...and very educational too.
Prehospital 12 Lead ECG
Enjoy...
BRM
Thursday, May 21, 2009
Vindicated...
Ran into a bit of trouble a while ago. All over a damn refusal...
Got a call for a CVA. We get there and this guy ain't having a stroke. All he had was numbness on one side of his leg, which he had a history of. His grand daughter was there, freaking out and she was the one who called us. He didn't want to go, he didn't want her to call 911. So of course he refused. He let us take his vitals and do a stroke screen on him. All were normal. We let him and his granddaughter know that he hadn't been examined by a physician and that we could not tell him definitively that he wasn't having a stroke and that we would be happy to take him to the hospital. He refused all of that. He was obviously competent and he was now informed of his condition. I felt he had every right to refuse further care and transport. So he signed my paper and we left.
About 3 hours later we get called to the local band-aid station for an emergency transport to the big city hospital for a stroke transfer. We get there and it's him. The charge nurse is pissed and she doesn't even give us a report, just points us towards the bed. We walk over and talk to him. The patient has no clue that he is being transferred or why. He said he only came to the hospital to shut his granddaughter up. We load him up and start towards the truck. That's when the nurse grabs my arm and tells me that the patient should have been transported from the scene and she will be making a complaint for further investigation about the situation. My reply was "OK" and we continued to transport.
Later that day the quality assurance guy from our service comes to call on us. He asks what happened, he already had a copy of my report so I told him that it was all there. He wanted to know more, so I pretty much told him the same thing that I had typed. In a round about way, he accused me of selling the refusal or encouraging the patient to refuse. Well that pissed me off and I let him know it. I asked him if he and everyone else in management didn't trust my judgment as a paramedic, then why in the hell was I out there on the road? Why was I able to function as a medic at all if he was going to question everything that I did? He finally left. The next day the charge nurse came to me and apologized for her actions. I accepted and I thought that was that. I was wrong.
Apparently he and the charge nurse are good buddies and he wasn't about to let it go. The next week I was at the office and he calls me into his little corner. He shows me a customer service questionnaire that he says that he sent to the patient about that call. He said that he had made this little form up some time ago but had never sent it to any patient so far. So this would be the first. Well, I start to get pissed all over again, but I managed to keep my cool. I asked him if he was going to start sending these out on a regular basis. He said no. I asked if he was even going to send them out randomly, he said no again. His explanation was that the budget wouldn't allow for it. Bullshit I thought. So I asked, "This is the only survey that you have ever sent out and the only one you're ever going to send out?" He just looked at me and I just about lost it. I turned to walk out and over my shoulder I said, "This sounds a whole hell of a lot like discrimination to me." I kept walking before he could reply.
I left the office steaming. I felt like this was a fucking head hunt and my head was on the chopping block. I also found out that the patient in question got sent home the same day, actually within a few hours of us taking him there. He wasn't having a stroke. I guessed our Q/A guy found that out and it just pissed him off that much more, since I was right about the patient. But that didn't change the fact that I had pissed off his buddy.
Well a couple of weeks go by and I get an email. It's the survey, apparently the patient had filled it out and sent it back in. It contained an excellent review of my care, on both calls; the refusal and the transport. It even had a handwritten comment saying how good the care was. I think I laughed out loud when I read it. It must have put a burr in his ass to get that back in the mail.
So now I am fully vindicated...
BRM
Got a call for a CVA. We get there and this guy ain't having a stroke. All he had was numbness on one side of his leg, which he had a history of. His grand daughter was there, freaking out and she was the one who called us. He didn't want to go, he didn't want her to call 911. So of course he refused. He let us take his vitals and do a stroke screen on him. All were normal. We let him and his granddaughter know that he hadn't been examined by a physician and that we could not tell him definitively that he wasn't having a stroke and that we would be happy to take him to the hospital. He refused all of that. He was obviously competent and he was now informed of his condition. I felt he had every right to refuse further care and transport. So he signed my paper and we left.
