Having been in EMS for a couple decades before coming into the remote medicine arena, I thought I had a pretty good handle on patient care. I did. What I was not aware of was all the other stuff I needed to learn. As I have mentioned before, my introduction to remote medicine was through a friend of mine who hired me to work in a remote area of a western state.
My introduction to seismic/ remote work started off well. Good pace, not too fast, not too slow. I felt prepared as I went to my first job site in nice, warm, sunny weather. I saw folks with some sunburn… nothing dangerous. Watched folks throughout the day in order to make sure they drank enough water. Again, not a bad gig. I saw my first heat rash. Easy to treat with a little Gold Bond powder. But, as I continued my work in more remote areas… like on the sea in the arctic circle, I quickly realized that while I was good at what I do as a Paramedic, I was not fully prepared to deal with the other stuff… athletes foot, common cold symptoms, the aches and pains of everyday life. I found that I had some time at work (how to fill the time at work will be addressed in another blog) on personal improvement projects.
When one works on an ambulance in an urban setting, it’s easy to do the minimum care that protocols require because sometimes that’s all the time you have before reaching the hospital and handing over care to the nurses and physicians. When one works more rural, say in a farming or ranching community, one is often able to do more as they tend to be further away from the hospital. However, when one works in an area that is far away from a hospital, maybe by hours or days, then one must be familiar with the steps that would normally taken to care for the patient if they were at a hospital much sooner.
In the case of a cold or athletes foot, it’s simply a matter of monitoring the patient and treating the symptoms with standard over-the-counter medicines, or making sure they are frequently changing their socks and using fungus cream. Then there are those times when the patient is sicker… vomiting, diarrhea that won’t stop, migraine headaches, or worse. Those are the times when having seen hundreds, if not thousands of patients over ones career can be extremely helpful as the astute paramedic has been learning from every patient encounter, realizing that paramedic school and the first few years of their career is the training ground.
Do I know everything about the patients I see? NO! Will I know everything about them before my career is over? NO!!! I do my best to stay current with accepted, standardized treatment for the illness’ that I expect to see. I spend part of my days at work reading medical literature online or by e-textbooks that I bring with me. I speak with my physician sponsor on a regular basis. When I am not in the field, I attend as many classes as I can in an effort to provide my patients with the best care possible.
There is so much to learn, everyday. I have always felt that. And I will continue to strive to for a high level of excellence.
By Scott Nelson, B.S., NRP, MICP