Archives for 2016

It’s Not My Job.

“It’s not my job…”

How many times have we heard this going in and out of nursing homes? We go in to pick up a patient and when we ask for paperwork, the bored CNA or LPN at the desk says:

 

“It’s not my job to do that…”

“I’m from another floor…”

“That’s not my patient…”

“I’m going on break so I’m not going to…”

 

 

When the patient is completely soiled and smells like they’ve been laying in their own pee for three weeks:

“I don’t know. Not my job to clean up…”

“Not my patient, not my problem…”

 

We hear it ALL the time! Day in and day out we go into so-called ‘Skilled Nursing Facilities’ and it seems like no one has a job or job responsibilities because they all say, “It’s not my job.” We vent and whine about how horrible the facilities and staff are because they never seem like they ever do anything. It’s always, “It’s not my job.” We could all sit around a bonfire and compare ‘It’s not my job’ stories until the end of time and we still wouldn’t run out of them. When we are all little old Paramedics and EMTs, our EMS Family will still have ‘It’s not my job’ stories. We all hate it when people say it to us.

 

I was looking through Facebook and a posting came up about weighing Dialysis patients. There were over fifty comments about this task and the majority of them said, “It’s not my job to weigh the patient!” Here are some of the comments:

 

“Patient’s being weighed have NOTHING to do with my job.”

“Biggest pain in the butt and not my crews’ responsibility.”

“This falls under the huge realm of ‘Not My Problem’.”

“It’s not my job to weigh your $#%^&(*$ patient!”

“I sure as #$^& ain’t weighing nobody.”

 

Uh…seriously folks?

 

We complain all the time that we deserve to be paid better. We bitch that it’s unfair that we aren’t respected by our medical peers. We want respect that we feel we are owed and deserve.

 

We aren’t going to get it with the ‘It’s not my job’ mentality. We aren’t going to get it by making comments like that. Patient care IS your job. No more excuses. Excuses show that you are too lazy or unmotivated to actually do something about it. I was a Transport Medic for two years and because of my start time, I got the dialysis shuffle. Guess what I did? I weighed my freaking patients! Two minutes on the Stryker website gave me the weight for my stretcher. We double checked it on the dialysis floor scale to be sure and it was spot on. I then took a sharpie and, with permission from my boss, wrote the weight on the stretcher. When we appeared with a patient, all we had to do was roll onto the scale, take off the extra crap, and we had an accurate weight. This took me all of 5 minutes! This was better than having to wait for a wheelchair or dialysis chair to appear, get the patient off the stretcher, and then wait for staff to weigh the patient. Why wait 15 minutes for someone to do something when you can do it yourself and be done much quicker?

 

Unfortunately, the ‘It’s not my job’ mentality is running rampant through EMS. I work in an ER as a Medic and I see EMS crews come in and out all day long. Routinely, they come in and something is amiss and when asked we hear, “Uh…not my job.” Uh…yes it is. It is your job to do a proper handoff. It is your job to make sure you have the right equipment for a transport. It is your job to ensure proper patient care. At the station, it is your job to keep the trucks clean and station tidy…not just a task you push off onto a lower ranked crew member or for someone else to do. We need to make it our job.

 

We keep asking for better pay, but do we deserve it? Why do we deserve better pay if we aren’t willing to show our value? Making excuses like, ‘I don’t know how to accurately weigh a patient so I’m not going to do it’ shows we can’t be trusted with a wider scope. If we are unable to get a weight on a patient because we can’t be accurate…how can we expect people to believe that we can be accurate when giving medications? If we are unable to do something as simple as weigh a patient, how can we do something complicated like Intubation or reading an EKG? We are devaluing ourselves by constantly saying the little things aren’t our job. If we can’t do the simple things due to (insert stupid excuse here) how can we be expected to do the hard things?

 

We need to step back and take a long, hard look at our culture and mentality. We need to start showing why we are valuable and irreplaceable. We need to step up and prove our worth. Want higher pay? Earn it. Want more responsibility? Earn it. We need to stop proving our naysayers right! We are rapidly reaching the point where the mention of a Paramedic or EMT will be met by the same sigh, eye roll, and sneer that talking about a CNA or LPN causes. If the ‘It’s not my job’ mentality continues, we don’t deserve higher pay. We don’t deserve the respect that so many before us worked so hard to get. We deserve to be treated the same way we treat those who say, “It’s not my job.”

