Afleveringen
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We discuss what things we want others to know about our careers.
In EMS we can tend to jump immediately to being confrontational, even when the other person isnât meaning to be confrontational.
We all have different scopes and different levels of knowledge.
Casey wants people to know that paramedicâs get extensive training in 12 lead interpretation.
Lucas wants people to know that doctors are not the boss or supervisor or the manager, we are a team and we each have our roles.
Egos tend to make people see the system in a hierarchy. We all need to be willing to teach and check our ego.
A good EMT will catch things that paramedics are missing.
Nurses are hard workers and tend to be on their feet longer than paramedics.
Advice for newbies:
You canât save everyone, regardless of how well you function.
The job is not all emergencies.
Take care of yourself before you take care of others. There may be times when you must prioritize other things in life, but long term, you must take care of yourself.
Have an identity outside of your profession.
Create rituals that help you perform during your day.
Casey prays every day before his shift to be his best self and take the best care of his patients.
Keep a journal. You may want the specifics of certain details later in life.
Create healthy hobbies.
If you want to support the show, follow the links below for some great health and fitness products.
My favorite protein:
https://1stphorm.com/products/phormula-1/?a_aid=PracticalEMSMy favorite 1ST Phorm Energy Drinks:
https://1stphorm.com/products/1st-phorm-energy/?a_aid=PracticalEMS
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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Meaningful patient interactions â Hold on to them.
The mundane calls, the rude patients, the horrible things we see - those are the price we pay for the one call where you save someone or have a meaningful interaction.
It is an honor to take care of patients that canât get help in any other medical setting except the ER.
Find one thing every shift that you find fulfilling. Be intentional. Find that thing. Someone sweet, someone grateful, someone you helped.
You need the right expectations. Not every patient is dying, and too much high acuity will actually take its toll on you as well.
Micaela talks about the MCI she ran and her question of how could God be present in the destruction. She came to realize that God is not in the event, Heâs in the healing and the processing of the event.
Providers should be educating those with less education and that want to learn.
Some things get easier with time, and you donât have to think about them as much.
If you want to support the show, follow the links below for some great health and fitness products.
My favorite protein:
https://1stphorm.com/products/phormula-1/?a_aid=PracticalEMSMy favorite 1ST Phorm Energy Drinks:
https://1stphorm.com/products/1st-phorm-energy/?a_aid=PracticalEMS
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Zijn er afleveringen die ontbreken?
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Our new panelists:
Lucas- ER Physician, Micaela- Paramedic, Alex- Paramedic, Rebecca- ER RN, Casey- Paramedic
We discuss struggles with caring for patients that have perpetrated violent crimes.
Recognize your own bias and your personal history that may affect patient care.
Itâs important to have a good self-care plan because you canât pour from an empty cup.
Pediatric calls will stick with you. They require intentionality to overcome.
We all carry scars with us.
Understand that we are human, and it is normal to feel emotions, but we owe it to our next patient to continue to be our best self.
Donât miss opportunities to tell your family and friends you love them. Life is fragile.
Find the âthingâ that works for you to help you heal from the things we see. Exercise, walk, talk with someone, watch a movie.
Overcome the challenges in a healthy way. Healing instead of coping.
Embrace the beautiful moments.
If you want to support the show, follow the links below for some great health and fitness products.
My favorite 1ST Phorm Energy Drinks:
https://1stphorm.com/products/1st-phorm-energy/?a_aid=PracticalEMS
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Struggles in emergency medicine
Casey struggles with keeping up with the changes, especially the technological changes.
If you worry about keeping up, put yourself in a position to teach the new people. They will force you to learn as well.
Micaela talks about her personal struggle with burnout and the significantly high acuity calls she has run
She ran a ton of high acuity in a short amount of time. She had difficult partners and students. She was a critical part of a shooting that made national news. She was medical control on a significant MCI as well.
Some paramedics will have periods of time that are much higher acuity than normal.
Some EMS systems are so busy that you gain experience much faster than others.
Casey talks about a pediatric cardiac arrest that we were able to get back and had a good outcome.
Making that human connection is important to preventing burnout. But it needs to be done with some wisdom. We cannot pick up burdens all day that our not ours to bear.
