Well, it was a quiet night.

So quiet that four of us decided to go for a ride. We took the ambulance out for some area familiarization. D., who was driving, knows the area like nobody's business. I've lived nearby for 30-some years and I don't know it as well as he does. Anyway, I went with them because I'd HATE to miss a call because I didn't. I learned a lot. We cruised the neighborhood and then headed over to a few special interest places. We have a high-rise residential building in our area where the entrance canopy is too short for our apparatus. D. dropped off H. and I in the front door, as if we were running a call and told us to find the loading dock around back. We didn't take the stretcher or bag with us but we were dressed.

The doorman let us in right away and I told him we were just doing training. The worried look left his face. H. seemed a bit lost. I seem to have an innate sense of buildings and how they work. I headed in what I thought was the right direction and grabbed a door handle. H. gives me a look as if saying, "Where the hell you going?" Yep, I was right. Down the Stairs to the "T" level and there's our ambulance. H. looked at me sideways. I shrugged and said, "Never been here before!" She didn't believe me.

Well, we headed out to other interesting sites in our area and D. kept up an informative and constant chatter as he drove. H., C. and I did our best to be sponges. On a few spots, I found I did, indeed, have some local knowledge. You see, D., H., and C., like most of the young people at the Firehouse, aren't from the area. I just have the years of living here in my favor. Worked there....Had a client in that building... good sandwiches in that deli... that used to be a baseball diamond... went to the prom with a girl who lived on this street... and much more useless information.

While running around, we heard a fire developing two areas over. We started edging in that direction and, sure enough, second alarm and we got called to go in. Fire in the office building, no injuries. We sat in the EMS sector staging area for an hour or so and then went home. Yawn!

The only things I really accomplished were putting stickers on my helmet with my company number and name and getting signed up for EMS Officer Class. Unfortunately, I was only one of 3 people in my whole area that signed up and the class was cancelled. Bah!

In my jurisdiction, EMS calls account for over 75% of the calls run by the Fire/EMS department but everyone STILL thinks that EMS is the bastard child of the fire service. It seems that the EMS aspect of what we do is either a necessary evil of firefighting or is shoved to the side. Why is that?

I read MacMedic's blog almost daily along with a bunch of others (see list to the right) and one entry in particular was interesting. I, too, have been through a lot of training and schooling for another career and decided to go the paramedic route. (see."About MaddogMedic" at the top of the links list for "the epiphany")

My Sister-in-law, T., asked about my decision to become a paramedic. T. is a critical care pediatric nurse and very good at what she does. She met my brother while she was working with my Mom who's a pediatric CNP in the neonatal intensive care unit of a local hospital. Her question is why the hell do I want to be a paramedic when nurses get to do so much more, push more drugs, get more respect and go through less schooling? I can do more advanced patient care and have more responsibility as a nurse. She seemed to think that I was short changing myself by "only" being a paramedic.

I said, "T., when was the last time you intubated a patient while sprawled across the hood of their car?"
"How many times have you gone into someone's home to save their life, and done it?"
"How often do you get the chance to extract a patient from a destroyed automobile, and push drugs, intubate, etc.?"

I grew up in a family of nurses and I have a lot of respect for good nurses. It seems that each specialty in patient care comes into play in a different phase of the patient's cycle. From trauma/illness onset, to rehabilitation and release and all the parts in between. Some people I've met in different parts of the process seem ignorant or disparaging of the workers in the other phases.

The nurses can't treat the patient if we medics don't bring them in treatable condition. It seemed that it didn't even cross T's mind that patients need care before they get to the hospital. That's where I want to fit in. I want to be the first or second provider of care. Thinking about it, I don't know that a hospital based caregiver has ever conducted a scene size up, or gotten clues about a patient's illness from their living conditions. There's so much more to providing medical care out in the field. We have MOIs to determine. We have our own safety to consider. Sometimes we have the opportunity to recognize a domestic violence situation and take action to protect the victim if we can. A quiet call to the PD can do wonders.

I feel there's so much MORE to medicine in the field. I'm with you MacMedic. EMS is a career choice. I don't think you are having trouble seeing what other see clearly. I discovered that my place in the world is in the field providing care to people that need it. That's all. Just because my Sister-in-law's place is on the ICU floor, that doesn't mean mine is too. Just because other people use EMS as a stepping stone to go to nursing or physician's assistant doesn't demean or belittle those who choose to remain and become outstanding medics. EMS is something that requires a lot of people who practice it and it's certainly not for everyone. Those who find that it is for them are a special sort, indeed.

Every military service has an "elite." The Army has Airborne, Marines: Recon, Navy: Seals, Air Force: Parajumpers, Coast Guard, well, I guess we're all "Elite" in the USCG ;). The point is, in EMS, I've always viewed the Paramedics to be the elite corps. They're the ones riding helicopters, performing heroic interventions in the middle of a highway, doing the things that gross everyone out but save tons of lives. They constantly train to hone the skills they have and add skills they don't. Just like the elite of any dangerous service.

The day my NREMT-P card comes, I'll be walking tall!

--maddog