Refocusing on Fire and EMS: Lessons From a First True Structure Fire and Bridging the Gap Between Pre-Hospital and Hospital Care

Sparks in a storm, a deadbolted door, and a corner call that taught us more than any drill—this one marks a true shift back to Fire/EMS reality. We took a month to recalibrate, and we’re refocusing on what happens on the street and on the fireground: pump operations under pressure, size-up language that actually works, and the messy truth about decision-making when the rain is sideways and the power line is humming above your rig.

We break down our first true structure fire as a crew—why the first 15 minutes decide the rest, how defining the apparatus as A-side fixes corner confusion, and what “hunt the glow” looks like when smoke eats your vision. We also talk frankly about fatigue and fuel. Cutting carbs might shred a belt size, but it can wreck your legs eight minutes into the job. If you don’t treat nutrition like PPE, the fireground will. Small departments get fewer burns, so each one becomes a high-value rep; we share practical ways to mine every scene for hard lessons and turn misses into muscle memory.

On the EMS side, we walk through a hospice code with no DNR on hand and the friction that followed. Field care runs on protocol and proof, while hospitals enjoy instant MD oversight and chart certainty—those worlds collide at handoff. We don’t rant; we offer a fix: require EMS ride time during hospital onboarding so nurses see what we see—tight crews, chaotic homes, tough choices, and priorities that shift by the second. It’s not about blame; it’s about building respect that speeds care and cuts noise.

If this direction hits home, subscribe, share it with your crew, and drop us a note with the next fire or EMS topic you want us to tackle. Your feedback steers the show—what should we break down next?

Transcript

A New Direction For The Shift

SPEAKER_02 0:02

Good morning, good afternoon, good evening. Where are you listening from? Welcome to the shift.

SPEAKER_01 0:11

Yeah, I was gonna say you're a hunter.

SPEAKER_02 0:13

Yeah. I'm Nash. Yeah. There it is. There it is. We're gonna get there. It's been a minute. It's been about a month. Uh we took a month off. I started a new part-time. Um, and we kind of took a step back to reevaluate the podcast where it was headed, what was going on, got some feedback. So now we are pun intended shifting. I see the shift.

Returning To Fire And EMS Focus

SPEAKER_02 0:42

Yeah. Shifting more focus on what the shift was originally started to be, uh, which is fire department, fire department issues, what's going on at the fire department, things we see and hear at the department, and you know, give our opinions and what we think the solutions would be for the department and other departments, not just ours, but like departments in Arkansas, and then you know, big events that happen within the fire department itself, along with EMS, not just fire department stuff. So anything you want to add to that?

SPEAKER_01 1:23

I think we did it right on the head there. Tried. Yeah, just really stick into the fire department world and the EMS world and not rambling as much about just random stuff. As much as we like to ramble.

SPEAKER_02 1:37

Yeah, I think I think we were just excited, we didn't know like what all to do, so rambling was just what we did at the department, but I think now shifting it this way, no pun intended on that one. Um that and they were like, if I wanted to listen to y'all ramble, I would have just gone to station three. Yeah.

SPEAKER_01 2:03

So makes sense.

SPEAKER_02 2:05

Um so that being said, um, get your coffee, get your energy drink, get what gets you going, and then let's uh let's jump into the month-long shifts that we have had.

SPEAKER_01 2:16

We've had a bunch.

SPEAKER_02 2:18

Well we didn't really have a whole lot. I mean, we had some

First True Structure Fire As A Crew

SPEAKER_02 2:22

interesting stuff. Like we had that fire about two weeks ago, which was our first true blue like fire as a crew. You know, we've done like grass fires here and there, but this was the actual structure fire. Probably one of my first, I think it is the first structure fire that I actually pumped by myself. Um I've punched pumped like shed fires and grass, but like true structure fire, pulling three lines, pumping it, watching gauges, like you know, setting up um a rehab area. So that wasn't really seeing that. Yeah, well, you're also exhausted and hot and yeah, we'll get into that in a minute.

SPEAKER_01 3:06

But yeah, yeah, first pumper?