 

Have fun and Be Safe,

~MT

 

 

 

Something I Wish I Was Taught in Medic School…

I had a FANTASTICALLY craptastic night at work. Like…I wanted to pull my hair out shitty night at work. I’m not going to go into it…it was that type of bad.

But…

I think I helped to make a difference Tuesday night. Through the crap, I actually helped someone. No needles or ALS skills involved. None. I didn’t do a single thing they taught me in Medic School.

I became a Paramedic for the end result; taking someone’s WORST day and turning it into a Good Day. I wanted to help stop the pain, heal the hurt, and bring just the smallest ray of sunshine into the horrible storm. As a kid, I would see Paramedics and EMTs helping people. They always seemed to know exactly what to say and exactly what to do to make the whole situation better. I wanted to do that. I naively believed that the drugs and skills were what built the confidence to allow me to say whatever I wanted and that the patient would just feel better. The Nine Red Letters seemed like they were what made the person; it was a costume, it was a banner. The Nine Red Letters gave me the ability to be that person to help with just a smile…but I couldn’t help with my smile or a kind word unless I could poke things with needles or give drugs.

That’s what the Nine Red Letters meant to me. They didn’t mean being there for someone by just being present, they meant that I could give a medication and the medication would make everything better. I could read a LifePak12 and everything would be better. In my mind it was the skills that I could do that would make things better, not just me being there for someone.

Slowly, through working, I discovered that it wasn’t the drugs, it wasn’t the skills. The patient could give a damn if I could start an IV in the ditch, in the dark, at 0200, while blindfolded on two hours of sleep. All the patient cared about was if I could help them. All they cared about was if I was able to calm their fears, fight the terror and the pain by their side. All they cared about was me being there and making it okay.

I did that. I helped to make it okay and I did nothing but talk.

I felt so unfulfilled in my ER job because I couldn’t. I thought the only way to help was by shining my Red Letters. I’d get so angry because “all” I could do was just take blood and do IVs. I couldn’t give meds, I wasn’t ‘treating’ people, I wasn’t making Differential Diagnoses…I was just a Vampire that knew all these big important Paramedic things, but I forgot that the most important thing of all was the one thing I wished they taught in Medic School; Morphine is not the only thing to take away the pain. A kind heart, a gentle word, and injecting a few MG’s of compassion with a bolus of understanding can do more than ten of Morphine will ever do.

So, don’t ever be afraid to take the gloves off and hold someone’s hand. Don’t be afraid to connect with your patient. They are scared, they are worried, they are frightened. Hold their hand, laugh with them, give them a hug…do something more than just pass out medication and needles. Do more than just give a ride and drop them off at the hospital. Do whatever you can to show the patient that someone does care about them in their time of need.

Be there.

Be someone’s light.

Be the dawn.

Have Fun and Be Safe.

~MT~

If Prince was a Drug Addict…So was I.

The Almighty Purple One left this world last week. Let’s all have a moment of silence for The Funky Purple One.

 

Prince

 

 

 

 

 

 

 

 

 

 

Sorry…couldn’t help it.

 

Prince was found unresponsive in the elevator in his home after not responding to phone calls. His friends arrived on scene to find him dead. EMS called him on scene at 1007. While the world continued to mourn, articles began popping up about how he died. Was it The Flu? Was it HIV/AIDS? Was it Prescription Drug Abuse?

 

The last one popped up into my Facebook Feed on April 29th and I immediately became angry. Here is the article that popped into my feed and made me so blindingly angry I couldn’t see straight. The first line of the article:

 

Prince had prescription painkillers on him when he died…

 

And your point? The article went on to highlight how he was possibly treated for a potential drug overdose just a few days before he died. It also talked about how investigators found prescription opioid painkillers in his home. Let us all stop for a moment and think of our Medicine holders. Whether it’s a cabinet, drawer, basket, bag, or whatever…just think about where you store your meds. How many of us can say there’s most likely a bottle of leftover Percocet from a Root Canal performed 5 years ago, a couple of Vicodin from a broken Hand, that bottle of cough syrup with Codine from the Bronchitis bout over the winter, or a leftover Tylenol #3 from the Flag Football game gone wrong from the summer? I know I always held onto the leftovers ‘Just in case’…I mean…I never knew when my pinky toe would try to make love to the coffee table at 0300 and get violently rejected and the throbbing from my foot would keep me from walking, let alone sleeping. A Vicodin from having a tooth pulled and a glass of…something…and I’d be back to dreamland.

