Me

Yesterday

About yesterday’s post. It’s been a trying week. At work in the ED, I had a guy with a serious heart attack (STEMI alert), some COVID patients, and more. The one that took the cake was the woman who was a mother of 3 kids. She was in the middle of a miscarriage and was bleeding to death. Her pulse was 120, her blood pressure was 72/42 and a MAP of 52. Her ER bad looked like a movie murder scene. Watching her fight to save her own life as well as the life of her unborn child, while at the same time watching other people literally fight to kill others. It made for a tough day at work. Emotionally draining.

On top of that, I am trying to complete my CEN certification while at the same time completing my BSN, all while working PRN in the emergency department. This will mean completing my 6th college degree. Lots going on that was physically tiring. Oh, did I mention that I am on the HOA board, my wife is dealing with some (minor) health issues, and I also had to do some minor repairs on the rental?

There are times when the cup is empty, when you are simply out of the energy that you need to do all of the things, and yesterday was one of them.

Today will be better, once I am done with today’s scheduled 3 hour class. I expect to be back to my usual opinionated self this afternoon. Thanks for listening to my venting.

By Divemedic, ago

Again

I haven’t posted in a couple of days. After managing to make it two years without COVID, I have managed to catch it twice in as many months. The odd part is that the two episodes have differed in symptoms.

The first time consisted of large amounts of congestion and coughing that lasted eleven days. I had no fever and COVID tests came up negative, but I lost my sense of taste and smell.

This latest bout had me with a mild stuffy nose and cough, no fever, and only lasted four days. I was so tired, I couldn’t stay awake. I wasn’t sure that I had COVID until my wife got sick, took a test, and it was positive. So I took one too, and what do you know, it was positive. Then yesterday morning, I woke up without a sense of smell or taste. This second bout with COVID has been MUCH milder than the first. The only other symptom is copious amounts of sweating.

I have no idea how we caught it. With my wife being a teacher and me working in a busy emergency room with daily contact with COVID patients, who knows?

By Divemedic, ago

Signal 7

To help in understanding the Disney rules, I want to take a minute to explain how Florida works when it comes to EMS and dead people. Florida’s EMS system requires that all prehospital services (like EMS) have to be supervised by a doctor. That doctor is called a medical director, and that medical director sets the rules under which all of the EMT’s and Paramedics that he supervises must operate. The rules are referred to as protocols.

Some medical directors don’t trust their underlings very much, and keep them on a very short leash by making protocols restrictive. Other medical directors allow their medics latitude to make more clinical decisions than others. There are all kinds of protocols.

My first medical director here in Florida was one of the strict kinds. We were not allowed to declare someone dead. Ever. Every single person got transported, and the doctor in the ED had to make the call. We once transported a person whose head was severed from his body. The ED doctors were pissed.

If you decide that the patient is dead on scene, the radio call used to be “Signal 7.” Then the 911 commission came along, and we were no longer allowed to use codes. From that point on, the radio call became: “No code, no vitals.”

Reedy Creek is, for all practical purposes, a government that is owned by a private company. Their medical director is VERY strict, and the protocols that they operate under are anachronistic. They wrote their protocols IMO with a lawyer and PR department in mind, but not a doctor, and certainly not the patient, in mind. One of the rules that Disney operates under is that all medical patients need to be transported to the hospital, even if they are dead. The majority of them go to Advent Hospital in Celebration, where the doctor then declares them dead. Since Celebration Hospital is not on Disney property, the person didn’t die at Disney. They died in the Hospital.

By Divemedic, ago

Plumbing Problems, Part 4

This is my only post of the day today because of my plumbing issue, complicated by the fact that I was scheduled to work in the emergency room 9-9 today, until my boss called me at 8 o’clock and rescheduled me to work 1 pm to 1 am today.

For six years running, we have had a plumbing problem. I have been suspecting it was a vent problem. It rears its head every fall and spring. We have had three different plumbers out, and I swear it has cost us thousands of dollars, and no solution has been found. The problem corrects itself after a day or two, so by the time a plumber gets here, they never find anything, but are happy to bill us between $100 and $500 to tell us nothing is wrong. Assholes.

The last plumber to come out (4 months ago) thought I was nuts when I asked him to check the vents. He found two large frogs living in one of the vents. That cost me $200. Other than that, nothing has ever been found. They even put a camera through my pipes two years ago. Nothing was found, but they still billed me $500.

Let me describe the drains in my house: There are two vents in the house: one over the laundry, which shares a drain line with the kitchen. The second vent is over the guest bathroom and shares a drain line with the master bathroom. There are three undersink vents that are covered by air admittance valves.

