Monday Monday...

So it's Monday for me. I work 1800-0600 Friday, Saturday, Sunday and every other Monday. Tonight has been an average night so far:

- 17y/o male crashed his motorcycle and has left ankle pain.
- 87y/o male with a blood sugar of 35mg/dL.
- 16y/o male unhurt after a car accident whose mother decided she would take him to the ER herself instead of having us take him. (Wonder of wonders! This almost never happens.)
- 87y/o male who had diarrhea twice tonight and a fever of 100.7F from SNF (Skilled Nursing Facility [I'll have a rant about these guys in the coming months too.]). The nurse said she called the doctor and the doctor told her to call 911 to have him evaluated at the ED. Are you fucking kidding me? You're going to tie up a 911 ambulance because you think a patient you haven't even seen needs to be evaluated? Isn't that why the SNF employs doctors? So they can evaluate the patients there? My partner teched this one. Oh the bouquet of c.diff diarrhea.
- 90y/o female with nausea for 3 days. I teched this one because of the stink of the last one. I felt bad for my partner for about half a second.
- 22y/o male with a cut to his nose after a bar fight. He is alert and oriented and doesn't want to go to the hospital, and nor should he. The cut is about 1/2 inch long on the bridge of his nose. Luckily we were running with Santa Clara County Fire or he would have gotten the full court press from San Jose Fire Department to go to the hospital to "have it looked at."

We still have 4.5 hours left on our shift so we probably have another 4 calls to go.

We've been at low levels (less than 7 ambulances available in the north and central part of the county) all night and at one point we had BLS ambulances and San Jose Fire Department STAR cars running 911 calls. At the same time, the ambulance posted in Gilroy, the post that is farthest south in the county, was headed to Valley Medical Center because that is a central point and where the available 911 system car goes when there is only one left in the system. I have long rants brewing about that shit. There is no reason in hell that we should ever go to level 1 or level 0 at night. Yet this happens A LOT. Going low levels happens, but we should not be constantly at low levels all fucking night long and there is no fucking reason we should EVER go to level 1 or level 0 at 0200 or 0300, yet it happens fairly regularly.

Every 6 months the deployment gets revamped and we bid on new shifts. We just did this and the operations manager decided that we didn't need all the ambulances we have at night and removed another ambulance from the nightly deployment. Actually he removed three ambulances but put two new ones up so we have a net loss of one ambulance. We're getting killed every night on the nights I work. We should have at least 4 more ambulances up than we do. Probably more, but the ops manager just doesn't seem to want to pay ambulance crews. At least that is the only logical reason I can come up with for what he's doing.

When we do not arrive to a call within our contracted response time, the company gets fined by the county. There is a whole convoluted system for calculating the fines based on location, code of response, how late we are, etc., but, on average, the company gets fined about $25,000 each time we are late to a call. Last tour, my unit alone had 14 exception reports (that's what we call it when we don't meet our contracted response time.) 14 x $25,000 = $350,000. I'm pretty sure that $350,000 would cover putting up a couple of ambulances for a whole bid. And that was just one unit over 3 nights. Granted, that was an exceptional tour as far as exception reports go, but we usually get at least one a shift which still comes out to $100,000 a tour in fines for just my unit. Combined with all the other unit's fines, that's a lot of cake and a lot of profit loss. To make the exception reports stop, you have to put more ambulances on the road. Period. There is no other solution. That's how I have come to the conclusion that the ops manager just does not want to pay ambulance crews. It seem he would rather pay huge amounts of money to the county in fines than pay ambulance crews. It does not make sense to pay fines, when you could be spending that money on ambulance crews, who will in turn MAKE YOU MONEY. It's not fucking rocket science. Fines are lost profits. Paying crews increases profits. From a patient care stand point, every one of those exception reports represents someone who called 911 and had to wait for an ambulance to arrive. It's a fire department engine crew that is unavailable for service elsewhere as they wait on scene for us to arrive. It represents prolonging the patient's delivery to definitive treatment. But this is a business, and share holders care more about profits than they do about patient care. Which also goes against the ops manager's decision to run night crews into the ground and collect exception reports like teenage boys collect speeding tickets.