 

If any of us died tomorrow (Please, Dear God, don’t take this as a challenge. 2016 has sucked.) none of us could positively say that an Investigator wouldn’t find some kind of Prescription Opioid Painkillers in our homes. Immediately, Prince began to be known as a Drug Addict. People began lambasting him in the media for doing prescription painkillers to get high. Why else would they be in his pocket at the time of his death if he wasn’t taking them just to get high?

 

I have a pretty…personal story about this and why it hit me so hard and I got so angry when simply being found to have Prescribed Painkillers on him lead him to be called an ‘addict’ and a ‘drug seeker’…that he was just getting high and his stupidity killed him.

 

Here’s a little story from my past. Before my Back Surgery when my Surgeon and PT thought it was a great idea to put the girl who couldn’t walk through an insane amount of PT…the ‘Pain Clinic’ just kept piling on the Pain Killers. At one point, this was what I was putting into my body every 4-6 hours:

Vicodin 10\325.
Neurontin 1000mg
Percocet ES
Fentanyl Patch 125mcg\hr\72
Nucynta 75mg
Morphine 10mg
Oxycontin 20mg
Motrin 800
Tizanidine 40mg
Robaxin 500mg
Ambien 40mg (At night to sleep)

This cocktail was given to me by a Physician. The one time I inquired if I might possibly be on too many Narcotics at once, they took ALL of my meds away that day. They refused to refill my prescription. Within 48 hours I was in full blown DTs, had a seizure, and nearly died…so they put me right back on the same pills, same doses, and said to just take them and suck it up or I’d only get non narcotics. Mind you, my L5 disk had wrapped around my Sciatic Nerve and was strangling it…so the pain was intense.

One night, I went to the movies with some friends and I wasn’t feeling well. I threw up multiple times and we left halfway through because I just felt like Hell. I kept dozing off and zoning out on the hour ride home. Once home, I made it to my bathroom…then woke up several hours later in the hospital.

I had nearly died of a drug overdose.

I have an insane tolerance to medication. My starting Propofol dose for surgery is 60mcg\kg\min and it can take up to 20 minutes before I’m out. Nothing like freaking out the Anesthesia Department because you are having a coherent conversation about Intubation Techniques after two ‘Happy Syringes’ and a crap ton of Propofol.

My body maintained that insane drug protocol for 18 months until it said screw it. Fortunately, my friends were all Paramedics and Nurses, so when they heard me choking on my own vomit they got me to an ER PDQ. Aspiration Pneumonia and a slow wean of my cocktail later, I had gotten off all that crap and resumed a normal life.

If my friends weren’t there…I’d be dead of a drug overdose. I would have looked like I had taken a fist full of drugs to ‘get high’ or to commit suicide and died.

In 18 months… I never ‘felt high’. Not once. No happy buzzing feeling from the Vicodin or Fentanyl…no dopey smile or stupid antics…I was depressed, in a considerable amount of pain, and extremely constipated. My life revolved around my ‘Bag o’ Meds’ and staving off the searing pain that would have me crying for hours if I didn’t stick to popping handfulls of pills every 4-6 hours.

So, for someone who had several Hip Surgeries who was on painkillers to ease the pain…of course they found Percocet in his possession. Of course his body finally couldn’t handle the Narcotic load and gave out. In my bathroom, I had 15 bottles of various Narcotics and a stack of Fentanyl Patches. In my purse I had an extra Fentanyl Patch in case mine fell off as they are want to do and my pills in case my 6 hours were up and I had to remedicate…but just like with Prince…it would have been chalked up to me doing it on purpose and that’s that. A Drug Overdose.

That I wanted to get high.

That I wanted to kill myself.