SPEAKER_02 3:08

Yeah, first like true like house fire pump. Like I've like I said, I've

Pump Ops: First 15 Minutes Matter

SPEAKER_02 3:13

done grass fires and little sheds here and there, but how do you think it went for you? Um I mean it's so coming from the Marine Corps and working as a radio operator, they say the first 15 minutes is crucial. So that's kind of how I went and looked at it was the first 15 minutes is nothing but you know, we gotta hit it hard, make sure I've got everything set up and ready to go, and then after 15 minutes, you know, you can kind of step back, look, make adjustments, but um the first 15 minutes, I mean, you're clicking, yeah, you're moving. And then after that, you know, you can kind of take a step back and go, oh, I should have done this, I should have

Scene Size-Up And Corner Confusion

SPEAKER_02 4:00

done that. One of the things I wish I would have done was um I wish I would have looked at the scene better because my report I gave over the radio, I gave the wrong corner because of the way the house was. So it was on the corn, it was on the um is it that intersection and it was on the corner. So the the fire was actually in the Charlie Delta corner, but I called it the uh Bravo Charlie corner because the front door is facing the the north side instead of the east side. And that threw off my directions.

SPEAKER_01 4:51

So I think we just need to call it from where the truck sits. And truck it truck needs to be A-side.

SPEAKER_02 4:59

Yeah, I think that would help a lot, especially in that situation. But then again, like when you're doing your file report, it's gonna have different it's gonna have a different um corner and orientation.

unknown 5:11

Yeah.

SPEAKER_02 5:12

But other than that, excuse me, I had to read Justin's chair. Um, other than that, I think it went really smooth. Apparently, I got a couple compliments. Not that I care, it just it was nice to know that I did my job like I was supposed to.

SPEAKER_01 5:26

Well, it helps your confidence in it. Because we don't find much fire. We really don't. And so when you get one, it's nice to know that

Power Lines, Positioning, And Rehab

SPEAKER_01 5:35

you know what you do know.

SPEAKER_00 5:37

Mm-hmm.

SPEAKER_02 5:38

Um, one thing I did remember from the last like structure fire pumped, which was the electrical um big power line that fell. I didn't I really watched for power lines this time. Um I parked just in front of the power line. Um I mean we kind of set rehab up over where the power line was, off to the side of the building, but it was dead by that point. Um, so I just you know, taking what I learned from one and moving it to the other. Especially a big event like that, because you know, we're really lucky on that one with the electrical, so I mean that was a pretty big but other than that, you know, I even got to spray a little water there for a little bit, which is not really happen when you're pumping.

SPEAKER_01 6:34

So and it wasn't little water too.

SPEAKER_02 6:35

It was no, it was a two and a half, two and a half in the side window.

unknown 6:40

Nice.

SPEAKER_02 6:41

But other than that, I think it went really smooth on my end.

SPEAKER_01 6:46

I didn't learn anything from the uh electrical because I walked right under that again.

SPEAKER_02 6:53

You did.

SPEAKER_01 6:54

Um it wouldn't I mean I did see it.

SPEAKER_02 6:59

Yeah.

SPEAKER_01 6:59

Um so when I got to that corner, I I pulled the line.

Nozzle Work, Hunt-The-Glow, And Pulling Out

SPEAKER_01 7:05

Felt really good about that. Mate went past the door to give me some slack and waiting for water, and I got water. As I was going to the door, I saw it sparking where it connects to the house. Mm-hmm. And I pointed it out to my captain, and I had that mental note from the last time. I was like, hey, look at that.

SPEAKER_02 7:27

Yeah.

SPEAKER_01 7:29

And but it was still connected to the house, so I was like, it it'd probably be okay. We'll get the meter pulled, we'll go get power cut off.

SPEAKER_02 7:37

This is the electrical fire, not this last one, right?

SPEAKER_01 7:40

I'm talking about the fire that you pumped.

SPEAKER_02 7:42

Oh, the okay, so it okay, yeah, yeah, yeah.

SPEAKER_01 7:44

So I had the mental note from the electrical fire. Right, okay. So I sprayed water out in the doorway, or sprayed water in the doorway, knocking fire out there, and then the door wouldn't open. There was no glass in it, so I reached in and tried to open it from behind. The doorknob would turn, but it wouldn't open, so I don't know if it was dead bolted or what, but it took me like four or five tries to get in that door, which hacked me off because you know, it's a burnt door. It should just, you know.

SPEAKER_02 8:21

Yeah, but 'cause there was a lot of fire rolling through that door. Yeah, it was pretty that corner was pretty engulfed. But if that deadbolt was engaged, I mean you can't really burned or not, you know.

SPEAKER_01 8:36

I ended up throwing all hundred and fifty-five pounds of myself plus gear through that door. And it came open. So you go. I was in there, I was knocking it off the ceiling and everything, off the walls. I was hunting hunt and glow, because the one that we fought back in February with Vali Department. Oh yeah, yeah, yeah. You uh you kind of mentioned something to me about hunt and glow.