We are planning on moving next year and converting this house into a rental. If this plumbing issue keeps up, I may just sell it, even though the wife doesn’t want to.

Anyhow, time to get ready for work. I am not looking forward to getting off at 1 am.

By Divemedic, ago

Paramedic

One question I get all of the time is “What is it like to be a paramedic?” There are a few places that you can work as a paramedic in the peninsula of Florida. I have heard that things are different in other places, but this is how it is here. I described it 9 years ago, if you want to compare.

Most new paramedics want to work flight. The glamour of riding around in a helicopter is pretty alluring, but due to weight restrictions on helicopters, they generally won’t let you be a flight medic if you weigh more than 150 pounds. Flight medics typically have at least 5 years of experience with a 911 service to even be considered for the job.

The next best thing is running with a 911 service. Running with a 911 service is not as boring or routine as other jobs, so that is where nearly all paramedics want to work. The catch is that nearly all 911 EMS on the Florida peninsula is run by fire departments. The pay is pretty good with 911 service, so the competition is fierce. There will be 200 or more applicants for each position, so getting hired for one of these jobs is difficult. Starting pay for a dual (fire, paramedic) certification paramedic is currently about $50,000 per year.

Then there are hospitals and doctors’ offices. They are largely avoided by paramedics because nurses have managed to get employers to prohibit paramedics from giving medications. The reason is that nurses don’t want to be replaced by paramedics making less money. Hospital paramedics are also prohibited from inserting endotracheal tubes, because doctors make several hundred dollars for doing them. They aren’t going to let an hourly employee perform a procedure that a doctor can do for the price of a Lexus payment. So many medics (especially new ones who want the excitement) don’t take these as full time jobs. What winds up happening is the paramedic gets to do all of the things the nurse doesn’t want to do. You start IV lines, draw blood, bathe patients, change adult diapers, collect stool and urine samples, run ECGs, fetch drinks for patients, and other gopher work. A medic in a busy emergency room can expect to walk 20,000 steps (over 8 miles) per day. Starting pay for a hospital medic is around $36,000 a year with no experience.

There are also the theme parks. Most of the work there is simple first aid, with a few emergencies, and a bit of employee health. There are the big ones: Disney, Sea World, Universal, and Busch Gardens. There are smaller ones like Lego Land, Cypress Gardens, and even water parks like the now defunct Water Mania or Wet N’ Wild. Starting pay at these places can be odd, because some require experience, and quite a few only hire part time paramedics who already work elsewhere. Starting pay is between $18 and $23 an hour.

The paramedics who get the least pay and respect in this area are the ones working on non emergency transport ambulances. The pay is low and the working conditions are poor. Shifts are long, normally 12-14 hours each. You do not get a station to sit in on those times where you wait for your next call. You sit in the truck and wait. No reading, eating, sleeping, watching movies on your electronic devices, no texting, no phone use, and no drinking of anything except water. (Not even coffee) These jobs are easy to get, but turnover is high, and most people don’t stay for long, using this place to get experience and move on. These positions are where many medics who can’t get a job elsewhere wind up. Most medics work one of these jobs at some point in their career, but strive to get away from as soon as possible. If you work at one of these for more than 2-3 years or so, most employers will assume that there is a reason why you can’t get a better job and will avoid hiring you out of general principle.

One manager at a private ambulance company told me that his crews were not allowed to eat during shift, because he doesn’t pay them to eat, he pays them to haul patients so he can make money. Expect no meal breaks for the entire 12 hour shift. Another told me that patient care is secondary to keeping the customer (nursing home, hospital, etc) happy, and that the patient was just cargo, and no one cares what cargo thinks. One of my former EMT students was told by an employer when he complained about working conditions, that for every EMT that was working there, there were 7 more looking for a job, and if he didn’t like it, he could be replaced tomorrow. Starting pay for a transport medic averages $32,000 a year. In contrast, a kid right out of high school can get a job at a fast food place for $25,000. Delivery drivers for places like Sysco are making $50,000 a year.

A person aspiring to be a paramedic who isn’t a firefighter is better off going to nursing school. An RN has the same amount of schooling as a paramedic, but makes about double the pay.

That and burnout mean that only half of all paramedics are still working as paramedics five years later. The half of paramedics that leave generally eventually become nurses or respiratory therapists, the rest usually leave for other professions. I know one that became an ice cream man.

Even becoming a firefighter paramedic is a tough road. About half of the people who spend two years becoming paramedics and another six months becoming firefighters never get hired by a fire department. They wind up either moving on to other careers or taking jobs like non emergency ambulance jobs as they wait for the big break that never comes.

