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Being an EMT in a Pandemic

Being an EMT in a Pandemic 

Scene at one of Portland’s larger hospitals today:

Nurse 1: So he asks me “well how many covid symptomatic patients got discharged overnight?” And I was like “Oh god, too many to count, but I guess say 5 if you need a number.”
Nurse 2: Can we track isolation patients in Epic (the software near-literally every hospital & doctor’s office in the US runs)?
Nurse 1: Nope.

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Being an EMT in a Pandemic 

I also got my first conspiracy theory patient today.

Him: Okay but like...where are all the homeless people, man? Where did they go?
Me: well there was an executive order to mandate hotels and motels provide housing, as well as possible seizure of private property to house them. So...they’re indoors.
Him: ...well.

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Being an EMT in a Pandemic 

Also the other day I loitered in a parking lot for an extra 15 minutes so a man who lives in a nursing home could say goodbye properly to his wife. Most elder housing has restricted or cut off visitors entirely, so they weren’t sure if they’d get to see each other again.

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Being an EMT in a Pandemic 

This anecdote in particular seems to be messing people up, which means I should definitely not tell any of my normal non-pandemic “I have worked multiple 911 shifts and thus I have watched people die” stories.

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Being an EMT in a Pandemic 

I don’t want to sound like Vanessa Hudgens about this, but people do in fact die every day. The disaster here isn’t the illness, it’s when we pass our capacity to treat it to the best of our ability. Sometimes, the medical issues are too great, and that’s sad but it happens literally every day. Someone dying because we just don’t have enough ventilators, though, is tragic and avoidable.

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Being an EMT in a Pandemic 

Anyway:

As I suspected, my work hours just got cut for the week (well...the opportunity to choose to not come in tomorrow was presented to me, to be accurate. But also my supervisor was like “I have to cut 11 people”.) My normal shift is non-emergency transport of people who are in wheelchairs, and there’s been a big reduction of that this week (which is good!).

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Being an EMT in a Pandemic 

I’ve seen a lot of threads where people advocate for service industry folks to get guaranteed paid time off and/or hazard pay “because they’re first responders too”.

I don’t know who lied to you like that, but first responders don’t get PTO or hazard pay. Congress had to be shamed extensively into paying for the cancer treatment of 9/11 first responders. I get 40 hours off a year for *anything* — sick, vacation, bereavement, whatever. There’s no covid19 PTO.

Being an EMT in a Pandemic 

And I am in, from what I hear from others, one of the highest paid EMS systems in the country. I was hired at $15/hour and that’s considered good money. In Colorado, apparently paramedics in the fire department make $10/hour, and trust me, paramedics do WAY more than I do.

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Being an EMT in a Pandemic 

(Not that people in service industry jobs don’t deserve PTO or hazard pay. My mom works at Trader Joe’s and talking to her over the last week she has gone from loving her job to intermittently loathing management, it’s been so exhausting and tough for workers there.)

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Being an EMT in a Pandemic 

Picking this thread up again! Last week I was laid off temporarily, and this week my job is entirely different than it was. I normally do non-emergency wheelchair transport, although I’m certified to do non-emergency ambulance, 911 calls, and am in the process of certifying for secure transport for behavioral health patients (and then on-site workplace monitoring after that). I do a lot of stuff but most of it is connecting people to health services.

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Being an EMT in a Pandemic 

Now/instead, I’m posted at one of the emergency shelters (aka a hotel) for houseless people who’ve tested positive for Covid19. So instead of taking people to heath services, I am the health services. But I’m also kinda hotel staff in that I deliver food, clean, and do whatever else needs doing. So basically: I’m a hospital worker now! But for a hospital that has no real clear rules yet and also just opened 5 days ago.

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Being an EMT in a Pandemic 

We were on version 3 of what the patient monitoring paperwork should look like, and I assume it’ll be different again the next time I go back (if I go back there! I was given two shifts and then told I’d know more by yesterday end of day, which I obvs don’t.)

Anyway, I’m now way more concerned about getting this thing, because when you cast a “quarantine hospital out of nowhere” spell with people who aren’t healthcare workers as staff, you get a lot of grey area.

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Being an EMT in a Pandemic 

The other EMT posted there and I kind of threw our weight around yesterday and without getting approval we designated the staff break room/kitchen for all the patient food as a clean area with no PPE allowed inside. Which means we’re going to need more gowns, but also 🤷‍♂️. We still don’t have bonnets which means basically trying not to touch your hair and then also taking a shower when I get home. But also then where does that leave my car I drive home in? Etc etc.

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Being an EMT in a Pandemic 

The shelter director is basically Hank Scorpio. I love him, I hope he’s not a super villain but every casual anectdote he has is like “wait WHAT”.