SPEAKER_02 9:04

Yeah, so in real dense, heavy smoke, you you're not you're not looking at anything, but you're just gonna catch flashes of like red and orange here and there. So in dense smoke like that, you're just looking for a glow. You're looking for anything that screams, hey, I'm possibly on fire.

SPEAKER_01 9:24

So so I was I was uh I had that in my head too. So great advice from you, thank you. Thanks, appreciate it. Um glad it helped. And I was praying around the room, and I guess the breaker box or whatever was in the middle of the room, uh, still had power to it, and so when I hit it with the water, it kind of sparked. And I got told to pull out.

SPEAKER_00 9:51

Mm-hmm.

SPEAKER_01 9:53

Which I get, but I should have just went to a different part of the house and

Storm, Live Lines, And Big Sparks

SPEAKER_01 9:58

sprayed.

SPEAKER_02 9:59

Yeah, I think I think our shift specifically though, like let's just talk about the fire that we're talking about that we keep saying about the spark. So it was uh it was super rainy, it was storming. Um, you know, driving to the fire, it was heavy rain, could barely see in front of me, so I'm taking it easy. I get there, I pull up, I get out, and I still can't see anything. Um electrical fire in the back part of the house. Um I guess Charlie side where the electrical comes into the house. Didn't realize it at the time, but it was one of the big lines that fallen onto the house. Um one that carries the high voltage line. Um still pouring rain, still soaking wet. Rain had lightened up a little bit. We can kind of see, and um unknowing to me. Sorry, coffee came to revisit me. Um I'd parked, I didn't park directly under it, but if the line would have fell, it could have hit the truck. So um didn't realize that at the time I was more focused on the fire, and then shortly after that um the line grounded out, and it uh it just sparked really bad. Super big sparks, super big, not really fire, but just big sparks, big blue white sparks. Um I got a good look at that. Yeah, there's a video of it.

SPEAKER_01 11:34

Um talk to our training chief, see if that's something we could like share.

SPEAKER_02 11:39

Yeah, we'll uh we'll see if we can't put that up somewhere so y'all could see exactly what we're talking about. But um so I guess our shift's a little weary of sparking. Because you were what, five feet from it? Yeah. Yeah. I could have stuck a pipe hole to it. I was that close. Yeah, so but I mean sparking obviously we put ourselves in dangerous situations, but if we can avoid a dangerous situation like that, it's probably best to pull out. Yeah. Um as much as we don't want to. It's it's for the best because we don't want another incident like that one to go.

Fatigue, Carbs, And Fireground Endurance

SPEAKER_01 12:20

Yeah, I get it. So, but I shut everything off as I was trying to pull out. We're back to the fire we just recently fought.

SPEAKER_02 12:29

Right, we're talking about this one.

SPEAKER_01 12:31

I fell through a hole just inside that door that I went through. That was fun. Um but we got outside and they s by then everybody else had arrived. And we were setting up ladders and getting on roofs, and I took my mask off and I'm sitting there and I'm trying to catch my breath, and I realized I am deadbeat. And I've only done like eight minutes while I'm in the firefighter. And I'm like, there is no way. Because I didn't get like that during when I was in the academy. Well when did you go to the academy though? It was about this time. Okay. Um October 11th is when I graduated. It's still been colder. So like But I mean, as far as war clothing go, like they're you're wearing a pack all the time.

SPEAKER_02 13:31

Yeah.

SPEAKER_01 13:32

And you're doing work. I mean, I I didn't feel like that. But this time it was I've never felt like this before. I was just beat.

SPEAKER_02 13:41

Yeah.

SPEAKER_01 13:42

And post-incident, I got to thinking about it. When I started going to this diabetes doctor, I was counting carbs super hard, trying to avoid them, you know, where I could. Eating less than like 120 carbs a day.

SPEAKER_02 14:00

Yeah.

SPEAKER_01 14:01

And I gotta thinking about it. That's probably what it is.

SPEAKER_02 14:06

You think the carbs are are affecting like your physical fitness? Is what your end? Yeah, your endurance.

SPEAKER_01 14:15

Because I don't have the energy.

SPEAKER_02 14:16

I can see that. Um I really don't know. I mean I do, but I don't. I've never really focused on carbs, so I don't know the I mean I can see it being affected.

SPEAKER_01 14:32

Because carbs give you the energy fuel. Right. And that's what I was feeling. I wasn't like out of breath. I was just like weak.

