I ran a call last shift and I had no idea what was going on with this guy...
We get called for an unconscious. Dispatch calls us back while en route and says that the patient is now conscious. Upon arrival the patient is a mid-30's male sitting up and talking. He doesn't look as if he feels well, but not in any specific distress.
I start my assessment and found out that he has been having multiple syncopal episodes for more than a week. He had been to see his doctor and had been to the ED and was diagnosed with "Occipital Neuritis". I didn't have a clue what that was, so I started asking questions.
He said that there was something wrong with a nerve in the back of his head and that made him pass out. He was also experiencing severe headaches, sensitivity to light and nausea. The only other medical problem he had was hypertension. His only medication was a anti-hypertension med. He said that he had been diagnosed and treated for the HTN a few years ago.
The reason he had called EMS this time was because he had passed out and hit his head. He had a pretty good goose egg on the side of his head, but otherwise was OK. We obtained orthostatic vitals and there was no change. He said that he had been eating and drinking normally, no bowel or urinary abnormalities, no recent sickness and no recent trauma other than the fall. His blood sugar and 12-lead were also normal.
During all this assessment, he passed out 3 times. At first I thought he was maybe faking. But after a serious sternal rub and an extreme pinch to the web between his thumb and forefinger, I figured he was really out. Plus I've never seen a patient faking and actually smack his head against something hard enough to leave a mark and not flinch. Each syncopal episode ended within 30 seconds and he was not disorientated upon waking up.
We got him to the truck and started a line and put him on the monitor. During transport his headache, nausea and sensitivity to light seemed to get worse. I wasn't sure if it was from his condition or the bumpy/ curvy ride in the truck or both. So I turned off the lights in the back and tried to make him as comfortable as I could. He passed out several more times during transport. His vitals and 12 lead stayed normal during the episodes.
Eventually I have him 4mg of Zofran for his nausea, so he wouldn't puke in my truck and to try to make him a little more comfortable. That helped with the nausea but he still had a lot of pain. I wasn't gonna give him morphine for that and he had already taken 1000 mg of Tylenol before he called us.
We got to the hospital and turned patient care over to the nurse. The doc came in and this is usually where I make my exit but I stuck around for this one. After the doc did his assessment I followed him out and asked him what occipital neuritis was. He looked at me and said that he didn't have the slightest clue.
Since then I still don't really have a clue. I've asked several people and have done an extensive Internet search all with no real answers. So if anyone out there has any information I would be grateful. Since that call a few of my co-workers have run him for the same thing and no one seems to know what's going on...
BRM
Tuesday, January 15, 2008
Thursday, January 10, 2008
Wondering...
Have you ever had one of those calls that you wonder about? You know, the ones that you're not sure if you did the right thing? I have them every once in a while. This is one that happened a little while back.
We get called out for a difficulty breathing. We get there and there is this 50-ish year old male sitting up and talking. He has a home health nurse and she is there giving us the report on why she felt it was necessary to call us.
The patient in question had a history of stomach cancer, COPD, hypertension, recent pneumonia and a productive cough with green tinged sputum. He doesn't seem to be in any distress at the moment. The nurse said that he had been suffering from dehydration and she had started an IV and had been administering fluids. That is apparently when the trouble began. The patient started getting short of breath and anxious. So she stopped the fluids and discontinued the IV.
The patient didn't want to go to the hospital, but apparently trusted his nurse and wife and various other family members on scene, and decided to take the trip to the Big City Hospital down the road.
We put him on some O2 and get him loaded up. His vitals were within limits, O2 saturation was good and his lungs had some diffuse congestion throughout all quadrants. 12 lead and capnography were both normal. I started an IV just for precautionary measures and kept it at a KVO (Keep Vein Open) rate. He still said that he felt fine and he didn't seem to be in any distress.
On the way down, I do a little more detailed exam and find that his ankles and abdomen are swollen. He says that this is normal for him from time to time. His abdomen has some bruising and he doesn't know why. I take another look at his medication list and he isn't on any blood thinners or diuretics.
He still says that he feels fine and I have to agree that he does not seem to be in any distress. He says that he is a little tired and just wants to sleep. So I lay his head back and turn down the lights so he can take a cat nap for the remainder of the trip.
