Enough is Enough

This blog post is going to start off with a little self-assessment. When you get called out to a call, do you dread carrying someone down from the 3rd floor? Do you constantly break a sweat, to the point some of your partners may be inclined to put you on the cardiac monitor instead of your patient? Does your diet consist of anything that actually grows from the ground, and not some processed food plant in the middle of nowhere USA?

This was me at the end of last summer (2010). We would get called out to calls, that would require extrication assistance (stair chair, long board, scoop stretcher) and I found myself getting so winded after the carry that I would need to sit down in the ambulance before I could continue with my assessment and treatment. In addition to that, I would sweat…the need a towel kind of sweat.

It was embarrassing.

Around September I decided to take matters into my own hands. I will admit that I didn’t start trying to get in shape because of my job. It was because of the job that I wanted. I was looking to join Law Enforcement in some capacity, and as many of you out there know it requires a good amount of physical fitness to really succeed in that profession. Well, I went out and I tried. I did work outs at the gym, and I ran on the treadmill. I thought I was doing great. I was energetic, lost 10 pounds. Then it came time to actually go and test. 3 departments, 3 failed physical agility exams. At first, I was willing to accept that this was not my fate. I was not meant to work in Law Enforcement. It was a lazy way to avoid the harder task here, ACTUALLY getting in shape.

Finally, at the recommendation of many friends and coworkers. I started my initiation into the CrossFit world. I’ve only done one class so far, and it was the baseline workout to gauge how you are doing physically. Let’s just say it was a wake up call for me :).

I’m not on here to promote the CrossFit product, although I will personally recommend it. The reason I am here writing tonight is to talk about the overall picture of fitness. While I was doing some online research, I found an interesting article on the US National Library of Medicine, it was a study from the Carolina’s Medical Center: The Center for Prehospital Medicine, in Charlotte North Carolina. Let me give you some figures from the abstract:

  • Survey’s were sent to 58,435 providers who recertified in 2007. 30,560 (52%) returned questionnaires. Individuals missing data were removed, leaving 19,960 individual records.
  • 23.5% or 4,681 individuals who reported at least one existing health condition.
  • The mean BMI for the study participants was 27.69 kg/m(2). A normal BMI is 18.5-24.9
  • 75.3% or 15,022 individuals did not meet the Centers for Disease Control and Preventions minimum standards for physical fitness.
  • 3,394 classified themselves as current smokers.

Those are some alarming numbers! These are the best statistics published, that I could find in recent history. Let me put it to you this way, you know those frequent fliers that we all complain about. Yeah, you know…the ones with the HTN or the Hyperlipidemia, diabetes, 2 pack a day smokers, and the ones that also happen to be having the inferior wall myocardial infarction on your stretcher?

Based on these statistics, You are not any better than they are at taking care of yourself!!!

I am not here today to point fingers at anyone. Lord knows, I am not perfect (despite being a Paramedic). All I am asking you to do, as a responsible healthcare provider…is to take care of yourself first. It is a concept that we tend to forget about, usually it is overridden by our need to help people. Simply putting a few changes in our daily routine can make a huge difference. We are a tightly knit group in Public Safety, we get bent out of shape when one of our own dies. My question to you is, why are we not getting bent out of shape for something that will put you in the grave much sooner than a line of duty death?

Take this as food for thought, like I said I am not here to point fingers. Merely inspire a little motivation for a better you. I hope it helps, feel free to leave comments with your changes that you may have made to improve your overall health below. I look forward to reading them!

Stay safe my friends!

 

2012: What Will It Do For You

This post is going to be straying from the usual gun-ho EMS topics, and take it to a little bit more personal level. After all, if we don’t take care of ourselves first…how can we take care of others?