SPEAKER_02 14:43

Yeah. I mean that I'm not gonna say physical fitness isn't important, but I think that you can't go too far with it.

unknown 15:00

Yeah.

SPEAKER_02 15:01

If that makes sense. Um I don't know the point I was trying to make. I had a point and it was in my forefront, and I don't think it came out right.

SPEAKER_01 15:12

I get what you're trying to say though, but since since that fire, I've gone back to the doctor and talked to her about it, and she's like, Yeah, you just need to eat more. I'm like, okay. And so now I'm eating when I'm at the station, I'm eating close to 300 garbs in two days. Told you to bring an extra ball, we were gonna tear it up. I know, we we pulled up on some wings and some sliders on game day Saturday.

SPEAKER_02 15:35

So but uh Oh, I know where I was going with that. That the um physical fit I'm not saying physical fitness isn't important, but like watching what you eat too closely in this line of work, like um, especially like those who want to lose weight, which is very important in the fire service, because I've noticed I don't know, I'm not saying all departments,

Diet, Weight, And Doing It Right

SPEAKER_02 16:05

but you know, you go to the fire department and generally you see um people talk about how there are you know bigger firefighters, and there's you know the cops get the same thing, there's these bigger cops, and we just sit around and eat and we don't really do much. Whereas you get to the point where you're like, okay, I need to lose weight, and so you diet and you start cutting calories and carbs and you're counting all this, and then like you said, you get to counting it, and then you have zero to no energy when it does come time. So it's one of those you have to watch very carefully. Yeah, that's where I was going with that. I knew there was a thought there, it's a balancing for sure, and it sucks. It does. But there's there's a right way to do it and a wrong way to do it, and I think sometimes you get the people who don't know how to do it, they do it the wrong way, and then like you said, they get to a fire scene and they're gassed. So um but yeah, I mean that's a very is is the learning experience for coffee. It's terrible.

SPEAKER_01 17:28

I think I think we need like a dietitian to come in.

SPEAKER_02 17:32

I yeah, um that or just somebody who wants to do the research, and I mean I got a couple people who know a lot about it that you know could very easily go in in each situation and be like, hey, this is what I think you need to do. The problem is they come in, they do it. I don't think people are actually gonna do it.

SPEAKER_01 17:55

Yeah. So but for the people that, you know, would do it, I don't think.

SPEAKER_02 18:02

I mean it'd be very beneficial.

SPEAKER_01 18:03

Yeah.

SPEAKER_02 18:04

Absolutely. And I have no doubt in my mind, the couple people I'm thinking about, if you went to them and asked, they would have no problems.

Small Departments: Learn From Every Fire

SPEAKER_02 18:12

Yeah. Just being like, hey, this is what we this is where you want to be, this is where you're at, this is how you get to where you need to be in a reasonable time frame. Yeah. But um, yeah, great, great experience for the the fire that we get, because like you said, we don't get very many. So the ones we do, you need to take and evaluate, especially for some of these small departments, like um, like us, um, Magnolia Camden, um, I'm not gonna say Pine Bluff because they fire fire all the time, but like these these smaller career departments when you get a fire, just to really take a step back, look at the entire scene from your aspect and everybody's aspect, and go, I have to capitalize on this, and I really need to focus on what went wrong, what went right, what can I improve on, and then taking a step back and going, okay, this is what I need to improve on. How am I gonna improve it when I don't have structure fires? So, like, say I were to have a problem with um the pump panel pulling three lines, you know, I've got not saying I did because I didn't, but if somebody were to walk in and go, hey, I ran into this issue when I was pumping. So when you go to check off your truck in the morning or that second day and you've got some downtime, just go out there and play with the plump, you know. Because like you said, we don't fight a lot of fire, so and then you run into another problem with that is people actually going out and doing it.

SPEAKER_01 19:48

So you gotta do your job and gain the experience at the same time.

SPEAKER_02 19:54

Right. So but great fire. Um I'm really glad we actually had a fire to talk about on this with the new direction we're going with the podcast.

Routine EMS Calls And A Hospice Code

SPEAKER_02 20:06

Um ambulance calls, nothing really super, you know, kind of run-in-the-mill stuff.

SPEAKER_01 20:14

Around that time we had a had a code that we can transition to the topic we want to do.

SPEAKER_02 20:23

I think that's a great idea. Um we did have a code. It was Lady on hospice. Yeah, I'm trying to think. It was late evening, right? Yeah, it's probably about eleven o'clock. Yeah, lady on hospice. Um just I think just got put on hospice, right? Not too long ago. I think so.

