My Father Was An Ambulance Chaser - Part 3 April 2010

Part 1

Part 2

TYING UP LOOSE ENDS

Armed with a diploma from the Stanford University Hospital
Paramedic Program,

documentation from Highland Hospital in Oakland that I had passed

my hospital rotations, documentation from Southern Marin Fire that I had treated the required number of ALS (Advanced Life Support) patients appropriately,

as well as a folder full of certifications:

BLS (Basic Life Support), BTLS (Basic Trauma Life Support), 

PHTLS (Pre Hospital Trauma Life Support),

ACLS (Advanced Cardiac Life Support), and 

PALS (Pediatric Advanced Life Support) — I was still a very 

long way from being employed.  Visa was beginning to send 
thank you cards.

Now, California wanted to know about me.  

Did I have a record?  No.
Did I do drugs, no - please leave urine sample as proof.
 

California DMV (Department of Motor Vehicles) 

wanted to know if I had any driving infractions.  No.

How about drunk driving?   No.

Well then, you must come by the nearest DMV, pick up your

ambulance driving manual and study it for your exam.

But before you take the exam, we want a full physical

by OUR doctors. . .not yours.

I passed the physical exam, passed the ambulance drivers

exam, and was awarded a license to drive ambulances

in the state of California for 2 years - renewable.  

WHEW!

I was STILL not employable.

California required all paramedics to pass

the aptly named, 4 hour, BARE (Bay Area Regional Exam)

before you could work on any ambulance

in the state as a paramedic.

The nearest and closest exam was to be held in

Sacramento in 2 months.

More studying, more stress.
I passed

and was blessed by the state of 

California to start job hunting.

My first choice was San Mateo County, they had an international
airport and 2 little ones, a long coastline, mountains. urban centers, 
freeways, and a brand-new company

that had designed and purchased a fleet of new ambulances

and equipped them with all the latest high-tech

sophisticated  bells and whistles.

We even had TVs between the captain chairs in the cab!

Each ambulance was stuffed with all the latest medical equipment.

And they paid well too - woo hoo!

More hoops to jump through.

San Mateo County perused my paperwork,

Baystar (my potential employer) gave me

oral interviews, written testing, skills scenarios, orientations,

CHP (California Highway Patrol) ambulance

drivers ed and testing,

and assigned me to a crew for an ALS 

5-call evaluation.

Passed.

There is nothing in all of this training and testing that can

prepare a new paramedic for their first day on the job!
With every crackle of the radio; my heart rate soared,
I perspired profusely, and turned a whiter shade of pale. 

There were 9 hospitals in San Mateo County,

I couldn't find any of them. 
I lived 2 counties away and was not familiar with SM.
My partners quizzed me between calls.
Ok, we're at the intersection of blah blah and blah blah,
what's the closest receiving hospital and
how will you get there?
Umm. . .
I memorized map routes, I asked fire to
direct me, I asked PD for an escort,
I found the hospitals on the first try — most of the time.

Meantime, I memorized the county protocols

(CHECK THEM OUT!)

until I could recite them in my sleep.

I started on the night car because I had no seniority

and worked 4 consecutive days of 12 hour shifts from 6pm to 6am.
Working twelve hour shifts required living in the ambulance the whole time
on street corners and in parking lots,
or wherever we felt safe.  Remember, we carry morphine.
I had an hour and a half commute on each end as well.

I was a mess.

My first call as a wet-behind-the-ears medic was for an

elderly woman, short of breath, in San Mateo, at 3:30 AM.

She scared the life out of me.

We found her in the foyer of her apartment building

breathing to beat the band, with a lengthy medical history,

and terrifyingly at the end of her rope.

  My partner and I assessed her,

her lungs were full of fluid and she was moving almost no air.

We put her on high-flow oxygen by mask, established an IV,

 sprayed Nitroglycerin under her tongue,  

gave her a IV diuretic, made her as comfortable as possible on our gurney,

and I climbed in back with her as my partner slid behind the wheel

for a Code 3 return to the nearest ER.

She made it — and so did I.

At the time, Baystar had 12 hour and 24 hour shifts for medics to work.

My favorite was the 24 hour shift because we worked only 10 days a month.

Part time job, full time pay.

My kind of career.

Eventually I accumulated enough seniority to bid for the 24 hour car
in East Palo Alto.
I arrived for shift change at 7 am

and got off at 7 am the following day.
The rotation went like this:  On, Off, On, Off, On, Off, On, 4 Off.
Those 4 days off were heaven.

We were free to do as we pleased between calls as long as we

were available and could be on scene of a call anywhere in our zone within 
the 8 minute county-mandated response time.

Life on a 24 hour paramedic shift:

 Again, this cartoon is the brilliant work of the funniest paramedic

in the business - Steve Berry

I Am Not An Ambulance Driver 

Ok, enough background, you get the picture.
Now for the fun stuff.  Stay tuned for:

•  EMS stories - as the sirens wail
• Real 911 calls
• Defibrillating on the reef
• The death of a partner
• Novel ways to kill time between calls
• 'Bending' the rules. . .shhhhhhh.
• An accidental needle stick
• Partners - the good, bad, and the scary Larrys
• Ambulances crash too
• System Status Management - get the gun
• Getto medicine - get in and get out
• Politics
• Fire guys - gotta love 'em, even married one
• Getting shot at
• Stop eating and driving - we can't get the salsa out of the radios
• Getting a clue