I'd almost forgotten what a 12 hour shift in the middle of the night feels like. It started off like any first shift at a new job, although it's nice that I know the employees, and the equipment, and the layout of most of the rooms. But just enough has changed that I feel I'm in some slightly skewed alternate ER- the beds have been renumbered, the crash carts have been reorganized, the charts have been shuffled. At first I contributed my mild confusion to the early a.m. pre-coffee haze, but then realized that this time, it wasn't entirely me.
first IV of the day is an EJ. No, I didn't get to do it, although I could have- the patient had ropes for veins. With the EJ came a marriage proposal from the patient, my first of two for the shift. DeepThroat, my Medic trainer, teases me a little. I tell him it's a little different in the back of an ambulance, where it's just me, the patient, and a bunch of 14 g needles. That combination tends to curb the flirtation a bit.
With DT hovering over my attempts on the next several patients, I botch 4 out of 5 IVs. Grrrr. Granted, I haven't started an IV in a couple of months, and each patient greeted me with "I'm a tough stick," but still. After lunch, DT decided to leave me be, and hovered outside the room instead of over my shoulder and- ba da bing ba da boom- I'm 7 for 7 the rest of the shift, with only one AC. Hallelujah, the tingle is back in the fingertips.
The cops showed up in the early a.m. with a meth head. The guy had been pounding on his sister/cousin/girlfriend's car at 5 a.m (he wasn't terribly clear on this, so take your pick- although since this is meth central, one person could actually be all three). The guy is barefoot, dirty and bloodstained, with blackened burn blisters at both corners of his mouth from sucking on a hot pipe. He is also about 6 feet of wirey, sinewy muscle. Not an ounce of fat on this guy. The night nurses give him Haldol and Ativan, and we calm him enough to get him to a bed. He's definitely high as a kite, but I think he was less violent than terrified of the cuffs, the bright lights, the restraints in the back of the cop car.
Later in the day, an ambo brings in a homeless guy who is somewhat disagreeable. He was drunk, and got in a fight, and doesn't really want to be here. I am amazed at the disgust his nurse shows him, how rude she is. DT says she's old school, and doesn't like change. Whatever. I can understand getting burned out and sick of the so-called human trash- I live in the middle of it. But I also know that most humans, if given the opportunity, will rise to the occasion when treated like humans instead of pond scum. The guy was lying on the bed, shivering, soaked through from the rain, and his nurse hadn't even given him a sheet. I put my hand on his shoulder, introduced myself. He lowered his arm from his eyes, told me his name. Smiled. I covered him with a couple of dry, warm blankets. He thanked me. The doc shows up, gives the guy a once over, orders dinner for him. Treats him like a human being. Thank god for that doc. I wanted to fwap the nurse over the head with a purple nitrile glove- fwap fwap fwap. But that may not have been my most excellent idea, considering it was only my first day.
I can't think of one employee that I don't actually like at Meth Central ER. Most are good people with high standards and excellent training. The nurses generally fall into one of three categories- the ones who appreciate the medics and view us as colleagues, the ones who view us as nothing more than housekeeping with IV skills, and the ones who resent the hell out of us. Luckily, the nurses in the first category far outnumber the other two, but I am only now realizing the intricacies of politics in the hospital setting- the docs are treated with kid gloves, but nudged along by the nurses, who seem to think the docs have no idea what they're doing. The docs tolerate this because, well, it's best to humor the nurses, don't you think?
Wednesday, February 28, 2007
Tuesday, February 20, 2007
it's a miles davis kind of day
you know, one of those cloudy rainy cold kind of blue days. Give me some Miles, give me some Coltrane, give me something that resonates with the mood of my restless, broken heart.
I'm a single mom, which in many ways is a good thing, although it can be difficult at times. MixMan and Miss Diva are lucky (and by default, I am also lucky) that The Dads (always referred to collectively) are so much a part of their lives. Both I and my two children are truly blessed, in so many different ways.
My son is turning 7 next month. He was born ten days early in Y2K after 23 hours of drug-free labor, 13 of it very, very hard. Nuchal cord, mild distress. Five pounds, 13 ounces. The first few weeks, when he would get colicky, I'd put music on the stereo (he liked just about anything, but jazz, particularly Thelonious Monk and Coltrane, soothed him the most) and we'd dance around my tiny apartment, MixMan tight against my chest. He hated the harmonica, though. My sister tried to play for him (and she's rather good) and he would scream like he was being pinched. Hard. Every single time.
When MixMan was 4 1/2 months old, I noticed a sudden loss in his responsiveness to the sound of my voice. I'd walk into a room and he wouldn't turn his head; he no longer smiled when I sang to him. But it didn't happen all the time, and his dad and I convinced ourselves it was nothing to worry about. But by 8 months, when the random noises he made should have been shaping themselves into vowels and recognizable sounds, he was still shrieking. He got hearing aids 2 months later.
My son is one of the sweetest, most loving little boys in the world. He has a deep, abiding love for animals and his people. He is generous to a fault, although not in ways you might recognize. He terrorizes his little sister, just like any good brother should. He also has autism spectrum disorder.
Watching my little boy collapse in a frantic pile of writhing limbs, screaming the same thing over and over, saying his throat hurts from all the screaming but being unable to stop, and finally covering his own ears because the sound of his own screaming is unbearable. . . it breaks my heart. So I do what any mother would: I sit down beside him. Pull him into my lap. Take out his hearing aids. Press his head against my chest and hum a riff from Miles so he can feel the vibration in his own body. Rock gently. And it's almost like the first few weeks after he was born.
Almost.
I'm a single mom, which in many ways is a good thing, although it can be difficult at times. MixMan and Miss Diva are lucky (and by default, I am also lucky) that The Dads (always referred to collectively) are so much a part of their lives. Both I and my two children are truly blessed, in so many different ways.
My son is turning 7 next month. He was born ten days early in Y2K after 23 hours of drug-free labor, 13 of it very, very hard. Nuchal cord, mild distress. Five pounds, 13 ounces. The first few weeks, when he would get colicky, I'd put music on the stereo (he liked just about anything, but jazz, particularly Thelonious Monk and Coltrane, soothed him the most) and we'd dance around my tiny apartment, MixMan tight against my chest. He hated the harmonica, though. My sister tried to play for him (and she's rather good) and he would scream like he was being pinched. Hard. Every single time.
