Yellow Blog Journalism

On Flying

On Redjusting to Life

I've just finished my third 24 in the last week, completing the orientation for the new Big Daddy EMS. and that combined to starting a new quarter in school and the classroom component of this orienteering has made for a pretty tired (action)geek. The entire orientation went very well. I have slipped back into my old "self" in a couple of encouraging ways. I feel very good about both my company and my skills. This quarter is going to expand both skill and knowledge in the field and probably radically change the caliber of care that I can offer my patients.

The major difficulties that I have had in the last few days have been getting my body back in the swing of a 24 hour shift with interrupted sleep being the norm and meals taken as they can be found. quickly, cold and almost never off of a plate. Also not seeing my family daily has had a noticeable impact not only on me, but on Jenn and Jack as well. This is a new stress that I'm placing on my marriage and family, one that will get us through school and onto the next phase of our lives and my career in nursing.

School is entering the first of my two most challenging quarters. If I can make it through to Christmas, I'm golden. The pace is furious and the information complex. I already feel a bit behind, but a good bit of studying in the margins at work and  regular study time on my off days will go a long way toward keeping me afloat.

Life is changing alot these days, and while I am going to have a bit more concentrated off time as the result of working 24 hour shifts, for the next 6 months quite a few  of my evenings will be spent with my nose in a book. Christmas is my next goal. Make it to Christmas, survive and thrive. If I can pass well, I might pick up a game system or something to reward myself with.

On Long Shifts

I'm told that today was a pretty atypical sunday for Big Daddy Ems. plenty of trauma, a few respitory calls, a touch of the "dude, I'm bored. Let's call 911". There was even a guy in the back of a cop car after being tazed. I doubt that he said the classic "don't taze me, bro". But I can dream.

Things settled down and I was able to get three consecutive hours of rack time after midnight. Three hours is about long enough to have a trippy dream about lockers (?) That I would spend the balance of my 5am DIB call wondering about.

Right now I'm in a good place. I'm just recently back on the truck, well, a truck owned by a company in the business of pt care, and I can handle this very well. But I remember when I was working far too often (96-120 hour weeks) in zones that would reliably produce 15-18 calls a shift. I exhausted myself and in doing so, I did no favors for my patients. And despite the high hour count this week, +90, I'm rarely if ever going to see the ugly side of 76 hrs again. There is just too much on my plate right now. Family and school will save me from my old "oholism", work.

 But the newness of this job will eventually rub off and I'm going to need more patience on nights like tonight where you walk into a house filled with cigarette smoke and the patient can't fathom why they can't breathe. God, teach me patience.

Hopefully as the next year of school wears on and in some cases wears out, I'll be able to keep my eye on patient care as its own value, something to be done well for the sake of doing it well. A good lesson to learn before getting into ems would be that even the jerks deserve a shot. Easy to forget when the jerk is on your stretcher and just being themselves. At 4am. And they are the 14th call. And dispatch is pushing you because they have a few more holding.

Some nights are like that. And some days the milk man and carpenter and executive have bad days too. 

On Refining Skills

Its been a tough lesson to learn in the last few months that it is easier to maintain skill and knowledge than it is to try and replace it once time and disuse have taken their toll. The theory is that the subjects and skills least used should be the most often refreshed, but the tendency is to focus on the things that you use the most.

I don't think that cpr should require refreshment quite as often as we do it. I've used the heck out of my cpr cert and I try and being an instructor, I've never met a medic that really needed more information than an update on the latest numbers; we're now @ 30-2 for 2 rescuer adult cpr. Most people who have a card will look at that last sentence, nod their heads and do good cpr. For those who don't do good cpr, we should be less shy about reccomending re mediation.

When I study I like to take a lot of quizzes. Quiz banks are helpful because they give you bench marks. You figure out very quickly what you know and what you don't know. Focus on what you don't know. I do very well with high yield studying. It is the basis of many of these professional test prep program.

Focus on your most weakly reinforced areas.

The other day I was given an opportunity to put my hands on every piece of equipment on my truck. The question that the training director asked first was which equipment was new to me. I've never had any contact with a king airway until now. When I first stared out in EMS in 2002the king was largely unknown if it existed at all. I was trained on comb i-tubes and ET tubes as primary airway devices (though I now question the wisdom of the "8 intubate" crowd) so I focused on building familiarity with this new adjunct. I'll hit the lab again every few weeks to focus on proficiency, for this and other skills.

The second question that was asked of me was which items have I not used recently. I needed to brush up on a lot of my secondary splinting devices. Localized trauma requiring more splinting than a frac pack is less frequent than the more generalized multi-system trauma. For a shotgun blast of splinting, a frac pack and long back board can take you a long way. More involved secondary devices, the traction splints especially as well as the KED, tend to gather dust being brought out only slight more often the. MAST trousers and the ever present sandbag. I was able to retrain on these devices without having to sacrifice my pride.

My goal for the next year is to begin going through each device and skill that I could possibly employ and brush up. Its been far too long for some of these, and I'd hate to be ill equipped to handle a situation, but honestly I've let too much knowledge and skill atrophy to approach this with the type of confidence that I would like to. While I'm still competent, I'm taking aim at greater proficiency.