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On pants.

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Since I mentioned that I would be chronicling my day to day life here on the blog, let me mention how much I hate PropperTM brand EMT pants. I know hate is a strong word, normally reserved for racists and baby killers… but these pants… oh man.

I hate “Teflon Coating”, I hate the ridiculous waist snaps instead of a simple button. I hate that fact that they have that STUPID trauma shears slot on the side with goofy straps to ‘secure your EMS tools’ and I hate that when I wear them on warm days I marinate like a rump roast.

Bah.

I’m going back to wearing simple black BDUs. Poly/Cotton + Breathable = Less sweaty unmentionable stuff.

/rant mode off.

Why I blog…

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I’ve been thinking about my blog a bit over the past few days. Not so much about the blog per se, but more about why I write it and how I feel about people reading it. When I started blogging, I wanted my pages to be like those from authors I admired. Witty, funny, exciting and chock full of “EMS goodness”. As I’ve now got over a year into the blog, my focus has changed a bit. Instead of an empty page aching to be filled with exciting tales of EMT daring do (which I don’t have many of), I now see a place where I can simply “empty out the day.” It’s my private place to take off the calls, like taking off my jacket, so I can leave them outside my home. Do I do this out of some self-preservation or unconscious urge to distance myself from my patients? Perhaps. I also believe it’s because I don’t feel it’s fair of me to come home and subject my wife to the stuff I see all day. I know we all need, and want, to talk about our job and the calls we did. I know we all have to let it out somehow. I just choose to do most of it with my blog, rather than over the dinner table with my wife. Don’t get me wrong … I tell her about my day, but it’s usually the funny calls (like Mr. Itchy Feet) or the experience between calls. Honestly, some of it is beyond her level of understanding or what I feel comfortable telling her. For true understanding, I’ll keep pouring it out to you … my EMS brethren.

Now, having said that, how do I feel about you all reading my blog? Well, it gets a little less weird every day. I’ll admit, in the beginning, I was pretty self conscious when writing posts. It didn’t really matter, because nobody was reading the damn thing and it was my own little on line journal. Now, folks comment on my posts and I get 20 or 30 views a day. Admittedly, that’s not much, but it’s still twenty new people reading my thoughts on an almost daily basis. the other side of this is, do people I know read the blog? Sure. Some people with whom I’ve shared my ‘secret identity’ read it and comment. I’ve found I like that. Trust me friends, If I didn’t like and trust you, you would never know about the blog. But no matter if I know you or you’re just an anonymous internet user, if you comment on my blog, I thank you for your time and words.

So, I guess the point of this is, after much reflection, I’ve decided that I’m going to continue sharing my experiences with y’all. I’m going to chronicle my day to day life as an EMT and what I’m going through in Paramedic School. Boring or not, I’m going to keep writing about it. It makes me feel good, dammit. I hope you continue to read and enjoy what I put out there. If you don’t, well that’s OK too.

4 days off.

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We’re enjoying the beach in Oregon.

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See what I see.

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It's really happening.

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Now, I’m getting nervous. It’s really happening! Yikes!

Hello Paramedic Students,

Congratulations on your acceptance to the 2009-2010 TCC’s Paramedic Education Program!

Hopefully by now you have received your acceptance letter and forms that need to be filled out and returned. Please make sure the disclosure statement and acceptance form is returned to this office by June 30, 2009.

If you need more time to obtain medical insurance and/or anything else, please let me know, we just need those items before you start the program in September.

In mid-July we will be mailing out your registration letters along with a textbook list and the certified background/immunizations requirements program that you will need to sign up for. Everything will be explained in the letter and materials in July.

Please let me know if you have any questions and/or concerns.

Again, congratulations and I look forward to working with each one of you to make this a successful year.

Posting

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Its 2158 and Claire and I are posted, covering another car’s area, listening to the fire radio. There was just a call for a possible small plane down in the area. There is also a fall/head injury. I wonder which one we’ll get.
As I was typing this we heard one of the other cars respond to the head injury call with Fire.

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***Update at 2212:

Turns out the plane landed on a private strip in someone’s backyard. Bah. But, since we were out they gave us a dialysis return.

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When it's busy, it goes by fast.

