I’m Giving Up

When I first got into this field I volunteered 6 months on the ambulance waiting for them to hire me. I have fought for every job I have to prove myself. Every day I work my ass off, cleaning, working, doing everyone else’s work. I volunteer to help all the time, do extra hours, volunteer time, stay around to help, but does it matter? Does it mean anything?

No. It never does and it never will.

I see people all the time get hired, never having to volunteer. People say what excellent employees they are, but I see them sitting around all the time. Zero experience and just walk into a job. They get full time while I’m busting my ass to stay on the part time list.

It pisses me off! More than I can ever explain! More than it probably should. I can’t explain the hurt inside me, the feeling of being forgotten. I can’t stop the pain and I can’t explain why it’s so strong. Tonight I can’t handle it anymore. I’m done! I give up! I quit! I’ll never be good enough, ever. It’s as simple as that.

Don’t Mistake Our Smile

I read an incredible story, written by a local paramedic. He was off duty and became a part of an amazing rescue attempt to save a life. Unfortunately the life was lost, however his story made me think. He talked about the hurt and feelings after the rescue, how quiet the car ride home was, and how he knew his friend had the same feelings but not once did they discuss it.

I am guilt of what I am about to write about, I’ve caught myself and partner doing the same thing. I hope one day to start educating fire and EMS crews, but right now I don’t have the degree for that. Instead I will stick to sharing my thoughts here.

I don’t remember a class during my fire and EMS training that was titled “Feelings: Keep Them Hidden.” I can’t recall a time in class where the instructors lectured us on not showing emotions. And I certainly don’t recall any training on how to deal with the emotional drain this career can have on a person. Is this what leads to so many suicides within our field?

We often see things the majority of the world is spared, our eyes have seen tragedy and our hearts have felt great pain, but no one ever talks about it. Many times I have ran calls with my partner, tragic calls, but we never discuss it. We ride back to the station in complete silence then we laugh it off with other crews.

Don’t mistake our laughter for not caring, our laughter has become our way to deal with the pain. Somewhere between school ending and starting to settle into the field we learn that laughter hides the pain. They say laughter is the best medicine, but laughter can’t take it away. The memories are still there, the pain still weighs in our hearts.

Sometimes the smallest thing will bring the memories back, maybe the same smell from that horrible day. Or the sunset after that day, it looks so much like the sunset now. All the emotions and memories come flooding back, but we just laugh it off.

Often times crews I am with discuss the sick sense of humor you have to have to be able to work in this career, but they don’t mean what I thought when I first heard that. What we mean is, you have to have the ability to laugh about it so you don’t let it bother you as much, but laughing about something so tragic makes a person look crazy to the outside world. To the normal people, that live their lives unaware of the horrors in this world, our laughter is confused for not caring.

We send men and woman to fight for our country and offer them very little help when they come back. We send police officers, firefighters, EMTs, paramedics, and first responders into some horrible situations, yet offer them no help to learn how to deal with the things they see. How many lives will be taken before we start educating and offering help?

The next time you see us laughing after a tragedy, please remember we are not laughing at the people, we are laughing for ourselves. We are human, we still hurt too, but to keep doing this job we must laugh it off. I remember some young kids asking how we deal with what we see and the firefighter standing next to me had the ability to explain it like no one I have ever heard.

“Each one of us has out own memory book, we take the pictures and memories of the events and file it away in that book. A book we never open willingly. We laugh then file it away, never to be opened again. Some people have books 5 inches thick and still live each day happy, while others books are only 1 inch thick and completely full. Each of us have our own limit, but you will know when that book is full. Once it is, you will know. You will know it is time to quit.”

So each of us must know our limit. You must know when it is time to stop. Once your book is full and you can no longer laugh the pain away, it is time to walk away. Don’t let this career take your beautiful life, you have done wonderful things. You were there for someone when they needed help, they will be forever grateful for that, but much like us and our feelings, they don’t always know how to show theirs. People often forget that a simple “thank you” can make us smile for weeks. A true smile, that makes this job all worth it.

