One for Ten

As is not unusual for me, it's been quite a while between posts. I've wanted to write, and even have a couple of ideas for posts stashed up....but ultimately what drives me to write is emotional release, positive and negative. Lately it's been a lot of negative energy. I've been frustrated with conditions at my employer, as well as the state of EMS in general. That being said, I thought I'd write a post about what keeps those of us in EMS going. 

A friend I went to paramedic school with recently had this status update:

Gotta love the EMS shift with no death, drunks, or drama....just a healthy newborn baby girl! Best job on the world!

That, friends, is in a nutshell what keeps us going. Depending on who you talk to, statistics in EMS range from 10-20% of the calls we run being the "serious" calls. That is, calls for help from people that are in that true life or death scenario. So, for every twenty calls I run, it's a pretty sure bet that 16 to 18 of those are going to be (to use a technical term) bullshit. 

.....47 year old female panicking because she "doesn't know what to eat when her stomach is upset..."

.....chronic drunk we are called to because he was sleeping in public and someone called in a "man down..."

.....same drunk calling because it's cold and he knows the ER is warm...

.....person calling FROM THE ER because the "wait is too long".....

In addition to the bullshit, there are the serious calls that take a little from your soul. It's the loved one that arrests in front of their family, that's too far gone for us to save. Chronically ill kids. Teens in a car wreck from drinking and driving.

The list goes on and on. It can grind one down as well, especially in a busier system. My medic unit averages 18-20 calls per 48 hours (closer to 30 this last rack). That's a lot of calls to wade through to hold out for that one.....

But we do. We all do. We tell war stories around the kitchen table of our "good" calls and take every complaint of chest pain from every drunk seriously, on guard for our 10%. 

When it comes, it is our junky high. Whether it is the sick respiratory patient (not being able to breath has to be one of the scariest things ever) that you can bring back from the edge of respiratory arrest, or the *rare* childbirth (nice job, Billy!), it is a call that stays with you. The "wins" buoy us through the storm, in the dark and frustrating moments that inevitably follow. There is nothing better than knowing that you have made a positive difference in a patient's life. That intimate moment and connection is unlike any other I have experienced.

Lately I have been feeling particularly run down. I rarely see that 10% any more. Coming back to the blog, to some introspection, I again come back to this quote. It helps give me some perspective.

To know even one life has breathed easier because you have lived.
This is to have succeeded.

Until next time....

Put me to work

It came to my attention recently that there are several people actually reading this. Thank you! I am humbled, as I mostly write off my ramblings as cheap therapy.

Anyway, I've been in a state of flux recently and to be honest haven't had anything too positive to write about. I feel that in some ways I have been boxed in by my system, and have reached a "stay or go"point.

The frustration is, I'm ready to work! I'm ready to be challenged as a paramedic, to provide excellent care to my patients. I want to receive more education, to participate in research and to have a voice in how our system evolves. However....I have no voice, budgets are reserved for "fire training," and I have about as much voice as an Army private in boot camp.

I don't think I am alone in this predicament. I'd like to see prehospital medicine (or paramedicine, as you may call it) flourish or even become established as a legitimate career in the US. I believe that EMS can be a part of building a stronger healthcare system. The days of a high speed taxi and low education should be gone. We are healthcare providers, not technicians that can follow an algorithm. I'd love to see EMS evolve to treat more in the field, for better patient outcomes and to ease the load on emergency departments. To the chagrin of many, I see this possible through increased primary care training. As my fellow practitioners know, many of our calls aren't for true "emergencies," but rather for primary health care issues from citizens who don't have access to the system.

Unfortunately....the current system is far from this utopia. Private EMS pays on par with what you might make flipping burgers at a fast food joint. Third service EMS constantly struggles for funding. Fire-based EMS....is often the butt of jokes in the world of EMS, and sometimes rightly so. It doesn't make sense to "force" a firefighter to become a paramedic, and doesn't lead to good patient care. It doesn't make sense to devote a majority of budget and personnel to training firefighters when fires make up less than 5% of all calls.

I'm making a call to those fire departments running their own EMS. Step up to the plate, and become part of the system. Take your medicine seriously, through your budgeting and training. Participate in the national discussion on EMS, and how it is changing. Participate in research. Now is a critical time for our field, and the fire-EMS system is the most well funded to facilitate change. The ambulance is not the bastard child of the fire department, the piece of apparatus to shy away from. Take pride in prehospital medicine, and take pride in your prehospital providers.

love,
MedicMuse.