That is when I notice the JVD (Jugular Vein Distension). I put the puzzle pieces together and come up with pulmonary edema. I take another listen to his lungs and still only hear ronchi or congestion. I was taught that if you have the patient cough while listening then the sounds will clear and then return if it is ronchi, besides the obvious sound difference between ronchi and rales. Well, this is what happened when I had him to cough.
This is my dilemma; his pedal and abdominal edema, JVD and the fact that he started having trouble breathing when he was getting IV fluids all point to pulmonary edema. The other half to the equation was that he wasn't having any trouble breathing, he wasn't anxious, his blood pressure was normal and I didn't hear any fluid in his lungs. The blood pressure and heart rate I could explain away on the beta blockers he was taking to control those very things.
I didn't treat him with anything other than O2. He made it to the hospital fine and never once displayed any signs of respiratory compromise. But I have wondered since then if I shouldn't have treated him. Maybe he did have edema and I just mistook it for ronchi. Who knows? But I still wonder...
BRM
We get called out for a difficulty breathing. We get there and there is this 50-ish year old male sitting up and talking. He has a home health nurse and she is there giving us the report on why she felt it was necessary to call us.
The patient in question had a history of stomach cancer, COPD, hypertension, recent pneumonia and a productive cough with green tinged sputum. He doesn't seem to be in any distress at the moment. The nurse said that he had been suffering from dehydration and she had started an IV and had been administering fluids. That is apparently when the trouble began. The patient started getting short of breath and anxious. So she stopped the fluids and discontinued the IV.
The patient didn't want to go to the hospital, but apparently trusted his nurse and wife and various other family members on scene, and decided to take the trip to the Big City Hospital down the road.
We put him on some O2 and get him loaded up. His vitals were within limits, O2 saturation was good and his lungs had some diffuse congestion throughout all quadrants. 12 lead and capnography were both normal. I started an IV just for precautionary measures and kept it at a KVO (Keep Vein Open) rate. He still said that he felt fine and he didn't seem to be in any distress.
On the way down, I do a little more detailed exam and find that his ankles and abdomen are swollen. He says that this is normal for him from time to time. His abdomen has some bruising and he doesn't know why. I take another look at his medication list and he isn't on any blood thinners or diuretics.
He still says that he feels fine and I have to agree that he does not seem to be in any distress. He says that he is a little tired and just wants to sleep. So I lay his head back and turn down the lights so he can take a cat nap for the remainder of the trip.
That is when I notice the JVD (Jugular Vein Distension). I put the puzzle pieces together and come up with pulmonary edema. I take another listen to his lungs and still only hear ronchi or congestion. I was taught that if you have the patient cough while listening then the sounds will clear and then return if it is ronchi, besides the obvious sound difference between ronchi and rales. Well, this is what happened when I had him to cough.
This is my dilemma; his pedal and abdominal edema, JVD and the fact that he started having trouble breathing when he was getting IV fluids all point to pulmonary edema. The other half to the equation was that he wasn't having any trouble breathing, he wasn't anxious, his blood pressure was normal and I didn't hear any fluid in his lungs. The blood pressure and heart rate I could explain away on the beta blockers he was taking to control those very things.
I didn't treat him with anything other than O2. He made it to the hospital fine and never once displayed any signs of respiratory compromise. But I have wondered since then if I shouldn't have treated him. Maybe he did have edema and I just mistook it for ronchi. Who knows? But I still wonder...
BRM
Thursday, January 3, 2008
The High....
I have had lots of different experiences in my life, lots of different highs. From smoking pot in high school, to jumping out of a perfectly good airplane at 15,000 feet, to scuba diving, white water rafting and rock climbing. Other than my son being born, I would have to say one of the biggest highs I've ever had is simply being a Paramedic.
I think that is probably the biggest reason that we all get into this line of work and stay for any length of time. Sure, you can tell people that it's helping people, but all of us love to race down the road to some trauma that sounds nice and juicy. We are all adrenaline junkies at heart.