EMS Week

It was a wonderful EMS week full of goodies! : ) Now it’s time to get out there and thank your veterans for your freedom! This holiday wasn’t free!

As you know, I hate being called an “ambulance driver” and there are many people that don’t know much about EMT’s and Paramedic’s. It’s ok if you don’t know, but please do not call us ambulance drivers. The picture pretty much sums up what we are.

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Working My Ass Off!

Not that I have one to work off. One of my job, when I started there last year the guys swore they were going to make me fat. Well, they have failed so far because not only are they not making me fat, I seem to weigh less now. I’m one of those girls you hate because I can eat anything and everything and not gain an ounce. The difference between me and some of those girls though, I don’t go around calling myself fat. I also HATE that I can’t gain weight! I’m too freaking skinny and don’t like it at all!

Now with that said, I started my newest job this week. It has been my dream job! They keep telling us to be proud of ourselves, that not many people make it there. They picked us because we truly are the best in the field. Boy is the pressure on! I’m loving it! Loving the people, but the pressure…I’m freaking nervous! I’m afraid I don’t know enough, I’m afraid I’ll mess up, or not know the drugs or doses, or just…I’m fucking scared!!! But my man swears I know my stuff, that it all comes natural on a call, and that I was just born to be there. We shall see.

What does this job  have to do with having no ass? Well ALL of my uniform had to be ordered! I’m too freaking small! They had no shirts, dress shirts, polos, pants, boots, job shirts, coats…NOTHING in my size! They didn’t even have gear for me for vehicle accidents and what not. It’s horrible! But other than that…I FREAKING LOVE IT!!!!! They people are great, the job is great, the Chief is really cool, the officer staff is awesome…I just love it! I’m SO happy with the job! I will tell you more about the pressures and stuff, but for now I need sleep. I’m stuck at hell job tomorrow…it’s going to ruin my week!

Day 19

I have nothing more to be thankful for. Not one. I thought all day and not a single thing comes to mind. Am I that horrible of a person? I can’t even be thankful for anything?

A little back story about the weekend and how I got to where I am right now…alone…

I was having a bad day, just one problem after another. Stuck at “hell” job all day, stupid drivers coming home, phone call from my mom all pissy, then my dad telling me about my grandma…just a bad day. Well, my man was in the area so he went to my house and waited for me to get there from work. I came in just stressed and not in a good mood. First he asks what my problem was, no hi…nothing…just, “what’s wrong now?” Am I that predictable? So I started by telling him crappy drivers made my day worse and without me even getting to explain about my grandma or the phone call from my mother, he responds with, “You’re ruining your life. You need to let it go.”

Probably not a bad response if you look at it and looking back now it wasn’t the worst response he could have chosen, however this particular night it was a “trigger” and I lost it. My response was something along the lines of, “I don’t need this tonight” and I took off upstairs in tears. I just couldn’t take anymore that day. His response to that? He left. Walked right out the door. I needed comfort, not another person to walk away. Am I that horrible to deal with?

By then I was pissed. Beyond pissed! I sent all kinds of horrible texts, ones I probably shouldn’t have, but I did it. I told him I’m done with him, with this family, with everyone. I told him to leave me alone and go enjoy his “happy fucking life” and that was the last message I sent. I have not responded to a single text message, phone call, nor e-mail from him for two days. He’s tried…sort of, but has yet to say sorry at all. So for now…I refuse to talk to him. I may have messed up, and I know my already bad day made things worse, but I refuse to let it be 100% my fault.

As for my grandma…got the call today that the doctors want to intubate so I had no choice but to go to the hospital. My mother and father are both on me about seeing her, but you know what…she’s been nothing but a bitch to me every time I see here…why should I take off work to go up there? I have bills to pay and I just flat out don’t want to be around her. Call me evil. I don’t give a shit anymore.

