scratrat

Springfield XD 40 caliber.....

If they want to curtail you using the site while on the clock, I can respect that. But that should have NO say in what you do in your spare time. BUT, it's your personal responsibility to maintain some professionalism. You have to understand that your co-workers/boss may see your post and find it distasteful. I don't feel the employer should be able to stop you from posting on your own time, but I do think they can hold you responsible for the posts no matter what. I work for the government. I can't access social media from work, but can at home. I post my political views and personal views. I'm not about to bash my employer or go into specific details on a social site. That's begging for disaster. We are told to be mindful of postings, but they know they can't stop what we do on our free time. But again, you can bet your ass they'll hold me responsible for something they don't like.

Women can have it anytime they want too!! They just have to tell us that we're allowed in the room.

I thought they disarmed them years ago??

Good thing I don't like tuna!

That was HILARIOUS! Kudos to him to have the courage to joke in that instance! Sounds like he's probably still laughing upstairs!

"Seriously?"

I have to agree with Mike. He may well just be an asshole, or he's just had horrible EMT's. Like he said, ask about YOUR expectations. Ask what you can/cannot do, or want he doesn't want you to do. Personally, my peeve was the drug box. We have narcotics that I'm responsible for. Unless I ask, don't touch my drugs. Other than that, I'm happy to educate and show you how to do a 12 lead, what I'm looking for, why I am or are not administering a medication. But like many people have said, form your own opinion. Learn first though. I couldn't help but notice you mentioned his lack of following protocols was that he wouldn't use a monitor when he's 3 minutes from the hospital. I probably wouldn't either. Why sit on the side of the road when the hospital is 3 minutes away?? Things like that aren't a big deal, so I wouldn't form your opinion around that.