That I was a junkie…an addict who was out of control.

No. I was following Doctors Orders and trying my best to not be in excruciating pain…probably the same thing Prince was doing.

He was going to bed and his body gave out.

I was feeling sick and vomiting when my body gave out.

 

Chris Kaiser prompted me to make this a Blog Post. I could flesh it out more here than I could on Facebook, but the meat is still there. If I would have died in my bathroom, they would have found enough pills and patches to start my own Pharmacy. They would have found enough drugs in my Toxicology Report to sedate Seabiscuit. I would have been labeled a drug addict just like Prince is being labeled right now. Prince had a history of Orthopaedic Surgery on his Hips along with chronic Ankle and Knee problems. Prince was known for wearing 5″ or higher heels and platform shoes as well as having an energetic performance style on stage. His Purple Rain Tour had him jumping off of risers 4′ and taller…in heels. A year of that punishment on the joints is enough for anyone to eat Percocet like Pez.

 

As to his hovering around a Pharmacy the night prior to his death and how he passed up numerous Pharmacies to get to that one…and how that shows a clear pattern for Pharmacy Shopping…I’m here to tell you that it’s not that nefarious. The other Pharmacies probably didn’t have the amount of pills his prescription was for.

Until my Pain Clinic began to fill my scripts, I had to ‘Pharmacy Shop’ to find a place that would have oh…450 Extra Strength Vicodin and 350 Extra Strength Percocet.

I’m not kidding.

2 pills every four hours plus 2 pills for every 2 hours for breakthrough pain equals a fuckton of pills. So, yeah…I was registered at a ton of Pharmacies because Pharmacy A might have all the Vicodin, but no Perc, but Pharmacy B might have half the Perc…but Pharmacy C would have the other half. As long as I was staying in the same chain, I could piecemeal my script together between 6 pharmacies. Some days, I’d travel between 4-6 Pharmacies trying to get all of my medications together. It was a constant fear that the Pharmacy wasn’t going to have my medicine.

Constant.

In the end…His Royal Badness was probably no more of a Drug Addict than I am or was. We were both seeking to help soothe a physical pain. The only difference is, he’s being vilified for being found with pills in his pocket. I can only imagine what would have happened if I was found with my stash.

 

(All of the hyperlinks that are of Prince’s name/nicknames are my favorite songs. Listen away!)

 

 

I Ain’t Birthin’ No Babies!

“No, Ma’am, for the last time…I cannot just let you smoke near the Helipad. I’m sorry…”

The woman in my chair sighed deeply, crossing her arms over her chest. I shook my head slowly as I looked at her Cheif Complaint:

Chest Pain with Dyspnea.

“Why can’t you just let me smoke? I’ve been here for eight hours!” The leather clad Harpie slammed her fists down on my desk, her chest rattling Smoker’s Cough propelling small flecks of greenish phlegm onto my desk. I pushed away a bit, my upper lip curling up as I felt wet, sticky, and not mine land on the back of my hand.

Reaching for the industrial size bottle of hand sanitizer, I pumped out several judicious squirts into the palm of my hand, rubbing them together.

“Ma’am…we are very busy tonight. If you go outside, which you are more than welcome to do, and we call your name and you don’t answer, we’ll skip over you and move onto the next patient. So, go outside if you want. Also…you’ve been here for less than two hours.”

The woman got up and walked outside. I saw the small orange glow of her cherry bobbing across the parking lot towards the main Hospital entrance. I shrugged deeply and took a sip of my water; I did my best. As I sat at my triage desk, I made a few notes on several patients before I continued with the next one. As I stood up, my phone let out a long, low buzz and I looked at the screen.

Have a good night sweetie. xoxoxo

I grinned stupidly as I touched my phone lightly, then I looked at my list.

“Amanda!”

A very pregnant woman slowly waddled up to me and I smiled, “Are we here for, uh, foot pain?”

Her husband smiled and put his hands on her shoulders, kissing the top of her head. She reached up, holding his hand tightly, “No…I’m ready to have my baby!” I grinned widely as I grabbed a wheelchair. “Well, I’m gonna get you to desk number one and the lovely ladies upstairs will be coming to get you. Has your water broken? How far apart are your contractions?”

