GAH!

I'm taking a brief hiatus to deal with the evidently never ending in law visit....but I'm working on some posts having to do with some sticky situations I've encountered in EMS. Included are considerations in dealing with a patient in custody of police, when and why to file a Elderly abuse and neglect form, and some issues that come up when working PB, or PI. I hope that everyone had a great Thanksgiving, and if you never hear from me again, just know that the stress of having extended family in my home for an undetermined, but lengthy, period of time killed me....

This one's for the girls.....

Let me say that I have rattled this all off and am posting it without thinking too long about it. Not that I mean to make an excuse, I truly believe everything that I'm saying, but just that I needed to work up a bit of courage to post it....

Its hard being in a male dominated profession. I've said this to my non-ems female friends and I usually get a chorus of, "yeah, what a burden, to be around all those men in uniforms, boo-hoo." And we laugh, and I-a happily married woman-shrug off the musings about turnout gear, and the finer qualities of a man carrying a gun, and I still insist that this world is difficult for a woman.

Let's get beyond the whole 'I can do anything you can do better' plane of thinking for a minute. If you're reading this, you probably already know that women are as capable of excelling in EMS as men. And if you're a man reading this, I have to say, this one isn't really for you.

Its for the Ladies.

Here's the real problem with working in EMS-and I imagine the same could be said for fire, although I have no first hand experience there-there is no room for your gender identity. I'm still getting my mind around this ladies, so bear with me, but when I leave work, and I shed my ill-fitting, made for a man EMS pants, and my boots, and my bulky job shirt, and I'm a mother to my son, and a wife to my husband, I feel feminine. I feel capable and tough, but there is still an inhearantly female undertone to the way I walk about in the world.
At work, there seems to be two main groups of women, those that fit in with they guys, and those that chase the guys. Good care providers? Sure. Fun to be around for 12 hours? Sometimes. But like me? No.
I'm bordering on insulting here, and I don't mean to be. Let me stress that I chased an EMS guy relentlessly. It turns out that he was the only EMS guy I ever chased, and now he is my husband, but I used everything I had to land him-not like I had to beg or anything, I mean, I'm not a troll.....but I was briefly sucked in to that world of feeling the need to prove my intrinsic womaness, in a world where I dress in practical, unflattering clothes and deal with things that are decidedly undelicate. And that's what gets me. The need to prove myself in the context of gender. Why do I feel that need? Why do I need to be a woman at work? I guess maybe part of the reason is that there are so many Men at work. And not men, little 'm', but Men, with raw steak and big trucks.
My work life is dominated by alpha males. Not just guys that are friendly and do their job well-although there are those too, and they're a breath of fresh air-but men that prove their manliness in every interaction, during every call, and in countless ways that could be featured in a comic strip. Why?
And is my feeling of gender neutrality related to the fact that most of what I'm exposed to is super macho or femanine wiles?

Do women that work in offices, that wear cardigans and heels think about this stuff? Do you? Am I completely alone on this?

I guess the bigger picture is that this kind of underlying concern about perception has bled over into my non-work life. I've often wondered about how my husband feels about my choice of career when we interact with other couples from his fire department, and the man does the fire fighting, and the scraping up of drunk drivers/overdoses/and the hauling away of crazy people, and the woman does the teaching/office/mom-ing. My husband of course knew what I wanted to do when he met me, and we went to medic school together. But I've noticed that even after 2 years of him being on the same group, some of the guys will still casually ask me what I do for a living. So, he obviously doesn't mention it-which can't really be held against him, because he's not that big of a talker, but I mean, it hasn't come up in 2 years, really?

Once I overheard a guy that I work with having a casual conversation with someone about his wife, who had just had a baby. He was asked if she was going back to work, and his response was an emphatic no. He said, "...are you kidding me? She's a basic. I don't want her on the ambulance. She's going to eventually go to school for [insert female dominated profession here]" Is that how men feel? When I work with my husband-OR, and this may be another subject all together, when I work with a man that happens to feel protective of his female partners-is he fighting the urge to step in front of me and protect my-my what, rosy view of the world? honor? My virgin eyes?-from the veritable shit show before us? And if he is DOES THAT REALLY BOTHER ME?

