5 things this Paramedic has no problem telling you

I stumbled upon this video last week – The top five things Firefighters won’t tell you. You don’t have to watch it – I’m going to type them out below. While Firefighters may not want you to know these things – I think you should.

Before we start, it is clear that this video is about Firefighter Paramedics. This is a breed of medics that work for a fire department. Many fire departments have taken over EMS because…money…and boredom. Also, fire departments tend to have a leadership matrix that EMS lacks. Fire is hundreds of years old – EMS hasn’t yet made it to 75 – we need more grownups in our ranks.  Except for one point that is a unique fire issue – I’m writing from an EMS perspective.

We may not know what’s wrong with you

This is because we don’t have drug tests, MRIs, CT scanners, ultrasound, or X-Rays in our ambulances. That said, in most cases, if we don’t know what is wrong with you – it isn’t likely to kill you before we get to the hospital. Which makes us wonder why you called 911 in the first place.

Something else to point out here – even if we do know what is wrong with you, EMS providers are not allowed to “diagnose.” It doesn’t matter if your arm has three new angles – I have to say “Your arm may be broken.” I cannot tell you that it is broken. This makes complete sense since I’m allowed to give medications when appropriate. I can’t diagnose, but I can treat. Brilliant.

Too many of us are out of shape

Fact. Undeniable fact.

Medics smoke, don’t exercise, and eat more processed food than the general population. Apparently dealing with America’s sickest is not a good enough warning.

The fire side of things is working on this better than EMS. They have realized that yearly fitness tests and physicals decrease injury and therefore drop insurance premiums. Money is a good motivator.

My current job is also doing well. Free gym memberships, a points competition, and insurance incentives are often the only thing that get me to the gym in the morning. That and looking at my patients.

We only work eight days a month

But those are 24 hour days so we end up working more hours than the average American. Also, we work holidays and weekends. On the 24/48 schedule, we are only off for a full weekend every three weeks. People say “long weekend” and we say “Huh, I wonder if I’m going to get holiday pay?”

Let’s talk about 24 hour shifts for a moment. Is there any other industry that thinks this is okay? I can’t think of one. In fact, it is becoming increasingly obvious that the point above can be blamed on this one. There is nothing healthy about being at work for 24 hours.

Problem: Those working the 24/48 schedule can’t afford the pay cut that would come with going to a “normal” workweek. Those paying the 24/48 employees can’t afford (or even find) the extra employees that going to a “normal” schedule would require. It is a viscous cycle.

Something else to point out – those who are working at 24/48 schedule often have part or full time jobs elsewhere. The fact that I don’t have a second job makes me rather weird.

You’re getting charged for this ambulance ride

Duh. I like getting paid. Eating is nice. So is paying rent.

I’m really confused about why the general population thinks that medical care is supposed to be free.

Here’s one I’ll tag on here – “In order for your insurance to pay for this ride, I’m going to have to lie on my report. I don’t lie on my reports.”

We don’t fight many fires anymore

It’s true. The fire department has worked themselves out of business. Most of them are quite fine with this fact. I was in a room of Paramedics last week and listened to four of them proclaim that they didn’t want to be medics at all. They were only doing EMS because it was the necessary rung on the ladder to a fire department job. In that job they would get paid to do “absolutely nothing for 24 hours.”

This is not a problem in EMS. As fire departments scramble to find things to make their existence necessary, EMS agencies are scrambling to meet the ever growing demand for service. We should probably take some hints on how to do this from the fire department.

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How I get paid

I mentioned a few posts ago that it would be nice to be paid as much as a plumber. I think our culture assumes that all medical providers make tons if money – after all, medical bills are certainly ridiculous. Let me help explain the situation.

When someone calls 911, I treat them to the best of my ability and take them to the ER of their choice. I write a report that documents my findings, treatment, and where I left them. That report goes to the billing department.

The billing department does the insurance coding – putting everything I wrote into a pretty little summary with numbers so someone in a cubicle can understand what happened. The billing department also does a review to make sure that each thing I did is billable. If I didn’t put any medications through the IV the pt won’t be charged for the hole I made in their skin – regardless of if it was put there because the patient’s condition made the hair go up on the back of my neck. If I document that the patient met us at the door with a packed suitcase and walked to the ambulance with no difficulty; the billing department sends it to the insurance company with a special code that means “we have no clue why they called EMS”. Guess who doesn’t get paid. If I’m doing a transfer from one ER to another 60 miles away for an infected finger (it happens), chances are, that special code is going to be applied.

Once the billing department has done their review and put in all the pretty little codes, the call goes to the insurance company. There, someone who has little to no medical knowledge makes the final decision as to how much money my company actually receives.

Unlike the plummer who fixes your toilet and hands you a nonnegotiable bill, I am not reimbursed for the work I do. I am only reimbursed for the work that others (who were not there) feel I should be paid for. Try that next time you call the plummer…

Oh, and of course the money doesn’t actually come straight to me. It is dispersed throughout the company. You try running a company where a large percentage of those you serve don’t pay for your hard work.