But the other side of that is just the job, the ability to actually reach people. The other day was just another day. I was working, as usual, with an EMT. He was just about done with his Paramedic, but other than clinicals, he had no experience above a Basic EMT. But he is the type that I love to work with. He likes asking questions and actually welcomes constructive criticism.
I've found that I love to teach. I don't know a whole lot, but what little I do know, I like to pass on to those that actually want to learn. I love it when the student gets this look during our conversation. You know that look, the one where you can almost see the neurons firing inside his head and the light bulb burning brightly.
The other part of the job is just being nice to people and seeing their response. I had two ALS patients last shift. One was a difficulty breathing and the other was chest pain. Both were elderly and had extensive history. Both were terrified of what was happening to them. With kind words and gentle touch, I think I eased their fears just a little. Or maybe it was just my imagination. But both patients seemed more comfortable and relaxed. I always pat a shoulder or shake a hand and tell them I hope they feel better soon and that they are in good hands as I leave them in the ED. I got what seemed like sincere thank you's from both of those patients.
As I left the ED from both patients I had a spring in my step and I felt good. I've read that it costs nothing to be nice and that you get out of something what you put in. I believe it. It was also an excellent teaching experience as I found out later. The EMT I was working with is part-time so he works with many different medics. He commented on my hospitality towards my patients and told me horror stories that we've all heard on how some medics treat their patients.
I told him my philosophy on attitude in EMS:
Always be good to the first responders. They are, for the most part all volunteers, so at 3 in the morning, when the blood pressure that they give you is completely wrong, don't berate them for it. Just take it in stride and thank them. If one of them is in your way, be nice and ask, don't tell, him/her to please step aside, and always listen to what they have to say. Just as our patients are different when we roll them into the ED, sometimes the patient was different when they arrived as to when we arrive. You never know when you are gonna need their help, so don't piss them off and always say thank you for whatever help you do get. Even if they didn't do anything more than just show up.
Always be good to your patients. It is their emergency, no matter how mundane it seems to you. They felt is was bad enough to call 911, so it is worth your time to be there. You are getting paid to do a job, not brow-beat people for their decisions.
Always be nice to the nurses, at all the facilities and the ED. This is something that I have figured out recently. Most people in EMS hate nursing homes. I have no love for the places myself, but the people that work their are not all lazy and ignorant. Someone has to do the job, and I sure as hell wouldn't want it. I've realized that if you give them your attention and listen to whatever it is that they have to say, they remember you and eventually you'll start to get better reports and have plenty of help when you need it. And again, always say thank you for whatever help you get.
Always be nice to the dispatchers. I hear people giving them hell all the time for wrong addresses and cross-streets and wrong dispatch information. This is another job that I wouldn't want, but someone has to do it. Just be nice and take it in stride. These people can always find a way to make your life a living hell if you piss them off.
So the words are, be nice. Eventually it will all pay off in the end and it will make your life and your shift much easier. I've read EMS books about this type of subject and I've seen a few medics that live and work this way. I learned from them and I try to teach that to the ones that I can. That is my high...
BRM
I think that is probably the biggest reason that we all get into this line of work and stay for any length of time. Sure, you can tell people that it's helping people, but all of us love to race down the road to some trauma that sounds nice and juicy. We are all adrenaline junkies at heart.
But the other side of that is just the job, the ability to actually reach people. The other day was just another day. I was working, as usual, with an EMT. He was just about done with his Paramedic, but other than clinicals, he had no experience above a Basic EMT. But he is the type that I love to work with. He likes asking questions and actually welcomes constructive criticism.
I've found that I love to teach. I don't know a whole lot, but what little I do know, I like to pass on to those that actually want to learn. I love it when the student gets this look during our conversation. You know that look, the one where you can almost see the neurons firing inside his head and the light bulb burning brightly.
The other part of the job is just being nice to people and seeing their response. I had two ALS patients last shift. One was a difficulty breathing and the other was chest pain. Both were elderly and had extensive history. Both were terrified of what was happening to them. With kind words and gentle touch, I think I eased their fears just a little. Or maybe it was just my imagination. But both patients seemed more comfortable and relaxed. I always pat a shoulder or shake a hand and tell them I hope they feel better soon and that they are in good hands as I leave them in the ED. I got what seemed like sincere thank you's from both of those patients.