Physical touch has power.
We all want to connect with patients, but this is difficult in certain settings. You must balance this with the emergent patients that require more of your time.
Burnout is avoided by connecting with patients.
If you get to know them, they might surprise you with their amazing stories.
If you want to support the show, follow the links below for some great health and fitness products.
My favorite 1ST Phorm Energy Drinks:
https://1stphorm.com/products/1st-phorm-energy/?a_aid=PracticalEMS
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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We welcome our new panelists.
Micaela (paramedic)
Simone (former ER RN and now ER NP)
Paramedicâs Alex and Casey returning.
Simone gives us a glimpse into the tough transition from ER RN to ER NP.
You need to love the medicine. Having to know so much of so many things was one of the toughest parts.
You must be second best at every specialty.
Alex talks about the transition from EMT to paramedic.
Being in a system that creates strong EMTâs makes the process easier.
Being able to think back to times when you were an EMT and what your paramedic did in certain scenarios is a great frame of reference.
Transitions like this are difficult to explain until you have lived them. Not having that safety net is a big difference.
Confidence only comes after practice in the field, not in school.
Donât make the mistake of thinking you know everything. It can be a dangerous mentality.
Critical procedures should always be taken with the seriousness they deserve.
Casey talks about pericardiocentesis (please follow your protocols)
Cricothyrotomy stories
Casey takes about doing this in the back of a helicopter.
Think about having to cric every time you intubate a difficult airway.
RSI discussion
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Emergent Standards
I address a comment about how we mentally handle the patients we care for that have committed violent crimes. We still care for them to the best of our ability; in fact we often learn the whole story after we have finished caring for them. We donât judge because that is not our role. We find ways to move on from the horrible situation.
Emergency standard:
Take care of yourself before you take care of patients.
75 Hard has completely changed my mindset. I actually stick consistently to goals that I set for myself like never before. I can get up early before work and get myself in the right mental space to take care of patients to the best of my ability.
Practical tips:
Pack your food. Pack your water.
Track calories and macros.
Wake up early.
Daily exercise.
Leave for work early.
Wake up before your family.
My favorite creatine supplement
https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS
My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMSIf you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Confidence in EMS:
Nate talks about how he was reaffirmed when learning ALS meds and a physician agreed with his treatment plan.
School does not make you confident.
As a provider, give the crews feedback because it helps them grow and confirm their plans and treatments were accurate. Donât just give negative feedback.
Some students do need an extra push to make them uncomfortable enough to progress or realize how far they still must go. They need to develop critical thinking for when they have no safety net.
Running calls when you donât agree with the other responders/providers:
Be blunt when you believe a treatment can be negligent. You must advocate for your patient even when this means confrontation.
Certain treatments have the potential to harm. Aggressive treatment is not always needed.
State where you stand when you disagree.
It can be difficult to broaden the differential when another provider is totally fixated on the initial impression.
We need to approach as a team. Have discussions. Be willing to consider your rationale for why you believe what is the right treatment path.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Random stories episode!
We often donât want to talk about the âcraziestâ call weâve ever seen.
I tell a story about a fireplace fueled by batteries and no real medical reason for the call.
We talk about things that surprised you about emergency medicine
Dealing with drunk people is a challenge.
Other great random stories:
Thoric dissectionâs, triple Aâs, rhythm changes, driving lights and sirens, hitting deer, getting into accidents.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Jumping back into our discussion on alcohol abuse in EMS.
Everyone is susceptible to overuse of alcohol so abstaining can be powerful even without it being your vice.
Interpersonal communication skills are key to developing in EMS. We need to connect with our patients.
Patients care more about being understood and listened to than good medicine.
Advise for newbies:
Itâs hard to admit when you have a problem but that is the first step to fixing it.
Itâs okay to fail but you need to pick yourself quickly back up.
Know you are not alone with these vices, be it alcohol or something else.
You must be prepared for that next difficult call or life event. Because it is always coming.
It is helpful to have friends that do EM and friends that donât do EM so you arenât always centered around work.
Our dark humor in EM is needed to help put things on the back burner so we can move on in the moment, run that next call or see that next patient and deal with it later.
Sarah tells a story about a grandma that passed away then immediately running a baby being born.
