Reflections on my first week

So I made it through my first week. It wasn’t bad (Except monday, but I’ll get to that), and actually kinda fun.

Monday was the easiest day of my week. I went to the station at 0800 and filled out a little paperwork. Then I went to City Hall (right behind the station) and wound up in Hell. The city orientation is basically locking you in a room with someone from HR, and you have to read, out loud, the city employee handbook. All 60 pages of it. Then sign some more paperwork. It only took about 4 hours, but it felt like it lasted forever.

Tuesday through Friday I ran on the 0600-1800 shift as third man on the trucks. Trying to get my feet wet and learn the protocols. I Found out just how different this system is than any other system I’ve ever worked in though.

One of the big things was when we were toned out to a MVC. It was out in the county and we wound up scrambling a bird to meet us on scene due to how far out it was. Our local VFD was also paged on an all-call, with no telling how long it would take them to get in the rescue truck and get to the scene, since it was the middle of the day and no one is on duty at the station, ever.

My medic unit got on scene first, and with a crew of three plus the cops on scene we split up and each took a pt. We also called in to dispatch and had them send medic 2 out when the on call crew got to the station. We had a 2 vehicle MVC, with one car being T-boned by the other. The car that was t-boned had two people in it, while the car that hit the first had one. I went to the side impacted vehicle and started assessing. The lead EMT-I on the truck (it was me, a basic, and another EMT-I as the crew that day) brought me a couple of c-collars and told me that I would be on my own as him and the basic got the first patient into our rig.

I looked around and noticed that the only people around me were LEOs. This in itself was very unusual for me. Back in ABQ or Denver, by this point, we would have at least an engine company on scene, and maybe a FD rescue as well. If not a truck and engine company. I got in and got collars on both patients and had PD hold stabilization for me while I assessed both patients. The driver seemed a little dazed but denied LOC, and only had a couple lacs on her forhead from glass from the passenger window breaking. She was belted in, with no damage to the steering wheel or starring of the windshield. I looked over at her passenger and decided she was stable enough to wait.

The passenger wasn’t so lucky. His side of the car had been hit, shattering the window and causing about a foot of intrusion into the passenger compartment. His seat also apparently broke and was reclined the entire way, with no sign of the seatbelt being worn. He was less than alert and moaning that his right ankle hurt (with the intrusion that was no surprise), and so did his back. We couldn’t get into the car from his door due to the damage. The crew of Medic 2 comes up to me while I’m assessing my second patient and getting a line in him, and asks me what I need. Imagine my surprise that my chief is on the crew of Medic 2! Talk about nervous.

I tell them that we need to get my guy out, but we can’t until the FD gets here with Jaws. So I tell them to extricate my female patient and get her to the rig. When that happens we finally get some FD showing up (about 15 minutes into the call) and they come over to me to see if I need anything. It’s at this point I find out that a couple are trained to the ECA (First Responder) level, and there’s only one EMT on the FD, who happens to be the basic on my truck today. Most don’t even know how to board and collar someone. Great.

While they’re setting up the jaws I see that his foot isn’t trapped on the door, just hung up. So I figure out a way to pull him out without cutting into the car. We get him out and on a board much quicker than we could have if they cut the car apart. This also pisses the FD off and makes them mad at me since I took away their reason for cutting apart a car.

To finish the story we get him loaded into my rig and run code to the ED with him, then wound up transferring him to the trauma center later. We cancelled the bird when we saw the scene and realized we didn’t need it.

This call woke me up to what a rural provider has to do. As the EMT-I on a truck with a basic partner (which will be my arrangement once I’m done with mentorship) I will have to be in charge of patient care, maybe of several patients, just the two of us. With no real backup except maybe our on call truck or a bird coming in. FD response can be very slow, and PD doesn’t like getting their hands dirty, at least that part doesn’t change.