Well, its here. Its 2012. Another year, another chance, another fresh start. That being said, I’m here to offer a few personal & professional points to carry with you through 2012. They say a lot of New Years resolutions fail because they tend to be too broad, and nonspecific. In order for you to truly succeed with your resolution, make it smaller and quantifiable. Take the “I’m going to loose weight,” and make it “I’m going to be able to run five miles in 30 minutes.” Instead of saying your going to be nicer to people, actually open up your smartphone calender and block off time to go to a soup kitchen, or volunteer at a shelter. It will surprise you how quickly you will see your resolutions succeed.

Now that you have an idea on how to write your resolutions, lets think about where to direct your time and energy. This is when I tell you to analyze your professional, and personal lives.

Are they in unison?

……..Are you content?

……………….Are you HAPPY?

We work in a profession of selflessness. Day in and day out, we are asked to give up time. Time spent with our Husbands and Wives. Time spent with our children, and time spent with our friends. We miss meals, holidays, long weekends, vacations, and most importantly sleep.

I want you to think about a couple of questions:

1) Do you still see the joy out of being able to help someone in their time of need?

2) Do you feel like you are trapped, and are generally uninterested in your career any more?

If you answered no to question number one, or yes to question number 2 then it is time for you to move on. You don’t have to leave EMS, just get some sort of change to happen that will renew your love for your job. See about opportunities in training, (speaking from experience) it can be a great renewal to work with people who are excited about the career. You’d be surprised how quickly you will “get the wind back in your sails.” If Education isn’t your thing, then try a change of scenery. Bid on another station, see about cross-training so you can work in dispatch. These are just a few things that you can see about changing at work before you loose all faith in your specific Public Safety profession.

Most importantly, remember those family members, friends, and other various loved ones I talked about earlier? See them. I recently had a 2 week stretch where I didn’t work ANY overtime above my 48 hour schedule. I felt like I had weeks off. I was used to having “hours” off here and there to make it seem like days, but after resting and stuff it really was just hours. I spent time with my girlfriend, friends from college, family members, and people that really do make life seem enjoyable. That happiness is something that your patients, and your coworkers will notice, because no matter how hard you try it is not something that you can hide.

A sense of contentment is what will bring this profession into the next level. If you are contsantly talking about how being a Paramedic isn’t good enough, or is “just a stepping stone,” then that is all it will ever be. If you can’t find the enthusiasm in your job, then why even do it at all?

What ever holiday it is that you celebrate, I hope it was one filled with happiness.

Stay safe in 2012, we lost enough brothers and sisters last year.

Close your eyes…

We are going to do a little “active blogging.” I want you to take a second, put yourself in the public’s shoes who have no knowledge of what us “ambulance drivers” actually do. [Definition: Ambulance Drivers (Noun) – Medics & EMT’s who are so ignorant that they have diluted themselves down to nothing more than human beings that operate a vehicle with red and white lights, more commonly known as ambulances. Ambulances also known as Rigs, Bus, Bone Box (callous snicker), truck etc.] You are transporting a family member of theirs to the hospital, that was complaining of chest pain for the last hour. Sitting nervously in the passenger seat next to you, the family member bends and twists in ways that you are pretty sure used to be anatomically impossible to do. They see thru the pass thru in the bus, and see all sorts of wires, electronics, tubing, and needles in or around the patient. Suddenly it happens. It is the moment of truth. The moment when they ask the age old question – “What is all of that for?”

You pause, deciding to embrace this moment, or pass it off in the front of the ambulance as that awkward conversation you try to have to fill the silence. You brush off the moment, and tell her: “It’s so we can check everything out, it’s protocol.” The person looks at you puzzled, and slightly unsatisfied and faces forward….”oh, ok then.” Is her reply.

Right there, that was your moment. That was the time you could have taken to advocate for your profession. It was a chance to display your pride in what it is that you do. A chance to show the public that the big expensive ride that they are getting to the hospital is actually making life saving diagnosis and providing substantial acute care treatments, AND ALL YOU COULD SAY WAS, “ITS PROTOCOL!”

Give me a break people. I mean seriously, if you came to me to complain about your wages, your working conditions, your equipment, If I were to tell you “its protocol” I would have a couple step grievances, maybe some workplace complaints, who knows. Collecting on my desk before the week is thru.

