April 4, 2007

A day in the life of a paramedic

By Erin Isings
eallison@uwo.ca

This is the first question paramedic Lee Nordstrom asks civilians riding along with him for the day. He is obviously comfortable with it, as he sits inside the ambulance at the beginning of his shift, checking the stock of various plastic tubes, bandages and sharp metal instruments used to draw blood, wipe up blood and stop blood flow.

"If you're going to get out and be sick, let us know so we don't leave you behind," he says.

Nordstrom, 28, and Shawn Hunsberger, 24, are paramedics at the Middlesex-London emergency medical service's "main base" on York Street. Both are below the average paramedic age of 36, and neither has experienced the typical back injuries that usually force medics to change careers by age 45. Both have completed two years at Fanshawe College to earn their Emergency Medical Care Assistant certification. Both Nordstrom, 5 feet 9 and 238 pounds, and Hunsberger, about 6 feet and 190 pounds, have worked as medics for two years.

They're on the Saturday 9 a.m. to 5 p.m. shift, which will include a seizure, heart trouble, almost an hour of The Wedding Crashers and a car accident.

Photo by Erin Isings

Shawn Hunsberger and Lee Nordstrom are paramedics with the Middlesex-London emergency medical service.

Despite the sensitive care they give patients inside the ambulance, Nordstrom and Hunsberger seem to dissociate once they transfer the patient to hospital staff. Although professionals say dissociation is not the healthiest option, the medics adopt it as part of their job.

"There's not much closure in this job. When you ask how the patient is, it's usually too early to know," says Hunsberger.

"You see stuff you don't want to see, and it will always stay with you," says Nordstrom, adding it helps to have attention deficit disorder.

Perhaps this defence mechanism keeps them going, less than two weeks after the death of one of their own. Paul Patterson, 30, a Chatham-Kent paramedic, was killed in a vehicle accident while responding to a call during a winter storm.

Nordstrom didn't know Patterson personally, and stayed behind to work so others could attend the funeral. He shrugs dismissively when asked about danger on the job. "You can't think about it. You just go. You're out there for the patients."

For the record, Nordstrom and Hunsberger dismiss ideas that they worry about death and danger on the job. They say gawkers at accident sites or "psych"(iatric) calls put them in the most danger. A critical incident stress manager is on staff - a paramedic trained to help others deal with trauma. This encourages the medics to talk about trauma, instead of the less-healthy alternative of dissociation, which can lead to psychological burn-out.

* * * * *

"Not feelin' so well today?" Nordstrom asks gently.

He squats before a tall, thin man sitting inside a local shelter at 9:30 a.m., the first call of the day. The man thinks he had a seizure the night before and describes seeing lights and not being able to move. Through further questioning, Nordstrom learns the man has a history of mental illness.

Nordstrom decides to bring him in. The patient feels well enough to walk, so they take him into the emergency department on foot. Nordstrom relays the medical information to the triage nurse and, having transferred care to the hospital, leaves.

* * * * *

"What happened to you?"

A tall, bald medic walks into the room where Nordstrom writes up the paperwork from the previous call. He's wearing white coveralls over his navy paramedic uniform that make him look like an astronaut.

"Oh, we had an old fella who was on his way out," he says quietly.

Nordstrom and Hunsberger grunt sympathetically. All three are silent, respectful for a moment, before Nordstrom asks Hunsberger to sign the paperwork, and the medic calls the dispatch centre to advise he needs time to clean the ambulance before accepting another call.

* * * * *

"Could you pass me a basin and some tissue, please?" asks the tired-looking nurse.

A very pregnant patient, who was airlifted to hospital last night after being pinned beneath a rolled vehicle, lies in the ambulance, her arm bandaged from fingers to shoulder. It's shortly after 11 a.m. and she's being transported to another hospital for reconstructive arm surgery. The movement of the ambulance makes her nauseated.

Her nurse and Hunsberger sit on the bench beside the stretcher. The nurse comforts the patient as she begins heaving, while Hunsberger readies more tissues and says softly, "It won't be much longer now, almost there."

