Tag Archives: Paramedic

Are We Misremembering or Is It Easier to Get into Flight Nursing Now?

Posted in Flight Nurse by

Spoiler: It’s not just you.

I remember when getting into flight nursing felt like chasing a unicorn while carrying a 12-lead and an arterial line setup. It was the elite club of critical care, the badge of honor you earned after years in the trenches, a hundred code browns, and more night shifts than the moon. You needed ICU cred, trauma street smarts, the ability to start an IV in the dark (with turbulence), and preferably a personality that didn’t crack under pressure, or in the co-pilot’s seat.

Now? Blink twice and someone’s in a flight suit with just the minimum required experience and a freshly laminated NRP card.

What. Is. Happening.

Okay, let’s talk about the pandemic-shaped elephant in the room. COVID didn’t just shake the snow globe, it shattered the whole thing. Healthcare was gutted, burned out, stretched thin, and then duct-taped together again. Experienced nurses left in droves, either because they couldn’t take another shift in PPE or they realized their lives were worth more than their paychecks (wild concept, right?). And just like that, the flight industry, already a small, specialized corner of nursing, was desperate.

Enter: lowered barriers. Don’t get me wrong, some of the newer folks coming in are absolutely incredible. Passionate, smart, adaptable. But the truth is, the bench just isn’t as deep anymore. So programs that once required five years of ICU, a resume written in Latin, and a letter of recommendation from the ghost of Florence Nightingale are now hiring with, well, let’s just say a little more flexibility.

Orientation programs got longer. Clinical ride time got shorter. Preceptors are working overtime trying to build experience that normally takes years because it has to happen now. And while this isn’t about blaming individuals (again, a lot of these nurses are stepping up big time), it’s worth asking: what does this mean for safety, patient outcomes, and the long-term health of the flight community?

Honestly? It’s a mixed bag.

On one hand, the door being slightly more open is awesome for motivated nurses who’ve dreamed of flying but didn’t want to wait a decade and sacrifice a goat under a full moon to get there. On the other hand, there’s something a little nerve-wracking about seeing the steep learning curve of flight medicine get compressed into a crash course, literally and figuratively.

Flight nursing isn’t just sexy uniforms and skyline selfies. It’s knowing how to titrate pressors, dose the sedation, all while troubleshooting a failing vent at 3,000 feet. It’s recognizing when your patient’s going south and there’s no code team to back you up, just you, your partner, and whatever fits in that aircraft. And let’s be real, there’s a difference between being “trainable” and being ready for a patient actively trying to die on you mid-air.

So yes, it’s easier to get in right now, but that doesn’t mean it’s easier to stay. Flight nursing still demands the same resilience, critical thinking, and ability to function with one eye on your patient and the other on your altimeter. The pressure is just distributed differently now, and it’s often falling on the backs of experienced preceptors and med crew trying to bridge the gap.

In the end, the skies may be a little more crowded with new faces, but if we nurture them, teach them right, and don’t skip the hard conversations, maybe this next generation will carry the torch with just as much grit and grace.

And if not? Well, I’ll be the one in the corner muttering about “back in my day” while re-taping an IV mid-flight.

Six Sentiments for Season Six: Nurses Week 2020

Posted in COVID-19, Motivation, Personal Growth, Uncategorized by

Heeeeeeey Nurseeeeeee!

In honor of Nurses Week 2020 and what will be my sixth year of nursing, I wanted to make a post with the six observations I have about who I am as a nurse and pieces of wisdom I wanted to share.