I guess being in EMS has given me a cold heart when it comes to the sick and dying. I’m used to it so to speak. It’s a part of life, I’m at peace with it, and know it’s coming. If it’s their time, it’s their time. If I lost the grandparents that helped raise me…yes it would hurt, I’d cry and miss them horribly, however it’s life. I don’t know…I don’t know how to deal with emotions. I don’t know what to do, what to say. I just…I don’t know. It’s life. And the grandma that is in bad shape…well, she has not been kind for a long time now…she’d be better off with my grandpa anyway because she has been a COMPLETELY different person without him.

What can I say…I’m a cold hearted bitch and I want nothing to do with anything right now. I’m done with it all. I’m tired of hurting. I’m tired of feeling. I’m tired.

Any Questions?

The Rules Of EMS

1. Skin signs tell all

2. Sick people don’t bitch

3. Air goes in and out,blood goes round and round, any variation on this is a bad thing.

4. About %70 of the battery patients more than likely deserved it.

5. The more equipment you see on a EMTs belt, the newer they are.

6. There is no rule 6.

7. When dealing with patients, supervisors, or citizens, if it felt good saying it, it was the wrong thing to say.

8. All bleeding stops….eventually.

9. All people will eventually die, no matter what you do.

10. If the child is quiet, be scared.

11. EMS is extended periods of intense boredom, interrupted by occasional moments of sheer terror.

12. Always follow the rules but be wise enough to leave them sometimes.

13. If the pt. vomits, try to hold the head to the side of the rig with the least difficult cleanable equipment.

14. If someone dies by chem. hazards, electrical shocks or other on-scene dangers it should be the patient, not you. (also known as rule 1313)

15. Any EMT, FF, LEO and/or scene chief who is more drunk than the patient is the real problem.

16. There will be problems.

17. The severity of the injury(s) is directly proportional to the difficulty in accessing, as well as the weight, of the patient.

18. Hand grenades and turret mounted machine guns usually work better than lights and sirens.

19. Make sure the rookie EMT knows that a med patch is a radio term, and not a medicated bandage.

20. “Paramedics save lives; EMT’s save Paramedics.” (to quote a T-shirt or bumper sticker)

21. If the patient looks sick, than the patient is sick.

22. If the patient is sitting up and talking to you, then the patient is not in V-Fib, no matter what the monitor says.

23. It is that bad.

24. Full spinal precautions were custom made for obnoxious drunks. So were NPAs.

25. If you absolutely must vomit, than it is probably best to turn your head away from the patient.

26. It is generally bad to use the words “holy shit” on scene, in reference to the patients condition.

27. Patients that crash in separate vehicles should be transported in separate vehicles.

28. Just because someone’s fully immobilized doesn’t mean they can’t be violent.

29. If I’m up, EVERYONE is up!

30. Better them (another unit) then me.

31. I saved the patient…from the fire department.

32. When responding to a call always remember that your ambulance was built by the lowest bidder

33. Never get into the front of the ambulance with someone that is braver than you are

34. When in doubt use industrial strength therapy

35. If its stupid, but it works, then it ain’t stupid

36. Algorithms never survive the first thirty seconds of patient contact

37. Always honor a threat

38. Always know when to get out of dodge

39. Always know HOW to get out of dodge

40. The important things are always simple

41. The simple things are always hard

42. If the pt is going to vomit (especially projectile) be sure to aim towards any bystanders that would NOT clear the scene. (This also works for OIC’s)

43. Sometimes it’s easier to beg forgiveness than get permission.

44. You can’t please any of the people any of the time.

45. Don’t go INTO Dodge without the Marshall.

46. They said, ” Smile, things could be worse.” So we smiled and sure enough, things got worse!!!

47. Always answer a newbie’s questions. (you once asked them, too.)

48. Always Trust bad feelings (let’s see if anyone notices I added in the missing #)

49. EMT’s are taught – “the man with the gun, is the man in charge” (i.e.: the police) WRONG !!!!! Real life (when the fire dept. is on scene) “The man with the NOZZLE (charged hose line) is the man in charge !!” Trust me , it’s true. I’ve been there. that charged hose will send you farther down the block & hurt more before the cop begins to think about shooting you.

