Refreshed. (And still) Real.

I did it. I turned into what alot of other bloggers are: silent.  I put a few posts out there, and then I disappeared. As you will recall I was feeling a little "crispy" at Christmas time and made a vow to come back refreshed.  Maybe it just took until March to get refreshed. Maybe I was busy. Or maybe I was just scared that what I wanted to type probably wasn't appropriate for most professional work environments.

Anywho- I am back. And refreshed. And according to many- still real.

What started out as an incredibly crazy idea to put South Dakota on a web based television show to highlight our STEMI system of care turned out to be the real deal.  If you haven't yet had the opportunity to see the first episode of "Code STEMI" that made it's national debut thus past week,  you can click here, on the  First Responder Network's website.  You should pop some popcorn and grab your favorite beverage and take a look at this.  My friends Tom Bouthillet from http://www.ems12lead.com/ and Thaddeus Setla from First Responder Network and their trusty companion behind the camera ( I only know him as "the Dridge") made the trek to South Dakota to see first hand not only our beautiful state, interview local STEMI champions, and meet a STEMI survivor, Mick Stanton, (yes- he has agreed to have his name out there for all of my HIPPA peeps)- who one year ago would have had a different outcome. 

You see, prior to the $8.4 million grant that our state received for our STEMI system of care- care would have gone like this: 911, EMS arrives, does a 12 lead but not able to transmit, no activation of "the system"  until the EKG was performed in the ER, then to cath lab after that.  Because of a wonderful gift and some really ambitious people-  that system has literally, changed overnight. Because of prehospital activation with the transmission of a 12 lead, a door to balloon of 19 minutes was achieved. Not 80 or 90 minutes after arrival, like it might have been prior to the grant.

Aside from what my daughter called "stick up hair" in my portion of the interview- I think it came off pretty well.  It has been an honor to be a part of a project that is truly having a first hand impact in saving lives right here in South Dakota.  Several of our local health systems, EMS systems, and even some old coworkers were highlighted.  South Dakota has received a rap for being "out in the sticks" and "a bunch of rednecks"- I think Tom and First Responder Network for setting the world straight on the first class health care available to the 750,000 or so people that live here.

I have continued to learn a ton in this journey. I am learning those that wanted to befriend me early on in the project maybe did so for less than moral reasons. I have learned its hard to figure out who your "people" are when you are in a completely foreign world- aka not a hospital. I am learning my family still has a hard time adjusting to the extensive travel.  I am learning that we all need an out- mine has become remodeling old houses. It's how I am spending my weekends.It allows me to think about something completely different than what I do all day long.

With that, I would like to give a huge thanks to everyone along the way who has helped this project come as far as it has. This project always has been, and always will be about the people of South Dakota. Those EMT's that leave their jobs, homes, and families to answer a chest pain call all the while volunteering their time. For the physicians who have championed this from the beginning. And especially for the "Mick Stanton's" of the world- there are hundreds of thousands of him across the nation, begging for "the system" to work for them too.  That's the beauty of the heart- if we intervene early enough on chest pain we can fix it.......

I leave you with this.  You see, she's cheaper than a therapist, doesn't talk back, appreciates the work I put into her- and hopefully will give me a little extra cash when I am done with her make-over.  Yep SoDak's version of HGTV's Rehab Addict and NurseMomSTEMI- that's me.

Crispy.

Crispy. I used to have a boss that would use this word to describe her/me/us when we were getting a little "burned out".  She would use this word to describe our mood and demeanor in the hospital when we could not take one more question, comment, concern, or complaint without the accompanying eye roll.  Today, I recognize that I am crispy. 

I am not burned out. I have a passion for rural STEMI care that is unwavering. What is wavering, is the belief that we will ever (simply) be able to get the EKG from Machine A, Machine B, and Machine C to ever filter through one (simple) "system" at the local hospital.  You see, I am having a "dickens" of a time (cleanest word I could come up with) in understanding why my new iPhone 4 can do all but make me a peanut butter and jelly sandwich (although Siri can GPS me to the grocery store, make my list, and then get me a YouTube video to walk me through the steps of making the PBJ)-yet I cannot help a local paramedic in a predominately BLS/volunteer/rural environment get his 12 lead EKG from point A to Point B (small Critical Access Hospital) and then (simply) pushed forward the 200 miles to Point C (the STEMI Receiving center) without utilizing technology that Zach Morris would have used at the Peach Pit on Saved by the Bell. (On a side note, If I have to listen to one more medical device sales person tell me of their significant other "scratching the Lexus", I am going to puke. On their shoes. And not apologize.)  Apparently I am crispy on that topic as well.  I have alot of time to think while I'm cruising around in the Mom Bomb (the Impala with 150,000 miles on it) trying to figure out STEMI care in our state.