When MixMan was 4 1/2 months old, I noticed a sudden loss in his responsiveness to the sound of my voice. I'd walk into a room and he wouldn't turn his head; he no longer smiled when I sang to him. But it didn't happen all the time, and his dad and I convinced ourselves it was nothing to worry about. But by 8 months, when the random noises he made should have been shaping themselves into vowels and recognizable sounds, he was still shrieking. He got hearing aids 2 months later.
My son is one of the sweetest, most loving little boys in the world. He has a deep, abiding love for animals and his people. He is generous to a fault, although not in ways you might recognize. He terrorizes his little sister, just like any good brother should. He also has autism spectrum disorder.
Watching my little boy collapse in a frantic pile of writhing limbs, screaming the same thing over and over, saying his throat hurts from all the screaming but being unable to stop, and finally covering his own ears because the sound of his own screaming is unbearable. . . it breaks my heart. So I do what any mother would: I sit down beside him. Pull him into my lap. Take out his hearing aids. Press his head against my chest and hum a riff from Miles so he can feel the vibration in his own body. Rock gently. And it's almost like the first few weeks after he was born.
Almost.
Monday, February 19, 2007
call FUBAR #1
I wish I'd started writing this while I was actually working on my training. Of course, it's the calls that I screwed up on that stick with me, and it's easy to forget the ones that went well. I figure, though, that as long as I can learn from them and not make the same mistake twice I'm okay. RevMedic reminded me frequently that mistakes like this are the reason it is called "practicing" medicine, because we constantly learn and grow with each experience.
It had been a fairly slow day for The Rev and I early in my training. The call came in as cx pn, the address way out in the boonies- took us over 10 minutes to get there, even going c-3. We find a man lying on his bed, barely responsive; a single firefighter has responded and a family member stands by, says his only previous hx is chronic pn, but he'd been in to the clinic for a long-lasting cold a few days before. I ask him the standard OPQRST, but he's unable to answer; I ask him to point out where the pn is, and his hand moves to his right side, hovering over the lower part of his ribcage. I ask him if it gets worse when he breathes in or out. No answer. Lung sounds are clear. No fever. SPO2 is around 90 on the O2 that FD has placed. BP isn't great, but isn't alarmingly low, either. 12 lead shows a controlled A-fib. CBG is fine. My mind is racing. I'm thinking pneumonia with that "long-lasting cold," but all I've got is my gut to go on. The Rev mentions the man's slightly puffy legs; considers furosemide. . .but that just doesn't sit right with me for some reason. RevMedic's searching the house for meds, finds an awful lot of empty methadone bottles. Of course! Pupils are constricted but not pinpoint, but I'm so relieved to find something to treat that my awareness goes out the window. I dig for an IV, can't get one. The Rev gets one in the hand, finally, and I push 0.5 mg of Narcan, standard for this company and most others, although things were a tad different during my internship. SPO2 rises a gratifying percentage. We're in the process of figuring out how to move this short, stout man from his bed to the gurney when I hear a noise. It doesn't register, at first-- I'm so focused on the task at hand-- until The Rev taps me on the shoulder. "Your patient is snoring." He hands me an NPA. And as I lube it and push it into the patient's nose with absolutely no response, the jumble of puzzle pieces that had been falling into place rearrange themselves. This can't be. . .if his SPO2 is rising, his mentation should be improving. If the call wasn't FUBAR before this, it's definitely heading in that direction now, and at an alarming speed. I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug. We move him with no grace or fanfare to the gurney, strap him in, and wheel him out to the bus. The firefighter says he'd come with us but he's the only one covering his district today. We head out c-3. Halfway in, my patient starts frothing. It is thick, and yellow, and not at all attractive. I knock on the partition, tell The Rev we need to intubate. He pulls over, heads into the back. I try to open my patient's mouth with the standard finger pry and his teeth snap shut, narrowly missing my thumb. I try again, and his jaw is clamped so tight I probably couldn't get it open with a hammer and a prybar. I am not at all impressed with my performance from this point on. I completely blanked on my sux dosage, almost forgot the Versed, and missed both tube attempts. I am sweating and close to crying, because I still cannot figure out what is wrong with this patient. Rev gets him tubed and on the vent, and we continue on. My radio report is remarkably coherent. My mind is not. The ambulance looks like a war zone. My pt starts frothing up the tube. I'm scrabbling through suction caths, the vent is beeping, and now he's bucking the tube. The vec falls out of my hand and goes skittering under the gurney. I go to get the vent on the portable O2 and realize it's empty. ER staff pulls out the gurney, they get him into a room, they take over. The Rev and I clean up. My written report finished, we head back home. Two days later, our physician advisor skins us upside and down. He insists this pt needed Lasix. I do not concur. We check with the ICU, discover the patient had an atypical pneumonia, had almost developed ARDS. Pt received 2 L of fluid in the ER, another 2 in the ICU. Lasix would have been catastrophic.
The list of things I learned from this call numbers in the hundreds. Seriously. I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition. I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia. The Rev taught me a way to prepare meds for an RSI that would prevent vials and syringes from slipping out of my butterfingers. My chart had been shoddily written, with some important things left out- the fact that our pt had trismus, and needed RSI instead of a basic intubation, the fact that the other medic unit was on another call, and could not assist, the fact that the FD had only one available person and was unable to ride along. A glaring typo in the vec dosage.
I forget, sometimes, that every new medic goes through a crisis of faith/education/whatever. But most new medics have something that I missed- that initial feeling of being unstoppable, the paragod factor that allows them the illusion of self-confidence while they build up the real thing. Self-doubt and perfectionism can both be crippling, and in my time, I've had scads of both.