“Uhm…they are 5 minutes apart and no. It’s my first. I wasn’t even dilated and I went earlier to see the Doc.” I patted her shoulder, “Well, in any event…congrats!”

I walked back to my desk, picking up the in house cell phone. I habitually looked at the number on my cubicle wall and I dialed 5252 on the phone. “Hey there, it’s Shao in the Bowl. Hey, I have a lovely young lady here who is having contractions about five minutes apart and her water hasn’t broken. She’ll be waiting!” I smiled as Mary acknowledged what I said, then hung up the phone. I looked over my packed waiting room, looking to see if anyone was looking better or worse than when they came in. With my list cleared, I pulled out my Chemistry text and started reading. Within a few minutes, the phone rang.

“ER, this is Shao, how may I help you?”

“Hey, it’s Lewis. How’s everything out there?”

“We’re twenty-four deep, longest wait is two hours. What’s up?”

“We just got a call. A lady is on her way in and she’s having contractions less than two minutes apart, but her water hasn’t broken yet. Can you take her straight upstairs?”

“I can do that. I’ll be waiting for her…” I hung up and walked over to the windows, pulling my jacket on. The February night was getting colder by the minute and I wasn’t looking forward to going outside for anything. Standing quietly, I watched as the security guards started to move around and they started to block off the road leading up to the ER. I watched for a few minutes, hoping to catch sight of the Bird landing; even 13 years into the job and I still got excited when a Helicopter landed. After a while, I wandered back to my desk wondering where the pregnant patient was.

Maybe they pulled over and they called 911 or some unsuspecting Cop got to deliver. That would be a pick me up for the Officer…

Smiling, I got back to work as the gentle whomp whomp whomp of rotor blades filled the waiting room, going from a barely noticeable noise to a loud roar. A throng of kids had gathered by the windows and I gave them each a Lollipop while they stood in amazement over the helicopter landing, still watching eagerly for the patient I was expecting. Wandering back to my desk, I jotted down a few notes from my book when the Valet walked in and over to me.

“Hey…there’s some pregnant lady out front. I think she needs help…”

I got up and walked outside with a wheelchair as a frantic husband waved me down, “Please help me…My wife is going to have her baby!”

“Okay, Sir. Let’s get her out of the car and into the warm…”

“I…I can’t go in.” I cocked my head to the side as I moved around the car, “I have my other baby in the car…I can’t just leave her.” I smiled and nodded, “We’ll get her registered and upstairs, it’s not a big deal…” Parking the chair, I smiled at the young woman in the car. Her blonde hair was matted to her forehead and she let out a gasp, “My water just broke and I’m having a contraction!” I nodded and looked at my watch, “Did it just start?”

“Yeah!”

“Okay. Big deep breaths, just pant…no pushing. I ain’t birthin’ no babies!” We all giggled as she powered through the relatively short contraction. Taking a few sips of water, she collected herself and I smiled, “Let’s get you inside, okay?” She nodded and I helped her stand up. Standing there, she shook out her legs as she began to tell me about their trip.

“We’re out past the 43 interchange. We were trying to make it into town, but I didn’t think…Ooooh!” She grabbed her stomach and crotch, letting out a small yelp, “Oh, Shit!”

“WHAT?!” Her husband and I said in unison.

“He’s here! The baby is here!”

“No, no it’s not!” I helped her waddle towards the wheelchair, “Can you sit?”

“No! The baby is coming! I have to push!”

“No! No! Just pant! Don’t push! Please don’t push!”

The Valet walked up to me, his eyes wide. I pointed at him, “You! Go inside and get me help…NOW!” I turned around and pulled down her pants slightly, using the light from the lamppost to look…

I couldn’t tell if it was an ass or head. She let out another scream, “I NEED TO PUSH!” The Husband looked like he was going to faint. Taking a breath, I ripped off her pants and put my hand on the baby, feeling around; it was a head.

“Okay…okay…uhm…are you ready?” She nodded. I cringed. Dad leaned against the car panting.

“PUSH!” The head slid out, then slipped back in. I felt around and noticed the nose and mouth were still inside the vagina. Cringing harder, I made the little V shape and I slid my fingers in, giving the baby a bit of room.

