Thursday, September 30, 2010

Some things are complicated, Rehab AIN'T one of them.

Many Thanks to EMS Chick who jogged me out of my stupor and reminded me of a valuable subject worthy of sharing on this blog in the hope that somebody somewhere might learn something to enable them to make a difference at a critical point. She mentions, in this post, about a recent rehab experience. Her experience should be familiar to most who work in a Fire and EMS service. Rehab is (should be) part of the job. The problem has always been in the execution.
 I could (and have) easily deliver an 8 hour classroom session on this subject but that's not the point I want to make here, and I'm sure you don't want to do all that reading. I have however, done a lot of study on this subject which continues to this day. Part of my research includes a subscription to the NFA LODD announcements which come in far too often to my inbox. I read and study the circumstances of each report. At the end of the year I summarize these for my own understanding as well as my students. As you watch these things, you begin to recognize patterns. 2009 showed a decrease in fatalities for the first time in a long time and we dropped below 100 for the year. Up until the last few weeks, it looked like this year would be even lower, but the last 10 days have shown a dramatic increase in the numbers. We'll see what fate, and other influences, provide for the statistics at the end of the year.
 I attend a fair amount of fires, and serve in either a fire officer's position, or engineer, or rehab sector.  I used to do a lot more rehab before I got involved and trained on the Fire side and in those days we all knew that the rehab folks were just a pain in the ass and didn't have a clue that they were keeping the Firefighters from doing there job. The rehab folks knew that the Firefighters didn't want to deal with EMS and they had to find a way to make it happen. That was then.
 Then we had a few close calls where EMS would not allow a Firefighter to return to duty because of his/her presentation. In one case we probably saved a man's life, because it turned out that just a few hours after EMS 'took him down' he was in a cath lab and got the treatment he needed. It was a wake-up call for all of us. Then we had a 'save' at a live burn training evolution and we knew we had to focus on this issue.
 Today, we have regular rotations through rehab, two bottles and you're in the tent. Anyone who skirts or refuses rehab is dismissed from the scene, anyone who refuses to stand down when rehab deems he/she needs to is not permitted back into the fight by the IC. The IC system steadfastly respects the recommendations of the rehab Officer. Rehab is part of the system and stands on its own with it's own responsibilities to the incident operation. There is no question of whether or not rehab counts, it is a given. But I digress.
  Read the reports, all the reports, over a period of several years. Read them over and over and over again. Look for a pattern or a common thread. It's in there, and you can find it. You don't even really need to look very hard. You will see it in the fire scene fatalities, the after action fatalities, and the training fatalities.
 Give up?
 It's the LOOK TEST stupid!
 In a vast majority of the LODD cases, the victim would have stood a chance of survival if someone had just done a look test on them and said "Hey man, you look like shit, somethings wrong, let's get you checked out". That's it. That's all it would take. Don't believe me? You don't have to. Just go read a dozen or so reports and put them to the test in your head.
 So here, at last, is my point: you don't need to be a Paramedic performing assessments every 10 minutes on every firefighter on an incident. You need to be a partner, or a friend, and LOOK at those you are working with and have the courage to make them get checked out and admit they are possibly in a bit of trouble. You don't need to be EMS trained to make that happen, you just need to take a good look at your crew.
 Have some courage, grow a set if you need to, keep them alive. If it doesn't seem right, it probably isn't. It sure won't cost much to check it out.
 This Sunday is the Fallen Firefighter's Memorial Service. I invite you to watch as much of this service as you can. The next time your are working rehab, or have your crew in a fire, think about the service and whether or not you want to be there next year because you have a fallen Brother on the 'list'.
 I have 2 Brothers on the list this year, neither of which fit into my 'look test theory', but I can tell you this: I would give anything to not hear the bell rung in their Honor.

Monday, September 27, 2010

Starting From Scratch

Recently we have been blessed with a flood for new applications for membership. Why this happened we are not sure because each new prospective member has a different reason and path for finding us. About half of these have applied for a new program we started, but the other half is just a mystery. We have enough newbies to up our ranks by a two digit percentage if they all pass muster. Just amazing!
 While the approval and vetting process goes forward, I have the duty of coming up with an orientation program for these folks. Usually we get one new member at a time and I spend a Sunday morning at the main station with the individual to go over all the little things that they should know. I base my discussion on all the things I SHOULD have been told when I joined, and instead had to learn the hard way, by getting yelled at. Much of this stuff I have put in a written form over they years to make sure I cover all the important stuff. Having a one-on-one with the newbie also allows me to feel them out and find out what hidden skills they may have and any weaknesses we might work on as their growth progresses.
 Each time I do an Orientation, I review my notes and try to add anything new that has popped up since the last time. The goal is to get them comfortable with how we operate so that they don't freak out or get their feelings hurt when they begin 'doing stuff' with us.
 Because I have so many this time, I am thinking about doing a slightly more formal classroom presentation and getting a few others involved in sections where I have less knowledge (such as the incentive plan and voting system) to mix it up.
 At any rate, as I have been going over my notes, I again began to realize the vast amount of information one needs to know just to respond and arrive at a call safely. Looking at it from a total newbies eyes, this can be a frightening experience: not knowing what everyone else is doing, or why, not knowing what they can do, or how, not understanding what the incremental goals are, or how to select them in order, and the worst of not understanding why, in what appears to be total chaos, everyone is calm and moving quickly toward the same goal without discussing it too much.
In the past I have had good success with my orientation program, based on the feedback I received. Two members told me that had I not prepared them as I had, they probably would have made an early departure, but knowing what was coming, and WHY, made it much easier to understand and work within.
 So I'm going through the whole program again with that in mind and trying to jazz it up a little as well as focus on the important stuff like safety, ethics, professional appearance and actions, and an overriding basic emphasis on why we exist in the first place. I leave out specifics that will be covered in their focused training later. The point here is to keep them safe and somewhat comfortable so they can get through the training and probation. We also pull no punches on what is expected of them to make sure they haven't gotten the wrong idea about what we do (i.e.: if you came for the beer, there ain't none here. We have no alcohol on the premises, sorry).
 Does your department do a new member Orientation? Is it formal or a one-on-one? What information do you include, and what do you leave for later? How long is it? Do you have a new member book or package? If so, what is in that package? I'd really like to know so that I can give our new folks a better leg up on the long climb to competence. This job is tough enough without wasting a lot of time trying to figure out what the rules are.

Sunday, September 26, 2010

Decisions, Decisions.......