- owns a 35yo parrot 🦜 “they live into their 70s, he’ll be dancing on my grave!”
- has his own black nitrile gloves “that are way more heavy duty than these blue ones, I use these when I’m repairing fiberglass on my boat, you know”
- contemplating selling the vintage Camero he built because (1/n)

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Being an EMT in a Pandemic 

- “I want to get a GTO kit, those things take the mustang engine. 700 horsepower in a car that weighs as much as my Miata!”
- He’s just volunteering and isn’t actually running this place as an employee of...anyone? “If they aren’t paying me I can quit if they piss me off, ha ha!” (He told this joke to the county official and apparently “she didn’t find it funny”)
- His day job is something involving AI and computer chip hardware, a job he’s still doing remotely???

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Being an EMT in a Pandemic 

Yesterday he was like “I got five whole hours of sleep last night, I feel AMAZING.”

Anyway, he normally runs a 1 night/week winter shelter in his spare time because “I realized I was giving money to Doctors Without Borders as a way to make myself feel good, so I started looking for something to do at home as well.”

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Being an EMT in a Pandemic 

More updates: I finally have a schedule that goes farther out than 48 hours! It looks like for the duration of ~all this, I’ll be working night shifts at the convention center (which is now an emergency homeless shelter). When people present symptoms and need to be screened/quarantined, I do the transport to one of the quarantine hospitals (motels around the city that have been taken over for this).

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Being an EMT in a Pandemic 

I’m also the fill-in medical worker when they’re short staffed, so I ended up screening someone and then also taking him over to be quarantined. “Well, if I die from this, it’s been really nice talking to you!”

People are so scared right now, and without housing makes that fear much worse. “What happens to me after this?” is something I was asked repeatedly when I was at the quarantine shelter, and it’s come up here too already.

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Being an EMT in a Pandemic 

I know everyone knows this, but if people’s lives are worth saving and protecting in the middle of a pandemic, they’re worth saving and protecting the rest of the time. And that complete cognitive disconnect is something houseless people can see and (seem to) struggle to reconcile. Because it makes no sense to shelter and feed and closely monitor someone for 2-3 weeks and then throw them back out onto the sidewalk with no support.

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Being an EMT in a Pandemic 

When I became an EMT I started becoming a hard ass about blood pressure and respiratory health, and going through all this is just ossifying my opinions about them, namely that you really want to take care of your veins and your lungs. All kinds of environmental shit can happen, but if your body can process oxygen and move it around efficiently, recovery goes so much easier!

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Being an EMT in a Pandemic 

Having worked at the shelter for a while now, I’m more used to the pattern of “first of the month = payday & benefits go through = people get too high and OD”. This happened last month too, so I figured this week would be busy.

I also remain the only person on staff apparently who feels comfortable telling sick people what to do. Very grateful to the paramedic who made me do full vital signs monitoring on a 3yo during my training.

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Being an EMT in a Pandemic 

As an FYI: if you ever have to narcan someone, start with the lowest possible dose and work your way up. The goal is to get them responsive, not slam them into full instantaneous sobriety.

And then keep an eye on them (if they won’t go to the hospital), because the narcan will wear off and they might still be too high to stay conscious/alive.

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Being an EMT in a Pandemic 

@courtney this thread is an empathetic reality check. thank you

Being an EMT in a Pandemic 

@courtney wow just saw this thread for the first time and... thank you. Both for the info and your work!

I'm an admin temp in the "make a better system to unify housing and healthcare benefits for our unhoused, now run COVID isolation hotels" division of my California county's public health dept, and it's amazing to hear about the hotel interactions. We get occasional overview updates from the folks at the hotels but not details. Wow.

Thanks again.

Being an EMT in a Pandemic 

@courtney Also, if you're interested / have the spoons, I've got some thoughts about connections and info sharing. 💜

Being an EMT in a Pandemic 

@bouncinglime sure! I’m converting from graveyard shift to day shift in...4 hours, so I might not be very responsive in the next day or so, though

Being an EMT in a Pandemic 

@courtney SF just announced 70 folks in a local shelter testing positive for covid yesterday, after our mayor delayed moving folks into hotel rooms and briefly (before outcry) had planned to move people into one huge room in the convention center. it’s a significant portion of SF’s covid-positive population and preventable. I’m furious. I believe we aren’t moving folks into hotels because more people would then believe our inaction at other times is also unconscionable

Being an EMT in a Pandemic 

@courtney 💔 ❤️

Being an EMT in a Pandemic 

@courtney thank you so much for the work you’re doing

Being an EMT in a Pandemic 

@courtney this seems like a very different job

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