Thursday, January 03, 2008

Chaos and assholes

Do ER Docs go to special classes to learn how to be pricks to the medics? I think some do. I think some forget what we have to work with on the streets. I think some forget that we are not glorified taxi drivers and most important I think some forget that not all of us are paragod idiots. Some of us do in fact know what we are doing. I am in fact a good medic, despite my faults (I can't add and I can come off as a dingbat sometimes) but I am, so I've been told, a good medic. I have even been told by a seasoned ER nurse who I have known for a very long time and love and respect that I am a VERY good medic. So when I have an asshole doc tell me during a hectic call over the radio in a very condecending tone "Did you think to give your unconscious, only breathing 4 times a min Pt that you're are assisting ventalations with a BVM with Narcan?" It makes me want to be a total smart-ass back. Which I kinda was. My response was "I would be glad to give my unconscious only breathing 4 times a min Pt Narcan, do you have any other obvoious orders for me Doc? I am 3 mins away from you guys I was trying to encode you before we got there since I am assisting ventilations, We actually just got the line" ASS.

What these ER docs Have to remember is this...I am working in a 4x6 closet on wheels with an EMT Basic who may be a very good Basic, but they can only do BLS. Meaning no Lines, no drugs, no intubations. Thats all on me and me alone. And I may have Fire too...but again...BLS...If I'm lucky I might have another Medic, but usually just one. So One more pair of ALS hands so four ALS hands. I'm doing the same job that the ER doc is doing with several veteran RNs, a respiratory thereapist, an ER tech or two, maybe a resident, a PA maybe all in a cloest with deisel engine. Going down the road at 60 MPH. Do you know how hard it is to hear lung sounds with a crappy stethescope with a siren going and a turbo desiel going at the same time? It's tough. I have even had a ER doc tell me "I don't know how you people get anything done in the back of those things." I just laughed and said "That's why you're a doctor and I'm the kick ass paramedic"
"That you are my dear, you fixed the Patient, now can you take him back to the shelter?"
"Nope, I am 911, strickly one way babe, he belongs to you now"
That happened to be one of the ER docs I like. One who understands what we do. What truly goes on in the back of a truck. That is really is oranized chaos.

9 comments:

Syd said...

I have a lot of respect for you and what you do. I've only ridden in an ambulance once when my 95 year old mother was dying and the paramedics were trying to resusitate her. It was hard just getting through traffic. Can't imagine the stress that you must have. Good blog.

painter in hiding said...

Thanks

RevMedic said...

"I'm doing the same job that the ER doc is doing with several veteran RNs, a respiratory thereapist, an ER tech or two, maybe a resident, a PA maybe all in a cloest with deisel engine. Going down the road at 60 MPH. Do you know how hard it is to hear lung sounds with a crappy stethescope with a siren going and a turbo desiel going at the same time?"

Excellent points. Not only that, we don't have the time/means to a) read the chart, b) talk to and assess the patient, c) order up some tests, d) check out the symptoms on the internet, and only then e) start treating the patient.

We do what we can, with the tools we have. We stem the tide, hold a hand or two, and hopefully save a life on occasion.

chucker said...

Hey, I read your postings and get a "ride in the the back" on the way to and from the mean streets of Charleston. Thanks.

But, I DON'T remember reading a lot about "DeFib." My posting about Jack Webb on my blog brought up a link about his hit tv series called "Emergency" that I feel you can relate to. Take a peek. I think it was early PR for EMS.

http://timpanogos.wordpress.com/2007/09/15/ddt-as-snake-oil/

painter in hiding said...

My dad tells me if he every requires my services he wants D5W and Ringers Lactate. I told him we don't even carry Ringers anymore. He said well you better find some because that what they saved every on Emergency! with.

Anonymous said...

There physicians with pleasant personalities that everyone likes and there are physicians that are imperious assholes. It's pretty easy to pick out which ones are which. I just let all that bullshit roll off my back. They've got egos that are too large to allow them to see that they are making fools of themselves. I have had the nice ER docs admit to me (off the record of course) that the asshole docs embarrass them too.
Emergency! Ah! The good old days. I remember when you had to call in to get permission to start an IV, intubate, or defibrillate. You had to send a strip first too, just like on TV! Every ER doc thought he was Dr. Early or Dr. Brackett. I actually met Randolph Mantooth last spring.

No

painter in hiding said...

Oh yeah, After the call, after I turned oever the pt, I was still kinda pissed and was venting to one of the RNs that I trust. and she said to me "you are a good medic, in fact, one of the better one your system has, pay no attention to [that particular doc] he tends to pick up the radio and speak without thinking. You did the right thing. You managed [the pt] ABCs as best you could with what you had to work with. And like you said You were still on the A...B part of the assesment, hadn't quite made it to C when you had us on the radio, so good work. You are still a rocking Paramedic in our eyes."

myPARAMEDICspace said...

Excellent article with an all too common problem. Can your site be added to the "sites to visit" group on www.myPARAMEDICspace.com?

If so send me an email.

Anonymous said...

wow, i don't mean to make you feel bad but.... narcan does not require an IV, it can be given IM, sub q or even SL. So it would be prudent to have your emt ventilate the patient while you give a quick dose of narcan before you transport. Or better yet, take the time to fully evaluate and treat the patient before you make a panicked trip to the ER. Narcotic OD is something we can treat, why "transport the emergency to the emergency department" when you could do what Paramedic are trained to do and stabilize the patient, then transport? It is best to listen to to others comments (no matter how rude) and try to learn from them. By the way, I am a paramedic and an artist too. Love your site.