ARRRGGGGHHHH! I thought I was getting off the hook for a while. Unlike our career brethren, those of us in the volunteer fire service, for the most part have either elected or appointed line officers. I have been serving in various capacities as a line officer for around the last 4 years, first due to abdication of elected officers, later by default, and lastly because I was asked by many to do 'just one more year, please'. This year, at the very beginning of the year, I made it clear I was not running again and somebody had best step up to the plate. I offered full assistance to the next in line, as well as all my notes, plans, and records.
 A few days ago, one of my subordinate Officers offered to run for my spot, just as I had hoped. He will be a good fit, and do a fine job. I breathed easy because I had found and prepared a successor that was good for the team, and also because I could get a little rest, take care of my home life, and put in a little more effort at my paying job. (Of course, I'll still be running calls, doing a scheduled duty night, and teaching for the county, but it lightens the load for me a bit.)
 Yup, I could breath easy... for almost 48 hours. Less than 2 days later the Chief asked if I planned on running again. I told him 'no', and he asked who was going to run for my position and I shared the info with him. He said "Good, then can I get you to run for Lt. in Company 6?". I answered with an open mouth and he went on, "I had put you on the eligible list for Assistant Chief but the Board knocked it down because you have never served as a FIRE officer, Only EMS." I looked at him and smiled, I said "Chief...". He cut me off "Yeah, I told them you have more qualifications to teach than I ever will, you also have more recent training and soak up the new stuff like a sponge, and you have also been a big help on all our major calls, carrying your weight in any job I put you in, BUT, THEY pointed out that the bylaws say you need 2 years as a FIRE line officer, EMS does not count."
 I guess I dodged a bullet. I hadn't considered running for Assistant Chief, at least not this year. Now that they have put a roadblock in the way, which is really ironic to me, as our Commissioners, save one, have no idea what I do for our Department. The Chief was trying to point out that I could do 2 years as a Fire Lt. standing on my head because the workload would be about 25% of what I am currently doing in EMS, mostly because I would only have 15 people in the company, no monthly supplies to order, no state DOH paperwork or inspections to worry about and I already know the apparatus because I am qualified as an engineer on everything would be in my charge. Also, I would be working under a Captain that has his act together, big-time.
 On the other hand, I am a bit insulted that they believe I need to 'start over'. From that perspective, I am considering just letting them hang until they realize that good people don't grow on trees.
 Decisions, decisions.......

Friday, September 24, 2010

Definately Educational, but not acceptable.

On Sunday The Happy Medic posted this short blurb about traffic fatality Memorials and questioned if it was acceptable to post a sign which read "A drunk driver killed themselves here".
 I see these memorials all the time and I don't really care for them, especially those at jobs I had worked. It brings back the video of the incident every time I pass one and I really do not wish to re-live that experience at that particular moment, thank you very much.

There is one of these not far from my home which I have to pass everyday several times. Each year it falls into decay as the year goes by, the snow comes and goes, the snow plows do their damage, and the weeds grow up over it. Every year I think the family will let it go and forget about it. I would really prefer that they do, honestly. But then on the anniversary of the event, everything gets freshened up, new flowers, more candles, and I don't know what else. At that point I know I have another year to look at all this stuff.

My problem with this one is that it reminds me of a particularly nasty incident, and also that there is no way for me to avoid it if I want to get home. It happened many years ago but is still vivid in my head. The bike's computer chip recorded 120 MPH as it's last recorded speed, there was no alcohol involved. He was out riding for fun with a friend, who was smart enough to slow down as they entered the turn. If I were going to post a sign like  HM, this one would have to read: """On this spot, a motorcyclist committed suicide and left a 24 year old wife and a 2 year old daughter to fend for themselves."

Some days I come around that bend and the Memorial catches me off guard and before I can catch myself, I get a flash photo of that night. When this happens I get angry and think about ways to make this thing go away. But then I recover and realize that on some level, this family is finding peace with the trinkets that reside on that rock wall. They need to have it there, much more than I need to have it gone.

Tolerance: Just another service we provide.
Still, there are those days........


Sunday, September 19, 2010

The Parents Pain

 I pulled up to the house and was impressed at the neatness and care the grounds were kept in. A large two story home separated from the neighboring homes by more than enough space to allow the neat landscaping to fold easily into the wooded barrier around the home. This place showed regular work by the owner to keep things looking just right. The patient was seated on a large rock, parked just so as to create a border for the two car wide driveway which had a casual bend up to the home.
 I pulled past the driveway and settled my vehicle off the road to allow room for the rig coming in a few minutes behind me. As I grabbed my bags and headed across the lawn I was again struck by the neatness of the yard, the flower beds placed here and there, the freshly turned mulch around each tree, and how much work this would take to keep in such fine shape.
 As I approached the patient, I took it all in. We had been to this address before, although I personally had not. None the less, when the dispatch came over, the address tripped the 'hot list' in my head and I knew there had been some dicey calls there. I didn't want any of my younger crew handling this without back-up. As it turned out, I got there first right behind the Chief who had been in the neighborhood. The Chief walked out to meet me and speaking in a low voice asked me if I knew the deal here. "Yup" I answered back, "Use all caution". He smiled and let me get to the patient only saying "I got your back" in a half whisper.

Last time we came to this address was a couple of years ago and it involved a lot of support from the boys in blue and grey. There was also a call several years before that which involved an overdose and occluded airway. Once we had a midnight call for a roll-over and found a vehicle that had ping-ponged off of rock out cropping on both sides of the road before flipping. I thought we'd have a DOA when I saw the car, but the driver was gone and made his way home somehow. He turned himself in the next day. The patient before me was the subject of all these calls. As he sat there, unable to keep himself erect, his Dad had one hand on his shoulder and one supporting his back to hold him upright. I looked at Dad's hands as I opened my kit. These were the hands of a working man. Strong, meaty, and tanned like leather, they had little difficulty in holding the son erect. I glanced at his face as I asked the basic questions and I was struck by the pain in his eyes. Here he was holding his 30 something year old son upright because the drugs he took had robbed him of the simple ability to do it himself. This was not the first time and he was all too familiar with supplying us with all the details and data he had on his son's condition. Cocaine, Vicodin, Mushrooms, and alcohol, all about 6 hours ago. They had witnessed 2 seizures after finding him in the driveway this morning. As I swung around to the other side of the patient to get a B/P, I noticed the Mother. She was standing 15 feet away and looked too frightened to approach. The look on her face spoke volumes and the title page read "anguish". This family has given all to their son, tried to raise him right, got him the best rehab, and when it failed they did it all over again. I looked back at the Father and saw again the pain on his face, but the patience in his voice showed a resignation that he would not give up on his son no matter what. If they had to go through this all over again, then that's what they would have to do. The only intelligible words I heard from the patient were spoken toward his Mother. He said "I'm sorry you had to see me like this." I 'm thinking to myself that if he was really sorry he wouldn't do it ever again. I wanted to smack him in the mouth and point out what he was doing to his family for too long, But instead I gave my turn-over report to the ALS crew that had just arrived. We got him loaded and I packed up my stuff.

