December 2, 2008

In which, JB has learned

If you've never read Skippy's List, you've either been living in a cave for the past year and change, or need more friends like mine who forward me every single funny think available on the internet.

There are EMS versions of the List, of course. TOTWTYTR has his (two parts: One, and Two), my former Field Supervisor at Grady EMS in Atlanta has one, and there are probably a couple more I'm missing.

This isn't one of those lists. Not exactly, anyway.

This is a list of things JB has learned as a medic, having worked EMS from Indiana to Atlanta to Colorado to Arizona.

1. You're not as smart as you think you are. There are a lot of things you simply do not know.
2. Treat every patient in a manner that you'd be proud to tell your grandmother about.
3. Until you have proof -- proof that would stand up in any court of law, anywhere, anytime -- the patient is sicker than you think they are.
4. Driving really fast won't save you enough time to make it worth the risk.
5. Your documentation can always get better.
6. Drunks can have serious medical conditions, too.
7. The loudmouth talking trash on the scene isn't the threat. Be wary of the quiet guy in the back of the room.
8. If a baby isn't crying, you should be worried.
9. Everybody dies at some point.
10. Paramedics can't change #9.
11. A comforting voice, a soft touch, and a smile will suffice most of the time.
12. It's the subtle things that get you. ANYONE can treat a 63 year old male with 8/10 substernal chest pressure that radiates to the neck, jaw, and left arm. But can you diagnose the forty-two year old female diabetic with nausea and two days of fatigue?
13. When it comes to IV lines, bigger is better, but "Any Port in a Storm" works, too.
14. No, you're not as good as an ER physician at intubation.
15. Experience is a bitch as a teacher. She gives the test first, and the lesson second. Best study ahead of time.
16. Shine your damn boots, iron your damn shirt, shave your damn face, and try to look professional.
17. Not everybody is cut out for a job as a paramedic.
18. Don't piss off the charge nurse. Ever.
19. Eat when you can, sleep when you can, pee when you can.
20. There is absolutely nothing wrong with telling the accepting physician "I have no idea what's wrong with the patient."
21. If you can't think of what to do, putting the patient in the ambulance and driving to the hospital is never a bad idea.
22. There are a lot of lessons I've forgotten to add or neglected to include....

... So feel free to add your own in the comments section.


Tom B said...

Either you control the scene or the scene controls you. Controlling the scene is better, but sometimes the choice isn't yours.

PJ Geraghty said...

I was (maybe still am) better than some ED docs at intubation, and I pissed off more than a few charge nurses with nary a shred of guilt.

As per #21, a diesel bolus will often improve your situation (not in conflict with #4, but sitting on a scene has cured very few people over the years of anything except their oxygen addiction)

Any patient over 18 does not have a first name as far as you're concerned... they are Mr./Mrs./Miss/Ms. [x] when you address them, not Elmer, Ethel or Agnes. My corollary to #2 is treat every patient as if he/she WERE your grandparent.

Lisa said...

Loved the list- the only thing I can enlarge upon is "if the situation can go wrong it WILL go wrong and in less time than it takes to blink an eye! "