It’s strange how there’s always a rush right before things go south. Like, have you ever noticed that right before a restaurant goes out of business; it’s always full of people? It has been like that at IFT over the last week or so. I’ve run calls out of facilities that I’ve never been to before. The discharge planners and nurses will make very happy sounding noises when we show up, saying things like, “Wow, you guys are on time! And so polite! We must use you more.” I just say smile and say thanks, knowing that in 2 weeks, we’ll be a different company.
As some of you may know, my current job is IFT. That’s the exciting whirlwind of “Inter-facility Transport”. In the IFT world, there are four basic of levels of patients that we transfer. Here’s the break out of my “Medic 7 classification system”. Level I patients are totally gorked out. One of my colleagues calls them,”self watering vegetables”. Level II are A&Ox1 or 2. That means they are aware of self or place, but not much else. These are typical dementia patients. Level III are pissed off regulars. These are the folks that go to dialysis and hate the world, you included. Level IV are normal folks that need a BLS ride and can’t tolerate a wheelchair or POV.
Level II and Level IV patients are my favorites. The IV folks can have a regular conversation and are usually interested and involved in their own care. Level II folks are usually confused and scared about what’s going on. I really enjoy being a compassionate caregiver in these cases. I transported a 83 year old guy with colon CA that had mets everywhere. Lungs, liver, brain. He didn’t have much time left and he was going to a Skilled Nursing Facility (SNF). He was confused as to time, place and event, but knew his name. When we picked him up, he was crying and scared and confused. I held his hand as we went down the elevator and one I got in the truck, I continued to hold his hand and try to engage him. He started to talk to me and we had a nice “small talk” conversation about the weather and chocolate and the condition of the roads and flowers. Whenever I would ask him something that he was confused about, he would twist it around to ask me a question. “Sir, do you know where we’re going?” I would ask. “Well, of course I do,” he would reply “We’re leaving the place we just were.” I know he was altered, but he was just a delightful man and not in any pain, so I just kept talking to him and we passed the time from the hospital to the SNF. When it comes down to it, isn’t that the most important part of what we do? Just try to make people comfortable and take their mind off what they’re going through? I have some coworkers that don’t (or won’t) talk to patients, or are uncomfortable with making small talk or don’t know how to behave around the terminal patients. When I work with a partner like this, I always hand them my copy of Thom Dick’s People Care. It’s a great book that explains how compassion is the key to success in EMS. If you haven’t read it yet, do it. It’s only 15 bucks, but maybe it’ll change the way you look at the people in your ambulance.
Oh yeah, I still really love the new Blackberry Curve. I’ve downloaded the Pandora app and now I stream it in my car while driving. These portable broadband devices are KILLING terrestrial radio and are one of the main reasons I got out of broadcasting.
You’re dead on regarding streaming and live audio over broadband or satellite. I give ground-based radio 10 years at most before it goes the way of the Dumont television network.
Thom Dick is a wonderful writer. I have a copy of “People Care” – in our business, they are words to live by. I’ve loaned out to different people I either currently work with or have worked with in the past. It has made more than half of them stop and reconsider things like attitude, work ethic, that kind of thing. Very powerful little book.
Do you guys just do BLS transport or do you do ALS/Critical Care with the level I patients you have? Just curious; noticing the level of patients you have listed it makes me think your system is similar to the system I work at in NH.
Is it true you’re getting sucked in by the evil empire? I worked for them for almost 5 years and I still have nightmares…
Hey Walt… good to see you're doing well. I read the "notes from captivity" every day. Blogging helps keep you sane.
As someone who working in the field for over 20 years, the radio thing is scary. I left the biz a year ago to go back to school and don't regret leaving it for a moment. My wife is still in radio, although she's on the sales side. As things continue to slide, it's becoming pretty bleak. Our long term goal is to get out in 5 years or so and buy a B&B in New England and she'll run that while I work EMS somewhere…or teach. Or whatever.
As for at we do at "IFT", it's just BLS. And the "patient level" is my own creation… more so to be humorous than anything else. The Level III guys are the ones that bitch about everything. These are the ones we do most often. However, we do take some gorked out patients (most of those are GCS 10 or less) to dialysis every other day. I think it's a shame that the families of these people continue to have them dialyzed and we're relegated to working as moving men… picking up a package and moving it from Point A to Point B. But, such is the state of health care and the reluctance to every let anyone just die, even if it is their time.
And yes, the big meeting is tomorrow at 1400. I think we're going to get the final word on what happens and who stays and who goes. I'm rather ambivalent about The Borg. One one nd, it's still going to be IFT for a while. On the other, it pays much better. So, I guess we'll see what happens.
The medic school entrance exam i in a couple of weeks… so it may all become moot in September anyway.