Leaderboard

I hate absolutes, and have in fact found that any time that I try and construct one the EMS Gods swoop down and make me look like a bigger shithead than usual. Never palm the breast in a 12 lead, never lie...never, never, always, always, yadda, yadda. I believe it all resolves around your moral and ethical intent. Tonight I had a breathing difficulty patient. Long time COPD, lung sounds silent in all fields, resps of 36 and shallow. Despite all of my best efforts, BVM through my CPAP and emptying my med bag into him via one route or another he was crumping very, very fast. He asked, "goin'........................to............die?" I said, "No worries brother, we're pushing it back. Can't you feel it?" But yeah, there was almost no doubt in my mind that he was going to die before I got him to the hospital. He didn't, thanks in almost no part to me, but what I really didn't want to do was tell the truth, add to his axiety and increase my already shitty position. So those that believe that lying is 'always' bad...was the better answer then, "Yeah man, I'm afraid you're going to die, I just can't get ahead of this thing.'? Whatcha think? Dwayne

I disagree for the EMT-B test. Often the CNA requires more hours of training and in some states such as Florida there both a written and skills portion with both being offered in Spanish. The EMT-B is still a 110 hour tech cert in most of the U.S. It requires no college. If the person chooses to go past this cert and enter a college then they should meet the English language proficiency standards.

It goes on the right shoulder below your state patch. That was what was in the instructions when I got mine. However, that was ages ago ! I've not worn mine though ever as every employer I've had has had us place patches on both shoulders and didn't want anything below 'em. I highly suggest what AK said - that keeps it from getting lost. A word to the wise though - keep your certs up because they are a pain to get back if you drop them and it is a little easier to move around with NREMT than without. Look forward to seeing you on the streets !

I agree that lying to a patient (in most circumstances) is not the professional method to 'get someone to the emergency room'. We had a thread here recently that discussed points similar to this one and I cannot find it. Anyways, I will repeat what I said in that thread. For starters, I will post the definition of coercion. co⋅erce [koh-urs] –verb (used with object), -erced, -erc⋅ing. 1. to compel by force, intimidation, or authority, esp. without regard for individual desire or volition: They coerced him into signing the document. 2. to bring about through the use of force or other forms of compulsion; exact: to coerce obedience. 3. to dominate or control, esp. by exploiting fear, anxiety, etc.: The state is based on successfully coercing the individual. Pay special attention to number 3. Exploiting fear, anxiety, etc, to dominate or control. In essence, getting the patient to do what we think is best for them. Another way to say it, and this one of my favorites which was stolen from DwayneEMTP, 'gifting them with our advocacy'. We, as professionals, have an obligation to respecting the freedom of choice concerning our patient's bodies (if they are capable of making decisions for themselves). We, as professionals, have no right or obligation to scare patients into going to the hospital because we know or think it is best for them. The decision is and should be their decision to make. Telling patients things such as 'you will die if you do not come with us', especially being a small remote chance, is coercion at its finest. Informing patients about complications of their medical condition is one thing, using those complications to promote your agenda is something entirely different. The same holds true for those who threaten medical procedures. 'Wake up or I will put a big needle in your arm' or 'tell me what pills you took or I will have to shove a tube through your nose to your stomach' or 'you will die if you do not hold still' etc are all forms of coercion. We should honestly take a look at how we talk to patients. Sure, compliance may be easier if you use coercion. Taking a moment to talk to your patient, explain to them the why behind why something is warranted go a whole lot further with patient interactions than using some of the above phrases. Matty

