4/23/2010

The Job Outlook

So recently I have been filling out and handing in large quantities of job applications hoping to find a place to use the license I will be graduating with in a little over a month. The first 5 were rejected outright for lack of experience. In there job descriptions nowhere did it mention the amount of experience needed to apply for the job. But I had another thought... Okay so you are rejecting me because I do not have experience as a Medic. I get that and that is totally your right. However, if no one is going to hire a brand spanking new Medic, how is she supposed to get this experience that they all want?

So I figured someone had to be hiring those of us out there who are just being given our patches and being punted out into the world. So I kept applying and yesterday I got a phone call asking me if I could come in for an interview. Now I do not know much more than I am supposed to show up at a place at a time for an interview because I was sleeping when the phone rang. So my first impression on that particular member of the board of trustees is a semi-unconscious, hoarse voiced, mildly confused, paramedic in training, trying to hold a conversation in her sleep. I did wake up enough to get the details and a name of who called but It was 7 in the morning and I had been awake until 5 am due to pregnant sisters and false labor.

However now I have to figure out how formal this interview is and what I should do to prepare for it. I was a ride-along at this ambulance service for 7 months so although I know all the people for the most part I am not sure what to expect from the interview. I have to go into the dreaded "Office". In all my time as a ride-along the "Office" was a place preceptors disappeared to to complete paperwork and the boss man spent most of his time. Rarely people were called to the office to do QA and be informed of things I was not supposed to be privy to. However most of the time I as told within 10 minutes anyway.

But all of this had me feeling positive until class. Yesterday we had the dreaded talk about how we have to work extra hard from here to the end because it is going to kick our butts from here to kingdom come. Our teacher is desperately trying to put fear in us and scare us and push us hard enough that come the Practical and Written we all find it easy. (Okay well not easy but at least we will not be barfing our guts out or failing epically)

4/21/2010

Things I am afraid of

There are things that I am afraid of now that I am graduating.

*I have never done CPR on anything except for a manikin. I am terrified that my first time will be when I am incharge/lead and that I will freeze.

*I am nervous about finding a job. So many places will just flat out reject you until you are completely finished. I just want a place that says when you graduate we will have a job for you.

*I need to find a new place to live but with no money in my name anymore because of school, and no job right now I am just working on keeping food on the table and gas in the car.

*I am worried that the people in my life who I care about will not understand how much I love this.

*I wonder if I am worth the man who is putting up with my whining. The one who knows the secrets I hide from the rest of my friends and family. The wonderful man who listens when I am crying or talking 90 miles a minute.

4/20/2010

The End of Clinicals

Well it is official I am done with clinicals. I have met many amazing people during my time in and out of hospital ER's and OR's and Ambulance Services. A few shout outs to the ER Tech's I was constantly stealing keys from to get into supply closets and who were constantly giving me advice and tips so that I was more efficient in my IV starts and so that I was not constantly blood letting pt's. To the nurses that put up with my constant begging to do everything that they would let me do and then begging for signatures for all skills I begged to be allowed to do in the first place. To all the RN's willing to sign for pt's they saw me at least check on at the end of the night. To all of the ambulance preceptors who joked with me, pushed me to do and say what was needed for pt care, to the preceptor who yelled at me in private when I left a sharps sitting between the bench and wall without telling anyone. To the preceptors who sat through my sometimes ridiculous questions and who went over EKGs and pt scenarios over and over and over.

Now onto some numbers...
630 hours at a clinical site.
57 shifts
30 ambulance shifts
22 ER shifts
5. OR shifts
225 Pts
16 Pediatrics
3 confirmations of death
175 IV starts
20+ IV Fails
108 Drug pushes (1/2 Zofran, 1/3 MSO4)
5 Neb treatments
12 ETT
40+ hours of clinicals a week
30 hours of class a week.
12 the number of times I did class to clinicals to clinicals to a 4 hour nap to class to clinicals.
2800 cups of coffee the coffee maker has kicked out for our class.

Tons of inside jokes. Lots of laughs. Quite a few new friends made along the way.

12/16/2009

End of the First Semester

Well the semester ends this Friday. I cannot believe how short the time has seemed and how little I feel like I have learned.

My classmates and I have grown quite close in the past few months. We have our inside jokes and we know exactly how to annoy each other to no end, and tend to do so. However we have also learned how to motivate each other and how exactly we all learn.

We wrapped up ACLS today and we still all feel like we do not know enough. Our teacher sensing this pointed out how far we have come. However he made sure we all knew that we have so much still to learn.