I had no pity for the patient, he had all the help in the world and still kept screwing up. For his parents, my heart cried.

Saturday, September 18, 2010

....AND.... We're Back

I LOVE to visit Chicago! It's a clean city with nice folks and some of the best restaurants in the world. Two of my favorites, Texas de Brazil and The Purple Pig received visits from my traveling companions and I. I have a connection at The Pig and they treated us royally. The food at both places is exceptional and The Pig is garnering a lot of attention since it opened in December of 2009. Both places are what I would call an 'alternative dining experience', so go with an open mind and an empty belly. If you have questions abut either of these places, leave a a comment or drop me an email.

While at the show during the day we worked our collective butts off. Contrary to what my co-workers back home would think, going to the show, although enjoyable, is NOT a vacation, it is a lot of work to maximize your time, see the folks you need to see, and collect useful information to aid in decision making and planning over the next several years. I'm taking this weekend to recover, my feet are killing me. There are around 20 miles of aisles at this show and we do them almost twice during the week. The eye candy in some of the booths takes the pain away a little. I didn't get any photos of the pretty girls, but here's one sure to get the attention of the guys over at Firegeezer:
This is a Tesla Roadster. It is a full electric car which can do 0-60 in 3.7 seconds with a range of over 200 miles per charge using a huge Lithium battery which looks something like this:
Not much of a trunk, but this baby can fly!

 We enjoyed taking some walks and seeing the sights while we had some off time. One night we had to attend a corporate dinner hosted by a machine supplier we frequently do business with. After the dinner we were catching some air before looking for a cab to get us back uptown. A nice limo pulled up and offered a ride. I told him he was above my pay grade, but he made us an offer we could not refuse and here is the rig that dropped us off at our hotel:
 It was interesting to pull up to the Hotel and see everyone on the street looking to see who was going to get out of this car. Boy were they disappointed.
 Incidentally, the limo driver made mention of the fact that the trade show business is way down and all the service industries, such as his, are really hurting (hence our cheap trip). He said they hadn't had a major show since April. I asked him about the FRI a few weeks ago, and he replied that "Those folks all drove their own cars here, stayed at the cheap hotels, and didn't go to the fancy restaurants. Besides, they was just here to plan their big operations that they was gonna execute elsewhere. They wasn't here for fun, and it was a pretty small group of people, only a couple of thousand." OK, so he missed the memo on that one I guess.  (By contrast, the show we attended brings in 90,000 visitors, plus the exhibitors from all over the world.)
 We had a great time, picked up a few new stories, and came home dog tired. On our return day we worked the show all day then headed out to O'Hare and didn't get home until 1:00am the next morning. In two years I'll be ready to go again.
 So it's good to be home and get back in the groove. I just ran an O.D. call a little while ago and my head is beginning to clear and get re-oriented from traveling mode. I see that my readership faltered while I was away, I hope this post will bring it back up. I did take advantage of the time away to keep up with everyone else's blogs and the debates that are raging. I am still trying to decide if I am up to stepping into the fray or not.
 Maybe I just need a few more days to form my thoughts.

Everybody be Safe,

Sunday, September 12, 2010

Outta town...

Starting Monday I'll be out of town and probably away from the blog for a while. I'll be attending a very large trade show for my paying job which only happens every two years. I know I should have been in Chicago 2 weeks ago for FRI, but this is as close as I could come. For those who were lucky enough to be at FRI, this show, by comparison, fills all four of those buildings at McCormick Place. It's a rough week for me, I assure you, I am walking the floor all day and have about 20 different appointments during the show hours. When the show closes, we head back to our Hotel, drop our junk, nap for 20 minutes and head out for a business dinner, every night. We get in at around 11PM (sometimes its a bit later) and do it all again the next day. Yeah, we eat in the best Restaurants and drink top shelf liquor, but it's all work. When I finally return home, I am shot and it takes me 3 days to recover. I usually get home from my flight at around 11PM to 2Am and have to make an appearance at work the next day. Not fun.
Returning to work the following Monday, my co-workers act like I have been on a paid vacation. I hate that. It is really hard meeting all those people, working on future plans, eating all that fillet Mignon and keeping up a professional appearance (falling down is considered in poor taste, funny as hell, but in poor taste). Then there are all the models on the show floor I have to navigate through, it wears a guy out. Last time I had a model sit next to me on the shuttle bus going in to the show and she was impossible to shake. When I walked past her booth later in the day it started all over again. she didn't even know I was a Firefighter, so I'm wondering what the attraction was. I'm sure it wasn't the fact that I was wearing a badge that indicated I was employed, and therefore making purchases for, a major worldwide corporation. No that couldn't be it, but what could it have been? It must have been the mustache.
 Anyway, you guys will have to read some of the better blogs this week while I am off working hard. Last time I was in Chi-Town I was going to try and visit a firehouse. It turned out there was one right around the corner from my hotel, a ladder company as I could see. Every time I grabbed my jacket to take the walk over I saw them headed out on a run. It seemed like those guys only came back to the house to pee. For an entire week I counted them going out on twenty runs and I didn't spend hardly ANY time in my room except to sleep. I heard sirens so much that I felt like I never left home. This year we've got a better hotel (read "closer") and I hope I can find a house nearby.
 So look for me to show up about the same time I return.

Saturday, September 11, 2010

I'm not quite there yet.

