Wednesday, May 21, 2008

The Routine

It is no secret that the majority of what we do in EMS is deal with the mundane. Routine chest pain, the ubiquitous "cold and flu" symptoms, benign shortness of breath calls and a mixed bag of minor trauma: these things fill up our days often from start to finish. Though these calls are far from the flashy stories of life and death, the reality is we ambulance drivers are much more experienced at dealing with the quasi sick than with we are with the deathly ill.

Those complicated calls - the ones where we are forced to make tough decisions or recognize an elusive pathology - those are diamonds in the rough. They happen so infrequently that news of them spread far and wide, across our service and beyond as tales of so-and-so's call permeates distance and time. If someone gets a good call, even in this city, you can bet that most will have heard about it by day's end. It seems sometimes that truly challenging calls are so rare, that when they do occur we find ourselves so surprised and unpracticed that we might be glad to get through it all without making an idiotic mistake. My last entry on this blog might serve as case in point.

And yet those calls are the reason why so many of us decided to do this job. I hope I have convinced my readers by this time that I have a genuine interest in medicine and that I do my best to learn from each and every patient, but I must admit that I too do what I can to seek out those elusive diamonds in the rough. I want to be challenged. I want the excitement and pressure of the unfamiliar. I want to be able to say that I've been there before. I want to respond to the side of a patient for whom a special skill or talent might mean the difference between better and worse. Who doesn't, right?

...But the mundane. Oh, the mundane. It is almost suffocating in it's volume. Paralyzing in it's persistence. My days are absolutely filled with it, and I find myself sometimes in the backs of ambulances, plugging away at the routine ALS as if my job could be performed by a machine. We get dispatched to calls like a short order cook during lunch rush. Chronic back pain. Hand swelling. Car crash and everyone is out walking around. We trudge through it for twelve hour shifts, heads high only for the hope that one of these might turn out to surprise, to challenge or intrigue. There are a lot of disappointments.

I would like to know how those who have been doing this job for a long time are able to withstand the mundane. Do they no longer live for the exciting calls? Are they content to relax in the routine, or have they a way to find interest in the subtleties that I may perhaps miss in my eagerness for something new?

Am I missing something?

14 comments:

Anonymous said...

How does that saying go again?... "hours intense of boredom followed by moments of shear terror"...'tis the nature of EMS. We could all be working desk jobs where the hours of intense boredom are not followed by anything but more TPS reports.

es said...

when you find out please let me know!

equine005 said...

I feel the same way about my line of work. There are only so many times I can handle Fido coming into the clinic for his yearly vaccines and physical exam. I too like the cases that make you think.

Anonymous said...

As a brand new medic myself, a class behind yours actually I am truly beginning to experience the "mundane" myself. I can say however though that you will find the mundane anywhere you go. We had a motto in the military "Hurry up and wait" you train and train and train for ever for combat and you hurry up and wait for it. By reading your posts I see your obviously intrigued and want to purse further things in medicine, and my advice is appreciate the mundane for it will be there too. The mundane patients we deal with on a regular basis, well we hand them off to the ED RN's and MD's who in turn deal with the same daily mundane. So I say keep your head up high, sit back and enjoy the mundane with an watchful eye for one day the mundane might be much more then you thought it was!

CJH said...

Leave the job at work. When you're out with your friends, the first 45 minutes are allowable for work-related conversation; after that, the offender buys penalty shots.

The words my mentor in Newark told me:

1. Treat everyone with respect.
2. Do the right thing.
3. Never compromise yourself.

She told me that when I was at a burnout at the beginning of the year, and I find that is what's keeping me sane.

RC Huder said...

You never know when you are going to make a difference and many times it is the little ones that you hardly remember. I know how it can be. Read the following posts for my perspective

You Never know when you might make a difference

http://dispatchesfromthestreet.blogspot.com/2008/04/you-never-know-when-you-might-make.html

The Little Ones

http://dispatchesfromthestreet.blogspot.com/2008/04/little-ones.html

One of the biggest challenges for all of us is finding our own unique reason for continuing the face of what can seem like an endless stream "sick, lame and lazy" as they use to say in the service. If you don't it can get in the way of the good parts of the job.

.m. said...

I'm starting Paramedic Academy in the fall, and wondering the same thing about this career I'm heading for ...

RC Huder said...

When I look back now after retirement on twenty six years as a medic. It is not the complicated that come to mind first. It was young single mother at 3 am with a baby and no one except us to help here. The baby simply had a cold we made sure she got him the care he needed. The look of thanks still resonates. It was a young man with a debilitating disease that was watching his life slowly ebb away and he began taking it out on his mother the only person in his life. We got them the help they needed. Nothing big just got them to the hospital where they hooked up with a social worker. My partner was stopped by the mother weeks later. She told him we had changed their lives, seeing the social worker had helped. It was the code where everything was a struggle and nothing seemed to work but we delivered her to the hospital breathing and with a heart beat. She died a few days later but the family sent us a basket of fruit in thanks. Those days had given them time to say goodbye. You don't know. I came to believe it was not about the medicine as much as it was about helping people.

Christian Kay said...

I am no EMT but would hope that if I was in the same situation I would just be thankful that no one's lives were being changed by horrible accidents or untimely deaths. I am sure it gets boring but the good stuff to you is actually the bad stuff for everyone else.

YankeeMedic said...

In my experience I look at every call as a new experience. I have been in EMS a long time and yes calls can become mundane, the same old calls. I try to find something in each call that makes it unique. My partner has been with my company for a little over a year and he makes it a point to learn something new everyday. I thrive for the fun calls, but sometime these mundane calls can be an opportunity to learn something new, an opportunity to help someone else, maybe even help them come up with a plan. I provide my care to the fullest and get a sense of pride when I drop my pt off in the hospital, when the pt thanks me for being there. A thanks is something we see offen in the city environment. We have medics that follow the routine, provide substandard care or just enough care, I am not like that. In 20 years, yes this job can be frustrating, but I come to work with an open mind.

NJ EMS said...

Just move to Newark NJ.You will eat stabbing and shooting morning noon and night.

fiznat said...

Heh NJ EMS I tried that already! Spent a year there (not working EMS) and I don't doubt you for a second! That city is NUTS.

Medicmarch. said...

I feel you, and am in the same place. Keep your head up, bro.

-MM

Anonymous said...

90% bulls***, 10% oh s***!