Sunday, January 25, 2009

CVA

New station, new area. Downtown, dirty, grimy hospitals with little to no county funding and nurses that are completely burnt out with their jobs.

I get an IFT call to one of these hospitals to pick up an older female patient who has suffered a CVA (cerebrovascular accident, AKA stroke) a few days prior. She's being discharged to a nursing home a few blocks away, but she had originally come from home. We get there and try to get a report from the nurse, who's waving us off and trying to get away with giving us one syllable answers. We finally decide to just go check out the patient instead of trying to get any info from the nurse.
We walk into the cramped room where surprisingly, 2 beds have been stuffed where only 1 actually fits. Our patient, a middle aged hispanic woman, is lying on her side facing us. Her hand is gripping the siderail of the bed and she appears to be in distress. She also appears to be covered in blood. We furiously search her entire body, trying to figure out where the blood is coming from. It's covering her pillow and sheets, so our first thought is that she's somehow hurt her head. We comb through her hair, but find nothing. She is crying now, moaning something in spanish that neither of us can understand. We find the source of the blood, she's ripped out her IV and has been flailing her arms around for at least 20 minutes.
Her nurse, of course, never noticed a thing.
Irritated, I walk back to the nurses' station and explain the situation. The nurse wanders over to the bed rolling her eyes as if to say "big deal" and cleans the patient up. I ask the nurse if the woman is oriented at all, she says "Yea." I ask "Does she speak or understand any english?" and the nurse replies "No." I ask "Do YOU speak or understand any spanish?" and the nurse says "No."
Then how do you know that she's oriented?
I don't ask this, for fear I'll get a complaint filed against me for being rude, so I shut my mouth and try to communicate in what I call my "broken, stupid spanish." My partner and I manage to figure out that, as far as we can tell, she seems oriented. She's gripping my hand, pleading with me in spanish and sobbing. She keeps saying "I'm ok, ok, bueno" when I ask if she's hurt. She's still crying, but I don't think she's in any pain. I think this poor woman has no idea what's happened to her, she's suddenly been shoved into a closet-sized room in a dingy hospital with mostly korean-speaking nurses who have no idea (or desire) to communicate to her what's going on with her illness or treatment.
The nurse relays to me that this is the patient's first time at the nursing home we're taking her to. Apparently, the family arranged for her to go there because they would be unable to provide care for her. The sad thing is, for the most part this woman is going to be fine. The CVA was minor, she has NO apparent facial drooping or one-sided weakness. She's able to walk and communicate in her native language. She's also fairly young for a CVA.
The family has not been to see her since she's been in the hospital. They have not told her that she isn't going home. When she understood that she wouldn't be going home (the nurse had somehow told her just before we arrived) she got upset. Hence, the crying and ripping out of IVs.

I feel horrible. I wish so badly that I knew spanish, even enough just to tell her that she was going to be ok, though I know that regardless of her condition, she will probably be in the nursing home for the rest of her natural life. She wails in the back of the rig, and with each sob I wince a little. I want to hold her hand, to apologize for the disgusting hospital, for the cold nurse, for her kids who were sending her away. I want to take her home, to her things, her memories. Pictures of her family, late husband, maybe grandchildren. Her own bed, her own space. I don't want to take her to the nursing home filled with screaming dementia patients, the home engulfed with the smell of urine and stale food. The home filled with the same, cold, unapologetic burnt-out nurses.
Inter-facility transports are supposed to be the easy ones. Patients who are usually being discharged, who are feeling better and happy to be getting home.
They're SUPPOSED to be the easy ones.
So why was it so difficult to turn and walk away from this woman after putting her in her new bed??
I couldn't stand to look her in those pleading, tear-filled eyes as I left.
I hope she doesn't hate me for that.

Over and out-
thePSYCHwrangler

Friday, January 2, 2009

A Sobering Moment...

So, regardless of recent events, (ahem...see post below) I have decided that the show must go on. I have many more stories to get out of my head and into yours.. Sit back, enjoy.

