...anxiety...

I think its fitting that my first real blog entry is being composed on a day when I needed to use my hard earned pto to just not be in the ambulance.

Ive had a heavy feeling of dread heading into work lately, and it seems to be more than the 8 month old medic jitters. I'm sure that more than one person in my inner circle will tell you that I would benefit from some type of anti-anxiety medication, but I cant wrap my mind around needing drugs to do my job. After all, its just a job. Of course, tell that to the sheer terror that seizes my diaphragm when my truck number booms out of the dispatch speaker while I'm riding in the passenger seat. I have come to look forward to sitting in the truck after my tech and opening up the computer to write my pcr. This glorious time of day is the best for one simple reason; in this moment, I am the furthest away from my next tech.

The strange thing is, everyone in my ems support group keeps telling me how good I am, and how I know my stuff, and 'when you need it, it comes back to you'. The people in my non-ems support group tell me that I do important work, and they would never be able to do this job-as if its easy for me. At the end of all that supporting, I usually am left wondering how I fooled everyone without even trying, and also, why no one is listening to what I'm really saying, and what I feel. The truth is, I'm not ready for this responsibility. I'm not trained enough, and I'm not good at a lot of key things (ie, ekg interpretation, med doses, anything involving breathing). I've intubated twice in the field, both times successful flukes, and I can't push a med without double checking the dose and indications in my protocol book, and not because I'm a 'better safe than sorry' girl, but because I don't know them. I'm sure I used to, in fact I had to in order to pass my medic program and to pass the state test, but it doesn't 'come back to me' when I need it most.

I keep waiting for someone to notice my lack of proficiency, but no one does, quite the opposite in fact, I keep getting the accolades of a seasoned medic, all the while watching myself be mowed over by my equally new, but infinitely more assured partner. I have become a medic who is constantly looking for a second opinion...

My medic instructor always said that we have to be like ducks; cool, calm, and collected above the water, but paddling our asses off under the surface. Its about presenting a good show, because, in my system at least, most people that call 911 aren't all that sick. I reassure myself while being driven to a call lights and sirens: 'this is nothing' or, 'it was just a seizure' or, 'she "can't breathe" because she's vomiting'. Whatever the call is, I downgrade it to its lowest possible acuity and then subtract 10 more points for EMD errors. I don't do this to be a better medic, I do it so that I can get out of the truck on scene. So that I can physically unclip my seatbelt, open my door, grab my gear, and make patient contact. I boil it all down to that one, very simple step:

Get. Out. Of. The. Ambulance.

There have been mornings where it takes every fiber of my being to convince myself to get out of my car in the parking lot. Twice now I have been unsuccessful in that task, twice I have been so overwhelmed with the endless patients, sad stories, ill-cared for children, and sometimes even my rotten coworkers, that I have been unable to pull myself together for a shift. I call them mental health days, and today was one of them, but they're not really mental health days, because I don't recover. I don't FEEL mentally rested at the end of that time off. I feel drained, I carry the weight of the current 'tough call' with me to all of the next ones, until I find a new tough call to outweigh the previous one. I'm not tough, I'm fundamentally not like the women that I know and admire. I have dozens of calls hanging off me at any given time, almost tangible in the way they drag me down, and break my stride.

Sometimes I think that my career as a road medic was meant to be short lived. I am interested in the business side of things, and I'm not averse to putting on a white shirt. I want to be in EMS, I just haven't figured out a way that my anxiety will allow me to be in this field.

Before you start sending me links for office jobs, let me assure you that the possibility that this horrendous feeling will fade has not been lost on me. I understand that there is a period of time (I've been quoted 2 years by several different people) during a new medic's career where the light at the end of the tunnel IS actually the train barreling down on her. I know that one day I could get into the truck with all the lightheartedness and confidence in the world. I just cant picture that day right now.