  1. I came into this profession shiny and new with clean, pressed edges and resounding hope. While I still believe in the goodness of people, my cotton is a bit wrinkled now from the disregard shown by humanity. It’s intact still, not threadbare and laid waste from years of abuse quite yet. You can see the change notably from six years ago. Sometimes something really good happens that irons out the wrinkles and makes the cotton look renewed though. Sometimes when a small tear happens, a kind soul will come along a patch it up. In our profession, we can’t expect our cloth to stay immaculate–we should expect it to become a bit dirty and a bit worn. But we need to allow ourselves to let it be repaired and refreshed. Our work is meaningful.
  2. Protect your “helpers.” Value them. Now when I say “helpers” I don’t mean that these people are there to serve YOU (The Nurse)–you are all there for the common goal of bettering a patient. These individuals help in making your jobs easier though. So value them. Protect their interests. Are your respiratory therapists lobbying for better equipment? Join them. They know their specialty and there is probably a reason. Is another nurse abusing her patient care technician? Step up. Be a leader by advocating for that person. Is the department paramedic pushing for more privileges their license allows them to do? Speak up! These are our team mates. Rally to their sides.
  3. Pass on what you learn. It is so easy to find information and hoard it but its better for a department when you disseminate it. In this pandemic, I early on volunteered to moderate a Facebook Group Covid-19 Healthcare Professionals (click for link) which at the time (early March?) had like 300 people. The idea was to have a place for professionals to share information and develop a community. It quickly grew to over 84,000 people (at time of writing). Ideas flew like crazy from how to prevent skin breakdown from face masks to setting up vents and pumps outside negative pressure rooms. But the idea was this: knowledge sharing. Teach what you know to others–precept new team mates and if more experienced or older staff ask for help with something, teach without judgement. Do all acts for the betterment of the whole.
  4. Nursing will disappoint you. A lot. Frequently. Management will promise you the world only to give you scraps whether on purpose or not. Toad, Four Year Degree in Bladder HoldingPatients will burn you despite you breaking your back for them. The pay will never equal the work some days. Lunches won’t come some days and your bladder will harden to that comparable to those weird frogs that hibernate for years in Australia (I pulled out that metaphor from somewhere…don’t @ me).
  5. You don’t always get what you want (to quote the Rolling Stones). In fact–get used to it. I had a lot of “no’s” told to me in six years. Career paths I thought I wanted that went to other people. It hurt, guys. Baaaaaaaad. But the funny thing about “no” is sometimes it’s just a primer for “because here’s this instead! TA-FRIIIIGGGGIINNN-DAAA!” And it really is better. I didn’t always trust that I was told no for a reason. I felt like that no was my own resounding failure when in reality it was just because I was a better fit elsewhere. That job I thought was perfect? It took a wiser nurse sitting me down and telling me I wouldn’t be happy doing it. I didn’t believe her for a while and I was bitter at her assumption–how could she possibly know what I wanted? But she was right. I should’ve listened instead of being angry. Because my dream job offer came half a year later. Even if you don’t get that dream offer like I did right away, keep at it. Something I always tell new nurses or nurses trying to strive for something is this: Never accept “no”–rephrase it as “not right now.” By accepting that no and letting the door slam in your face, you’re missing possibilities of three more doors opening just down the road to even better opportunities.
  6. While nursing has given me the most painful memories and caused me some of the worst heartaches–it has given me so much more. It has given me purpose. Friendships. Meaning. It has saved my life when I felt it didn’t mean anything. Days I didn’t want to get out of bed–I knew I was needed by my coworkers and patients. Somedays that made the difference for me just knowing that the work I did with my two little hands caused change gives my career meaning. I’m proud of what I do and I couldn’t imagine doing anything else even on my worst days… find meaning in your work. This will help you power through the ugliest parts of our job.

 

So this week… this whole month… this whole year… hold your heads up high, Nurses.

We have faced insurmountable odds in some parts of the world and in those not necessarily being inundated by viral illness but rather facing unemployment from low-census or budget-cuts. The world sees us and while they may not necessarily empathize with our plights and administration may still gift us pizza parties (not you night shift–you get half eaten stale donuts because “tradition”) instead of safe staffing and all the things we really need…we’ll still keep showing up and providing top-notch care.

Happy Nurses Week!

 

 