After literally MONTHS of waiting, my closest friend at work and I finally got scheduled together. Ironically, our ONLY shift together also happened to be HIS last day. Lucky dog would be continuing on to a more prosperous company far far away, and it was certainly bittersweet for both of us.
This is a guy who I went to EMT academy with. A guy who, on my first day of work, walked through the door and we both yelled, "HEY! What are YOU doing here?!" and hugged excitedly. (We had no idea we were both working for the same company, he had been hired just a couple of weeks before my first day there.) He has since become one of my closest, best, and dearest friends.
This guy, who we all lovingly refer to as "Bobby" for reasons I will not explain here, is an amazing person. An incredibly compassionate, caring EMT and friend to all who surround him. He has what we call "bedside manner" that is absolutely jaw-dropping to watch. He can convince any patient, sick, crazy, or otherwise, that he is there to HELP them, and that he will do his best to take good care of them. And he does, every time. He has helped me through every bad call, nightmare, harrowing experience that I have endured through my last year in this field.

After one particularly horrendous shift, I was completely convinced that I was done with being in Emergency Medical Services. I came home early in the morning, after a 72 hour shift with probably about 5-6 hours of sleep, and sat down to have a beer. I called Bobby, and broke down. I cried for awhile, telling him I'd had it, I was done. "I can't do this anymore dude, it's so not worth it. What was I thinking?!" I kept telling him. "I've been at it for 9 months now man, and I feel like I haven't even made a dent in humanity. It's hopeless, I'm nothing. I don't help people, I just taxi them around all day." He was quiet for a minute, and then spoke.

"Hey," he said, "Do you remember that shift we worked together, before I left? We had a little girl, she was like 13 or something. Do you remember her?"

I did remember her. A young girl on a psychiatric hold who we had to search for before finding her in a dingy old apartment downtown. She had run away from home and gone to her recently-released-from-jail's brother's house to escape her parents, who were the ones sending her to the psych facility. She didn't want to go, she wanted to stay with her brother and live with him. We waited while her and her brother cried and hugged for several minutes before ushering her into the rig to go. We took her to the hospital, where we waited for a couple of hours for her to be examined. We both tried to keep her distracted, playing games with her, joking with her, deciding which of the firefighters who had come in was the cutest. We received several dirty looks from the nurses for disrupting the quiet E.R. but ignored most of them, trying to keep the girl entertained. When she finally got a bed, we hugged and with somber faces, my partner and I left. We never get to hear about what happens after we leave, and I don't know where this young girl is but I hope she's happy and doing well.

"Yea, Bobby. I remember her."
"Do you realize that she remembers YOU? And she's going to remember you for the rest of her life as the "cool ambulance girl" who took her to the hospital while she was literally being ripped out of the arms of her family? You DO make a difference, you need to remember that. She was comforted for a little while by our jokes and I hope the whole thing made it a little easier on her, I really do. We made her laugh through a traumatizing time, assured her she'd be back with her family soon. You DO make a difference."

After thinking about it from time to time, I start to realize now that I got into this field to help people. It is truly my passion, my first love. And regardless of how I manage to obtain this goal, I do my best in every situation. I see hundreds of faces a month, but those faces only see one of me in a lifetime. Even looking back on the conversation, it struck me that I still remembered the Paramedics who took me to the hospital when I was 4, after a bad car accident with my dad. I have the teddy bear they gave me to hold on to, to calm me down during the short ride to the hospital, away from my dad for the first time. I hope that I am to that little girl, what those Paramedics were to me; comfort in a confusing time of my life. Where nothing made sense, but I felt safe in their arms as they pulled me out of the smashed and burning car and into their ambulance.

I recently applied for and got accepted to Paramedic school, (after I pass an entrance exam in February.) This is all thanks to my friend Bobby, who has held my hand through all of this stupid bullshit that we love about our jobs. "The toughest job you'll ever love" is a well known quote about this line of work that rings true on several occassions over the past 18 months. I love and hate what I do at the same time, but the love exceeds all and I hope to do more good in this field for the rest of my working life.

So this one's to Bobby. I know you're reading this dude, and I want to let you know that I love you. You are such a good friend, a great EMT and you will be an INCREDIBLE Paramedic. I'll see you in school, sucker!

Over and out,
the PSYCH wrangler