What changed you?

[DwayneEMTP]

What changed you as a medic?

I was watching "Combat hospital" tonight. If you've never been to Kandahar Afghanistan, you should watch it. It is so true to life that it freaks me out a little bit...

Anyway, I'd been helped into Afghanistan as a new medic, by an amazing friend that I won't name, out of respect to him, but am more than happy should he feel comfortable with it. Two things changed me as a medic forever...

The first. I was called to transfer a patient that had a traumatic amputation of his right humorus and left femer. He was 4 hours post op. I was told that he was comatos, yet when I approached him he seemed to track me with his eyes, and when I ran my pen up his existing foot it flinched. B/P 120/90, H/R 130, RR 26, skins moist, diaphoretic. In other words he seemed to be alert and in pain to me. I told the male nurse that he wasn't unresponsive, and that his vitals seemed to indicate significant pain, and asked what he had on board for pain management. You see, our treatment was likely to be the only that he would recieved before he was transferred and died. I was told by a Canadian nurse that, "If he wants proper pain management that perhaps he should show his insurance card!" As I began to unwind on him I was told that I could just manage his pain on my own...I moved him to our plywood ambulance and just did that..but never forgot the look on the nurses face...

The second call..only a few weeks into my time overseas we get a mass cas alarm. Expected casualties...400. I've never done a mas cas before that involved more than 3 patients. I call to my supervisor and he says, "Do your job. Call me if you need help." At the end of that radio contact, all of a sudden everything becomes clear. I see ambulance lanes, placement for red, yellow and green patients. I have a gazillion people lined up waiting for me to tell them what to do....And we end up with 4 pts.....The bomb had gone off over the top of a building and though there was a bunch of property damage, very little human damage. But I could have done it...though I might have never known that if this person hadn't had faith in me...

Both times, when things seemed really hard, the same person gave me the same advice...if you can guess who, and should he give permission to say, I'll send you something really important to me...a challenge coin from the remote medics in Afg....

Have you had such times? Times that defined you and let you know that you would rather do the right thing than anything else? That you would walk away from your medic/EMT cert rather than violate the morals/ethics as lay down by someone you respected?

Lets hear it if you want. I believe that this is the most important aspect of paramedic medicine. Unfortunately, me and my mentors are in the minority....but....what do you say?

Dwayne

[Just Plain Ruff]

Ill go out on a limb and say AK

Sent from my SPH-D700 using Tapatalk

[paramedicmike]

AK was my guess, too. Ruff beat me to it.

[DwayneEMTP]

Good God. I fly tomorrow for another month away from home...that always makes really sappy and sentimental.....gross....

Yeah, AK it is. Just about everything about me as a medic has been shaped by him, or the opportunities he sent my way.

With the first patient I was so angry that the hospital wouldn't manage his pain. I learned then that I can't always effect others, but that I can choose to try and do MY personal best always....The second scenario taught me that I just simply have to step up...every....single....time. If you put the two together you kind of see where I'm most often arguing from here at the City. Also, that expecting 400, when you have access to the resources that we did there, is really not so different than preparing for 4. Just busier.

But how about you? No pivotal moments in your life/career?

Ruffster, send me your address and I'll send you the coin...Their kinda cool...

Dwayne

[chbare]

No single, pivotal moment in my career. I have slowly developed over the years and currently am the product of total life experience. I've had bad calls and have changed the way I think about things after certain situations; however, much of my development has been a slow process of career evolution. After much reflection over the years since I left Afghanistan, I've changed the way I view the world (for better and worse), but again, nothing drastic or sudden.

Take care,

chbare.

[EMS Solutions]

As an EMT in a large EMS system I found myself becoming burnt and indifferent to the patients I was responding to and treating; all too often being annoyed at the calls that obviously just didn’t require an ambulance and more often didn’t even require a doctor.

While attending paramedic training in the hopes of doing more serious calls that would be true emergencies and require an ambulance, I had yet another call that seemed to be a waste of my time and energy.

I responded to a general illness call and upon arrival found a bed bound young woman in her early thirties who had a history of brain lesions. Her primary issue that day was abdominal discomfort. While assessing the patient and getting a history, the family advised us that she rarely spoke or made any type of acknowledgment to her surroundings.

How they were able to tell she was having any complaints is beyond me. I did not note any distress but they were the family and I figured they knew better than I.

As this emergency became a “two flight of stairs carry down” and a transport to hospital, that the family could have done or perhaps utilized any number of other means to get her to her doctor or emergency department, I slowly began to get more and more annoyed with the non-emergent call my emergency ambulance was dispatched to.

Being a professional though, I refused to let my inner thoughts seep through to the family. I did my job with a smile, asked appropriate questions and gave informative answers. Once complete, it was just me and the patient in the ambulance with my partner driving to the hospital.