As I left the ED from both patients I had a spring in my step and I felt good. I've read that it costs nothing to be nice and that you get out of something what you put in. I believe it. It was also an excellent teaching experience as I found out later. The EMT I was working with is part-time so he works with many different medics. He commented on my hospitality towards my patients and told me horror stories that we've all heard on how some medics treat their patients.
I told him my philosophy on attitude in EMS:
Always be good to the first responders. They are, for the most part all volunteers, so at 3 in the morning, when the blood pressure that they give you is completely wrong, don't berate them for it. Just take it in stride and thank them. If one of them is in your way, be nice and ask, don't tell, him/her to please step aside, and always listen to what they have to say. Just as our patients are different when we roll them into the ED, sometimes the patient was different when they arrived as to when we arrive. You never know when you are gonna need their help, so don't piss them off and always say thank you for whatever help you do get. Even if they didn't do anything more than just show up.
Always be good to your patients. It is their emergency, no matter how mundane it seems to you. They felt is was bad enough to call 911, so it is worth your time to be there. You are getting paid to do a job, not brow-beat people for their decisions.
Always be nice to the nurses, at all the facilities and the ED. This is something that I have figured out recently. Most people in EMS hate nursing homes. I have no love for the places myself, but the people that work their are not all lazy and ignorant. Someone has to do the job, and I sure as hell wouldn't want it. I've realized that if you give them your attention and listen to whatever it is that they have to say, they remember you and eventually you'll start to get better reports and have plenty of help when you need it. And again, always say thank you for whatever help you get.
Always be nice to the dispatchers. I hear people giving them hell all the time for wrong addresses and cross-streets and wrong dispatch information. This is another job that I wouldn't want, but someone has to do it. Just be nice and take it in stride. These people can always find a way to make your life a living hell if you piss them off.
So the words are, be nice. Eventually it will all pay off in the end and it will make your life and your shift much easier. I've read EMS books about this type of subject and I've seen a few medics that live and work this way. I learned from them and I try to teach that to the ones that I can. That is my high...
BRM
Monday, December 31, 2007
On Studying...
I had an instructor that once said that we would study more after we got out of school than we ever did while in class. Even though I have the utmost respect for that instructor, I had trouble believing him. Just like a teenager, as I grew up he got smart all of a sudden. By growing up I mean gaining experience as a paramedic.
I have opened my paramedic text so many times in the past few weeks I am thinking that I may have to buy another one because the spine is wearing out. I have been recently fully cleared to ride with anyone. Lately my supervisor has made full use of this. I have been working with the round-robin of brand spanking new EMT's and Intermediate's, not even one new paramedic.
One of my favorite shows to watch is ER. I have started collecting past seasons and my wife got me a few of them as stocking stuffers for Christmas. I have been watching them lately. It's kinda funny, I have watched that show for a long time. But now it invokes a much different thought pattern. I don't know if any of you readers out there watch ER, but as the name implies it's about an ER and the doctors and nurses that work there. There are paramedics in the show, but they are all just extras. They do make us look good most of the time, they roll into the ER with their patients neatly packaged, ready to hand off care with a quick, concise report. Then they roll back out, usually unnoticed as the drama of the ER unfolds.
The reason I mentioned this is that while I sit here watching this show and see the different types of trauma and medical patients that they treat, I wonder how I would treat that patient or that presentation if it were me.
So that leads me back to the original topic of discussion...studying. When I see a presentation or just think about something that may happen. A situation that is unlikely, but nonetheless a possibility each day I go to work. That in turn leads me back to my text, protocol book and of course the Internet.
It's funny how things work. They don't turn you loose until you have the experience on the street, but by the time you have the experience you are so far removed from the classroom that you've forgotten all the little details on all the stuff that hardly ever happens. I know that we are all supposed to be machines in our ability to remember every little thing on the fly, but that's not what happens. At least not to me. When I finally graduated, I never wanted to see another textbook, much less spend hours staring at one. So for the past few months, that is exactly what i have done, or rather what I have not done.
But to be honest I am terrified that something will happen and I will not remember what to do. Like the exact placement of the BIG on an adult patient, or how to mix an epi drip or some off the wall pediatric dosage. So I study, all the time, every time something new comes to mind.
