Subtle things

I am going to be honest, when I first came to Israel, I was thinking about how my skills that I had worked so hard on during the year were going to survive not being used for a semester. Of course this is also in retrospect a little knowing now what I didn't know then which is the fact the Magen David Adom never got me on an ambulance up until now. In any case, I was still worried back then even with the thought of being on an ambulance here and there in Israel. I was nervous, I was not confident in all of my skills and abilities, and I didn't feel like I was cut out for the job. This thought ebbed and flowed throughout my time here, with me floating on air some weeks and being absolutely overly obsessed with EMS to feeling down about it, not feeling like I could do it, and worrying constantly about whether or not I would be able to prove myself on an Israeli ambulance. After my first shift (the details of which will be in the next post) I realized just how great it felt to be sitting in an ambulance again responding to people in need. Even more recently, my whole outlook on myself changed in relation to my confidence in the field.

I was called by a friend to come and take a look at another friend who had drank way too much for her own good and was now vomiting heavily. I arrived to find her passed out and unresponsive. I immediately called her by name and when she didn't respond to verbal stimuli, I grabbed her hand and her eyes began to open slowly. Within a very short time, I had the patient talking, smiling, and squeezing my hand. After collecting a detailed list of past medical history, allergies, medications, symptoms, observations,and pulses and respirations, Magen David Adom arrived. The medics seemed impressed with my work and it made me feel on top of the world.

Over the past several months while studying abroad in Israel, I have taken the time to listen to EMS podcasts at every possible moment. I have read each and every morning, and sometimes during class, the multitude of blogs, journals, and social medias regarding EMS. I have even been waiting on edge to see the newest installment of Chronicles of EMS. I have to say that while experience has helped me hone my skills and will continue too, it has been this time of studying and listening to people in the field that I feel I have learned the most. I have still so much to learn and so much to see in EMS, but I have never been more excited to get back in an ambulance and start helping my patients. With my new skills that I have learned through reading Medic 999 and The Happy Medic about approaching patients I now have the confidence and knowledge to approach a patient in a polite way that will increase the patient's confidnece in my abilities. Through watching Chronicles of EMS I have now become aware of, and am searching for, differences between my US EMS system and the Israeli EMS system (I have really noticed these differences and plan on sharing them with friends and on this blog). I even ventured as far as to try and read up on the Italian EMS system which I became intrigued with when seeing an Italian ambulance (image above).

I have listened to podcasts throughout Israel and even throughout Italy (most notably my trip from Venice to Naples) so I can honestly say this learning has been a truly international adventure.

I am no expert and will never claim to be, but the skills I have acquired through reading, listening, and watching have thoroughly enhanced my abilities to take care of patients on scene and to understand my role in the EMS system. I thank all of those who take the time to write on their blogs, who take the time to create shows like Chronicles of EMS, and who take the time to make weekly podcasts. I think you all know this already, but what you do really does help people learn, often times, critical information. I have learned a lot from all of you, I have learned the value of patient care and initial patient contact, I have learned how to best take a pulse, how to search for the best possible blood pressure and what the best course of action is when you can get one. I have learned that even with nothing to help you (i.e. BP cuff, and other gadgets), just by being there with the patient and performing basic assessment skills, you can not only give the patient hope, but you can also provide equally excellent care. I have learned how to assess a patient and to treat the patient as opposed to the symptoms. I have learned that we all have our bad days and our tough calls, but that in the end of the day you need to pick yourself up and get back on that ambulance and try, try again. There are two quotes that I use daily to keep me going, here is one of them:

 "Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength." -unknown

My experience the other night with the intoxicated patient, having no gear to help me out, really made me realize that the simplest of things such as just talking to the patient and holding their hand can be the difference between the patient getting significantly worse or significantly better. Without anything to help me and no other experienced EMS person with me, I found these subtle actions that I heard spoken of so much on the blogs and podcasts to be the life saver in this specific case.

Again, thank you for all you do...you have helped yet another EMT fulfill his potential and have given him the bug to learn more and more. Thank you for all you do!