The medics wheel her up to the surgery ward, transfer her to the hospital bed, and leave.

* * * * *

"What's going on here? How come no one called me? Where did this happen?"

The mall manager is frantic at the sight of medics in his mall. The medics ignore him and help the frighteningly pale elderly man off a bench and onto the stretcher. It's 1:30 p.m., and the medics' half-eaten lunches are stashed in the front of the ambulance.

Nordstrom straps an oxygen mask onto the patient while cheerfully asking questions. Hunsberger sticks heart-monitoring electrodes onto his chest and prints off a reading from a tiny monitor stashed under the stretcher. Nordstrom continues to speak loudly to the patient, apparently trying to remain upbeat. The patient's terrified daughter stands a few metres away, watching.

The medics are muttering numbers, almost like a code, back and forth to each other, as they check his pulse and monitor his heart. The mall manager still shouts questions and the medics ignore his intrusion as they focus on their priority: the patient.

Photo by Erin Isings

Oxford Street traffic pulls over as the ambulance crosses the median on the way to an emergency.

Nordstrom buckles him onto the stretcher and Hunsberger explains to his daughter that they think her father has heart trouble and she can meet them at the hospital.

The medics wheel the man into the ambulance. Nordstrom is nearly shouting at him, calling his first name, asking what day it is, and how many fingers he's holding up. Hunsberger calmly flips on the lights and sirens. A pedestrian stares and his dog howls to the moan of the siren. Western Road traffic magnetically pulls over to the right, Hunsberger floors it through red lights and onto the wrong side of the road. The patient is almost without vital signs. Hunsberger races through several stop signs to the ambulatory entrance of the hospital.

The medics lean over at odd angles and lift the orange blanket under the patient to transfer him to the hospital bed. A young nurse appears and chats cheerfully with the patient as she looks for a vein to begin an IV. Her tone changes when she gets no response and shouts, "Sir? Can you hear me?"

A dark-haired nurse with dark circles under her eyes shouts, "Does anyone have any scissors? We need to get his clothes off!" Hunsberger and Nordstrom help the nurses undress the patient. A doctor in green scrubs runs in. Nordstrom brings them up to speed on his condition. Another nurse pulls a pastel curtain around the area to guard the patient's privacy.

A few seconds later, the paramedics emerge. They fill out paperwork and don't stop to check on the patient on their way out.

* * * * *

"Should I?" Hunsberger laughs, his fingers hovering over the lights and siren switches on the dashboard of the ambulance.

A black Toyota sedan comes to a dead stop in the middle of the one-lane road for the fourth time in 100 metres. The driver is clearly confused about where he is going. The medics are clearly annoyed about his confusion.

Nordstrom mutters something about temptation. Both men laugh as the driver turns off into a parking lot. They continue back to the main base, where they watch movies until their next call.

* * * * *

"So, what are you up to tonight?"

It's 3:20 p.m. Hunsberger chats with a pretty, 20-something passenger of a smashed-up car. She smiles up at him and giggles, perhaps smitten with his good looks, perhaps because of her head wound from a car accident. Blood runs out of a tiny cut near her temple, turning her blond hair into sticky-looking clumps.

But Hunsberger doesn't like what he hears. The woman plans to spend the evening home alone and she has had five drinks in four hours. The young woman's male "friend" rubs her shoulder in a way that makes Hunsberger feel uncomfortable about leaving her in this man's care.

Although she is not seriously injured, he decides to drop her off at the hospital for observation.

* * * * *

"What else did we use today?" asks Nordstrom.

He restocks the ambulance cupboards at the end of the shift.

The next crew of medics arrives for the Saturday evening shift, generally a busier one because of weekend celebrations. Nordstrom hands over the keys. Both head home; Nordstrom, who is single, to relax, Hunsberger to a purse party - like a Tupperware party - hosted by his girlfriend.

Neither of them will think about today, they say. It's the only way they can do it all over again tomorrow.