Hello friends, it’s been some time. To the four people other than my mom who read this, thank you. The process of writing helps me process my emotions and clear my mind. You know the drill by now, three things and a song. Thanks for playing along. Talk soon.
Thing 1: Try and Make it Nice…
In our house, we have created what we call “The Music Corner.” It’s located in the northwest corner of the living room. Its purpose is to provide strings to play and a place to play them. A record player is the main feature and is primarily utilized to boom hype music across the hall for me and my wife when we need the motivation to do the dishes. The leather chaise lounge along the wall gives the impression of a counselor’s office furniture, but I’ve grown rather fond of it. For many years, music has been a form of therapy for me. Turning chaos into order, providing words in the form of lyrics when I had none. If I didn’t sound like a tone-deaf musk-ox when I sang I would never stop singing. But alas, I am only human. So I sit and listen to the music while I try and find the words to write. Not for a song, but for the thoughts I’ve had over the past month. Three verses if you will, to a melody that I’m still figuring out. But that’s what practice is for I guess.
Thing 2: Project Feedback
“If you stick that needle in me, I’ll punch you in the face!”
This is not the typical reaction I have when I tell a patient in the back of my ambulance that I’m going to insert an IV catheter into their arm. But this was not a typical patient either. My partner and I had responded to a one-person camping trailer behind a shed in the rural Virginia woods. We had met a very distressed patient, who for the sake of this story we will call “Doug.”
Doug was having severe chest pain and was quite upset about it. He voiced his distrust for medical providers, confirmed his recent history of substance abuse, and screamed that he felt like he was dying, all in the 4 minutes we were on scene. As my partner turned on the lights to pull out of the driveway I purposed my treatment plan which included monitoring his heart, obtaining an IV, and giving him some medication to relieve the pain. Doug promptly proposed his plan of punching me in the mouth if I stuck him with a needle.
Negotiations continued, and two minutes later a needle entered Doug’s vein. This was accompanied by screaming and my partner asking if he needed to pull the ambulance over. I told him that we did not and that Doug and I were beginning to get along better. We kept speeding down the road towards the city. I called the hospital and informed them of my concerns relating to Doug’s 12-Lead ECG. I was very political in my response to Doug when he asked what the picture of his heart looked like.
“I’m seeing some concerning trends that I’m going to tell the hospital about but it’s not enough to be called a heart attack just yet.” This was barely enough to keep Doug buckled in as his anxiety rose. Doug’s eyes nervously darted around the hospital as we rolled the stretcher down the brightly lit ER hallway. My heart felt for him. Over the past hour, we had come to an accelerated understanding of one another and now I was going to abandon him in some random ER room where the doctors and nurses were going to ask him the same questions all over again.
“Let them take care of you.” I reminded Doug as I stepped out of the room after giving a report to the nurse. This is where I anticipated the story of Doug and me to end. But really, this story isn’t even about Doug. I’ll explain that in a minute.
Two days later I was walking down the same ER hallway on my way back to the ambulance. I heard a shout from the nurse’s desk. I turned around and walked toward the voice wondering if I was in trouble for something. I was relieved to see it was the fiance of one of the firefighters I work with and a nurse that I had a positive working relationship with. She asked if I had brought in the anxious chest pain patient last week. I nodded. She told me that the patient had ended up having a massive STEMI (heart attack). And was in intensive care recovering. She explained that Doug had been so distressed and anxious that they had to sedate him in order to get a second IV. Even after a successful trip to the cath lab, Doug had to be reintubated and paralyzed because he was a risk to himself by trying to pull out his ballon pump threaded delicately into his body. I thanked the nurse for keeping me updated and boarded the elevator. As I walked through the ambulance bay I began to replay the events in my head. Should I have alerted the hospital more aggressively? Should I rely more on my gut feeling than the artifact-ridden ECG strip? and what would I do differently next time? I produced more questions than I had answers for but I realized the questions weren’t just about Doug’s case. As I sat in the passenger seat of that ambulance one thing became clear.
We must seek feedback.
As a paramedic, when I leave the patient’s side in a hospital room I often leave the closure available you get when you know a patient’s diagnosis, outcome, or treatment plan. This closure is more important than you might think. It’s more than being “nosy” it’s confirmation of an intervention, it’s learning from a mistake, and it’s validation that what you’re working for doesn’t disappear behind the curtain of an exam room.
Businesses around the country have realized that feedback can often reduce burnout. Feedback can improve an individual's future performance. So I have begun my journey to request and help implement safe and sustainable feedback for myself and other paramedics. I don’t know just quite how that will look but I can guarantee that if you’re reading this by now the email inboxes of people much smarter than I have received an email from me. Hopefully, the people with the alphabet behind their names will be willing to help me out.
And if you’re looking for a reminder. Go seek feedback. Regardless of position. Seek feedback in your jobs, relationships, and daily life.
Thing 3: Pine Rd Home
I try my best to capture the house updates as they uncoordinatedly waltz by. This documentation reminds us that even though the dining room is covered in sawdust, we are in fact making progress. So here are a few rapid-fire updates on the last cape cod on Pine rd.
- I replaced the two rotting front porch posts and corrected the leaning and stroke-like symptoms the porch had been exhibiting. I breathed a sigh of relief when a matter of hours later the insurance adjuster showed up to photograph the outside of our early life crisis we call home.
- Harper is currently digging a trench in the front yard large enough to fit a small platoon of soldiers safely. She is very proud of herself which makes one of us proud. She celebrates by opening and disassembling all of the amazon packages that arrive. Thanks, Harper!
- Jen started fixing plaster cracks in the upstairs bedrooms. It’s a passion project for her. Just negative passion though.
- I started demolition on our downstairs bathroom. It gets worse before it gets better. We still use it to pee late at night when we’re too lazy to go upstairs.
Tune in next time for more useful (useless) updates.
Final Thoughts:
I think you’re a wonderful person.
Song Suggestion: “Loved Loving You” Jordy Searcy
