the best job in the world

There is a tendency in EMS--at least in urban areas--for paramedics to diminish the importance of our work. I mean, don't get me wrong, we deal with a lot of nonsense, but still, it's not all bullshit.

Take today.

My plan was to come home and write a funny story about heroin addict we saved. The man shouted at us indignantly, "You didn't give me Narcan, did you?"

Well, in fact we did.

The man left the ER minutes after we arrived.

Note to self: don't do mouth-to-mouth on a junkie, even if you're alone. They don't deserve it.

But then we picked up an old guy with asthma. He didn't speak much English, and for that matter, he couldn't say a whole lot given his level of distress.

We hit him with the whole kit & capoodle: Albuterol x 4, 2 grams of Mag, and 125mg of Solu-Medrol. (For those of you who don't know, that's a fairly aggressive asthma treatment regimine). By the time we got to the ER, he didn't even need oxygen or his breathing treatment.

His daughter, who spoke broken English, thanked us profusely.

I smiled as I did the paperwork. There's this feeling, you know, when you feel like you really did the right thing. I didn't have to get on the phone and call for Mag or Solu-Medrol. I could have just taken him to the hospital, ya know, he would have lived. But he needed the good shit, he needed what we could give.

It was just so...so gratifying to see this guy 180. I mean, we fixed him, we did it.

The doctors in the ER give the orders. The nurses execute them. But me, I get to do both. I use my brain and my hands.

Last week one of the docs at work asked if I was thinking of med school. Nope, I said, what I'm doing no is my favorite part of medicine. I mean, being a doc would be cool, but you're not as directly involved in patient care. I mean, sometimes you are. But it's not your job to provide for the whole of the patient's needs. Doctors are the brains, nurses are the heart, but paramedics get to have both.

I mean, I'm young man, and EMS is a young man's profession. But still, I love my job. I love the fact that I get to make decisions--I mean, we're talking real decisions here, life or death shit--and then I get to execute them. It's just so damn gratifying.

In my other life, I am trying to be a writer. It's a cerebral world, ya know, but when I am here, at work, I feel present, I feel alive in way that I don't in anything else I do. I lose myself in medicine, and that...that is the best feeling in the world.

Comments

[Mama Mia]

Great blog and great work with your patients, but I do take exception to your inference that nursing is brainless task following. You use your assessment skills to implement the appropriate protocol. I work from my assessment skills to discuss directly with the physician about the appropriate care. We are more alike than you think, which is partly why I love both worlds so much.

[Mama Mia]

Great blog and great work with your patients, but I do take exception to your inference that nursing is brainless task following. You use your assessment skills to implement the appropriate protocol. I work from my assessment skills to alert the physican and discuss directly with the him/her about the appropriate care. We are more alike than you think, which is partly why I love both worlds so much.

[Tyson]

You're right about Nursing. It's not brainless, i mean, i know that, i take my patients to the ER where there are, ya know, nurses. But as a nurse in an Emergency room you will never have the degree of independence that an EMS provider has in the field. It's not really a knock on nurses, it's just the different roles we have. Of course, that independence is a big part of why I am in EMS

[ems_wench]

Tyson, you hit the nail on the head. Hubby is a medic, I’m an EMT-B (read ambulance driver). We are also ED Techs in the local hospital. My scope of practice is expanded while working in ER, but the medics’ scope is limited. Hopefully this is only until the rules are written for the law just passed to allow us to function in ED.

Hubby started out at a nurse, knew he was going to hate it and signed up for medic class upon graduating from nursing. He’s in the majority; no one I know would jump ship—even the better salary considered.

Medics perform from protocols and are trained by their Medical Directors to perform skills nursing staff can only perform once the orders are written. Medics perform based on protocols, but also have to think quick, decided appropriate care and execute that care, delegate when necessary, along with being in some really nasty conditions at times, pt’s with no history, no witnesses to the emergency or worse, hysterical family members, dogs running wild, litter box odors so strong you smell it for days, mice coming out of the woodwork to check out what you are doing, starting IV’s at 80 miles per hour on roads built along old cow paths. What a picture that paints, huh. From the bottom of my heart, I wouldn’t change careers unless I became unable to perform as an EMT-B. We see things no one should see…but we do it because someone has to do it. If we can handle it, more power to us. Nursing in ED, from my observations, sucks. I couldn’t do it and I am so thankful for those who can.

PS – ya gotta love those unresponsive diabetic emergencies – D50 and you see instant gratification. That’s what makes me forget about that stinky litter box.

[S.]

You put into words exactly why I don't want to be an RN or MD.

I always described MDs as "Monday morning quarterbacks" in the way that they don't spend as much time w/the patient as RNs do. And RNs, well, they just get crapped on from every angle-figuratively and literally.

[Lola, nurse]

The most important about one's job i sto feel present and alive at work.

[Barbara]

I was going to post a comment regarding the idea of nurses as task-mongers....but I see MamaMia beat me to it. Do allow me to say this, though...in smaller ERs we get it all...it's not specialized and half the time the docs are just family practice docs. It's not uncommon for me to tell the doc that "I took the liberty of doing...." After 18 yrs experience I am usually deferred to in that respect.

And "S" hit the nail on the head. We ARE crapped on from every angle. Sheesh.

Keep it up, man. Always do what makes you happy.