SPEAKER_01 20:49

Completely bedbound. Living with brother.

SPEAKER_02 20:54

It's either husband or brother, I don't remember. Sometimes. Um yeah, we uh get a call for an unresponsive um patient. We go in, she's laying on the bed. She um we can't feel a pulse. Um said she's been down for from the time that they called, so probably about three to five minutes, something like that. Um we get there, um, we evaluate, we start. Did you bring we brought the Lucas in, right?

SPEAKER_01 21:33

I had the Lucas set or like the backboard on the cot, right? It was all outside. Because I didn't know what what we had at that point.

SPEAKER_02 21:42

Right. Yeah, we were pretty prepped to work it, like we always are. Uh most of the time we would get an unresponsive patient. Um, you know, depending on who's driving the person in the back, because we run a three-man crew, which is super nice. Um, the person in the back will get a BVM, put it at the head of the cot, um, and then we'll take and we'll put the backboard down so we can just pick up place, and then when we get out to the truck, we can um just clip the Lucas on and free up some hands. But um, you know, being on

DNR Paperwork And Medical Control

SPEAKER_02 22:25

hospice, they said that she had a DNR, but couldn't locate one, is what it was, right? I'm remembering that right.

SPEAKER_01 22:32

Yeah, there was a DNR, but he didn't have a physical paper. Right. And that's that's what you need if you have a DNR. We have we have to have a physical thing that states DNR.

SPEAKER_02 22:45

Right. Or do not resuscitate. Um, we didn't have one, so we decided the crew, you know, we kind of mutually decided, hey, we're gonna work this in the house, wait for the paperwork. Um couldn't get the paperwork, no paperwork was found. We ended up um calling it on scene um per medical direction. Yeah um called a doctor. We got online medical control, but this is gonna go right into um the topic that we decided to talk about today is the disconnect from nurses, you know, hospital care to EMS pre-hospital care. Because um calling, you know, medical control. We had a nurse pick up, says um, if they're on hospice and they say they have a DNR, just stop. We we we can't do that. We have to have a physical copy, especially in the field, to you know, stop CPR, and I

The Hospital–EMS Disconnect

SPEAKER_02 24:05

think that they don't understand that concept. One, because they're not EMS, but two, they have medical control. They they can they can just go, hey, they say they have a DNR, they don't have a physical copy of it. What do you want us to do? They've been down for so long, and he'll be like, oh yeah, call it. And then he fills out his side, and you know, we don't have that luxury in the field, we don't have an MD, we don't have medical control, we have to call, we have to, you know, do A, B, and C. And so there's a big disconnect from you know, nurses in the clinical setting to EMS in the pre-hospital care, and I see it all the time, especially when I was doing clinicals. I would I worked along some nursing students. Obviously, my fiancee is in nursing school, but you know, she's she's in EMS, she gets it. She's um she's a dispatch, she does dispatch and she's an EMR. So like she understands like some of the protocols, she's gonna end up going and getting her EMT. God bless her. Um, she's even talked like dabbled into getting her paramedic, which she'll be better paired prepared than I was. But they don't fully understand the EMS and what we do. Like they get like, oh yeah, we go pick up the patient and we bring them to the hospital. And I think that's all they see us as is just this glorified taxi service. Glorified number, yeah. And it's ridiculous. I don't know how much you've seen um of it, but it it's even gone as far as when you bring a patient in and you're like, hey, this is what we got, this is the sign of symptoms, this is the vital signs that we picked up, um, this is the history we got. And then, you know, the nurses they ask us a question like, Well, did you get this, this, and this? And you're like, no, we did we just didn't have time. How did you not have time? What do you mean, how did we not have time?

SPEAKER_01 26:32

I remember a question vividly. The only time I've heard it is we brought in a code before, and the question was, did you what's their blood sugar? Like, we could a billion other things we're trying to do. Blood sugar and temperature is not really on my agenda at that point.

SPEAKER_02 26:54

Right, especially on like a full code.

SPEAKER_01 26:57

If we're pumping chest, I don't really care what their blood sugar is.

SPEAKER_02 27:02

Say you've got a 300-pound patient. I

Codes, Priorities, And Not Enough Hands

SPEAKER_02 27:05

mean, yes, a blood sugar is important. Absolutely. Don't get me wrong. But if I don't have circulation, there's no re I can't a blood sugar's not gonna help them. Is it gonna affect in ROSC? Absolutely.

SPEAKER_00 27:18

Yeah.

