HERBIE1

The only way you will make a decent living as a paramedic in the Chicago area is to work on a fire department. Private providers do not pay well. There are a couple companies- Superior Ambulance is a huge one- that actually employ both Critical care and flight medics. I know they pay pretty well, but I do not know the details. I believe the pay is based in large part on your experience in the field. As for flight medics and critical care medics, employers generally want at least several years of field experience as a paramedic and it is a very competitive and expensive program to get into. Additionally, there are so few flight medic positions available, they can be very selective with their new hires. You might be better served looking into more rural areas where flight medics are used more extensively.

The problem is the power of unions and their collective bargaining agreements. This speaks to the heart of the battle going on in Wisconsin, Ohio, and other places. The pro union folks are framing this as an attack on unions, on the little guy, and the working man. That is utter BULL. This is about a group becoming so powerful that egregious and even criminal behavior- not to mention poor teaching skills- can get rid of a teacher. At what point can we as a society say- sorry, but these unions have amassed too much power? Obviously Democrats will defend these unions to the death since they contribute hundreds of millions to their coffers, so any reform will run into an immediate roadblock- as we have seen in Wisconsin. I have said this a million times, but the era of unions has come and gone. The Dems are pushing for things like protections for folks trying to organize a union in their workplace. Er- sorry, but those protections already exist. Protecting children from being exploited? Protection from unscrupulous employers? Minimum wage laws, EEOC, ACLU, OSHA, child protection statutes, FLSA- there are dozens of agencies and laws on the books to keep workers from being exploited. Does it still happen? Yes, and every time it is revealed, there are a dozen The Dems realize that the downfall of companies like GM was due in large part to the unsustainable contract obligations of unions. Why do you think the shareholders and bondholders lost everything, and instead of the company going belly up, control was given over to the unions? The government demanded that in return for a bail out, control must be given to the unions. The unrealistic demands of the very people who destroyed the company have been given the keys to the kingdom. Are you friggin kidding me? So the unions are now essentially management AND the workforce? HUH? I digress... Back to education- We get things like "No Child Left Behind" because there is only so much that can be done before the unions stonewall any true reform. NCLB is one of those laws with good intentions, but is doomed to fail since it does not address the root causes of the problems in education. Any meaningful changes that are suggested are immediately shot down by the unions, and this resistance is supported by their Democratic watchdogs. The "solutions" offered by the Department of Education are nothing more than something that benefits the teachers. Don't get me wrong- a good teacher is worth every penny we pay them and much more. I simply feel that the system protects the bad seeds- to the detriment of the good teachers(the vast majority of them fall into this category in my opinion) and the students. Something has to change.

So which is worse- having the government check out the web sites the suspected terrorists visit at the library- ala the Patriot Act- or allowing some pervert to jerk-off to hard core porn, while sitting next to an 8 year old kid researching a topic for a school project? Sorry to be so graphic, but the priorities of some people are seriously screwed up. If people can only see this as an issue of "freedoms" and liberties, then they are seriously myopic.

Wishing and hoping do not make it so. Besides for things like experimental and untested treatments, how many Americans travel to places like Canada, the UK, or anywhere else for their medical care? Look- do we have problems here? Of course. Do I think involving the government in the "solutions" to these problems is a good thing? Absolutely not. Beyond health care, we have shifted as a nation from self sufficiency to embracing dependence, entitlement, and victimization. How can that possibly be a good thing for our future?

Using Stephen Hawking, one of the most brilliant minds in the world- as an example is not exactly an appropriate person to try to prove a point about this. Even early on in the course of his disease, when he was a young professor, I am quite sure there would have been a long line of folks more than happy to help subsidize his care- and first in line would have been his university. I am also quite sure they DO help him with his medical expenses. . Money- and power- talks. Always has, always will. From communist Russia, to any uber-liberal European nation, to Castro's Cuba, this is reality. Do you really think Hawking's situation is in any way comparable to John Q British citizen, and that he needs to wait months for an appointment to see his doctors? There is a reason we are were the greatest nation on earth. Why are some folks in such a hurry to change that? We used to be the world's leader in so many areas. Why is this a bad thing?

We judge people every day. What do you think our legal system is all about? Sorry, but God has nothing to do with this. This guy was judged as being guilty of being a pedophile and a rapist. Is he entitled to his transplant? Unfortunately, yes. If it were up to me, however, he would rot in jail and die a slow, miserable death. Call me "unChristian", but I am not as charitable as Jesus- especially when.children have been harmed.