Nate tells a story about connecting with a patient and that how that is the exact reason he got into medicine.
Kate talks about how itâs worth taking the time to explain things to patients.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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New panel!
We welcome Alex, paramedic and Kate, EMT.
Welcoming back Sarah, paramedic and Nate, EMT.
What makes a great paramedic?
Treat your EMTâs like a partner. Talk about calls. Teach your EMTâs. Educate without belittling.
Create an environment where your partners can question the plan if they donât understand it.
Learn from those that have been doing this for awhile.
What makes a great EMT?
Ask questions.
Have desire to improve.
Nate talks about his struggle with alcohol
When you crave alcohol or vice in general, you usually have one of the following:
HALT: hunger, anger/anxiety, loneliness, tiredness.
Alcohol abuse is a huge problem in EMS.
It being so socially acceptable makes it more difficult to overcome.
Alex and Nate open up about how they have had success overcoming this vice.
EMT schools sound like they are doing a better job at preparing EMTâs in the skills needed to verbally deescalate a situation and empathize with patients.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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You guys ever see a dead family member in a patient? Like they look similar, act similarly?
No?
Maybe itâs just me.
Nate talks about his life experiences and how it helps him talk with patients that are struggling with mental health. He talks about a patient experience where he really connected with a patient and how the patient was seen years later having changed his life.
We talk about God in EMS and the really unfair and tragic things we see. How this will test your faith.
Kiley talks about how, seeing so much death, itâs seeing the patients themselves in their last moments that convincing her there is a God.
Burnout
Lean into your coworkers, share your feelings. Talk with people to help heal.
Follow up on that critical patient you are worried about.
Avoid substances.
Talk with people about how you feel.
Use those frustrations to exercise or do something productive.
Calls add up over time. Sometimes it not just one call, its multiple in a row
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Leadership in emergency medicine
Good nurse to patient ratios is very important to good patient care and allowing those little moments where you can spend some extra time making sure the patient feels cared for.
Management doesnât always equal good leadership.
Part of being a good leader is being the calming presence in a chaotic scene or situation. Walk, donât run. Be mindful. You can be freaking out internally but externally you must show confidence and calmness.
Sarah tells a story about going the extra mile to simply get a patient a coke. Sometimes these small things that we overlook make a huge difference to the patient and pay huge dividends to you personally.
It doesnât take hardly any effort to go above and beyond.
Casey talks about a patient that he went the extra mile for and how it completely changed the patientsâ affect from mean and grumpy to much happier and gracious with the staff. He remembers that case from 30 years ago because it made such a difference to him and made the job worthwhile.
This job is about service for others. If you donât want to serve, you are in the wrong job.
A big risk with going zero to hero is you may have done a lot of work to find you donât like the career.
You must be willing to teach and be taught in this field.
Burnout can really be decreased when we take short moments to make a patient feel cared for and listened to.
We need to make patients feel heard and treat them like human beings.
Casey tells another cool story about a stroke patient with resolved symptoms after he was able to deliver fast treatment.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Is burnout moral injury? Is it out of your control?
ZDoggMD talks about burnout being moral injury. Link here:
(30) It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout" - YouTubeWe jump back into our discussion on the video.
Casey says one of the great things about this job is that we have the privilege to be with people on their worst day.
Nate talks about the conflict we sometimes have one scene when treatment plans are not agreed upon. He talks about burnout from not trying to get to the source of a patientâs psychiatric problem and just medicating them.
Kiley talks about the reality of practice vs school and that we canât fix every problem we encounter.
We can take the time to be empathetic and this can help combat burnout if you allow it.
The sorrowful aspect of our job is really difficult. You must know your limitations.
Kiley discusses how sometimes we canât do much to help or even do adequate alleviation of pain, and all we can do is hold the patients hand.
We all got into this job to serve others and we can lose sight of that. We need to remember to express appreciation for each other in the quick moments we have before chaos descends again.
Leadership is key at every level in emergency medicine. Saying no to a bad plan takes some confidence and leadership skills.
A good leader takes weight off other peopleâs shoulders by leading well. By doing everything we can for a patient.
A good leader can take criticism and remains humble. They take the opinions of others into account.
