ccmedoc

I am going to agree with chbare. You can bring up your concern as a concern, but be prepared to back it up with documentation, preferably from the text or outline they are teaching from. Nursing Professors and instructors do not like to be challenged, certainly in front of the class. You would be best served by bringing it up quietly on break or after class. I think most professors would be open minded if it were brought up as a concern rather than an outright challenge to their credentials; and that is what it would be seen as most likely if you spoke out in class. Like was said, I don't agree with a lot the of politics in Nursing school, and the culture is certainly unique to Nursing, but you need to get along to get along...if that makes any sense. Presentation is the whole battle. Just be sure you are correct most of the time... As far as for the "why"; there should always be a why. If the professor cannot explain why something is, then there is a bit of a disconnect somewhere. Telling you that the answer is because it is; I see this as a problem. A private meeting should sort this out, and usually does. Just explain that you need more background and cannot seem to find it on your own. Play to their control. As he also said, EMS and Nursing cannot be compared; certainly in this setting. Do not rely on previous experience in EMS to pull you through Nursing school. Making comparisons outright in you courses will likely make a very difficult path to get through Nursing school. I hear things are slowly changing at University level with newer professors and instructors, but the "Nursing eats it young" adage still holds strong in most institutions I have been in..Sadly enough.. Sit back, learn, and enjoy Nursing school..As difficult as it can be, it can also be very fun and rewarding..

see also HERE!!

Yeah, get the Medical director to sign (or representative) and either the same or a training officer to check the requisite boxes. You can be certified as competent by chart review, clinical stations, etc. as determined by the training staff. Most times they know you enough to just sign off (I would hope ) This is the only way I can keep NREMT cert as I do not have enough time to accumulate 72 CEU and nursing does not cross over.. The letter you get for recert should explain it, as does the website.. On a side note..interesting how little things actually have changed around here..the site looks good, but its been a year since I last logged in and the topics are eerily familiar..Guess thats a good thing meaning more new members or visitors, but bad in that they dont read back or (re)search.... I guess rehashing isn't bad, as I have seen some of my views change drastically in the last few years..Open mind and learning does that to a person I guess..LOL @MetalMedic the CBT(computer based test) is adaptive (CAT) meaning that unlike a standard CBT, either random or fixed, the CAT initially gives the test taker a bank of "medium" difficulty or base questions. The test then adapts the difficulty to the test taker's initial responses. That is to say, if you answer 3 high difficulty questions in a certain area correctly you may not see any more questions on that subject as you have been deemed "competent" by the computer. You may have to answer more "easy" or "medium" type questions with fewer misses to achieve the same "competence". You generally have to be at a certain percent, say 70%, without dropping below a certain threshold (65%) for a given bank of questions. This is why people that miss a couple of high difficulty questions, but answer 4-5 (just sayin) medium questions correct, have a test shut off at 85 questions and they pass. If the next person answers one difficult question correct, but misses the easier ones (4-5) and drops below the threshold, they may shut off at the same number and fail. There is a theory that, since the test shuts off when it determines competence or not, if the last question answered is known correct you passed, if you miss the last question before it shuts off you fail. Most experts that write these tests deny this, but statistically it makes sense. The "beauty" of these are is that the test computer plays to your strengths and everyone has a fairly equal chance of passing or failing. In a static test it is similar, but difficult to write many tests, so cheating is (can be) prevalent. True random tests may put one tester in a majority of high difficulty questions, while another gets easy ones. Cheating is difficult, but so is studying for the CAT. You should know a little about a lot, not the other way around. This is difficult to explain, I hope I did OK.. The last time I took the test, I had a ton of mother/baby/infant, lab value, electrolyte adjustment and antidote questions. Something that I have heard little about from others taking the tests... EDIT: Additional Text

Get the pre-requisites done for nursing school at university. Get accepted to a School of Nursing, then you can become a military on graduation with a commission. See here for starters Online, accelerated, transition, or ADN programs are not going to cut the mustard though. You need to find a good accredited University and attend a BSN program. It is a good career and, at your age, you can retire from the military into a very nice civilian job.

How about this then... A little boost for our medic students: What is this rhythm interpretation? Rate: 80 Rhythm: Regularly irregular PR Interval: Variable (getting longer or shorter before drop? Consistent?) QRS: yes P waves: Yes Hint(in my estimation)...PR intervals..... The interpretation is up to you folks...

