Just Plain Ruff

Becksdad, what an insightful post. I agree with you wholeheartedly. Who do you respect more? someone who admits his error or mistake and learns from it or someone who tries to weasel out of it by blaming someone else for their mistake? I can tell you I respect the person who admits their mistake. Case in point, I had a patient who was pregnant, started to seize, and being a brand new medic I sort of panicked and grabbed out of the narc box the morphine instead of valium. I thought for sure I had grabbed the valium, could have sworn I did and I gave her 5mgs of morphine instead of valium. OOOOOOOPPS I did not realize my mistake, My partner found the half used morphine. He asked why I gave valium to a seizure patient and I said, hey I didn't give morphine and he showed me the syringe. I went holy heck batman and ran in the ER, told the attending doc what I had done, he said thanks for telling him, he then called my supervisor, told them that the error was made but he was very proud of my admitting the error that he actually praised me in my care for this patient and told them no ill effects were caused. He also praised my integrity for ocming forward and admitting my error. If you come clean when you make a mistake it's doing the right thing.

good post Madaxe I do not agree that management will cave every time though. I've seen it too many times where they didn't cave. But I do agree that solidarity on the labor front is a tremendous asset to have and more often than not with even the remotest threat of losing their jobs labor will cave first and continue to work in the crappy conditions. Our service tried to unionize and it was basically quashed by management but then again, we did not have union support behind us.

NREMT basic, you are not reading my post. I have always said in my posts that you carry what works for you. I've never called anyone a whacker on this forum and I have never said it's my way or the highway. Plus, I hope that you are not thinking I'm calling you a whacker when you carry that trauma pack, if you use it on a call and regularly use it then thats a good thing. As long as you use it. A carefully packed trauma pack is different than what we are talking about here. I said specifically that you carry what works for you. You need to re-read my posts. I've always said that if you can't remember the last time you used something you carry then it might be time to re-evaluate the usefulness of that piece of equipment that you are carrying. If you have every size hemostat imaginable which in the past I did, then you could be considered a whacker. But I reiterate - you carry what you feel you need to carry and don't let anyone tell you otherwise. I'm speaking from personal experience on the amount of stuff I carried and I realized that I didn't need half of what I carried. I've never told anyone what to carry and what not to carry, just the fact that if you carry it just to look cool and have it for that one in a million call then you need to re-evaluate what you are carrying. I have to wonder if you wonder who appointed me the Whacker-sheriff, who appointed you to criticise my opinion. It's my opinion and you have yours and I have mine. Do the job you are hired for, do it well and don't let anyone tell you it's wrong. you know opinions are like aholes- everyone has them. You have yours and I have mine. I'm just speaking from 20 years of experience what has worked for me and what i've seen. So please stop turning my words around.

Bushy, no one is calling you a whacker, you keep bringing it up but here's your list and I'll try to answer your questions trauma shears - definately not a whacker but if you have more than one pair you are carrying then maybe you are. scissors - sounds like overkill with a 2nd set of scissors mini maglight - works as a penlight so no not whacker material tweezers - when did you use them last - if you use them regularly then no whackerdom there but if you cannot remember the last time you used them then yes sign of a whacker leatherman - i dont know why i have that actually - but the little scredwiver has come in handy - what do you need a screwdriver for in ems? Stethoscope - if im the treating officer i put this in my access pack - integral part of your equipment so no whacker part there Kelly forceps - again when is the last time you used these? if you use them regularly then you are not a whacker but if you cannot remember the last time you used them then it's probably time to stop carrying them Probably a window punch (and yes i will use it.....) - If you are going to use the centerpunch regularly then you are not a whacker but why not put that piece of equipment in your trauma pack because at every MVA you will take that trauma pack with you. So if you regularly use the above then no you aren't a whacker - We are calling the people who have every little new fangled gizmo on their belt and pockets in their uniforms. Like every size hemostat, center punch, 3 pairs of scissors, 2 pagers, 2 cell phones, 1 radio and whatever else they can get from Galls or whoever. Those are the whackers we are referring to. Listen, it all boils down to one thing, a professional appearance, someone with all that extraneous crap on their belts, pant pockets and shirt pockets does not to many on this forum nor to many in their own service promote a professional appearance. If you have all that stuff on your person how professional does it make you look? Granted, I was one of those whackers when I was a noob but I was also very devoted to patient care, devoted to the company and would do any call requried of me without bitc(*)ing. I would come back and say "thank you ma'am can I have another" and work every overtime shift available to me. I said it was to "increase my experience" yet in the end like I said in my previous post - I came to my senses and my partner said good to have you normal. Carry what you need but don't go overkill and carry stuff you never will need. Just how many hemostats do you need, really????