I got lucky. I spent two decades running 911 calls with fire departments. I have worked in all of the settings above (except flight- I am too heavy): three hospitals, four different fire departments, two doctor’s offices, three different theme parks, and two different ambulance companies. Each had its plusses and minuses. The biggest minus for most is pay, closely followed by poor working conditions.

In Florida, a nurse can challenge the paramedic exam and become a paramedic, but a paramedic can’t challenge the nursing exam. I can say with all honesty that nursing school doesn’t teach you anything that you didn’t already know as a paramedic. Even so, nurses who began their careers as paramedics make better nurses, especially if you are working in the ED.

By Divemedic, ago

It Took Two Years

But the coof finally caught up to me. It started on Day 1 with some post nasal drip, mild fatigue, and a sore throat. No big deal, but I knew I was coming down with something.

Day 2, and I woke up to discover that I had a stuffy nose and my throat hurt so bad I couldn’t swallow. After some cold water and Ibuprofen, it eased up enough that I figured it was a mild cold.

Day 3 was more fatigue, congestion, and a mild cough. Dayquil worked fine. I took a home COVID test and it was negative. I was tired and fatigued, so I spent a good bit of the day napping before going to bed early with a dose of Nyquil.

Day 4: I went to work and pulled a 12 hour shift. I felt slightly under the weather, but still not too bad. I have had far worse. Symptoms to this point were mild fatigue, a runny nose, and a mild, non-productive cough. I went to bed at midnight with Nyquil and Robitussin. I didn’t sleep well.

I woke early on Day 5 (at 0430) because I couldn’t breathe. I sat up in a chair, eating Vick’s cough drops like candy. That and some extra strength Robitussin DM seemed to work. A second at home COVID test of a different brand also showed negative. I slept on the couch for a good bit of the afternoon before getting up to take a shower. I was shaving when I realized that I couldn’t smell the Vick’s shower tablet. Then I realized I couldn’t smell anything- not my soap, shaving cream, nothing.

My wife and I did some experimenting. I couldn’t even smell Vick’s Vaporub when it was rubbed on my upper lip. The only thing that I could smell (very faintly) was vinegar. That’s when I knew. COVID.

It’s now day nine, and I have spent the last few days sleeping in the recliner, coughing up large amounts of mucous. It feels like I am breathing through a straw. That and fatigue are the only remaining symptoms. Even my senses of taste and smell came back after two days.

My wife doesn’t think that it is COVID, mostly because the home tests say that it isn’t. I don’t want to take an official test, because my job would require me to quarantine for 14 days. Regardless, my wife woke up with a sore throat this morning, so now it appears as though she has it.

By Divemedic, ago

Childhood Hijinks

When I was a teen, the cool kids had a phone in their bedroom. The rich kids had their own line with a phone number that was separate from the rest of the house. I didn’t, mostly because my mom didn’t want to “waste money” on that sort of frivolity. For those of you who don’t remember this, ask your parents. It was in the days before the Internet, before cell phones, you know, the ancient days.

So of course, whenever I would be talking to a friend (usually girls), my mother would pick up the phone and say embarrassing things like “Did you take out the trash? Did you do your homework yet?” – you know, the sorts of things that mortify teens by letting other teens know that you have parents.

I had a curfew of midnight on any night when there was no school the next day. The thing is, my parents always went to bed around 10 pm. There were many nights that I would stay out later than curfew, and my parents would frequently catch me staying out until 2 or 3 in the morning, until I hatched my devious plan.

I would call my house from wherever I happened to be at 11:30 or so. The phones would ring throughout the house. My father would pick up the phone at his bedside, and answer it while half asleep. In his groggy, half asleep voice, I would hear: “Hello?”

I would reply, “Dad, I’ve got it.”

He would say: “Tell your friends to stop calling so late.”

Then I would resume whatever I was doing, safe in the knowledge that they wouldn’t catch me, as long as I was home before my dad woke up in the morning.

Like the chemistry story, I didn’t tell my mother about this until Dad’s funeral. Mom found it quite funny, and still tells the story to her friends when she talks about all of the funny situations I got myself into as a young lad.

By Divemedic, ago

Chemistry

Wirecutter posts about his first chemistry set and how he built the mother of all stink bombs. Something similar happened to me when I was a kid. My parents had given me a chemistry set, and the experiments that came with the kit were deemed too boring by me.

