Monday, December 31, 2007

Baptism By FIRE.... the early days

Just last week, Hunny and I were discussing our early experiences in EMS. I had shared my experiences with my first "tote" job. Crazy Family Drama EMS. The company is known in the Metro-Atlanta EMS community for their surprising longevity, and the fact that they had had some of the worst contracts ever. Most local "old-heads" got their start there. I guess I fall into that category. The current opinion is if you survived 5+ years at Grady EMS these days you've earned your "old head" badge.

When I worked for CFD EMS, their primary money maker contract was with Grady Hospital, to take home all discharges off the floor that were true "bed-bound" stretcher patients: paraplegics, quadriplegics, contractured stroke survivors, amputees, etc. They also did ALL the ER discharges. Sure, there were the true bed-bound patients. But you also did a fair share of providing taxi service for lazy healthy and/or youthful adults... ambulatory folks who refused to cough up $1.75 in transit fare to get home, medicaid recipients who already had ran up an unnecessary $400 ambulance bill for their stomach flu symptoms and didn't wanna call babydaddy to give them a ride home, and the indigent un-bathed homeless folks needing a cab ride over to which ever shelter the social worker had conned into accepting them at 2am... you name it.

A bad spot to be caught in was ending up somewhere close to Grady around 10 am when the oncology floor began their daily ship out of a dozen or so cancer patients needing EMS transfer to the radiology clinic two blocks down the street for their treatments. It would be nonstop all morning and afternoon. Go to the floor and get patient A, take them to the clinic and leave them on the table for treatment, rush back over to the hospital and get patient B. Leave patient B and take patient A back to the floor and get patient C. See the pattern here? The non-stop "Radiation Shuffle" could occupy the better part of 4+ hours to shuffle these dozen or so patients back and fourth. No, there was no time to grab lunch in this disaster of air traffic control. That was the shitty part of it.

The one good that came from this mess was that I quickly learned the city, and really learned the Grady EMS response territory inside and out. I was well prepared to drive a Grady Ambulance, rarely needing a map book in the 7 years I worked there. I simply don't understand EMT's with 5+ years at Grady who never remember frequent flyer pickup locations and busy neighborhoods.

The other aspect of working for CFD EMS, was that 75% of their daytime business was medicare dialysis transports from all over the 5 county metro-Atlanta area. These were often some really sick folks. Many times they would get to the dialysis clinic only to be deemed too sick to do their treatment, and we were called right back out to transfer the hypertensive bradycardic pulmonary edema patient to the ER for stabilization.

Herein lies my "Baptism By Fire" as Hunny labeled it. I often worked the day half of my 24 hour shift with a lazy ass burnt out medic and RRT (respiratory tech) we will call Harry. Harry was all of 5 feet 3 inches, and weighed a buck twenty at best. For so long I thought Harry had the most severe case of Napoleon Syndrome I'd ever witnessed. He was always hyper-agitated, hyper-aggressive, and hyper-anxious. He often cursed out nurses and hospital staffers, and was a total jackass to family members and co-workers. AND he was lazy.

All those SICK dialysis patients got pawned off on me, a super-green EMT with wet ink still on her card. I learned quickly how to run EKGs, give breathing treatments, and give Lasix to dialysis patients. Yes I said give breathing treatments and Lasix to dialysis patients. Not only was that beyond my scope of practice, but I was being directed to treat patients with medications that were usually inappropriate and often futile for their history and current conditions. Lasix works on the kidneys. Dialysis patients often have little or no kidney function. So this was a waste of drugs. Secondly dumping breathing treatments on patients who were already oxygen starved and short of breathe didn't really help their heart's demand for oxygen to keep the heart tissues nourished.

Crazy Family Drama EMS was a sink or swim experience for me. It taught me a lot, good and bad. There for, as Hunny pointed out... it was my Baptism By Fire.

Only a few weeks after I left CFD EMS did I find an answer to all his behavioral issues. HE WAS COKED OUT!!! Apparently he went ape shit one morning before shift because he had lost his keys at the station. He refused to go inservice without those keys. The owner even offered to pay for a lock-doc to come during the day and unlock his truck encase they were in there. Finally he bowed out and went to work. Later in the day someone found his keys, complete with a vial of cocaine neatly linked to his keys by a chain. Um.... YEAH. That explained A LOT!