When something goes well, give away the credit. When something goes wrong, take responsibility.
Good leaders know when to follow. They are not dictators.
When everyone leads at their own level, chaotic cases come together smoothly.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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Jumping back into Principles in Emergency Medicine
Nate- People lie. Despite the fact that we are not judging them, and just need to know accurate details to provide the best possible care.
Casey- Expect the unexpected.
EMS is long periods of boredom punctuated by moments of sheer terror.
Adam- the job is always out to get you. We see the 1%, it is a self-selected population. So, if you are going to consider a rare or uncommon diagnosis, you are more likely to find it in these patients.
He found a passive pulmonary embolism in a patient with very mild and vague symptoms.
Casey- Arrogance can really cloud your judgment. You must be more confident in what you donât know than what you do know.
Nate- pay attention to those subtle details like bradycardia. It could indicate a bigger problem than initially thought.
Watch your ego because it may cause you to focus too much on a differential and ignore details to the contrary.
Casey tells a story about a woman who was assumed to be drunk but just had a low blood sugar.
Adam- Know the difference between confident and cocky.
Kiley- A confident provider with a clear plan is very helpful to nursing staff because they can convey this to the patient, and everyone is on the same page.
I always plan on a negative work up because a positive work up will dictate the plan.
Sarah- Donât stop learning. Look things up. Learn every day.
ZDoggMD talks about burnout being moral injury. Link here:
(30) It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout" - YouTubeI agree with certain aspects of what he is discussing but I also believe there will always be aspects of our job we cannot control so we must remain focused on the things we do have control over. Ourselves. Our patient care. How we show up.
Adam- The emergency department is unique in medicine because we donât have a lot of oversight and rules from the insurance companies. We can order the tests and take care of the patients regardless of their race, gender, insurance coverage. We are the safety net of society.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm products. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance NutritionEverything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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We meet our new panel and some returning guests!
Kiley â ER RN and new NP
Sarah â Paramedic in EMS for 8 years
Welcome back Adam ( ER MD), Casey (paramedic) and Nate (EMT).
Nate talks about the transition from field EMT to ER EMT. Itâs a new world with new things to learn.
Sometimes a change in environment can get you out of a rut.
Sarah also worked in the ER but as a paramedic and loved learning new aspects of medicine but her scope was diminished compared to the field.
Paramedics are still a new asset in the ED and have a fluid job description.
Principles in emergency medicine
1. We do not diagnose in the ER.
2. Take care of yourself before you take care of patients.
Sarah recommends outlets and hobbies that are totally separate from medicine.
Make yourself a priority or you will end up neglecting yourself.
Sleep deprivation will affect you more than you think.
Casey talks about how you can get lolled into relaxing by low acuity calls but then you may be tested to your limits the very next call.
Kiley talks about patient autonomy and how it is our job to present options and educate but the patient must ultimately decide to accept or reject our options whether we agree with it or not.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm products. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance NutritionEverything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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We revisit the question âWhere is God is emergency medicine?
Doug- Iâm a believer in science and a believer in God.
There are some occurrences that we canât explain with modern medicine. He tells the story of a cardiac arrest that woke back up an hour after pronouncement.
Sarah- God has given us the science to learn and be able to use.
We often see the victim of a horrible tragedy as well as the person that caused the trauma. Itâs hard to believe there is a God when we see such injustice in the world.
I talk about the difficulty taking care of a drunk driver who was the reason for the death of his friend in the passenger seat.
Casey prays every day before work for the safety of his partners and that he would be the best paramedic he can be.
Casey tells an awesome story of recovery from a horrible head injury. How it redeemed this person from a bad path in life.
Advise for those struggling:
EMS changes every day. So, stick around and donât give up.
Avoid substance abuse. Donât neglect your emotions.
Hold on to the good calls.
Find something youâre passionate about outside of emergency medicine. Use it to get the frustration and the things that bother you out.
Take a break. Talk to someone.
If you are a nurse. Know that you have to be true to yourself and you can always switch nursing specialties if you need to.
Write down the victories.
You must be intentional with your mental health.
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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Crazy stories episode
Delivering babies!
Not something most of us look forward to but it happens, nonetheless.