http://www.app.com/apps/pbcs.dll/article?AID=2012310100030&nclick_check=1 Asbury Park Times In communities like Berkeley Township, where 26,000 senior citizens live, residents rely on volunteer first-aiders to get them to the hospitals in emergencies. But what if they suddenly were charged $2,000 for every trip? That’s what some volunteers fear may happen. They say that a new bill designed to regulate emergency services could result in them being squeezed out by paid paramedics — and they say a free service that residents rely on could now cost them money. “Paid service companies want to come in because it’s a cash cow in the senior communities,” Berkeley Township Councilwoman Judy Noonan said. “Anybody who believes differently is kidding themselves.” But supporters say that a paid EMS system is necessary in order to make sure that no emergency call goes unanswered due to a lack of volunteers. “What it does is upgrades the system,” said Senate President Stephen Sweeney, D-Gloucester, one of the sponsors of the bill. “Volunteers are great. In my county, they are wonderful. But facts are facts: Too many calls go unanswered. There are just not enough of the volunteers anymore.” The controversial bill is touted by Sweeney and other lawmakers in Trenton as a statewide EMS redesign. It would govern the qualifications, training, and operations of paramedics, emergency medical technicians and emergency medical responders, as well as first aiders. And volunteer first-aiders say the new training and other requirements will shrink their ranks, leaving paid paramedics as the only choice for some communities. Unlike volunteer first aiders, paramedics are a paid service. The average charge for paramedic service in New Jersey at the beginning of 2005 was about $2,000, according to the website for MONOC (Monmouth Ocean Hospital Service Corp.), a nonprofit company comprised of state acute-care hospitals). The amount covered by commercial insurance companies varies. Bills from services for a paid rig could mean “thousands of dollars” in charges for patients, said Joseph R. Busse, captain of the Silver Ridge Park First Aid Squad in Berkeley. The Silver Ridge, Holiday City and Holiday Heights first aid squads handle more than 7,000 calls annually in the township. Busse, 73, said he and other volunteers are trained to handle any emergency, adding, “There is no charge.” But he fears that the new law would place new “unreasonable requirements” on volunteers and cater to professional crews. There are other potential costs from the legislation. The nonpartisan Office of Legislative Services says there will be a “probable increase in administrative and training costs to state and local entities,’’ but the office could not make an estimate. The bill also creates the position of State Medical Director for Emergency Medical Services and authorizes the appointment of up to three regional medical directors, all of whom would be salaried. Salary and fringe benefit costs for the four positions would total approximately $600,000 per year. Carl Lazzaro, the mayor of Fredon in Sussex County, who is captain of his town’s emergency services squad, said the bill will transform duties handled by local volunteers into new government jobs. “This is all about money. This is about unions. This is all about everybody getting onto the state rolls and the state pension and medical plans,” he said. Lazzaro’s prediction: “Those costs are going to be passed on to the municipalities (and through) property taxes. But we’re tapped out.” Proponents say the intent is to provide timely and qualified emergency services. Sweeney said volunteer squads in many parts of the state have been fighting a losing battle to sign up new members. In Sweeney’s home county, Gloucester, he said unanswered 911 calls topped 800 in one year before a countywide EMS system was implemented. Michael Bascom, finance officer and tax collector for Neptune and Monmouth County’s EMS coordinator, said currently thriving volunteer squads will have little problem adjusting. “I don’t see that changing so long as volunteers can provide the service. In areas where volunteers can’t provide the service, the first selection is not going to be to find a career agency and bring that cost into the budget. It’s going to be to work toward regionalizing volunteer services,” Bascom said. Assemblyman Anthony M. Bucco, R-Morris, in a statement, said the current measure “is essentially a redo of the one passed in the Legislature’s previous session.” “The governor indicated the bill could potentially cost the state and municipalities millions of dollars,” Bucco said. “He advised the Legislature that further study was warranted and that the bill’s impact on property taxes, volunteerism, background checks, licensure versus certification and fiscal impact to the state budget should be studied.” Sweeney said the Senate will hold its vote Oct. 25. Once again, sorry volunteers. I’m probably going to hurt your feelings. You have your place, believe me. But in this day and age, unless it’s a VERY small community, people expect the best service possible. Let’s take this bit by bit, shall we? “Paid service companies want to come in because it’s a cash cow in the senior communities,” Berkeley Township Councilwoman Judy Noonan said. “Anybody who believes differently is kidding themselves.” Seriously?? A cash cow??? You can barely make ends meet with Medicare/Medicaid reimbursements. I wouldn’t want a senior community. I would want people with private insurance that pays more. No one wants senior communities. The controversial bill is touted by Sweeney and other lawmakers in Trenton as a statewide EMS redesign. It would govern the qualifications, training, and operations of paramedics, emergency medical technicians and emergency medical responders, as well as first aiders. So basically the bill ensures that everyone, no matter what town you live in, what taxes are paid, what population exists, etc., you’ll all have access to the same level of care. What is so wrong with this? And volunteer first-aiders say the new training and other requirements will shrink their ranks, leaving paid paramedics as the only choice for some communities. Oh, darn. Bills from services for a paid rig could mean “thousands of dollars” in charges for patients, said Joseph R. Busse, captain of the Silver Ridge Park First Aid Squad in Berkeley. The Silver Ridge, Holiday City and Holiday Heights first aid squads handle more than 7,000 calls annually in the township. Captain Dumbass, are you aware that since the township hands you $25k a year ALL residents already pay for the service whether they use it or not??? Busse, 73, said he and other volunteers are trained to handle any emergency, adding, “There is no charge.” Busse, 73. Doesn’t that just sum it up right there? When I’m 73, I’ll be damned if I’m going to attempt to be doing CPR and extrication. But he fears that the new law would place new “unreasonable requirements” on volunteers and cater to professional crews. It is not unreasonable for someone to get the same level of care and professionalism no matter where they are at within the state. I expect to call 911 and get two certified EMT’s who are NOT wearing pajamas and reeking of stale beer. I expect to not have a 73 year old show up and look like he’s gonna code whilst carrying me down a flight of stairs. Carl Lazzaro, the mayor of Fredon in Sussex County, who is captain of his town’s emergency services squad, said the bill will transform duties handled by local volunteers into new government jobs. What the hell are you talking about? If anything, they’d be privately owned and not municipal based. Most municipalities have gotten out of public service (save for police) because they realize it is NOT the cash cow you seem to think it is. Furthermore, the paramedics don't want anything to do with it. It would most likely still be EMT's. “This is all about money. This is about unions. This is all about everybody getting onto the state rolls and the state pension and medical plans,” he said. Sir, are you retarded? It still requires paramedics to be hospital based, therefore, they’d still be employed by the hospital and NOT the state. What money are you talking about??? Have you not been paying attention to the fact that no one is getting paid anymore with all the cut backs? Lazzaro’s prediction: “Those costs are going to be passed on to the municipalities (and through) property taxes. But we’re tapped out.” IT’S ALREADY PART OF YOUR PROPERTY TAX WHETHER YOU USE IT OR NOT!!!

