatches directions. Medic Partner grabs the map book as neither one of us are familiar with the part of town we're in.

Mom Dispatcher: "Unit X, you have a county run, Code 3 for the county, 410 Morris Ave, that's 410 Morris Ave, cross of Jackson. Code 3 for the county."

Epi: "Unit X to dispatch, we're clear on Morris." I look over at Medic Partner and ask him if he's familiar with either street. I know I'm not. He's furiously flipping through the mapbook.

Medic Partner: Looks like it's over the river and through the woods. Head for the bridge... Three streets after the light make a right. Look for the big red truck."

I flip the lights on and Medic Partner takes control of the siren. Have I ever mentioned how much I HATE driving with the lights and the sirens on? Riding as a passenger, no problem, but when I'm driving... It seems like every idiot within ten blocks decides to cut me off. Cursing is not out of the ordinary. Medic Partner beats me to it.

Medic Partner: "WHAT... WHAT??? WHAT... IS... HE... DOING???" (followed by a thirty second rant I can't type out, but trust me, he's former Marine... It was impressive.)

When the second pickup truck in a row decides to cut in front of me and hit his breaks, Medic Partner loses his mind completely, picks up the PA mic and strongly suggests that the truck in front of us get out of the way.

I think I might love Medic Partner.

This disembodied voice returns.

"Dispatch to Unit X"

Epi: "Unit X, go"
Dispatch: "PD's on the scene. Please stage and wait for further information."
Epi: "We're clear on staging"

Four minutes later we are two blocks away with the lights off. With our 911 runs we are never given a nature of the call, we pretty much go in blind, meeting a Firefighter on the way in who gives us a quick rundown: Nature of the call, vitals, etc. We sit and wait. We wonder what we're about to walk in to.

Medic Partner: "It's a domestic. I guarantee it."
Epi: "No, let's go with gang fight. I'm willing to bet Chipotle on a gang fight."

The truth is, it could have been a gang fight, or a domestic, or a heart attack, or a police chase or any other number of emergencies. We were in one of those neighborhoods.

Dispatch: "Dispatch, Unit X"
Epi: "Unit X, go"
Dispatch: "TPD has cleared the scene, continue on"
Epi: "Okay, Unit X is clear, continuing on."

We drive the next two blocks in silence. I pull our truck up in front of the Engine. A firefighter instantly meets us. I roll down my window. The heat hits me in the face.

Firefighter: "We have a domestic... She's pretty banged up. Bring the stretcher."

My heart instantly sinks.

Medic Partner: "DUDE... You TOTALLY OWE ME CHIPOTLE!!!!" He does a dance on the way to the back of the truck.

I take a deep breath, grab a pair of gloves, and head out. The excitement is gone. I hate domestic calls. I hate them. I hate them. I hate the fact that Medic Partner is excited over free lunch. I hate the fact that I was excited over a county run.

I make an attempt to clear my head. We walk into the house with our cot and assorted bags. I'm not prepared for what I'm walking in to.

To my left, what used to be a large aquarium, toppled over to the floor. I try not to look for it's former inhabitants. I picture them flopping around on the floor. To my right an overturned end table, broken glass, and blood. Then I'm forced to look at my patient.

She's sitting on a white couch, surrounded by splotches of blood. Her eyes are starting to swell, my guess is that in an hour she won't be able to see. She's bleeding from a multiple lacs... on her forehead, on her cheeks. What looks like a claw mark stretches across her exposed chest. Her pink shirt ripped and covered in blood. A large lac to her forearm is already bandaged and dressed courtesy of the Fire Department. She's sniffling and rocking back and forth... Blood runs into her eyes. She wipes it away, smearing it across her face. It looks like war paint.

I try to move but I can't. It's completely silent in the room. I look at Medic Partner who seems to be soaking the scene in.

Then a cry breaks through the quiet. There's a baby in the house. Five grown adults jump out of their skin at the same time.

I look instantly at Medic Partner. "Was that a baby?" I look at the Firefighters and ask the same. Medic Partner and the Firefighter look at our patient. They all want to know the same thing...

The Firefighter interrogates her: "Are there children in the house? You said you were alone!" Medic Partner asks the firefighter where perpetrator is and the Firefighter shrugs. "PD cleared the house, that's all we know." They take off down a hallway to find the baby.

My heart starts racing again. I instantly feel like I'm in over my head. I sit next to our patient, who at this point is rocking back and forth. I begin to talk to her. I look her in the eye and try to get her to focus on me.

"Your name is Michelle? Michelle, I'm Epi... I'm here with EMS. Honey, can you look at me? I want to take a look at the cuts on your face and head."

She rocks back and forth, a blank stare on her face.

I swallow hard. I feel ill equipped... I feel... like I'm drowning. I feel like a fish out of water.

"Uhm... Michelle?" I lower the volume of my voice, "Honey... Talk to me. I want to help you." I slowly reach forward with my gloved hand to touch hers. She doesn't flinch, so I dab a 4X4 at some of the lacs on her head. I want to clean her up. I squeeze her hand gently. She looks at me... She looks at me with the saddest eyes I've ever seen. Swollen, bruised, bloody. The tears are dry now, there's nothing left but a vacant stare. I want to hug her, instead I place my hand on her back. "Michelle. honey, we need to take you to the hospital. you're going to need some stitches." I speak slowly, quietly, gently.

Medic Partner emerges with the baby. She's beautiful. She had been in her crib napping. Medic Partner gently rocks the 14-month-old baby girl. "Michaela is fine" He coos in her ear. "She's just fine. Aren't you honey?"

Michelle turns to face me. It's the first time she's made any significant movement, and it makes me jump. I am face to face with her.

Her voice broke. "I'm fine." That's all she would say. Over and over. "I'm fine."

The house was hot. It was muggy. Uncomfortable wouldn't begin to describe it. The heat made my uniform cling to me. My emotions were raw. I wanted to find this guy and kill him with my bare hands. SLOWLY.

I continued my assessment while Medic Partner played with the baby. When it finally came time to get her on the stretcher and leave, she refused.

"Absolutely not. I'm fine. I was dizzy and fell. I feel better now" she insists in a quiet voice.

The firefighters, who have hung out much longer than they usually do, look uncomfortable. The Lieutenant speaks up. "You told us you walked into a door, then you told us he hit you, then you told us that you got dizzy and fell out, then you told us that you had no idea what happened. You need to be seen. You do."

Michelle was not going to be swayed. Not by the firefighters, not by my Medic Partner, and not by me. I felt like I failed her. I called online medical control for the AMA, and after a brief conversation with her, they let her go. Her shaky hand signed the refusal, she took her baby girl into her arms and promptly kicked us out of her house.

Just like that. It was over.

(If my ending feels incomplete, you can imagine how I felt after this run.)