SPEAKER_02 27:19

Um but it at this point in time, you know, we've we started compressions. If they're big enough, we can't get a Lucas on. That's two hands out of the equation, you know, and for two-man crews, I can't imagine. I haven't worked a code at private EMS yet. I'm not gonna lie, I haven't done it. But if you can't get a Lucas on, then Lucas or um an autopulse, I think is another good uh brand that they use. Whatever you use, you've taken two of your six hands out of the equation. So you've got um you got a BV, you got you gotta breathe for them. You haven't got a tube in. It's two more hands.

SPEAKER_01 28:06

You gotta get somebody to do the report. Well, I mean like to the hospital before you get there.

SPEAKER_02 28:13

On pulsar, exactly. You know, pulsar, you know, um you know, if you use something like pulsar where you send it in and you've gotta type everything out, I mean there's just no there's not enough time. Or you've got to decide what is most important. I'm not saying there's not enough time because right, you've got to go, hey, I've got this 350 patient. I can't get the Lucas on, and you know, two-man crew, you're like, what's more important, circulation or breathing? Well, in that point, it's gonna be circulation with breathing every once in a while when you've got a free hand. Um, you know, for us, it's definitely a lot easier because we've got six hands in the back. We can, you know, I'll have just we'll just use our crew, for example. You can be pushing chest, I can be BVMing, and then you know, our captain can be starting an IV, getting that going, everything runs smoothly, and you have no one to send in a pulsar on. Now, when we used to call it in, you know, you can sit there, have call in, put the thing on speaker and go, hey, we've got A, B, and C, we're currently doing compressions, it's a big patient. Um, and then give the report that way. But I just don't think that they fully understand everything that goes into this scene when we pull up, especially if it's a hectic call. And I'm not talking about like the patient. themselves being a hectic call, or like sometimes family makes things so much harder than it needs to be. I go to a patient, and you know, say it's an older patient, and the family's there, but they don't show up all the time. We're like, hey, what's he got medically? What kind of medications are he on? Oh, I don't know. We only come in once a month. Or last time we were here all the time, which was like six years ago, he had this and this and this. I don't know if you know, but in six years a lot can happen.

SPEAKER_01 30:35

Absolutely.

SPEAKER_02 30:35

You can be taken off medication, put on medications, new medical problems. It's just

Chaotic Scenes And Poor Historians

SPEAKER_02 30:41

you don't get good historians. The patient doesn't give you all the information, and then you're trying to do, you know, start a line, and you're trying to, you know, get vital signs, and with a you try to stay within a 10-minute scene time, but with all the hectic stuff, sometimes it drags out a little longer, or you're like, we just need to go. And nurses just don't get it.

SPEAKER_01 31:15

I feel like so I think part of nursing school, and correct me if I'm wrong, I think they should have a mandatory ride time.

SPEAKER_02 31:27

Absolutely.

SPEAKER_01 31:27

I've been they need to ride in air they maybe not. Maybe there'll be a a little bit of time where they have to stay the entire night. Because sometimes those chaotic calls come in at night. And so you don't have to do it all the time, but you have a mandatory ride time with so much overnight. And they do that, that way they see both sides. Because they work, they work in a zoo. I get it. That it's it's chaotic there, and it can get bad. I've seen it bad. They're in organized chaos, and I feel like we're in more of a unhinged chaos. Absolutely.

SPEAKER_02 32:16

Um, and the problem you run into, because me and Anna have had this conversation too, she even pushed for you know nursing her class to do right time. And the problem you run into is that whereas the small colleges, like, you know, you get these communicated colleges or these small universities like SAU, they're one of they're like the biggest small university or whatever, whatever their title is, they're considered a small university. They get like their policies and procedures from like the national nursing, you know, curriculum society or whatever, or the Arkansas, you know, nursing board or whatever, that dictate what they can and can't do during their school year. And so nursing school is a long drawn out, lot more information like paramedic school is. It is a very strenuous, difficult program because you're running 90 miles to nothing, you have to learn all

Mandatory Ride Time For Nurses

SPEAKER_02 33:35

this information, you have to, you know, you've got to have all these things check marked, and for some reason, there's no time in the world that the board has dictated for nursing students to ride on an ambulance, which is wild for me because in paramedicine, when I went through paramedic school, I had to do 60-70% of my clinicals in the hospital or in a clinic, or you know, I had to do so much ER, ICU, I had to spend some time in labor and delivery, and I got to see what all the nurses do, how they run, how they operate, as well as riding on an ambulance. Mainly because that's what you know, that's where I'm gonna be. Right. But they don't see, and this goes back to a worldview, not just nursing students, it goes to a view of like I stated earlier, we're just a glorified taxi service, and you see it based on the calls we get, like we'll get called for someone who you know doesn't feel well, has a headache, got a toe pain, this, that, and the other, and all they want is a ride to the hospital. What stopped you from getting in your car and driving to the hospital? Not saying I'm not gonna come pick you up. Right. Because I will. I will come pick you up all the time, but then again, let's let's take a look at what's going on and going, hey, do I really need an ambulance or do I just need to drive myself?

