THE MOVE from NIGHTS to DAYS – One year later was it worth it!

So this week marks a change for me. After working one of the busiest systems in the country on night shift for three years I have moved to days.

It takes a special breed of worker to perform at optimal levels in the middle of the night. Throughout my career I’ve done some of my best work at night. Now at the age of 41 I have gone to days. Mostly to improve my family life. I have a wife that works from home and my son who likes to have daytime pool party’s with his summertime friends. These two things make it impossible to get decent sleep. I will also be able to be awake when they are, especially on the weekends. The larger question is how will I perform as a medic, will my skills suffer during the acclamation phase? Well, I have worked two shifts so far and they have kept up I am 6/7 on IV’s and 100% on diagnostic impression vs ER Dx. At home it has been a struggle to switch my sleeping patterns. I came home the other night EXHAUSTIPATED, a word we made up at work (to tired to give a shit), I took a 50 minute nap and then went to dinner with a few friends. I ended up going to bed at 3am. Needless to say the dogs were giving me all sorts of attitude, they apparently wanted me to go to bed too…..(What you just read was a saved draft I wrote July 3rd 2013).

Currently it is June 23rd, almost a year later. So how did the transition from nights go? I will admit its was very hard for me and my family to transition. Life stresses of the time didn’t make it any easier. It took about 4 months for me to acclimate my body and sleep patterns to the day shift. Was the switch work it, the short answer ABSOLUTELY! The question as to why it was worth it has nothing to do with the job but my home life. Lets look back to those first four months though. When this started I had been married 7yrs and a few days. In those 7 yrs my career had changed from full-time FIRE / Medic to private service medic and part-time ER tech / paramedic. Those prior full-time jobs were 24hrs on 48hrs off and the part-time job at nights(better pay)! My wife had learned to be alone at nights and use to falling asleep without someone beside her. My current job started on Nights with a weird rotating shift I wont even begin to explain. I am now a Field Medic / Assistant(fill in) Supervisor & Critical Care Team Member. My wife has her own sleep routine and habits totally separate from mine and they collided in extraordinary fashion when I went to days. She hogs the covers and turns on an overhead fan, then she kicks the covers off in the night. She is a restless and active sleeper. On more than one occasion I woke up beaten and bruised because of some horrible dream she had. Apparently in her dream she was beating the crap out of someone. There were more than a few nights I would sleep in the spare room. Now we sleep in better harmony. I go to sleep first while she reads her tablet and most nights all is well, at least until my alarm goes off at 3:50am so I can be to work between 4:30 – 5:00. She still hates that part. I do my best to be quiet but its near impossible. I set my clothes out in the living room the night before. I NEED my morning coffee and the machine is loud. Thankfully my wife falls asleep within 30’sec of waking, My son wouldn’t wake if a train hit the house. Home life for me and my son has clashed a bit and yet improved too! He wasn’t use to my strict structures of doing home work and chores. Mom is a bit more relaxed than I am about those things. I am the one he prefers to help with his math and science, that is until I make him show his work and how he got his answer. Homework and chores aside, we spend more time together than ever, playing Xbox (when his friends are not around..LOL). Getting in the swimming pool, going for ice cream and McDonald’s or his favorite Taco Bell (yuck)!

Every once in a while I Feel the need to go play on the night shift, that is when I pick up a night-time supervisors shift and go rolling around in my SUV. IF you find yourself thinking of switching to days. There are pro’s and con’s and nights is not for everyone, and certainly the same can be said for day shift work. During days there is less violence on the streets, there is more supervision, more calls, more traffic okay a ton more traffic, more nursing home and hospital transfers, there is also more units on the road to cover those at least that’s how it looks on paper. The truth about units it all equals about the same. In some company’s working nights gets you more income, not my company. It’s where you begin your career, and it take about three years to get off night’s by then you are so accustomed to it you stay there. The last thing that was difficult about going to days, was all new nursing staff at all 13 of our hospitals. Getting to know them and getting their trust in you, you have to earn it and that takes time.

Have a great day!

Breaking in a New Partner

Well, sometimes you get what you ask for in spades! I have been wanting a regular partner for two months now, and I have one. When I say he is new, I mean he has been an EMT less than 4-5 months. He has chosen to work as a new EMT in one the strictest and busiest systems in the Country. God Bless the meek for they shall inherit the earth!

I have not had the pleasure of breaking in a new partner in several years. Lets just say its an art form. Getting to know each other, defining each others roles and expectations. Fixing the misconceptions or misinformation he got prior to entering the EMS profession. This will be a test to my skill, in handling people, something I am good at as long as they are patients…LOL j/k.

He is 21 yrs old, a brite kid. who knows enough to be dangerous and that literally is all he knows. He has high aspirations which I applaud but lacks direction to get there. The crackle of the radio spurs an automatic adrenaline response, that directly corresponds to the gas pedal. He lacks certain clinical skills, how he made it through school, testing, preceptor & FTO and not be able to take a BP on a critically ill patient is beyond me. But in all we survived the first three shifts together. This week we will have some clear communications about resources available to him. And do our best to get him taking accurate BP’s in sick patients, or be honest enought to admit he can’t find one. There are times I have problems finding them but that just means I have someone else in the truck confirm it.

