Saturday, March 17, 2007

The First Week of Precepting

I'm done my first week...hooray! Thanks for all of you who are out there rooting for me, it is great to have so much support. My second precepting shift in Abbotsford went well; it was pretty slow and most of the calls were pretty run of the mill. My preceptor there signed me off with lots of 'excellents' on his comment form, and with many well wishes for the future. I then spent two days at "Station 48," which, as I mentioned in my previous post, is in the innermost guts of the downtown East Hastings area of Vancouver. It doesn't get much poorer and wilder than station 48. My preceptors there were amazing--street smart AND book smart, and funny to boot. My first day there I did 10 or so calls, and the second call I literally saved this guy's life. I mean, we 'save lives' but we frequently joke that we 'saved another life' after we return from the routine or boring calls with leg wounds or toe pain or drunkenness, etc. But THIS guy was minutes away from death; he still had a pulse but he was not breathing, which means he had another 4-6 minutes from when he stopped breathing to the beginning of irreversable brain cell death. So we put a tube in his airway, pumped air into him, I started an IV and gave him some drugs, and WHAMMO!! He woke up. He looked like crap and he was definately having a cardiac event, so he was ONE SICK DUDE--but he was alive. It was VERY cool. We have two unofficial categories we place patients in: Sick or Not Sick. Sick means dying. Not sick means not dying. This dude was Sick! When you get experienced you start being able to tell from the doorway of a patient's room if they are Sick or Not Sick just from the way they look, and I have enough experience now that as soon as we walked into that guy's apartment, I thought "Holy crap, this guy is dead" which he wasn't, but near to.
After that call I felt very thirsty and slightly nauseous, and I definately had no energy left for more critical, Sick patients where I'd have to use my brain and an adrenaline rush...luckily, the rest of my patients were non critical.
The following day was SLOWER THAN HECK!! We had six calls, four patients, and transported only ONE person to the hospital all day. That opened up the opportunity for my preceptors to grill me on my pathophysiology, drugs, and protocols, which was great practice. By the end of the day, though, I was exhausted, and my preceptor kept grilling me and hovering over me while I was doing things, and all his feedback was helpful but negative. So this salty watery fluid started leaking out my eyes and I had to run to the bathroom at St. Paul's Hospital ER and empty their kleenex box for 20 minutes. So of course I look like I've been sprayed with pepper spray or smoked a bunch of weed because my eyes are beet red and my face all blotchy, but I can't hide out in the bathroom any longer because someone is going to send security to hunt me down soon! I left the bathroom and immediately went outside where it was dark and cool, and waited for my preceptor. He was worried about me because he could tell I was upset and didn't like that he had been the trigger for my really wasn't him. I was tired, missing my kids, and TOTALLY stressed out to be working the downtown Eastside, which is like a totally different culture with different rules and different people...
anyways, after my weeping session we got to teasing each other again and all was good, though I felt a bit foolish. Well let's face it, I felt a lot foolish. He is a great guy and we had a great rapport so everything was okay, but I did let him know that it's helpful if he tempers his criticisms with positive comments, and he thanked me because he is a newish instructor and needs feedback, too.
A little humility never hurt anyone, especially us paramedics. I know some paramedics who wear imaginary superman capes and think they are God's gift to the world, so it is nice to know I'm not one of them. ;)
Keep my kids in mind this week, if you will! They are missing me tremendously and starting to act a little wild, and it is six days yet before I can spend any significant amount of time with them again...feeling guilty...and aweful for them... it's temporary!! I promise!! It's just so hard for them to understand "next week" when they live so emphatically in the present moment. I'll keep you posted on this week as well!

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