There it is folks, there's the root of it. The message that I'm sending that could send the womens movement straight back to the 1950s. Do I really mind being a member of the "diminuative" sex? No. I don't. But, and here's where things get all jumbly in my mind, I'm good at my job, and I can absolutely do my job without the assistance of a member of the male species, but at the same time, I want help to be offered. As if help, or assistance, or protectiveness from the male half of the partnership isn't offered, then I'm less of a woman, and more one of the guys...and being one of the guys is not what I want......and chasing the guys is not how I want to prove my feminity. So what else is there?
I'm not so foolish as to believe that I'm writing without ramifications here, I am more than aware that some women have to fight, tooth and nail to be tolerated, much less respected in their fire house or station. And that, folks, is complete shit. Gone are the days where scantily clad calendars hang in the day room, and the boys club should take notice of the rising number of female leaders in fire and EMS. I'm not saying that I'm on track here, or I'm starting some radical new wave of thinking for the womens movement. I'm just saying, this is how I feel. Where does this come from? And how do you feel?

Its been a while faithful friends (all 7 of you!), and I have no excuse for my absence. Not true, I have several that all stem around the fact that going back to work after taking a year off to have a baby really screws with a persons life. As you well know, my confidence about my ability to be a paramedic hovers around 0 on a day to day basis, and as you may be able to guess, I have had a lot of issues about leaving said 'baby' (2 is still a baby right?) to go back to work. But no excuse, just my just my pithy offerings for your alter of forgiveness.

I went part time again. There were a lot of reasons it was the right decision for us, not the least of which is that our supply of free babysitting seemed to be dwindling. My husband works the rotating fire schedule, which really meant that some weeks, our days on and off would be opposite from each others, and other weeks we literally needed 40 hours of childcare. Hence part time. The fun thing about part time is the ability to not work for weeks at a time with no negative employment ramifications at all! Of course the bank account ramifications prevent that from happening, but its nice to have the option. The less fun thing about being pt is the epidemic spreading across the nation even as we speak, folks-lock up your children-NEW BASICS! Ah, what a short period of time it took for me as an infant medic to begin complaining about the very people occupying the job that I was performing not 2 years ago! And of course, as always, I really don't mean to offend, and if you're reading this, you're probably an experienced basic and probably a great one! The kind of basic that makes me sigh in relief when I see you on scene. Its not likely that you're a NEW BASIC. I'm fairly certain that my company has tripled our work force in the last 3 months with slightly gawky, socially awkward, too afraid to ask questions and too stupid to admit they don't know everything basics. When I was a new basic, there was a certain hazing period that we all went through. Nothing malicious, nothing dangerous. Just some good natured being completely ignored and knowing not to speak until spoken to. Now it seems that the influx of NEW BASICS has overwhelmed our ability to properly put them through the paces and we have given up, only muttering a few choice words about the names we've never heard of before on the strength report and assuming the worst of all of them as one. Please don't imagine that I have forgotten the learning curve involved with joining the world of EMS, quite the opposite in fact. As a new medic I rely on that learning curve not only to not look like a jackass at the hospitals, but also to keep my job. Maybe I am being too harsh, but when I'm the only medic, with 3 basics at a trauma code and I ask for someone to set me up a bag and a bp cuff is placed in my hand.....I get that warm and fuzzy feeling inside that alerts me to the fact that my head is about to explode in anger

It is nice however to be A MEDIC, in a culture of NEW BASICS. Do you remember who that awe-inspiring medic was to you? Mine was Beth. Beth was, and still is, a very small, very funny, very badass medic who was full time when I started as a basic. she was my FTO on more than one occasion, and I remember watching her stairchair a hugely pregnant woman down a flight of stairs, crushing her hand between the stairchair and the banister, never flinching. I also remember her telling me to check that pregnant woman for crowning...She went part time a few years back when she got a fire job, and I miss seeing her all the time. When I do see her however, its different now that I'm a peer. But I remember what it was like, to feel looked upon with favor, to feel included in the conversation by a medic that you respect. I'm trying to be that to these tiny little basics. I'm trying to be someone for them to look up to, and I'm discovering that its not easy. Its not easy to feel so rushed, so relied on, so stretched thin by a system that constantly outgrows itself, and still make nice, and exude teachable moments to these kids that are surely as scared as I was 4 years ago.

