Middle of Nowhereness

I've been thinking that some of what I post may not be that interesting to people who have a lot more experience, or who live in an urban area.  Ah, well, it is what it is. Life is... different out here. Part of why I'm blogging at all is to share the experience that comes with my situation.

I've been playing with a couple of lists, things I do and don't have to worry about here, that might be different from a lot of you. They aren't anywhere near complete, but it's what I have so far, so I thought I'd share.

We're a small volunteer ILS non-transporting agency, in the middle of nowhere.

Things I Do Not Have to Worry About:

1. What to do with down time on a slow shift. No shifts.
2. Being "posted" somewhere.
3. Whether or not to call for ALS backup; it's automatic.
4. A high crime rate.
5. Frequent flyers- at least not nearly as much as more populous areas.
6. Not being able to figure out which apartment a patient is in. Very few apartments.
7. How much I'm paid, or whether I can get the vacation time I prefer.
8. Being observed by a supervisor.
9. Language barriers: rare out here.
10. Choosing which hospital to go to.
11. Patients anywhere higher than the second floor.
12. Heavy traffic.
13. Traffic lights. We don't have any. There are only two intersections with four-way stop signs.
14. Nursing homes or schools; we don't have either.

Things I DO Have to Worry About:

1. Going to a call alone, without a radio.
2. Overall having little help.
3. Seasonal roads that are at times impassable.
4. Waiting a LONG time for law enforcement. Availability is limited.
5. Not being able to get to a patient in time to help: furthest house from here is over 15 minutes.
6. Running out of gas on the way to a call in my personal vehicle.
7. A call being for someone I know. It is almost a given.
8. Whether or not the helicopter can fly: nearest trauma centers are 50-75 minutes away by ground.
9. Waiting a long time for an ambulance to get there. Sometimes they get lost.
10. Finding unmarked houses down long dark roads and driveways.
11. Having the only other responders be people with little to no training.
12. Hunting accidents way off the road and/or people lost in the woods.
13. Elderly people living alone in isolated houses without nearby neighbors to check on them.
14. Calls phoned in by a passerby who has no idea where they actually are.


I'm not saying no one else has to worry about the things we have out here, but urban/paid and rural/volunteer EMS definitely have some differences in what things are most likely.