I QUICKLY DEVELOPED THE MINDSET OF WHAT KIND OF MEDIC I DIDN'T EVER WANT TO BE: lazy, irresponsible, slack-skilled, uneducated, jackass. Between Harry, and the first couple of shitty skilled medics I got partnered with at Grady, I quickly developed an appetite to learn my scope of practice, have good skills, and (sometimes to a fault) be very demanding of perfection. My underlying OCD reared its ugly head and peaked when I hit Paramedic school. My opinion is that OCD and demand for perfection can only make you the best medic possible when it comes to competent patient care and documentation. CQI/QA will back me up here. That can only be in your patient's favor. Unfortunately if your partner doesn't share your concept, it will quickly become sand in their panties!!! Especially when in your partner's first quarter of paramedic school, they already know more than your established attending physician **A-hem**

So with all that said, I think I became a better medic for it. I have an unequaled demand for my patients advocacy, care, and transfer of care to a competent and appropriate facility for whatever ails them. Heart attacks don't go to a non-cathlab hospital. High mechanism traumas go to Atlanta Medical Center, or Grady (on Emory days). Strokes go to Neuro-capable ERs. No one can ever say any patient of mine suffered for it. Partners... well, that is obviously a different story.

Sunday, December 16, 2007

NEW JOB....

NEW JOB - Grady Jr. EMS

I spent Monday (12-10-07) through Friday (12-14-07) doing the typical classroom orientation stuff. How GJ-EMS got it's start, how it's grown, benefits, training and CEU programs *a lot of CEU's ONLINE - yippie*, Toughbook's and touchpoint PCR software, road safety / CEVO, HIPPA, etc.I was definitely impressed with their "employees are our most valuable asset" concept: meaning that if Mama ain't happy, ain't nobody happy. They eat it, breathe it, sleep it, poop it, and maybe even brand it on your ass when you get released from orientation. But it's true. Basically they believe that if they meet (actually, most often exceed) the expectations of how the employees want to be treated, perks, nice equipment, comprehensive training, new (and actually functioning) technology, etc... that we will be more productive, nicer to colleagues, patients, and the public, less likely to burnout, less likely to climb a tower in Smyrna and start taking pop-shots at cars on 285, you get the picture. I like that. Actually from what little I have had the chance to observe, I see it in full action. The employees ARE HAPPY, NICE, and so far even seem competent. It is a 180 from Grady EMS. THAT, I LIKE.

Example one: On day three of class, my hunny went to the orthopaedic who is treating the ever persistant back injury. Doc said it's time to try Cortisone epidurals. Before I even knew what day it was gonna be scheduled, I asked the Ops Manager (sooo unlike his Grady EMS counterpart "Dragon Lady, head of the Grady Gestapo") what our third ride schedule was going to look like so I might plan to be off for the procedure. He tells me to go ahead and schedule the procedure and they will work around it. Say what? That shit would never have happened at Grady. The Grady mentality was screw you, screw your family. You work around OUR needs, not yours or theirs! Off the bat - I'm impressed.

I did my first third ride yesterday. Obviously since I've been around the ambulance a few times, my FTO asked me what *I* needed to work on to feel more comfortable to transition to GJ-EMS. I answered honestly that I was very inexperienced (intimidated) with the laptop and the PCR software. He immediately designated THAT as my main task for the day... to write all the PCR's for all the trips.

The mind blower came with our final call of the day. We responded to a vehicle that may have hydroplaned sideways on a 4-lane and was struck at high speed t-boned in the passenger door. Lucky for that car it was a single occupant, because there was nearly two feet of intrusion damage to the passenger side. She did not walk away unscathed though. She had a positive loss of consciousness and kept asking repetitive questions all the way to the trauma center. Probably a nasty concussion, not to dismiss a more serious brain injury is also to be considered. But what amazed me was Cobb Fire. Their rescue unit was already on scene, the patient was in a collar, c-spine being held, a full assessment had been performed, an IV started, and they were just waiting on the transport unit to arrive before pulling her out and back-boarding her in the downpour. Once we arrived the tented a tarp over the work area keeping us all dry as we worked as a TEAM to get her immobilized and into the ambulance. TEAMWORK! Smooth as glass teamwork!

I think I am gonna like it here!

