As Promised

Our EMS is growing by leaps and bounds. What started as a good ol' boys club with some hose and rubber boots has become a fire department that offers medical. In the last six years alone, we have gone from 4 EMTs to 15 and a rescue squad. It has been a drastic change, particularly for me.

When I started as an EMT, I was handed a jump kit, a pager and a pat on the back. We didn't even have radios. Between the new EMT fire and the lack of personnel, I really experienced a lot of first in patient care. I had no choice but to take control of the scene and get the assessment done at the same time. There was no option otherwise. Since we did not have a rescue squad, so more often than not, patients were assessed and then handed over to the next department over for transport. Every so often I would transport with them, but rarely had primary care.

Eventually, we developed a plan for a stocked non-transport first responder unit. This not only brought the EMTs to the station first, it encouraged some of the younger/less experienced EMTs to come on more calls as it was less intimidating arriving on scene with more than just yourself. The general view of me declined as I tried to teach the newer EMTs skills, tactics and for some of them; plain old common sense. I'm not going to lie, I don't mince words, sugar coat the truth and I know that I am not as patient as I should be. Some loved me, some hated me. Either way, I was losing interest. My contact with patients was declining rapidly. I was handing over patients to be transported by the newer EMTs so that they could get some more experience. I got bored and went back to school.

Finally, after a long and hard fight, we were granted one EMS officer. Two people applied for this position: Jenny and I; Jenny being my senior by one year and now an RN. While there were other politics involved (when isn't there), we were both being strongly considered for the job. The night of the decision by the chief, I retracted my application. After much thought and tears, I decided that with a husband that was not walking or working, it was not feasible for me to have two jobs, go to school full time, care for my husband and be a Lieutenant for our department. It wasn't fair to me, my husband or the other EMTs. Jenny got the job as I knew she would and should.

Call volume increased and responding personnel decreased. It was always the same 4 people on 90% of the calls. We were starting to become unglued responding to calls at night and not sleeping. The call load was not being shared evenly. I suggested crew nights; we would share the night shifts and build camaraderie, and more importantly, we would be able to sleep. Most resisted as I thought they would and no one wanted to be held accountable. This was "just volunteer", we couldn't make them come if they didn't want to. I continue to push and when I couldn't push anymore, I took a leave of absence. The number of calls that had no responders went up and the officers got concerned. I got my crew nights.

Since then, an ambulance has been thrown in our lap and told to get it running in less than three months, which we did. I doubt I would have been able to the job that Jenny did. But now we have an even bigger need for more officers causing the span of control to be far off balance and leaving Jenny with more tasks than necessary.

We now have a new chief with a big, wonderful goal of reorganizing our department, which includes more EMS officers. He has pulled me aside on more than one occasion to discuss my interest and abilities.

My attitude has been less than stellar lately. I have not been on many calls; I am doubting my skills and meeting resistance with Jenny. We can tolerate each other and can be cordial, but there is not much honest communication there. For lack of better words, she is unpredictable. One day she is sweeter than sugar, the next volatile and short with everyone. You really take a gamble with what you are going to get out of her on a day to day basis. I have intentions of sitting down and having a heartfelt, let it all out, no holding back conversation, but I just haven't gotten up the courage or the time.

Jo seems slightly reluctant to my becoming an officer and I can definitely see where her concern lies. Since the Lieutenant and I have been trying for kids for a while, there is plenty of emotional baggage that comes with that; and then there is the possibility of me actually getting pregnant. (Don't hold your breath though.) Eventually, that would seriously limit the number of calls I could go on, but it would not limit my involvement behind the scenes; at least I hope not.

I have a lot to think about, plenty to say and yet generally, I have been biting my tongue. It seems unfair for me to say anything when I don’t have it all straight in my head. I would love to take on the roll of Lieutenant as I feel I do have great qualities and plenty to offer, but there is that little voice in the back of my head that keeps telling me I am not a strong enough EMT for the job. It is a classic case of an angel on one shoulder, devil on the other. I fear I may want more encouragement and reinforcement than one should need to be in this position.

If that is not enough to process, an opportunity to take a course to become a higher level of care has presented itself. I have always vowed that I was quite content just sticking people with needles as an IV-tech. Whenever the conversation would arise of taking Intermediate, I would smile and kindly decline for the sole basis of not being strong enough in my skills as an IV-tech. Don’t get me wrong, I can run a scene, stabilize a patient and get them to the hospital, but only when there is someone I trust peeking over my shoulder, ensuring that I have not screwed the pooch. I am not comfortable in the back of an ambulance. My comfort zone lies in the middle of the farm field, in the upside down car and in the tiny bathroom. Once you get me in the stable environment, I start to doubt myself.

While I am sure that I have the skills required and I can get a patient to the hospital in at least the same condition I found them in, there is always something in my head telling me I am not good enough. I read books; I go over scenarios when I’m bored only to feel as though I am never prepared enough, but never do I feel like I am good enough. As soon as I feel confident, I am presented with a situation that knocks me back on my butt and cuts me off at the knees.

I want to be better, I want to be like Fran – unshakeable and stoic. I want to be the one people look for when they don’t know what to do; the one they look up to as the solid EMT. Unfortunately, that comes with day to day experience, a luxury (or curse) I just don’t have.

Fran is practically begging me to join her and others in Intermediate. She has the confidence in me that I lack. I know that we will need Intermediates when we eventually break off on our own. I just can’t shake it though. I know I can finish the class and walk away with more skills than I have now, but if I don’t feel strong enough at this level, why would I add more things to doubt myself on?

Obviously, I have plenty to think about and process. I have at least until the end of the month to make the decision about Intermediate and maybe longer about the officers position. Until then, who knows what I will decide.