You work in a profession where with a single act of dialing 3 digits on a phone, a stranger puts their life into your hands. You are so much more than a “ambulance driver” For those out there who’s career is a little on the crisper, maybe even well done, side of life…remember back to Paramedic or EMT school. Remember when you were excited when the instructor would lecture about such interesting topics as cardiology, or trauma? I do. For those who’s careers just got thrown on the EMS Hot Plate, don’t loose that enthusiasm. This is a great career, a rewarding career. You CAN change people’s lives out there. Don’t let that moment pass you by to educate the public on what it is that you do.

That family member I mentioned above, she’s on the City’s Board of Alderman. She is in charge of budgeting. How do you feel now about saying “it’s protocol.” I’ll tell you exactly how she will feel about it, when the budget line item comes up that pays for EMS, she’s going to remember it being protocol. She isn’t going to remember that you have life saving tools in the back of your ambulance, she isn’t going to remember an eloquent explanation of every detail that you perform on a daily basis. She is going to remember that it is just protocol.

We are shooting ourselves in the foot here people, with a 12 gauge shotgun. EMS is an awesome profession. I am proud to say that I work with an excellent group of men and women. Don’t sell yourself short in the eyes of the public, and in your own personal perception of the job. You just never know who might be watching, or listening to you.

Ten Years Later

The Towers seconds after the second plane hit.

Today was challenging. I wanted to write a deep and meaningful post today, but I decided to keep it simple instead.

I came into work today, like it was any other day. I came in, checked out my truck and signed out my narcotics. Then as usual in my routine I turned on the day’s news to see what was going on around the country. There it was. The North Tower as already on fire, and within seconds the second plane hit the South Tower. I relived that fear, and anxiety all over again almost instantly. Where did the last 10 years go?

I was left speechless all over again. This time, I knew the pain and suffering that happened that day. I was a freshman in high school when this happened. I am not going to bore you with the story of what I was doing or where I was. We all have that story. It is just another thing that united us as a nation on that day.

It is not about me today, it is about the men and women of the FDNY, NYPD, PAPD that gave their lives that day, and the countless civilians that didn’t get that choice.

This video was published on YouTube on the 6th Anniversary, but its a very moving clip and wanted to share it.

Keeping it Together, a Discussion About Unity.

So I have taken a couple weeks off from blogging. It’s been a busy end of August.

As usual, I was browsing the typical social media outlets and I saw a post from a fellow paramedic. He was mentioning how there was a showing of different agencies from around New England for (what I believe) was an EMS LODD Funeral. He was in shock that there was less than 300 people there for a LODD Funeral. To be honest, I can’t say that I blame him.

I look at the displays of unity from across the area, PD and Fire always have a strong showing at a funeral for one of their own. Thankfully, I have yet to experience a first hand EMS LODD Funeral. I have had colleauges sadly pass away due to accidents or illnesses. They are just as sad, just as tragic, but there isn’t that sense of sacrafice because it obviously was a tragic passing.

When will EMS providers get the picture about unity?

I sit around work and listen to people who do nothing, but complain, about doing work. If something goes wrong, there’s 10 people in line to throw some one under the bus, and 2 standing next to him. It is sad really. These attitudes are our biggest downfall. I would love nothing more than to see the EMS Profession grow into something that people want to make careers out of…but day after day we are sabotaging our own advancement.

My suggestion? Get involved. Get involved with National Associations, such as NAEMT (Please forgive my shameless plug). They are really making a substantial effort thru political channels to give EMS Providers the legislation necessary to bring our profession to the next level. I applaud them for doing that.

Next, share you’re ideas. We are not going to get anywhere if we don’t even try. Maybe using blogging websites, or other forms of social media opens doors I, personally, never thought of walking through.