 Today is 9/11 and I am trying to take a big step, but I'm still not quite where I need to be. I am still bordering on denial and some other place I haven't figured out yet.
 I never watch any of the 9/11 stuff on TV, when anything that comes on in relation to this subject I automatically change the channel. If I am not in charge of the remote, I leave the room. I don't even watch commercials for shows about this incident. Sorry, I still have real problems dealing with it and I don't think at this point it will ever get much better.
 I won't tell you where I was, or what I thought or what I felt. It does not matter a lick to me, why should it make a difference to you? Just like in the CISD sessions, I do not need to share, thank you very much, now may I leave?
 However 9/11 did affect a lot of my friends, family, and brothers in the Service and still does today. I spent nearly 6 months collecting the courage to call one of my closest friends from my youth who I knew would be working in the towers at thar time of day. He was running late that day and survived. After a cheerful back-slapping reunion on the phone I hung up and cried for an hour. I was so sure he was lost.
 Two members of my Department went down to ground zero and worked for 4 days until they were relieved. They were first assigned to do recoveries of the Firefighters that never made it out of their rigs when tower two came down on them. After that, I'm not sure what they did. It is still too soon for them to re-live the event and share it with me. I am not about to ask them to talk about it, they will tell me someday, or not, as they choose. I do know that when they returned, one of them got a hotel room in town because he didn't want to see his family yet, and he spent 24 hours trying to get hold of his emotions before he could see his wife and children again. He told me a few details, but they are so private and painful I will not share them here. as a matter of fact, I won't ever share them with anyone.
 Another friend of mine in Law Enforcement went down on special assignment for the first month, and then 1 week a month for the next year. Another close friend spent almost 2 years working on identification of remains. We are in an area that is close enough that everybody knew somebody that was either in the towers or supposed to be in the towers on that day. I could go no where without hearing somebody's story. I could not get away from it and still can't.
 Consequently. I closed my mind to all discussion and references to that terrible event. One of my co-workers wanted me to watch a show about a conspiracy theory connected to the event last year. I respectfully explained that I would 'rather not'. He asked me again and again. He had a technical interest and wanted my opinion as another Engineer. Finally, I gave in and tried to watch it. I got through more than half of it before I turned it off. The next day at work I told him how much I saw and what I thought of the technical merits presented. He wanted to know why I didn't watch the whole thing and I just said I could not finish, 'sorry'. He pushed and said I really needed to see the end to get the conclusions. I snapped, "Bill, how dare you? You have no idea the pain you've caused me to do what I have done and now you want me to do it again?! I did not sleep all night, and will likely not sleep again tonight. It's a freaking TV show. I don't need to think about this stuff again, I'm not ready yet." He didn't get it. He thought I'd lost my mind. Perhaps I had.
 But I may be getting better. Later this morning I will be attending my first ever 9/11 Memorial Service. It's a big step for me. If we get through it and it degenerates into the usual discussions afterward about recent events, apparatus, and fire service scuttlebutt, that will be fine. If the conversations change to "where were you on that day", I think it will be time for me to go. I'm not ready to do that yet.
 I think of the 343 every day because I see reminders everywhere. I also think of all the EMS personnel and Police officers that we lost. I know that this could happen again anytime, and involve any of us, with no warning. We are a bit better trained now, but the event could be overwhelming none the less. One thing is for sure, prepared or not, good people will offer their lives in the Service of others without a moments thought, just as they did  9 years ago.
 I deeply regret that our Government and political leaders lack the backbone to provide the needed support to the rescue personnel and their families that were left behind and still suffering. As an American I stand ashamed of how we have treated those who offered the supreme sacrifice and yet survived to suffer lasting torment of their injuries while being cast aside by the people they served. How short is the memory of these political leaders? These same leaders who stand before a Fire Station collecting campaign photos and then turn around and vote "no" on the bills to supply benefits to these very same people. It disgusts me.
 So yeah, you could say I'm a bit conflicted and having some issues dealing with all this. September 11th is still a very personal and private day for me. The fact that I am even writing this shows I am making progress, but lets not all expect too much too soon.

Thursday, September 9, 2010

Basic stuff in EMS

Those of us who have been in this business more than 10 days talk about making improvements. Those of us that have been in this business more than 5 years know we NEED improvements. Those of us that have been in this business more than 10 years know that if we don't force major improvements it will get much worse then it is now, which is pretty bad from the patients perspective. I think most of us agree that the reason we exist is for the patients.
 Rouge Medic has once again come up with a great post which speaks to the fundamentals of how we do business when it comes to the basics of assessing patients. This has long been one of my gripes. RM's post helped to make me realize one of the problems we might 'easily' solve in EMS 2.0 and how we might do it.
 As it stands now, we have a 'tiered' training system (my term). The Doctors receive their training, the Nurses receive their training, and we, EMS receive our training. None of these programs overlap, and none of these programs are parsed out against the others for relevance and compatibility, let alone cross training.
 Let's face it, we bring in patients and are oftentimes hit with a lot of criticism about our decision making process. This should not occur unless we exhibit incompetence. In addition most hospital side practitioners are not even vaguely familiar with what we are taught as working parameters.
 Case in point: I attended a CME about a year ago regarding adjustments to the State's Backboarding protocol. The CME covered all the points, which when boiled down meant that just about everybody gets a backboard. During the presentation which was delivered by a CIC (Certified Instructor Coordinator), the Medical Control Physician sat in the corner half listening and sucking on some chicken bones left from the buffet. At the conclusion of the presentation, the CIC asked the Physician if he had anything to add. The physician put down his chicken bone, cleared is throat, walked to the front of the room and said "Look, all this training is fine, but the fact is that we have too many people coming in on backboards. Ulcers begin forming in 15 minutes and if the backboard is not really needed, don't use it. Please think about your choices and only use the backboard when the patient really needs one. I would like to see an 80% reduction in backboard use." In three sentences the Physician had shot down the entire State protocol. He didn't care. He was looking at the patients, not the protocol. The Doctor was right. In our system, we backboard way too many people. As a consequence, the E/D staff pulls them off the backboards almost as soon as we bring them in. This leads to situations like the following: I brought in a PED patient that had suffered a direct blow to the head as a result of a sledding accident. She hit a small barn head first at the bottom of the hill. We boarded her based on MOI AND her symptoms and complaints, as well as our assessment. We considered a medevac, but chose ground transport instead. The E/D had her off the board before I finished my paperwork and I went to the attending and re-iterated the mechanism as well as our assessment. He ignored me. The girl was discharged in 4 hours and was taken to her family Doctor the next day along with the x-rays. The family Doctor found 3 separate skull fractures on the x-ray and had the girl admitted to a level 1 trauma center 60 miles away, within the hour.
 Until we are all training together on the same set of rules we shall remain in competition with each other. Basing a treatment of what actions occurred regardless of what ACTUALLY happened to the patient is just insane. Learning to treat the patient based on what actually happened is just the right thing to do. Call me a simpleton, but why is it so hard for us to get this one fundamental process right?

Wednesday, September 8, 2010

Indulge me, Please...