I See You…

Posted in Motivation, Personal Growth by

Hey you…

I see you. Sitting on your dorm room bed, second day hair, blinking repeatedly because that drugstore waterproof mascara that they said wouldn’t flake is flaking in your eye. You keep hitting next on Pandora but your skips are out because who wants to pay for that, I mean really? Books are everywhere. Clothes are everywhere. There is a fast food bag from some time last week peeking at your disapprovingly from your garbage can.  This wasn’t in that sleek brochure they gave you at open house, senior year in high school. Your friend from a university two hours away is supposed to visit this week but you can’t make the numbers work as you stare at your perfectly organized agenda–color coded of course. The information on the pages you stare at is blending together. How could this instructor expect you to really learn all the bones and every lump/bump/groove and physis AND every muscle with its function and origin/insertion in just two weeks? Doesn’t he know you have math homework and paper for English? At least that Public Speaking thing is done…even if you did drop an F bomb when your PowerPoint crashed. It’s suffocating.  You should probably shower–not because you smell but because every minute you sit and become disheartened by the material, your self-esteem drops. You question why you’re doing this. The nurses at mom’s hospital looked so calm and collected; there is NO WAY they sat in crusty ankle socks (because of course the washers were all occupied during the ONLY free time you had to do laundry yesterday) with 16 missed notifications from a myrid of social media accounts (“COME OUT! We’re going for tacos!”), and a room mate who has been dropping snide remarks about living in an episode of Hoarders. But that nurse seemed to know what was going on and she was patient with mom. How will you ever make it for three more years of this?

fleur-de-lis-lee-gray

I see you. At the fire house in the kitchen. Half eaten Subway sandwich left neglected, cooling. A meatball attempting to elope from the wrapper lest it disappear down your gullet. There are empty bottles of Mountain Dew all over. The guys are in the lounge laughing as they play whatever new FPS is trending; you can hear them ribbing each other and a few expletives flying around, maybe a loud thump. Who knows what that was. You had to head to soccer right after school let out but you had planned to study for your NREMT exam at the fire house because your brothers and sisters keep bothering you. So now you sit, trying to focus. “A-B-C…. Scene Safe… Nitroglycerin, Aspirin, Oxygen, Transport…” but your heart drags you back into the lounge where the guys are relaxing. They worked all day and came down to hang out. You were hoping to bang this out before they got here. You got another question wrong in your prep book. You went over this material two weeks ago–why can’t you remember it?! The township is volunteer based in the middle of the state. Numbers are down. Your dad is a Captain at the company and wanted you to follow in his footsteps. Surrounding companies are shuttering their doors all over, there just are not enough people willing to volunteer anymore. But you wanted to help. You saw a need and wanted to step up for a little while. Mom has been getting your case about padding your application with some clubs to go to college. College didn’t really interest you but there was a trade school an hour away that offers welding. Right now though, you just need to survive this test. Then finish that physics project. Your pager goes off: vehicle accident with fluids on the roadway. You sigh as you stand up. You know the older guys will need help on the scene and the junior firefighters usually help. The studying will have to wait. How can you hope to pass this test?

fleur-de-lis-lee-gray

I see you. You were harassed again in the grocery store for using food assistance by a woman behind you. She criticized the fact you had a new phone. The phone was a gift from your dad because you needed to coordinate your children’s lives. He was generous. You know the youngest won’t like dinner tonight but it is quick to throw together before the sitter comes over. You’re going out. The community college has night classes every Tuesday and Thursday for Respiratory Therapy. It took you two years to work up the courage to enroll. How can a 42-year old mother of two hope to go through a drastic career change? You remember when the big kid was a baby. Born premature with immature lungs. That Respiratory Therapist explained everything to you. You didn’t know much about health or babies or lungs. He was kind. And your warehouse job was in jeopardy. Potentially closing that facility.  It has changed hands twice and the news is dismal. You knew it was hard work two years ago but three months ago when you enrolled, you knew you did not have much choice. You loud your groceries in the car and get in. You wince as it makes THAT noise again. But finances aren’t there for this. You can’t do this right now. The big kid wanted to try the cello–the rental fees seemed asinine but the school helped a little. It still hurt. You didn’t want to deny the opportunities. Do they know the sacrifices are meant to secure their future?  It’s that woman again. She’s sitting next to you at the red light in her two year old Honda. She’s talking on her phone. No doubt telling her friend or family member about that woman using the system. You rest your head on the steering wheel, hold back a sob. A honk blares from behind you–the light is green. Can you survive this?

fleur-de-lis-lee-gray

I see you. There is a smile on your face. A paper in your hand. Your name is bold printed as if to scream “YOU DID IT!” It doesn’t feel real. The journey almost defeated you. It took so much from you that you almost lost sight of what it could give. You interviewed recently. There was an offer made quickly contingent on this piece of paper. You smooth out a wrinkle in the corner from the shipping envelope. This is it. The worries. The stress. The self-doubt. That little wrinkle. Smoothed away. It was so small in the grand scheme–the whole rest of the paper is immaculate and grand. But the wrinkle is still barely visible, as if a badge of honor to show you survived. Most won’t ever notice its there, but you do. You know it exists. But over time, eventually it fade into the larger image and your eyes won’t pull towards it quite as much. I see you–you made it. You.

