Complacency

As described in the Fire Service it is a dulling of the senses, becoming content in routine and mulling over the day in/day out tasks. Complacency causes us to stop learning to look at calls as mundane. To not be prepared for the big one, if you will. 

I haven't been in the EMS field long. Certainly not long enough to be a victim of complacency but after a recent call I had I couldn't help but dwell on the fact that I had in the very essence of the word, complacent. Here's the back story.

It was this past Sunday and I had just started my shift. A bright and early 7am. I had just finished the daily check lists and the phone rang. I recognized the number, a local nursing home. I thought to myself oh great what could it be this time? A stubbed toe? A presumed fall that didn't actually happen? Who knows. I received the information from the nurse and it was what I had presumed. A patient with shortness of breath and had an 02 saturation of less than 90%. This is usually a pretty run of the mill call. Bring in to the ER, they check them out for pneumonia and we bring them back. Well we ran code to the Nursing home as per our directives. When we got there a scene unfolded that I wasn't quite mentally prepared for. We walked in and the nurses told us to run, the patient is coding. For those of you that don't know, when a patient is coding they are void of a pulse or any other vital signs, circling the drain or on the brink of death.

I ran to get the heart monitor and jump kit as my medic partner went to assess the situation. As I was running back the hospital medic service was pulling in. We went in and I fielded all the tools my partner needed and I was amazed at being able to remember where everything was. Thank you daily/weekly checks, I will never take you for granted again. I jumped in and started doing chest compressions. This was the first call where I was having to do them. My partner was working on establishing an airway and the hospital medics were working on hooking up an IV. Well sadly to say we couldn't get a line and had been performing CPR for too long and the hospital medics called medical control and called the guy.

Now I bet you are probably wondering just where I became complacent or maybe you have an idea. It was at the beginning of the call. Through countless Nursing home calls that turned out to be nothing I grew accustom to the routine. I did not treat each call like the big one. Did the patient receive a lack of proper care because of it? No. I was lucky, we showed up and did everything we could, the best we could. Could we have done anything differently on the call? I'm not sure. I could have gone into the call with a better attitude for sure.

What sticks with me and what will stick with me is I let a series of mundane calls cloud my judgment on other calls. What I swore not to do is the very thing I did. However what I came to understand is that it happens. Complacency hits everyone and no one is free from it. But if we are more proactive about our jobs, and we look at each call differently, or each shift differently, the job doesn't become mundane, it doesn't become routine. This in itself brings us closer to becoming less complacent and better care providers. 

A Year in Review, Resolutions, The Suicide and A Look Ahead

Well howdy gang, it has been entirely too long since I have updated Smoke Before Fire. No I haven't abandoned the blog, I have just been entirely too busy. So let's kick it off, my last post of 2010.

Helena


So after living here for a year come August I came up with the amazing revelation that in such a short time I had built a complete life here. Friends, a worthwhile job that I enjoyed and finishing my schooling combined into a nice place to live and thrive. Throw into that equation the fact that my sweetie came back from Japan and we "took the next step" and moved in together it comes as a complete package. As I stated before, an amazing revelation.

A Year in Review


This year has been busy. I've come into my own as an EMT-Basic and have seen some incidents that I still think about. I have even pushed myself further in becoming an ALS provider by getting my endorsements. I admit I am still intimidated by the fact that I can do these procedures but I am slowly becoming comfortable with them.  I have joined a volunteer fire department that I am proud to be apart of. We don't run a lot of calls, roughly 60 a year, but they take firefighting seriously and I am amazed at the amount of experience they bring to the table. All of this as helped push me further into the EMS field and I am thankful for every day I am apart of it.

Resolutions


As the year is coming to an end it's time for New Year's Resolutions... The promises we make to ourselves that seem to fizzle out and something we seem to start to dread every year we make them. Am I going to make a New Years resolution? Yes and no. I am going to work out more, I am going to love more, I am going to enjoy life more, not because I feel that I am obligated to make such resolutions, but more because that's how I want to live my life. So no in the aspect that it isn't a resolution and more of a daily choice. Lame sounding I know, but very true.

My Third Semester


Well I am 75% of the way done with school. This semester didn't end in the 4.0 I had expected but in a 3.5 bringing my accumulative GPA to a 3.8. Everyone chalks it up to my sweetie being back but I chalk it up to being busy. A 3.8 isn't bad in my eyes. So I'll accept it. This semester was a lot more book learning and a lot less hands on which made the semester drag on but I made it through.