It had been a fairly slow day for The Rev and I early in my training. The call came in as cx pn, the address way out in the boonies- took us over 10 minutes to get there, even going c-3. We find a man lying on his bed, barely responsive; a single firefighter has responded and a family member stands by, says his only previous hx is chronic pn, but he'd been in to the clinic for a long-lasting cold a few days before. I ask him the standard OPQRST, but he's unable to answer; I ask him to point out where the pn is, and his hand moves to his right side, hovering over the lower part of his ribcage. I ask him if it gets worse when he breathes in or out. No answer. Lung sounds are clear. No fever. SPO2 is around 90 on the O2 that FD has placed. BP isn't great, but isn't alarmingly low, either. 12 lead shows a controlled A-fib. CBG is fine. My mind is racing. I'm thinking pneumonia with that "long-lasting cold," but all I've got is my gut to go on. The Rev mentions the man's slightly puffy legs; considers furosemide. . .but that just doesn't sit right with me for some reason. RevMedic's searching the house for meds, finds an awful lot of empty methadone bottles. Of course! Pupils are constricted but not pinpoint, but I'm so relieved to find something to treat that my awareness goes out the window. I dig for an IV, can't get one. The Rev gets one in the hand, finally, and I push 0.5 mg of Narcan, standard for this company and most others, although things were a tad different during my internship. SPO2 rises a gratifying percentage. We're in the process of figuring out how to move this short, stout man from his bed to the gurney when I hear a noise. It doesn't register, at first-- I'm so focused on the task at hand-- until The Rev taps me on the shoulder. "Your patient is snoring." He hands me an NPA. And as I lube it and push it into the patient's nose with absolutely no response, the jumble of puzzle pieces that had been falling into place rearrange themselves. This can't be. . .if his SPO2 is rising, his mentation should be improving. If the call wasn't FUBAR before this, it's definitely heading in that direction now, and at an alarming speed. I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug. We move him with no grace or fanfare to the gurney, strap him in, and wheel him out to the bus. The firefighter says he'd come with us but he's the only one covering his district today. We head out c-3. Halfway in, my patient starts frothing. It is thick, and yellow, and not at all attractive. I knock on the partition, tell The Rev we need to intubate. He pulls over, heads into the back. I try to open my patient's mouth with the standard finger pry and his teeth snap shut, narrowly missing my thumb. I try again, and his jaw is clamped so tight I probably couldn't get it open with a hammer and a prybar. I am not at all impressed with my performance from this point on. I completely blanked on my sux dosage, almost forgot the Versed, and missed both tube attempts. I am sweating and close to crying, because I still cannot figure out what is wrong with this patient. Rev gets him tubed and on the vent, and we continue on. My radio report is remarkably coherent. My mind is not. The ambulance looks like a war zone. My pt starts frothing up the tube. I'm scrabbling through suction caths, the vent is beeping, and now he's bucking the tube. The vec falls out of my hand and goes skittering under the gurney. I go to get the vent on the portable O2 and realize it's empty. ER staff pulls out the gurney, they get him into a room, they take over. The Rev and I clean up. My written report finished, we head back home. Two days later, our physician advisor skins us upside and down. He insists this pt needed Lasix. I do not concur. We check with the ICU, discover the patient had an atypical pneumonia, had almost developed ARDS. Pt received 2 L of fluid in the ER, another 2 in the ICU. Lasix would have been catastrophic.
The list of things I learned from this call numbers in the hundreds. Seriously. I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition. I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia. The Rev taught me a way to prepare meds for an RSI that would prevent vials and syringes from slipping out of my butterfingers. My chart had been shoddily written, with some important things left out- the fact that our pt had trismus, and needed RSI instead of a basic intubation, the fact that the other medic unit was on another call, and could not assist, the fact that the FD had only one available person and was unable to ride along. A glaring typo in the vec dosage.
I forget, sometimes, that every new medic goes through a crisis of faith/education/whatever. But most new medics have something that I missed- that initial feeling of being unstoppable, the paragod factor that allows them the illusion of self-confidence while they build up the real thing. Self-doubt and perfectionism can both be crippling, and in my time, I've had scads of both.
Wednesday, February 14, 2007
hungry hungry HIPAAs
Second day of orientation at MethCentral MedCenter. Had to go in a tad early for a chest x-ray since I had a positive skin test in 2004 (well, not really; it turns out the damn stuff was contaminated and what was initially thought to be a positive result bump got very painful and red and swollen and kept growing until it finally erupted in a slew of pus-ish goo about 4 months later. I still have the scar!!). In any case, I no longer get the skin tests. I get chest x-rays.
Ahem. So the radiologist calls my name, and I follow him into the dark hallways of radiology. He's a little bit gawky, still kind of looks like he hasn't grown into his nose and limbs yet. He turns around and looks at me, clears his throat. "So, are you wearing a bra and all that?"
Well. Let me see. I know I haven't got the biggest boobs in the world, and I happen to live in a hippie mecca, but I don't dress like a hippie, and I don't stink of patchouli, and there are more than token bumps under my shirt, so yes, chances are, I'm wearing a bra. But what the hell does he mean by "all that"? A corset? Push-ups? Nipple clamps? I decide not to ask. He instructs me on the use of a hospital gown (?!), tells me that if I have a problem tying it he'd be happy to do it for me.
Yeah, right.
Orientation is another long day of sitting and listening. My brain is swimming in its CSF, drowning in all this information, paperwork, check here sign here answer these questions true false multiple choice. HIPAA, patient safety, disaster protocols. We learned all the code codes (code blue, red, evac, 10, etc). I'm downing coffee like it's water, and my eyelids are still drooping.
Finally, a break, and I head to the ER for a brief reprieve. I talk to the charge nurse, find out I still don't get on the schedule until I finish with the RN orientation this week and next. Three more days of sitting, three more days I don't get to stick anyone with needles. But I find out the three medics I'll be training with are my three favorite medics in the department-- there's DeepThroat, the one who has kept me in the loop this whole time about possible job openings (he'd call and leave whispered messages on my machine every now and again: "psssst. Firefighter Girl. There's something you should know. . ." but I think he only did it so he'd get a bonus when I got hired. Then there's the RN Paragod, who has been around for ages, but is at the end of nursing school and will be leaving the department for a different one when he graduates. And then there's Stu. Good old Stu.