50. The number of drugs a patient has on board is directly proportional to the number of knuckles tattooed.

51. If you respond to an MVA after midnight and you don’t find a drunk, keep looking – you’ve missed a patient.

52. PVC’s can be eliminated by sending a strip to the hospital.

53. The ultimate QA program in EMS is an autopsy.

54. Best time to work a code – overtime.

55. Pain never killed anyone.

56. All fevers eventually fall to room temperature.

56. A Pt.’s weight is directly proportional to the chances the elevator will be non-functioning.

57. Here is a simple ETOH test: Hold your hands about 6 inches apart with thumbs and forefingers touching and ask pt. what color string you are holding. If pt. indicates a color it is a positive test.

58. A tourniquet around the neck solves all problems.

59. If you drop the baby, pick it up.

60. The dead never get better, on the other hand they never get worse.

61. O2 is good, blue is bad.

62. Never trust a ER doc with anything sharper than a tongue depressor

63. Less than 8, intubate (GCS score).

64. Asystole is a very stable rhythm

65. A Pt.’s weight is in direct proportion to their altitude in the building.

66. A Pt.’s weight is directly related to the number of stair flights between him/her and the rig.

67. “When in trouble, when in doubt, run in circles, scream and shout”.

68. EMS RULE OF THREES (as it relates to codes) 300 pounds <30 minutes to shift change 3 stories up in the building.

69. Whoops: 1) the monitor just fell down the stairs, 2) the cold and flu patient just coded, 3) the wrong house. ( hint: the one with the lab probably didn't call 911)

70. Rules: 1) Don't get dirty, 2) Don't run, you may violate rule #1, 3) If it looks like you might get dirty doing something let the new guy do it.

71. For every ALS skill we learn, we forget a BLS one.

72. The fire tetrahedron consists of the following: heat, oxygen, fuel, chief officer. Take any of them away and the fire goes out.

73. "Compassion Kills", don't dive into incidents.

74. When a call comes in 2 min. before shift change you will always pass your relief 1 block from the station. he/she/ it will be laughing and waving at you.

75. If there is little to be gained, there is little to be lost. If there is a lot to gain, there is a lot to be lost.

76. If you lift an inch, crib an inch.

77. What do you call a medical student who finishes last in their class? Doctor.

78. If you think the cost of education is expensive, check out the cost of ignorance.

79. Universal Precautions – Is it wet? Is it yours? If it is, and it isn't then leave it alone.

80. Death is a stabilization of the patient's condition.

81. Every Emergency has three phases – PANIC, FEAR, AND REMORSE.

89. You are bound to get a call either during dinner, while you are on the can, or at 02:00 in the middle of a great dream.

90. Training is learning the rules, experience is learning the exceptions.

91. Rocket scientists that get into stupid car crashes are the first ones to complain how bumpy the ambulance ride is.

92. "Poke & Hope" = blind sticking

93. Why do fire chiefs where white helmets? So you know where the Preparation H goes.

94. Never trust your rig, drug box, or airway bag to be fully stocked. (In spite of the assurances of the off going crew.)

95. If you don't have it, don't give up. Adapt, improvise, overcome, (then call for a second unit).

96. There is no such thing as a "textbook case".

97. Newbies always look for large things in the smallest compartments and vice versa.

98. There is no such thing as a bad call. Only calls that didn't go the way you planned.

99. Just because someone's EMT or Paramedic original license date is before yours does not mean they know what they are doing.