I have read this last part of the thread, and I really don’t know what can come from this discussion. The education of a nurse and a paramedic are different. Maybe in the community college the pre-requisites are the same or similar, but the core classes are different. As far as I know, ADN nurses do not need chemistry courses, but require a biology/microbiology course. I think this is not required for AAS paramedic yet is it, it wasn’t for mine. I think these go a long way to understanding the base of disease and treatments, certainly from an outcome standpoint. Most nursing pharmacology courses are much more in depth than the paramedic curriculum, if you attended the same course as nursing, count yourself lucky and in the majority. Paramedic training, education if you are lucky, focused on emergent, short term care and taught in a very medical model. Find the problem, focus on the problem, and fix the problem. Nursing is a more holistic assessment and treatment process, and brings into this process a lot of psychosocial and less tangible factors than medicine. I think you can assume, and you would be correct, that the nursing model incorporates many aspects of the medical model; plus the additional factors of home situations, recent lifestyle changes, ability to care for oneself, support systems, etc. None of which would be taught in any paramedic program I have been associated with, although they are all proven to affect the healing process significantly. The additional education in psychiatric nursing is far beyond anything you will see in paramedic school; community health is non-existent in any programs I have seen; geriatric medicine is a specialty barely touched upon in paramedic education, but what percentage are the elderly in your patient logs? Pediatric education is severely lacking in the paramedic education, but is a primary course in nursing; how many pediatric clinical rotations were in paramedic school? There is a depth and breadth of education issue, I believe, at the heart of the question at hand. Nursing education is much deeper in detail and wider in breadth than that of a paramedic. Simply a difference in curriculums and focus; the intent was never to have a paramedic perform long-term care, as far as I know. As far as skills; monkeys can learn skills and perform repetitive tasks, but thinking through the technology and how it is going to affect the patient is certainly dynamic and an exercise in critical thinking. During all the “clinical” in the ICU, CCU, Stepdowns, med/surg, etc; how much time did you spend actually caring for a patient, talking to the patient and their family, assessing the treatment plans, adjusting the plans accordingly, conversing with the physicians and students and interns….. I still believe that there is a big difference between the “education” a paramedic attains and that of a nurse. Most paramedic programs are based on training that, like it or not, is based on cookbook type medicine. The average paramedic school graduate doesn’t not have the education that an average nurse has, and I can also pretty much guarantee you than a well educated paramedic would not have anywhere near the education or training that a well educated and trained ICU, CCU, or other intensive care based nurse would have, unless they were also the latter. This, of course, would start the micturation competition you were not looking for. As both a very educated paramedic and a fairly educated nurse, I can assure you there are differences between nursing and paramedic. Both have their place in the health machine, and are two totally different animals. Although I don’t think nurses should insult a profession they possibly know little about, if the nurse worked in the ED for any length of time, the insult was likely warranted. You say you are educated to a much higher level than most paramedics (medically I assume); she sees most paramedics. Most medics are the same way towards nurses and they are both way off base. I still think that comparing a paramedic education to a nursing education is ludicrous, and I also know this discussion will be going on long after this thread is closed, regrettably… If you don't want to be a nurse, don't. There are already too many disgruntled practitioners out there that are only in it for a paycheck. This can make for very poor patient care and you will be very miserable....I guarantee it.

You know the DOT/NHTSA said the biggest problem of Paramedic students was lack of basic english ability bloody hell now I don't doubi it!

while some live by the saying of "Keep your friends close and your enemies closer" i am not that person. To be labeled a "trouble maker" is ignorant when you don't know what really goes on. While my thoughts and ways of doing things definetly come out of left field sometimes, there is sanity to them and cause. Since meeting Kaisu, i've become a better person. She has taught me things and is what I consider to be my best friend. Management knows they couldn't get me to throw her under the bus. We would end up going down together. However, thank you for your concern and looking at another aspect. No hurt feelings.

Once again, I remind everyone here of the OTHER PETA: People Eating Tasty Animals!

Wow, just wow. I guess you cant do much but wait till more info is available to you about this. I would be crappin my pants in your position. I know its hard to do, but relax, breathe, and see what happens, and go from there. ((hug))

Ive seen some local fire trucks around here at Subways, KFC, and the such. I wonder just how wrong, i.e. funny, it would be if one of these trucks pulled up at KFC with the PETA ad on the side...lol And I just have to say that meat is muder.................... Tastey, tastey murder. Yummmm *I wonder if I will start getting negative votes now lol