Once again, my disclaimer...if you're offended easily, DO NOT continue..

@systemet Sorry for the blue but I was trying to show my responses to each. Well, regardless of his intentions and whether the practitioner "saw it once on TV" or was properly trained, State guidelines say "no". End of story. I guess it's a good thing I'm not serving on that board. I don't need to know anymore information as to why he thought it was warranted, what the outcome was, or other mitigating factors. The only mitigating factor I need is a doctor repeatedly instructed you not to perform a skill that is outside your scope of practice in a certain state, and you did it anyway. Period. A few paragraphs back I read one about paramedics doing a c-section. I had heard of one of those in NJ and I was fairly cetain their certifications were revoked but I may be wrong. The doctor accepted responsibility. But you still practiced medicine without a license and went outside your scope. If they did NOT in fact lose their licenses, they should have. Including some sanctions for the physician who authorized it as well.

(1) This calls sounds like a nightmare. Any scene where one of the responding crew is a relative of the patient and they are acutely sick has all sort of potential to become a massive cluster. In an ideal world there would be enough people on scene to remove any patient care responsibilities from that person, and have someone take over their role. Even with them still present on scene, with no patient care responsibilities, it's going to add an additional dynamic to an already difficult and stressful situation. And that crew member should have been immediately removed. (2) I'd like to know more about why he felt the pericardialcentesis was indicated, before I judge him too harshly. I realise that from a legal perspective, that if you perform outside of your scope of practice, you're done. Completely irrelevant as to why its indicated. If you felt it was warranted, you should have immediately transported him to definitive care to have the procedure performed. There have been plenty of times where we've had traumas right outside the trauma centers doors, and I wasn't about to waste time performing a needle decompression. It sounds like this medic saw an opportunity to perform a skill and look like a "hot shot". But from a peer-review or professional conduct perspective I'd like to know first: * Did he believe that the percardialcentesis was a lifesaving measure that needed to be performed in the field? Even if he did, he was not authorized to do it. So again, transport to definitive care. This isn't the TV shaw "ER" * Was this belief reasonable given the available information? Again irrelevant. * Had he had the necessary training to perform this intervention in a competent manner? Not permitted to be performed at his level at that particular time, in that particular state. We have procedures and protocols and a scope of practice for a reason. You can't have gung ho people performing whatever skill they choose and then justifying it by saying "was he trained properly in another state even though it's not permissable here?" I'm permitted to perform suturing in my federal job. Let me try that on the ambulance and see what happens. Scope of practice is designed to protect the patient from poorly-trained or untrained providers. And to prevent practitioners from performing skills that are not authorized to do. If he was adequately trained to perform the procedure and it was indicated, as ArticKat pointed out, it's a very different scenario to just being a cowboy. Perhaps the violation of the scope of practice was in the patient's best interest? Vermont, that State were it occured, does not train or allow it's paramedics to perform this procedure. It's not a different scenario at all. You are NOT permitted to perform said skill and you knew it, and broke it, and now there's a dead body. This only compounds the situation a little bit. Had the guy survived the ordeal, I said would have voted to gank his license. This also speaks a little to the particular silliness in many regions, including the US and Canada, of having multiple scopes of practice and training standards within the same country. Agreed, however, that is moving forward somewhat and most States are adopting standarized protocols. Almost all paramedic programs are conformed to the NREMT standards. NONE of which include pericardiocentesis by the way.