 God knows I am not a normal person. While most people have hobbies, I have PASSIONS. I am obsessive and compulsive in these pursuits. In for a penny,  in for a pound, I always say. God hates a coward, lets jump all the way in.
Believe it or not, my life is not entirely consumed with Fire, EMS, and my work life. I actually have a family and other interests. As a matter of fact I have a lot of interests which I have, in turn, dedicated an inordinate amount of time to over the years. My dear wife of 30 odd years (well OK, about 5 of those were not too odd) knows that when I pick up a new 'thing' it will run about a 5 year cycle until I have mastered it or gone as far as I can go based on my money, resources, physical, or mental abilities. To give you an idea, over the past half a century I have heavily participated in the following (I also list in brackets at what point I faded away from the and into something else): Cycling [Worked as lead mechanic in a bicycle shop with 40 other mechanics and completed my first century ride in 8 hours, 41 minutes], Amateur (Ham) Radio [Mostly focused on radio contesting I put this one on hold after I had become licensed as an Extra Class operator and was regularly finishing in the top ten in North America and top 20 worldwide with a few wins in my emtry class, my code speed was about 35 WPM when I faded out], Friendly competitive handgun shooting [Consuming almost 250 rounds of hand loads every week kind of tapped out my bank account when we had a new baby], gunsmithing [see previous], Hunting [We moved into the area where I hunted and it somehow lost it's charm, now I just walk out the back door], Hiking [checked off a few items on my bucket list, particularly in the 'winter ice climbs' section and a 10 day trek through the Rockies at elevation], and Fishing [Fished many different methods and mediums, this one will never go away, I get out every year for a 5 day trip, it's therapy]. There are of course a few more, but you get the point. I have left all of these at levels where I can pick them up later in life when I have more time and my physical abilities slow. Ham radio will probably be the big one for me when I hit around 75, I can wait.
 One I did no mention is genealogy. I put all my waking spare time into researching my families history for almost 10 years. I used to put in 2 hours before work every morning and after dinner I would put in 4 more. I traveled all around a 4 state area, sent letters around the globe, and spent three weeks in the old country doing research. I was hooked. That one started to wane after I had self published a 300 page book on the family history, but not before I had amassed 4 bookshelves full of reference works and a 4 drawer file cabinet full of notes and original documents. I had over 3,500 people in my database and the lines went back to almost 800 A.D.. Yes, I was a sick sick person. I burned out and haven't really touched it in 10 years now, but the juices are beginning to flow again. Six months ago I received a Facebook note from a cousin I don't know in the old country inquiring about data and photographs for a book he is working on. What he asked me for would require a few hundred hours work on my part. I confess that I put him off, but have been thinking about it more and more. Soon I will step down from my post as Captain and might actually have some time on my hands again.
 Today I received a phone call that might have tipped the scales. You may remember me mention in this post that I had re-hooked up with some family I haven't seen much in the last 30 years. Well, that day turned out to be a good one and we did a lot of catching up. When the day ended one of my cousins promised to send me some stuff he had from his visit to the old country in the 1960's, mostly photos he had taken and put in an album. He also promised to send my Dad an old Mauser rifle stock that my Dad had given him as a kid (turns out Dad still has the action and wants to restore the rifle). Well as things would have it, it's been several months and I haven't heard from my dear first cousin. Not really a big surprise, I know we are all busy and he is getting prepared to retire and move south. Today he called me and explained why he hadn't yet sent the stuff he promised. Then he moved into this: "OK, so the third reason I called you was: when I was over in Germany in 1968 and we took a 2 week holiday back to the old country to see Tante [Aunt] Margaret, she gave me some photographic glass plate negatives and I took those back to Germany with me and I still have them." I almost dropped the phone right there in the hay field I was walking across. "Lindy", I said "Do you have any idea what you have there?" It was a rhetorical question, but he tried to answer, "Well I really think I have some pictures of Family in here, but I..." I cut him off , "Lindy, you have the other half of the pictures that our Grandfather took on his trip home in 1903. The other half of this series is with our cousins in Texas and I have only been allowed to examine and print them once. I have one set of contact prints from those plates. Now you have come up with another piece of the series that NOBODY even knew existed. This is freaking amazing!" "Well" Lindy tried to go on, "I was wondering if you would be interested in having them? If so I would like to give them to you because I know you like stuff like this." I have tears in my eyes. I put in over 300 hours investigating and documenting who was in the photographs on the plates I printed, now he has come up with an unknown group of photos from the same series. My dear cousin still has no idea what he has. These plates are over a hundred years old and were taken by my Grandfather in a time when taking a picture meant carrying around 70 pounds of gear. My Grandfather brought back 50 pounds of glass plates from that trip and he must have left the rest in the barn at the family farm to be discovered by my cousin in the 60's and eventually they made their way across the pond where, 107 years later they will come into my hands so that I can print and publish them for the whole family. I'm thinking "MAN, do you have a CLUE how prophetic this is?!".
 Poor Lindy still doesn't get it. I am already calculating drive time to his place, checking my wallet to see if I have enough money for gas, and doing calculations to see if I will be back home in time to grab a shower before going to work tomorrow.  "Well" he said "You take a look at your calendar and see what weekend works for you. I can drive halfway and meet you somewhere to hand them over. There is no way I would want to ship something like this." "OK Lindy", sanity is starting to come back into my muddled head, "Sounds good, let me see what weekends are best, but I will make time to get with you. Just take good care of them until we meet."
 I think I detect a passion welling up in my soul.
 I know this stuff isn't of much interest to my readers, but there are other things in life. Part of what we do in EMS and Fire is to keep people around for longer than they might have been otherwise. My work on the family history will long outlive me, and in that respect, has tremendous value to others. Today was truly a special day for me, I just wanted to share it with somebody.

Monday, September 6, 2010

The Decision

OK, for whatever it may be worth, I have given much thought to my dilemma posed in this post and those prior to it. I have arrived at an action plan, as the corporate speak would prefer I say. I'd like to thank those that either posted opinions or support as comments or sent private emails with advice. These actually helped me firm up what was the right thing to do.
 First, let me briefly recap my thinking, which may or may not be correct, but is the basis for my decision, which also may or may not be correct.
 First, the COHCOHN is a clinical ass. Although she carries years of experience in areas I do not, she has no EMS training, experience, or knowledge whatsoever. She is totally correct in stating that The Company has the right to determine what level of care they will provide and support. This is where her factual information ends. I actually contacted the Assistant Director [AD] at our State DOH, who this Nurse had talked to regarding the laws in our State. (You see I know this person professionally and have a good relationship with her and her office.) The AD tells me that the Nurse never asked any specific questions about the level of care I (as an EMT-B) was permitted to provide. The AD had suggested that any specific questions we had could be sent in writing and they would be happy to provide written rulings based on the law, but the Nurse only wanted very general stuff and never talked about specifics. This tells me the Nurse didn't want to whole truth of what I could and could not do under the law. In doing so, she became persona non grata in my consideration. She is irrelevant because she did an incomplete job. (I'll ask HM to put a Letter in the File for her.)
 The EHSM lacks the spine to come out and support me, or rather our workforce because she is too lazy to do the homework and fight for what is right. She could have made all this happen the way we wanted years ago, but she took the easy way out and assigned it all to the EHSW. Now she has no idea where any of it stands and why it is all screwed up. She is too lazy still to play catch up and straighten it all out. She will most likely not back me up when I do what is needed for a patient because it is the right thing to do. She MIGHT fill out the incident paperwork in such a way that the issue of my actions are never mentioned, but that would be as far as she would go. (She IS under some pressure to keep me in the building because of my professional contributions and the company's inability to find another person with my skills. The search has been underway for a long time, we are 2 people short in my group.) Still, I can't turn my back to her for fear of what she might stick in it.
 The EHSW is simply a waste of a paycheck. She is completely irrelevant.