I don’t know how many of the medics I worked with in ABQ would be willing to, or do well at, working in a system like this. They got way too used to have 3-5 medics plus a slew of EMTs standing around on scene just waiting to be told what to do. Working in my new system means I’ve got to handle everything that comes at me, and be able to do it fast and efficiently. Not to mention long transport and response times.

But to tell you the truth I don’t think I’d trade it for anything. I’m very excited to go to work tomorrow morning (well, except for the whole having to be there at 0600 thing šŸ˜› I much prefer nights), and continue to work here.

There’s a few more things about this system that shocked me, but I’ll get to that later. For now I’m gonna crash out pretty soon.

Another chapter begins

Over 10,000 miles, travel through ten states, and three long months. All of it to get to this point.

Tomorrow I start my new job :) First day is of course paperwork and going over the handbook. I also have a meeting with my new medical director. I start ride-outs on Tuesday :)

It’s been a long, disheartening process to get here, but I keep getting told that everything happens for a reason. Let’s hope that’s right.

Now it’s time to sleep. I hate long drives lately, and although my drive today wasn’t too bad, it still tired me out. Tomorrow will be a busy day, especially since I still have to find a place to rent in this small town.

Tomorrow is the start of a new chapter for both work and school. Let’s make the best of it.

Are those shears in your pocket…? My Handover post

“So this is it, guess it’s time to head in,” I got out of my Jeep, made sure I had my pack and binders, and walked in the front doors of IFT Hell. This would be my first night ever being on an ambulance, and I wanted to make sure I was early and had everything I needed.

I checked in with dispatch, let them know who I was, and who I was riding with. They told me that my preceptor and his partner would be in shortly and that I should wait for them in the break room. I get there and put down all my stuff and decide I should go through it one more time.

“Lets see… shears, check, on my right leg, protocol book… there it is, let me just put it in my backpack. Penlight… Yep, right next to my shears… along with several pens… oh hey there’s a sharpie there too. iTouch w/ Epocrates… Yep it’s in my left side ankle pocket. Cell phone in my left thigh pocket. Wallet… crap. I need that to drive!” I scramble frantically and pat every single pocket I have, till I notice it sitting on the table right by my backpack. “Right, that goes in my right thigh pocket. I’ll put some gloves in my right ankle pocket.”

Now, lets see what I put on my belt,” was my next thought. “Leatherman, flashlight, rescue hook, and radio loop. Got all of that where I can get it.” Well, it looks like I’ve got all my stuff.

I waited there, looking at my PHTLS book and protocol book waiting for my preceptor to show up. I must have waited there for a half hour before the dispatcher came rushing in.

“Good you’re still here! I kinda forgot to tell the crew you’re riding with that you were in here and they left without you. Just get your stuff and wait out front.” She blurts out as she’s almost literally pushing me out the building’s front doors. “Sorry!” Was her final words as she rushed back into her little den of evil.

Great… first day and I’m already late… At least it’s not really my fault this time.” I think to myself as I fidget nervously with all my crap I’m carrying. The ambulance comes to get my quickly as I get introduced to the crew I’m riding with. The medic takes one look at me and laughs at me, as he asks, “This your first EMT job?”

—————————————————————————————-

A lot has changed since that night two and a half years ago. As I’m getting stuff packed up to get ready to go to TX on Monday I take stock in what I have for uniform items and compare it to what I carried then.

First boots. That’s one thing that’s stayed the same. I’ve worn the Converse side zip tac boots for years and love them. Comfortable from day one and they seem to last a while. I might switch it up and try Magnum boots when I need to buy another pair, but we’ll see.

Next is pants… I used to just wear the cheapest pair of EMT pants I could find (usually the original Propper EMT pants) but now I’ve mainly switched to 5.11 EMS pants. Heavy enough for NM winters, but not too bad for our summers, once the knee pads get taken out anyways. I love the shear loops on both sides, since I’m left handed, and I prefer my shears on that side. I’ve got a pair of the new CuttingEdge Propper pants coming in so I can test out a pair at my new job.