GREAT DIVORCE AGREEMENT In God We Trust Since we are not going to get gasoline back to $1.50 per gallon and coffee to $2.00 per pound maybe this would be a solution we could live with. DIVORCE AGREEMENT -- This is so incredibly well-put, and I can hardly believe it's by a young person, a student!! Whatever he runs for, I'll vote for him! * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Dear American liberals, leftists, social progressives, socialists, regressives, Marxists, and Obama supporters, et. al.: We have stuck together since the late 1950s for the sake of the kids, but the whole of this latest election process has made me realize that I want a divorce. I know we tolerated each other for many years for the sake of future generations, but sadly, this relationship has clearly run its course. Our two ideological sides of America cannot and will not ever agree on what is right for us all, so let's just end it on friendly terms. We can smile and chalk it up to irreconcilable differences and go our own way. Here is a model separation agreement: 1. Our two groups can equitably divide up the country by land mass, each taking a similar portion. That will be the difficult part, but I am sure our two sides can come to a friendly agreement. After that, it should be relatively easy. Our respective representatives can effortlessly divide other assets since both sides had such distinct and disparate tastes. 2. We don't like redistributive taxes, so you can keep them. 3. You are welcome to the liberal judges and the ACLU. 4. Since you hate guns and war, we'll take our firearms, the cops, the NRA, and the military. 5. We'll take the nasty, smelly oil industry and you can go with wind, solar, and bio-diesel. 6. You can keep Oprah, Michael Moore, and Rosie O'Donnell . You are, however, responsible for finding a bio-diesel vehicle big enough to move all three of them. 7. We'll keep capitalism, greedy corporations, pharmaceutical companies, Wal-Mart, and Wall Street . 8. You can have your beloved lifelong welfare dwellers, food stamps, homeless homeboys, hippies, druggies, and illegal aliens. 9. We'll keep the hot Alaskan hockey moms, greedy CEO's and rednecks. 10. We'll keep the Bibles and give you NBC and Hollywood . 11. You can make nice with Iran and Palestine and we'll retain the right to invade and hammer places that threaten us. 12. You can have the peace-niks and war protesters. When our allies or our way of life are under assault, we'll help provide them security. 13. We'll keep our Judeo-Christian values. 14. You are welcome to Islam, Scientology, Humanism, political correctness, and Shirley McLain. You can also have the U.N., but we will no longer be paying the bill. 15. We'll keep the SUV's, pickup trucks, and oversized luxury cars. You can take every Subaru station wagon you can find. 16. You can give everyone healthcare if you can find any practicing doctors.. 17. We'll continue to believe healthcare is an earned luxury and not a right. 18. We'll keep "The Battle Hymn of the Republic" and "The National Anthem." 19. I'm sure you'll be happy to substitute "Imagine", "I'd Like to Teach the World to Sing", "Kum Ba Ya," or "We Are the World". 20. We'll practice trickledown economics and you can continue to give trickle up poverty your best shot. 21. Since it often so offends you, we'll keep our history, our name and our constitution and our flag. 22. Would you agree to this? If so, please pass it along to other like-minded liberal and conservative patriots and if you do not agree, just hit delete. In the spirit of friendly parting, I'll bet you answer which one of us will need whose help in 15 years. Sincerely, John J. Wall Law Student and an American P.S.: Also, please take Ted Turner, Sean Penn , Martin Sheen, Barbra Streisand, and Jane Fonda with you. P.S.S..: And you won't have to "Press 1 for English" when you call our country.. Forward this every time you get it! Let's keep this going; maybe some of it will start sinking in! If you can't stand behind our Military, Please feel free to stand in front of them!

I respectfully disagree. I could have been taught procedures in Florida that are illegal in New Jersey. In Florida, I could do a LOT including RSI without consulting my physician. In New Jersey, you'd kiss your license good bye. Just because you are taught a skill set in one area, does not mean that you can practice it everywhere!! Even after becoming a paramedic, I (regrettably) continued with a volunteer BLS service. In this state, paramedics must be operated under the direction of a medical center. BLS entities are not. Meaning, even though I was a paramedic, I could only function as an EMT while on those rigs. I could not start IV's, etc and could have lost my license if I did even though I was trained and certified to do it. Practicing outside your scope is irrelevant to your training. If the State says "You can't do this", then you can't do it, regardless of your education and background. You have to abide by the laws governing your particular State and that particular employer. You cannot justify saying, well in this state we did this. They don't want to hear that.

Plain and simple: He was practicing medicine without a license. I don't think they were heavy handed at all. He got what he deserved. Everyone has probably bent the rules slightly to conform to the patient's condition but this was blatantly outside his scope of practice. And Arctickat, it's irrelevant whether he received the training and is permitted to practice said skill in another state. All states can be different. It's up to the practitioner to understand and abide by that particular State's laws and guidelines. He clearly knew he was overstepping his bounds when he made the "I may lose my license" comment. If you have to say it, then that probably means you shouldn't be proceeding.