Let me ask a question - does a centerpunch actually work with a windshield, I was taught in my extrication courses that a centerpunch will not work on a windshield due to the laminate between the glass panes. I've always seen the FD cutting the windshield with a saw tool of some sort. Or did I miss something in that extrication class.

I agree, normal values must be there to determine how out of whack the labs etc are. But every paramedic should have a basic understanding of lab values in order to help guide(not determine but guide) patient care. I'm not saying we need to be able to interpret what the minutia(sic) results are like mcvh and other parts of the cbc is but the H&H, CBC(main values), CMP or Chem 22 and basic metabolic panels. We also should understand the pt, ptt and INR if we are to be giving clotbusters or blood thinners. If you are a paramedic in the ER then you better be able to at least interpret the most used labs in the ER. Interpretations of the Urinalysis is important also. So to further the discussion - What labs should be basic knowledge of a paramedic/emt? Here's my list cbc cmp or chem 22 Basic metabolic panel or Chem7 CK/MB PT/PTT with INR Urinalysis Lytes maybe alcohol that's a short list.

BushyfromOz, step away from the koolaid and get your knickers back out of their bunch. If you would have read all the posts you would have seen that several of us have said to carry what you need to do the job. Tell us all in your non-attitudinal way when the last time you used those tweezers and hemostats besides on yourself. No-one ever suggested a trauma pack on your volunteer days made you a whacker. Tell me also when the last time you used the leatherman? No-one ever accused you of being a whacker, YOU did.

sounds to me like your first time drinking was not the greatest. I could tell you that being under 21 you shouldn't drink but maybe you are realizing that now. I think, just from your small note here that you are keeping it all in and that you have not had a good system to deal with the bad calls you have run. Talk with someone you trust be that your friend or a co-worker or a shrink but it sounds like to me that all that drinking = letting it all out and that's not a great thing. I also agree with Dust too.

Yes they will go out of business hence the Fire services and big conglomerate services such as AMR and MEdTrans and others to come in and pick up the pieces at a rock bottom price. So yes they will go out of business but not quickly.

good points there. But unfortunately you cannot get blood from a turnip and there are two hot button issues facing the working EMS staff members, pay and medical insurance. Pay can only go so high and comparing a large ems service with big revenue with a small service there is no way that that service can compare in resources yet many mom and pop ambulance services pay better that surrounding areas and then again some don't. With this piners situation, we had a union rep posting here, a couple of post piners employees and one or two piners employees yet no management. WE got a one sided discussion and that is unfortunately all we are going to get. I get quite suspicious when a union rep posts things on a message board - smacks of impropriety.

I'm shocked at your instructor for two reasons 1. His flippant attitude that you will get used to it. 2. the fact that you lifted without knowing what you were doing. The instructor should have shown you how. Shame on your instructor.

I too when I was just an emt noob had all my pockets full of the latest and greatest gizmos. I even had 7 different sized hemostats. After 6 months at a very busy urban system, I took a look back at how many times I had used each of the said above and found that the only ones I used were trauma shears, pen light and pen. I took all that stuff out of my pockets, felt 5 pounds lighter, stopped snagging on doors and such and my partner said something to me that rang very true quoting as best I can "It's about time you got away from being a Wanker!!!" but he had a couple of other words that would get me suspended here. I urge anyone who has all that extra crap on their belts and pockets, when was the last time you truly used each piece of what you carry? Can you remember the last time you used the small hemostat? or the last time you used the ring cutter? So to make a long post short - get rid of all the extra weight and concentrate on doing your job, no one whos been around for too long thinks you are cool with all the extra junk you have on your belt and pocket. And get rid of the cell phone and extra pager while you are at it. You know who I'm talking about.