He's young, Stu is. Been a medic for only a couple of years. We bonded during my ER clinicals over a truly remarkable code brown (that one's not in the orientation curriculum, but if you don't know what it is. . .guess). When the stream first hit the floor with a splat and the panicked doc called for help, Stu just shook his head and grabbed the Vicks, rubbed some under my nose, and we rolled up our scrubs sleeves (so to speak) and dove in, log-rolling the bariatric patient toward us to avoid the spray. Yup. I tell ya. There's a lot you can learn about a person in a situation like that.
So. A couple more weeks before I can get my (gloved) hands bloody and dirty again, but it's going to be worth the wait.
Ahem. So the radiologist calls my name, and I follow him into the dark hallways of radiology. He's a little bit gawky, still kind of looks like he hasn't grown into his nose and limbs yet. He turns around and looks at me, clears his throat. "So, are you wearing a bra and all that?"
Well. Let me see. I know I haven't got the biggest boobs in the world, and I happen to live in a hippie mecca, but I don't dress like a hippie, and I don't stink of patchouli, and there are more than token bumps under my shirt, so yes, chances are, I'm wearing a bra. But what the hell does he mean by "all that"? A corset? Push-ups? Nipple clamps? I decide not to ask. He instructs me on the use of a hospital gown (?!), tells me that if I have a problem tying it he'd be happy to do it for me.
Yeah, right.
Orientation is another long day of sitting and listening. My brain is swimming in its CSF, drowning in all this information, paperwork, check here sign here answer these questions true false multiple choice. HIPAA, patient safety, disaster protocols. We learned all the code codes (code blue, red, evac, 10, etc). I'm downing coffee like it's water, and my eyelids are still drooping.
Finally, a break, and I head to the ER for a brief reprieve. I talk to the charge nurse, find out I still don't get on the schedule until I finish with the RN orientation this week and next. Three more days of sitting, three more days I don't get to stick anyone with needles. But I find out the three medics I'll be training with are my three favorite medics in the department-- there's DeepThroat, the one who has kept me in the loop this whole time about possible job openings (he'd call and leave whispered messages on my machine every now and again: "psssst. Firefighter Girl. There's something you should know. . ." but I think he only did it so he'd get a bonus when I got hired. Then there's the RN Paragod, who has been around for ages, but is at the end of nursing school and will be leaving the department for a different one when he graduates. And then there's Stu. Good old Stu.
He's young, Stu is. Been a medic for only a couple of years. We bonded during my ER clinicals over a truly remarkable code brown (that one's not in the orientation curriculum, but if you don't know what it is. . .guess). When the stream first hit the floor with a splat and the panicked doc called for help, Stu just shook his head and grabbed the Vicks, rubbed some under my nose, and we rolled up our scrubs sleeves (so to speak) and dove in, log-rolling the bariatric patient toward us to avoid the spray. Yup. I tell ya. There's a lot you can learn about a person in a situation like that.
So. A couple more weeks before I can get my (gloved) hands bloody and dirty again, but it's going to be worth the wait.
Saturday, February 10, 2007
search and rescue, country style
I love drill day. I especially love drill day when the drill is in a crappy little mobile home that I know we get to burn in a few weeks. This drill, though, is SAR- search and rescue-to help Captain Snappy, the training officer, train all the newbies. The mission: Find and remove from harm our victim, Rescue Randy.
Let me set the stage:
The mobile home is set on a hill of dirt. The only vegetation is dead blackberry brambles, each stalk as thick as a rope. The carpet on the inside of this place is soaked with what I'm hoping is water, as opposed to some other unpleasant substance. There's also a large bag of Krusteaz Buttermilk pancake mix torn open in the middle of the floor, and a layer of flour coats everything. There's quite a paste forming on the carpet of the living room. There are toys and cast off things everywhere; cabinets torn from hinges, holes in the floor. You can see the ground several feet below.
I'm engineering (if you can call it that) so that the newbies get some experience with the officers on SAR. About 25 minutes left of drill time, and Captain Snappy decides he wants the last two senior firefighters (that would be myself and Ms. J, the only other female on the department) to do a run through. We mask up and head in, faces covered with our hoods so we can't see. I have the nozzle and the halligan, Ms. J has the radio. We head right, a quick search through the kitchen, and continue down the hall, pausing at each doorway. I leave Ms. J and the nozzle at the door, and take the halligan in, sweeping it with my left arm while keeping my right foot or hand in contact with the wall all the time. On one broad sweep, my halligan hits something. It makes a very loud noise. The noise it makes as it falls on me is even louder, and the noise I make as it lands on me takes the cake, particularly since I have my amplifier turned on. I'm flat on the floor on my stomach, spread eagle under a damn door. I'm laughing so hard I know I'm sucking air. . .I hear Ms. J at the door of the room screaming "Firefighter Girl! Can you hear me!!" And the most I can get out between guffaws is "collapse!" "collapse!" And all the firefighters watching me from outside do just that. In fact, they are so entertained that they decide to come in and follow us through the rest of our initial search. I can hear their little comments and shuffling bunker boots behind me as I crawl through the hallway.
The next doorway, it turns out, leads to the bathroom. I know this because when my Krusteaz coated gloves hit the linoleum, I shoot right over the nozzle and don't stop until my halligan hits the base of the counter 4 feet away. I've still got the hose with my foot, thank goodness, and I've definitely maintained contact with the wall. I search the cabinets and the little closet, and then. . .I've found our victim, Randy, in the bathtub.
He's a heavy bastard, 175 lbs of dead weight, missing a forearm from an escapade a certain firefighter had with him last year that may have involved a long chain, the staff rig, and a gravel road, although I could be wrong. More likely, the arm came off from somebody yarding on it during a different SAR drill (you know the firefighter motto. . .if it doesn't work, force it. . .). In any case, the easiest way to get this sexy beast out of the tub is with webbing. I loop my webbing under his armpits, and then get Ms. J's done up the same way. About then is when I realize there's a toilet between the bathtub and the doorway. I know this because I smacked my head on it when I tried to get at Randy's feet.
