Persevere, Improvise, Adapt, and Overcome

Sometimes I’m amazed we all stuck with it.  

I got hired in a group of three.  Of the two other guys one was my age (30) and the other a year or two older.  Our orientation was plagued with incidents, injuries, and ill advised training practices.  Looking back, I understand what they were trying to accomplish, but almost nothing worked out like it was supposed to.

The first day we reported to training we were met by the newly appointed training chief who was holding three brightly colored tie dyed t-shirts.  Wait, let me go back a step.  The normal uniform for PT is a blue t-shirt and shorts with the department logo on them.  As a means of instilling a goal in us, we were not allowed to wear a department t-shirt during orientation - we had to earn it. Instead we wore plain white tees and department shorts.  The Chief passed out the tie dyed shirts to us and told us to put them on.  He then took us on a three mile run around the city.  

                  

Now, we were firefighter recruits in pretty good shape, but not one of us was a “runner”.  This would prove important as the training wore on.  Apparently, the point of the tie dyed shirts was to instill in us the fact that everything we do is in the public eye and that they are watching our every move - we’d better get used to it and respect it.  Toe the line, someone is always watching.  

It really was not a big deal to us.  No one felt stupid wearing the shirts, we just didn’t really get it immediately.  But the message was driven home much more forcefully when the Chief got called on the carpet by his bosses for subjecting the new recruits to what someone else viewed as “hazing”.  So it was true, someone is always watching.

We were told that every morning, before 8 a.m. (the official start of training) we were to run this course together (the three of us) in less than 30 minutes.  So, taking three non-runners and having them run three miles a day on hard city streets before a day of puling hose and throwing ladders, etc. eventually took its toll on one of my classmate's knees and he had to stop running.  That left just two of us to do the run which would later become known as the “Bataan Death March” by the other line personnel.

                 

Shortly after the knee injury we got our first day of live fire training.  We would take turns advancing a hoseline into the burn room, feeling the heat, staying low, putting just enough water on the fire to darken it down and then let it build up again.  As we went in time and time again our gear and our gloves became wetter and wetter.  On the final pass, my, as yet uninjured, classmate felt his hand really heating up inside his glove but he wasn’t about to say anything and be dubbed the weakest link.  He was the last one to go through so the Chief told him to advance all the way in to the burn room and put the fire out completely. In the process of doing that, so much heat was generated that the water in his glove turned to steam and literally boiled his hand inside his glove.  He came out of the burn room and pulled off his glove along with a pretty decent amount of skin.  It looked something like this:

                       

The paramedic on the crew we were with that day treated the burn immediately and the Chief threw him in his car and drove him off to the hospital.  He didn't get pain meds until they reached the hospital and it was not a pleasant ride. Needless to say, the Chief heard quite a bit about that one too.

With one hand and nearly one knee out of commission the chiefs had to rearrange the entire training schedule and do anything and everything that wasn’t manipulative first.  With the burn to the hand, my classmate wasn’t even supposed to sweat so he couldn’t do the morning run either.  I asked the Chief if I was supposed to report early and still run by myself.  In a frustrated and somewhat defeated tone he said no.  It was supposed to have been a team building exercise and it wouldn’t serve any purpose for me to run alone.  So the morning run became a thing of the past.

In the long run, we all passed and moved on without permanent injury. Although, the rest of our orientation was not without further incident. But that will be a story for another day.

Well, that sucked.

When we get dispatched to a call we have 90 seconds from the time the alert tones go off to get dressed, get on the engine, and get going.  From that point we have four minutes to arrive at our destination.  The ambulance company doesn't have the same rules.  For one, the ambulance could be coming from anywhere: a staging location, the hospital, another city.  It all depends on how many units are available at the time of the call.  They also have a priority dispatching system which means an ambulance responding to a lower priority call may get diverted to a higher priority call and a new ambulance dispatched to the original one.  We always go Code 3, lights and siren, but the ambulance may only be coming Code 2, following all normal traffic rules.  Unfortunately I wasn't paying enough attention to the priority level of my ambulance when this call came down.

We were responding for an elderly female with abdominal pain.  Abdominal pain can mean a million different things and the severity of the pain makes all the difference in how quickly and aggressively we treat it.  My patient was in a lot of pain.  Also, it was new onset pain so something was definitely going on.

 

I knew I had to give this woman some pain relief. She already had a fentanyl pain patch on and had taken a percocet and she was still hurting.  I set about trying to get an IV established but this woman had extremely papery skin and only the tiniest of spider veins.  She apologized and said she knew that they always have a hard time getting a vein with her.  I guess I was pretty focused on finding a suitable site for access (mostly by braille) and wasn't paying attention to the radio traffic.  I felt what I thought might be a good enough vein, though I couldn't see it, and went for it.  Miraculously, I got the welcome flash of blood in the chamber that meant I was in the vein but it collapsed immediately and I could not advance the catheter even the slightest amount.

At this point I heard my captain say, "Oh wonderful".  I asked what happened and he said that our second ambulance had just been diverted. Damn, I hadn't realized they weren't coming code 3.  I told my captain to upgrade the new ambulance.  That's when I found out that my new ambulance was coming from over twenty miles away.

I wound up having to give this woman a morphine injection into the muscle which unfortunately takes much longer to take effect than if it were administered into the bloodstream.  She was also a diabetic with horrible circulation, so really I knew that this was almost pointless. I fished around on her other arm for IV access with no luck. I gave her another injection before the ambulance arrived forty minutes after the initial dispatch.

I knew it wasn't their fault and I was just mad at myself for not thinking about the response code from the get-go.  If I could have gotten the IV it might not have been so bad, but overall I just felt pretty useless.

Sucks when that happens.