10 doses of D50 per rig? That's incredibly wasteful IMHO. I think you would need to worry about expiration dates far more than keeping up with a par stock. I work in a busy system, and there is NO WAY we would ever need that many. We are officially required to stock 3, and generally most rigs have an extra couple they "acquire" as spares just in case. In other words, the official required stock is often quite different than what crews may actually carry. When I worked the ghetto, I would carry a pocket full of Narcan- especially if we had runs of extra potent heroin OD's, or extra Albuterol when asthma cases flared up, but I never saw a need for that much Dextrose. I realize the recent drug shortages forced many areas to hoard their supplies- Narcan, Epinephrine- 1:1,000 were also at risk. It seems the manufacturer finally retooled their production and seems to have caught up on their numbers, so I see no reason to stockpile. Waste of money, space, and effort.

It's sometimes tough to get back in the groove after being off for awhile. Been though it myself. I couldn't wait to get back to work- I was climbing the walls, but I felt a bit our of synch for a couple weeks after I returned to duty. You say you still enjoy the job, so it sounds like personal issues you need to address. Don't let it get out of hand- see someone ASAP. Good luck.

You do not say why you were absent from work for 2.5 months, but it certainly sounds like a depression type issue. Get some help to find out.

Yep. The vast majority of deliveries are easy- at least in terms of our job. Mom does all the work. For centuries, moms have delivered babies without any help whatsoever. I will say this- that when things DO go bad, the pucker factor red lines at around 11. Nuchal cord, placenta previa, prolapsed cord- scary stuff because what you do will determine whether that baby grows up normally, or has a lifetime of problems. Deliveries are fun- most of our calls deal with death, dismemberment, dying, and other assorted tragedies. It's nice- but messy- to occasionally bring a new life into this world.

How about a couple more honest questions, such as: What is the racial make up of your area? What special provisions, exemptions, and set asides have been made in your area to accommodate blacks to get a job or a promotion? Then, the ultimate question: How many of those black supervisors made it to their positions WITHOUT any special treatment? In other words, how many are actually qualified for, and/or actually earned those positions? I have plenty of black supervisors in my area, and the vast majority have been the recipients of separate standards to get their initial jobs as well as getting special considerations for any promotions they received. Would they have attained their status/rank/success without that extra help? There was one notable exception in my case. I worked for a guy(he was more like a mentor) who busted his arse, studied for every promotion, and outscored nearly every other person- black, white, or green. I learned more from this man than from any teacher I ever had. He earned an MBA on his own time- for his own edification, and is one of the smartest men I know. Personable, honest, quick witted, shrewd, a hard worker, and had more integrity than anyone I know. Sadly, because of all the BS he endured- not being with "the poor me, I'm a black man club" , or the arse kissing politician type, he quickly tired of the game and retired as early as he could- with a nice 6 figure pension. He rose quickly through the ranks and should have been the top dog, but would not sell out his soul. Damn shame and a huge loss for us-he was a quality guy all the way around, and now he is enjoying life, playing golf and traveling as much as humanly possible. This may be hard for you to comprehend, but it's not about quantity, it's about quality. Get off the pity pot. As a black man, you have opportunities afforded to you for no reason other than your skin color. Given your constant bleatings of the evils of racism here, that makes you the poster child for hypocrisy.

It certainly would not hurt to give that epi- even better if you could access a vein with the injector. Whether or not the dose is subtherapeutic is irrelevant- the person is already dead, and if that is enough to jump start the heart, great. Possible to bring someone back with a ROSC, and full mentation with simple CPR- sure. Common? Nope.

Looking at this strictly from a cost/benefit perspective, an advanced degree is not a quality bet. I agree that field promotions are often based on subjective factors, or straight seniority, which means that field providers who opt to get Bachelors or advanced degrees are rolling the dice. Their degree- and the time and money spent obtaining- may not pay off financially for them any time soon- if at all. It has to start somewhere. There ARE folks out there with degrees, and this will be a long process. Yes, those with advanced degrees will generally want to move beyond the streets(if for no other reason than to recoup their investment), and that is exactly what we need. We NEED street providers with experience AND the education in management positions to move things beyond the status quo. They will be the policy makers, and set the agenda for the future. New ideas, new blood, new energy, and a new direction.

Again- a BSP sounds like a great idea, but it all depends on what your future plans happen to be. For those intent on moving up in the public safety realm- not just in EMS-I think they need to be well rounded in their education, for a multitude of reasons. Realistically, I'd be happy if providers received ANY education beyond their EMS training. If we want to be treated as allied health professionals, we need to walk the walk, not just talk a big game.

My sincerest condolences on the passing of your friend. Sounds like he was a special guy.

No flames from me. We are in agreement here. Political correctness is not only out of control, but it has jeopardized the safety of the civilized world.