In the beginning for chest pain we had pretty much 1 route to follow.
*Aspirin 324mg chewed (as long as they were not allergic).
*Nitroglycerin up to 3 tabs (As long as the patient hadn’t taken any and BP was above 110 systolic. Also no sexually enhancing medications).
*Oxygen 15L by NRB
*3-5 lead EKG. We can see if the rhythm looks strange and potentially send to the hospital for prewarning.
*Gasoline to Hospital.

If they happen to code on the way to the hospital we did what the AED told us to do and we called for more trained help. Performed CPR and used a BVM, OPA, NPA, or Combitube.


Now we know why we do what we do and have more options.
*Aspirin: to make the platelets slippery so the clot does not get worse (be careful of allergies, ulcers, active bleeding. It does it by blocking Thromboxane II.)
*Nitroglycerin: up to 0.12 mg. Vasodilates vessels in the body. Is used in the hope that blood will then be able to squeak past the blockage. (Can be repeated as long as systolic above 90 systolic)
*Oxygen- At whatever level will keep the patients O2 sats WNL and in the hopes of getting more oxygen to the ischemic tissues causing the pain. O2 also vasodialates in high concentrations.
*5-12 lead EKG- We can see abnormal variations in rhythms and the electrical activity in the heart. Using all of its capabilities and our basic knowledge we can now tell roughly where the problem is, and potentially even how bad it is.
*Morphine: We can give morphine to reduce pain. It also reduces preload, afterload, and myocardial oxygen demand.

Now we can treat some of the abnormal rhythms we see in the hopes of preventing codes. We do this with medications, and electricity. However if they do code we can monitor their rhythms and provide appropriate shocks to treat the severely disorganized electrical activity. We also give many medications dependant on what we see. Amiodarone, diltiazem, lidocaine, epinephrine, atropine sulfate and more. We still perform CPR and use BVMs, OPAs, NPAs, and Combitubes. However we can also intubate via the oral- or nasal- pharynx.


Looking at what we have learned I guess we are in a vastly different place then when we stated the class. However we still get stuck sometimes. Some days we do not think enough like Paramedics and we under treat the patients. Some days we think too much like Paramedics and forget a basic intervention that would have been easier, and just as effective as the advanced skills we jumped to.

It is a challenge to remember to start basic and move towards advanced; while still remembering that there are advanced skills for a reason. This is especially challenging with the growing sleep deficit the class is beginning to experience.
40 hours of class a week
+ >10 hours of HW and reading to do a week.
+ 30-40 hours of Clinical time a week.
= >80 hours a week

None of that includes drive times to and from all of these places, sleeping, eating, bathing, laundry, second jobs, or families.

Not that I am complaining I am loving every minute of it. Despite my new caffeine addiction or ability to fall asleep when and where I want.

11/22/2009

Month 3-4

Well we finished up Respiratory and started Cardiology. I am currently drowning in EKGs. Sometimes I think I understand what is going on and then I look at the net strip and suddenly I have no clue what I am looking at and might not even know how to find out what it is.

Clinicals are in full swing and I am currently pulling 24 -30 hours a week in random hospitals in my area and soon I will be pulling random shifts on ambulances also. I had two fairly slow shifts, one at the blue hospital and one at the teal hospital. Each shift I had a maximum of 3 patients in 8 hours. However on my second shift at the blue hospital I had three pediatric patients come in in the first 10 minutes. With a rash, a transient medical issue related to a permanent debilitating medical condition, and a little baby needing stitches. I did a quick sets of vitals on all three and then helped hold down the baby for stitches. Then a little old lady who had a syncopal episode. The next patient was a college age student to fell and dislocated her wrist at a family function. Then another college age student came in with a severe medication reaction. All in all it was a fairly slow night but better than the ones I had been having.

I am really excited to begin working OR shifts and being able to intubate patients and start massive quantities of IVs.

That is all for now more to come.

10/28/2009

0200 Beginning of Month 3

Well it is official my professor's predictions and warnings on the first day of class have come to fruition.

*SAY FAREWELL TO YOUR FAMILY AND FRIENDS BECAUSE FOR THE NEXT 9 MONTHS YOU ARE MINE. I OWN YOU:
I have no life. All my friends are at university or working and when they have free time I am in clinicals. I am not meaning to whine I love class with all my heart and soul. However the only time I am able to talk to my boyfriend is really late at night (right around now) or random five minute bursts

*YOU WILL LEARN TO LOVE COFFEE. THIS IS NONEGOTIABLE.
I am getting less sleep now than I did during college. The only difference is used to stay up late to hang with friends and eat and play games. Now I stay up late studying Calcium channel blockers and Tricyclic antidepressants, Medications, dosages, uses, indications, contraindicates, special considerations, routes, dosages (adult and peds). I have begun to consume coffee to stay awake during lectures in class.