Finally…When push comes to shove, be there. Don’t back down, don’t run away, and fight for yourself (collectively, not individually) EMS is a profession that I love very much. However the majority of EMS Systems are built on the never ending “revolving door.” Meaning there is always a constant turn over of employees and experience levels. If we ever solve these fairly substantial issues, then we will see EMS rocket into version 2.0

Empty Sky

I was relaxing between calls today at the station, and looking at random YouTube clips. Something caught my eye and almost surprised me that it was really beginning to trend. It was an acoustic performance of Bruce Springsteen preforming “Empty Sky.” It is one of the tracks off of his 9/11 tribute CD known as “The Rising.” It is a song that makes you feel the pain from the second he takes his first strum of the guitar. I have embedded the video in case you have not seen or heard the song.

There is a line at the end of one of the verses: “I want an eye for an eye, I woke up this morning to the empty sky.” I have never been able to really discribe my feelings about that day before I heard this song. I could easily throw out a series of angry words, but never be able to simplify it like he did. I still want justice, because frankly I feel like it hasn’t been served. Yes, we did send Osama to his maker, and frankly I hope he was met by a merciless God and was sentenced to infinite torture and suffering in the lake of fire.

I don’t know if American’s will ever be able to get full closure for that horrible day back ten years ago. For now, we can hope.

As part of that, we get back out on the trucks, and respond to that job…who know’s if its gonna be our last. I am going to go out an honor the men and women that died ten years ago, and everyone that has died in the search of justice, by continuing to do what I do. (yes I did mean for that to sound like a Ladder 49 paraphrase)

Until we all meet again, I will always wake up “to an empty sky.”

God Bless, and stay safe everyone.

Gotta Have Faith…

Science can be black and white. “B” happens because “A” happened first. As professionals it is easy to understand the way things happen the way that they do. That being said, do we discount the benefit of faith in our practice all too often? Every once in a while we are confronted with a case that we cannot logically explain. There is no apparent cause and effect for the patient and it seems impossible to explain. On the other hand there is several instances where there had to be some form of divine intervention to prevent death and dismemberment.

I talk a lot about the CISM process and its actual (experienced) benefit. Without that process I probably would have been in a different place than I am today. Now before you go cracking about the “Hug-Me, Hold-me Squad,” understand that is the viewpoint of the person who doesn’t care any more. You can put on the “tough as nails” exterior but you know that when push comes to shove you still have a heart.

CISM is awkward. We don’t like talking about our feelings, especially with each other. It is one thing to talk about what is obvious, the care we provided. When we dig deep down into our chests and expose the tiny cavity known as our heart, shit gets ugly. REAL QUICK. In order to control the whirlwind of issues that will come up, we approach CISM from a “wham, baam thank you ma’am” perspective. Keep it quick, dirty, and leave a trail of doubt in your path.

When done properly, CISM is proven to be the most effective tool to deal with the problems that can haunt you from helping people. I am writing this article for two reasons. First, I was inspired by the idea of faith and its role in CISM from this article http://www.emsworld.com/features/article.jsp?id=17910&siteSection=4, found on EMS WORLD. The second reason I am writing this article is to tell you my first hand experience with a CISD Meeting.

Now is when I get to tell a story. I try to stay away from war stories, frankly because they annoy the hell out of me, but this is relevant. Let’s go back to the summer of 2006. I was just cleared to work as an EMT-Intermediate at the time. I was working one of my first shifts cleared on a warm summer evening in the big bad City of Springfield. I can remember the taste of the Tony’s (Boston Rd) Pizza that I was eating. Dispatch came over the air and sent us to a call on the other side of the city. Initially it came in as an infant with a laceration.

I casually finish my bite of pizza and store it properly so that I can revisit this occasion at a later time. We begin responding down the winding streets of the “outer belt” section of Springfield. Dispatch hails us again, “Dispatch 411 – ETA for PD?”

“411- we were coming from Central Post, about another 3 minutes out.”

“Dispatch 411, message received. Per PD they are going to be transporting from scene and are looking for an intercept location.”

Puzzled I reply “ahhh – received Dispatch. Tell them we will meet them at the corner of Centennial HWY and Winter Ave.”