I know that in the end it will only make me better, but I wonder if all new medics go through this...
BRM
I have opened my paramedic text so many times in the past few weeks I am thinking that I may have to buy another one because the spine is wearing out. I have been recently fully cleared to ride with anyone. Lately my supervisor has made full use of this. I have been working with the round-robin of brand spanking new EMT's and Intermediate's, not even one new paramedic.
One of my favorite shows to watch is ER. I have started collecting past seasons and my wife got me a few of them as stocking stuffers for Christmas. I have been watching them lately. It's kinda funny, I have watched that show for a long time. But now it invokes a much different thought pattern. I don't know if any of you readers out there watch ER, but as the name implies it's about an ER and the doctors and nurses that work there. There are paramedics in the show, but they are all just extras. They do make us look good most of the time, they roll into the ER with their patients neatly packaged, ready to hand off care with a quick, concise report. Then they roll back out, usually unnoticed as the drama of the ER unfolds.
The reason I mentioned this is that while I sit here watching this show and see the different types of trauma and medical patients that they treat, I wonder how I would treat that patient or that presentation if it were me.
So that leads me back to the original topic of discussion...studying. When I see a presentation or just think about something that may happen. A situation that is unlikely, but nonetheless a possibility each day I go to work. That in turn leads me back to my text, protocol book and of course the Internet.
It's funny how things work. They don't turn you loose until you have the experience on the street, but by the time you have the experience you are so far removed from the classroom that you've forgotten all the little details on all the stuff that hardly ever happens. I know that we are all supposed to be machines in our ability to remember every little thing on the fly, but that's not what happens. At least not to me. When I finally graduated, I never wanted to see another textbook, much less spend hours staring at one. So for the past few months, that is exactly what i have done, or rather what I have not done.
But to be honest I am terrified that something will happen and I will not remember what to do. Like the exact placement of the BIG on an adult patient, or how to mix an epi drip or some off the wall pediatric dosage. So I study, all the time, every time something new comes to mind.
I know that in the end it will only make me better, but I wonder if all new medics go through this...
BRM
Monday, December 10, 2007
Just another day...
I apologize to the readers who come back to my little corner looking for something to read and have been disappointed. With the new baby and the other two kids, the Wife, work, teaching and taking classes, I've not had that much time to write. So here is the account of my last shift...
We had a student rider to come and do his clinicals with us. Have you ever noticed that whenever a student comes, it's either feast or famine? Either you run the worst calls or absolutely nothing. Well, this student is a "white cloud", meaning that we run nothing. Every time he has showed up I can count on being able to catch up on my sleep.
I kinda hate it for the guy because my cert card is barely dry and I remember all too well what it was like to do field clinicals. I know that he wants to get out there and tube someone, push every drug we have in the box and shock people 'till all the batteries are dry. I've offered to answer any questions he has. He's asked a few, I showed him all about the monitor, CPAP, BIG gun, MAST trousers, the pressure infuser and any other piece of equipment that we have on the rig. We've went over all 42 drugs in the box and he knows them by heart. So now we just sit around and watch TV or sleep. You know, just another day in EMS.
Last shift, he had no sooner pulled his little hatch-back car with all the EMT stickers and red lights out of the parking lot than the tones went off. We didn't stop for almost 8 hours. God, I wish they'd let him ride for 24 hours instead of just 12.
First call was for a choking at a nursing home. Nothing to it, little old lady got choked up on her mystery meat and the nursing staff freaked. You shoulda seen the look on the doc's face when we brought that one in...
Next was a CVA (stroke). Middle aged man had an acute onset of right-sided paralysis with blurred vision also in his right eye. No prior history except for diabetes and migraines. His symptoms were fully resolved way before we got there, and we only had a 4 minute en route time. He's a little sweaty, but otherwise he looks fine. The first responders say that his pressure is like 280/ 140 and they took it 3 times just to make sure.
We got him in the truck and they were right on the money. IV, O2, monitor and we were on the road. I gave him 2 sub-lingual nitro's and a clonidine. We were about 40 minutes away from the hospital and I actually got to see the clonidine work. Finally got his pressure to 160/ 100 and that was good enough for me. He never had any complaints whatsoever.