*IF YOU ARE AT ALL SHY YOU WILL NOT BE. BY THE END OF CLASS YOU WILL HAVE BEEN IN EACH OTHERS PERSONAL SPACE SO MUCH YOU WILL NOT BE EMBARRASSED ANYMORE.
I have officially passed into the realm of, my hand is going into your crotch to tighten a strap and you know this, so I will simply mutter move the boys if you need to while tightening. I also do not feel bad popping an angiocath into somebody's arm and fishing a little bit to get a decent vein and flash.

*YOUR HUMOR IF NOT ALREADY SLIGHTLY WARPED WILL BECOME WARPED SOON ENOUGH TO DEAL WITH WHAT YOU ARE GOING TO SEE.
We make jokes about the songs we sing while doing CPR to keep a steady beat. We had a debate about when it is appropriate to sing "Another One Bites The Dust" vs. "Staying Alive". We came up with some definite guidelines that shall never be repeated.

*YOU WILL KILL SOMEONE.
No one in class has done this yet and this is part of the prophecy that we hope does not come true. However as a class and as individuals we have killed several simulated patients in scenarios. In our defense we were trying to do this while looking at an examiner in a chair not acting at all and having no paper on which to write vitals or anything from SAMPLE or OPRST or anything else pertinent. And the patient we killed as a class had a problem none of us had ever heard of and we were only allowed to ask one question before the professor moved on to the next person. It was the worlds weirdest way to diagnose and very hard to get other tudents to follow your line of thought.

Well for now that is it but there will be more when we start respiratory and cardiology and definitely some clinical stories. Of course all the stories will be completely fictional or so generic no one will ever know who it could possibly be.

10/01/2009

What can you do?

I am writing this because... Well I need opinions and I need to get it off my chest.

So you are called to a house for an assault. Her roommate states that your patient stumbled into the house crying, bloody and very confused.

When you open the door to her room you find an approximately 18 year old female cowering in the corner. She is bloodied, her clothes are torn, and she is rocking back and forth slightly. As you introduce yourself from the door she doesn't move or acknowledge your presence. You slowly enter the room watching her and talking to her the whole time. Eventually you are close enough to see her well enough to start your assessment. You can see she is breathing, slightly fast but adequate. You observe quite a bit of blood coming from some deep lacerations to her face and arms. As you keep talking to her, your partner brings you a sheet to wrap around her while you take her to the hospital.

As you slowly move closer she still is not showing any sign that she sees or hears you.
**How do you proceed?

You touch her foot as they are the part of her closest to you. She looks up at you and starts rocking faster.
**What do you do now?

You keep talking to her and reassuring her but you back up a little to give her some space. You bring the roommate in, in the hopes that a familiar face will calm her down and it seems too. You have the roommate help explain who you are and what is going to happen now to your patient.

Eventually you get her in the vehicle and start towards the hospital. She still has not spoken but she is following simple commands and nods in the affirmative and negative in response to questions. She starts crying and grabs onto your hand. You just keep talking to her.
**What do you talk about? (Anything you can think of? weather, sports, school)

When you get to the hospital and the nurses take over and ask you to leave the room she will not let go of your hand.
**Do you reassure her and leave? Do you see if you can stay just a little longer? Do you out her hand in a Nurses and tell her that she will be taken care of?

** How do you decompress?
** What if this was your best friend, your little sister, your mom, your girlfriend, your daughter?
** What would you have done differently?

9/19/2009

Weeks 1-3

Ok so for the 2 of you that actually read this I apologize. It has been more than a little crazy around here. I am sorry that I have not posted in such a long period of time. So here it goes.

Wow so classes 2-11.
We have been covering everything we ever covered in Basic class. Taking vitals, Pt assessments, immobilizing Pts on backboards, standing take downs, KED, extrications, KTD, hand washing, PPE use and removal. Then we moved on to Anatomy and Physiology. We have been studying body systems, the differences between the different age brackets, how to approach and interact with patients.

We are now in our second book of the 5 books we have for this class. It has been hard work to keep up with class mostly due to the fact that we are going very fast to get through the information that we should know already and the information that we will build upon for the rest of the class.