Uniform shirts have definately changed. My first service gave us gray polos that, while they were really comfortable, didn’t look the best or the most professional. My service I worked for in Denver issued white Class A shirts… I hated those. Now, my new service, is issuing me two short sleeve black ‘button down’ shirts, and one long sleeve. Complete with service and certification patches. Now I say ‘button down’ because they look like they have buttons, but really have a zipper. Should make it easier to toss it on when we get a call at 0300 and I go from asleep to truck in 60 seconds.

Hat… well, I’ve always worn hats. And this is the first time I don’t get a service issued hat, so I went and bought just a generic EMT hat, since all my other hats are service or agency hats… Or a Farleys hat that says FU in really big letters on it :p

Now for what I carry.. Here’s where the biggest change it. On my left leg I carry shears and pens, and keep my wallet in that pocket as well, along with a pen in my shirt pocket. Right leg pocket has my phone in it, along with a pen light in one of the pen sleeves on the outside. My phone that has replaced carrying a PDA and music player. I have a few hours worth of music, plus Pandora, on it, along with Epocrates, the Infor-Med ALS field guide app, and Skyscape medical calculators on it. Gloves still get put in my right ankle pocket though. I also carry a knife in my left front pocket. And of course, on the bottom of my right wrist is a watch. Can’t do my job without at least a watch.

Speaking of phone, what I’m carrying for that now is the Sprint HTC Hero, running the newest Android 2.2 build. Great phone and Android is an awesome alternative to the iOS. It’s a great reference device, entertainment device (aforementioned music, plus Twitter, FB, and games), and also, ya know, calls people.

Flashlight, rescue hook, all that other stuff either doesn’t get carried or it gets tossed into my backpack, along with a netbook and a Kindle. A shift’s worth of amusements all in a neat little package :)

Now to just find my work backpack so I can actually get it packed for next week! I might have mentioned in previous posts… but I HATE PACKING! šŸ˜›

It's gonna be an interesting few years

After doing a lot of talking with my new boss and others members of the service, I’ve come to the conclusion that my first year or two working for this service might be interesting.

First, what I really don’t like. This agency was an all-volunteer agency until about a year ago, and it shows. Now, I’m not trying to put down volunteers, as sometimes they are very professional and great to work with. But we all know some volunteer agencies who are only there because it looks cool and don’t want to do anything more than bare minimum. Or they’re there because it’s a family thing.

This service seems to be a little bit of both. Only 3 medics on the staffing list, mostly EMT-Is and EMT-Bs. A lot of them related in one way or another, and think that it will only help that they are. I’m ok with that, though, since they are willing to hire from out of the area and, hey, they’re giving me a job :D.

What I can’t stand though, is how little they care about education. They are excited to get the newest toys and gadgets, but don’t really like to look at the newest research to see why or why not they should be doing something. Tradition plays a very big role in how they think. The old “We’ve always done it this way”. Luckily they have a medical director who doesn’t like that and wants to keep pushing the protocols to be more progressive.

But things still fall through the cracks and are done just like always. One of them is working a code on scene. I’ve always been taught that you only transport a working code once you get ROSC. They are a big fan of stopping CPR to get the patient into the bus, then running hell-bent towards the nearest hospital with only one provider in the back working the code, in a moving rig, running L/S, and getting thrown around. I’m not a fan of that. Hopefully it’s one thing I can help change their mind on. But we’ll see.

I’ve talked to the chief about going back to school, since I want to finish up and get my medic soon. He’s all for it, but the minute I said I wanted to go for the AAS as a minimum, his eyes kinda glazed over. HE doesn’t understand why anyone would think that a medic isn’t quite educated enough. I love the fact that TX recognizes the extra education and issues a license, not a cert in this case, of Paramedic.

I’ve talked to a couple of the people at teh station about the EMS 2.0 movement and things like #CoEMS (I wore my EMS 2.0 pin on my dress shirt for my ‘interview’, so it was kinda obvious), and one of the on duty crew said she was all in favor of it (she was a part timer who also works as a flight medic). The other just kinda shrugged and said she had her basic, which was more than enough education for her. Not quite what I was hoping to hear. But the chief said he’s ok with me continuing to blog, as well as being active in the EMS social media aspect, which is what I wanted.

