The Hardest One

As a paramedic, people often ask me, "What's the grossest call you've ever run" or "What's the coolest thing you've ever seen" and the dreaded "What's the hardest call you've ever run?"  Running on a kiddo absolutely breaks my heart.  Especially now as a mom it hits home even more.  But I guess that's to be expected.  No one likes pediatric calls.  Then, there are the calls where you walk into a room and realize you're surrounded by brain matter.  Yes, it really happens that way.  Definitely gross and nobody likes to see that especially after dinner.  But these are often times not necessarily the calls you cannot shake. 

Besides the children and the brains, the hardest calls for me are the ones where you encounter a patient who genuinely needs your help and for reasons beyond your control, you cannot help them.  It's the emotions that make a call weigh down your heart.  It's leaving the scene and aching your brain to think of a way to run back in there and give them the result you know they need.  I had one of those calls tonight.  The shift was going well.  The system was busy but that's how it goes.  We were dispatched to a nursing home.  In all honesty, these calls sometimes make you roll your eyes.  No one wants to give up a good "shooting" or "stabbing" for an "abnormal lab values" or something of the sort.  This one was a "fall."  We figured it to be a somewhat straight forward incident and the call would go smoothly and just how they always do.  Evidently we figured wrong.

We arrived on scene to find a patient who was not complaining of a fall but was in fact having trouble breathing.  It was so significant that his frail fingers were blue and he was struggling with every breath.  Through our courses of breathing treatments and monitoring his oxygen levels, we realized this patient would need more than we could provide in the field.  However, he refused transport.  Refusals are not uncommon.  People refuse transport all the time.  But this man desperately needed further treatment and he absolutely put his foot down.  After discussing our normal routine of risks and such, we realized he was not going to come with us and legally, there was nothing we could do about it.  That's when things really got sticky.  While talking with the nursing home staff, they became uncooperative and just, for lack of a better word, questionable.  They began making comments that made me question their thoughts about the patient's welfare.  It really is not uncommon for people in healthcare and the like to have negative thoughts about nursing homes.  Often times, they appear selfishly driven with no concern for the patients.  Almost as if these patients are a hinderance to them.  Here's an idea.  Get a different job. 

So here we are with a staff who is trying to tell us it is their policy that the patient be transported and we are telling them how legally, that is kidnapping.  Not to mention the "unusual" comments they were making amongst each other.  I won't go into detail but rest assured, everything was documented and reported as necessary.  What really broke my heart about this whole situation is in a position like that, you begin to feel such passion about patient advocacy.  This poor elderly gentleman probably did great things in his life and here he was in a time of significant medical need, minimal family (non of which were on scene), and the people who wanted to help him, couldn't while the ones who could, would not.  There were several things on scene that we had to correct and while that makes me feel good to know we helped him, it makes me wonder how many other things go uncorrected.  The bottom line is, do not put me in a nursing home.  I wouldn't wish that on my worst enemy. 

All of that coupled with a few other details I won't discuss really took our energy.  After that call, all three of us were pretty much ready to go home.  It irritates me because it really frazzles me.  Then, I have to quickly get my thoughts straight again and prepare for the next call.  Just another reason why medics have such a hard time with stress.  We are constantly pushing it down because you have to get your mind right for the next patient.  There's no time to center yourself until you get home.  Which by then, you are inevitably so exhausted it is all you can do to drag yourself into the house, strip your disgusting, germ-laden clothes off, and crawl into bed where it takes you about 4.2 seconds to fall asleep, only to do it all again in another 12 hours. 

On some non work-related thoughts...I got to spend some time with Cooper this morning which was fabulous.  Yesterday, I had a meeting before my ambulance shift so I left the house before Cooper was awake and did not get home until after he was asleep.  A whole day of not seeing my tiny guy.  Again, broken heart.  But I did get to get him when he woke up and he was tickled to see his mommy.  Smiles galore! I intend to do the same with him tomorrow morning before my shift.  Tomorrow is my "Friday" which absolutely thrills me!  I am ready for some good sleep, family time, and just plain downtime.  It's hard to take care of people for 12 hours a day when you realize you haven't even had a chance to take care of yourself.  This weekend is well-deserved, if I say so myself. 

With all that being said, I suppose it is time to lie down and wait the 4.2 seconds to fall asleep.  I am so exhausted today it is unreal.  Those emotional calls really take my energy and it just does not get replenished until I get some good sleep.  Fingers crossed! Maybe tomorrow we will encounter something "cool" or "gross."  I just hope it's not one of the "hardest" calls to run.