So, tomorrow I will return to work and suck it up. I will verbally make it clear that they are putting me in an awkward situation in the event that we have a serious patient. I will request that they document these new rules they have fabricated so that I can see where the lines are. In my mind I know that the statistics are in my favor to not have another serious case for a long time. We've had 3 in the last 8 months with none in the prior 5 years. However, should somebody have a serious issue, I will do what I have to do. I will not keep any special tools or equipment IN the building, knowing that they are always out in my truck in the parking lot. If I really need them, I WILL send somebody out for them. If they fire me for treating a patient who needs care within my scope of practice, I am OK with that and will get a lawyer if I feel like it. Actually, a paralegal should be able to win that case.
 In short I will toe the line. I will not like it. I plan to let my boss, who is away on 3 weeks travel, know clearly that this has put a severe crimp in my relationship with the company and let it go at that.
 As for making my point: I will be writing a new article for one of the occupational safety magazines bringing this point to light. My company does not allow people who do this sort of writing to use the company name. So I clearly have no association with the company in this endeavor. Ironically, I have an article pending publication in the September issue of one of these magazines that touches ever so slightly on this subject, my next article would be a natural followup. As for the COHCOHN, I will break even with her also. She travels in much higher circles than I and this will take some patience. I have been known to wait up to 10 years to fire my singular shot, but fire I will, and I will make things right with her, and on her political level. She will know where the return fire came from and she will protest to no avail.

 So there you have it. I caved in to the establishment because my family needs to eat. They win, and everybody in the plant stands to lose. Does that make me a bad person? I hope not. Sometimes you have to compromise with assholes when they happen to be in power.

More Curricuclum Corrections

 My old friend Justin, over at the Happy Medic has, just this very morning posted his suggested "Upcoming Curriculum Changes" required in the soon to be released version of the EMT program.
 I dusted off the copy of this document which was handed to me months ago and read through it again to see if I agreed with what HM was proposing and if I found any other loose ends or missed opportunities for good guided learning experiences of the endless line of untested, fragile, and good-hearted EMT Candidates which traipse through classes every year and enter the frightening world of EMS.
 Sure enough, I find that Justin is correct and there are quite a few holes in the teaching material. Justin started a good list of critical points and with the fine example he has set, I would humbly like to offer mine. I will focus here on those skills which apply to ALS Support, as these are sorely lacking in the text.

1) The vast majority of jobs you will work are BS BLS. The most meaningful way to support ALS is to keep them available for 'real work'. Don't call for ALS unless the patient needs ALS.

2) The Medic is taking charge of patient care because the Patient needs ALS, not because you need ALS.

3) EMT's do not save Paramedics. If the Paramedic needs saving that should have been done long ago by his preceptor. You can (and should) provide all possible support to allow that medic to focus on the patient. Be prepared to ward off the occasional bullet, explosion, projectile vomit, or anything else that might distract the Medic, he is thinking really hard. (Psycomotor Skills: practice throwing your body out to catch these distractions.)

3) Unless you have a VERY close relationship with your Medic, do NOT speak to him when he is interviewing the patient. He has a switch in his head that turns off all voices not coming from the patient when he is seeking specific information.( He turns this filter on and off without warning, so if you think he is not listening, be careful what you say.)

4) In your off hours, focus your workout sessions on doing many reps of squats with weight and stair climbs with weight. This will allow you to function through long 24's without collapsing. You are the equipment donkey, get good at it.

5) A medic's brain works in mysterious ways. Do not try to figure it out (you could do irreparable damage). He is calculating drug dosages based on weight and/or size while you are worried about how to get the cot in the room.  He is thinking about where to eat lunch while you are trying to figure out if you can get all these bags back to the rig in one trip. He is trying to remember what's on TV tonight, while you are spiking a bag for him. Don't try to figure it out, just know that it works. Let him think about whatever he needs to. He'll tell you when he wants your opinion. (And he might even tell you what that opinion should be.)

6) KNOW the difference between a macro drip and a micro drip. Unless of course you think walking around with the incorrect choice protruding from your nose makes you look sexy.

7) If an EMT does his job with excellence, the Medic can also perform with excellence. If an EMT does a lousy job, the Medic has to do the work of two mediocre providers. Do your job well.

8) It's all about the Patient, stupid!

9) Try not to step on the Medic's cape. They HATE that!

10) If you do step on the Medic's cape, offer to get him a fresh one out of his locker and pay for the dry cleaning. (Scene Safety tip: Use care not to fall off the pedestal when helping the Medic into a clean cape.)

Everybody enjoy a safe Holiday,
(P.S. Sorry HM, once again, I just could not resist.)

Sunday, September 5, 2010

I'm Still Thinking

Yes, I am still ruminating on the issues surrounding the the previous posts. I have set a goal of making a firm decision before returning to work on Tuesday. But for now, I'm still thinking.
 In the meantime I wanted to throw in a catch up post here where I relay some other things on my mind.
 First, I have noticed that the traffic to my site has been increasing and even though this confounds me, I appreciate it very much, as I appreciate being listed in the Blog Rolls of other, more eloquent Blogs. I take this as  an undeserved, yet high compliment. I am humbled. So I thank you all. I continue to try to find what it is that interests the readership while at the same time satisfying my own needs to get some things off my chest and lighten my own burden. So don't be shy about putting up comments about things you don't like or things you do. I learn more from the critical comments than I do from the flattering, although they both serve a purpose.