I too when I was just an emt noob had all my pockets full of the latest and greatest gizmos. I even had 7 different sized hemostats. After 6 months at a very busy urban system, I took a look back at how many times I had used each of the said above and found that the only ones I used were trauma shears, pen light and pen. I took all that stuff out of my pockets, felt 5 pounds lighter, stopped snagging on doors and such and my partner said something to me that rang very true quoting as best I can "It's about time you got away from being a Wanker!!!" but he had a couple of other words that would get me suspended here. I urge anyone who has all that extra crap on their belts and pockets, when was the last time you truly used each piece of what you carry? Can you remember the last time you used the small hemostat? or the last time you used the ring cutter? So to make a long post short - get rid of all the extra weight and concentrate on doing your job, no one whos been around for too long thinks you are cool with all the extra junk you have on your belt and pocket. And get rid of the cell phone and extra pager while you are at it. You know who I'm talking about.

Good to have had your predictions come true in this case MadAxe but not every instance will the employees win. I've seen it both ways and yes Fire has come in and taken over and many of the employees were fired. Don't gloat too much on your predictions though you will find out that you will be wrong the next time or two.

i had a sage doctor friend one time told me this "it's not your emergency so get over it and treat the F*&*ing patient" and I have lived by that rule because I do not see things changing due to most of the above reasons posted. He was having a really bad day and the very next day he had a Huge MI while working. He survived but he hasn't practiced medicine in about 5 years. I would love to see patients that have a true emergency but when I was working in the ER. Unfortunately there are many many factors that go into ER visits and abuse that not one solution will fit this scenario.

I'm in the consulting world now and still work part time as a medic and my true belief is that if you are not credible or if your integrity is ever questioned then you have some real work to do. I don't think we can have integrity without credibility nor can you have credibility without integrity. There is a beer commercial or some type of commercial out there where two guys drive up on a beer truck that one of the panels opens unsuspectedly(i just made a word). The guys drive up to the truck and just when you think they are about to grab a 12 pack one of the guys grabs the handle to the door and closes the door. They end it all with the words Integrity, do you have it? Integrity is doing the right thing when you know it's gonna make some people mad. Credibility is the same. there are many people I know with integrity and credibility but not many have only one.

I think one more question that needs to be asked and if it was posed on this topic already I must have missed it. Integrity - do you have it?

every country has these morons and idiots who will do anything for money. Too bad we cannot keep them from breeding.

so it's been a while, how did this turn out for our original poster? We demand information ha ha

Again we have a topic that has gone to heck in a handbasket. peoples feelings are hurt, people are hurling insults and it's just not a good scene man. MCI's never have enough resources. MCI's never go the way we want them to. these types of threads just eminate nasty responses and such. To quote one person we all know "Can't we all just get along"

Toysoldier, that guy you described fits the WHACKER description to a T. My advice, everything this guy does make sure you don't do the same. Do not try to beat the ambulance if you are in your pov, don't get any radios unless they are provided to you by the company, do not put lights on your car, don't work 7 days a week and don't ride 3rd person if you don't have to. He's a whacker and that is definately what you do not want to become.

I've never understood trendelenburg The patient is in shock and having a hard time pushing all the blood out to the body and extremities. If we tend to shut down the peripheral circulation then if the legs were up wouldn't the heart have a harder time pushing that blood into the legs especially if the patients extrems were shut down basically. to me it's like this, think of pushing a barrel up a hill, it's pretty hard, wouldn't it be more logical to keep the legs at the same level as the heart? It's easier to push that barrel on a flat surface than up a hill. Just my thoughts.

ok, you might have wanted to say in your post that it was a poem only and not something that you were feeling at the time of writing.

windsong, I don't know how to read your message. You sound like you are in the same boat as this persons partner.

I have refused to transport a number of patients in the past. all of them have been super critical and refused on the ground of not having enough help. ONe in particular, had a patient in a hospital ICU who just had a IABP (balloon pump) set up on him and they told me to take him to the cardiac center across town. They were going to send the balloon pump machine with me. I said, wait, this is way out of my realm of practice nor do I have any idea of how this thing works. Well, they hem and hawed around the issue, told me to take the guy, I said NO NO NO NO and called dispatch. Dispatch and the supervisor and the director of EMS backed me up. The hospital ended up sending a nurse with me. Well the unthinkable happened, the baloon pump air hose connector that connects the hose and the machine bent and crimped while we were getting him in the ambulance. He started to crash. I had the foresight to ask them to bring anything along that could help us out in the transfer and the doc said, take an additional connector and hose just in case. We were able to change the hose and plug it back in and the patient re-stabilized and the transfer was uneventful. I cannot imagine other than coding that guy what would have happened.