Now the service isn’t all bad. Like I said earlier, they have a very progressive medical director. I was told by the chief that if I came up with any research, that the medical director’s door was always open to improvements in the system. Also if there were any new toys that he was more than ok with me learning how to write grants to try and get money for them, pending MD approval. One of those devices is the Zoll Autopulse or the Physio equivalent. I figure if they want to risk everyone by running codes in a moving bus, I’ll see if I can get a device to make it safer and easier for all involved.

Their medical director wants them to get serious about hiring good ALS providers, and according to the chief, the MD would eventually like to see the system move to an all ALS approach. I’m more than ok with that, since it sounds like they want to try to model if after ATcEMS, which seems to be a great system. I have an official interview with the medical director already requested so I can talk to him and get a feel for how he like his ALS providers to function and talk to him about a few questions I have over just how long a leash he gives to EMT-Intermediates in his system, so hopefully I can get a goodĀ rapport with him started.

The other good news about the area… I went to the nearest big city on Wednesday morning to talk to their community college’s medic coordinator. He seemed to be a great guy, and seemed interested in me entering their program. They do offer the EMT-P AAS, which I want to take advantage of. He did tell me, though, that I can start their certificate program as early as January if I get paperwork in in time, and then finish the gen-ed courses for the AAS after I get my #discopatch. Not a bad idea. The downside is a 75 mile commute one way for classes. And clinicals. I do, however, get to do half my ride time in my small-town agency. So it is not as bad as it could be. And my new boss said he would be willing to put me on 1 24 and 1 12 a week of first out, and 1 12 every other week as second out (on call), or 2 24s a week and 1 12 of second out every other week, whichever I wanted. He is not a fan of 24s, but he said in my case it might make things easier.

I think I’ll get my medic and try to stay here for another 4 years or so at least once I get it. Then I’m seriously debating trying to transfer to ATcEMS and trying to get on with their system to finish out a career if I decide to stay a medic. but I’m not sure.

Either way, it’s going to be one hell of a ride. Maybe I can make my own little #thunder out there.

WOOOOOHOOOO!