The Suicide


About two months ago I wrote about that call. The one that haunts us and at the end of the post I wrote about how I would see more calls that would stick with me. Well about three weeks ago my medic buddy and I were working when we were paged out for an apparent suicide. We got there and came into see a person who had used a gun to commit suicide. Once we saw the gun we backed out and waited for law enforcement.  I'm not going to go into details anymore other than I helped officers with their investigation and then helped transport the person to the morgue in Boulder. The person's kid found them and that is where it hit me. But thanks to my friends and family for being supportive of seeing something so shocking. My heartfelt condolences go out to the family in their loss.

A Look Ahead


So after a busy year I look forward to my final semester in Helena, my final few months here and a new start in Billings with my lady. I look forward to the internship with the local Fire Department and I look forward to a few pleasant surprises and whatever life plans to throw at me. I wish everyone a Happy New Year and hopes that you all get to spend it with the people that make you happiest. Thanks for reading in 2010 and I look forward to seeing you for another edition of Smoke Before Fire in 2011.

Updates!

Hi everyone! It has been an entirely busy few weeks. I battled strep, registered for my final semester of fire and rescue classes, had some 911s, hunkered down for a blizzard and so on. Without wasting time lets jump into it.

My First IV Patients 


Now I know what you're probably thinking. He's already talked about his first IV patient. Well that's true I have,  but that was my first IV patient with people supervising. This was my first patient on my own after the endorsement was applied to my license. A 93 year old lady with dehydration etc. Every IV I tried to do I lost the vein. They would disappear. I was hoping to tell you all of my first successful patient stick but alas, I did not get one on this lady. I could have continued sticking her but rather than treat her like a pin cushion we just got her to the hospital.

Two Sundays back I had to run a trip to Kalispell for an ALS (Advanced Life Support) run. It was an ALS run because the hospital had a bag flowing with Normal Saline (NS). Plus the doctor wanted us to give the patient insulin. Which I didn't mind you because it is out of my scope of practice. But it wasn't bad. Just watched the bag to make sure it was flowing.

Wildland Fire v. Snow/Sleet Storm


Well it is November as you all know which for the state of Montana usually means cold rain storms that turn into sleet then snow. So it was safe to assume that our Wildland fire days for this year were over. Well it just so happened that during a storm like I stated above MCVFD was paged for a wildland fire. We all wore our structure gear and even though there was a combination of rain and snow hitting us, these spot fires had 20-25 foot flame lengths. Pretty amazing for being in a storm. However exciting as it sounded, all it turned out to be was two people with 7 slash piles burning. We waited with a charged hoseline for the fire department whos district it was to come down and tell us what they wanted to do. They were okay with the giant flames and we were cancelled. Lesson learned from this call, Wildland fires can happen all year round, even in cold wet rain/snow storms.

My Battle with Strep


Well about three days before Halloween I was hit with an obnoxious cold/flu thing. Fever, chills, nasty sore throat and so on. Real nasty. Well I expected to be over it in a few days. I wasn't. The sore throat was miserable. So I went to the doctor and my quick strep test was negative. So I thought I was fine, but I got a call the next day and the 24 hour culture test was positive. So after 10 days of sickness and 10 days of anti-biotics I am strep free and feeling awesome. Going back to the gym was rough but I did manage to get back up to speed.

Other than that, not much is going on. As I stated above I registered for my final semester of classes and I really can't wait to be done and off to paramedic school. I don't know why but I have the itch to learn more and more. I blame my sweetie. Always pushing me to be better and stuff. But I'm off for much needed gym time so stay safe and stay tuned!

To The Left...

You all may have noticed a widget to the left of these posts showing the names, faces, fire departments and so on of various firefighters. This widget shows those who have died in the fire service, be it a Line of Duty Death (LODD) or something related. It is important to recognize what others have done in this service and what they have given for the safety of others.

Coming soon to a blog near you:

- My first IV patient
   - Patient's since my IV endorsement
- A wildland fire in the middle of a rain/snow storm.
- My battle with strep throat!

So stay tuned!

That Call...

When I first got into the EMS field I heard stories; stories of close calls that became saves, calls that turned out to be stranger than fiction, and even calls that turned out to be nothing  Every EMT has them. Every EMT loves telling them. However when asked one simple question you get a completely opposite reaction. "What's the worst call you've ever been on?" Most people's face expressions become stoic, the moment they remember the call that continues to haunt their thoughts every so often, the one that still comes to them in their dreams.

It would randomly be brought up from time to time, some able to share that call that got to them, others just dismissing it by changing the subject. Others would blow off their own recollections with suggestions as what was to come for us new EMT folk. Most of the EMS people I talked to were curious as to how I would handle my first truly bad call. I have to be honest I wondered that myself, the thought coming up at least once every time I was paged to a call. Would it cause me to lose sleep like it does most? Would I freeze up being completely useless during the call? Was I cut out to be there in someone else's worst moment?