I'll echo this- do NOT lie on your application or during an interview. Thanks to technology these days, it is too easy to find out about a person's past. Social media sites, personal blogs- all provide a wealth of info to an employer. In other words, it's easier than ever to find out if a person is telling the truth about themselves. Your lie WILL eventually catch up to you- maybe now, maybe later. After an explanation of the circumstances of your termination, I see no reason why it would keep you from getting hired. I have 2 schools of thought on this: First- Don't volunteer the information unless asked on an application or during an interview. Answer it honestly, directly, and emphasize how you have changed- with letters of recommendation as evidence of that change, if possible. Second- Be upfront and address the issue. Admit you had problems with punctuality when you were younger, but you have matured since then. Admit you are concerned about how it makes you concerned about chances for future jobs. Make it a selling point, but be sure you have some sort of "proof" you are no longer a liability to an employer. Letters from instructors, former bosses, friends, etc. Not everyone can sell this approach- you need confidence and be able to show/prove your maturity and responsibility.

Here's my take on the education issue. First- education is never a bad thing, but does a bachelor's in paramedicine make you a better or more effective provider? If that's what interests you, by all means, go for it with gusto. An undergrad or graduate level degree is a great idea, but I see limited value in a degree only related to paramedicine. If we are trying to move forward in this profession, we need to think more broadly than just EMS. We do not operate in a vacuum, meaning we interact daily with police and fire, as well as other public safety agencies. Learning how our jobs are linked to these other professions- beyond the obvious day to day work- is vital. Management, leadership, budget, interoperability issues- all need to be understood in order to move past our second class citizen status.

Been called to pay phones outside of ERs many times. We tell them we would be happy to transport them- 25 feet back to the waiting room they were just in. In every single case, the person had a very minor, low acuity complaint, which explains their extended wait for care. We take patients to the closest appropriate ER, and unless that person has a specialty need(stroke, OB, cardiac catheterization center, etc.) they go back where they came from. The fact that the ER is exceptionally busy is not our concern- unless they are on diversion. If the patient has been triaged, then they are that hospital's responsibility. That means unless they are discharged, leave AMA, or leave without being seen by a doctor, or officially transferred for a legit reason, we have no authority to take them away from a higher level of care.

No, if the only people who called for an ambulance actually needed one, the system would no longer be overwhelmed, and things like prehospital primary care would probably flourish. The only way to change the system and the problems within is making everyone shoulder some responsibility for their choices and their care. Everyone- even those with top of the line insurance- needs to follow procedures to receive that care. Don't contact your insurance provider prior to seeking care? You get stuck with the ambulance and/or ER bill. Same should be for someone on public assistance. Pay a nominal fee for your care and ride(deducted from your monthly subsidy) and suddenly folks would need to be judicious about obtaining that care.

There were several issues here, and Kiwi offered that his service allows the provider to advise the patient they do not need an ambulance transport to an ER. I don't think anyone would argue that point is true, but like I said, most services do not have protocols in place that cover this. The knowledge of the provider is not the issue, the failure to follow protocols is.

We do not have the ability to provide a hard copy of a refusal of service to the patient- everything is electronic. There is a statement the person can read on the computer when they sign their refusal, but it is exceedingly rare that someone even requests to read it- they simply listen to my verbal cautions.

Treatable is NOT the same as curable. Yes, this disease IS treatable AND often curable, but not always. I lost a good friend to this disease a few years back. Tough call for sure. This child was severely autistic and developmentally delayed as well. Couple that with the cancer? Sounds like mom was overwhelmed with her situation. I hope I will never be placed in a position to ever have to make such a decision but I do know I will do what I think is best for my child- whatever the personal cost.

Been there, done that- especially on the older rigs that were bare bones- no warning lights or chimes. Embarrassing? Sure. Funny? Yep. These days, we have so many idiot lights/displays/monitors on our various panels that the cab area looks like the cockpit of the Space Shuttle. LOL

I disagree with this, Bieber, but maybe this is simply a case of semantics. The point was, just because you are CAPABLE of providing a treatment/procedure/medication, does not mean that is what is best for your patient. Sometimes less is better- for a multitude of reasons. Starting out as new providers, we want to use every medication in our drug box, and perform every procedure. We want to show everyone how much we learned, and to use our newly acquired skills and find every reason possible to justify doing so. After awhile, we realize that not every person who has basilar rales needs for us to provide a diuretic to "save" them. Our protocols are supposed to be guidelines, not iron clad rules that are blindly followed without question. Each patient and situation is different, and as long as medical control concurs, deviation from protocols may actually be what is best for your patient. THAT is being a patient advocate.