fleur-de-lis-lee-gray

Whatever your reason for seeking a profession in healthcare, just know it won’t be easy. However, the things that are worth it will never be easy and the things that are easy will never be worth it. People are drawn to healthcare because of exposure to providers who have cared for their loved ones, what they see on TV, to fulfill family legacies, to service a higher purpose, or because a healthcare worker made a difference in their lives. They often see the end result of long periods of hard work. They don’t see the blood, sweat, and tears as well as the sacrifices (friends, time with family, social events, personal grooming!, giving up jobs to go to school) that those healthcare workers went through to get to where they are. It breaks a lot of people and they drop out of their respectful programs. But what I want you to know, friends, is that you can and will survive. This too shall pass. There is an end and that end is a glorious thing. Our careers aren’t always rainbows and sunshine, there is still hardships that arise. However, our work matters. You matter. We want you here. And when you’re finished, all the hard work and sacrifices will shape you into a stronger person. Like that piece of paper they may stay with you, but they are smaller in comparison to the greater thing you have achieved.

So to you who are sad, who are mad, who are hopeless/helpless, and about to give up. Keep pushing. Ask for help if you need to. Take care of your well being as well. Learn to say no to obligations if it means your mental health is protected. At the end of the day, you are your most important entity. All things you do spiral outwards from yourself.

 

You CAN do this and you WILL do this.

And we can’t wait for you to join our team.

 

-Clear skies and tail winds.

Delete “just a” from your vocabulary

Posted in Motivation, Personal Growth by

 

I hope you can excuse me a second while I get on my soap box *pushes a very large soap box into the light…because you know… I’m all of 4’11” and no one can ever see me*.

How many times has the phrase “I’m just the…(your title)” slipped out of your mouth? When someone asked you something or asked what you do, how many times did you say “Oh, I’m just the nurse/EMT/CNA/secretary?”

Have you ever considered how this phrase is demeaning to your role in healthcare? How often do we compare our roles to those of others?

  • RNs versus Paramedics
  • RNs versus LPNs
  • EMTs versus CNAs
  • Nurse practitioners versus Physician assistants

We crack jokes sure about what the role of XYZ healthcare employee does. Lovingly, I have called my EMS cohorts “ambulance drivers” or “stretcher fetchers” while they call me “doctor helper” or “butt wiper.” But how often do we actually see conversations online or hear in-person how XYZ healthcare employee is “useless” or somehow less than? I know I can’t go a day on an EMS joke page on Facebook without seeing CNA cracks.

How does this look to our consumers, though? To see us behaving like this? Would you feel comfortable with that if you were a patient? Probably not.

Healthcare is broad and dynamic–it encompasses a great deal of collaboration between all members to ensure quality care that is efficient and safe. No matter how small, each person has a role.

I’m going to be frank– the custodian is as important as the CEO. Those small, seemingly insignificant contributions to the system are cumulative and critical to day to day operations. Infection control and patient outcomes can be effected by something as simple as proper disinfection by a housekeeper.

So knowing that everything we contribute is small cog to a larger machine, would you still consider yourself “just a…”?

CNAs–you provide the care needed to enhance the quality of life of your patients/clients. You matter.

EMTs–whether you run on the 911 ambulance or simply interfacility runs, you are a crucial step in saving lives and preserving health. You matter.

LPNs, RNs, Paramedics– each of you have training that makes the difference in both chronic and acute patients. No one can expect you to master everything but you give what you know your all. You matter.

I think it’s time we stop degrading other professions simply because “we can do XYZ and they can’t” or “they didn’t know what to do in an emergency.” Understand we all have our training and our roles and instead of being degrading–teach. Take the time to make faulty practices teachable moments. How can they improve in the future?

So whoever you are, where ever you are, and whatever you do–you matter. Healthcare is a team that needs every member. You are never “just a”–you are “a” or “the”. Be proud of whatever you do because you are never “less than”–simply “different than.”

Clear skies and tail winds.