June 10, 2008

Just....

I hate that word. "Just."

Not "just" as in "the decision of the jury was fair and just," or "the beer can chicken will be ready in another 10 minutes, so just hold your horses."

No, I mean when it's added to someone's professional title.

You're not "just an EMT." You ARE an EMT. Be proud of that. It's not something everyone can do. It takes time, effort, and a special mindset.

Sean isn't "just a friend." He's a real pal, a guy I can always count on when the times get rough and I need an ear to bend.

Like today. I'm teaching another ACLS class (seems that's all I do these days,) and we've got an L&D nurse (Labor and Delivery, for the uninformed.... delivering babies and such.) She's noticeably nervous about this class, since dealing with heart attacks and cardiac arrests isn't the typical job of an L&D nurse. Fair enough, I can help her with that nervousness.

In the same group, I've also got a recently graduated physician. He'd gone to medical school at the Greatest Medical School in the World, and was starting his residency at Man's Best Hospital. He's pushy, he tries to control the group dynamics, and he thinks he's smart. To be honest, he thinks he's smarter than me.

Foolish young doctor.

Anywho, I've given my L&D nurse a chance to be "Team Leader" for a Mega-Code scenario, and keeping her experience in mind, I make her patient a 28 week female who gave birth a couple hours ago, and is now unresponsive, apnic, and has a very rapid, thready, faint carotid pulse.

Ought to be pretty easy.... assist ventilations, start IV fluids, hook up the monitor, and give Epi if the pulse goes away. Oh, and get a physician.

She's actually getting right on it.... good thinking, strong direction of the team, accepting input from the rest of the group, and so forth. I'm pretty happy for her, as I can see her confidence building.

Then the doctor starts flapping his jaw.

Foolish Young Doctor: "You have placed all your faith that this is internal hemorrhage, but have you considered DIC as a cause?"

L&D Registered Nurse: "Well, no, I hadn't. I mean, uh, I guess it could be, maybe, but...."

FYD: "That's why the code leader needs to be a physician. You other folks just don't think of all the angles."

L&DRN: *blank stare, frustrated look*

FYD: "Even if you HAD considered DIC, would you even know what to do about it? Does anyone here know what to do?"

JB: "You mean other than Fresh Frozen Plasma, Prothrombin complex concentrate, and activated protein C? Oh, and Vitamin K, should the patient be Vitamin K deficient? Now, Doctor, why don't you explain to all of us how to tell the difference between Orthodromic AV Nodal Re-Entry Tachycardia and Pre-excitation Tachycardia, specifically how they relate to Wolff Parkinson White and Lowe Ganong Levine Syndromes?"

FYD: *blank stare*..... then "But, but... but, I thought you were just a paramedic..."

Foolish, foolish, kid.

7 comments:

Kate said...

I'd have been tempted to wrap my hands around his throat and throttle the snot outta him...among other ideas.

EE said...

:)

Ambulance Driver said...

Heh. I love a good smack down.

Rogue Medic said...

And I teach charm school. :-)

TOTWTYTR said...

Under similar circumstances, but in an ED not an ACLS class, I handed an attending physician an EKG strip his boss had just told him I had right and he had wrong and said, "Why don't you frame this and include a tag that says, "The Paramedic was right again"?

He probably would have said something if his boss wasn't laughing so hard.

Rogue Medic said...

JB and TOTWTYTR,

That is just horrible, shameful, disrespectful, . . . .

Bad, bad, bad.

I'm clawing my eyes out after reading such heresy.

:-)

ParaCynic said...

Gotta love it when you're teaching the 'cookie-cutter' classes, and inevitably someone feels the need to get WAY off subject.

When they hear hoofbeats, they immediately think "ZEBRAS!"