One of the chemicals was labelled “DANGER: DO NOT MIX WITH ACID.” Well, being an inquisitive sort of lad, I decided to mix it with acid. Hiding in the bathroom, I mixed it with one of the containers of acid. As soon as I did, copious amounts of blue-green smoke began issuing from the test tube. It looked like I had rubbed the lamp with the genie inside.

I panicked. My bathroom had a door that led to the outside, and I rushed out there, quickly dug a hole, and shoved the test tube inside, burying it where my parents would never notice what I had done.

Until my parents moved out of that house some eight years later, my father could never get grass to grow in that spot. That bald spot in the lawn drove him nuts.

I didn’t tell either of my parents what had happened until I related the story at my father’s funeral, 17 years ago. My mother found the story to be uproariously funny, telling me that he tried everything to get grass to grow in that spot, but nothing ever worked. Even sod placed on that spot would wither and die within days.

I wish I knew the name of that chemical. It is a great weed killer. The people who live there now probably have cancer.

By Divemedic, ago

Transitions

Posting has suffered here as of late. The posts are shorter and not so prolific. The reason for that is that I finally have grown tired of my diversity hire of a boss and have been taking steps to transfer to a different department. I have been working for both departments lately: 3 twelve hour shifts for my home department, and 2 twelve hour shifts per week in my soon to be new department. I hope that I will be released from the old department in the next several weeks, which will give me some more time off.

The road to this has been long. I was hired to work from 7a to 7p for 3 twelve hour shifts per week. I was to supervise the unit, write the monthly work schedule, and generally make sure that screw ups weren’t being made. It was a new position created because mistakes were made in the unit that resulted in the death of a patient, and I would answer directly to the department head. They told me when they hired me that my qualifications greatly exceeded those required for the position, and I was hired at what they claimed was the top of the scale for the position.

The unit was falling apart. Of the 14 employees, 9 of them were gone in the first three months I was there, resulting in me working 5 and 6 twelve hour days per week for the three months it took to hire replacements. So I spent last summer working 60 to 80 hour weeks. I was told during that time that I would not be writing the monthly schedule.

In August, they tried to hire another supervisor to split duties with me. He didn’t meet the minimum requirements for the position, but they were hiring him for $12K more than I was making. I was livid and expressed my displeasure. I even did my own background check on him, and discovered that he had been arrested three months before for punching an Orlando cop. The wound up not hiring him.

Then in October, annual evaluation time came, and mine said that I had missed the quarterly staff meeting, and that I was not doing my job because I was not writing the schedule (that they had told me not to write). That quarterly meeting I missed? I missed it because it was being held on my only day off, sandwiched between a 6 day workweek and a five day workweek. Even 132 hours worked in 12 days wasn’t enough. They wanted more.

So November came and they hired another new supervisor to split duties with me, and she also wasn’t qualified for the position, so they had to rewrite the job description in order to accommodate her. Her pay was equal to mine.

Beginning the week of December, they changed my working hours to be 11a to 11p, while also cutting my hours an bonuses. Now my take home pay was lower by about $15k.

Then I was told that the new supervisor would be writing the schedules. Guess who is now getting her choice of what days she wants to work, and guess who is working the leftover days? So I began looking to see what I could do. I was prepared to quit and see if I would be eligible for unemployment, since they had cut my pay and changed my hours so drastically.

Instead, a department head that I had been working with all throughout the COVID outbreak in August asked me why I was wasting my talents where I was. She said that I could work some OT in her department, and once my original department head releases me, I could work for her.I could additionally set my own work days. For now, that means temporarily working 5 days a week, but I get all sorts of bonuses and OT for it.

So that’s where I am. Buried in work, and waiting for my original department to release me. Hopefully another couple of weeks, and I can take it easier. A little.

For now, I can bank away a few thousand a month extra. Today is my only day off this week.

By Divemedic, ago

Taxes

So I told you I am considering taking a swing at doing my taxes this year. I begin this tax season by getting my forms together and reviewing last year’s return. Still haven’t made my decision.

My tax return for last year, counting all schedules and miscellaneous forms, was 21 pages long. As far as backup, there were four 1099’s, a pair of W-2’s, a P&L statement for the business, and a form 5498. The statement from my stock broker was 11 pages long.

This year, there will be five 1099’s, four W-2s, the P&L statement (which I still haven’t finished), and the 5498. I also won’t get the stockbroker statement until after February 15. I do know I had about two thirds as much in capital gains as 2020, but thanks to some carryover losses that I can no longer take advantage of, I will wind up owing more capital gains taxes than I did last year.

For today, I think that I will be completing the P&L statement for the year. Joy. I would have to do that, whether or not I use an accountant.

By Divemedic, ago