My exposure to the ER was both accidental and purposeful. In high school, I had a vague interest in becoming an EMT because my dad wouldn't let me do the CNA program. He said I would hate it and never do healthcare because of it. Which is one of the reasons why he pushed me towards EKG and radiology. I figured if I couldn't do CNA then maybe EMT might be the way to go. I didn't have much of an interest in emergency medicine then. I thought I would never be able to function under the pressure or handle the things they handled. Of course, I was also under the same public misconception that everything that happened in the ER or in the field was a crazy traumatic emergency. It never occurred to me that people would go to the ER for bullshit reasons. That would be ridiculous. But alas, I had missed my window for the EMT program because I didn't do the other program needed for it. So that was out of the question.
My next exposure to the ER wouldn't until my last few months at Cottonwood in dietary. I had to deliver sandwiches to the fridge. I was scared to go there fearing I might see something gruesome. I went in there trying to look as official as possible. I couldn't understand why everyone in the ER didn't look so crazy stressed. The staff seemed reasonably happy. All I could hear was moaning from a patient behind a curtain. I was somewhat scared for some reason. I busted out of there as quickly as I could. Whenever I worked in the cafeteria, I always thought the ER staff looked the most hardened of all the people in the hospital. I had an odd respect for them. I just thought all ER staff went above and beyond. Not sure why I thought this, since I had no exposure to the ER at all.
My next exposure to the ER was when I worked in the lab. On my tour of the hospital in the first week, I vividly remember walking through the ER. Everyone was always moving around. There was always something happening it seemed. Everyone seemed happy even if they appeared stressed. I was intrigued by this. I was still guided by the misconception that everything in the ER was an emergency. I thought, if they could be happy under these kind of circumstances, why couldn't I be? Over my course in the lab, I got to know some of the EMT's who worked in the ER at Alta View. They were cool people. They were young and normal people. Not odd and hardened like I had thought. I decided to get my EMT that fall.
I took the EMT class for a variety of reasons. Not only was I inspired by the working indirectly with the ER staff from the lab and radiology, but I wanted something new. I wanted a certification that could get me a better job. All the jobs I saw at the hospitals required a CNA or an EMT. I decided that EMT would be more practical and longer lasting. I am happy with this decision as it has saved me so much trouble.
I remember being so scared my first day at the campus. I took the SLCC course which required it to be at a military facility way out west. Which was kind of intimidating. They spent the first two days of class completely psyching us out. Making everything into a big deal. I'm sure the speech was designed to make people care and take it seriously. It worked to say the least. As the classes went on, I felt less qualified to do the work. There were people who were much better than me at it. But there were also people in the class who were surprisingly much worse. It absolutely shocked me that people so stupid could actually be on an ambulance. It shocked me more how little the requirements actually were for people to go out on the street and help people. Not to mention the insane low pay, low respect, and burn out rate of it all. I remember how inadequate I felt during a team lead exercise. We all had to take turns being the leader of 5 people for a patient who was critically ill or wounded. (These were mock scenarios so don't be alarmed.) I failed miserably every time. I clumsily stumbled through the exercise failing at almost every turning point. Someone else in the group would take over for me and do it correctly. I really felt as though I could not competently do the job. To make matters worse, I was terrible at splints and bandaging. I had consistently done poorly on trauma management and splinting. They forced us to remember several splints that are actually never used in the field with 5 different types of devices. Awesome.
We had to do one clinical to get some hands on experience with patients. Ideally this was supposed to be on an ambulance. But since there wasn't any ambulances allowing ride alongs, I had to go to an ER. I was disappointed by this notion. I wanted to be on an ambulance! I was starting to lean more and more towards becoming a paramedic for an ambulance in the future. I was still extremely nervous for the day I had to work 8 hours at Pioneer Valley Hospital. Where the hell was this hospital? Was it any good? I remember it being busy all night long. I remember running up and down the hallways watching IV's and a good amount of sick patients pass through. I remember an elderly man who was dying of stage 4 liver cancer in an insane amount of pain. I remember an Asian man who was practically in DKA. I didn't fully understand what was going on but I actually enjoyed it, even though I felt like an idiot most of the night.