About 3 hours later we get called to the local band-aid station for an emergency transport to the big city hospital for a stroke transfer. We get there and it's him. The charge nurse is pissed and she doesn't even give us a report, just points us towards the bed. We walk over and talk to him. The patient has no clue that he is being transferred or why. He said he only came to the hospital to shut his granddaughter up. We load him up and start towards the truck. That's when the nurse grabs my arm and tells me that the patient should have been transported from the scene and she will be making a complaint for further investigation about the situation. My reply was "OK" and we continued to transport.
Later that day the quality assurance guy from our service comes to call on us. He asks what happened, he already had a copy of my report so I told him that it was all there. He wanted to know more, so I pretty much told him the same thing that I had typed. In a round about way, he accused me of selling the refusal or encouraging the patient to refuse. Well that pissed me off and I let him know it. I asked him if he and everyone else in management didn't trust my judgment as a paramedic, then why in the hell was I out there on the road? Why was I able to function as a medic at all if he was going to question everything that I did? He finally left. The next day the charge nurse came to me and apologized for her actions. I accepted and I thought that was that. I was wrong.
Apparently he and the charge nurse are good buddies and he wasn't about to let it go. The next week I was at the office and he calls me into his little corner. He shows me a customer service questionnaire that he says that he sent to the patient about that call. He said that he had made this little form up some time ago but had never sent it to any patient so far. So this would be the first. Well, I start to get pissed all over again, but I managed to keep my cool. I asked him if he was going to start sending these out on a regular basis. He said no. I asked if he was even going to send them out randomly, he said no again. His explanation was that the budget wouldn't allow for it. Bullshit I thought. So I asked, "This is the only survey that you have ever sent out and the only one you're ever going to send out?" He just looked at me and I just about lost it. I turned to walk out and over my shoulder I said, "This sounds a whole hell of a lot like discrimination to me." I kept walking before he could reply.
I left the office steaming. I felt like this was a fucking head hunt and my head was on the chopping block. I also found out that the patient in question got sent home the same day, actually within a few hours of us taking him there. He wasn't having a stroke. I guessed our Q/A guy found that out and it just pissed him off that much more, since I was right about the patient. But that didn't change the fact that I had pissed off his buddy.
Well a couple of weeks go by and I get an email. It's the survey, apparently the patient had filled it out and sent it back in. It contained an excellent review of my care, on both calls; the refusal and the transport. It even had a handwritten comment saying how good the care was. I think I laughed out loud when I read it. It must have put a burr in his ass to get that back in the mail.
So now I am fully vindicated...
BRM
Tuesday, May 19, 2009
Great Reads...
Two new blogs I recently happened upon. They've been around a while, but I'm...well...a little slow..
Pink, Warm and Dry
Paramedicine 101
Pink, Warm and Dry
Paramedicine 101
Friday, May 15, 2009
Transferred...
In my three short years working for my current employer I have now worked at every station. They call me the shift whore. I am usually the one that has to move around when a Medic is needed to work with an Intermediate or Basic. But now a co-worker has been injured and my semi-permanent station is the farthest from civilization that you can get in our county. It's over an hour to the nearest major hospital from our response area and that's going emergency traffic.
We also get the fewest calls of all the stations. That in itself isn't so bad, I get plenty of time to sleep, work on lesson plans for my teaching, read and stare at the walls. When we do get a call it usually takes about 3 hours to get back to the station.
Yesterday we traveled through 4 different counties, not counting our own and went to 5 different hospitals for a total of 7 calls. Most of them were bullshit, one actually needed to go. That one was a bad breather. Her house was sweltering and her rain-barrel girth and permanent growth in the shape of a cigarette glowing at the end of her fingers certainly didn't help. I wanted to tell her this but didn't, just put her on O2, loaded her up, gave her a few nebs and listened to her talk in a raspy voice for the 78 minute transport.
Anyways....I reckon that's enough bitching for the time being...Till next time..