Friday, November 30, 2007

My day, yesterday

My day, yesterday

I awoke at the usual 5:30am to get dressed and ready for my almost two hour rush-hour commute to Alpharetta. Upon arriving at work at 7:59, my partner was yet in the office, so I set myself busy to ready us for the day ahead. Mike, co-owner and C.O.O. of the company (of 5 full time employees) calls me into his office.

I will simply sumarize my feelings as this: My intolerance for incompetance, drama, bullshit, unsafe work conditions, and unreliable paychecks, along with my feelings that the newbie EMT's skills should be nurtured and honed, and demand for partners who actually bathe regularly - did not set well with management. I was branded as a boat rocker, and trouble maker with a bad attitude. While all my EMT partners told me just how much they liked working with me, learned things from me, and agreed with my views on company operations, management told me repeatedly over the last week just how much no one wants to work with me.

So either management's view on me was grossly exagerated, or all the EMT's I worked with were liars. I'd like to hope it was the first and not the later. I really liked my EMT's. They were still fresh, starry-eyed, save the world EMT's, and not bitter jaded EMS employees that places like Grady eventually turn out. I wish them the best of luck, and hope they actually do find a way to change or save the world some day. I never did.

As for management, they now have no full time Paramedic to staff their only ALS unit. Only a couple of FireMedics who work a day here and a day there, because this was not their "real job" as they have put it.

I spent the better part of the day applying online for nearly 20 various clinical positions around Metro Atlanta that a Paramedic could fill, all along hoping that the Blackeye I carry from Grady won't keep me from being considered.

Friday, October 5, 2007

Only at Grady..... Another Sumdood Sighting

Lenya is working tonight (at Grady) with a reputable Class Ten Shit Magnet named Shawn Moore. Shawn is the kind of Shit Magnet who has two cardiac arrests back to back followed by a couple of critical traumas, ending the night with a decompensating CHF'er that gets intubated. That's his daily norm. Always has been.

Tonight beats all I have ever heard. Sumdood strikes again!!! Shawn was mugged outside the CNN center by a crackhead. For his radio. Not an I-Pod or other portable entertainment device. His DISPATCH RADIO.

It wasn't long before the thief was talking in Spanglish over the dispatch frequency. APD, EMS, and Park Police followed the sounds of the radio communications, and said crackhead was found by Lenya and the shift supervisor hanging out near the bushes over in Centinnial Olympic Park where he was tackled and subdued, and held at MagLight point until poe-poe could put him in handcuffs.

His story: Shawn "sold" him the radio. Uh-huh. Sure.

Sumdood seems to have shapeshifted away again, leaving a dazed and arrested crackhead to take his heat. ONLY AT GRADY!!!

Wednesday, September 26, 2007

The Kidnapping of Lucy

I had a late arrival home last night. 11:30 give or take a few minutes. As usual, I backed my crappy Kia into the space designated to my townhouse with a faded #13 painted on the asphalt. My eyesore of a car, currently missing the left rear door window (temporarily patched by an industrial sized black garbage bag), shared a single space with Lucy. Lord knows I have had enough pissy ass neighbors bitching about my household owning three vehicles and where we park them. Lucy was all snug in her parking place last night when I arrived home.

Who is Lucy? Lucy was my 2005 Honda Shadow Aero 750 motorcycle. She was practically the one remaining material thing from my 4+ year relationship with Candice. A nice stretched frammed classic styled fat fendered cruiser, painted brugundy, with a suprisingly appealing factory chrome package. Lucy saw me through a nasty divorce, an even more ugly rebound, and all the follies associated with Jordan. She has carried me on the 2005 Trail of Tears ride, and on a more fond note carried Lenya and I on our first breakfast date.

I awoke this morning with the intension of running out for breakfast while Lenya was on her way home from work, just to meet her back at the house with fresh biscuits. To my complete and total devistation..... Lucy was gone. Someone had taken her during the night. Despite the sudden realization that I still have $4700 left on the note, I was completely overwhelmed by anger and rage.... AND sadness.