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This morning I finished my first “official” 24-hour shift. That is, a shift where I’m assigned as a permanent crewmember on a truck. As you can see by the previous posts, my assignment is in a pretty busy district, and Fire, as the first responders, have a really good working relationship with us. Rather than just relegating us to serving as “taxis with lights”, we actually assess then treat, not just transport, a lot of patients. We also work pretty well with the county medics. They seem to enjoy teaching how to help them do what they do, and as they realize that most of the crewmembers at OAC aspire to become a medic or firefighter, they know we’re willing to jump right in and help.

I’ve mentioned before how different working on an ambulance here in the PNW is, compared to where I’m from back on the East Coast. At home, Fire only rolled if it was an MVA or CPR calls. Otherwise, it was just an ambulance, with maybe a medic on a fly car if you needed help. Here, Fire runs the show. Not a big deal, just different.

The rundown of calls on the last shift was a little wacky. My new partner Claire and I were getting to know each other, and it was her first 24 hour shift, ever. Oh yeah, she had never driven the rig on a red response.

First call. Red Response to a house in BFE. Claire did a great job, didn’t drive the truck like she stole it and was very cognizant of the other drivers. I was impressed. I navigated while she piloted the truck up the winding roads. It turned out to be a 48 year old guy with a suspected kidney stone, who was SCREAMING and crying like a baby. Poor bastard. I sympathized, as I too have suffered the hell of a kidney stone and wouldn’t wish it on my worst enemy. I told him my kidney stone story and how the doc in the ER wanted to do a CAT scan and how I howled “Noooo!” He explained it was noninvasive and wouldn’t hurt a bit. My reply, “No Doc, you don’t understand, I’m allergic to cats”. I actually got him to laugh. That was good.

Next call, low blood sugar. Fire was making the guy a peanut butter sandwich when we got there and he refused transport. We hung out for a few and chatted … then back in service.

Syncope in an assisted living apartment building. Fire on scene with the PT. We spent 20 minutes trying to talk the woman into going. Refused. Back in service.

Two separate calls, both canceled while we were en route.

The code I mentioned in the previous post was next. Obviously, the medics took him. Back in service.

We headed for Starbucks and as I was ordering, another call for a head lac after a fall. This one was not canceled, and we did transport. Blood everywhere. Those head lacs bleed like crazy.

We deconned, and back to Starbucks. We grabbed food for dinner and ate at quarters. It was quiet for a bit. I managed to catch a few Zzzzz thanks to the little fan I bought for my bedroom. It drowned out the noise of the street and the breeze was nice.

An hour later, out to a possible CVA. 99 year old with decreased LOC. This woman was living with her 92 year old husband, and was unable to care for herself or him. Conditions in the house were beyond appalling. Documented and talked to ER staff to get Elder Protective Services involved.

Discharge from the ER came up on the MDT as we were clearing, but cancelled as the PT went by POV. Thank you! Back to quarters.

Out to the assault at the bus station. A 17 year old kid was jumped. He was kicked and punched and roughed up pretty good. No bleeding trauma, but he was C/O pain to his left rib cage. I didn’t feel any deformity or flail sections on palp. He was tachy at 160 and while looking at him, it was obvious that things were just not right. We assumed a head injury due to his LOC. So, we boarded him and got a medic en route. The medics grabbed him, put him in the truck and moments later, out came the sux for RSI. The medics, same guys from the code earlier, invited us into the truck to bag and help as we could. When I ran into the medics at the ER earlier, I had mentioned that I was accepted to medic school this fall. The senior medic had originally attended the program I was accepted to, so we talked for a while and when he saw me on scene, he grabbed me and told me to stick close, watch what he was doing and ask any questions I might have. Pretty cool experience. After we finished, we cleared. Back to quarters.

Up around 2330 for an intoxicated male/SOB. He was faking the SOB…and was quite an SOB, attempting to spit a huge loogie on the Fire LT. Off to the ER we went.
After dropping off the intox and getting signatures, we did a discharge from the ER that was a quick shot to a Group Family Home in the next town.

Back to quarters around 0100 and sleep ’til 0500. We drew the short straw for a dialysis transport at 0530. We did that run and grabbed coffee. As we were heading back to quarters we got one last fire call, another possible CVA. 87 y/o male who fell out of his chair in the living room and had (his wife said) a slightly decreased LOC. No other s/s, the stroke scale was negative, BGL was fine. He was oriented in all spheres when I examined him. It seems like he just FDGB and had a big lump on his head. To the ER we went, ice pack in place.