I recertify every two years by taking the test and having my paperwork signed..thats it. I have done it this way for years, as we have little in the way of CEU or re-training classes in the areas I have been in. Apply for testing online, set date, pass test (usually know w/in 48 hrs), get paperwork signed, and your done.. The test is not getting any harder, I can tell you that..LOL I used to take the test every so often to monitor test difficulty for my students, now at least I seem to benefit from the 45 min of time invested..(I'm a slow test taker)

Kila make a good scope for beginning. You can hear without worrying about taping the sprague together (The tubes rub but they can be had for $15.00) ADC also makes a very nice scope..price just marginally less than Littman. Sprague is a fine piece if you just take your time and learn. The kila site

here is a decent article [re]examining the use of tourniquet in civilian practice.. Doyle, G.S., & Taillac, P.P. (2008). Tourniquets: a review of current use with proposals for expanded prehospital use. Prehospital Emergency Care, 12(2), 241-257.

This whole "debate" thread could have been shortened with this post, however, most wont realize the wisdom until they have seen the difference between the medic mill and the CC education. The courses in red are much more important than most realize in the understanding of your prospective patients and their reasons for calling you. I believe some more respected diploma programs, some based in hospitals or CC, have additional requirements for college level algebra, A/P, and psychology. Don't underestimate their value to you or your patients. These classes have their place.. This is a fabulous perspective..and very, very true. (I remember these discussions... ) Shortcuts in Nursing, Paramedic, or virtually any other vocation is a bad idea in my opinion; but being allowed to participate in personal and family health and other situations is an honor (to some of us). These individuals call YOU for help, generally when they are having a very bad day. You owe the patients, their families, and your fellow professionals to be the best caring and educated professional possible... If you can stomach the college courses, this is the only way to go and it will set you up for furthering your education; whichever way you take it. Remember...“You don’t know how much you don’t know.” I think a research project would be very well suited for the paramedic curriculum. The courses I have been connected with preach the value of participating and understanding research and evidence based practice and QA, but little is done to teach this. Dwayne means well, and obviously has an intense reverence for the profession . Keep the discussions going as long as they are informative, even if they get a bit inflammatory at times.....

Not that it wouldn't be indicated, but what she did wasn't appropriate here..RSI with inline stabilization and ORAL intubation..See the cords and pass the tube..that's all. I guess I was saying "HER" RSI was questionable. I am not a big fan of nasal intubations in general, and performing one here is way off base in this scenario. I understand some would not think to align the neck initially, but to splint in the the lateral facing position would be most difficult to secure, and I think you would get dinged on arrival to the ED for sure..Airway is priority...and sandbags are a no-no.. I wasn't necessarily bashing your position on the re-alignment, just making note that is should be standard procedure..

With all due respect, this is very old school thinking and has no merit. Any evidence that being a basic for three years makes a better medic? Does being an intermediate first make a better medic? I never worked as a basic, and I think it is very individual as the the benefits of working as a basic or EMT-I for a number of years first. I , for one, think it is a waste of time. As far as the Paramedic/Nurse thing, This is an argument that doesn't need to be going on. CCRN as a Paramedic is as perfect as you can get without going NP or Physician IMHO. With the requirements to attain this certification, the individual/critical thinking and practical skills are a given. Couple that with the additional bit of pre-hospital and transport education and it is a beautiful thing.. To say a (almost any U.S.) paramedic is more educated than these ICU practitioners is, well, misinformed to be sure. Certainly from my Point of View as being licensed as both and having advanced certs and experience as both.. As usual....Just my opinion.

I think splinting in position found is ludicrous. Positioning to inline with gentle traction applied during rotation should be allowed. I stress 'Gentle', and cease rotation if 'any' resistance is met...I think airway management would be very difficult with the positioning of this patient as laying, even with the Crich crowd. I think this treatment was OK..The RSI was questionable, nasal intubation after the fall from height and obvious impact of the head. Basal skull FX a thought??? I would hate to intubate the cranial vault....This was a bad decision. -IMHO....