SPEAKER_01 35:33

But in their head, they are having the worst day because they don't know what's going on.

SPEAKER_02 35:41

Some of them aren't having the worst day though.

SPEAKER_01 35:44

But in their head they think they are.

SPEAKER_02 35:46

Yeah, I mean, and I get that too, but I don't know. It's super frustrating because, you know, as before, and you can correct me if I'm wrong, but when I got into this perfection, perfection?

SPEAKER_01 36:02

It's not perfection.

SPEAKER_02 36:03

It's not perfection. When I got into this profession, I wanted, you know, the traumas, the the cardiac arrest, the NVAs, the, you know, the stab wounds, the, you know, the the bad

Patient Choice, Policy, And Friction

SPEAKER_02 36:22

stuff, which is terrible to say, but I want I got in this because I wanted to help. I wanted to fix problems. I wanted to make it better. Whereas now I've gotten to the point where I can identify the problem, but there's nothing I can do to help. I can't, you know, you tell me you have a headache, okay, there's not much. I I can take you to the hospital and they can give you medications for that, or they can give you, you know, if it's bad enough, they can give you a CT, they can give you an MRI, they can, you know. Here's water and a Tylenol. Right. I can't do that.

unknown 37:07

Yeah.

SPEAKER_02 37:08

I can drive you there, I can get vital signs, I can start this process, and I can probably say, hey, based on your vital signs, and based on what you're presenting and how it's going, this is probably what they're gonna tell you is wrong. But that's it.

unknown 37:26

Yeah.

SPEAKER_01 37:28

And we get you there and they go through all their stuff and then they hand you a bill.

SPEAKER_02 37:33

Right. Like it it's just frustrating because they teach us in school, EMT, paramedic, AEMT, EMR, here's what, here's the bad stuff. This is how you fix the bad stuff. Go out and do it. And then you get the bad stuff once a month.

SPEAKER_01 38:01

If that?

SPEAKER_02 38:02

Twice a month, maybe, if you're lucky. No, well, not lucky. Lucky's probably a bad word. But like, if it happens. If you're fortunate. Yeah, if and I don't know. There's just and then people get upset and they say, well, the healthcare system's broken because they didn't do anything. Because there's not much we can do. You know, you gripe and complain that, hey, the ambulance didn't do anything for me, and they gave me this, you know, $1,500 bill. It's not that high, but you know. What did you expect us to do? Our policies and for seizure state we can do A, B, and C, and you need X, Y, and Z. I don't know if you know, but there's a big gap between those letters. Or there's about 20 different letters that come before what you need. And I I don't know. But there's there's a big disconnect between mainly nurses and EMS, but also the world in

Onboarding Fix: Nurse EMS Ride-Alongs

SPEAKER_02 39:20

EMS. And it's just frustrating.

SPEAKER_01 39:26

But it's probably been like that for you know two hundred years, and it's gonna be like that.

SPEAKER_02 39:32

We haven't even been around that long.

SPEAKER_01 39:34

Well, as far as people giving care to other people, that's been going on forever.

SPEAKER_02 39:40

I g yeah, I can see that.

SPEAKER_01 39:45

We'll just say a hundred years, and it's gonna be a thing from the end till the end of time. Yeah, I don't because you can't make everybody go through an EMR class growing up.

SPEAKER_02 39:59

No, you can't, although sometimes I wish they could. I don't know. I feel like how much time we got? Because I really I I could spend hours on this.

SPEAKER_01 40:10

Oh we have 40 minutes.

SPEAKER_02 40:12

We're for okay. So I'm gonna say, you know, we've talked about the ER nurses and ICU and MedSearch and those nurses in a hospital setting, and then we've we've kind of talked a little bit about civilians. Those more than more so not as important because they haven't had medical field training. But another area I see nurses not understanding is in the nursing homes.

SPEAKER_01 40:41

Yeah, I feel like that's a pretty big topic that we could have just a whole episode on.