We headed back to HQ, cleaned up, restocked and punched out 30 minutes late.

Not a bad shift. When it’s busy, it goes by fast. I’m back on the truck at 0800 Tuesday morning.

Code

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We responded with Fire to a man down. The LT was running across the road to the aid unit to grab a board. “CPR in progress” was what he shouted as we rolled up. We jumped in with the firefighters and did about 8 minutes of good, solid BLS before medics got on scene. Between us and Medics, we got 5 shocks on board… then it was ACLS with Epi & atropine and then ROSC. Good femoral pulses when we lifted him on to the board and into the truck. We later saw those medics at the ER and found out that the PT made it to the cath lab.

My new partner, a new EMT that I will call “Claire”, did her first CPR. She did a great job.

Now, my friends, it’s almost 1900. Dinner awaits. We’ve only done 5 calls so far. But, the night is still young.

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That was a long day.

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I finished a 24 this morning and when I came home, I pulled off my uniform, took a hot shower and climbed into bed. I slept for a few hours and now I’m up, but still feeling a little foggy.

The shift wasn’t a bad one; it just seemed to be a little off kilter all day. I had a headache that I just couldn’t shake. Every time it would start to go away, we’d get another call and BANG! It was back with a vengeance. I’m thinking it may be related to my new eyeglass prescription. I am still experiencing the vestiges of it now. My partner was nice enough, but was more interested in yakking with the fire fighters than helping me out. In addition, she’s tiny, has some physical limitations and she couldn’t really lift. As an added bonus, we spent the first few hours on shift cleaning the quarters. The previous shifts hadn’t done any station chores, the place was a shambles and needed a pretty through cleaning. Yep, it was a long shift.

The majority of people we took yesterday could be classified as “DNNA”. Did Not Need Ambulance. Isn’t that the way it always is? We ran non-stop pretty much all night, doing 13 calls, only canceled on one. I still don’t have my key fob, so I’m still the tech on every run. I think the call that summed up the entire shift came at 0420 this morning. We went with Fire to a 24 hour grocery store where we found a 275 pound guy sitting on a chair outside the store, bellowing like a wounded sea lion. I took report from the firefighter on the engine and it turned out that this guy was riding the bus and made the driver stop the coach and call 911 because he had ‘foot issues’. I asked, “Did he get it run over or something? Maybe get it caught in the door? He sounds like his toes were amputated.” The firefighter grinned, motioned me over and leaned to whisper in my ear. “I think he’s got athlete’s foot.” I started to laugh and my partner, who overheard this exchange, walked over to the guy, who had a significant amount of EtOH on board, and proceeded to lambaste him. “I can’t believe you got us out of bed because your TOOTSIES itch! What’s wrong with you?” By this time, the engine crew and I were all snorting and chuckling. She waved her finger at him. “We’ll take you to the hospital, but I don’t like it! Not one bit!” When we arrived at the ER, my favorite nurse was in Triage. After checking him in she said, “Let me see if I have a room for him.” I replied, “You’re being far to kind.” We laughed and she looked across the stretcher at me inquisitively and tilted her head toward he waiting room, which was still full after a busy night. I nodded. We helped Mr. Itchy Toes hop off the stretcher and watched as he strolled out to the waiting room. She smiled at me and said, “You look like you had a night from hell. I’m sending him to limbo just for you”. As we walked with our stretcher out to the rig, I could hear his “OooooOoOoooohhhhssssssss” echoing out of the waiting room to the ambulance bay. I bet my partner he’d be in a room in less than 10 minutes and back on a bus in fewer than 30.

My wife and I are going out for a nice dinner tonight. It’s a three-fold celebration; my birthday, our first anniversary as a married couple and my acceptance to medic school. It’s going to be a good night. Tomorrow during the day is the annual Solstice Festival, which is kind of a big deal in my neighborhood, and an evening party with the neighbors. I’m back on the truck for the first of a 3 day set with my new partner on Sunday morning.

I'm in!

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My wife just called to tell me that the letter arrived. I've been accepted into the 2009/2010 Paramedic Education Program!

Yahoo!

