Tired

Day started off with a maternity call. A 20 year old woman with abdominal pain, six months pregnant. This is the third time in the last two weeks she has called 911. She's being treated for the flu and dehydration. The only difference is this morning she isn't feeling the baby moving around in her. We took her up to L&D and they shooed us out before we could find out if they still had a fetal heartbeat.

The women up at L&D are protective of "their" patients to the point they are rude to us. I brought a near delievery up there once, and after we'd moved the woman over to the bed, they asked us to leave the room so they could change the patient like I hadn't already examed her for crowning. You try to give a report and they ignore you and ask the patient questions instead. Unless I have something essential to say, I try to just give an abbreviated report and then leave as quick as I can.

Usually an L&D call is BLS -- patients are rarely iminent delieveries. I used to wait on the floor as my partner would finish the run form, then one day a nurse asked me what I was doing up there. I'm wearing a uniform that says "paramedic." It ought to be self-explanatory. "I just brought in a patient," I said. She looked at me like I needed to give her a further explanation. I pointed to my partner. "I'm waiting for my partner to finish his run form." When that didn't seem to appease her, I added, "So I can sign it." She grunted and walked away then.

Last week we brought up a woman having contractions two minutes apart and were joined in the elevator by a woman in a wheelchair, being pushed by a nurse. We let her go ahead of us at the registration desk. The woman was panting and grimacing. She delievered before we had even gotten our patient to her room. I had a bad feeling about the patient today. I hope everything is alright with the baby.

We did a dsypnea, CHF/asthma, big obese woman with elephant legs that were even more swollen than normal. She was walking out the door when we got there, all done up in a full-length bathrobe and other clothes. I managed to get the bathrobe off before we sat her down on the stretcher, then she plunked herself down. I couldn't hear any lung sounds again. I tried putting earwax remover in my ears last night (I also ordered a new stethescope), but this lady was so fat, I don't think I could have heard even with it. I didn't even try to get IV access. We were a few blocks from the hospital, and her arms were like elephant skin. I asked her where they usually got IVs in her, and she rolled her eyes and said they didn't. She was speaking in full sentences so we just took her in on 02.

Also did a syncope refusal AMA -- old lady who passed out, but was better when we got there, said she just hadn't eaten. She checked out okay, but still I try to always convince syncopes to go, particuarly with no history of it. But she was adament, and that was that. At least she had her daughter with her to call us back if anything happened.

Last call was a nursing home unresponsive. Fever, pnemonia, UTI, hyperglycemia, MRSA -- usual nursing home unresponsive story. I gave her some fluid.

I was tired all day. Tired at the gym this morning and tired at work, now I'm tired at home.

Listening to Bruce Springsteen's new CD. "Devils & Dust."