100. Truckies are people who are over 6 feet tall and their hands drag the ground while walking upright.

101. Newbies have there own way of doing things.

102. When it comes to needles, 'tis better to give than to receive.

103. Listening to some EMT's talk on the radio makes you wonder why they don't become professional auctioneers.

104. For every 25 calls you run, only 1 will be exciting.

105. Take comfort in the fact that most of your patients survive no matter what you do to them.

106. The old EMS constant; no matter how bad the politics get, the doors go up and the trucks go out.

107. ALS really stands for "absolute loss of sense".

108. Most of your patients are healthier than you are.

109. Being in emergency services means you get to celebrate your holidays with all your friends, while on-duty.

110. Being an EMT means you get to expose yourself to rare, exotic and exciting new diseases.

111. EMS does not save lives, EMS is to care for people. It is 95% of what we do.

112. You fall, you call, we haul, that's all.

113. There are two kinds of EMS calls: "Oh-Shit!" and "Bull-Shit!"

114. Call 1st, call fast, gotta make that v-fib last, till we shock 'um, make 'um jump,get a rhythm, and a pump

115. When rate is slow, when BP is low,we give atropine, so we can go go go!

116. When you join the kidney club, you usually cannot go.

117. Common sense isn't.

118.The more reflective stripping there is on your jumpsuit, the easier it is for the only drunkdriver going by the MVA to find you.

119. If you have a ride-along you want to show the real world, nothing will happen that shift.

120. EMS goes against the process of natural selection.

121. Just because you're paranoid doesn't mean your supervisor's not around the corner.

122. You can't cure stupid.

123. If it's wet and sticky and not yours, leave it alone!

124. If at all possible, avoid any edible item that firefighters prepare, especially the tuna casserole.

125. Heaven protects Fools and Drunks.

126.We are all slaves to the god "Motorola"

127. Only medical control option that can always be used # 48 "Drive Faster"

128. Murphy was an optimist.

129. The address is never clearly marked.

130. EMS doesn't save lives we only "postpone the inevitable."

131. Supervisors become that because they won't be missed in the field.

132. The god "Motorola" desires sacrifices of hot food at least once a shift.

133. Even sterile water tastes great on a hot day.

134. The stereo must always be louder than the siren.

135. At the beginning of your shift, your main O2 tank, fuel tank, and stomach will be empty…but the call volume will be full.

136. you know you are in trouble when the directions to a patient's house include… " turn off of the paved surface…"

137. Anyone with a "T" to "T" ratio of less than 5 to 1 is guaranteed to be drunk, on drugs, or both. ("T" to "T" means teeth to tattoos)

138. All arrhythmia's eventually straighten themselves out.

139. Dead is dead, leave it at that.

139. Your seriously ill pt. will miraculously get better when you roll them into the ER.

140. Your pt. will get new symptoms after radio report and pulling up to ER.

141. Don't get excited about blood unless its your own

142. The pain will go away when it stops hurting.

143.If nothing has gone wrong you obviously don't understand the situation.

144. You should always stop CPR after the second ouch!, from the PT.

145. People don't call an Ambulance because they did something right.

146. The quickest way to gather the relatives is to leave the primaries on while at the scene.

147. Every nurse is right as long as you are in THEIR E.D.

148. When in doubt, always take another set of vital signs.

149. If your patient is violent you can always use O2 therapy (an O2 bottle across the head usually calms them down).

150. The larger the house the furthest from a door the patient will be.

151. If the patient fell and was moved by the family, they will have moved them so that climbing stairs will be involved.

152. The furniture will always be arranged so that a stretcher or stairchair will never fit easily.

153. The problem won't be that bad until a major disaster strikes. (you have had chest pain for 3 days and wail till the middle of a blizzard to call?!?!?)

154. The Patient will all of a sudden develop a PMH as soon as the ED nurse asks for one.

155. The same (#154) applies for medications

156. Whenever you have NO lights or sirens on, everyone on the road will pull over for you, whether you want them to or not.

157. The probability of getting a code 3 call is directly proportional to how badly you need to go to the bathroom.

158. You've never been as sick as just before you stop breathing.

159.Dispatchers tell everyone where to go, inversely, everyone would like to tell the dispatcher where to go!

160. If you ever do tell the dispatcher where to go they will give you more places to go (or never piss off the nice dispatcher).

161. A patient's weight will always be inversely proportional to the size of the vehicle they choose to wreck. (in other words, the fatter they are, the smaller their car.)

162. It's not our emergency……….it's our patients! (For all you newbies who forget to take a chill pill!)

163. If someone is pointing a gun at you, 2 things 1. you should have waited for PD, 2. you wish you just hadn't made that wise ass comment.