Well, it’s been a busy day, but a very fun one :)
I drove 6 hours today, started out at seven my time, to get to BFE, TX from BFE,NM. Checked into my hotel (thank god my brother works at this chain, so it’s dirt cheap) and changed and cleaned up a little so I’m presentable (black medic pants, boots, blue button down shirt) to meet this municipal service’s chief.
I get to the ambulance station (which is cohabitated with the VFD) and part next door at the SD building. I wander up and look around.
Outside they have an older Type III with a long box mounted on it, and a regular Type III marked for the FD extrication gear. As I get closer to the EMS side I see a newer Chevy Type II sitting in the center bay in front of what looked like an old school pumper. And in the bay next to those was real beauty. A medium duty Chevy box rig. Looks almost brand new, behind that is a slightly older IH medium duty box. All of it looks in great shape.
I knock on the door to the EMS station and am invited in by the two on duty crew members. They tell me that the chief is out at the moment but should be back soon. They offer me a seat and we start BSing. They seem to be a pretty laid back bunch and ask me questions about my past experiences while I return the favor and pick their brains about this small service. They seem to like working there, and tell me that it’s a small group so it really is like a family.
“That’s great for me, sicne I’ll be away from family and friends if I get this job” I think to myself.
They are glad to hear that I’m an EMT-I that applied for their service, since they can use more FT ALS providers. The medic on duty tells me a little about their protocols while we’re talking, and it seems like that really do have an agressive medical director.
After about an hour of talking, the chief shows up and greets me. He seems to be a very nice man, that is respected by his crews. He asks if I’ve been shown around, and when told no, he proceeded to take me upstairs to show me the living area (downstairs is the kitchen/office/supply room) and bunkrooms. It all looks pretty nice for an older building. He explains to me that for right now the firefighters are housed in the other side of the apparatus bays in a similar arrangement, when there were any firefighters on duty. He also explains to me that this town is odd since they have a career municipal EMS dept (albeit they’ve only been paid for just over a year) but an all volunteer FD. And there is only one FF that is trained to EMT or even ECA standards. The rest have just been show how to help the medics and EMTs on accident scenes.
After showing me the inside he takes me out to the rigs to look around. The Chevy MD is gorgeous. He says they have another Type III C4500 on order w/ a 12′ box on the back of it. Inside is some nice gear.
EZ-IO, LP12 w/ all the goodies, vacuum splints, cool rail mount type head blocks, power cots, the normal EMS supplies, and a small disposable vent that is just a plastic piece that hooks into the O2 tree and requires no electricity. It all looks nice. They also have CPAP masks, but no controller boxes yet… but talking with the chief and playing with a vent and the CPAP mask I was able to rig up a poor-mans CPAP (thanks @ambodriver, your book is what gave me the idea!) that the chief wants to try out the next time they have a CHF pt CTD.
After he was done telling me about some of the protocol questions I asked about, and showing me around… the next words out of his mouth were “Well, lets take you to my boss to get you started working for us”
I was flabbergasted to say the least. I guess us talking counted as my interview šŸ˜€
After talkign with the city manager I had a job offer from them. Decent pay, good benefits, TX Municipal League retirement plan, school reimbursement, agressive protocols, great medical director, and long transport times. I thought I had died and gone to heaven.
Now all I have to do is wait. My background check still hasn’t come back, but since I passed a more intensive check earlier when i got me TX cert, I’m not worried. Then it’s time to pee in a cup and take their ‘physical’. I’m not worried about either of those, especially once they described what their physical was. So hopefully by late next week I should be out here again and starting my orientation rides :)
Now to sleep a little. If my BG check comes back tomorrow I’m doing the drug test and physical tomorrow, and I’ve also got an appointment at the nearest big city (about 75 miles away) to see what we can do about me finishing medic school :)

Huh

The last two days have been interesting. Right after I make my decision that I’d be more than happy to stay here in NM and finish up my BS-EMS, I get an email. From the EMS Chief at a small, west TX municipal EMS agency. I had emailed them a few weeks back to inquire if they had any openings for EMT-Is. I didn’t get any response and had kinda just put it out of my mind.

Fast forward to yesterday. I get an email asking if I am still interested in coming to work for their service, and then he give me an idea of the area and their coverage area, etc. They cover roughly 3000 square miles of their county, plus provide mutual aid and ALS intercepts for neighboring counties. They run primarily 911, but do occasional IFTs to the trauma centers about 70-100 miles away. Their calls can be anywhere from 5-40 minute response times, long transports to definitive care, extensive air-medical use, an aggressive medical director w/ progressive protocols.

It sounds like heaven to me, so I told him I was still interested. I get an email back asking me to please fill out an application (I had previously only attached my resume and copies of all my certs) and fax it to him as soon as possible, so Ā I did. He then emailed me saying that he figures I would want to come out and see the area, and he offered to give me a tour himself, as well as talk with me about coming to work in the area. From what everyone has told me, this seems like a very good thing.

Today I sent an email to the Chief and told him I was trying to plan on leaving my parents on Tuesday morning and getting into his area early afternoon. The next thing I know I get an email from the town’s HR office asking me to fill out the official forms for a background check and fax it to her ASAP, and to also bring the original with me for my visit.. I wasn’t aware I was going to be talking to HR when I went east to visit.

To be honest I’ve never had to do this much paperwork for anything short of an interview. So we’ll see how it goes. Since I’m not sure what it’s going to be like, I figure I’ll dress in business casual, just in case. Fingers crossed, because working for this muni third-service sounds perfect. And it’s within 75 miles of a good AAS Paramedic program.

