I feel like a different person. I am acutely aware of the new patch on my shoulder, yes, but there is more than that. I have done a lot of this before. Routine clinical practice in school, calls on my ride-time internship, more calls while precepting. All of them, experiences designed to bolster my confidence and add wisdom to my choices, but still: sitting in the front of the ambulance - the paramedic with an EMT at my side - I feel like I am in a new and strange place.
The feeling strikes me as contrast to those Peter Canning expressed in his most recent blog entry. He writes how things havnt seemed to "stand out" lately, that he could write about some of the things he has seen, but he has been there before- written about it and now considers it old news. He's met a lot of amusing patients, seen the good medicals, and was there for the big traumas. ...And yet the experiences no longer seem to stimulate as much as they once did. Peter is experienced. Stable.
I sure as hell cant say that for myself. I've seen a total of 4 patients so far in my career as a cut-loose paramedic, and each one has seemed so important, so groundbreaking, that I really had a hard time choosing what I wanted to write about.
It isnt as if I have had all great calls, either. A seizing, ex IV drug abusing hypoglycemic who woke up after 3 tough IV attempts and an amp of D50, a deformed ankle, female weakness x 6 days, and a drunk. I went through my routines with each patient, assessed, treated, and even downgraded one of them-- but the experiences were so fresh and new. I was shocked to watch a first responding firefighter glance at our patches and then come to me to give his report. It was such an odd experience to act as the final word on scene. We're going to stay here and take a look. We're going to get going as soon as we can. The words came out of my mouth, not for the first time but with newfound impact. I was in charge of the scene, and people listened. Maybe they have no idea how new I am, that this is my first day and that behind my sunglasses, my eyes probably betray this overwhelming uncertainty.
I hung tough though. Played it cool and, I think, made the right choices for these first four patients. Even the routine feels new these days though, and I worry how I will fare when something really tough, some zebra comes along and forces me to make a decision. I hope I make the right choices and, even more, I hope I dont have to make those until I can get a little more experience under my belt. This job seems to favor trial by fire, though, so I doubt it.
Things sure are different here on planet paramedic.
I left my last entry with the news that my first shift would be with a friend, standing-by at a boxing event. So it was, although we didnt get any patients. We did, however, get awesome seats to a pretty good show:
Cant complain about that!