“Received.”

My palms get sweaty, I have been working a lot of hours due to my new-found hourly rate. I was probably over doing it.

We turn the corner onto Centennial Hwy and we are now about one block away from Winter Ave. We can already see the hue of blue LED strobe lights. I pick up the mic, and blurt “Dispatch, 411, 411 is on scene.”

I wait for a second and hear a “last unit,” simply come over the air. Out of frustration I throw the mic and get out of the vehicle. Here is where the haze begins.

I approach the cruiser, and see an older male (presumably the father) holding the toddler in a blanket as if he were swathed to keep warm. I take the child from the father in my arms. My partner and I climb into the back of the ambulance. I leave my paramedic partner to get back on the radio.

“Dispatch, 411 calling. Requesting BLS Driver Priority 1.”

…silence

“411 be advised, closest unit is out in the meadow post. ETA 15 minutes.”

I scream “Fuck it, PD is going to drive.” Oops, did I have the mic keyed?

Standing next to me was a supervisor from the police department. He pretty much ran me over trying to get to the driver’s seat. I got back into the vehicle with my partner and we were off to the local trauma center. I opened up the blanket for the first time and can just remember sitting back and going “oh shit.”

The patient had bilateral femur fractures, bilateral tib-fib fractures, gloved evulsion of both feet, and an amputated 1st digit on the patients right foot. I didn’t even know where to begin. I applied as much bleeding control as I could. Before we knew what was going on, we were pulling into the hospital and the patient stopped crying and started to become unconscious. As if this call wasn’t already bad enough right?

Our arrival at the hospital was like that of a movie star. There were cameras, other officers, and other fellow paramedics as well. We make our way down the hall to the trauma room. We transferred care, and I walked out side. It was at this point that I began to feel reality again. I opened up the back of my ambulance and stared at the mess that was that call. Not really thinking straight, I thought…

“man, I wish I finished that pizza.”

A walk landed my about 75 yards away from that ambulance and at the entrance to the hospital’s heli-pad. An officer from the city approached me and began to make small talk. His superior was not far behind him. They both asked if we were okay, and gave us both a hug. It was a simple gesture that had a profound impact on me to this day. Let’s put all the bull shit aside. When shit hits the fan, we are here for each other.

I remember thinking to myself, “I am completely fine. This is something that will pass in a day or two.”

We went back to base, “on-scened” a roll-over with ejection and one unconscious. No big deal. I can’t tell you what I did on that call, because frankly I had no F*cking clue!

At the base, there was a CISM team waiting in the office. I had no idea what CISM was supposed to be. I thought it was just a bull shit way for people to get out of the rest of their shift and take a couple of days off. So, of course I didn’t take it seriously. We talked, laughed, cried, got angry so on and so forth. The CISM team members were more than supportive about giving us their contact information and knowing that we weren’t alone in dealing with this.

Fast forward a few weeks and many hours of missed sleep. I was irritable, nasty, and very quickly approaching “burnt-out.” Definitely not good for someone who is only two years into the profession at this point. I got a bitch slap from my friends and got my butt into gear. Talked to a professional and worked out some long-standing issues I had. Forgive me for not going into detail, I just want to keep that out of it.

Do I still have your attention? Okay, good. If you scroll all the way back up to the top of this post, you will see that I started it based on faith. Whoever your God may be, he/she/it/they can often give you a deeper understanding of why things are happening. Even if that understanding is that you’re not meant to understand. In this case, thankfully the kid survived. He had obviously go thru major therapy but last call, I was told he would be just fine. I will never know if this was because of, or in spite of what I did. All I know is I got to play a role in the big plan.

I am certainly not here to preach to you as providers. We all know that we get into this profession to help each other. I am opening this part of my life to you, my fellow public safety personnel, so that you don’t forget that in the process of caring for everyone else…you still need to care for yourself.

Feel free to comment, let me know about ways that you deal with the stresses of “the job.” It is always interesting to hear about other people’s stories.