The last call of the shift was for a reported unconscious. We get there and the first responders are freaking a little bit. An elderly lady is propped up in bed, unresponsive, breathing about 30+ times a minute and looked like crap. We got her out to the truck and got to work. Her O2 sat's were in the 70's and her capnography was 23mmHg. History of COPD and CHF and lung cancer that was in remission, but no wheezing and no rales. Her lungs sounded good, for the little amount of air that she was moving. She came back around before we got to the highway and stayed that way until about 5 minutes prior to pulling up at the ED. She just finally wore out. I had my intubation stuff ready, but there wasn't any time, so I got a nasal airway in and bagged her the rest of the way.
As we moved her over to the ED bed she woke back up. We waited around just to see what they would do for her. I figured about CPAP or BiPAP, my partner thought they should just tube her. I didn't think she needed it and if they did, she would probably never come off the vent. Her sats dropped to 50 by the time the doc decided to do something about it. I didn't feel like watching them let her die, so we left. Not sure what happened. We got back and slept for the few hours before the morning wake up call.
And that was just another day...
BRM
We had a student rider to come and do his clinicals with us. Have you ever noticed that whenever a student comes, it's either feast or famine? Either you run the worst calls or absolutely nothing. Well, this student is a "white cloud", meaning that we run nothing. Every time he has showed up I can count on being able to catch up on my sleep.
I kinda hate it for the guy because my cert card is barely dry and I remember all too well what it was like to do field clinicals. I know that he wants to get out there and tube someone, push every drug we have in the box and shock people 'till all the batteries are dry. I've offered to answer any questions he has. He's asked a few, I showed him all about the monitor, CPAP, BIG gun, MAST trousers, the pressure infuser and any other piece of equipment that we have on the rig. We've went over all 42 drugs in the box and he knows them by heart. So now we just sit around and watch TV or sleep. You know, just another day in EMS.
Last shift, he had no sooner pulled his little hatch-back car with all the EMT stickers and red lights out of the parking lot than the tones went off. We didn't stop for almost 8 hours. God, I wish they'd let him ride for 24 hours instead of just 12.
First call was for a choking at a nursing home. Nothing to it, little old lady got choked up on her mystery meat and the nursing staff freaked. You shoulda seen the look on the doc's face when we brought that one in...
Next was a CVA (stroke). Middle aged man had an acute onset of right-sided paralysis with blurred vision also in his right eye. No prior history except for diabetes and migraines. His symptoms were fully resolved way before we got there, and we only had a 4 minute en route time. He's a little sweaty, but otherwise he looks fine. The first responders say that his pressure is like 280/ 140 and they took it 3 times just to make sure.
We got him in the truck and they were right on the money. IV, O2, monitor and we were on the road. I gave him 2 sub-lingual nitro's and a clonidine. We were about 40 minutes away from the hospital and I actually got to see the clonidine work. Finally got his pressure to 160/ 100 and that was good enough for me. He never had any complaints whatsoever.
The last call of the shift was for a reported unconscious. We get there and the first responders are freaking a little bit. An elderly lady is propped up in bed, unresponsive, breathing about 30+ times a minute and looked like crap. We got her out to the truck and got to work. Her O2 sat's were in the 70's and her capnography was 23mmHg. History of COPD and CHF and lung cancer that was in remission, but no wheezing and no rales. Her lungs sounded good, for the little amount of air that she was moving. She came back around before we got to the highway and stayed that way until about 5 minutes prior to pulling up at the ED. She just finally wore out. I had my intubation stuff ready, but there wasn't any time, so I got a nasal airway in and bagged her the rest of the way.
As we moved her over to the ED bed she woke back up. We waited around just to see what they would do for her. I figured about CPAP or BiPAP, my partner thought they should just tube her. I didn't think she needed it and if they did, she would probably never come off the vent. Her sats dropped to 50 by the time the doc decided to do something about it. I didn't feel like watching them let her die, so we left. Not sure what happened. We got back and slept for the few hours before the morning wake up call.
And that was just another day...
BRM
Friday, December 7, 2007
The Power of Being Nice...
