Patients are the people we will be

To all of you who work in the health care professions:
I know that we sometimes get caught up in ourselves, and with the call loads, large amounts pf paperwork, and drug seeking frequent flyers, we sometimes find ourselves becoming burned out and jaded. In some cases, we may even begin to resent our patients. This goes for my nursing friends as well. When you feel that happening, remember this story:

When an old man died in the geriatric ward of a nursing home in an
Australian country town, it was believed that he had nothing left of any
value.
Later, when the nurses were going through his meager
possessions, They found this poem. Its quality and content so impressed
the staff that copies were made and distributed to every nurse in the
hospital.

One nurse took her copy to Melbourne. The old man’s
sole bequest to posterity has since appeared in the Christmas editions
of magazines around the country and appearing in mags for Mental Health.
A slide presentation has also been made based on his simple, but
eloquent, poem.

And this old man, with nothing left to give to
the world, is now the author of this ‘anonymous’ poem winging across the
Internet.

Cranky Old Man

What do you see nurses? . . .. . .What do you see?
What are you thinking .. . when you’re looking at me?
A cranky old man, . . . . . .not very wise,
Uncertain of habit .. . . . . . . .. with faraway eyes?
Who dribbles his food .. . … . . and makes no reply.
When you say in a loud voice . .’I do wish you’d try!’
Who seems not to notice . . .the things that you do.
And forever is losing . . . . . .. . . A sock or shoe?
Who, resisting or not . . . … lets you do as you will,
With bathing and feeding . . . .The long day to fill?
Is that what you’re thinking?. .Is that what you see?
Then open your eyes, nurse .you’re not looking at me.
I’ll tell you who I am . . . . .. As I sit here so still,
As I do at your bidding, .. . . . as I eat at your will.
I’m a small child of Ten . .with a father and mother,
Brothers and sisters .. . . .. . who love one another
A young boy of Sixteen . . . .. with wings on his feet
Dreaming that soon now . . .. . . a lover he’ll meet.
A groom soon at Twenty . . . ..my heart gives a leap.
Remembering, the vows .. .. .that I promised to keep.
At Twenty-Five, now . . . . .I have young of my own.
Who need me to guide . . . And a secure happy home.
A man of Thirty . .. . . . . My young now grown fast,
Bound to each other . . .. With ties that should last.
At Forty, my young sons .. .have grown and are gone,
But my woman is beside me . . to see I don’t mourn.
At Fifty, once more, .. …Babies play ’round my knee,
Again, we know children . . . . My loved one and me.
Dark days are upon me . . . . My wife is now dead.
I look at the future … . . . . I shudder with dread.
For my young are all rearing .. . . young of their own.
And I think of the years . . . And the love that I’ve known.
I’m now an old man . . . . . . .. and nature is cruel.
It’s jest to make old age . . . . . . . look like a fool.
The body, it crumbles .. .. . grace and vigour, depart.
There is now a stone . . . where I once had a heart.
But inside this old carcass . A young man still dwells,
And now and again . . . . . my battered heart swells
I remember the joys . . . . .. . I remember the pain.
And I’m loving and living . . . . . . . life over again.
I think of the years, all too few . . .. gone too fast.
And accept the stark fact . . . that nothing can last.
So open your eyes, people .. . . . .. . . open and see.
Not a cranky old man .
Look closer . . . . see .. .. . .. …. . ME!!

Defense free zones

Roger Ebert says that the recent shootings at the Cinemark Theater prove that concealed carry doesn’t help prevent crime, because no one at the theater took out the shooter. That is a major disconnect with logic. That is like saying that a building that has a fire proves that fire extinguishers don’t work. By that same logic, police don’t prevent shootings either, so we should get rid of police.

Ebert also overlooks that Cinemark Theaters have had a long standing policy of posting their property as off limits to legal concealed carry since at least 2004. Here is an encounter that happened in 2009. Here is another that occured in 2004.

Here is a picture of the signs that are posted today. As of last month, the Cinemark closest to my house was posted as not allowing carry.

Signs demanding that guns not be brought into a store only guarantee that a killer will not be facing armed resistance. After all, if he is willing to commit murder, a sign isn’t going to stop him.

You aren’t as good as you think

Ego. That is what you get when you get a room full of paramedics together. Needing CEUs, I was sitting in an advanced airway class today. During an in-class discussion, the subject of intubation came up, and I remarked that I often use airways like the King tube for intubation, because it allows a provider to manage the airway of a cardiac arrest victim without stopping chest compressions, and there is no worry about missed intubations. This increases survival rates.

A medic in the row in front of me said that he gets enough intubations that he isn’t concerned about that, because he is confident in his abilities. He also told me that he performs RSI in his agency, and he feels like he is good enough that he doesn’t usually bother to prepare a back up airway in the event that he cannot secure a tube. Later in the day, during a break, I asked him how many intubations he gets.
He replied, “Three or four.”
I asked: “A month?”
He says, “No, a year.”

How do you think that you are proficient in performing a very complex skill that takes 30 seconds, and that you perform once every three months? You are so confident that you will give a drug to a patient that makes it impossible for that patient to breathe on his own, without making sure that you have a back up plan in place, in the event that your primary attempt fails to secure the airway?

Later in the afternoon, we had the opportunity to intubate a METI man. (This is a computerized high fidelity mannikin that reacts to medical procedures like a human would.) This medic and his partner were given a scenario where the patient stopped breathing, and were expected to intubate the patient before he desaturated to the point where his heart began to malfunction.

They failed, because they spent over three minutes trying to intubate, and were not ventilating the patient. He blamed the other paramedic that he was partnered with for the failure.

This is what we want to emulate?

A man in the UK died while waiting for an ambulance, because the closest crew was on a government required lunch break. We are told that this is the health care system is the one that we want to emulate, but is this really what we want?

EMAS chief executive Phil Milligan said: “Our practice on meal breaks comply, as they must, with the national NHS Agenda for Change employee terms and conditions, which require staff to be given a 30-minute undisturbed break.”

Andto those who think that EMS and fire, being public employees, should be treated like every other employee, remember that this is what you get when you want them to be like everybody else- when you need them, they might be out to lunch…

like everybody else.