Today, I lost a friend. I wish Lucy would come home. :-(

Thursday, September 13, 2007

My Aunt's Touching Words

My Aunt Shirley is pushing mmm I'd say 65-66 years old. She won't actually admit to me just how much older she is to my dad - who is 62 this year. Bless her heart, she gets on AOL and sends e-mails, forwards jokes, and occasionally has been known to IM. Not bad for a lady her age with no formal education. I am honestly impressed with her eagerness to keep up with friends and family by way of ye ole internet. So I sent her the links to my blog here, honestly because she has been digging at why I no longer work at Grady. Last night when I read my e-mail I got this touching reply:

"What a wonderful touching e-mail about 9=11 (she addresses me by my family nickname that I will NOT share with you schmoes) you have a wonderful way of writing have you found a job? Im sure what ever you did at Grady it was good Im sure you got tired of all the people who used the hospital for a doctor office instead of going to the dr.But the job you are trained for is important I wish we had got someone who cared and knew their job as much as you do when we called for help for Wayne (my uncle) he might have had a chance and still be here Talk later aunt shirley"

I am thrilled that someone in my dad's family thought so highly of the job I chose, and has so much faith in me. Certainly more sentiment about it all than my dad ever chose to share. None the less, her comments touched me deeply.

Tuesday, September 11, 2007

SUMDOOD Strikes Again

Alternate Title: Straw... Meet Camel!

23:05
Dispatch: "7262 prepair to copy."
Former Grady Medic: "262 go ahead"
Mouthy Renegade Partner: "Fuck Me! We get off in ten fuckin minutes!"
Dispatch: "Respond to blah blah blah Peachtree Street, Hyatt Regency, Difficulty Breathing. Stand by..... Text advises your subject will be across the street, at the liquor store. Be advised your 78 will be a black male, wearing all blue, and a straw hat."
MRP: "Oh great. Some drunk-ass rooter at the liquor store. Bet he wants to go to Piedmont to sober up and have a place to sleep it off."
FGM: "We'll see if he'll go to Grady. Just grab and go. Me and (Starry-Eyed Intern) will treat 'em on the way in."

(pulling up to liquor store opposite to the Hyatt)
MRP: "I don't see 'em"
FGM: "Leave the lights goin so he can see us."
*Just incase he is deaf and couldn't hear all the sirens blaring*
Starry-Eyed Intern: "Wadda we got?"
MRP: "Just Some Dude, drunk at the liquor store"
*Oh Jesus, it's Sumdood. Ambulance Driver has been warning us about him for months now. Could he have really relocated himself to Atlanta to reorganize, and plan a whole new batch of dastardly deeds? AD says he has super mystical powers beyond all human comprehension. Ready your defenses!*
FGM: "I'll see if he is inside"
*any other time I'd be fired for hanging out in a liquor store in uniform*
(walking inside liquor store and announcing our already obvious presence)
FGM: "Did anyone call 911? Does anyone need an amalance?"
*dramatic pause, waiting on every customer as a whole to respond in three part harmony their desire to enter alcohol rehab at 23:00 hours on a Friday -- NO RESPONSE, thank gawd*
(returning to the seizure inducing LED and strobe lit ambulance, firmly held in place by MRP and SEI leaned against the cab)
FGM: "He ain't in there. My radio is dead, you call it in."
*Probably some do-gooder cellphone samaratin' callin for Sumdood passed out on the sidewalk*
MRP: "He's gone. Time to go home.... 262 to Radio"
Dispatch: "262 go ahead"

