
Mike restarts his EMS caregiver adventure
For a while I was a "Paper Paramedic." Had the certification, did the continuing education and worked the absolute minimum required field rotations. Often weaseled field time, counting EMS Supervisor tours instead of ambulance time.
Taught the summer semester cardiology course to keep up-to-date on rhythms and medications. My internal justification was that I had a dozen years as an ALS provider. A closer examination will reveal that half of that time was spent in staff, suppression or training assignments.
In Room 2 of my Johari window – things known to others but not to me – it was clear that I was "faking it" as a medic.
I did not exhibit the ease and familiarity of a medic who frequently started IV's, like Medic 9 did a half dozen times a day.
A Forced Change In Behavior
The department had not implemented fire company paramedic response, but two of the three fire officers assigned to Engine 9 were ALS credentialed. We got a prototype engine medic bag.
My counterpart on Medic 9, Harry Scott, knew I was hiding. The medic crew decided that the engine paramedic would start every third IV.
I learned this after walking into a house to assist with a 50-something alcoholic with chest pain.
Normally, Harry and his crew are quick. The engine's role is to help pack up and move the patient out to the ambulance. On this bright afternoon, it seemed that everyone was waiting on me.
A Rush of Flop Sweat
Starting IV's have been a challenge. It was the skill that took the longest to demonstrate consistency. Would never get to mastery.
I remember three specific patients.
My first IV attempt was in a clinic, with a physician assistant preceptor. I was sweating more than the guy having the heart attack – he asked if I was OK. The preceptor started mopping my brow.
The second patient was a teenaged girl struck by a car. I was a paramedic intern, 0 for nine attempts that month. The Lieutenant was patient and supportive, but was starting to talk about extending my ALS internship.
The girl had life-threatening injuries, including significant blood loss. I had no time to think. The 14 gauge catherer sunk like a hole-in-one.
The take-away lesson that day was that I was thinking too much when picking up the 18 or 22 gauge catherer, sabotaging the muscle memory developed through practice. Finished the internship on time.
Standing in that drunk lawyer's sun-drenched home office is my third vivid memory. It was a dozen years since I kneeled on hot asphalt sticky with plasma and willed a 14 into the antecubital fossa.
The flop sweat started.
Took the starter kit from Harry and stopped thinking.
Started the IV.
Lived Happily Ever After … (Really?)
If this was an afterschool special or an ems textbook sidebar, the paper paramedic would become empowered and evolve into an unconciously competent caregiver. That did not happen.
Harry broke my habit of hiding on ems calls. Which was helpful since Engine 9 was working three or four life-threatening ems calls a month, waiting for a much further away transport units. Medic 9 and Ambulance 9 were some of the busiest units in the department.
Working in a community of poverty and blight, I started more IVs and defibrillated more patients from Engine 9 than I did on the medic unit during my internship. It was a fantastic three year run.
Drifted back into hiding when transferred to a nicer part of the county, with a much slower EMS workload.
Things keep drifting away …
Could not stay engaged as paramedic in my home community after retirement. ALS credentials not renewed – 22 years certified. Gotta admit I felt a weight released when I made that decision.
Stopped teaching EMT refreshers for the fire academy because of other obligations. Need to teach to maintain instructor status – 28 years as a state EMT instructor. Still credentialed to teach EMS for the District of Columbia. A mix of frustration and relief
When I went to recertify as a Virginia EMT-Basic in Fall 2009, discovered that my agency affiliation was removed. Should have kept that part-time fire academy gig. No affiliation means no recertification test. That hurt.
… and then come back.
Have written a little bit on the massive EMS changes within the unique city-state called the District of Columbia:
On top of the complete adoption of the National Registry of EMT credentialling process, there is a strong city-centric push within the regulations.
All of our faculty and lead instructors hold Virginia or Maryland ems certifications, many without National Registry credentials. Ahh, that may create future problems.
Deja Vue all over again
My medical director allowed this lapsed EMT to teach instead of attend an EMT-Basic class.
Taught a Spring 2010 course to undergraduates:
Getting signed off on the Psychomotor exam took much more time than I expected. Not that anyone was being passive-aggressive in an organization that thrives on years-long conversation over a vital issue.
Today completes my teaching an accelerated seven week EMT Summer Program for 17 to 20 year olds interested in Health Science/Emergency Medicine.
10:00 to 17:00 every day … 50 question weekly quizzes … Tuesday/ Thursday afternoon "enrichments" … so thankful that a colleague was between jobs and could help out with the lectures.
They took their 120 question course final Tuesday. Ninety minutes after the last student left I was getting a palm vein scan at a PearsonVUE test center.
Mother … Jugs … and Speed
I took my first EMT-Ambulance state certification exam May 1971.
Now that I have passed my National Registry EMT-Basic exam, need to affiliate with a District of Columbia response agency.
It would be nice if it was affiliated with the university.
DC Fire Station 23 does not use volunteers.
Oh yeah, the student-staffed Emergency Medical Response Group – EMeRG.
Their busiest time are the first few weekends of the Fall semester, handling two dozen incidents 9 pm Thursday to 3 am Sunday.
Most patients are freshman discovering the limits of alcohol, physiology and physics.
I hope that I pass my application interview.
Wonder where my EVOC certificate is?
Mike "FossilMedic Speed" Ward, NREMT-Basic
August 19, 2011
Updated: Title changed from "It Was Almost 40 years ago today …"
Morning Lineup – August 17
Comments OffWednesday Morning
This Morning's Lineup Will Be
Conducted by "Firehat," Patrick Mahoney
Do you remember that TV show Quantum Leap? This was the one about the time-jumping physicist on a mission to "put right what once went wrong." Scott Bakula played the good doctor, ably assisted by Dean Stockwell as his sidekick Al. The program ran on NBC from 1989 to 1993 and was a modest, but memorable, hit. I was a youngster in those days but I watched the show with the devotion and attentiveness reserved for all first encounters with inventive creativity, those theretofore unsullied by the realization that everything has been done before.
There was, however, something else here, something that I didn't realize until I was grown and recently rewatching the show occasionally on late-night syndicated television. That "something" is pretty darned subversive: Sam Beckett, the prototypical white American male (the character was from an Iowa farm, in fact) played by the movie star handsome Scott Bakula, was shown in place of the person into whom he had leaped. That is to say, those characters, be they black, women, mentally handicapped, or any other minority, were depicted by this clearly white Anglo-Saxon Protestant archetype whose job it was to bear their burdens.
For a young white Anglo-Saxon Protestant watching the show this was truly an inventive dramatic device that taught empathy to the involved viewer. The stories themselves offered concise moral and ethical dilemmas and conflict in the aim of their resolutions. Stories are good for that sort of thing; the enduring ones are really told for those purposes. The stories we take inside our minds to become part of ourselves are invariably about morals, ethics, resolution through conflict, and, sometimes, empathy.
We'll have time for those stories later, and maybe even time for the one about the guys on B-Shift flouring the rookie the other day. In the meantime, I'll start some more coffee while you guys get the apparatus checked out.
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