After the class I took my written and practical tests with success. Now the challenge was to find a real job where I could actually use my skills. I had applied to Gold Cross twice. No success. I had walked in to a station where Southwest ambulance used to operate and basically threw myself at the mercy of their kindness. Unfortunately, I was not yet 21, which was the minimum age requirement for their company. I had lost a little bit of hope. I decided that maybe I should try to work in an ER instead until I could get on with an ambulance. By this time, I had formulated a long term plan that involved me becoming a full paramedic. I gave up hope of becoming a doctor. I soon discovered that getting into an ER was harder than getting onto an ambulance which was pretty ridiculous as it was. My only way in was to suck up. So I started volunteering at Alta View Hospital and UUMC in the ER. I was hoping since the staff at both places knew me from both my jobs already, that if I proved my worth I could get hired on. I did just that. I worked harder than any volunteer could. I tried to be sociable and nice. Basically I tried to make myself appear I was employable.
The experience I had gained at those places was inspiring and invaluable. As the months went on, I realized more and more that the ER was what I wanted. I liked the people. I liked the atmosphere. I liked the teamwork. I remember seeing traumas at the U. I remember seeing a full arrest at Alta View and watching everyone try as hard as they could. I remember the ER doctor ending the code by asking "Can anyone think of anything else we can do?" There was no response. She then said, "Is everyone comfortable if we call it?" Everyone agreed with the decision. The patient had died in front of me. Later on that night, I had got to help transport a patient to the helicopter pad to help Lifeflight load a patient. I got to see the helicopter and talk to the nurse and medic who were on the copter. I was so excited. The staff at Alta View trusted me to help take the patient to the pad. I knew now I wanted to be a part of this somehow.
I eventually got an interview at the U a month after I started this idea. I didn't get the job, which was extremely disappointing to me. The interview was awkward. It was silent most of the time while I got stared down by a nurse and a tech. Both of whom I would eventually have to work with later on when I did eventually get hired there. I knew I didn't get the job after I left the interview. I tried to stay in good spirits with the staff to appear that it hadn't bothered me at all. Even though it was only a PRN job, I wanted so badly to be apart of it. I had felt most comfortable at that ER despite not getting along with the staff as well as Alta View's. I wanted to see the high acuity the U had. That was the main allure.
I tried every way I knew how to get in to an ER. I spoke to ER staff managers, recruiters, human resources people, just anyone who could help me get in. Later on, I got a chance again. Four chances actually. I got interviews for four different ER's in one week. One interview a day. I was to be interviewed at UUMC for a second time, Utah Valley Hospital in Provo, Cottonwood Hospital, and LDS Hospital. The one at the U didn't work out well again. I knew I wouldn't get the job that time too. Again it was awkward. The one at Utah Valley went well, but they didn't seem particularly interested. It seemed like they may have already had someone else in mind and they were just going through the motions. The interviews at Cottonwood Hospital and LDS had both gone really well. Both were very interested. At Cottonwood, I thought I had really made it clear about how badly I wanted the chance to prove myself at the job. At LDS, I had a little bit of extra help. The manager had recognized my name because of my dad, and an incident that had occurred nearly 3 years ago from that point. At my company orientation for my food service job, she was one of the speakers. She recognized my name because of my dad and announced to everyone how much she liked that name. When I told her I was related, she was ecstatic and said that she would not forget me or my dad. I thought it was all just empty words. Funny thing is, this lady had remembered that exact situation and me 3 years later as I was interviewing in her office. Kind of interesting how life does that to you.
I wanted the job at Cottonwood more. Intermountain Medical Center was 2 months away from opening. If I got the job at Cottonwood, I would get to move to IMC. Be at a brand new hospital. See crazy traumas again. Be apart of something big, like I had always wanted. If I went to LDS, I would only see trauma for a couple of months, then be stuck at a community hospital. I was thinking of the big picture. I wanted the big stuff.
I worked my jobs at radiology, cardiology, pathology, plus my two volunteer jobs almost every day. I waited impatiently for a phone call from human resources from any one of those places. Just anywhere. I wanted to finally do work that I wanted to be apart of. But my mind became sidetracked. My great grandmother had just passed away. Suddenly, nothing else mattered. Although I knew her passing was near, it was still shocking all the same. She had not been doing well for a few months. All I could think about was how guilty I felt for not seeing her more often. Not getting to know her more. It consumed my thoughts for a days. I couldn't concentrate. The day I was leaving for the funeral, I was in the car with my family. We were just about to hit the freeway and head up to Idaho. I got a call from human resources to to be offered the job at LDS Hospital. I wasn't disappointed. Though I think the lady on the other line might have thought I was. My voice and affect was flat. I accepted and said I would be out of town for the weekend. It was a short transaction with little information exchanged. I was happy. But I decided to keep generally quiet about it. I wasn't in the mood to celebrate.