As you can see it's 0100 and we've run 6 calls. I wasn't kidding about the 4 more calls either. We're averaging 8-10 calls a shift. Day cars average 4-6 calls a shift. There is something very wrong with that. Actually, we just got another call, so I have to go...

UPDATE....
I was wrong, we had 3 more calls not 4 to go. We ended up running 9 calls last night. It's now 0700 and I am lying in bed about to try to get some sleep. I'm moving into a new house this weekend. Yay! Today is the only day I can foresee getting any sleep this weekend. The new bid starts Sunday. I had decided that unless the company put up more night cars this bid, I was going to go back to day shift. Well, they didn't, so I start my new shift on Sunday. I'll be working 1800-0600 tonight and then 0500-1700 on Sunday. Actually it will be 0600-1700 but my new shift is Sunday, Monday, Tuesday, 0500-1700 and Wednesday on a different unit from 0800-2000.

I really like working at night. I've always said, I would work a night shift even if they didn't pay us more. But not if I am going to be run into the ground every shift. Though we do get $5 more an hour as a night pay differential, there are two fewer shifts a month than a day car schedule, which means my gross pay working at night is $0.96 more than my gross pay working during the day. So we don't actually get paid more to work at night, we just get two extra days off a month. I'll gripe about the effect working a night car has on overtime and lowering our average pay because of the asinine way the company computes our pay at a later date. I need to sleep. Good night.

My Dogs

This morning I went to sign my Dogs up for welfare. At first the lady said, "Dogs are not eligible to draw welfare". So I explained to her that my Dogs are mixed in color, unemployed, lazy, can't speak English and have no clue who their daddies are. They expect me to feed them, provide them with housing and medical care.

So she looked in her policy book to see what it takes to qualify. My Dogs get their first checks on Friday.

Is this a great country or what?

Welcome to hell...

I have tried very hard to figure a way to deal with the frustration that comes with my job. You would think that the blood, sickness, and death and dying would be the hard part, but to be honest, it is dealing with people who call 911 for a hang nail, or people who ignore vehicle laws as they pertain to Public Safety vehicles, or the "if we give nitroglycerine everyone who says 'chest pain', we will never get in trouble for not giving it..." cookbook, I don't want to use my brain medicine of the local fire departments.

So... this is my solution. Blather on here, or go nuts and probably end up going off on someone. There is going to be A LOT of swearing and gory details so you probably shouldn't let your kids read this. There is also going to be A LOT of revelations about the inner working of the San Jose Fire Department, the San Jose Police Department, Santa Clara County Communications, Santa Clara Valley Medical Center, the Kaisers, and the other medical facilities of the County that the public has no idea about, so you might want to send some of these posts to people you know that live in these cities or County. There will also be A LOT of gory details about calls. Due to HIPPAA, I will make sure that there will be no actual names or locations and will try to obscure dates as well so I don't get my ass in trouble with the medical police.

I will not reveal or make any comment about my current employer though it won't be tough to figure out who it is I work for. I have been told there are people at the company I work for that do nothing all day but search facebook and other sites looking for posts by employees that are either anti-company or that could get the company in trouble and turning them in to Operations where they are written up or threatened with termination. If one of you rats finds my blog, FUCK OFF! It is my first amendment right to post whatever the fuck I want about whatever the fuck I want! If you wish me to take any of this down, I hope you have a good fucking lawyer, and if you fire me for any of this I hope you have your next job already lined up because I'm going to own the company and the first thing I am going to do is fire your ass!

If there is something you would like to know more about, especially if you are in the media, leave a comment with contact information and I will contact you. I am more than willing to spill the beans about anything and everyone. This crap has been going on for FAR too long.