We have also been working on learning drugs. So far we have to know, Name, class, doseage, route, actions, emergency use, contraindications, and special considerations. For the first 9 drugs. Acetominophen, Adenosine, Albuterol, Amniodarone, Aminophylline, Amyl Nitrite, Asprin, Ateolol, Atropine.

The class is definitely bonding though. We joke and tease like we have know each other for a very long time. We have begun forming study groups and exchange emails and text messages of a fairly regular basis.

We are becoming the family that we will need to survive and pass this class.

Week 3

Ok so for the 2 of you that actually read this I apologize. It hasbeen more than a little crazy around here and I am sorry that I have not posted in such a long period of time.

8/24/2009

Day 1

Today was day one of Paramedic school. We began today with 12 students, 4 girls, 8 guys. We spent eight hours in conference room that will serve as our classroom for the next year. After an hour of paper work and procedural things our professor Jay began to lecture. He began his lecture with a small bit of a reality check for all of us in the class.

Jay: Look around this room. Go home tonight and say good-bye to your families. You are mine, body, mind, and soul for the next year. The people you see around you will be your family for the next year. No matter what you back each other up. You all need each other to learn from and to be there for support. Your significant others will not understand, your children will not understand, you friends will not understand. The people in this room will understand. You miss classes or come in drunk or hung over you will be automatically dropped. If you fail to achieve a 80% or higher on every test and every quiz you fail. You fail to complete a skill, you fail. You do something outside you scope of practice, you fail. Understood?

Class: (all looking like we want to run for the door and yet still smiling and looking like we want to be there) Understood.

Jay: However I am the rule maker. If you are a good student and a good person and are working hard in the class and something comes up tell me. I will do whatever I can within my power to help you. But there are limits to how much I can do for you. Try your hardest and we will get along just fine.

So now I am both excited and terrified. This is what I want to do no matter how hard I have to work to achieve it.

6/10/2009

5/29/2009

Memorial Day

This Memorial Day was more bittersweet for me than most others have been. With my little brother gone with the Marines I found myself reflecting on the true meaning of the day more than usual. I have never really thought of it as just a vacation from school like some people I know. But this time it truly made me think of the men and boys my brothers age who died so that I can live and have the freedoms I do have.

Later in the day I went to a party with my friends. Some of whom are enlisted and some of whom were missing from the party because they are currently in deserts in other countries. One got back from field training the day before and one left for 4 months the next day. Playing kickball and swimming and dancing with these men who have just left boyhood and who would be leaving soon was also sad. Everyone made sure to give them a few extra hugs for the road.

I almost had to use my EMT Training more than once at the party. We play this game that is a mix of wrestleing, tag, and frogger. It leaves major bruises and more than a few people had to tap out before they got hurt. Playing it in the water was even more dangerous. It had less of a danger of simply getting bruises but more a danger that someone would be held under water by accident.

All in all it was a good Memorial day.

5/08/2009

Silly Police

Disclaimer: I have no problem with law enforcement personel. In fact I have many friends who are in law enforcement.

So at 0645 this morning I was driving down the hwy in Fond du lac. I was going maybe 70(at the most) in a 65 zone. Yes I know I should have even been going that fast but I was keeping up with traffic. And then I made the mistake of trying to pass the car I had been following for an hour. As I was passing him I saw the trooped ahead of me and took my foot off the gas and let it drop to 65. At this point the guy on my right flew past me. And after I got in the right hand lane again the trooper pulled me over.

He took a good look at the box that was taking up most of my car and then told me he was giving me a written warning for speeding. Yeah right. I know he did not clock me speeding. I figured he had pulled me over because he didn't think I could see well enough to be safely driving with that box in my car. In fact he tested this by pulling up behind me so I could not see him out of my side mirrors and then turned his lights on so that he was only in my rear view mirror.

So now for the first time in my life I have gotten in trouble with the law. I am more angry that he pulled me over for going 1 mph above the speed limit when all the cars around me were going faster. And he could have just said that the box looked dangerous and not given me a warning.

Grrrr

5/03/2009

Reciprocity

For my summer job I was getting all ready and packing. Buying sunscreen and soap and such things necessary to live somewhere for 2 months. And then my boss sent me an email. Dear Freckles I sent your credentials into the health department and they have decided that you are not qualified enough. Apparently in this state being a NREMT is not enough. So now I have to prove that I took a class and have the WI EMS bureau fill out paper work on me to send to them. And then I will get a number that will allow me to take a refresher course and test to be a legal EMT in the state I will be working in all summer. That is all fine I can do that. The problem is this state is a 10+ hour drive for me and I have to take the refresher course there. And with enough time to fill out all the necessary paperwork and have it all filed and cool before I am supposed to start working. I have 1 month.