Sumdood: *sprinting down the sidewalk*
"Hey! HEY! WHERE THE FUCK YA'LL GOIN?!?!"
*Oh yeah, I can tell already he has level one BS respiratory distress*
FGM: "Sorry man, thought you'd left. What's goin' on tonight?"
Sumdood: "My knee hurts"
*Did I loose my mind, or did our "new and improved dispatch" send this out as respiratory distress?*
FGM: "Is anything else bothering you?"
Sumdood: "What da fuck that mean?"
*obviously his airway is intact*
FGM: "Our dispatcher said you had other problems, just wanna' make sure you're a-ok"
Sumdood: "Whatever, lady, them people on da phone wuz trippin. Look, my leg hurtin' like hell!"
*and he AIN'T having no problems breathing if he is yellin' like that*
MRP: "What's goin on with your leg?"
Sumdood: "It fuckin hurts, man. I dunno what's wrong wit it. Dat's what I call' you fo!"
(complete with excessive and aggressive gesturing)
FGM: "Well tell us about your leg... did you twist it? Did you fall on it? Did somebody jump you?"
Sumdood: "Fuck dis shit, man! I done answered all dis shit on da phone! Why ya'll fuckin' trippin too?"
FGM: "Look, if you don't answer our questions we have no idea what is wrong with your leg, we can't do anything about it, we can't write a report, and we can't tell the doctor anything about you to get you seen. You gotta' chill out and let us do our job. Why won't you let us check you out?"
MRP: "We can't do anything with you yellin' and actin' a fool"
*Oh that's great. Piss 'em off even more. I'm puttin your ass in the back with him*
Sumdood: "I ain't stupid. I am an educated man!"
(shuffling around, anxious, restless, aggressive)
*Bet he's probably tachycardic with some pupillary constriction too. Certainly in need of some calming chemicals... valium would be a good start*
FGM: "Sir, no one said you were stupid. Why don't we take you to Crawford Long? It's just down the street, right around the corner. When you get done, it's close enough, you can walk back or catch a cab. You just gotta decide what you want us to do for you."
SEI: "Man, they can't do anything with you unless you cooperate, settle down, and answer their questions"
FGM: "So, will you tell us about your leg?"
Sumdood: "Yo, fuck you crazy white mothafuckas"
(flipping the bird with both hands, and giving us "the hand" as he strode off hasitly down the side walk on Baker St.)
FGM to SEI: "And that behavior is why you go with your gut instincts, if they are acting all wierd and aggressive, you certainly don't wanna lock yourself in the back of the rig until they chill out, you can bet that there is a big chance they will get violent"
MRP: "262 Radio"
Dispatch: "262 go ahead"
MRP: "Be advised... Farmer John has flown the coop. Patient was belligerant with EMS and walked away cursing"
Dispatch: "10-4 on the respiratory distress that walked away"

(driving away from scene)
MRP: "Look there he is, already a block away!"
(Sumdood is still cursing EMS. walking back toward liquor store)
Sumdood: "Fuck you, ya fat dyke bitch!!!"
*I wish I had a dollar for everytime some jackass said that*
Dispatch: "7262... You are clear for end of shift"
MRP: "Let's go home!"
(hitting the block, Sumdood is back around on Peachtree Street now, jumping up and down screaming at the ambulance. Doesn't seem like he recognizes us until we are directly in front of him and he starts screaming racial slurrs again)
FGM: "Now ain't that some shit! Lemmie get this freakin report wrote before we get back to the house. You'd better call the supervisors and let 'em know about this guy, my radio is dead."
MRP: "Those two are probably off in their love nest somewhere. If one stops suddenly the other one' s head would be stuck up the other one's ass"
FGM: "ahhhhahhhahhhhahhhahhhhhh"

*(*)*--*(*)*--*(*)*--*(*)*--*(*)*--*(*)*--*(*)*

Apparently, Sumdood called 911 later in the evening and was treated by another crew. What I was told officially was that Sumdood complained that we were rude, flipped HIM off, and used racial slurrs towards HIM. What they did not tell me was that all written accounts DID confirm that Sumdood was belligerant, uncooperative, and aggressive. Verbal interviews were documented by supervisors to indicate that MRP sold me out saying that in his opinion my repetitive questions to the caller were in a manner to intentionally aggravate the patient. SEI's limited view through a 6 inch peephole into the cab of the truck allowed him to formulate the opinion that I was laughing at Sumdood rather than our sarcastic comments towards night supervisors that are always riding together rather than apart (making them less available to crews).

Unofficially, the word is that Sumdood may have assaulted the Paramedic that transported him, and was charged with felony assault. And said medic couild have been in Cardiac Ops all night after being kicked in the chest by Sumdood.

Being that these types of calls are increasing in frequency, more and more medics are ending up in the ER after being assaulted and injured. Supervision and administration's answer is "get over it, it's part of the job". Having my ass kicked once or twice a month is NOT what I signed up to do. We have no training in self defense, carry no weapons, and medics have gotten reprimanded for physically defending themselves. We are not APD.

Although I was under investigation for less than pristine customer service skills, I could not afford to sit for weeks with no income while Grady EMS drug out their already-made decision to fire me. I chose voluntary resignation, so that I could collect my banked vacation time and pay my mortgage this month, eat, and have gas for my car and the impending job search.