SPEAKER_02 40:46

Well, like next episode that's what we're gonna talk about. We're gonna talk about the nurses' home. So let me let me let me go back to ER and ICU and the hospital care. They have this, they also have this mentality that if we don't give them the information that they need, what was the point of us even showing up to their ER?

SPEAKER_01 41:15

Because we have a legal obligation to do so.

SPEAKER_02 41:21

Just because we didn't give you the information that you needed or you wanted doesn't mean that we didn't do our jobs, and that's frustrating. Because it's almost as though we don't even need to exist, which in some situations when we bring patients to them, you're right, we didn't need to exist in this, but that goes back to the is this a really emergency? But don't get mad at me because either A, I didn't have time to get that information, B, the patient didn't give me that information, or C, the family's a terrible historian and knows nothing about the patient.

SPEAKER_01 42:02

I've seen that too.

SPEAKER_02 42:04

It's not my fault, and you shouldn't be mad at me for something I can't even control. That's a problem as well.

unknown 42:16

Yeah.

SPEAKER_02 42:18

And then not so much for our department, but you know, in the county over that I work for that's private, sometimes we have to bring patients from our hospital that we would normally take them to in the county over to theirs. And it's because they have ortho on call or this, that, and the other, or it's patients' choice because you know, outside of outside of El Doreda, you know, our policy state we go straight to, you know, our hospital here in town. But you know, private, they have a choice where they want to go. And if I bring in a patient and I'm like, hey, they've got this, this, and this, this is what they want, this is what we got. Well, why'd you bring them here? One, it was either their choice and that's where they wanted to go. Well, why couldn't you just take one, this is where they wanted to go. They have that, they have that right to get care at the facility they want to get care at. Why just don't under it's not okay, cool. You may not understand that may be something you need to work on personally is you know, get educated. Why do I have to know hospital policies and procedures? But y'all don't have to know my policies and procedures.

SPEAKER_01 43:50

So I had a thought just now, and that would be my last thing I say. If the state nursing board won't allow time to let students do right times, what if it would be on the hospital or whatever clinical setting make that part of their hiring? You gotta go through all of this, you know, pre-boarding stuff, but you have to do so much ride time with the local EMS that you're gonna be working with the most. You have to do so much ride time with them. I've never had that thought. That way you skip you you get you meet the state and the national certifications and their requirements and you check those boxes. But whatever clinical setting you're in, they set it up to where you have to go ride with the local EMS.

SPEAKER_02 44:54

As an orientation or an onboarding process.

SPEAKER_01 44:59

That'll

Closing And Listener Feedback

SPEAKER_01 45:00

make you a better nurse, that'll make you understand what EMS goes through.

SPEAKER_02 45:06

I mean, yeah, that's a that's a solid point, actually. I've never had that thought.

SPEAKER_01 45:13

And now it'll be on the hospitals to to do that. And if they want good nurses, then you know.

SPEAKER_02 45:35

Because yeah, that'd be an easy thing to implement. Like, hey, your next shift, you know. I mean, it's one shift.

SPEAKER_01 45:47

It might put some constraints as far as staffing, maybe.

SPEAKER_02 45:52

But it's one shift.

SPEAKER_01 45:53

But it's one shift. I don't know. Just a thought I had just now. Blind squirrel find a nut here and there.

SPEAKER_02 46:04

Yeah, that's pretty that's not a bad idea. As an onboarding hiring process, you have to spend X amount of times with X amount of calls, like you do for EMT. Like you gotta at least spend at least 24 hours overnight at a you know, EMS facility with at least four calls. Yeah. So that's a good idea. I like that.

SPEAKER_01 46:36

That's all that's all I had.

SPEAKER_02 46:38

I think I think the podcast has gone in the right direction now. I like today's topics.

SPEAKER_01 46:43

I felt like I talked a lot, but but it was about stuff that was impertinent to the job.

SPEAKER_02 46:51

Right. Anyway, that's all we got for today's episode. Sorry it's been a month. We've been trying to figure out some stuff and um, you know, like I said, point this thing in a direction that's more focused on you know, EMS and firefighting. So um, like always, if y'all enjoyed the episode, let us know. If you've got comments, concerns, or you want to see um it's specific. Right. If you want us to talk or uh hear something specific, write us in. Um I've got fan mail up, so if you send us a message on you know Apple or Spotify, it shows up. We can read it, we can talk about it, and um have a good rest of the day.

SPEAKER_01 47:42

I know I'm gonna try to.

SPEAKER_02 47:44

I'm gonna try to.

SPEAKER_01 47:46

Yeah, have a great day. Deuce. Thanks.