It’s my first day back after a four day stretch. In the morning I’m excited for what the day will bring. In emergency medical services each day is unique. It's never routine and always unpredictable. I meditate over who I will meet and the lives I'll have the opportunity to touch.
I arrive to the station and learn that I have been reassigned to work with a new employee I’ve never met, Joe. This is Joe’s first shift as a paramedic. His innocence and excitement is palpable. The shine on Joes boots and his bright green eyes are devoid of darkness. In emergency medical services, the first day working with anyone is equivalent to going on a blind date. It can be incredibly awkward and filled with expectations.
As we pull out of the ambulance bay Joe gets my mantra about teamwork and communication. “I’m here to support you, this is a learning environment, etc. etc”. Then I share a small piece of wisdom with Joe. “Don’t ever loose your curiosity about what the day will bring”. Joe smiles and I can see him relax. I smile, and take a sip of my coffee. “Good morning alpha 105 is on the air.” My wonder for what the day will bring can be heard over the radio.
After our ritualistic greeting to dispatch Joe and I drive to our first shift point assignment. Three minutes into our drive we are dispatched to the west side of our coverage area for a patient in cardiac arrest. Joe begins asking questions and we discuss our potential scenarios and treatment plans. I can see Joe’s hands shaking, he’s nervous. I smile, and take another big sip of my coffee.
Minutes later, we arrive on scene to our community medical first responders (MFR’s) performing CPR on a 65 year old female patient. I always look forward to our MFR’s contagious enthusiasm and drive to make a difference. Joe does well and is very attentive to direction. We almost immediately achieve ROSC (return of spontaneous circulation) and are off to the hospital. Our patient comes with many challenges, one of which is morbid obesity. Transport involves an ACLS (advanced cardiac life support) mega code with every flavor of cardiac rhythm you can order on the menu. In addition, no intravenous access and a difficult airway.
As the seconds tick by in our speeding emergency vehicle I become quiet. I find the team and those big green eyes looking to me for guidance after loosing ROSC en route. An outward calm is displayed, I run through every scenario and treatment plan in my head. My eyes are on the patient and my mind is focused. The chaos is shut out and clarity is achieved. I know we have to enter the grey area of EMS and make decisions quickly. Through-out my career, I often struggled with difficult calls after completing them. Going over and over the details of care provided in my head. Critiquing the what if. I learned early on that the outcome is often not up to us. You can provide the best care and have no chance of fixing what’s happened. We are often there to bare witness, to give comfort to those involved, and to learn from the scenario. What no one could see is that this focused calm provider was reciting a prayer in her head “God, your hands are my hands, your mind is my mind I ask for your guidance.” This practice became a career habit for me. It was my secret to staying grounded during the most difficult situations and achieving peace after experiencing and dealing with things many people only imagine encountering.
Minutes later, we arrive to the hospital with our airway managed, intraosseous access established, and an organized cardiac rhythm.
After our call Joe asks me, “how did you stay so calm? I was freaking out!” I smiled and assured Joe with experience calm will come. I explained to Joe that when others are looking to you for guidance you set the tone. One day, you will decide how you want to deal with these call types. You can move quickly and still convey a calm demeanor. You can make others leaders by leading. Acquire the traits and qualities you admire from those around you and become the provider you want to be. There was a moment of pause, I was tempted to share my secret with Joe, but that moment passed.
I then took another big sip of my now cold coffee and smiled.
Today Joe is a senior paramedic and an exceptional provider. I never did share my secret with anyone…. until now.
Our patient expired, but family was given the opportunity to say their goodbyes.