Reference no: EM132218374

Question: Trauma Queen

"Nine-oh-five, we need you priority on a patch to five-seventeen Third Ave, at midnight thirty-two." My partner reached over and copied the call while I sat up straight in the passenger seat and rubbed my face vigorously, trying to wake myself up. I checked our tablet for call notes, the response was for "toe pain for two months, unable to walk." I laughed at the absurdity as my partner flipped on the lights and sirens. And away we go.

It was a quick drive as most responses in downtown Seattle are, helped by the fact that there is rarely traffic after midnight early on a Tuesday. When we pulled up in front of the shelter there was a small crowd out front. A few people talking loudly, many smoking cigarettes or marijuana, others openly partaking in harder drugs. The usual. Armed with very little knowledge about our prospective patient, we exited the vehicle and began our search. "Has anyone here called 911 for foot pain?" I asked. A few people looked our way but most continued to ignore us. Turning our search to inside the shelter, we got buzzed in. Immediately the pungent odor of stale urine filled my nose, but after four years of this, I was prepared. I popped some gum in my mouth and donned a face mask, the pleasant smell of spearmint promptly took over. Once we emerged upstairs a staff member waved us over to the front desk. "Yeah John is the one who called, he's over by the men's bunks". She handed us some paperwork with a photo and demographics and gestured towards his general location.

We rounded the corner to our destination and noticed someone a few bunks away was waving frantically at us. As we got closer, the unmistakable scent of infection grew stronger. John was sitting in a wheelchair with his left leg propped up, allowing us to get a good look at his foot. He had removed his sock and pulled up his pant leg. What was immediately clear was that he definitely could not walk and that this had probably been going on for longer than two months. His foot only had three toes and some bandages that were seriously overdue for a change, this was evidently not his first time dealing with this. I took another look at the paper given to me; history of type two diabetes, MRSA, and other chronic infections. I continued asking questions as we wheeled him outside and transferred him to the gurney, then we loaded him up and headed for the hospital.

I started working in EMT school when I was 19 and was hired on to a private ambulance company shortly after. Unfortunately, there's a lot that the classwork doesn't cover, and it's up to you to figure it out. Sure, I was armed with knowledge about what to do for a femur fracture, or what a normal blood pressure is, or even how to do CPR. What I wasn't prepared for was how to approach a sexual assault victim about their injuries, or how to talk to your suicidal patient about their plan to hurt themselves. These are things you learn as you go, and not without mistakes.

When people hear about the more gruesome side of my job, they often ask why I started doing it in the first place. Like most people in this field, my answer is that I wanted to help people. I wanted to be a part of something greater than myself and I wanted to give back to my community. You'll notice that I write this in past tense. It's true that this job isn't for everyone, and after four years I can confidently say that it is no longer for me. Four years in and I'm jaded and numb. Combative patients, an overworked and largely unsympathetic nursing field, the over and misuse of the 911 system (by a population of people determined to use it as their primary care provider) and a questionable employer have all played their part in this burnout. I've become detached and desensitized to the physical and the emotional misfortunes of my patients. Studies have proven that working night shift is detrimental to your health, both mentally and physically, and I've been working nights for four years.

Despite this laundry list of challenges, I'm still grateful for my experience here. Outside of a clinical setting, I'm more empathetic to other people's circumstances than I used to be. I'm now more confident in the decisions I make, and I'm able to do so more rapidly than I was able to before. In the past, I've had trouble taking things personally, but after having enough psychiatric patients calling you every name in the book, you learn to let things roll off your back. In the same vein, I've also developed a mean poker face! We're often reminded by our supervisors that while it may just be another day on the job for us, it could be the worst day of our patient's life, and this thought process has followed me outside of work as well. In fact, it may be one of the most valuable lessons I've learned. You never know what other people may be going through at any given time, so it's important to approach people with respect and kindness.

A familiar bump let me know that we were rolling into the ambulance bay at Harborview. I asked for a signature and gave John my spiel about permission to bill insurance and his right to privacy with HIPAA. Once inside, I gave the charge nurse the lowdown on what was going on and she sent us on our way to a room. We transferred the patient to the bed and I gave a thorough report to his primary nurse. Once patient care was transferred, I headed out the door, on to the next one. Up until this point, it was a very standard call. On my way out John caught my arm. "Thank you," he said. "I'm so grateful for you guys. I wouldn't have been able to get here without you and I don't know what I would have done otherwise." I smiled and shrugged before replying. "Just doing my job."

Below you will find the questions you need to answer about your partners' essays. You and your partners will post your essays in the discussion post on the next page. That is also where you will submit your answers to these questions. Please email me if you have any questions about this.

You can format your Peer Review by numbering your answers the same way the questions are formatted.

PEER REVIEW: Personal Essay

1. What identity is discussed in the essay? Is this clear and easy to see? Explain.

2. Summarize the essay you read.

3. What changes does your partner experience throughout the essay?

4. What emotions are present in the essay and what emotions do you feel after reading the essay?

5. What qualities/characteristics does your partner acquire by living in this specific identity?

6. Point out the most memorable places in the essay. Explain why these instances and/or images are the most effective and strongest.

7. Point out places in the essay where you felt like your partner needed to provide more information or clearer details? Explain why.

8. Were you ever lost in time? Were there places where you were confused about what was happening or what your partner was trying to convey to his or her reader?

9. Does the intro grab your attention and make you want to read more? Why or why not?

10. Does the conclusion "end" the story? Do you still need to know more? Explain.

11. Is there a balance of scene and analysis? Does your partner provide enough experiences to earn the change he or she went through? Does your partner reflect on those experiences? Explain how this is accomplished.

12. What questions do you have? What might your partner consider adding to his or her essay?

13. What other advice do you have for revision?