Well here is hoping for Reciprocity to go quickly and everything to fall in place easily.

4/29/2009

Presidents and Press Conferences

Thank you president Obama. Without you how would we know that to prevent Swine flu we should... wash our hands, cover our mouths, and stay home if we are sick. I am not sure about you but I have known this since I was 2. Get off my tv and talk to people who care.

I strongly dislike when presidents interrupt regular programming to hold a press conference. I also dislike when they do it because something they deem really important happens. I do not mind a quick blurb or a scrolling across the bottom of the screen.

I feel that maybe there should be a tv channel completely devoted to the president and world events or something like that. A news team on every continent could broad cast on it for 2 hours a day each covering world events on their continent that are important. And when the president feels that he has something really important to say he can go on there and talk to his hearts content. And they can replay the president on it for those that missed it the first time and really want to see it. Heck make it interactive let us pose questions for him.

Sorry I really have nothing against presidents or press conferences and I am not that addicted to tv I just really do not like all 3 together.

4/24/2009

Results

Today I found out many things
a) I do not have Tuberculosis (I already knew that) 1 test down 1 to go.
b) I got offered the job I have been waiting for. Outside doing first aid all summer!!!
c) My parents really are worried about me going away all summer.
d) Allison (my car) looks better with out paint on her front bumper.
e) My Big Brother from school is graduating in a couple of weeks and is on his way to being a grownup.

My brother is also sleeping next to me on the couch right now he got leave for a week before he is leaving again.

Today is a good day.

4/18/2009

Yay for paperwork

Today I received my Pre-Paramedic paperwork and it made me feel like a dog. I have to prove that I have had all of my shots and in the proper order and amount. I also have to go get more shots and boosters to satisfy the requirements of my program. MMR, TB, Varicella, Hep B, Hep A (recommended),Tetanus. Not that bad but still trying to find the records is tough when you have had several different doctors over the years.

Yay for TB tests I have to have a 2 step test again because it has been 12 months and 4 days. At least this time I know I am allergic to their bandages so I will not get a false positive due to a bandage reaction this time.

Well off to become a human pincushion. Here is hoping I do not have TB.

4/15/2009

Paramedic Mandatory Meeting

Today I went to the mandatory meeting about paramedic school. I showed up 25 minutes early and was told that I was at the wrong building but that they could set up a Video Conferencing relay for me so I did not have to make the hour drive and miss the meeting.

So they set me up in a quiet room with a note pad and a pen staring at a tv screen of an empty room. Not a good sign when the meeting was supposed to have started 5 minutes ago. Then the teacher and my fellow classmates showed up and we got down to business it was slightly awkward but not too bad.

Then a woman came into my room to give me the papers that I was supposed to be filling out. She chatted with the people on the tv for awhile and then left.

5 minutes later there was a man outside my door signing.
He signed "need interpreter?".
I signed "No".
He signed " Deaf?”.
I signed “No hearing”.

Yes folks that is right apparently if you accidentally sign while you are talking you get an interpreter! It made me happy because they were trying to make sure that I knew what was going on and being helpful.

I also found it hilarious that at the meeting for a profession in which you cannot be deaf I was asked if I was deaf.

4/11/2009

I love WI

So for the last few days I have been up north in northern WI. Now as many of you know it is pretty much Spring in most of the country. Well not here it isn't today I had to shovel snow out of the way so I could walk down to the lake. Then I proceeded to walk out to the end of the pier and walk across said lake. Yes in northern WI the lakes are still frozen enough to be considered safe to walk and ice fish on. The lake still has 2 feet of ice in the center but the edges are sketchy. I also made a very large bonfire to burn all the wood and pine needles that fell during late fall and winter. This was so that come true spring we can plant things. And by things I mean anything that the deer will not instantly devour. I have also been interviewing for a summer job and I will know by the end of the week if I have the job or not. I would be health officer at a camp this summer. Well that is all.

4/08/2009

Marine Corp Symbol


So I have decided that this Blog will be Bipolar. I will be posting about the Marine Corp and I will also be posting about Paramedic school. So today's Marine bit is the story of the Marine Corp symbol.

"We stole the Eagle from the Air Force,
The Anchor from the Navy,
The Rope from the Army,
and on the seven day when GOD rested,
we overran his perimeter and stole the Globe,
and have been protecting our shores ever since,

We Are.....The United States Marine Corp