Alone with the patient, I took better stock in the situation. Noting her obvious struggle with her disease; I thought how she may have felt living in this helpless condition. Did she feel like a burden on her family, friends and even me?

Without consciously knowing, I put my hand on her shoulder and said "I know it must be hard". Without missing a beat she looked at me and said "It really is - it really is", in a voice that was part sob and part plea. These few words, spoken by a patient that rarely spoke or acknowledged her surroundings to an EMT who was beginning to doubt his role and career choice, resonated in my mind, silenced my doubt, and renewed my faith in the role of an EMT. This heart wrenching call stays with me on every call I go to. That brief moment of connection is what I think of regardless of what level of emergency care is required. I became a better EMT and even more, I like to say I am a better human being – just for touching her shoulder and trying, with a few words, to provide a little comfort.

This one call stands out for me above so many others, big trauma, severe pediatrics and even 9/11. It always reminds me that it is the patients’ emergency we respond to and not ours. Whether they call 911 for chest pain or a cut lip; to them or their family it is an emergency and they called for help - even if that help is a band-aid, a ride to the hospital or a few words of comfort.

I like to think that perhaps acknowledging this patient’s situation let her know that she was not a burden on me. I wish I could tell her that in those few moments the small gesture I made ended up being so much bigger to me; and how it has helped to make me into a true EMS professional. It was like a reset button I needed then, but one that has never had to be pressed again.

[Richard B the EMT]

While I'm an EMT-B of 37 years experience, and never served in a war zone (the "Harlem, USA", South Bronx "Boogie Down", and South Jamaica areas of NYC are, dispite accusations otherwise, NOT a War Zone), I feel I'm kind of like chbare, formed by life experiences.

[DwayneEMTP]

No single, pivotal moment in my career. I have slowly developed over the years and currently am the product of total life experience. I've had bad calls and have changed the way I think about things after certain situations; however, much of my development has been a slow process of career evolution. After much reflection over the years since I left Afghanistan, I've changed the way I view the world (for better and worse), but again, nothing drastic or sudden.

Take care,

chbare.

I get that, and am sure that we're all pretty much the same in general. Being formed little by little, being shaded by many things as opposed to be painted a new color by one shocking brush. But I do find that there are often 'light bulb moments.' Like with that nurse...he knew the patient was in pain yet had no interest whatsoever in mitigating it. At that time in my career I found that shocking. I thought that we all wanted to do 'right' as a team...it never occured to me that a medical professional could enjoy watching a patient in pain. But man, I saw some pretty cruel shit come out of the Canadian hospital, along of course, with some amazing kindness and competence.

As well as being a newer medic and not being pulled off of that mass cas call. It never occurred to me that I wouldn't hear Ak calling me on the radio to tell me that he was on his way to take over. I can't even tell you how grateful I am for that moment. I've never again been afraid on scene, no matter what was happening.

Now, did the first moment make me a kind person and a patient advocate? No...but it cemented into my head that I had to pay attention to everyone concerning my patients and not simply assume that the right things were going to be done. Did being involved with the mass cas suddenly gift me with balls? Of course not, but it gave me a moment in time that many would have run away from, or quite, and showed me that I didn't, and won't, and I find that comforting... :-)

Not arguing against your point Chris/Richard, only stating that for me they coexist. Maybe because I'm not so bright, every now and then the EMS Gods feel the need to slap my face and make some points more obvious.

Thanks for participating all...

Dwayne

[medicgirl05]

In the first few months of my basic career my partner and I had a call for a patient in respiratory distress, despite our persistence that he go to the ER he refused. A&Ox4, so we couldn't change his mind. Later in the day we got a call to the same residence, this time it was respiratory arrest. Upon arrival my paramedic partner had a moment of panic. I did the few things that I was capable of, BVM and OPA. Patient still had a pulse and the call worked out OK. I just remember looking at my partner as he stood in the doorway of the bedroom where the patient was, and thinking, I've done everything I can do, it's your turn...He just stood there. I called for a second truck and my supervisor showed up within about a minute. As soon as she was there my partner came back to reality and got his stuff together. Point of the story is that in that few minutes that I was stuck there with a patient needing care beyond my capabilities I realized that I wanted more...I never wanted to be in such a situation again...I knew what the patient needed but I was unable to provide that for him. I had the crap scared out of me that day and that situation, along with many others, shaped me into the paramedic that I am today.

[BushyFromOz]

Systematic bullying in my workplace by front line manager, has eroded my confidence to the point where i started making silly mistakes. It has taken months to get back to some semblence of my previously energetic useful self, but even now i find myself lacking drive and general care factor

Moral to this story, not all experiences are positive and stick up for your rights sooner.