I know already that someone (yet unknown to me) is attempting to blackball my name in the EMS community, because the job I was supposed to start yesterday was suddenly withdrawn when I arrived for orientation. All I can say is that life goes on. All things happen for a reason. Blah Blah Blah. And all that optimistic shit. We will just have to see how things pan out.

Sumdood may not be as bad a guy as AD thinks. He DID, after all, save my sanity, and get me the hell out of Grady. My hat's off to ya. But next time... I may just have to show you what a pissed off fat white dyke can really do. Next time I might just really flip you off and tell you how much of a racist bigot jackass YOU are!

September 11, 2001

We awoke early, newlyweds, frantically packing our bags at the beach house. Just three days earlier Candice and I had shared our vows in our commitment ceremony in North Litchfield SC. The air was crisp, and the sun was up already. The tons of things to do was my motivation. We had planned on going home via detour to Savannah. I never bothered to turn on the TV, since there was no cable TV we never really bothered to watch much TV that week anyway. Our bags were packed, the car was loaded, and off we went.

It didn't take too long of driving down the highway to notice things were strangely different. Cars were pulled off on the shoulder and drivers were staring blankly through their windshields. Large groups of people stood together talking in front of businesses along the way. I pulled into a CVS drugstore to buy a cheap road atlas so we could navigate scenic roads to Savannah. Candice and Mike stayed in the car chatting nonsensically like brothers and sisters do. Once inside I could not help but to overhear key words on the lips of other customers talking amongst themselves. Bombs, terrorists, World Trade Center. I remembered learning about the first attempts to bomb the World Trade Center when I was hired at Grady EMS, during orientation training.

I returned to the car and told Candice and Mike that something terrible had happened. It seemed as though someone may have bombed the WTC, and I turned on the radio. Every single station had stopped their music programming and everyone was talking about the obvious terrorist attacks. People were calling in voicing their opinions, and it seemed the whole country was a-buzz. At that moment we had no idea of the magnitude of what was occurring. All day we listened to DJ's and callers describe the tragedies unfolding.

I immediately called into work and asked Hedy what was happening in Atlanta. She told me that things were crazy, and that basically Public Safety agencies nation wide were on high alert, unsure of what to expect next. She knew we were out of state, and begged us to be careful driving home, to drive safely, not to rush back. We immediately redirected our route to Warner Robins to Candice's house, and it took us hours to get back, long emotionally draining hours of hearing caller after caller on the radio express their feelings over the horrendous loss of human life.

It wasn't until we made it to Candice's house and turned on CNN that we saw the footage of the first plane perched dangerously in the side of the tower, scorching and burning, and later the second plane crashing into the tower. We saw the towers collapse over and over as the media replayed the film hundreds of times that evening.

And then the reality hit. Terrorists had not only attacked America, they had purposefully attacked my family. My family of first responders. Smirking in hiding, in a foreign land, that on 9-11 they would kill the caregivers and officers who work for 911 everyday. Hundreds of EMT's, Paramedics, Police Officers, and Firefighters had been trapped in the buildings, doing their jobs, trying to evacuate occupants before the inevitable happened, before the thousands of tons of concrete and steel crumbled. Rescuers who knew the danger they ran head-on into, doing what they were trained to do, what they were paid to do, but most importantly, what they were passionate about doing... because of their love for their fellow man.

Within a couple of days, my honeymoon was over, and I returned to work at Grady. I continued onward in my career as a glorified taxi driver and bandaid applicator. An ambulance driver, occasionally blessed with the opportunity to utilize my skills and be a Paramedic, rendering aid to a small handful of critically ill or injured patients every month. And it ate me alive.

Taking asymptomatic patients to an already bursting ER for a Rx refill, kids with fevers or scraped knees, chronic backaches, headaches, toothaches, and violent drug addicts itching to kick my fat white dyke ass - became a depressing and hostile work environment a long time ago. I lied to myself for years. I lied to myself about my abilities to manage a mouthy renegade EMT partner.

For me, there was rarely any satisfaction in my work. It didn't take long to realize there was no true purpose in being a Grady Medic anymore. It was just a paycheck. But on September 11, 2001 -- those folks realized their purpose, and they charged into the vicious face of danger to save innocent lives.

THEY WILL NEVER BE FORGOTTEN!!!