Snow

I have a love-hate relationship with snow. I love how even an inch can turn a grimy cityscape into a fresh Winter Wonderland. I love the reflection of my strobing red lights in falling snow. I love the way the town is turned into an otherworldly Christmas card.

I love the feel of an all-wheel-drive vehicle hugging the road, even through a thick white blanket. One can even practice things like resolving skids and handbrake turns without putting undue stress on vehicle parts.

Snowmen. Snowball fights. Even just walking in snow can be fun, if you're in the right mood.

I hate snow, though. It piles on you and weighs you down. It makes even the most routine responses anything but routine. It hides the street signs, and it can give you the same powerless, out-of-control feel of sledding - in an ambulance.

After its done, though, all there is to do is hate it. It goes from pretty to dirty, soot stained and yellowed in a day or two. Then, depending on how much there is, it can linger. It makes simple tasks like parking on the street, and walking down the sidewalk, a treacherous challenge. It also makes good people have accidents. They slip and they fall, and as they shovel out, they overexert and injure themselves, in some cases, they even have MI's


Tonight I get to enjoy it, though. It is only a dusting - an inch, maybe two. Someone else did the driving, and I'm off duty for my last weekend off before my (hopefully) last undergraduate semester starts next week.

Jon

Pins and Needles

I'm in a dark room, with a one-armed man. I'm trying to find an IV so I can give Nitro and Morphine for his chest pain... I search and search for a vein. I've got one, but it's resting on fatty tissue, with nothing to put tension against to hold it in place. I swing... and a miss. Clean the site and try the other side of the AC. Swing and a miss. Again... back at the first site. I get flash, but can't advance the catheter. I try to float it in. It blows. I swear in my head.

We load the patient up, and once in the truck, I find one more vein on the arm that I think I can get. I pray. I miss. I look at my partner and say “Just go”. I talk to the patient on the way to the hospital. Trying to keep his mind off things. It doesn't really work.

At the ER, we place the patient in bed. I explain that I can't get a line. The nurse looks at me and incredulously says “Are you a paramedic?” I doubt myself. I think I stole the patch and don't deserve to wear it. I say Yes, but inside I wonder.

After registering the patient, I peek in on my way out the door. The nurses are on try 4 or 5 themselves, with no more luck than I had. I walk out with my head just a little bit higher, recognizing that it wasn't JUST me.

~~~~~~~~~~~~~~~

I hate IV's in my own arms... it hurts. I cringe when I stick my patients. I don't dig for the vein, because that trick never works. I hate turning my patients into pincushions, but sometimes they have NOTHING for veins, and I'm desperate to get a line so I can push drugs to make them feel better.

Standbys Pt. 2

So... 3 days of standbys and no interesting patients.
The only buisness we really had was the parade of folks, mostly (entirely) female, who bought pretty new shoes before coming to the convention - and now have blisters on their feet and want band aids.

Really.

I mean... you go and you KNOW you'll be STANDING in a booth for hours on end. Or you'll be walking the exhibit hall all day... and you wear new shoes.

Darwin was on to something.

Tuesday - Post 1

So... I'm sitting at work. Working 2 hours overtime to cover a hole in the schedule. I'll take the money.

I'm about a month into medic school - and we've got some form of mid-term tonight. There is a study group gathering before class... and I might stop by.

I've been running myself ragged between work and school. I need sleep. I need a day off. I'm also sick - had a sore throat start last night during clinical, runny nose today, and I feel miserable.

I had 3 calls so far today at work - 2 were cancelled before getting to the scene, and the third was a moderate MVA - high speeds, limited injury.


Last night at clinicals was cool. I had the first shift of the class in Labor and Delivery. That meant that I was the guinea pig. I stood around looking a little out of place (6'3" big guy in gray shirt and blue pants surrounded by female RN's in green scrubs. Then they realized that I needed to get into scrubs - which I did.

I don't like wearing scrubs - at least not in public. My scrubs at home are reserved for around the house and use as pajamas. I'm used to having pockets, and thicker fabric. I feel so out of my element in scrubs. No trauma shears, no key ring, no glove pocket.

I got to observe a C-section last night. C-sections are WAY out of the paramedic scope of practice, but it is intresting to watch. Because I went through a different paramedic program already, but now get to start over from scratch, I'd actually already done a few shifts through L&D, but at a different hosptial, in the City. So I actually had seen one before... but it is still intreesting to see. I also spent a lot of time talking with a medical student doing his mandatory OB rotation. I learned some from him... and even more from watching the attending teaching him. I also spoke with a PA in the OR.

I've been in OR's before. I understood what was sterile, and what wasn't. I had to ask where I would be able to stand out of the way... but otherwise, stayed back and watched. The procedure seemed to go without any trouble, and the NICU folks were there to resusitate the baby, but didn't have to do much. Initial APGAR was 9. I had a discussion about that, too. Although the perfect score would be 10, they only usually get 9, loosing a point on color.


Anyway - it was a good experience. But I really hope to keep my rig "life-neutral"... no one dies in my truck, and no one is born in my truck. I've done pretty good on the second half, lately. OB was a great change for me - in my previous 2 clinical shifts, I'd worked 3 codes... 2/3 were unsuccessful. The 3rd one we actually got ROSC (Return of Spontanious Circulation)... AFTER we started working the code, the nursing home gave my preceptor the patient's living will, which called for no heroic measures. By the time we got this, we were transporting - so we kept going, consulting with the hospital staff. So we walked in the door and got a pulse back - but the patient didn't want to be there... now what? I'm not sure if the ED staff continued mechanical ventialtion, as the patient had no spontanous respirations. I'm going to guess that that patient died, too... making me 3/3.