April 23, 2009, 8:02 pm

Ridin’ the Storm – a 12 Year Storm

chief-roy-wont-let-me-friveIn honor of the The Handover, the new EMS carnival to be hosted here at Emergiblog on April 24th, I invited guest blogger (and long time reader) Black Cloud ER Tech to write about his EMS experiences.

Many thanks to Black Cloud for taking the time share his story and perspective!


“Rampart, this is Squad 51.  How do you copy?”

Orders for D5W, Lactated Ringers, etc would follow.  Being born ten years after this show first debuted, “Emergency” wasn’t on my radar… until I set foot in the firehouse where I held my first EMT/Firefighter job.  After I saw the first 5-minutes of this show, I was hooked.  It was, and still is, the COOLEST show I have ever seen!  It should be a prerequisite to watch seasons 1 and 2 on DVD before starting any EMT course. It teaches the lingo and culture behind EMS, as well, and more importantly, the rudiments of EMS… and of course, seeing Johnny and Roy getting their butts kicked, missing lunches and being up all night.

Ok, so maybe I am an EMS dork…


I have been in EMS for over 12 years.  I started as an Explorer for the local fire department, then as an EMT/Firefighter, and finally as an ER Tech.

Since day one, I have had a black cloud.

Starting as an Explorer, I would ride along on the Engine Co’s. We would bag plenty of runs. As an EMT/Firefighter, other crews would sleep through the night, while my crew would bag 3 or 4 after midnight. As an EMS coordinator for sporting events, no adverse incidences would have occurred in 25 years, but the year I coordinate the medical, we get not one, but two cardiac arrests. Finally, as an ER Tech, I get the ugliest shifts out of all of the techs in the ER. The black cloud has followed me all around the great state of California.

We all know EMT’s, medics, RNs and MDs who have black clouds… the ones who get the proverbial sh*t thrown their way.  Whether it be the night where they run their rear ends off due to sheer volume of patients, or the shifts where they get the patient who takes 4x the amount of time and energy to keep them alive, or the crew who deals with the social drama that ends up ruining their shift, we all know them.

And the perfect storm? Two health care providers with black clouds working together.


Black clouds inevitably lead to burn-out. Somehow I am still standing… and am even going to nursing school to return as an ER or Trauma nurse.  More than one person has asked, “how do you keep doing this after getting kicked every shift?”  Are you a glutton for punishment?

And my favorite question of them all… WHY!?!?


So, how does one ride the storm and stay interested in EMS without burning out?  I’ll share several ways that have worked for me.

1. Take care of yourself.

As Fire/EMS, I worked a system in the rural Sierra foothills.  Transport times were a minimum of 45 minutes; from time of dispatch to time of going in quarters, we were usually gone about 2 hours.  With my black cloud luck, we would bag back to back calls.  I eventually learned to get a small cooler, and put snacks and drinks in it for my medic and I (this also won major brownie points when working the occasional shift with the EMS coordinator of the department). I see crews on a weekly basis who don’t pack snacks, run multiple back to back calls, and complain CONSTANTLY about being hungry.We were able to hydrate and eat even though we didn’t have time.

I have carried this habit with me into the ER. Even on the busiest shifts, I can slam down a Gatorade and half of a peanut butter sandwich.

We, by nature, are programmed in EMS land to go-go-go. Between shifts, you have to rest.  And I mean rest.  SLEEP.  I am guilty of not doing this, going to work on a 12 hr night shift, going to a chemistry lecture, sleeping 6 hours and then going back for another 12 hr night shift… and I’m paying for it.   I found that when I get my rest, I am able to survive the inevitable black cloud shift much better.

2. Know your coworkers.

If you are on a bus, in an ER etc, know their work habits.  This will allow you to stay one step ahead of them.  By being able to stay ahead of them, the flow of patient care will be smoother, getting the patient to their destination or discharge from the ER more efficiently.  The quicker the flow, the quicker you may be able to catch that break.  By getting to know your coworkers, you learn their idiosyncrasies and personalities.  I knew that when my Engine Co. captain was up all night with his infant son that he would be tired, and certain “fun” things usually acceptable in the EMS world, weren’t so kosher.

3. Have a comrade in EMS.

In EMS (and studies have proven this), the divorce rate is extremely high.  I have experienecedmy share of break ups due to the stressors of working in EMS and the lack of interest by the other party in the relationships. It helps to have a close friend, whether you work with them or not, who is in EMS.  It’s good to know that you can talk things over when you have the shift from hell or are questioning something that happened during your work week.  Even though my fiancé is in pediatric critical care are a local children’s hospital and understands my job, I still have a couple close friends in EMS who I can talk to and bounce things off of.

4. Work with the new kid.

When I work with paramedic interns and nursing students who do their rotations in my ER, I accomplish two things.  I am able to pass along my knowledge and experiences to these eager beavers.   What most students don’t realize is that I am gaining something from them.   Their extreme energy level and eagerness may annoy some people;  I, on the other hand, suck up that energy.  I feel more energized when I have the new kid with me in the ER.  Their enthusiasm is greatly appreciated during the particularly bad black cloud shifts.  Because they are new, they always want to be where the stink is (figure of speech that is… not a code brown).They just want to do everything!  I love it!

