Back at work. I've been trying to put together my conference notes, but for some reason I just feel all EMSed out. It's odd because usually when I come back from a conference, I'm all psyched up and rearing to go. Today, its been like "What hospital do you want to go to? Okay. We're going to get the stretcher ready." And then at the hospital, my report has been, "Here's my patient, he's...ah, ...he's sick." That's been about it.
I don't know why I'm in this funk. I'll take a stab at it though.
The last seminar I went to was on ambulance safety by Nadine Levick. Here's her website:
Objective Safety
There are lots of handouts and slides you can see that will hit her main points.
She is famous for showing her videos of crash test dummies in the back of ambulances, and it is not a pretty sight. The bottom line is while we spend billions on biohazard prevention, we (EMS people) are being slaughtered in ambulances. We are sent lights and sirens to BS calls in vehicles no safer than than laundry trucks. While other countries have state of the art ambulances with roll bars, automotive safety seats, brackets to hold down equipment, helmets for personnel to wear, we are just waiting for the reaper to call our numbers.
I'm guilty. I don't wear an seat belt in the back -- I can't do patient care and wear a seatbelt. I don't fasten down any of the equipment. My oxygen tank is laying there often on the bench next to the monitor. I don't always put the harness restraint on the patient. I drive with people who I wouldn't consider the safeest drivers.
It is making me reconsider the way I practice. I hardly ever go lights and sirens, but I also hardly ever wait on scene. I usually do everything en route to the hospital in a nonemergency mode. I may seriously start doing everything on scene and then belt myself, my patient, and my equipment in, including buying a helmet.
For years I have seen medics wear bullet proof vests. But that's not what is going to save their lives. Start with seat belts, include gloves, and throw on top the helmet. You're way more likely to get killed in an accident than shot on the job.
But what will my patients think, if I put on a helmet, but don't have one for them? Should I offer mine to them? Maybe I can buy one, get one half off. Then I would have to decontaminate the patient helmet after every call. Not a pretty thought.
What else has me down besides worrying about getting killed on the job?
I think the EMS EXPO depressed me. By EXPO I mean the vendor area, not the educational sessions. On the one hand, I should be "Wow look at all this cool stuff to help my patients," but on the other hand, it was like, "Everyone is out to make a buck and how much of this stuff is even neccessary or does what it claims to -- save lives!" (Aside from the helmets, which I would have seriously looked at but I hadn't yet been to Levick's ambulance safety seminar).
Along with the money line, I am bothered by the research dilemna. Much of the research being done is on potential money-making products. Research costs money so industry sees to it their products get researched by their experts. You don't see too much research on the cheap stuff.
The EMS conference/expo (while great from an educational perspective) brought it home just how much of a big business EMS has become.
On the educational part, I always end up coming back with new knowledge that says something to the effect that you know the way I have been practicing, well, that's all wrong. Instead of doing it that way, I need to do it this way. I'm all for change and evidenced-based medicine, but I get depressed when I learn the way I have been doing something is wrong and it makes me wonder what else is going to change. Last year it was the CPR (and I am a huge advocate of the new CPR -- it just sort of depresses you that all those compresions over the years weren't being done right). This year it is smaller. I learned that psuedoseizures are an actual problem, not just someone being a psych. I learned that there are many grades to a seizure, not just the tonic clonic, bite your tongue, pee your pants kind. I mean, I knew that already, but having it explained in such detail brought to light that I have had some patients who I probably judged to be full of it when In fact they really did have a seizure problem.
The Epilepsy Foundation sells a video cassette called How to recognize and Classify Seizures that you can get for $40. Bob Page showed excerpts from it during his session "A Whole Lotta Shaking Going On." I should probably buy a copy and show it in educational sessions around here as penance for the times, I thought my patients were just faking it.
What else is bothering me? I came home to find a new Emergency Medical Services magazine in my mailbox. In it there was an article called "Preventing Bloggerrhea". It was a needed article advising EMS managers to make certain they have a policy on blogs and that every employee knows what it is, but I resented the implication and title -- Blogerrhea. Sure, there are some bloggers who have stepped over the line, but still to compare blogs with diarrhea, that's pompous and ignorant. The only article I've ever read about blogs in the magazine and it compares them to watery crap. There are a lot of bloggers out there who are doing good work. I am going to try to make a better effort to highlight other bloggers -- important voices from the field who should be heard.
Maybe I'm going through a midlife paramedic crisis. Instead of feeling fresh, I feel stale.
I met with the bloggers/podcasters and as much as I like blogging, I am feeling that podcasting is where its at as far as the future. Its like books and movies. But I was meant to write, so it shouldn't matter. I need to just keep doing what I do.
I check my hit counters too much. I get around 220 a day. I've been as high as 400 lately, as low as 150. I check it way too often. Why should I care? I worry sometimes the quality of my writing suffers when I try to crank out some quantity, some new content. I'm from the tedious rewrite school, but I have sort of gotten out of that style. I need to think about the best way to do this blog, to keep it fresh. Sometimes I think I have had my say, it is time to let other voices take the stage.
I'm a little depressed I was going to be precepting Baby Medic, but there were union/administrative issues that seem to have interfered. We have a precepting list that needs to be followed in proper order, I guess. I thought it would be interesting to read two blogs about the same calls, one from the perspective of the new preceptee, the other the tired preceptor. Baby Medic was down at the JEMS conference too, and reading his account of the conference, I envy his enthusiasm, his future. I guess one way or the other I will be getting someone to precept, and that usually is good for me. Most of the new preceptees coming out this year are top of the line.
Still, I'm in a funk. Maybe it's because they turned the clock up an hour last night and I didn't find out until 12:15 when I thought I was going to bed at 11:15 -- even that too late, and had to get up at 5:00 to come to work, so I'm a little sleep deprived, a little trip tired.
Yeah, and I got a hair cut just before I went on the trip. Even I thought I was looking a little unkempt -- my hair was about to land again on my shoulders like it did when I was 17. Now I am clean cut again, and everyone is complementing me, but I feel like a sellout in some way. When I was young I had long hair, and with long hair again recently, I felt young again -- and with that I felt like my own man, like the world was whatever I wanted it to be. The problem was while one person told me I looked like a wistful old hippie, another told me I looked like an ax murderer freak.
Every so often in your life, you need to just stop and figure out what is important to you. What battles do you want to fight? What flags do you want to wave? Who do you want to love? What mark do you want to leave? What kind of person do you want to be?
I need to think about this all.
I don't want to be stale, not as person, not as a paramedic, not as a writer/blogger.