I never had to quit 5 jobs before. I gave my two weeks notice for all of them. I wanted to stay PRN at radiology for the money. They said that was ok, but they never called me for any shifts. My supervisor said it was ok to stay PRN to my face, but apparently had let me go the day after our conversation without me knowing. I didn't find this out till 5 months later. I didn't care though. Everywhere else, had congratulated me formally. It was an odd feeling of letting go of so much for one thing. The jobs I had were generally good to me. All of them taught me so much. All of them would be relevant to this new job.
I don't remember my first day. All I remember is that I had to do a twelve hour for the first time in a long time. I remember how nervous I felt. I had every right to be as nervous as I did. I soon found out how cut-throat a trauma center ER was. I knew it was rough with my experience at the U as an EKG tech. But I never knew just how ridiculous it was. It was like a high school clique. If they liked you, it was a grand time for you. If they didn't know you or didn't like you, you knew about it every second you were there. People didn't trust you. People didn't talk to you or treat you like a person. You really had to prove yourself there. Although the first month there was peppered with awesome stories that I continue to tell to this day, (Me tipping over a cricothyroidotomy tray in the middle of the procedue, the fake seizure girl who asked for dilaudid, and a few that I will touch on later.) I had never felt so alone and hated. I began to dislike my job a little after a couple of months. Although I was decent at my job, the nurses and other techs made no effort to be nice to me. A few were nice when they wanted something, a couple were just genuinely nice.
I remember talking to the doctors the first time. Some insisted on being called by their first name, some were just cool and down to earth. A quality I had yet to see in other types of doctors I worked with previously. The pathologists I worked with were nice, but generally awkward and stern. The radiologists I worked with were typically high stress for just reading images all day. They had no problem being mean just because. There was only one doctor in radiology that was ok with being called by their first name and he was super nice. Most of the others, if you failed to call them doctor I would get a lecture about how they didn't go to med school for 4 years and 6 years of residency to get called by "just" their first or "just" their last name. I had to call them doctor. Because of that stigma for a couple of years, I still have trouble calling doctors I know really well by their first name. I fear somewhat of a consequence to it to this day. Cardiologists were very much the same. Suddenly, I'm talking with doctors who talked with nurses and techs like regular people. Talking about hobbies, beer, making funny jokes. I had never seen that kind of teamwork before.
I loved being a part of traumas that came through. I saw so many good ones. But each trauma, it was made sure very quickly that the nurses did not trust me and the techs who were with me didn't either. I guess with reason. I wasn't very good and made mistakes. But I also did a lot of good and enjoyed being part of the moments that counted. I didn't want LDS Hospital to stop being the trauma center. I wanted to go to IMC when the move happened so I could still be apart of it. I did eventually go PRN there. I was touring the ER a week before it opened and happened to come across the manager of IMC ER. I talked about how I wanted to transfer there the second there was an opening available. On the spot the manager offered me the PRN position and said they needed help with filling gaps in the schedule. I had no idea what I was getting myself into. I worked the first week of hell that it opened....
I remember my first interactions with homeless people. At first I thought it was sad and it tugged on my feelings hard to see people live the way they did. I felt like I was doing a service to the community helping take care of them. I had no idea that people abused the system just to sleep in a bed. I had no idea so many drunks came to an ER. I had no idea so many people were mean and combative. I had no idea people came in for nothing. It all felt so wrong. It shocked me. The most shocking was watching a male nurse I work with get punched by a crazy homeless guy in the CT scanning room while I stood horrified. I then saw that nurse retaliate back. I was in so much shock. I thought it to be so wrong to hit a patient or to be hit by a patient. Who would want to hit someone who is taking care of them? So much was so new and unclear.
I remember how valuable I finally felt to have skills and to see things that mattered. I remember irrigating a laceration for the first time. I couldn't help but have a stupid grin on my face while thinking "this is real medicine, this is what I came for." Seeing torn flesh for the first time was such a big deal. It seemed so crazy. I loved irrigating lacerations. I have come to hate it since it's generally time consuming and all the same nowadays. But every time I stepped into a patients room, I remember how fresh and awe inspiring it was every time. I felt like I was making a difference. I felt important and useful.