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Creative Writing

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I’m a few credits shy of my degree and I’m taking yet another creative fiction writing class this summer. I started this last night and thought I’d share. (Honestly, this is a little scary, putting it out here for all to see. The stuff I write for class is different from the regular blog somehow…)

Some of the folks who read my blog are published authors, others are EMS professionals and still others are just curious about the EMS field. I’d appreciate any feedback that any of you may have. Obviously, it’s not complete, it’s a rough first draft and this is my first attempt at any type of straight “EMS fiction”.

*****************

Tires crunching over gravel and broken glass, the stutter flash of the strobes light the dark alley behind the Greyhound station like a garish carnival midway. We roll to stop behind a couple of police cruisers parked next to an overflowing dumpster and I climb out of the ambulance, locking and slamming the door behind. While my partner Tommy pulls the stretcher from the back of the truck, I sling the first in bag and the Lifepack monitor over my shoulder and walk across the trash strewn, potholed parking lot toward the broken and taped glass entry doors of the apartment building. I’d been here before.

The cop sitting on a folding chair in the lobby never looks up from the clipboard he is writing on, “Sixth floor boys” he said, gesturing toward the elevator.

I throw my gear on the stretcher while Tommy and I stand in the urine soaked elevator, not looking at each other as it makes it’s creaking way up to six. Neither of us has to say a word. We’d ridden this elevator to the sixth floor countless times together. We know what is waiting in the apartment at the end of the hall.

Tommy and I worked B shift on Medic 92. We’d been partners for a little over five months and I could see that the stress of the job was beginning to get to him. Rather than grab a beer or hang out to bullshit at the end of the shift, like he did in the beginning, now he bolted for his car, making excuses about family commitments and forgotten dinner plans. He was withdrawn from the rest of the crew, keeping mostly to himself. I was getting worried. I’d overheard him on the phone with his girlfriend the other day. He was saying he didn’t think he could take much more.

The elevator reached the sixth floor and we pushed the stretcher out and hung a right, our heavy black boots clomping down the linoleum hallway, the sound echoing off the cinderblock walls. We could see a bright light spilling from the open door at the end of the hall, two cops at the threshold, waiting for us.

The first time Tommy and I came to the sixth floor apartment together was for a heroin overdose. My old partner had just transferred back to an engine and Tommy was new to the medic unit. I could see that he was jazzed. Every call in the beginning gets you pumped. It’s not knowing what you’re going to find when you walk in to a room that sends that little blue ball of electricity screaming down to the pit of your stomach, where it rolls around, sizzling. It makes your hair stand up and breath quicken.

I looked over at Tommy as we walked down the hall. He was shaking his head, fists clenched, eyes half closed. It looked as if he was muttering to himself.

In the apartment that first time with Tommy, we met Julia. Our Julia. A Medusa-like redhead, but still young. She was somebody’s daughter. She was pretty once, Julia. You could see it if you took time to look beyond the indignities the streets had marked on her face and body. She was lying in the tiny bathroom, barely breathing. Her junkie friends said she spiked up and the next thing he knew, she “looked dead, man!” I had kneeled behind her motionless head and tipped it back, placed the mask of the ambu bag over her face, and squeezed air into her lungs. Tommy had struggled to start an IV in her delicate hand vein. I watched him draw up a syringe of Narcan, a drug used to counteract heroin, and slowly inject it into the port on the IV tubing.

The end of the hall. The cop on the left, a younger Hispanic guy I’d seen a few times before, looked down at my gear piled on the stretcher. “You ain’t gonna need that stuff.”

A few minutes after the Narcan, Julia started breathing on her own, but she was also puking and ready to fight. Tommy and I held her down as I tried to explain what had happened. That she had almost died. That she needed to go to the hospital with us. She writhed underneath us, sweaty, trying to bite, trying to break our grip. Looking up, she spit at my face, luckily missing. “Fuck you! Now I have to score again.”

All quiet on the Western coast…

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It’s been a quiet couple of days. I’ve been off since Friday and don’t have another shift until Thursday; another fill in 24 at what will become my regular quarters starting on the 21st.

The last few days have been nice. I’ve gotten a lot stuff done around the house and actually did a 25-mile bike ride on Saturday morning. I used to ride a lot, but I haven’t been on the bike in over a year. I forgot how much I loved long distance rides. I felt really good and could have done another 20, but we were on a marked route and I didn’t have anything other than a bottle of water with me. So, I think tomorrow I’ll head out again and put some more miles on.