The desire to share stories about calls is deeply rooted in most medics that I come across. I, evidently, am no different.

Dispatched pri 1 for the "machete fight" (at 9am on a Sunday), coming from across the city, no other trucks available. Ops supervisor on scene prior to our arrival. I pulled on the street and passed the victim, lying prone with the supervisor holding a trauma dressing on his back. My partner, with the door open before I put it in park says, "oh Ang, he's in a bad way."

Her first clue was the ever expanding pool of blood.....

We walk up and the supervisor-never the calmest tech in the world-rips off the trauma dressing to reveal a foot long laceration almost down to the bone. Patient transported, chatting with my partner during the clean up, when all of a sudden, it hits me,
"I know we're medics and all, but I feel we should have some more warning when someone is about to show us that kind of gore...."

Dispatched some priority for a rehab patient with headaches and general get-me-outta-here-itis.
Giving the cmed report to a secretary (isn't that a great idea?) and said the patient was in rehab status post fall and deteriorating. Three times this ever-increasingly angry secretary asked me if the patient sustained any injury from the fall. Three times I explained that the fall was not recent, I finally just hung up the mic. On arrival at the hospital the secretary pulls me aside to tell me that she was trying to get to the root of the problem, and that when the chief complaint is a fall, they expect a report of injuries. I did not explain to her the meaning of 'status post'. It bothers me to this day that I didn't.

The stories that I generally share always end with me feeling pretty uncomfortable actually; getting 'spoken to' by a secretary who doesn't understand the idea of being in rehab status post fall? Really?

I can do better.

The desire to share stories about a child is deeply rooted in most moms I come across. I, evidently, am no different.

My son is 21 months old. There is only one story that I can tell you that captures his personality perfectly.
At our local YMCA there is a program called Tumble and Play for toddlers. They open the gym up, set up all kinds of mats and big ramps, put out balls and hula-hoops and play music. It gives parents a little while to exhaust the children, while simultaneously feel like they are out of the house and with other adults. One day my little guy saw another child trip and fall and immediately begin crying. The mom knelt down and comforted the hysterical toddler. I turned my head for one second, and when I turned back, my son, this little boy with my knees, my round face, was attempting to become part of the embrace with this mother and her child. He had this look of concern on his face that I will never forget, as if he were saying to me, "Mom. Something here isn't right, I'm gonna see if I can do anything to help, ok?" My son, my whole world, my very reason for putting one foot in front of the other, HE is a true care provider.

Do you hope your children follow in your footsteps?

...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.

My Intro......

Recently, my world has come down to just three sure things:
1.I love being a mom.
2.I'm committed to making a career for myself as a medic (and not a firefighter).
3.And I'm never going to stop writing.

So, since I've created this space with lofty goals, I'm going to use it. The following will be a simple tour of my life as a new medic working 911s for a private company in a medium sized urban setting; trying to go to work and do my job, come home and do my job and not get dragged down by toxic people.

A small note here before we begin. Rereading my words, 'not a firefighter' sounds rude, as if there is something wrong with firefighters, let me assure you, I have as much respect for our fds as a wide eyed first grader on a field trip. BUT, and since I'm married to a firefighter, I feel that I'm a good non-biased judge of this, I don't believe that fire run ems systems are the best way to manage a community's needs. Not only because I would never want to be inside a burning building, but because I would never as my lawyer to wire my electrical what-nots in my house. Two highly skilled BUT COMPLETELY DIFFERENT jobs. Imagine all the potential firefighters, or potential medics that are turned off from the job totally because of the dual fire extinguishing and iv starting requirements. Like me. A medic. Interested in the benefits, respect and schedule offered by fire departments. Terrified of fire. I hope you enjoy my antics and rantings, and as always, feel free to comment, or to tell me when I'm out of line. ;-)