I come back on bended knees

[Just Plain Ruff]

What the hell? We loved you when you were here, we've missed you for being gone. But the, "If I'm not wanted, I'll leave?" has got to go. What evil new whiny bullshit is this? When you posted regularly you were one of the strongest members here...enough with that crap, ok? If I'd left every time I wasn't wanted I'd have missed out on being the medic that I'm becoming. And I've actually come to respect that medic pretty well.

When I tried to work with the vollies (Not volly bashing, I know of some that are amazing) I was sumarily hated by nearly everyone despite my best effort to be supremely positive and gentle. ( And by normal standards I mean, not just mine.) But man, I couldn't make it work. I believe that the service is much diminished with me gone, but the service is much happier that way.

Stop focusing on the ass kicking you may have taken and be grateful for the experience that you gained. You now know much better where you don't want to be, what you don't want to do, and the places that you actually do have the power to make positive change. You know of some approaches that won't work, and others that will...And that's no small thing.

Good to have you back Brother. I'm excited for you to be here. But straighten your friggin' knees, stop looking at your shoes, take a deep breath and get back to the business of being who we've always known, ok? Because that guy friggin' rocked and was a force to be reconned with.

Dwayne, what you say is a lot of times easier said than done. I have no doubt that Ugly tried his damndest to work with the cards he was dealt and it was a losing hand. Sometimes you really do have cut your losses and say "fuck it, let them sink" and it sounds like he did everything he could but in the end, the result was best for him.

I've been in Ugly's shoes and no matter how hard you try, no matter what tact you take, what route you go, what things you do to accomodate people, there's just nothing to do but to walk away and learn from the experience. I had to do that with a service that was in huge transition. They had brought in a new ED Nurse manager (contractor - head chopper) and she was making work unbearable. Many of us tried to work with her but she was such an ugly person that it was impossible. Several of us saw the writing on the wall and left for greener pastures. Those who were left were either her "ass kissers" or the ones who couldn't afford to leave. Three weeks after several of us "writing readers" left, a mass firing took place and all the non ass kissers(some were very poor medics/emts/nurses) were fired in one morning leaving the ass kissers and non-confrontational types employed. They dropped down to having a single EMS crew on duty with a on call crew sometimes available, they brought in agency nurses to fill in the slots of the fired staff. morale hit the skids and patient care suffered greatly. Overtime increased due to call offs because people just didn't want to work in that environment. The hospital ED's reputation which was stellar prior to this shakeup was tarnished beyond repair for over 2 years. People would drive 50 miles to the next ED to be seen. Some of these patients died during their drives because they refused to stop at the ED that they didn't trust. Some families would request the ambulance transport their loved ones to the next hospital 45 miles away. They are just getting their reputation back to where it was prior to this shakeup. Each and every one of those who left prior to the shakeup(firings) saw what was happening, tried to work with the management who refused to listen to the employee's concerns about morale, management issues and work life balance among many other things, and we felt it was in our best interests to find work elsewhere.

When management refuses to work with you, when some staff feel that it's ok to go to management when you say the least thing bad about the hospital (those were the ones who were not fired) and then I got written up for saying what I said and after trying to get the ED management/hospital management to see things from the staff perception which they refused to do, it's time to stop trying to work with that type of toxic environment and move on. That sounds like what Ugly had to work with.

But I could be wrong in my perception of what Ugly went through.

So yes, sometimes you just have to leave no matter what you try.

[uglyEMT]

Thanks Guys and Gals!!! I am glad to be back. Thanks for making me feel welcomed.

Dwayne. Thanks Buddy. Yea I will be back as the force I once was, I have learned alot about myself in the time off and will dust myself off and be strong. I guess the opening post was more of me not knowing how I would be recieved more so then being a whiney bitch. I make no excuses for what I did. I didnt go out with a whimper thats for sure, I fought tooth and nail right up until it all took its toll on me physically and my health took a crap. My wife looked at me one day and asked me why I was litteraly killing myself over alll this. At that point I had to think about her as well. It was for the best I think. I realized that during my recert classes, when we were doing some of the practicals and other EMTs (some with more time in then me) turned to me to lead the scenario. I thought about that afterwards and realized I DO have the skills, I DO have the knowlege, and I never lost it I just compartmentalized it and let the bullshit take over.