Well having that call is inevitable. Sooner or later it is going to happen. The best I can do is do what I have been trained to and do it to the best of my abilities. So I was told, and what I told myself.

Well I was hoping to finish this rambling with a quip about me still having yet to experience this call and how I think I can handle it. The truth is, Last Friday night, October 22nd I experienced that call. ATV crash with a patient who was DOA. I won't go into details on it as I would rather not like to think about it, but forever will the patient's face, body, everything be burned into my mind, forever will the screams of hysteria and the patient's significant other clutching me haunt my thoughts. I did my job and did what I was supposed to, but I didn't sleep the rest of that night. I'm still waking up every so often with my mind going to that night. Yeah these calls will become easier in time and yeah I am going to see a lot of these calls in my career.

I've been told that I need to not take my work home with me, and I am getting a stronger stomach in taking these calls but having people tell me that I will get to a point where they won't affect me at all. In all honesty I'm hoping I never reach that point. I have to learn to not let these calls take a hold of my life and strangle it and I need to learn to accept that call for what it is and move in but it won't. That call, my first bad call, will forever be with me. I hope to learn to let it not affect me so deeply but to not let it affect me at all in my opinion causes us to lose the very thing that made us want to lose sleep in the first place, to see people at their worst and help them. Without that empathy, without that sense of what those people are feeling and a longing to make that go away we become complacent. We lose our urge to do our best and we lose a chance to make a difference.

I end on the fact that I will probably continue to lose sleep thanks to my career choice and what I have/will see. I am learning how to handle these calls. Most importantly I am learning how to be empathetic without letting these calls eat me from the inside. It will take time, it will take struggle, but in the end, that's what makes it worth it.

Facing Your Fears... Or Those Things That Make You Question Your Sanity

Hello everyone. Here it is, another blog post. I know, I know, it has been a bit since my past post. Well I have been busy. Cranking out three tests a week, volunteering at more than one place and work just seems to fill up my entire life. So here we go.

For our Rescue class I believe I mentioned the fact that I was going to be going repelling off of a 200ft cliff face. Well I did and it was a hoot. Moving on. Ha not really here we are. We go up to an area called Blue Cloud which for those of you who don't know where that is, it is by Baxendale Fire Department on the way to Missoula. The road was bumpy and it took some off-roading to get to, plus a half mile hike up the mountain and there you are. We had a stokes basket with 300lbs worth of gear to carry up too. Needless to say we got a workout before we even hit the actual cliff face. Once we got up there two facts were quite evident. One, the view was amazing, two, the view was amazing because we were really high up. The second fact playing a lot into what I am about to write.

We set up all our stuff and got it ready so that we could repel down the cliff face. Anchoring to a tree, getting our helmets and harnesses on, and strapping in. So we went one at a time and I spent most of the day taking pictures for the programs Fire and Rescue Facebook page. I was second to go over the cliff face. So I get strapped in and after triple checking my harness and rope I start making towards the point of no return. I get there. Staring down I see our belay guy staring up at me. Two thoughts are going through my mind, man are we high up, and this really gorgeous view isn't going to mean anything if this rope snaps. Words of encouragement are shouted, prayers to the powers that be are muttered and look out below. I was scared out of my mind but I proceeded cautiously. You know that feeling of panic you get when you're doing something that causes the voice in the back of your head to shout "WHAT THE HECK HAVE YOU BEEN SMOKING!?", the same feeling you get when you look at that first downward path of a rollercoaster? Well yeah that feeling was very much present. I very cautiously started leaning myself back until my legs were perpendicular to the rock face. The only thing between me and a very fast approaching ground being the grip of my left hand on the rope. I found that as I inched further down the feeling of dread went away and as I got more comfortable The repel came quicker and more comfortable. Once I hit the ground and shouted "Belay off!" I looked up. The wall had been conquered. My sanity had been questioned. My heart was still racing.

We spent a few more hours repelling and getting over our immediate fears of height. As the day progressed so did  the wind and we decided to call it a day.

Unrelated Notes


On an unrelated note or two, my sweetie passed her first responder practicals. All she has left between her and her license is the National Registry test but as we all know she will pass with flying colors. We volunteered at the Boulder Rodeo and there were no injuries short of the minor breaks and usual dislocations.

Other than that, that's about it. So stay tuned. I'd make a mention of promises to update this more frequently but who knows when. So stay tuned. There will be updates. Sometime in the near future.

Coming Soon to a Blog Near You!

Stay tuned for a new blog post tomorrow, complete with pictures!