Lastly and most important I would like to bring your attention to some outstanding writing which I have taken the time this weekend to delve into better than I can do in an evening read alone. Looking Through A Pair Of Pink Trauma Shears has presented us time and time again with some outstanding pieces which bear up even as stand alone writing if taken outside the Blog. If you are already a regular reader of hers, then you know this already. If you don't and you want to see what real writing is, don't waste your time on sites like mine, go read hers. If you are not a regular reader on her site, then I strongly invite you to read these 4 posts in the proper order. First Trying to Meet My Maker will bring you through some of her experience and give the reader an idea of what she is made of. The second post, Tear Drops On My Trauma Shears shows the long road many of us take to get where we are, as well as the price we can pay. Some pay a higher price than others and I believe this is the case here. I'm Sorry will bring you along on her recovery and healing path. You should read it prepared for a difficult trip. Finally, in Renewing My Soul she shows how it feels when you come out the other side with a fresh start and the benefit of what you have learned and survived, all put together in a not so neat package that somehow works for you.
All put together, these make for some powerful writing. If there were blog awards given for individual pieces, each of these would be top contenders in my book. They are written in a manner that will grab the uninitiated civilian, wake up the newbies who think this is still all fun and games, and penetrate the hearts of those who have truly been there and done that, and know the pains and emotions they each have dealt with.
 We are blessed to have some exceptional writers out there in the blog world. I won't try to start picking out my favorites because I will miss someone. Go look in my reading list on the right and check some of them out. Medic Trommashere is, in my opinion, one of the best. You should go check out her stuff.
 I'm just saying.

Everybody have a safe weekend,

Friday, September 3, 2010

As the Cretin Thinks (or not) Episode 3

If you haven't been keeping up with the ongoing saga of the developments at my non-Fire/EMS employer, read the first installment HERE and the second installment yesterday is HERE. You really need to read these in order if you are just catching up. I don't want to bore anyone with repetition.
 I will also summarize the positions of each of the players to spare you the blow by blow. To type it all  out is too painful right now (I am still pretty angry) and would use too much space. Frankly, it's not funny anymore. The company has put me in a very difficult position and I am spending the weekend deciding if I can remain there with the parameters they have established, or if my ethics require that I move on.
 So let me introduce you to the players: First, coming on as the local EHS specialist we have the Environmental Health and Safety Wienie [EHSW], you all met her in the last installment. She is the gal who is charged with making all the programs work at our plant. Next we have the EHS Mangler [EHSM], she is the Manager at our plant that makes the hard decisions and really makes things happen. She is EHSW's boss. Rounding out the brain trust we have the Corporate Occupational Hygiene Consulting Occupational Health Nurse [COHCOHN].
 OK so what follows is the bottom line stance of each of the players after we had a phone conference today which was clearly crafted to ambush me, put me in 'my place' and make it clear that what I or the Law said made no difference. It had been decided, and I was to pay attention. What I was told, on the other hand was that this was my opportunity to have my concerns heard and find a workable solution. I came prepared with both the public health law of our state and the documented standards of our Corporation which we had used to establish our procedures.
 Here are the closing arguments. no further discussion will be considered:

 [EHSW] I am just a pion here and do whatever they tell me, I just want everyone to get along. I don't like all this talking and debate, it makes my head hurt. Whatever they say, goes. I will do what they tell me whether I understand it or not.

[COHCOHN] I understand your concerns because I used to work in an Emergency Room. I appreciate that you want to help your co-workers when they need you. However we have concluded through a super secret  method (that is so secret, even we don't know what it is) that your facility does not require the services of an EMT and we will therefore not support that level of care. Yes I know you have made it clear that you need no support and offer the assistance freely, but we don't want you doing it anymore. You will remove any tools, appliances, or devices from the building which require training above the level a a Red Cross Basic First Aider. You may not use a stethoscope, B/P cuff, Splint, BVM, oral or nasal airway adjunct. You may stop bleeding, take a pulse, count respirations, apply band-aids, and perform CPR on adults with the minimal tools we provide and no more. I have covered my ass, that's all that matters to me. So I have spoken, so you will do.

[EHSM] I have tried to find a compromise between the ridiculous requirements set forth by the COHCOHN and our EMT who has demonstrated his value to our employees beyond doubt. However, I really like my job so I have to do what Corporate dictates and I cannot put anything in writing that is against policy, so I won't. Besides, this is a holiday weekend and it's almost noon so I need to get out of here and begin partying. Let's all be polite and say goodbye on the phone call, and you and I can go talk in my Office......... OK, now that it's just you and me and you have no witnesses I am going to tell you what I really think we need to do. Let's just put this process in place and document it the way the COHCOHN wants it. We will remove all those dangerous things from the building and make her happy. When somebody has an issue, you do whatever you have to do, just like you have before and we'll worry about it later. Don't worry, we'll figure something out, we just won't tell anybody. I do not want to have somebody die because we told you that you can't do certain things, even though we have told you that you cannot do certain things. I also have to insist that you never tell anybody that we have told you to withhold care, even though we are telling you do do just that. That would look really bad.  In other words, I am trying to cover my ass, make sure our employees are protected, and put the whole responsibility on you to do what you know is right even though we have told you not to do it in an official/unofficial kind of way. That's pretty simple and should work for you right? Good! I have to go to my hide-away cabin in the mountains and start drinking now...BYE! OH, and have a NICE holiday!

[ME]: I have been prohibited from performing basic assessment skills. The jackass that the corporation has hired to advise them is going to advise them right into a lawsuit of major proportions that could be successfully waged by any paralegal. The Company has taken away the tools I need to provide a complete basic assessment to the responding Medic hereby delaying transport. That's in the best case, in the worst case, with no airway adjuncts, no BVM, and no O2, I could very well lose a patient before the medic arrives (6-25 minute response time, as recorded). The "Company" says "NO", but the Mangler says "Yes, sort of" with a wink.
 My bottom line is this: can I live with this very undefined set of rules? I asked: "what if I 'did what I had to do for a critical patient', would I get fired?" I got no answer, just "we 'll worry about that later". I know already what that means, even if she doesn't. If the patient dies, I get fired, and if he lives, we'll let it go, this time. I am having a hard time with this because I am a very honest and ethical person. I don't lie to others or to myself. The pressures of patient care are tough enough without worrying about the rules you are working under.

I am going to have to take this weekend and decide if I am staying in this job or not. I really don't enjoy working with people who have no ethics or spines. They want my help, but they don't want to say that out loud. As long as I stay in the closet and take it on my own chin, they are ok with it. As soon as they need to put some skin in the game, they run for their mountain cabins and liquor cabinets.

This is a tough one for me. ANY advice out there? How about the big boys? Justin, Mark.. are you guys listening? This is my version of EMS 2.0, "The war of the Cretins" industrial style.


Thursday, September 2, 2010

You Just Cannot Make This Sh*t Up!