Now you know why I hate all forms of health insurance.

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Homemade protein mini muffins

I have now made several batches of these mini muffins and I am happy to say that I’m no longer addicted to Cliff Bars. Which is good because I was going through a box a week. That was nearly six dollars a box. Not to mention the sugar… I do however, keep a box in my locker at work because they are good for emergency situations. I honestly don’t think that the Cliff Bar manufactures intend them to be eaten every day.

I use this recipe as the foundation of my muffins. And by “foundation” I mean that I use the quinoa, flax, oats, and coconut oil as directed. Other than that – I do my own thing. Also, I add green tea for a little caffeine.


Green tea makes the quinoa look so…yummy?


Note: if you follow the recipe directions for making the quinoa, you will end up with twice as much quinoa as you need. 

I find the flax seed thing most interesting. Water and flax seed meal turn into a gel of sorts. It brings out the curious child in me.


This particular batch had three bananas (for the first time in…ever…my freezer has no bananas) and chocolate chips for flavor. Right now I’m using milk chocolate chips from Aldi, but I’m going to look for some organic dark chocolate chips for future batches. That way they will be “healthy chocolate.” Also, I’ll be less likely to eat the chips by the handful when I’m craving chocolate… I’ve also used apple (run through the food processor), cinnamon, and chocolate chips with equally yummy results. If I were a pumpkin person, I’d try that next. But I am not a pumpkin person.


I do not grease the muffin tins. Thus far, this has not caused me any problems.


After baking for 30 mins, I try not to eat them all while they cool.



Once they are cooled, I place them in an airtight container and store them in the refrigerator. I have learned that airtight is important. I haven’t attempted keeping them at room temperature.

I should probably do a cost analysis of this recipe vs. the Cliff Bars, but I’m guessing that these homemade muffins are far more cost effective than the Cliff Bars. I’ve made almost six batches of these and I’m just now needing to buy more quinoa. It may be years before I need to replace the flax meal. And oats really are not that expensive. So, I’m thinking that where a Cliff Bar was nearly a dollar a pop, these muffins are pennies each. Even eating three at a time (which I do), probably doesn’t exceed 25 cents.

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Happiness is…

…family photoshoot success. I’m gonna need more wall space.
…having patients that are actually sick and that I can actually help.
…free lunch provided by and eaten with the bosses, all while having relaxed conversation.
…audio books. Last week I listened to “The Book Thief.” This week it’s “We Bought a Zoo.”
…run endorphins. They beat all the other endorphins.

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Accepting the gifts

My parents love to give me gifts. They are pretty good at it too. I left their house last week with a case (a case!!) of my favorite pretzels. The list of carbs that I enjoy is very short – homemade popcorn and these pretzels. I’ve been struggling to find these particular pretzels in my area so my parents stocked my selves for the next few months.

But, back to the gifts.

I love getting gifts – on my birthday and Christmas. But there is something about random gifts given at other times of the year – they make me feel…different. Oh, I do enjoy being on the receiving end! But in a way – I feel guilty accepting them.

Maybe it is because I’ve built this view of myself as an “independent woman.” Maybe it’s because I have the ability and intent to buy (well…if I could find the pretzels here) these things myself so it isn’t like I need them to be given. Maybe it is because I’m an American and I just take pride in doing things myself.

Maybe it’s because I don’t feel worthy of the blessings of gifts. Maybe it’s because I feel guilty for not, in some way, “earning” the gifts.

I find that the same mindset is true of the gift of salvation. Or at least, it used to be.

I used to have a long list of things I did and believed in order to make myself “worthy” Christ’s sacrifice on the cross. I had received the gift of salvation, but I did not accept it as a gift. If that makes any sense at all.

Thanks to my parents, I’m learning that gifts are given, not because of my “worthiness,” but because I am loved. The givers – be it my parents or God – are simply giving me tangible expressions of that love. I’m learning not to just accept the gifts – but to receive them as well.

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Things you might say if you show up to work with an injured nose

“I was not diving.”

“Yes, I am a rescue swimmer.”

“There was no alcohol involved.”

“That’s my blood. At least, it should be.” This was in response to a nurse pointing out that I had blood on my nose after I brought them a slightly bloody patient. 

“No, you may not wrap my nose in gauze.”

“I don’t want you to touch it with an alcohol swab.”

“Nor can you wrap my glasses in gauze.”

“No, you may not use your knife to cut off the loose scab.”


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Sometimes I wonder…

…if teachers put their collective feet down and refused to spend their own money on items for their classrooms – would children stop learning?

…if companies stopped having benefits packages and instead passed that money on to the employees – would we use the extra money for retirement, health and life insurance, and disability plans; or would we spend it all?

…of the NTSB investigated and produced a written report on every car accident in which a child was killed or gravely injured; would parents start using carseats correctly?

…if my company actually got paid for all of the services we provide to the community; would I make as much as the average plumber?

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