Archives for May 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!)