I remember being there for my first full arrest. It was the first time I did chest compressions. The guy was huge and looked super dead. When they called it shortly after, I couldn't help but feel it was slightly my fault. I remember seeing my first trauma not make it. He passed away before my very eyes. I also felt responsible as the family cried over them. All I ever wanted to do was help people and make a difference. And there I was stood, 20 years old and powerless. I had failed them. I failed myself. It was nothing like I thought it would be.
I quickly grew tired of working at IMC. I hated how disorganized it was there. I hated how nothing stayed the same. I hated how I knew almost no one there. I hated the requirements they were putting on techs there. They asked me to leave since I was not picking up more than 2 shifts a month.
When LDSH stopped being a trauma center, everything changed. Staff that I was just getting acquainted with were gone. Acuity that I was used to, gone. Large numbers of patients, gone. It was like starting over again. It didn't matter to some degree. It was partially my fault being so shy. I could barely muster a word out for a nice conversation. I hardly talked. My first year I was practically dead silent.
As time went on, I got better at my job and got better acquainted with the people I work with. I was better, more confident and still felt useful. This led to me getting more PRN jobs. I eventually worked at UUMC ER PRN but hated it more than IMC. It was a fun place for learning new skills. But I soon learned that the staff was worse. Many were arrogant assholes with a "god complex." So many of the other techs there had no particular hopes or dreams. They just worked at that ER for life. As a result they saw me as inferior and treated me as such. The doctors weren't bad. I never had a real connection with any of them. I saw good traumas and strokes, good high acuity and learned new skills. But none of it mattered to how much I was treated by management and staff. I left after only 10 months. I couldn't take it. I later learned that most of the people I used to work with there left shortly I did. Management was falling apart and everyone knew it. I work at Park City ER PRN with which I have no personal feels for or against. It's a nice hospital with nice patients. It's the most laid back place I have ever worked and have enjoyed my time there thus far.
It's been almost 4 years since I started in the ER. So much has changed about myself. I want more out of life and a job. I feel more useless than useful. I'm embittered by my patients and used like a kleenex by some crappy nurses. The challenge of my job is gone. But yet I have no where else to go. No where that I might enjoy something as much as I do with this. My struggle through school has only proved to be a bigger problem with this. Nurse. Physician assistant. Doctor. I'm getting older now and am no closer to moving up. I fear that this job is my peak and I am done fore. Although that's not the case. I can't help but feel so burned out by what I'm doing. I don't hate it, but I don't love it. I don't like being a great tech. I want to be a great something else. Anything. I don't want to be stuck with this job forever. The perks are many, but not enough.
The other day I walked out of a critical patient's room that I had just helped out in. I smelled something familiar. It had nothing to do with mouthwash, urine, poop, homeless stink or anything. Just a smell that was faint and familiar. It forced me to think of everything I had been through. As I was thinking about it, everything seemed to slow down. I was on my way off a long night shift. The halls that I'm familiar with seemed to blend to white. I was taken down through memories of what brought me here. Where I started. The people who have influenced me greatly. As I walked through the hallways, into another room, it was more like the room passed around me and time had slowed down much slower. I thought of the nurses who taught me so much, believed in me, trusted me. I watched them all make huge differences in their patient's lives so many times. Each time I thought, "I want to be more like that. I want to be more like them." I thought of the doctors who inspired me to care, to go further, to do more, to do more. I see so many of them as people I wish I could be. Their instinctive qualities to medicine. Being so intuitive on what's going on. Being so smart and hardworking. I have stood in envy of many of these people and have hoped to become as great as them. I thought about the people who got me here. All the way back to food service. I hated the job, but a few people thought I would make it further. I wanted out and a few pushed me to go further. The job sucked but it made damn sure that wasn't the end of the road. The people in the lab taught me to be more laid back. To work harder to make it and earn trust. Cardiology taught me that clinical status is all I wanted. Radiology gave me the invaluable knowledge to know what the hell I'm looking at in scans. So many people and qualities to thank. I finally clocked out and walked out of the ER. I had to be back later that night for another graveyard. I didn't feel so bad about being here. But I didn't feel so great about coming back as still a tech.
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