Victim removal is not a tidy thing. It's not particularly gentle, either, and in zero visibility, frankly, you're going to run into things. I accept this. Chances are, your victim's going to end up with some bruises. I accept this, as well. Ms. J is on the other side of the toilet, and can't get much purchase, so it's pretty much up to me. I grab onto the webbing, we count to three, and I feel Randy lift over the edge of the tub. The last thing I want is him wedged between the toilet and the tub, so I keep pulling. I've got both feet propped against the edge of the tub, and I'm pulling, up and over, up and over. And there's a scraaaaaaape craaaaaash boom spray and water everywhere. I check the bale of my nozzle, which has somehow miraculously remained closed during the fray. I hear Ms. J on the other side of the toilet, her voice more muffled than usual. The sound of water flowing is getting louder, and I hear someone from the audience start laughing. (thank you. thank you very much.) And it turns out that I took off the lid, seat, and tank cover from the toilet, pulled part of the tank away from the wall, and managed to turn on the bathtub faucet. As I said, victim removal is not a tidy thing. But Randy's out, although he's now on top of me.
From there, we're pretty much home free, just have to get him outside. There was a small incident with Ms. J mistaking me for Randy, yanking on my boot and screaming "I've got him! I've got him!" While I was trying desperately to maintain my hold on Randy's leg. When what she thought was Randy started kicking her, she re-evaluated her decision. By this time, she's trying to give a report to command on what her hold up is (she wisely decided not to mention that the two of us were now wedged into the doorway, weak with laughter. She did manage to tell command that we were planning an exit through the back door, although I'm not sure how much of that was understood by command because Ms. J was snorting so loudly.) The actual exit was uneventful but less than graceful, because I fell out the back door over two steep stairs, and Randy landed on his head next to me.
Guess what? Mission accomplished. Our victim is most likely now a paraplegic, but hey. . .details.
Let me set the stage:
The mobile home is set on a hill of dirt. The only vegetation is dead blackberry brambles, each stalk as thick as a rope. The carpet on the inside of this place is soaked with what I'm hoping is water, as opposed to some other unpleasant substance. There's also a large bag of Krusteaz Buttermilk pancake mix torn open in the middle of the floor, and a layer of flour coats everything. There's quite a paste forming on the carpet of the living room. There are toys and cast off things everywhere; cabinets torn from hinges, holes in the floor. You can see the ground several feet below.
I'm engineering (if you can call it that) so that the newbies get some experience with the officers on SAR. About 25 minutes left of drill time, and Captain Snappy decides he wants the last two senior firefighters (that would be myself and Ms. J, the only other female on the department) to do a run through. We mask up and head in, faces covered with our hoods so we can't see. I have the nozzle and the halligan, Ms. J has the radio. We head right, a quick search through the kitchen, and continue down the hall, pausing at each doorway. I leave Ms. J and the nozzle at the door, and take the halligan in, sweeping it with my left arm while keeping my right foot or hand in contact with the wall all the time. On one broad sweep, my halligan hits something. It makes a very loud noise. The noise it makes as it falls on me is even louder, and the noise I make as it lands on me takes the cake, particularly since I have my amplifier turned on. I'm flat on the floor on my stomach, spread eagle under a damn door. I'm laughing so hard I know I'm sucking air. . .I hear Ms. J at the door of the room screaming "Firefighter Girl! Can you hear me!!" And the most I can get out between guffaws is "collapse!" "collapse!" And all the firefighters watching me from outside do just that. In fact, they are so entertained that they decide to come in and follow us through the rest of our initial search. I can hear their little comments and shuffling bunker boots behind me as I crawl through the hallway.
The next doorway, it turns out, leads to the bathroom. I know this because when my Krusteaz coated gloves hit the linoleum, I shoot right over the nozzle and don't stop until my halligan hits the base of the counter 4 feet away. I've still got the hose with my foot, thank goodness, and I've definitely maintained contact with the wall. I search the cabinets and the little closet, and then. . .I've found our victim, Randy, in the bathtub.
He's a heavy bastard, 175 lbs of dead weight, missing a forearm from an escapade a certain firefighter had with him last year that may have involved a long chain, the staff rig, and a gravel road, although I could be wrong. More likely, the arm came off from somebody yarding on it during a different SAR drill (you know the firefighter motto. . .if it doesn't work, force it. . .). In any case, the easiest way to get this sexy beast out of the tub is with webbing. I loop my webbing under his armpits, and then get Ms. J's done up the same way. About then is when I realize there's a toilet between the bathtub and the doorway. I know this because I smacked my head on it when I tried to get at Randy's feet.
Victim removal is not a tidy thing. It's not particularly gentle, either, and in zero visibility, frankly, you're going to run into things. I accept this. Chances are, your victim's going to end up with some bruises. I accept this, as well. Ms. J is on the other side of the toilet, and can't get much purchase, so it's pretty much up to me. I grab onto the webbing, we count to three, and I feel Randy lift over the edge of the tub. The last thing I want is him wedged between the toilet and the tub, so I keep pulling. I've got both feet propped against the edge of the tub, and I'm pulling, up and over, up and over. And there's a scraaaaaaape craaaaaash boom spray and water everywhere. I check the bale of my nozzle, which has somehow miraculously remained closed during the fray. I hear Ms. J on the other side of the toilet, her voice more muffled than usual. The sound of water flowing is getting louder, and I hear someone from the audience start laughing. (thank you. thank you very much.) And it turns out that I took off the lid, seat, and tank cover from the toilet, pulled part of the tank away from the wall, and managed to turn on the bathtub faucet. As I said, victim removal is not a tidy thing. But Randy's out, although he's now on top of me.
From there, we're pretty much home free, just have to get him outside. There was a small incident with Ms. J mistaking me for Randy, yanking on my boot and screaming "I've got him! I've got him!" While I was trying desperately to maintain my hold on Randy's leg. When what she thought was Randy started kicking her, she re-evaluated her decision. By this time, she's trying to give a report to command on what her hold up is (she wisely decided not to mention that the two of us were now wedged into the doorway, weak with laughter. She did manage to tell command that we were planning an exit through the back door, although I'm not sure how much of that was understood by command because Ms. J was snorting so loudly.) The actual exit was uneventful but less than graceful, because I fell out the back door over two steep stairs, and Randy landed on his head next to me.