5. Don’t let the little things get to you.

If you let the little things get to you, the black cloud will win. Working with slackers is just one of many of the “little things”. We all have coworkers who kick ass and give 110%, but we also have those who give 55%.  Slackers are my pet peeve, but if I let the slackers get to me, I would end up in “The Bin.”

6. Go the extra mile.

Everyone has a crappy day.  When you get to work, step up to the plate and do the best job you can.  Your patients will notice that you go the extra mile and so will family and friends.

Several years back, I had a Code 3 return to the ER for a post cardiac arrest.  While we were busy caring for the patient, I kept thinking of the family members in the next room.  Once we got the patient settled and the family was allowed to come be with the patient, I went the extra mile.  A simple smile, a cup of coffee, a teddy bear for the scared child, that is all it takes.  Late one night, some time later (during a black cloud shift, of course), the family was exiting the hospital and stopped by the ER to say hi.  The elderly husband of the patient remembered me by name, shook my hand, and thanked me and the ER team for their care and compassion.  A lot of times the little things go unnoticed, but when they are noticed, it makes the black cloud a little more bearable.


These are just a few things from your friendly neighborhood Black Cloud ER Tech.

I do have shifts once every blue moon that have me saying “I am too old for this stuff,” and I’m only 26 years old (keep in mind I started at 14 as an fire explorer).

Somehow I am able to make it through the rest of my work week, go to school for my nursing prereqs, enjoy time off with my fiancé, and come back to work the next week ready to give 110% to my patients and coworkers.

{Editor’s note: and he does! : ) }

April 21, 2009, 9:32 am

A Great Day for Grand Rounds!

cookieIt’s Tuesday….

Yep! That means Grand Rounds!

And Amy over at Diabetes Mine has done a great job with her Birthday Edition!!!!

Hence, the accompanying photo of one of the coolest Cookies by Design bouquets I’ve seen!

Grab a (virtual) “Admit One” cookie and head over to Amy’s place for the latest edition of the medblogger carnival! Oh, and don’t forget to bring home your “goodie bag”!

Amy, you really ARE a “Blogstar!”



Friday is the day!

The Handover EMS Blog Carnival will be hosted right here at Emergiblog.

I’m still open for any last minute submissions from any and all bloggers who wish to blog about the emergency medical system, from the field, right through the ER.  EMT, Medic, Doc, Nurse or Patient!

You got a story?  I want to include it! Use the contact button up top.  I’ll be taking submissions until Thursday at noon, Pacific Time!



The next Change of Shift will be hosted by none other than Gina over at Code Blog: Tales of a Nurse! The theme is being “human”. I have about a few hundred ideas for that! : )

Submissions can be sent to “codeblogrn at gmail dot com”.

Many thanks to Gina for hosting!

April 18, 2009, 10:51 pm

You Don’t Tug On Superman’s Cape, You Don’t Spit Into the Wind….

star-trekWell, it’s been interesting in my neck of the woods, I must say.

Even Picard is speechless.

It happened.

I admit it.

I wrote a controversial post.

What the hell was I thinking?


I wrote a post that makes the ADN vs. BSN debate look like a high five.

And I did it without benefit of asbestos underwear.

Don’t make the same mistake.

Here are a few pointers so that if you choose to take on a controversial topic, you will be better prepared than I was.

  • In polite society one does not discuss politics, religion or sex.  Oh, you might be able to get away with one of those.  Two is rocking the boat.  Three causes a big KABOOM!  I took on all three! No, I’m not brave, just stupid.  Because…
  • No matter how good you think you write, and I don’t care if you think you’re the next Jane Austen, you cannot phrase the post in such a way as to address the topic and avoid the KABOOM!  Because…
  • Everyone projects their own world view and feelings on what they read.  This is not a bad thing, it’s reality.

Which brings me to the next point:

  • Know your limits! If you are sensitive or “thin-skinned”, think twice before you write. Because….
  • It will get personal.  Names of animals will be invoked.  Your integrity will be questioned. Your favorite Nascar driver will be insulted. Okay, not the last one, but you get my point.
  • If you can’t take the heat, don’t turn on the stove, you will get burned.  I not only turned the stove on, I put it on “broil”. Hence the need for asbestos underwear.  No blog post, no topic is worth coming to tears over (or whatever the equivalent would be for a guy).

So, you’ve decided you can take the heat, you’ve lit the match and you are going to hit “submit”.

  • State your case clearly and unambiguously.  Don’t try to be clever.  Don’t try to be artistic.  If you aren’t clear about exactly what you are saying, it is more likely to be misunderstood/misinterpreted/confusing.
  • If you can provide links to sources that will help people understand the issue, do so.  This was a great suggestion I received from one of my readers (thanks, Kim!)
  • Decide how you want to respond to comments.  I usually do it by email, but when I found myself addressing the same issues over and over, I added a prologue to the post.
  • Your post may lead to other bloggers responding on their own blog.  Link to these at the bottom of your post as you become aware of them.  Not all opinions can fit in a single comment.  They may disagree with you, but those posts are part of the conversation and links are the life-blood of the blogosphere.


I survived my foray into controversy, and despite a brief period of “why the hell do I bother to blog at all” and a good pity-party with a bottle of Bud Light (with Lime), I am ready to blog on.

Only I think I’ll leave the heavy stuff to the bloggers who do it best.

I will, however, take on all comers over anything Nascar.

For that, I really do have asbestos underwear!

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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