Yes people, I am crispy. I am Kentucky Fried, crispy sick of the corporate entities that are driving (or stalling) STEMI care in the world. Every day I ask Steve Jobs for a message from the grave.  For if anyone can solve this problem, I remain convinced that a 19 year old intern at Apple can come up with a way that a 12 lead EKG can (simply) be sent to where ever I want to send it no matter what brand of monitor I purchased-  without the equivalent investment of a college degree.  My new friend Tom Bouthillet at
ems12lead.com summed it up quite well recently.  He told a story of buying a toaster. You see, whether we buy a $9 toaster on Black Friday or a $90 toaster at Macy's, I can bring it home, set it on my counter and plug it in.  The beauty is that it will work in my outlet.  The outlet doesn't care what brand the toaster is, or where we bought it.  It is just simply there as a universal adapter to supply it power. Interesting concept, huh? Too bad our own world of Medicine cannot do the same thing.

With that being said, I am going to be taking a little time off. By January 2nd, I promise to come back energized and enthused about finding a solution for this problem.  I also have a new saying “Unless someone like you cares a whole awful lot, nothing is going to get better. It's not.” ― Dr. Seuss.  With that being said, I look forward to the upcoming year and all of the adventures it will bring. I look back on the past year and realize how much my life has changed. I am thankful for the people I have met- those that want to change the world as much as I do, and those that remind me when I am crispy.  Merry Christmas folks!

Curly Hair and STEMI Care

Confession #1: My hair is curly. Over the top, ridiculous curly. I fight it every possible step of the way and recently a very astute young hairdresser told me to "stop fightin what the good Lord gave ya"!  I'm not there yet but I am giving it some serious thought.

Confession #2: Curly hair got me thinking about STEMI care. Especially after this recent article Reducing STEMI transfer times proves difficult was published this past week.  The article asks people to take a second look at lytics for treatment of STEMI and stop referencing that treatment as the "red headed step child" of STEMI care (OK, I added that part- but I believe it's the truth). Humor me and read through this post and I'll tell you how these two confessions connect.

How can the two of these possibly be related you ask?? Let me break it down for you.  There are places in the nation where we are doing a crappy job of getting patients who could be within the window for primary PCI, out of their referring hospital and into the primary PCI center within the 90 minute window.  As a tax paying citizen of this country, I say shame on you! If there is an option for a PCI center just a couple of miles down the road- I pray that your medical community comes to their senses and endorses the bypass protocols you need to get there.

There are also places in the nation, like the great state of South Dakota- where I think that we need to get the rest of the world to understand that we have stopped fighting what the good Lord gave us.  What does it mean? It means we are a lytic state.

That's right people, if you are a resident of South Dakota, or passing through (perhaps on your way to the infamous Sturgis Motorcycle Rally), and have a STEMI and land in a referring hospital, you will get lytics.

You will get lytics, you will get them under the 30 minute window, and sent down the road for your PCI. Are we still aiming for a Door In Door Out time of 30 minutes? Yes.
Here's why:

• 6 PCI centers in the state (3 are in Sioux Falls, 1 in Aberdeen, 1 in Watertown, 1 in Rapid City
• Distance to the PCI center (Up to 250 miles in parts of the state)
• 4 helicopters that cover the entire state (2 in the SE Corner, 1 in the SW corner, and one in the north central part of the state)
• 3 fixed wing airplanes in the whole state
• An 80% volunteer, BLS EMS environment in the state

Keep in mind South Dakota is 76,000 square miles.  You could put 40 states the size of Delaware within the South Dakota borders.

Yep, there comes a time when you stop fightin what the good lord gave ya. That doesn't mean you aren't going to have the most bitchin, beautiful curly hair and the best STEMI care you could ask for! 

Happy Holidays my friends......JD

Real.

Three times in the past three weeks, and by three different people I have been referred to as "real".  It got me thinking, what does that mean and was I being complimented or insulted?  I'm going to take it as a compliment and run with it.