“STOP! STOP! IT HURTS!”

“I know…but I really, really need you to push! PUSH!” With another push, the head popped out. I felt around quickly and didn’t feel the cord.

“You okay, Mom?” She nodded. “The head is out. One or two more pushes and he’ll be out!” She nodded again as she gripped the arms of the wheelchair, trying to catch her breath. I looked around; we were alone outside in front of the Helipad.

“I’m having a contraction!”

“PUSH!”

With one more push, the shoulders came out, barely giving me time to angle them before…

Before I was holding a brand new infant in my hands. Mom collapsed into the chair and I stayed knelt on the ground. I was covered in amniotic fluid and was frantically trying to wipe the waxy crap off the baby and stimulate it at the same time. It took forever; I frantically rubbed, flicked, and patted the baby.

“Come on…come on Little Dude…” I turned him over to face me and with a deep breath…he started screaming at the top of his lungs.

I’ve never EVER been so happy to hear a baby cry in my life. I cradled the new person who had just dramatically entered the world in my arms while he sobbed his little brains out and I held him to me, trying to keep him warm and rub all the slimy crap off of him. A car pulled up and a woman ran up to me, pulling her shirt off.

“I’m an EMT! Here’s my shirt!” I looked up to see a middle aged woman handing me the shirt off her back, her daughter throwing a coat over her mother’s bare shoulders. I took the shirt and wrapped the baby up, still trying desperately to keep the baby warm when I heard a voice behind me.

“Shao…is everything okay? You’ve been out here for a while.”

“I JUST DELIVERED A FUCKING BABY!” Gretchen, the Triage Nurse stood there, her jaw slack, then she turned around and ran inside. What seemed like ages later, the ENTIRE EMERGENCY DEPARTMENT and OB Nurses were outside with blankets and towels. Dr. Sampson came around the car, a smile on his face.

“Hi, I’m Dr. Sampson…I’m just going to see how far along you are…”

“SHE DELIVERED THREE MINUTES AGO, DOC!!!!!” He looked down to see me cradling a baby that obviously wasn’t mine. OB came running around and they smiled at me, “We’ll finish up…”

“FINISH WHAT?! I HAVE THE BABY!” The message was never relayed that I was actively assisting on the delivery. Gretchen never relayed that I was holding a screaming baby. OB had no idea what was going on. No one had any idea what was going on. We hustled and got everyone inside. I duck walked next to the wheelchair holding the baby since trying to rest the Little Dude on Mom’s belly just wasn’t happening and as we got upstairs, I watched forlornly as they went through the doors, myself not crossing the little yellow line into the OB Unit. Slowly, I trugged downstairs, my phone ringing in my pocket.

“ER, this is Shao.”

“Hey, this is Registration…I have people waiting to get seen…”

“I get that. It’s gonna be a minute, I need to get changed.”

“But there’s a chest pain here…”

“Tell Charge or Triage, I need to get changed. I’m covered in Baby Butter…” The line went dead. I set my jaw and marched to Registration, a wicked smile on my face. The ladies backed up away from me, shocked looks on their face.

“So. I’m going to get changed. Call someone that isn’t me to get the patients seen.”

I stalked to the Locker Room, my hands shaking. I had never done that before. The Hospital just became an OB Hospital, so we had done some deliveries in the ER, but I was surrounded by Doctors and Nurses who knew what they were doing. I even pulled one off in an elevator…but I had Doctors and Nurses who knew what they were doing with me. I looked in the mirror; I was covered in all manners of fluid and goop, my hair was a mess, and I felt sticky. I had a whole world of ‘Wet, Sticky, and not mine’ all over me and it made me cringe. I quickly changed and went back to my desk.

A few hours went by and I felt a tap on my shoulder as I was deeply immersed in a book. I turned around and saw the new Father standing there, a huge smile on his face.

“Can I help you? Is everything okay?”

He nodded, then he grabbed me and hugged me.

“Thank you. Thank you for saving my baby.”

I smiled softly, digging my toe into the carpet. “It was nothing. Just what I was trained to do.”

“Well…thank you. You will always have a place in our hearts and in our family. Thank you.” With that, he walked away.

I watched him go, a smile on my face, then I set back to studying.