Perfect is not something I expect. I expect an honest effort, and the truth. I have the skills I have because I have worked on them throughout my career.

Before I close this artilce a few words for Lt. David LeRoy “Lee” Grounds, Marion City Fire Dept. Marion, Ohio. A friend, a gentleman, a courageous Husband, Father, Son, and Fire Fighter / Paramedic. You will be missed. Rest In Peace my friend.

WHY IS RECRUITMENT AND RETENTION SUCH A PROBLEM IN OUR PROFESSION

I would have to say the major reason for the shortage is a lack of respect for our profession. Lets face it most professionals in the medical community who have real life and death responsibilities garner wages that double or even triple the top wage earners for field personnel in EMS. If you want to make money in EMS you must work an insane amount of hours, spend an equally insane amount of time in training and continuing education (away from family). A typical paramedic will commit to 1500 hours initial classroom, clinical and ride time to earn certification. To maintain their certification they do more annual classroom and training, 4 times more hours than an ER Nurse. The sacrifice of time away from loved ones to enter a profession that allows us the duty of saving a life, we get paid a starting wage of $25,000.00 a year. I can tell you when I first started in the EMS profession 18 years ago, I worked my way through school. I worked fast food and made $17,000.00 to flip burgers.

EMS is a hard job, it takes a physical and emotional toll on you as provider, as a husband or wife, a Father or Mother. There are weeks that go by and I get to spend less than 15 hours awake with my family. The sacrifice my family makes for me to do this job is not lost on me either. There are special occasions, birthdays, holidays, and anniversaries that I end up missing. I do what I can to make it to the big stuff, but even with the best of intentions sometimes I just fall short.

Is there a disconnect between the field providers and management? A majority of large companies yes there is. How about the mom and pop shops, not as much. But what happens to the mom and pop shops, after 30 years of struggling against the big corporate machines they decide the heck with it. I want to increase my profit margin so I can retire sooner than later and really who blames them.

I have worked a lot of different types of systems, yet I just finished a three month orientation with a company to prove I am fit to be a medic for them. All for the poultry starting wage of $35,000.00 a year. One would think with a shortage of paramedics wages would take a sharper increase. Of all the medical jobs that have direct patient responsibilities EMS seems to be the only one that is not making a steeper climb on the earnings ladder. If there’s interest in this subject I will post more of my opinions about this.

Policy makers need to realize we need two things a living breathing wage, just like they need living breathing paying customers. We also need job security. Not hey we lost to many contracts, or we grew to quick because we didn’t utilize a realistic business model plan for growth. Sorry we have to sell-out to someone who is going to offer you less money than we were already paying you.

I Met the most Burnt Medic I ve seen in a while.

Another joyous day at work. I was paired with A medic that has been doing this job just six months less than me. There happens to be a stark difference between him and I. Someone has taken a blow torch to him and burnt him to a crisp (figuratively speaking). We ran 8 or 9 calls nothing serious but we had one call with a gentleman that had a CONFIRMED hip fx, and he wanted him to walk to the cot! When I stepped in and said lets just sheet him over, he actually said in front of the patient but we will hurt our backs. The guy could not have been more than 100 pounds. BTW there was three of us on the truck yesterday. One day I am going to spend some time and write on here about the GOLDEN RULE OF EMS. DO NO HARM!!!

Today’s activities

So I just got home from work (4:30am), what a shift too. Without violating any form of HIPPA lets start and finish with: I never want a repeat of that shift ever again in my career. Part of the day was one place dumping to another and as typical the EMS got caught in the middle. Nothing that hasn’t happen in the past and sorry to say it will probably continue to happen all across this country on a day-to-day basis. The other part of the shift was just frustrating at best, and infuriating at times.

Remember when I was talking about someone finding that last nerve and jumping on it like it was a trampoline, well today the EMT I was working with must have been a circus acrobat performer. He likes to get his digs in when ever he can, and thinks he is the perfect gift to EMS. Just got his state paramedic cert. I mean its less than 24 hrs old. I made a suggestion tonight when placing the CID to lower the cot and slide the head of the board off the end of the cot, he acted like I was insane. Tell me who hasn’t (with a cot in the fully lowered position) slid the head of the backboard off the cot so they can tape the CID without lifting the patient. It truly is the safest way to do it. If we are spinal immobilizing someone there’s a reason. lifting the board places the patient at risk and it places the EMT at a greater risk for back injury.

Well I think that’s enough for now, I have to be awake in five hours so I can get ready to do this all over again. Hopefully the circus performer got humbled after all his jumping around landed him right smack dab in the center ring of fire, but that’s another time another story.

Why Cant We All Just Get Along? Part – 2

Why Cant We All Just Get Along? Part – 2

This part is centered on why Private EMS 911 providers and Public 911 Providers clash.