And since this service is desperate for ALS providers (which in TX I fall under ALS instead of ILS like in NM) they might be willing to help me out to get my TX LP (Licensed Paramedic) ticket.

Just thought I’d share the last few days :)

Three posts, three days? Really?

A couple of days ago I asked people for advice… I got some advice, and did a lot of thinking.
My results? Going back to school ASAP and getting my medic cert and BS-EMS + BSN are the most important things to me right now. So with the exception of an application I’m going to be putting in Ohio, I’m done applying out of state. Any applications that are already out in CO and TX will stand, and I’ll consider offers, if I get any, from those companies. But for the most part, I’m staying in the ABQ NM area.
Thsi took me a while to decide for a lot of reasons. One of them is I want out of this state. In the worst way. Going to Austin and then to TN this summer for interviews and to see someone who used to be very special to me (still is really, but apparently I’m not worth talking to… but that’s antoher story entirely) showed me that I don’t like living in the desert. Especially this desert. I don’t like the people, I don’t like the culture.
But I have a solid support net already here, I know the area, the services, and the state protocols already. I know the schools’ reputations, how they operate.
So, since I’m having such a hard time getting hired with a temp cert, I’m looking for any jobs out there. Starbucks, waiting tables, book store, motorcycle shop… anything that will help me take care of myself till December when I completely nail the state EMT-I test and I can start working on a bus again. I have one service that wants me when that happens, so I’m already doing better here in NM than I was looking at moving to other states.
At this point I’m making my one and only priority school. I want that bachelors degree. I really really fucking want the disco patch.
And guess what? I’m gonna get them both.

EMS for the Cure

My one or two readers may have noticed a new little image up in the upper right side of my blog. It’s to show my support for EMS for the Cure. It’s something that this year I can only support by trying to let more people know about it, unfortunately, but I’ll do what I can.

We all know someone, either directly or indirectly, who has been affected by breast cancer. For me it was my mother. She was diagnosed with a rare form of skin cancer that hadĀ metastasizedĀ to the breast tissue. This was during my Jr year of high school. For the next two years she battled the cancer and went through horrendous chemo treatments, two surgeries, and lots of poking and prodding. She was really the strongest person I have ever known as she went through all of that. She wasn’t going to let anything stop her from seeing me and my brother walk across the stage at graduation, and it didn’t. Two weeks before we graduated she had an appointment and was told that the cancer was in remission. That was the best graduation present I could have ever gotten.

She was there in the stands as her boys walked across the stage to get their diplomas. She was there with us at our graduation party, and she was there when we moved out to start our college careers. Since then she has been cancer free, but I know not everyone is so lucky.

And it’s for those people, and the ones who did beat cancer, that I ask everyone who can to give just a little, or a lot, to help fight this disease. Those of you who are fellow bloggers, go pink for the next few weeks, in honor of national Breat Cancer month. For all of you that already have, thank you.

I'm frustrated and have a decision to make… I need help making it!

I’m frustrated right now. I’ve had two phone interviews in as many days. They’ve gone great! But at the end of the interview they have told me that they don’t have any FT positions and that they can’t pay me enough for PT positions to warrant me moving out there. And I’ve gotten four more rejections in the last week, plus well over a dozen services that I haven’t heard from except for them asking for a copy of this or that. Frustrating, yep it’s a good word for it.

I’ve been debating finding any job (probably a job waiting tables again) and staying in Albuquerque. If I do that, I can hopefully start UNM’s BS-EMS/EMT-P degree program in August, and I’d be getting my full NM EMT-I cert in December, so I could start working on a bus for LCAS after that. I know the school, it’s got a good reputation, and would set me up by being a great educational background for moving on later.

I’m just getting frustrated and am wondering if moving states really is such a good idea. On one hand I paid the money to TX DSHS EMS for my EMT-I cert, but so far it doesn’t seem to be paying off. I’m sick of living with my parents and just want to get back out on my own, get my life back on track. I want to go back to school and get my medic cert ASAP. I just can’t figure out what the best thing to do would be.