Friday, December 17, 2010

Raising the Bar...

What does it mean to you to put on the uniform?? Is it about you?? Or is it about the patients we treat?? All to often we get think about how it inconveniences us. Guess what... YOU are in the customer service industry. It is about the PATIENT. A fellow co-worker wrote this letter to the rest of us and allowed me to share it with you: 


"People who made EMS their profession, understand relatively quickly that a sense of monotony can set in when we get toned out - yet again - to a local senior's residence. It becomes easy to feel like these simple, routine calls are a poor use of our time and skills while we sit or what may be hours in a hospital hallway with non-acute patients. We may forget that our patients, despite any age or chronic-related ailments afflicting them, did at one time live full, vibrant lives. As practitioners we need to step back and recognize the human element of our industry and not just focus on treating medical conditions. We need to take a holistic view of the patient - examining physical, mental and emotional health.

One evening while working with Calgary Metro EMS, our crew witnessed how much impact we can have not only on a patient and their family, but how connecting with a patient and showing a little extra compassion can significantly impact ourselves as health care professionals.

On arriving at the hospital and being triaged to the hallway, our patient was becoming increasingly agitated and frustrated with his situation. Just when it seemed we were running out of options to appease our patient, the Crew Chief informed us he'd spoken with the unit nurse where our patient's wife was and we were permitted to bring him up to see her. There, we found a very frail woman, seemingly unaware of her surroundings and struggling to breathe. the unit nurse said she felt there was a strong likelihood the woman would not survive the night and that she'd been unresponsive for the last several weeks. We were able to make room for our patient's bed in the small room, aligning the beds head to foot. At that moment, our patient took the hand of his wife, ending two months of separation, and uttered the words, "hello love." The crew watched as the woman who only a moment before was struggling for a breath and not able to acknowledge the movement in her room, looked up in recognition, smiled and squeezed the hand of her husband of 52 years, saying "Hi". We and the nurse watched in shock at the change in both patients - a true moment of peace radiated throughout the room. We left the patient's room to allow the couple a moment of privacy, allowing them to say their good buys, when we wiped away our won tears. When we re-entered the room, both wife and husband seemed to be at peace. As we wheeled the husband out of the room the last words passed between the couple was when the husband whispered the words "I love you, and I will see you again soon".

Our patent was then taken back down the emergency department where he reclined contentedly. The Crew Chief then went out and spoke to the son explaining that we had taken his father to see his mother. The sone was overcome by emotion. he thanked the crew for taking the time and effort in showing compassion and empathy, and for bringing his parents together for what could be the final time.

We later learned that the patient's wife died an hour after the reunion and our patient died the following day. They were buried together two days later. This confirmed that the decision to take a moment out of our busy night shift to do something extra for our patient allowed this couple and their family the peace, dignity and respect they deserved.

It was just another night shift at Calgary Metro EMS."


This is OUR duty as EMS professionals. 


Friday, December 3, 2010

Dream Job

It was Thursday, I was at work and about to lay down for a nap. That didn't happen. Phone rang and I got the call I was waiting for. The lady on the other end informed me "AHS (Alberta Health Services) would like to offer you[me] a casual position with Calgary Metro." I was excited. The process had taken about six weeks and I had been waiting for over a year just for the opportunity to apply. So after all the details were passed on, I talked to my manager where I worked full-time that I would need sometime off for orientation. No problem so on Monday I will be sitting in a classroom.

So why am I nervous? Is it the apprehension of something new? I got to thinking about the differences between Calgary and the rural services (Two Hills - full-time and Strathmore - casual) I work for now.
Calgary is a big city with over a million people residing within its limits. The rural areas have 50,000 people combined. Calgary has about 30 full-time units and also a number of peak cars and pru's and again combined the rural services had five full-time (2 ALS and 3 BLS). It is quite clear that size is the major difference.

My nervousness stems from the apprehension that working for a large urban service rather than a rural service is a new experience. It will have its own set of pros and cons and will definitely add to the learning curve ride I'm still on. Being a casual position I have the opportunity to work about as much as I like which enables some flexibility so here's to a new beginning...