Captain yes it was a Volly agency. I am going to be back on the road soon. Just getting my ducks in a row so to speak to make sure I can be active with whatever agency I join to. Even though I haven't been riding I still have been helping folks when I can. Its amazing how it kicks back in.

Paramike thanks. I will always look twords the future with the knowlege of my past.

Happiness like I just said to Dwayne I stuck it out till my health was being affected but I know what you mean. I got the promotion for a reason and I did have my backers. Even though the others were the minority they made it a living hell. I mentioned before it wasn't so much a physical problem with patient care as it was a lack of involvment which made me have to put less experienced people together more and more which could have led to something. Not that they did anything wrong but sometimes the experience does help spotting the unusual S&S that on the surface look benign but are more serious. They would eventually get it I am sure of it but not intially.

Good example would be one I witnessed. 40 yo Female with jaw pain and nausea. No chest pain no dyspnea. Im thinking ALS right off the bat as the jaw pain and nausea from my experience could be cardiac related. My rookie I was mentoring was asking the right questions but the answer he came up with in his head was bad tooth ache needs a dentist not a hospital. When we met ALS the ECG did show unusal rythems. After the call I was Q&A him and his reasoning was being her young age and no chest pain or difficulty breathing it couldnt be cardiac related. I had to explain its not always the elephant on the chest or the pale grey skin thats a heart problem and in females it can be down right wierd. It was my experience vs actual vitals or patient S&S that got the ALS ball rolling so the patient got to a higher level a care quicker.

Thanks for the welcome back Richard. That was a good line to remember.

Thanks again everyone for making me feel welcome. Now off to get involved in some discussions.

Wow Captain you posted while I was typing this up. You basically hit the nail on the head as far as it is concerned. Not listening to reason and just making it toxic.

Also changed my screen name a little as it was no longer fitting.

Edited May 24, 2013 by uglyEMT

[Arctickat]

An interesting call uglyEMT, and a good catch. My most unusual symptom for an MI patient was repeated and frequent belching. He had no discomfort as all, but every few seconds he'd let out a small hiccup/belch. I have an idea as to the cause, but I suppose that should be a discussion for a different thread.

[uglyEMT]

No problem Artickat. Dont mind a seide track now and then. Yea it was just an example thats all, having had the jaw pain present on 3 female cardiac patients with the stomach issue (2 females called it upset stomach, one said heartburn) with no other S&S I kind of drew the conclusion. That was the point I was trying to make there the experience got the ball rolling vs vitals. In the rig the rookie did ask why he was having such a hard time getting the pulse right. During Q&A the rookie did tell me if he was alone or with someone else he would of called ALS at that point because he felt the pulse was "funky". So the patient would have gotten the proper care but just a little later in the process.

It was something I was pushing for in my squad, a great mentoring program. As Dwayne probably remembers I was a huge patient care advocate, something he helped instill in me, and we chated about mentoring and possibly making a thread or something about it to help new EMTs along. That was the biggest resistence I got, the more experienced members not wanting to "babysit" when in reality I was trying to make us stronger as a unit by helping the rookies think critically, make connections between different patient's S&S based on experience, and to do good medicine. Thus more people that can be paired together to help with scheduling and other things that come up so we can be flexible as needed but with the best in patient care as possible.

[DwayneEMTP]

[Edit: Was posting at the same time as Ugly.]

Not sure how I gave the impression that I believe that you should have stayed...Man, I don't believe that at all...

We had an difficulty breathing at the service that I worked at. The vollies had shown up. When I got there the NRB was on upside down, the O2 not turned on, patients house was full of people, (maybe 8-10) some laughing and visiting, others smoking on the porch. I quietly turned the mask over, turned on the O2, etc...got help getting her loaded...not emergent, though I don't remember the issue. Before taking off I called everyone together, asked about the call. They named the errors, though no one could 'remember' who put the mask on, and all swore that the O2 had been turned on...that the patient must have turned it off. I wrote it off to insecurities..something that can be fixed if humiliation is left off of the table. They seemed really excited to have someone take the time to talk to them.

I kind of made a joke out of it, explained that we all make mistakes, and that we do the best we can...blah, blah, blah. We all laughed, they thanked me for doing the call review and for my advice, I explained that I was excited to work with them, etc. Just a bunch of good ol' boy buddies.