I went to a great comedy show with my wife and another couple on Saturday night and then, Sunday morning, dropped my wife off at the airport. She’s spending a couple of days with her girlfriends for a quick recharge. I went out and had breakfast with my friend Jane this morning. She’s seriously one of the coolest people I know, and one of my few friends that I can talk about EMS with. She was an EMT-I in Oregon and even though she denies it, I think she’s still got a slight itch to get back on a truck and run some calls.

The rest of the week is low key. I’m going to see the B-52s on Wednesday night. Yes, I’m a dork. An old dork that likes the B-52s. Ahhh… I love me some “Quiche Lorraine”.

Anyway… I’m waiting again for a letter from the Paramedic Program People. I think I’m in, but I won’t know ’til I get that damned letter. Like Tom Petty said, “the waiting is the hardest part.”

At the track…

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*camera phone pics of the track.

I’m on a stand by detail at the race track today. A beautiful sunny day, watching a bunch of guys pumped full of testosterone riding Hell bent for leather on fast motorcycles pumped full of Sunoco racing fuel.

Usually, a day at the track is a slow day. Bring a book and a cooler full of snacks and enjoy the races. Usually there are no emergencies, just an easy 8 hours of OT.

Not today.

An hour into the session, one of the expert riders is taking practice laps and comes screaming around turn three, goin’ about 50, wipes out in the turn and eats it. Hard. All I could see over the barrier were plastic bike parts flying through the air. The crash guys on the radio started screaming, “Need medics on the track! Step it up!” I drove the truck out on the track and and found the rider on laying on his left side, unconscious. I did a trauma assessment and started shouting in his face, “Hey Dude! Open your eyes!” Yep. He was able to open his eyes and groan at me. My partner, who was new helped me and the crash truck guys log roll him onto a board to get him of the track. We got him in the truck and got his leathers cut off. (No great loss as they were shredded from the crash. I did however, cut along the seams.) After I did a full exam he became more alert. His only complaint was some tenderness to his right ribs and an avulsed fingernail on his left thumb. Ouch. He wanted his helmet off, but our protocols say leave it on, so it got taped to the board with him still in it. Since it would have taken medics a good while to get out there, I decided to hold off and send him to the local ER with a BLS crew. Those leathers saved his bacon and I expect to see him back here at the track later today. These guys are animals.

I also had to do a quick lesson with my partner. “When I say I need a board, that really means I need a board, straps, collar and a Head bed. All of the accoutrements.” Not her fault, she hadn’t put anyone on a board since EMT school and hadn’t done any emergency calls … only the ‘renal roundup’ IFT type stuff.

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Words to live by.

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A few more days

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I’ve got the luxury of a couple more days off before the next set of shifts. I found out that I’ll most likely be on B shift at the station I worked at over the weekend. (Yeah, that busy place in the post below.) I’m pretty excited about it, because I wanted a busy shift. Looks like I’m getting it. I’ll know for sure next week when all of the new shifts are finalized.

I’m doing some more float/fill in the next couple of days. I’ll be on a 13 hour day car on Thursday which will be a nice change. The day cars seem to be a little more laid back than 24 shifts, as we only cover 911 during shift change for the 24 hour crews and as back up when they’re all on calls. Most of the rest of the calls are simple IFT.

I ran a few more errands today. I stopped by the uniform shop to change out my regular sized shirts for “tall” and visited the eye doctor to get a new prescription for my glasses. Now it seems that I have a slight astigmatism in my right eye. Things were a little blurry and I needed new glasses anyway.

My wife and I had a great night last night. We went out for dinner, had a couple of glasses of wine and then came home, watched a movie and just hung out together. It’s so good to be married to your best friend. I know that a couple of the other bloggers that I read mention their significant others frequently. It’s really important to have a good, strong support system to get you through the days. My wife is well aware of the rigors of medic school and she’s the one that pushed me to apply this year. I wanted her to know what I do for a living now and what to expect in the future, so I gave her my copy of Kelly Grayson’s book to read. She laughed and snorted and got teary eyed and said, “I get it”. She really is wonderful. And, she bought me a laminated Thomas Guide for my birthday. Is she swell, or what?

the count so far…

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So, when I said I was going to be busy today, I was right. Here’s a rundown of what my partner and I have done so far today.