The short answer is it’s a turf war. The complex answer goes much deeper. Generally the reason for the system setup is political and out of the hands of those who it affects the most.
I have had the opportunity to work for both and I can say this, never once did I change the level of care I provide base on the ownership of the truck I am in. The argument that fire provides better service than private and vice versa is mute to me. Yes the privates are for profit and will do what fits their bottom line the best with cheaper equipment, but that cliché is not always true. I work for a private company that provides 911 cover to an entire county with excellent equipment. Fire Depts are competing for a different kind of profit and its called a job market. It is about making sure the number of fire fighters they have on staff stay on staff. They justify a few extra personnel with operating an EMS system. They are financially competing for tax base and insurance dollars. With all the players cards laid on the table, let’s talk about where the stethoscope meets the chest wall.

When I arrive at a call and Fire arrives first, my first contact is with whoever has been providing care to the patient. Why is that? Well, why we are there? Someone is having a terrible day and needs our help. If I come into the scene with a big attitude that’s my patient I‘ll ask the questions how reassuring to the patient is that?. Act like that too many times and eventually you will hear get another person to take me to the hospital because that one isn’t touching me. There is also something to be said for mutual respect, and yes even trust. My next contact is with the patient, a formal introduction of sorts to let them know I will be taking them to the hospital. This does a couple things, It tells the patient who I am and tells them why the fire dept is telling me everything they went over before I got there. I actually preferred this method it allows me the opportunity to formulate a differential diagnosis in my head. I also get the opportunity to do other things and pick up on subtle clues in an environment and I know that while I am doing this the patient is getting cared for. If for some reason I believe a patient is being put at risk by someone’s care I also get the opportunity to try to understand the EMS providers logic and possibly re-direct them. Face it no matter what truck you ride, we have all blown a differential diagnosis. If you say you have never done that there’s only two reason why 1. you haven’t been doing this long. 2. your arrogance won’t let you learn. Number 2 is very dangerous, and will kill someone, maybe even you!!!

So in closing we are all sent to a scene to take care of a patient, we all went to school to help people. Leave the policies and politics of why we are sending 8 paramedics to one call to the people who pay your checks. Don’t take it out on the person showing up in that other truck. Be professional and be responsible for your actions, sometimes that means saying I screwed up and I am sorry. It means saying why don’t you take this one and I’ll grab the next run. It can mean picking up a heavy box and carrying it down a flight of steps. Don’t be a push over but don’t be so rigid against the other team that you forget you are there for the person on the stretcher. A little goodwill can go a long way towards making sure the guys on the street are doing the best they can for each other and not just for themselves, so managers get involved, promote these philosophies!

Part 1 Why Can’t We All Just Get Along

Why can’t we all just get along?-Part1

I have heard this question as the punch line in a series of jokes many times in my career. But the truth remains that we typically would eat our own to get ahead in the job market

So I have a few things I would like to talk about, I believe they will make a better work environment for you. Let me start by saying that your work partner is a person you will spend a majority of your time with. Typically we spend more time with them than we do our significant others. That doesn’t include training and other work functions. Here’s a question for people to respond back to. How long would you keep a relationship if you had to spend 36 -72 hours a week in constant contact with them? I am not talking sitting around the house. I am talking sitting two feet away from them for all those hours. God bless my wife and son I love them til death do us part, but that many hours in a confined area with them would drive me insane. Here is the scary part your significant other is someone you get to pick! How often do we get to pick our partners at work? Almost never, at least not without paying a few people off and or a few shift swaps. Even if we do get the partner we want, usually there will come a point when the person we want to work with gets on our last nerve and they jump up and down on that nerve like it’s a trampoline.

So how do we get along in the workplace with a person we didn’t get to pick?
Well to start off hopefully you have some common ground and interest. You both enjoy EMS for one reason or another. Explore and talk about why you sought out this profession. This may sound weird but limit the total time you spend together outside of work. There’s a lot who may disagree with that statement, but there will come a time at work when you don’t have the option of being best buds. You may have to become an educator, or even their boss because they did something sooo stupid you don’t have a choice. Then it gets weird and feelings get hurt. I have a lot of great friends and yes most of them are from my work life, but in the same token they all know that if it comes down to making sure the job is getting done right that’s going to happen above all else.

My next post will be Part two in this series
Private 911 providers Vs. Public Based EMS, my points of view may surprise many who think they know me

Miss fire

So trying to start a blog and get through this last week may have been a miss-fire on my part. I do have part 1 of the two part series nearly complete. I hopefully will revise it tomorrow morning and post it before I go to work. BTW I will leave for work around 1345hrs, It should be posted by 1300hrs unless the second coming of Christ beats me to the deadline. But if that happens then all is well anyways.

Hello world!

This blog will serve people currently working or looking at a career in Emergency Medical Services. Some people have entered this career with a varied array of misconceptions. Hopefully this site will dispell some of these. There are a number of people who get “burned out” this site will give those with concerns of the effects of burn out a place for resources and links.

Please be patient as this blog is built over time, I will work on it when I am not working or being a husband or a father.

My First Subject based Post will here on Sunday Sept. 19th 2010. The subject “Why cant we all just get along?-PART 1”