164. Fellow paramedics always have a better story than your's.

165. Just when you say, "You know, I have never had a hanging….", you will get one.

165. The only time you go out on a limb (As a Dispatcher), and not provide coverage so a crew can eat, a serious call will come in that area.

166. The only time you need to fart is when you have your patient loaded in the elevator.

167. The only time your pant's split is when there are gorgeous Police Officers there to assist you.

168. You will get caught sleeping, eventually.

169. never say the kind of call you are in the mood for in the begining of the shift, you will get it in the worst way (I.e mva in the pouring rain)

170. Make sure the newbie knows that the portable O2 is the one to bring to a code (not the main)

171. God made Paramedics and EMT's to give him a chance to change his mind!!!

172. Beware when a firefighter says "Check this out."

173. never let a rookie drive the truck when they drive a tiny car. bridges are scary as hell and curbs are ruff.

174. your driver will never hit a pot hole or curb unless your pt has a bad fracture.

175. the worse your pts breath is the quiter they will talk. you will have to get closer to hear them

176. No matter howmany times and ways you ask the patient questions, the story will always change once they get into the ER making you look like an ass.

177. If ever in doubt which house you were called to look for the stairs.

178. If there aren't nurses around when you get called to a nursing home go to the last room in the hallway thats always where the sickest pts are

179. Never start putting your stuff away before you are told to go home because you have just given yourself another call

180. When in doubt let your partner handle it

181. When getting a TMJ call on Sunday never say it around your pt it sucks when you have to tell them what it means ( too much Jesus)

182. When giving a radio report never tell the er nurse that your pt is stable, by the time you get there you will be working a code!!

183. If the patient pukes, it is not unprofessional to puke along with them it is sympathetic puking. You have something in common with your patient and
can relate to how they feel. That is what they made the big step well by the side door.

184. If the patient only moans when you listen to lung sounds …. They aren't as sick as they want to be.

185. If a p/t tells you he/she is going to die, believe them they are probably right. (been there).

186. When in doubt remember the p/t is sick, the ambulance has wheels, USE THEM!

187. 911 The government's answer to dial a prayer

188. The more addicted your patient is to valium, morphine, etc…. The more they are allergic to torodal…….

189. You can have circulation with no breathing-but you can NOT have breathing with no circulation

190. On trauma calls – survivability is inversely proportionate to social worth!

191. How you know an unconscious is a DOA 1) If it weighs over 300 pounds it's a DOA 2) if it lives more than three flights up in a walkup apartment it's a DOA 3) if its less than 30 minutes left in the shift it's a DOA

192. EMS providers know how to say "got shoes" in 7 different languages.

193. All fevers eventually reach room temperature

194. Cops make the best gas leak detectors in a Haz-Mat incident, they approach the scene and pass out

195. Message to Newbies: People are going to get sick, People are going to get hurt, and People are going to die. This is not a multiple choice job. You must be able to handle ALL OF THE ABOVE!

196. Never go past the first dead cop.

197. There will be no dying or multiplying in the back of my unit. (They die on scene or are pronounced at the hospital. Birth happens on scene or at the hospital.)

198. The worse you have to use the restroom, the farther the distance it will be from the location of the call to the hospital.

199. When entering a HazMat scene: "Never pass the first dead canary (cop)"

200. Some people can do this job some can't. Pray you are partners with one who can.

201. All rhythms will eventually degenerate into one you will recognize and can treat.

202. If God had intended you to have a rapid response to the call, you would have been parked in front of the location.

203. Upon arrival at a code, check your own pulse first, if it is still there everything else is easy.

204. As soon as you finish cleaning the rig up for a parade You'll have to drive ten miles down a road filled with mud puddles for a difficulty breathing.

205. IF you ever go to a call and find the cops laughing on the front lawn…worry!

206. Cops are wonderful assessment tools at a HazMat incident. Send them in with a lit road flare. If they don't pass out or blow up, it's safe.

207. Remember that it is the patient's emergency, not yours

208. Try to keep your pulse rate lower than your patient's

209. If you drop the baby-fake a siezure

210. Trauma is treated with diesel first