Casey talks about a breech presentation birth that, thankfully, turned out just fine despite delivering at 28 weeks in an ambulance as well as a prolapsed cord case.
Stabbing victims!
In a sex shop, in their homes, we run them everywhere.
Butt stories!
Stuck vibrators with full batteries, flashlights you name it.
Shitting in a trash can. This episode has it all.
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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Pronouncing in the field is a difficult part of EMS. In a lot of ways, the ED insulates us from some of the aspects of this that make it challenging when you are in the patients actual home.
The ED is mentally taxing in other ways. High volume, high acuity, multitasking, consulting etc.
Nate talks about how âyouâre just an EMTâ gets thrown around a lot. Just because itâs a lower-level of education doesnât mean that EMTâs donât have valuable information and knowledge level.
Collaborate with your EMTâs and other providers to give patients better care.
It takes experience to understand that, regardless of care level or education level, everyone needs to be allowed to speak up.
Newer ED providers, LISTEN to the entire EMS report.
Casey- one of the most difficult things to hear is that heart wrenching scream that family gives when they arrive in the ED to find a dead loved one.
Casey tells a moving personally story about his son that died of cancer. How you return to the job after that kind of loss.
He talks about the family of public health and safety people that surrounded him and carried him through.
It is very difficult to see certain patients and not take it personally.
Child abuse cases are on the rise. Have a high suspicion with pediatric trauma. Listen to the details on scene and document them.
Casey talks about a traumatic call involving child abuse. Sometimes we must take care of the perpetrator of horrible crimes.
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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Challenges in emergency medicine
Burnout can creep up on you and can occur even in one shift.
Nate got burned out working nights and started drinking heavily and almost got into blows with his partner. He went through a tough period and came out the other side.
Substances will become an easy outlet and a way to avoid dealing with real problems if you allow them.
Everyone has their coping strategies; you need healthy ones.
Casey- If you run 2000 calls a year or more you may burnout, if you less than 200 calls you may burnout.
You need a balance at a certain point. Being the right kind of busy can give you energy as well.
I cannot overemphasize how amazing the 75 hard program is.
In emergency medicine we need to be MENTALLY TOUGH
Try cold plunging.
Doug- recognize you are burned out. Some variety and less hours overtime can really help extend your time in EM.
Sarah- Recognize burnout in yourself. As a nurse you have job flexibility if you are getting burned out.
No one is going to remember that extra shift you worked except your family.
Life is not easy to balance and sometimes work will take priority or money will take priority but the more you keep your family on the back burner the more they will suffer.
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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Jumping back into failures in emergency medicine
Doug, ER physician, discusses how he missed a traumatic intraabdominal injury and an ectopic pregnancy. Itâs easier in hindsight to see the things we could have done better. Admitting you screwed up can be difficult.
Leave work at work as much as possible
Nate talks about a patient that was initially written off as flu like symptoms, with no initial vitals being obtained that end up being in V-tach.
Anchoring bias is a big problem. Overcome your bias or you will miss something.
Doug, ER physician: The waters of emergency medicine are deep. You may be walking around in shallow water and then suddenly end up over your head.
Objective reports are much more helpful than biased ones
Nate, EMT: Whatâs the worst-case thing that could be going on with your patient? Start with the worst differential and work your way backwards.
Sarah, ER Nurse: We all strive for excellence, no one wants to miss something, but we are all capable of it. Hopefully we learn from the mistakes.
She tells a story of working a presumed cardiac arrest before checking a pulse.
She talks about a time where another nurse had to step in for her and advocate for a patient and she learned a tough lesson that she needs to be the one that steps up, no matter how uncomfortable and advocate for her patient.
Nate messes up an IO but initially didnât want to admit his mistake.
FAIL STANDS FOR FIRST ATTEMPT IS LEARNING
Doug, ER physician: You must be able to move past a failure or this job isnât for you. Things donât always go right. If you havenât failed yet, you will.
Casey, paramedic: Youâre going to make mistakes. The culture is changing to make it easier to discuss mistakes with preceptors rather than be ridiculed.
HAVE EXTREME OWNERSHIP OVER YOUR FAILURES
Everything you hear today from myself and my guests is opinion only and doesnât represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Support the Show.
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