1- Heroin OD. Narcan and LR line. He was CAOx4 when we got him. (*Medic eval)
2- 58 yo male Syncope/HTN. (*Medic eval)
3- Metro Bus vs car. Low speed, <15mph. 1 pt on bus was backboarded.
4- SOB with severe WOB. Sats up to 98% on a NRB, but I had my hand on the BVM ready to jump in.
5- 2 car MVA. We took the self extricated 26 yo male driver. Medics took the other driver.
6- 88 yo female with weakness.
7- 80 yo female with COPD, sob.

Its only shortly after 10 pm and we still have 10 hours to go.

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(addendum @ 4pm on Sunday afternoon)

-here’s the final count, in addition to the 7 above, we also did:

8- A 68 year old man who fell out of bed and possibly fractured his nose. Copious amounts of blood. But, he was hilarious.
9- 29 yo male found down in an alley. GCS 8, responsive to pain only. Judging by smell there was a LOT of EtOH on board and a huge occipital lac. He had a gag, so no OPA. (*Medic eval)
10- Return the 88 yo female with weakness to her assisted living facility. Hey, we were there and the ED needed the bed.
11- Unknown Aid Call. Canceled.

I’m not yet cleared to drive the trucks, so I was the tech for every call. At OAC they make you wait before you’re allowed to drive and they issue a Road Safety key fob. (Fine with me. I still need practice writing their reports. Lots o’ boxes to check off.)

By 2am the triage nurse at the ED was laughing when I called in on the radio with a short. “Not you guys again”, she said.

Anywhere between 10 and 15 calls is about the average for a 24 hour shift in this district. I finally got some sleep around 3 am. We were yanked from the loving embrace of that welcome slumber by the tones for an aid call at 06:20, but were canceled by fire while en route.

So goes a 24.

I came home and took a little nap, and now I have just returned home from running errands with my wife.

The Weekend

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The last few days have been interesting. I’ve been working float shifts, filling in on shifts where people have called off or need coverage and I’m about to start my second 24 hour shift. Our 24s all start at 0800, so I can get an extra hour of sleep, which is nice. Thursday, I worked in one of the slower districts. We did three calls in a 24 hour span, which was a little slower than I would have liked, but I’m not complaining. My partner and I watched a couple of episodes of “Iron Chef” and discussed the merits of peanut butter on cheeseburgers. (Both of us agree it’s tres magnifique!)

None of the calls were anything special; a possible pneumonia, a low blood sugar, which thanks to the medics, was corrected with 12.5g of D50 but was still transported to the ER and a call for “general weakness” which came in at about 0630 on Friday morning. We were lucky that we were able to sleep through the night. I doubt I’ll be so lucky today.

I still don’t have a permanent shift, so I expect a few more weeks of “catch as catch can” shifts, working a mix of 13s and 24s to fill up my hours for the week. If anything exciting happens, I’ll jot it down here in the bliggity-blog.

As an aside, I offer a serious piece of advice, “When washing a white uniform shirt, make sure there is NOTHING colored in the load with it.” My sparkling white shirt is now a strange grey/pink color. OxyClean helped, but it’s still not quite white. And, I can’t bleach it because of the patches and insignia. Oh yeah, did I mention I’m still waiting for my other uniform shirts to come back from the tailors? Yeah. Me= dork in pinkish shirt. FML.

Howdy y'all

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Not much new here, aside from the stupid amount of sun we’ve been exposed to. For God’s sake, this is the Pacific Northwest. we’re simply not used to not being rained on constantly. Everything I own has finally dried out and I’m lovin’ it!

I’m not working again until Thursday, when I’m pulling a fill in 24 for someone who needs a day off. The scheduling guru told me I can expect another week of float work until the new 24 hour shifts come on line. That’s fine with me. I’ve just been getting stuff done around the house. Haircut, bike tuneup, garage cleaning. The typical stuff that I never have time for.

As soon as I get word on the new shifts, I have to let the folks at the water park know. I’ve had them on hold until I know more about my “real” schedule. All of my friends with kids (and some without kids) have asked if I get free passes to the park. “Yep, I do.” All of the people that want to go have already put in their request. Don’t worry guys, I’ll hook ya up. I promise.