BRM
We also get the fewest calls of all the stations. That in itself isn't so bad, I get plenty of time to sleep, work on lesson plans for my teaching, read and stare at the walls. When we do get a call it usually takes about 3 hours to get back to the station.
Yesterday we traveled through 4 different counties, not counting our own and went to 5 different hospitals for a total of 7 calls. Most of them were bullshit, one actually needed to go. That one was a bad breather. Her house was sweltering and her rain-barrel girth and permanent growth in the shape of a cigarette glowing at the end of her fingers certainly didn't help. I wanted to tell her this but didn't, just put her on O2, loaded her up, gave her a few nebs and listened to her talk in a raspy voice for the 78 minute transport.
Anyways....I reckon that's enough bitching for the time being...Till next time..
BRM
Wednesday, May 6, 2009
One of My Very Own...
These past few months have seen a couple of my career goals come to light. I finally finished my Level I EMS Instructor. That took almost a year and a half to complete. The other is finally getting my own EMT class. I got a call the other week by the coordinator of the EMS program of the local community college that I have been teaching part-time for. It seemed like he was in a bit of a bind and my name popped up on his radar.
Apparently there was a course scheduled for this summer that didn't have a maximum capacity, or someone forgot to put a cap on it when they did the paperwork before the class began. Well, to make a long story shorter, there was over 40 students that showed up for the first day and no where to put them all. Hence why I got a call.
I had made it known that I wanted my own class for some time now, whenever the powers that be deemed me experienced enough to handle it own my own. Evidently, that time has now come. So for the last few days I have been running around trying to put a lesson plan together, go through all the presentations and generally getting everything ready.
The night before the first class I was nervous as hell. At first I couldn't really understand why. I had been teaching for some time now, and I knew that I knew the material. I don't have a problem with standing in front of people and talking. So why was my gut in knots and my hands all sweaty?
Then it hit me. This one was all mine. Whether the students pass or fail will ultimately rest on my shoulders. Plus, if I am ever to continue on to further goals, like being a training officer or a coordinator of a program, this was the first step. I figured that if I fuck this up, I probably won't get another shot for awhile, if ever.
Now I know that not all students will pass. The drop-out/ fail-out rate is almost 50% in EMT-Basic courses around here. I have dealt with problem students of many different types and been through many courses on how to deal with various learning styles, etc, etc.
As far as my teaching style...well...I try to roll with the punches that come and also try to get the information to the students in as many ways possible. That way, hopefully, most if not all will understand the material, pass the test and ultimately become good EMT's.
So..with all that in mind, I got some more work to do....
BRM
Apparently there was a course scheduled for this summer that didn't have a maximum capacity, or someone forgot to put a cap on it when they did the paperwork before the class began. Well, to make a long story shorter, there was over 40 students that showed up for the first day and no where to put them all. Hence why I got a call.
I had made it known that I wanted my own class for some time now, whenever the powers that be deemed me experienced enough to handle it own my own. Evidently, that time has now come. So for the last few days I have been running around trying to put a lesson plan together, go through all the presentations and generally getting everything ready.
The night before the first class I was nervous as hell. At first I couldn't really understand why. I had been teaching for some time now, and I knew that I knew the material. I don't have a problem with standing in front of people and talking. So why was my gut in knots and my hands all sweaty?
Then it hit me. This one was all mine. Whether the students pass or fail will ultimately rest on my shoulders. Plus, if I am ever to continue on to further goals, like being a training officer or a coordinator of a program, this was the first step. I figured that if I fuck this up, I probably won't get another shot for awhile, if ever.
Now I know that not all students will pass. The drop-out/ fail-out rate is almost 50% in EMT-Basic courses around here. I have dealt with problem students of many different types and been through many courses on how to deal with various learning styles, etc, etc.
As far as my teaching style...well...I try to roll with the punches that come and also try to get the information to the students in as many ways possible. That way, hopefully, most if not all will understand the material, pass the test and ultimately become good EMT's.
So..with all that in mind, I got some more work to do....
BRM
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