My partner came to our service from the Big City EMS down the road. He has what I call the "Big City Attitude" most of the time. Don't get me wrong, he is an excellent medic and when someone is actually sick, he is one of the good ones to have around. But he had no patience whatsoever. Especially when it comes to patients that fall into the "BS" category.
We had a good day last shift, not too many calls. All but one were BLS, the other was just a simple diabetic. We sweetened her up and then she refused. She was a little old lady who had delt with her diabetes for over 20 years. Her husband had delt with it as well. All the while we were trying to start an IV he was up and moving around the little apartment they shared. You could tell he was nervous. He knew exactly what was wrong and that we would help her, it had happened many times before. But he was still anxious over his wife of over 40 years.
My partner was getting irritated at the husbands actions and how he was worrying us all with his advise and him going on and on about how she hadn't been taking care of herself as of late. I could see the growing frustration in my partner, so I stopped looking for an IV and got up to help the man look for whatever it was that he was searching for at the moment. I talked to him and offered reassurance that his wife was going to be OK. The look in his eyes was relief as someone was actually paying attention to what he had to say.
The rest of the day was all BLS. Most of them at nursing homes. Another little old lady fell and now she was having hip pain. She was scared that her hip was broken. Even though there was no deformity, shortening or rotation, I handled her with the same care that I would with my own grandmother.
A large lady had fallen out of her wheelchair while trying to get to the toilet. She was over 400 pounds and did not smell very well. She was having some trouble breathing and was embarrassed of being on the floor. We helped her up and I gave her one of our bedpans so she would not have to move from the bed to do her business. I listened to her story of how she had just been released from a long hospital stay for an infection. We got her situated and then left.
All through the day I made it a point to be nice. To listen to my patients, no matter what the circumstances or what they had to say. I noticed that as I continued to "be nice", my partner's attitude also changed. He didn't completely loose the "Big City Attitude", but he toned it down a great deal. It was as if my actions were effecting his. That by seeing how I was toward the patients, he unconsciously was doing the same.
Interesting how our attitudes and actions affect others around us, even those who we look up to and should be teaching us.....
BRM
We had a good day last shift, not too many calls. All but one were BLS, the other was just a simple diabetic. We sweetened her up and then she refused. She was a little old lady who had delt with her diabetes for over 20 years. Her husband had delt with it as well. All the while we were trying to start an IV he was up and moving around the little apartment they shared. You could tell he was nervous. He knew exactly what was wrong and that we would help her, it had happened many times before. But he was still anxious over his wife of over 40 years.
My partner was getting irritated at the husbands actions and how he was worrying us all with his advise and him going on and on about how she hadn't been taking care of herself as of late. I could see the growing frustration in my partner, so I stopped looking for an IV and got up to help the man look for whatever it was that he was searching for at the moment. I talked to him and offered reassurance that his wife was going to be OK. The look in his eyes was relief as someone was actually paying attention to what he had to say.
The rest of the day was all BLS. Most of them at nursing homes. Another little old lady fell and now she was having hip pain. She was scared that her hip was broken. Even though there was no deformity, shortening or rotation, I handled her with the same care that I would with my own grandmother.
A large lady had fallen out of her wheelchair while trying to get to the toilet. She was over 400 pounds and did not smell very well. She was having some trouble breathing and was embarrassed of being on the floor. We helped her up and I gave her one of our bedpans so she would not have to move from the bed to do her business. I listened to her story of how she had just been released from a long hospital stay for an infection. We got her situated and then left.
All through the day I made it a point to be nice. To listen to my patients, no matter what the circumstances or what they had to say. I noticed that as I continued to "be nice", my partner's attitude also changed. He didn't completely loose the "Big City Attitude", but he toned it down a great deal. It was as if my actions were effecting his. That by seeing how I was toward the patients, he unconsciously was doing the same.
Interesting how our attitudes and actions affect others around us, even those who we look up to and should be teaching us.....
BRM
Wednesday, November 14, 2007
10,000!
Today this blog hit the 10,000 mark! Thanks goes out to all those who have me linked on their blogs and the people that have come and read and commented. Thank you all very much!
BRM
BRM
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