- Posted using BlogPress from my iPhone

Wednesday, December 1, 2010

What's The Job To You??

So recently theHappyMedic wrote about Recognition and Medic999 wrote about How Do You Want To Be Seen (Part 1 & 2), it got me thinking about how patients view me and also should I even worry about it.

Should I?? I believe I should. Why?? Because being a medic in today's industry is more than just treating the patient, let me explain:

Just over a week and a half ago, my partner and I had a pre-booked transfer for a gentleman (who we will call John) who was recovering from a CVA. Due to complications from his stroke, John had a NG tube in place and was going to another hospital for a consult and some tests to see if he was ready to get the NG tube removed. The receiving hospital is about 30 minutes from our town. John didn't really need any care in a medical sense.

So off we went, my partner driving and me and John in the back... What do you do with a patient you don't need to treat?? I asked him a question "What did you do before you retired?" Well, he opened right up and before John and I knew it we were arriving at the hospital. My partner and I waited for the John to finish the procedure (roughly 1 hour) and then we headed back to the "home" hospital. On the way back we talked about everything from technology changes to farming to diesel engines. Well, I listened and he talked. We brought John back to his room and said goodbye and off we went. So what?? That's exactly what I thought. In my mind I had just dealt with another patient and done my job.

I didn't think about the effect of "my job" had on my patient until a week later. My partner and I were in the same unit picking up a different patient when I hear a person saying "I thought I recognized the voice" I turned around and there was John in his wheelchair, smile on his face, and NO NG TUBE. So I walked over and he's told me that he just wanted to say hi and asked how my day was going. I was floored. Normally I take patients to and from appointments or drop them off at hospitals and never talk to them again. There is the odd time that I'll notice them and go ask them how they are doing but for me to be approached by one of my patients because he recognized my voice... I barely spent half a day with John. Either way, that exchange with John got me thinking...

We may think we are just doing our job and not going beyond the call of duty but what does the patient think we are doing? What's going through our patient's mind when we ask them about them? Did we leave a lasting impression on them no matter how small? Did we just make their day? Or does it even matter??

A friend passed on a quote that is so fitting to the subject:

"Enthusiasm is not based on how fun your job is or how much it pays; it's based on why you do what you do. " - author unknown

So beyond the medical aspect.... What is the Job To You????

John is improving, eating solid foods and starting to walk with assistance. To John, I am glad to be a small part of your life.

Cheers

Also a good read:
EMS in the New Decade - Some Things You Should Know.

Sunday, November 21, 2010

Take Care of Yourself

Throughout your EMS training, it is repeatedly drilled into your head to look out for you and your partner's safety. You want to remove the possibility of injury/illness to you and your partner and remove the possibility of further injury and illness to your patient. We all do scene safety to make sure there are no hazards and take appropriate action to mitigate the hazards to make it safe for us and the patient. We all put on BSI precautions without even thinking about it.   Do you ever think about why?? You're probably thinking "Of course, I do it to protect myself from catching any transmittable diseases from my pt." Absolutely, you do it to protect your some from illness but what else can and should we do to prevent ourselves from injury and illness? EXERCISE! 

What?? Are you kidding me?? No, I am serious. Our job requires us to work in all types of conditions, lift a variety of weight, and work while in awkward positions. The #1 injury to EMS professionals is back injuries. Industry studies have found:
  • "One in four EMS workers will suffer a career ending back injury with in the first four years of service. The number one physical reason for leaving EMS". (mytactical.com, EMS Back Injury Facts, 2007)
  • Back injury from improper lifting is the number one injury suffered by pre-hospital care providers, according to a New Mexico's EMT training manual.
  • "Almost one in two workers (47%) have sustained a back injury while performing EMS duties", (National Association of Emergency Medical Technicians, 2005)
Back injury is one of the main concerns but we should keep every aspect of our bodies in good shape. A number of things we can do to limit the possibility of injury are fairly simple and can be done at home or outside. Yes, you do NOT need an expensive gym membership. 

