This is number thirty of my blog entries out there to the ol' interwebs. It's all about busting cherries so I'll call this one the "Dirty Thirty"
Not so long a go in a hospital emergency room not so far away there was a scared and rather timid new EMT student. It was her first clinical rotation and first experience with a large hospital like BCH. Never an ambulance ride before it was truly her first day in nearly way shape and form. It was a rather slow morning and early afternoon at BCH nothing too exciting was going on and then we got a code into the resuscitation room. Hearing the page overhead I crawled out of my unchallenged stupor to shuffle into the resuscitation room to see if I could help. EMT student was plastered on the wall.
It was the usual code stuff and we "saved" the patient while waiting for ICU to accept report the EMT student and I (who I was not precepting the nurse who was pushed her into the room to "watch") were talking about her school and training so far. I was doing my usual thing which we all do after awhile, talking to someone while watching the monitor. The pt HR was going down down down and her pressure cycled and it was shit. While this was going on I told the EMT student "You up for some CPR?" I was feeling for a pulse (there was none) then waving at the nurse, 3rd year and attending and said "Guys she ain't got no pulse...check the monitor and check me." Meanwhile the EMT student says "I've never done CPR before." Which was very honest, then a great thing happened. Everyone in the room says to the EMT student "Get on the stool and start compressions" It was one of those "teaching moments" where everyone coached her on proper technique and was encouraging her.
The EMT student showed some gumption and got into it doing her compressions like an old pro in no time. When she stepped down for a pulse check she had a big smile on her face. She was hooked and came out of her shell. It ended up being a long nasty code where the pt would come back with a round of epi we'd hang pressors and do a procedure and then it was back to chest compressions. We had the EMT student do more chest compressions bag the pt with a BVM, help roll the pt to get the pt off of the back board all sorts of "cool" things EMT students love to brag about in class. This I know because I was new once too. I never worked a code until I was a "certimified" EMT and hired on the ambu (which is another story for another day) I was telling her the whole time "You're gonna be a rock star when your class meets again." When she looked scared one of the nurses would come over to her and pat her on the shoulder for a second and then go do something all nursey and shit.
The student got to see things they had only peripherally discussed in class. We all explained what we could when we could about what was going on with the pt. The pharmacist would explain the drugs, the second and third years would explain a procedure or the pathophys of what was going on inside the pt. I'd fill in the spaces as best I could when I was not looking for equipment, taking my turn at compressions or otherwise occupied. In all it was a team effort not only to save the patient over and over again but to ease the EMT student into the often jarring world of modern medicine. It's a mind searing event and one you'll never forget. Whether you're having sex or doing CPR for the first time. I guarantee you'll never forget it. Yes, it can get rough during codes and trauma activations we all made the effort to make the student feel as welcome as we could under the circumstances.
Finally we got the patient as stable as we were gonna get her and made a dash for the ICU. Naturally on the way up there we lost her pulse while we were waiting on the elevator. Fortunately the ICU charge and an ICU nurse met us at the elevators and helped out tons. As soon as we got to the appropriate floor The ICU charge nurse sprints out of the elevator and runs into the ICU pod and calls a code and literally the entire ICU drops what they are doing and helps us out. Man we were running down the hall with this pt. Which is something I had not done in a long while. After another long bit (more epi & more chest compressions) we get the pt into the ICU bed and we leave. Which is when the EMT student said the line of the month:
"That was the coolest thing...ever!"
The ER nurse and I started laughing because we have both been there and yeah it's pretty awesome running down the hall doing CPR on a pt. Besides the ER nurse was and old EMT and knows what it's like to be a exposed to this for the first time. The EMT student is totally hooked. I made it a point to tell her this was a rarity and it does not happen every shift or call. Learn from the experience of course but also enjoy the moment.While I was doing my final checks in on everyone for the day the EMT student gave me a big hug around the neck and just profusely thanked me for pushing her to do more during the code.
When I precepted EMT students years ago that's how I could tell who wanted to do the job and who just wanted to just slide by. Sure it would have been easy for her to walk out of the room and no one would have had a second thought or blamed her. She stuck with it and that's a telling sign in and of itself. I told her to make sure she thanked everyone else too. She did, she practically floated out of the department on that big smile and adrenaline.
For all the horseshit I (really all of us) have to deal with those moments are what makes the job worth while and I am thankful for the opportunity.