Guess what? Mission accomplished. Our victim is most likely now a paraplegic, but hey. . .details.
pitchfork, trident
I have, on my left wrist, a tattoo. This tattoo happens to be from the poem "Spel Against Demons" by Gary Snyder. Perhaps my brothers (the firefighting ones, as I only have one actual male sibling) are somewhat ignorant because I've had this tattoo for ten years now, and frankly, the first time anyone ever really commented on it was when my training officer at the fire station informed me that it looked like two pitchforks f***ing. I have since been asked by at least two other firefighters just what the heck the pitchforks are doing on my wrist. So. A brief lesson in a) garden tools and b)anatomy and physiology. We'll save c) poetry for a completely different time.
A pitchfork, if I may be so bold as to state, generally has 4 tines, similar to (gasp) a fork. It is used for pitching hay, turning compost, and the like. A trident was Poseidon's scepter of choice; "tri-" meaning, of course, three, as it has three prongs.
As far as I am aware (although one never really knows what happens in the tool shed while everyone is sleeping), neither the trident nor the pitchfork have the sentience or the . . . uh. . . equipment to do the deed.
My tattoo, although not pitchfork or trident, most closely resembles the latter.
I hope this clears things up. For any of you still confused about the issue, I have pictures of both for comparison.
A pitchfork, if I may be so bold as to state, generally has 4 tines, similar to (gasp) a fork. It is used for pitching hay, turning compost, and the like. A trident was Poseidon's scepter of choice; "tri-" meaning, of course, three, as it has three prongs.
As far as I am aware (although one never really knows what happens in the tool shed while everyone is sleeping), neither the trident nor the pitchfork have the sentience or the . . . uh. . . equipment to do the deed.
My tattoo, although not pitchfork or trident, most closely resembles the latter.
I hope this clears things up. For any of you still confused about the issue, I have pictures of both for comparison.
Friday, February 9, 2007
bureaucracy sucks
Showed up right on time for filling out paperwork Thursday, looking rather spiffy, if I do say so myself. Blouse, slacks, heels (yes, heels). Shoot, I even wore pantyhose. I may have been slightly overdressed, since the other new employee showed up in jeans and a "somewhere over the rainbow" t-shirt. It took about an hour and a half to fill out everything I needed to fill out. I don't think I ever want to write my name, birthdate, and the last four digits of my social security number again. Phew! Then they hustled me up the stairs for a pee test and a blood draw (the tech laughed at me after I pointed out my best vein, then turned away and cringed when she came at me with the needle). I was then informed that I would have to come back for a physical in approximately an hour.
Okay. Sounds good. The physical included some random balance testing (walking heel to toe, starting on heel, rolling up to tip-toe) which I can't do even on a good day, people!! God help me if I ever have to do a sobriety test. . .grace is certainly not my strong point (I have been called disgraceful. . .oh, wait, that's something different), although, starting when I was in kindergarten, my parents did attempt to streamline my klutziness into something that passed for normal with years of ballet and then yoga. . .so now I'm an extremely flexible klutz.
Anyway, that segued into fit testing a mask for airborne pathogens and a decon suit physical exertion test which involved me donning the equivalent of my firefighting SCBA, a seatbelt, a car battery, a helmet, muck lucks, and a vinyl shower curtain, and running up and down the hospital hallway several times to "get my heart pumping."
Did I mention I was wearing heels? Tall ones? And have I also mentioned that I am earlythirtysomething, but because of the previously stated long-term lack of coordination, I didn't get my first pair of high heels until about a year and a half ago? I just got my training wheels off, for goodness sake! Ride a bike in heels? yeah, I can do that. Run in heels? With a bunch of extra gear on? Probably not.
So I kicked 'em off, jogged in my stockings. Got some strange looks, but that may have been because of the outfit, not the stocking feet. Finished up with a HR of 68, BP 117/76, RR 12. RN then told me that she needed all my worker's comp paperwork from my on the job shoulder strain from November.
I went home, retrieved the paperwork. Came back. Was informed that I needed a doctor's release to return to work before I could start at Meth Central. I argued, in my nicest, sweetest voice, that because I didn't miss any work for the injury, I didn't get a release to return to work. Was informed that I needed one, anyway.
Huh. So Diva Daughter and I vroomed to the MD's office clear across town. Brought bubble gum, paper, and crayons, and hunkered down in the waiting room for an anticipated long wait. After an hour, the receptionists finally took pity on us and set me up with a doc who, I've heard, ordinarily has the bedside manner of a dirtclod, but who this time managed a grunt and a smile as he signed me off. Seven minutes and a signature, for the cost of a regular appointment, of course.
Back to Meth Central Med Center. (anyone else keeping track? The tally is now at 4) Slid papers under RN's office door. Headed home, kicked off the heels, cooked dinner for my kiddos.
Tuesday, tuesday, thank my lucky stars for Tuesday. A paycheck is on the horizon. . .
Okay. Sounds good. The physical included some random balance testing (walking heel to toe, starting on heel, rolling up to tip-toe) which I can't do even on a good day, people!! God help me if I ever have to do a sobriety test. . .grace is certainly not my strong point (I have been called disgraceful. . .oh, wait, that's something different), although, starting when I was in kindergarten, my parents did attempt to streamline my klutziness into something that passed for normal with years of ballet and then yoga. . .so now I'm an extremely flexible klutz.
Anyway, that segued into fit testing a mask for airborne pathogens and a decon suit physical exertion test which involved me donning the equivalent of my firefighting SCBA, a seatbelt, a car battery, a helmet, muck lucks, and a vinyl shower curtain, and running up and down the hospital hallway several times to "get my heart pumping."
Did I mention I was wearing heels? Tall ones? And have I also mentioned that I am earlythirtysomething, but because of the previously stated long-term lack of coordination, I didn't get my first pair of high heels until about a year and a half ago? I just got my training wheels off, for goodness sake! Ride a bike in heels? yeah, I can do that. Run in heels? With a bunch of extra gear on? Probably not.
So I kicked 'em off, jogged in my stockings. Got some strange looks, but that may have been because of the outfit, not the stocking feet. Finished up with a HR of 68, BP 117/76, RR 12. RN then told me that she needed all my worker's comp paperwork from my on the job shoulder strain from November.
I went home, retrieved the paperwork. Came back. Was informed that I needed a doctor's release to return to work before I could start at Meth Central. I argued, in my nicest, sweetest voice, that because I didn't miss any work for the injury, I didn't get a release to return to work. Was informed that I needed one, anyway.
