Burn Out

Unfortunately a common problem with EMS providers is burnout. Burnout though not exclusive to the EMS field it is a prominent problem. The most accurate defination I have found of burnout was "unrelieved job-related stress characterized by the person suffering from burnout may lose concern or respect for other people and often has cynical, dehumanized perceptions of people, labeling them in a derogatory manner". Personally I see where the cynicism comes from but for outsiders to the EMS it is probably difficult to imagine why people who dedicate their lives to serving the general public in their time of need can come to hating their job or the people they serve. Apparently it is already starting to effect me according to the observations of my girlfriend, it is difficult to not become angry when people call 9-1-1 for slipping on soap in the grocery store and when you get there they are more concerned with filling out a police report and making sure they get a copy. It is also infuriating when people call 9-1-1 for taxi services people who dont have a car or somehow have no friends, family or neighbhors willing to take them to the hospital 10 minutes away. Instead of calling a cab that would cost money on the spot they call 9-1-1 for an ambulance ride (that will go the same speed as a regular car) and most importantly they will not be seen quicker at the hospital and they wont pay when the bill arrives next month.This is the reason an ambulance ride cost $1500 because some people wont pay. Anyways regardless of  my little rant there, I still demand the most professional behavior of myself when on scene even if I believe that the call is an abuse or misuse of the 911 system. There reason I am writting about this is because I witnessed a senior member act verbally belirgerntly toward a patient, granted the pt was according to herself educated as a nurse, and was having a textbook panic attack, hyperventilation followed by her loosing the feeling in her fingers. The problem with this for my fellow member is that it was 3:00 AM and it was not the first call of the night that had been non-emergency. While that is not an excuse I just wanted to put that in context. Witnessing the behavior of my teammate made me more aware of my own behavior and what feelings to guard against when dealing difficult or frustrating situations.

My first positive experince with Vitiligo

I am not sure if you are familiar with the skin pigment disorder I have, Vitiligo, so a brief overview. It is a skin pigment disorder specifically a loss of melaninocytes loss of production of melanin. The disease is thought to be autoimmune in nature but ultimately idiopathic. There is not a whole lot of research in it because its incidence is less than 1% worldwide, it’s not very noticeable if you are already light skinned and it’s not really all that harmful except for maybe increasing your chance for sun burn. Yes, this is what Michael Jackson had except his was the more severe form of Vitiligo universalis. The treatment is often topical corticosteroids considering how the condition might be autoimmune but that never helped me, anyways I have resigned to it being incurable. Okay enough background; in my experience I have not had one positive thing ever come out this disease. There has been plenty of shame, self-esteem issues, ridicule and pointing fingers of blameless children, that hurt despite their innocent question. Last night I got a call to an assault. The pt had been assaulted by his neighbors, who fled when the pt’s brother had called the cops. Unfortunately the pt under the influence of ETOH was belligerent and noncompliant towards the cops and they hand cuffed him. When we got to the scene, the pt was sitting in the back of a cop car. The pt due to his altered mental status clearly did not understand why he had been tackled and handcuffed and was naturally very upset so much so that it was interfering with me and my colleagues trying to assess him and determine a treatment plan. Eventually when my partners went to go talk to the cops about what had happened, I noticed the Vitiligo on him in almost the exact same places I have it, hands, knees, elbows and feet all scarily similar to mine. I took off my gloves so he could see and that allowed me to distract him from his current situation. He quickly calmed down and I gained his trust. Through his trust I helped him to truly understand his situation and the need to cooperate with the police as well as me, in the end because he had calmed down the cops released him from his cuffs without charging him with anything. All thanks to a common bond through Vitiligo.

Quality vs Quantity

This last shift we had this elderly woman had a vasovagal syncopal episode while going to the bathroom. She also had incredibly overgrown toenails. So that while I was walking her to the stretcher and she had another syncopal episode and snapped her great toe nail off. The paramedic couldn't find a vein to stick,(her arms felt like bags of water absolutly no veins just hematoma after hematoma) her to get blood or to even give any fluids to help raise her blood pressure so she would stop fainting. She did not really want to go to the hospital and probably wouldn't have if it was not for her daughter.  Oh and like most fainting patients she did not believe that she had fainted and was quite sure of herself, Sorry little side vent there it just suprisses me everytime that people expect to remeber themselves fainting. Anyways this patient reminded me about my mortality, which I don't reflect on often even in this field its hard to feel that way about your self especially at my age. Sorry about not having a post for last week didnt have a shift  but I am doing 3, 12hr shifts sat sun and mon this week so I will catch up.