What is real in the world of Nurse. Mom. STEMI.?  Here goes, whether it is in healthcare or life, I firmly believe in a saying that one of my favorite family practice residents of all time used- "You can't polish a turd."  Laugh if you want, but it's true.  I believe in healthcare we make two crucial mistakes.  We do not admit when we suck, and we do not celebrate our successes nearly enough. 

I have watched many nurses, doctors, EMT Basics, Paramedics, therapists, PA's, NP's-you name it-come and go over the past 16 years.  I still look back and think fondly of those that looked me square in the eye and said "I think I screwed up." Now keep in mind those numbers are small.  But it takes alot to admit a screw up, especially in healthcare.

Take the topic that my life surrounds, STEMI.  Across the nation (and the world by the looks of who is reading this crazy blog) people are trying to do things better and faster in regards to STEMI.  What seems crazy to me is that rarely will we, in this world of competing health systems, let our guard down and share our "suckiness and our successes".  There is a small piece of me that believes if we could all get together in one room, put a couple 30-packs of Busch Light on ice (South Dakota beer), and tell our stories- we would accomplish more than we would give ourselves credit for. 

So back to the topic of "real".  South Dakota STEMI care is on a journey to greatness. Are we there yet? No. Are we on the right path? Yes.  Can we learn from what others have to offer? Yes. Can they learn from what we have to offer? Yes.  So let's just get real and admit what our barriers are and work together.  I love to visit with people as I travel and get their take on their STEMI program.  I'll visit with anyone who will give me 5 minutes.  (I particularly like the lunch lines at conferences to visit.)  While I admire those that are wonderful, I sometimes learn more from those who say "Boy we suck at our First Medical Contact to ____ (fill in your data point of choice)".  When people are willing to knock down those barriers, we find that we are all fighting the same battles.

On the topic of life and being "real".  I did take the past two days off and have worked really hard at not "working".  I did something I never do, I baked.  The yummy smells of caramel corn and puppy chow (that's a Midwest treat I'll share with you someday) currently fill the house.   The kids just walked in the door from school and said "Mom, it smells funny in here."  Welcome to the life of the working mom. Yep, ya can't polish a turd.

Day 1 of Blogging.

Well, here goes.  I am officially a blogger. Kinda feels like the first day at a new job when you don't even know where the bathroom is.  I am not a distinguished writer, I do not have alot of letters behind my name, and I almost flunked my college English class.  With that being said, I wouldn't be doing this if I didn't think I had something to offer.  In fact, on my life bucket list reads #3: "Change the world".  Right after #1 and #2 which are "Lay on the beaches of the Carolina's" and "eat BBQ in Memphis".   Deep, huh? I believe health care, particularly EMS and ED's have an opportunity to change STEMI care and change the world at the same time.  In a recent conversation, I learned others have the same goal.  Well, maybe not the BBQ or the beaches-but they do want to change the world.  I carry some hope that these blogs are a step in the direction of changing the world.

First, I suppose I should give you the lowdown and me, my history, and why Nurse. Mom. STEMI. has come to be. I have worked in healthcare for 16 years. Actually aside from waiting tables it is the only thing I have ever done, and more importantly the only thing I have really ever been good at.  I once had a frequent flyer patient that I got to know really well tell me "Jodi, I think you are a much better nurse than you are wife or mother."  The funny thing was that I didn't take any offense to it.  I knew exactly what he meant.  Healthcare and caring for people comes very naturally for me.  Being a wife and mother is something that I constantly have to be working at. 

As we all have our journeys in healthcare, mine has taken me to building a heart attack system of care for our very rural state, South Dakota.  I titled this blog: Nurse. Mom. STEMI. because those three things dominate my life. Whether we ever care to admit it or not, work is one of the biggest parts of our lives. Like many others, I think sometimes my priorities get blurred. 

I have not yet decided if this blog will be educational for you, or therapeutic for me.  Maybe it will be both.  In the last year I have become a "secret blog follower" meaning that I follow more blogs than I care to admit to.  I don't read books, I read blogs.  I have always believed if you want to succeed at something, you should surround yourself with those that do it well.  In the last months, I have been fortunate enough to be in the company of some of the best. And last night I decided it was time to join the masses.   So while driving home from my dad's 60th birthday party, Nurse. Mom. STEMI. came to be.  Thanks for following along with me on this journey.