I've finished my first week of precepting, and as all of you have probably noticed: I havn't posted any new entries.
It most certainly has not been for a lack of things to write about. These past six or seven shifts have been completely full with new experiences, new lessons, and new stories. Already I have done things that I never thought that I might have to do, bore witness to things I hadn't planned for. Working as a paramedic is a completely different adventure, and as of late I have found myself so overwhelmed with experience that I havn't had the time to sit back and expound on them in type.
I'm surprised by the number of mistakes that I'm making. I suppose that this should be expected, but the devil truly has been in the details. There are so many more decisions that I am responsible for, often it has been all I could do to perform BLS, control a scene, make a plan, and thrust a feeble attempt towards ALS. It is a special skill to remain organized in the face of chaos, to do things methodically so that nothing gets missed and no wires get crossed. It is most definitely a skill that I have not yet come close to mastering. I feel like I wheel each of my patients through the ER doors half-finished, always asking assessment questions in triage.
I find myself constantly hoping for a few more minutes, a moment of calm to sit back and peruse my options. In this city the hospital is always so close, looming down from a few blocks away is the promise of my patient's salvation. How long am I supposed to spend in a patient's house or in the street: assessing, tangling monitor wires and inserting needles? Time is always an issue.
With my attention focused (or spread out, perhaps) on the newness of all of this, I have made some fairly silly mistakes. I splinted the wrong wrist on a fallen motorcyclist, started an IV without spiking a bag first, forgot my oxygen bottle on a 6th floor asthma. Mistakes I would never have made as an EMT-B, but with my new responsibilities I have had trouble remembering the basics: something that I have been working hard to keep from happening.
A step back so that my next one forward is sure.
Along with failure, though, I have had some successes. The purported diabetic who I recognized as an overdose, treated, and laughed with the rest of the way to the hospital. A chest pain that I feel I managed well, offering palpable comfort to a worried old woman. While some calls have left me feeling helpless, I have been blessed with many opportunities to be the face of relief, comfort, and compassion for my patients. My preceptor seems to be reasonably pleased with my performance. He wrote in a recent evaluation sheet he feels that I am both doing well, and capable of better.
I'll make sure that he's right.