Huh. So Diva Daughter and I vroomed to the MD's office clear across town. Brought bubble gum, paper, and crayons, and hunkered down in the waiting room for an anticipated long wait. After an hour, the receptionists finally took pity on us and set me up with a doc who, I've heard, ordinarily has the bedside manner of a dirtclod, but who this time managed a grunt and a smile as he signed me off. Seven minutes and a signature, for the cost of a regular appointment, of course.
Back to Meth Central Med Center. (anyone else keeping track? The tally is now at 4) Slid papers under RN's office door. Headed home, kicked off the heels, cooked dinner for my kiddos.
Tuesday, tuesday, thank my lucky stars for Tuesday. A paycheck is on the horizon. . .
Wednesday, February 7, 2007
glory hallelujah
Soooooo. Driving from the bank this morning, where I had just deposited a significant sum of money I begged from my parents for February rent, when the cell phone rings. Diva daughter in the backseat is singing along at the top of her lungs to Nelly Furtado. (So was I, but I had to stop singing to answer the phone. . .) It's the head RN from Meth Central Hospital. He informs me the job offer is now official. I cannot contain the "Thank God" that slips out. I think maybe he doesn't hear it over Miss Diva's off-key vocals until I hear him chuckling.
Whoops.
He says sorry for not giving me more notice, but he has to have me in there tomorrow a.m. to fill out paperwork, pee in a cup, etc. so that I can start on Tuesday.
TUESDAY!!
I spent the rest of the afternoon celebrating this fabulous news by cleaning out part of the garage. Still can't get my car in there, but I think my bike might just fit.
Whoops.
He says sorry for not giving me more notice, but he has to have me in there tomorrow a.m. to fill out paperwork, pee in a cup, etc. so that I can start on Tuesday.
TUESDAY!!
I spent the rest of the afternoon celebrating this fabulous news by cleaning out part of the garage. Still can't get my car in there, but I think my bike might just fit.
Thursday, February 1, 2007
in case you were wondering what i've been up to. . .
The clock keeps ticking. Today was supposed to be my official hire date at Meth Central Hospital, but unfortunately, they forgot that they are a union hospital, and are required by law to post a position in house for a full week before hiring or some such nonsense. Nonsense because the only Paramedics in house already work in the ER as paramedic techs. But laws be laws, and I want to follow the rules. . .I hope something happens soon, though, because I feel like I'm going to gnaw my appendages off from sheer boredom. To stave off losing a hand (that would be awfully messy, really, and would probably get infected), I decided to dye my hair. Yes, really. It was one of those temporary mousse thingies, and since I won't be working for a couple of weeks, I figured I'd go for broke and go burgundy. What I ended up with was a pink scalp and no hair color difference- my hair, apparently, likes the color it is, and is somewhat resistant to change.
The closest thing I've gotten to EMS lately is my son's bloody nose and my daughter's head injury that happened when I opened the front door and the knob connected solidly with her eye. Whoot whoot! There were definitely some tears, some screaming, the usual. Oh, wait-- there was also that minor episode of projectile vomiting when I picked her up from daycare. . . I think more mothers should be paramedics, really. We're already amply prepared for it. My former field training officer told me once he's a sympathetic puker. And he gets car sick in the back of the ambulance. I raised one eyebrow in wonder. . .I've caught vomit in my hands when nothing else was available to hold it, not to mention accidents out the other end. Bring it on, I say. At the age of two, my daughter walks into the bathroom in her little white nightgown, blood pouring out a gash in her forehead. She looks a lot like Carrie at the prom, covered in pig blood. But this is Miss Diva blood, and the bump on her forehead is amazing. She tells me her brother hit her with a train. She says she needs a bandaid. Bring it on. Blood, guts, goo. Chest pain, abdominal pain, itching, weakness, shock, general furking medical, I really don't care. I haven't started an IV in a month, and I'm getting so desperate I may just start practicing on myself. . .if I didn't pass out at the sight of needles aimed in my direction. Okay, okay, we all have our little weaknesses.
Random other things:
Was at the current interest's house visiting him last week when- lo and behold- (and those of you who know me and my Seabiscuit Syndrome will find this both amusing and typical) his ex-wife called. Wanting to get back together with him. And I say this: to those women who can't make up their furking minds: once you dumped him, he became fair game. Once he dumps you, he's fair game. Oh- and I should add this, because I have gotten crap about this from a few male friends' girlfriends: If you've got a problem with him being friends with women, you should probably address those issues in therapy instead of on my phone. On the other hand, if he can't keep his peepee in his pants, you don't want him anyway, and you should probably thank the women he cheated on you with. Ahem. I do apologize. I just wanted to clear that up. Reading my former training officer's EMS blog, I'm actually jealous. . .bone drill, RSI, dopamine drip, all in one day. I've gotten desperate. . .I hadn't realized just how ingrained EMS is in me until I started drooling when I heard sirens outside. I dug out a few EKG strips from my sock drawer, went through them like flash cards. I'm considering letting my children climb on the roof just so I can do a trauma assessment when they fall off. (And if you think I'm actually serious about that, you obviously do not know me very well. . .) Although perhaps I'll try to convince one of the gangstas on the corner to clean out their gutters instead- while it would be nice to have some peace and quiet around the house, it's much easier to ship the babes off to dads' houses than call 911 for a transport. And- quite frankly- the gangstas on the corner are pretty much a waste of space, and letting me practice trauma assessments would be their one contribution to the good of humanity. Although- to be fair- they do provide good entertainment- SWAT stakeouts, drive by shootings, cops swarming over the property, guns drawn; I'm waiting for a taser episode to happen soon- as a medic, I've seen (and cleaned up) the aftermath, but never watched it happen . . .My nightly prayer: please, do not let me become a product of my environment. I'm overly sensitive to crap overflowing from the garbage, the smell of cat urine, home hair-dye jobs, too much makeup, my children's dirty faces. There is a very, very thin line between poor and poor white trash. As I hang up the wet laundry (the dryer is broken, but I've left it in the garage instead of on the front lawn- that counts for something, right?), I think I'll be okay as long as I don't bleach my hair and start shooting meth. I've been so bored, lately, that I've considered starting smoking cigarettes again- until I walk by the overflowing butt can by my neighbor's door, which does so much for the ambiance of my white trash neighborhood. Super sexy.