OK Folks, pay attention, this could be the post that leads to me losing my job if anybody connects this blog to who I am in the real world. I do not refer here to my EMS job, which is volunteer. I don't know if I could risk that. No, rather I refer to the paying job by which I provide shelter and sustinance to my family and myself. This is why I chose to remain anonymous so I can share stories like this.
 It all started with THIS, so go read that post if you haven't.

Honestly when that was over I thought it was a done deal and we could all move on. Apparently I got on the bad side of the Corporate Industrial Hygienist and she decided that "we have a cowboy out there we need to rein in". She has had further contact with the Safety people at my facility and told them I can no longer fuction as an EMT within the facility. Apparently when she called my States Department of Health to check on the local rules, they told her that an EMT in our great state may not dispense medications when not responding within their response area. In other words, our interventions are controlled by our agency medical control and when we are not under that control we cannot use those prescriptive interventions because we have no medical oversight. (This includes Oxygen.) I get this, and my hope was that we could get a small bottle in the building on a non-prescription basis under this elusive FDA regulation which allows it. I mistakenly thought these EHS folks would know more about those regs than I did. I am learning otherwise.
 So I get this call from our EHS Weenie [EHSW] who is educated well beyond her intelligence. Honestly she tried, but she is hopeless. The following conversation sounds like I am yelling at her in a demeaning manner, but one thing she clearly understands is that I am not mad at her, rather at the company. She feels her job is to explain it to me, and barring that, explain my points to CORPORATE (queue the echoing thunder).

EHSW: So they tell me that if you are not responding with your Agency you cannot perform as an EMT.
ME: What! Do you have a clue what you are saying, let alone implying?
EHSW: Not really. It's no big deal. You can still help people, but only at the level our other first reponders are trained.
ME: First of all, we have no First Responders, we have First Aiders who are trained by [Deleted national training organization] who sends instructors who have never treated more than a finger cut and never participated in CPR. They are good people and try hard, but they can't identify an MI, stroke, or diabetic emergency, they have no training in that area.
EHSW: Well we never have those things here.
ME: Not yet.
EHSW: Well, I'm just telling you what they told me.
ME: OK, then you can tell them this: I need a letter from the company explaining what I can and cannot do to help someone, and it needs to be signed and notarized.
EHSW: What do you need that for?
ME: To bring into Court to defend myself against the abandonment charges.
EHSW: What's "Abandonment" mean?
ME: That's what they call it when you stand there and watch someone die when you might have saved them if you just tried. Anyway, don't bother your head with that, the corporate lawyers will deal with it, because a family is really going to go after them more than me. They have big money, I don't. Once I show the letter I am free and clear and the Corporation is probably holding the bag bigtime because they instructed me to withhold treatment. By the way, this is called "Obstruction of Emergency Services".
EHSW: Look, I know you are upset and I understa......
ME: DON"T YOU DARE FINISH THAT SENTENCE. You have no idea now I feel and likely never will. When you are called to a sick or injured person and arrive to find an unconscious and unresponsive person on the floor barely breathing and you look around and realize everybody is looking at YOU to DO SOMETHING and you realize this person's health, and perhaps their very life is in your hands and is YOUR RESPONSIBILITY for the next 15 minutes and you need to make a decision NOW on what to do, then you will have a clue. Repeat that experience a couple of hundred times and year and you will have a fair idea. I got into this business because I watched a friend die before me and I didn't know what to do. He had people who did, and they  took care of him but he died anyway. I had nightmares for 3 years until I finally decided to do something. I got some training and made up my mind that I would NEVER EVER watch somebody die again without doing everything in my power to reverse the process. Up to now I have kept that promise and no Corporate weenie is going to change that. I still have options.
EHSW: What options do you have. They are telling you that you can't do this.
ME: Sweetheart, you are young and naive. There are always options.
EHSW: So tell me, what options do you have?
ME: Nobody is making me work here, in fact it appears that some would prefer otherwise.
EHSW: You would quit!? Are you serious? Over THIS?
ME: In a New York minute sweetie. You cannot make me compromise my ethics and incidentally, I believe we have policy which states that. Kind of a conflict, don't you think? I was looking for a job when I found this one, I can move on. Been doing it for 40 years and I'm starting to get good at it.
EHSW: What do you want me to tell them.
ME: heh, heh, nice straight line, thanks. But I'll send you the States DOH law which states that an EMT performing in or outside their agency boundaries is held blameless. That should shut them up because it covers their asses. If it doesn't.. we'll we move on from there and each do what we have to do. by the way, what do you think the union folks are gonna do when they find out you took me out of the game?
EHSW: (With a giggle) Oh, lets not go there.
ME: I'm not going there, you are, and you better have a damage control plan. I'm not in the union, but most of my patients are union members and they've been pretty clear that they like having me around. You might want to think about the impact of your actions. The contract negotiations come up in, what, about 8 weeks? Ohh, that's rough timing for you guys, isn't it? Then of course, if I don't work here anymore, that would make it easier for you wouldn't it? But then you have the issue of finding a replacement for me. As I recall it took the company 5 years to find and hire me, didn't it? Well, maybe it will be easier next time, right? But then again on the downside, I DO write freelance for some of the widely read Environmental Health and Safety Magazines don't I? So perhaps my experiences might show up in some of my writing, now THAT would be embarrassing, wouldn't it? Especially for a Corporation that boasts about how it cares for it's employees and the environment with progressive plans on all fronts. One ugly article could cost them millions in PR dollars. All that because the company is afraid I might make a mistake and they MIGHT get sued, even though I enjoy protections under the law, and even though there has never, in the entire history of the Good Samaritan laws in our country, been a successful case against a responder that acted within his training. Even tough there are countless successful cases against employers in this country for not planning for and providing care for reasonably predictable incidents and injuries. By the way, "Risk Assessment" is part of YOUR job right? Pity, but I suppose the corporation will supply you a good lawyer.
EHSW: Are you tryiing to scare me? Because it's working and I don't like it.
ME: Well maybe, but more or less I am trying to educate you as to what you are in for when you pee in somebody else's puddle and you don't understand the ramifications. I have no intention of making this ugly. If you and the Corporation persist in this lunacy, I will go away simply because I will not be a part of it. You will bear the responsibility even if you don't understand it. Hopefully nobody will suffer too much because of it. Someday when you are working in another place you will think of me, and this conversation, and realize that you were so wrong and made some really bad decisions, and you will feel bad. The shame of it, is that these people outside your office will have suffered so that you might be educated. Don't feel bad now, it happens all the time in Corporate America. You'll feel bad enough in about 20 years, just wait for it.

I say again, you just can't make this stuff up. To be continued....