Got back to quarters and was called into the Grand Pubah's office where two of the vollies sat, sad faced and angry. It was explained that after the call I'd simply walked out of the house, said, "You're all a bunch of idiots", got into the back of the ambulance and drove off. That's when I knew that this wasn't going to be a good fit.

I tried a few more times to be a team player, with like results, and then simply, with a couple of exceptions, viewed the on scene vollies as I would any other spectator. I was disliked, but liking me or improving, or even being part of the team wasn't their goal, so it didn't really ping on my radar.

I'm confident from your posting history and our personal messages that you did the best that you could. In no way would I prioritize my health and family's happiness under my duties to a service, neither paid nor volly.

[island emt]

Ugly: Been there done that got the T-shirt.Politics in small services can be a bitch even when those that are against you are dead wrong.

Many times it's because they are afraid of change.

[uglyEMT]

No problem Dwayne. You didnt give that impression at all, I just wanted you to know I went out swinging. I remember a few conversations we had about leaving places that were bad and everytime it was about the patients and fighting for them. Yes once my health went down and my wife didnt like who I was becoming or how I was feeling I knew it was time for a change.

Speaking of family I hope all is well with yours.

Many times it's because they are afraid of change.

Thats all it was.

They hated the State's new protocols (able to take blood sugar, standing orders for epi and nitro, and able to give ASA). Yea seriously those were the changes they didnt want, said it would be to involved and what if they make the wrong call. Plus the mentoring program. Hell they even bitched when I formed a comittee and got us a new rig through a grant. They bitched the rig was bigger, had a few different compartments, no cup holders, and the air horns were too loud, there were too many lights and finally the stripes on the back made us look like the fire deptment.

It was what it was. Its over and I have moved on.

[Just Plain Ruff]

No problem Dwayne. You didnt give that impression at all, I just wanted you to know I went out swinging. I remember a few conversations we had about leaving places that were bad and everytime it was about the patients and fighting for them. Yes once my health went down and my wife didnt like who I was becoming or how I was feeling I knew it was time for a change.

Speaking of family I hope all is well with yours.

Thats all it was.

They hated the State's new protocols (able to take blood sugar, standing orders for epi and nitro, and able to give ASA). Yea seriously those were the changes they didnt want, said it would be to involved and what if they make the wrong call. Plus the mentoring program. Hell they even bitched when I formed a comittee and got us a new rig through a grant. They bitched the rig was bigger, had a few different compartments, no cup holders, and the air horns were too loud, there were too many lights and finally the stripes on the back made us look like the fire deptment.

It was what it was. Its over and I have moved on.

They just werent' going to be happy no matter what the hell you did. You could have gotten em all laid every night by a different chick and they'd say the girls weren't the right fit or whatever. You were spot on for leaving that bunch of whiners.

Dwayne, the vollies you got called into the office with, are you sure they didn't come from down where I used to work? I think I worked with a few of them.

[Happiness]

An interesting call uglyEMT, and a good catch. My most unusual symptom for an MI patient was repeated and frequent belching. He had no discomfort as all, but every few seconds he'd let out a small hiccup/belch. I have an idea as to the cause, but I suppose that should be a discussion for a different thread.

I would like to point out two things, ugly you did what was important for you and your family and even though it can be precived as quitting I personally admire you making the right decision.

The burping and cardiac, I had heard this before, brought in a guy, told the nurse his symptoms and mentioned I had heard about the conection to cardiac. They ignored me and ten mins after I left he had a massive mi. In telling this story to my boss one day it saved her life. She had remembered this story one evening as she was what she caled a different kind of burping, went to the hospital in time for them to catch her having a heart attack and she is still here today. My point being is that here we all learn from others and that is is one reason I come to this site, to learn from everyone.

[Arctickat]

I would like to point out two things, ugly you did what was important for you and your family and even though it can be precived as quitting I personally admire you making the right decision.

The burping and cardiac, I had heard this before, brought in a guy, told the nurse his symptoms and mentioned I had heard about the conection to cardiac. They ignored me and ten mins after I left he had a massive mi. In telling this story to my boss one day it saved her life. She had remembered this story one evening as she was what she caled a different kind of burping, went to the hospital in time for them to catch her having a heart attack and she is still here today. My point being is that here we all learn from others and that is is one reason I come to this site, to learn from everyone.

And the reason? 2 words, Vagus nerve.