Was recently discussing music with the son's daddy. We share a love of the good stuff. I dunno why it is that some music has it and some doesn't. Probably just like any other art, I guess- it's all about the soul. (Was talking to daughter's daddy about art, and he mentioned that he didn't really like photorealism in painting- if he wants to see what a tree looks like, he'll look at a photo. What he wants to see in art is the artist's interpretation of a tree. . .I concur!) Back to music and soul- for example: Everclear's "Welcome to the Drama Club" is, for all intents and purposes, a great album, but I just can't get into it. There doesn't seem to be much feeling behind it. 30 Seconds to Mars, on the other hand, has somehow managed to become my favorite music, and has lasted in my car stereo for far longer than just about anything else but a hip hop mix I made once.
Hopefully, with the tax refund this year, I'll be able to afford to move. Hallelujah! Can't hardly wait. . .even though I've done an awful lot to this place-- put in a sliding glass door, a stone path, a large flower garden. . .I want my kids to be able to play outside without worrying about stray bullets and broken glass.
For dinner tonight, we're having what my son euphemistically refers to as "pasta," but which is really homemade gluten-free mac and cheese. And the babes are screaming for it now. . .better go put on the mama hat again.
The closest thing I've gotten to EMS lately is my son's bloody nose and my daughter's head injury that happened when I opened the front door and the knob connected solidly with her eye. Whoot whoot! There were definitely some tears, some screaming, the usual. Oh, wait-- there was also that minor episode of projectile vomiting when I picked her up from daycare. . . I think more mothers should be paramedics, really. We're already amply prepared for it. My former field training officer told me once he's a sympathetic puker. And he gets car sick in the back of the ambulance. I raised one eyebrow in wonder. . .I've caught vomit in my hands when nothing else was available to hold it, not to mention accidents out the other end. Bring it on, I say. At the age of two, my daughter walks into the bathroom in her little white nightgown, blood pouring out a gash in her forehead. She looks a lot like Carrie at the prom, covered in pig blood. But this is Miss Diva blood, and the bump on her forehead is amazing. She tells me her brother hit her with a train. She says she needs a bandaid. Bring it on. Blood, guts, goo. Chest pain, abdominal pain, itching, weakness, shock, general furking medical, I really don't care. I haven't started an IV in a month, and I'm getting so desperate I may just start practicing on myself. . .if I didn't pass out at the sight of needles aimed in my direction. Okay, okay, we all have our little weaknesses.
Random other things:
Was at the current interest's house visiting him last week when- lo and behold- (and those of you who know me and my Seabiscuit Syndrome will find this both amusing and typical) his ex-wife called. Wanting to get back together with him. And I say this: to those women who can't make up their furking minds: once you dumped him, he became fair game. Once he dumps you, he's fair game. Oh- and I should add this, because I have gotten crap about this from a few male friends' girlfriends: If you've got a problem with him being friends with women, you should probably address those issues in therapy instead of on my phone. On the other hand, if he can't keep his peepee in his pants, you don't want him anyway, and you should probably thank the women he cheated on you with. Ahem. I do apologize. I just wanted to clear that up. Reading my former training officer's EMS blog, I'm actually jealous. . .bone drill, RSI, dopamine drip, all in one day. I've gotten desperate. . .I hadn't realized just how ingrained EMS is in me until I started drooling when I heard sirens outside. I dug out a few EKG strips from my sock drawer, went through them like flash cards. I'm considering letting my children climb on the roof just so I can do a trauma assessment when they fall off. (And if you think I'm actually serious about that, you obviously do not know me very well. . .) Although perhaps I'll try to convince one of the gangstas on the corner to clean out their gutters instead- while it would be nice to have some peace and quiet around the house, it's much easier to ship the babes off to dads' houses than call 911 for a transport. And- quite frankly- the gangstas on the corner are pretty much a waste of space, and letting me practice trauma assessments would be their one contribution to the good of humanity. Although- to be fair- they do provide good entertainment- SWAT stakeouts, drive by shootings, cops swarming over the property, guns drawn; I'm waiting for a taser episode to happen soon- as a medic, I've seen (and cleaned up) the aftermath, but never watched it happen . . .My nightly prayer: please, do not let me become a product of my environment. I'm overly sensitive to crap overflowing from the garbage, the smell of cat urine, home hair-dye jobs, too much makeup, my children's dirty faces. There is a very, very thin line between poor and poor white trash. As I hang up the wet laundry (the dryer is broken, but I've left it in the garage instead of on the front lawn- that counts for something, right?), I think I'll be okay as long as I don't bleach my hair and start shooting meth. I've been so bored, lately, that I've considered starting smoking cigarettes again- until I walk by the overflowing butt can by my neighbor's door, which does so much for the ambiance of my white trash neighborhood. Super sexy.
Was recently discussing music with the son's daddy. We share a love of the good stuff. I dunno why it is that some music has it and some doesn't. Probably just like any other art, I guess- it's all about the soul. (Was talking to daughter's daddy about art, and he mentioned that he didn't really like photorealism in painting- if he wants to see what a tree looks like, he'll look at a photo. What he wants to see in art is the artist's interpretation of a tree. . .I concur!) Back to music and soul- for example: Everclear's "Welcome to the Drama Club" is, for all intents and purposes, a great album, but I just can't get into it. There doesn't seem to be much feeling behind it. 30 Seconds to Mars, on the other hand, has somehow managed to become my favorite music, and has lasted in my car stereo for far longer than just about anything else but a hip hop mix I made once.
Hopefully, with the tax refund this year, I'll be able to afford to move. Hallelujah! Can't hardly wait. . .even though I've done an awful lot to this place-- put in a sliding glass door, a stone path, a large flower garden. . .I want my kids to be able to play outside without worrying about stray bullets and broken glass.
For dinner tonight, we're having what my son euphemistically refers to as "pasta," but which is really homemade gluten-free mac and cheese. And the babes are screaming for it now. . .better go put on the mama hat again.
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