1) Running: Increases your cardiovascular and your stamina allowing you to have more energy so by the time you are at the end of your busy shift you still have a little left in the tank. Better cardiovascular also reduces the risk for heart disease, stroke, and many other diseases. 

2) Stretching: Increases flexibility, muscle control, and range of motion. When you're in an awkward position in that car at an MVC holding C-Spine on your pt, you do not want your muscles to cramp up.

3) Core Exercise: Increases the strength of the "central part of your body: Abs and Lower Back. Exercises that are considered working the core are crunches, leg raises, v-ups, and etc.  I would say this is the most important group of exercises due to the fact that back injuries are so prevalent in our industry. Yes, it is important to use proper lift techniques but what happens when you can't because of pt position?? 

I know I have only scratched the surface but this gives a quick view of what can be done to prevent injuries. There are also lots of home workout programs available on the web as well as other resources. Personally, I have complete the workout program from Beachbody called P90X and it covers all the areas that would physically benefit an EMS provider. 

You take precautions against illness but are you taking precautions against injury?? Losing excellent minds due to the "inability" to do the physical part of the job, seems like such a waste especially since it is so preventable. Look out for yourself and your co-workers to stay in shape. Encourage and challenge each other. Do whatever it takes so we don't lose co-workers to injury.

Stay Safe...

References:
EMS World - http://www.emsworld.com/publication/article.jsp?pubId=1&id=11115 
Exercise for EMS - http://www.livestrong.com/article/300120-exercises-for-ems/
http://www.itecmfg.com/liftinglawsinjurystats.html

Friday, November 19, 2010

How It All Started...

It was three years ago this week that I signed up for my Emergency Medical Responder (EMR) course. Truth be told, I was never planning on joining the EMS industry, I laughed at the people who asked if I would ever work on an ambulance.  I guess those people knew me better than I thought. So why take my EMR??

Since I was in high school I wanted to be a police officer, so I took all the necessary steps: I volunteered at a number of places, I went on to get a post-secondary education, and was careful to stay out of trouble. Wanting to volunteer more, I decided to look into the local volunteer fire dept and the one requirement they looked for that I did not have was my EMR. At the time, I was working in the landscaping industry but due to some unfortunate incidents I was let go. Looking back, it was the best thing that happened to me since two days later I was signed up to take the EMR course in the city.

During the course, I was fascinated with the human body and how it works as well as the medical breakthroughs that allow us to assist others. The paramedic teaching my course passed along some war stories and I was hooked. It was then that I decided to look into becoming a paramedic. Looking into it, I realized that it was everything I looked for in a job. I would be able to help people in stressful and traumatic events. I would be able to always learn about the human body, the mind, culture, society, and the list goes on. I would also be able to get the excitement and variety I was looking for in a career.

So having decided to continue on in my medic education, I continued on and am currently working as an EMT. I have been working on car for 1.5 yrs. Working in the rural EMS industry, it is quite a bit slower than urban/suburban areas. I was finding myself stuck in a rut just going to work and spending time on facebook, watching TV, and playing video games over and above attending calls and doing base duties. A co-worker was talking about how he listens to podcasts to assist with his paramedic studies. Figuring this would be a good way to spend time while driving, I started the search. Starting with Itunes, I found EMS Garage, First Few Moments, GenMed Show, EMSEduCast, and the new podcast Pedi-U. After a couple of months of driving to and from work and listening to lots of podcasts (I had a lot of catching up to do and still haven't completely caught up). I noticed one trend with the podcasts in one word - Twitter. 

I joined Twitter and found a whole new world of like-minded people of what and where the EMS industry should go. I started to get excited about the possibilities finding many quality blogs, more podcasts and websites. Realizing that I wanted to share my observations and opinions with others and receive feedback, I looked into blogging but had initial reservations due to my lack of skill in the writing department. Thinking about it I decide that it doesn't matter as long as you the reader get the point that I am trying to get across... so here's to a new chapter in my EMS career...