Get the BLS, LALS and the paramedic flycar. Transport patient 1 and patient 3 together with the Basic truck and paramedic attending to level one center ALS. transport patients 4 and 5 together basic on the LALS truck to probably the same facility. transport patient 2 basic from the described assessment. Was this a problem in the real world?? The priority patient is the pregnant woman IMHO...28-30 weeks I am assuming...months is not something would be interested in as describing a pregnant woman, you should get used to speaking in terms of weeks. Not sure what orders online would give, or why to contact other than to give a heads up to the receiving facility and to see what they can take. I think I would not contact med control for any advice here..

With the JVD, why is IV access not possible. E.J. is a viable option. Unless you have experience with PICC lines, I would suggest you stay away from this option. EJ is not a last option, it is a very good primary option for IV access..

Is this what you are looking for???? If you are in Brighton, Flint is a great option. Meat in the seat is the rule for most companies. There a a few great paramedics in the city..but that is the exception and not the rule. Newbies are the rule here...Burnout is high. Star EMS is in Waterford and Waterford Twp.....Most others are Fire based and not worth the effort.

likely you wont see the question. I take this test every two years, and I just took CBT again last month for the fifth time. I have never had a question this vague. They would probably ask you about the unconscious patient in an emergency situation and give you implied as an option. I did see more lab value questions on this last exam, as well as antidote and reversal agent questions..Very few legal questions... The difference in the scenario you provided was LEO and the fact that the patient was combative and needed to be restrained for his and others safety. This is the difference between implied and involuntary. Implied assumes that under normal circumstances, the person would consent to treatment needed...Involuntary is just that..I do agree that the word "consent" is a bit misplaced in the term..

Yep. I have watched from the beginning and I think it is fairly entertaining. Inaccurate, sure, but entertaining. If it were true to life, it would be unbelievably boring all season, except for the one off exciting call..Entertainment for the masses is what you get. You want documentaries, get your camera out... If I remember correctly, the show 'Paramedics' was real calls all rolled into a show, and was less than stimulating, and full of very bad medicine. I have only seen one or two Emergency episodes, and barely made it through them...but for some reason that show is held in high regard..for accuracy?? certainly not entertainment value IMHO.. I say it is what it is...like it or not, you dont have to watch it. I would imagine a lot of current providers could be picked apart as the show is (and has been), and they are seriously impacting lives in the real world...seriously. I haven't figured out if the bashing is entertaining or not. Watching the show with your textbook to highlight errors is certainly something; if not entertaining. Prime time shows will never be true to life, but this is at least close in some stereotypes... I say lighten up. There are too many important things to try to change or worry about.... -Opinion (disclaimer: the word "You" is used as a generalization and not meant towards any one in particular)

Just adding to Lonestar's observations; having worked in Flint and Detroit as both Paramedic and RN in the last 14 years. Genesee county is a mess logistically, but an awful lot of fun to work in. Detroit is just terrible.

No evidence based reason..probably just personal preference. I am not convinced of the aseptic procedures pre-hospital and I have seen some raging Osteomyelitis in my time...not pretty and very hard to get rid of. I would think that if you have one good IO, why chance another infection and punch two? I have seen it; I have done it...I just dont like it. This would be my chance to look further for an IV line. You can usually find at least one; usually. I think with the newer EZ-IO and such, my mind could change. But I would try to avoid two IO sites if I could, certainly if you are using Illinois needles or similar technique..

Yep, its a game. Double concentrating (or more) Dopamine and other meds is common place for fluid conservation in sensitive patients, what do you think that does to the margin for error.. makes for a crazy dance some nights.. Pumps are an absolute necessity in a MICU I would think..

I cannot recall you ever sounding stupid.....-just sayin.. I think your ARDS question is valid, and if Vent doesnt get to it, I will add to this after shift..I am on my half break for 16 hrs..

Nope..but most protocols call for "titrate to effect"..then move to pump after delivery to ED.

Yeah, I would want to hold off on vasoactives until we see what PPV and fluids do.. probably go with dopamine if thats the choices we have..after the fluid challenge.. Wait on the ABX until others are sorted..no use adding to the soup at this time.. I like the CVP and A-line..mandatory in my opinion.. If only IO then look for EJ, IJ, or subclavian...I dont like double IO.

Yep, agreed. I think none of us are going to do it "because we can"..but you should always have the equipment to do the drips if you have to and this does not include gravity sets IMHO...I think too many medics are afraid to initiate a drip; certainly when it is dopamine or similar. Pumps should be mandatory for all 911 systems now days...