Dustdevil

Wow. All these questions raised, and all of them already addressed without me even lifting a finger. My work is done here.

Very good observations. Just one small, but significant correction here. Those who developed the 120 hour EMT course are not the problem. It is those who have fought to keep it that way for the last thirty years that are to blame. 120 hours (actually, it was 80 in the beginning) was perfectly reasonable for the early 1970s. Not anymore. In fact, any education measured in hours is probably inadequate. Other than that, plus 5 for recognising the important elements of professionalism.

Mike, Mike, Mike... You were doing SO awesome before you got to that part. :? Moving on... what is the FDs involvement in EMS in SD? Do they only do first response, or do they claim the ALS domain, like in L.A.? Are they "in charge" of EMS, with RM being utilsed pretty much only as transport, or does RM get to run a serious system? I love SD, so I am curious about how things are run there. And dude, what's up with that mayor crying like a little bitch on televison the other day?

LMAO! Sounds just like my ambulance trip from Dallas to Detroit and back. We get to Detroit in the middle of the night, locate the hospital we will be picking up from in the morning, then go searching for a motel close by. We pull into the first motel we see, and just like the White Castle, the night clerk is behind bullet proof glass at a drive up window, with an electronic iron gate blocking the driveway. Better security than the White House. We tell the clerk we need a room. He asks, "for how long?" We tell him just for the night. He replies, "ALL NIGHT?" with a surprised look on his face. Then he notices that we are in an ambulance and says, "Uhhh... I don't think you want this motel. We rent by the hour."

Ah, well I agree that is currently the case. My point is that it should not be the case in our future.

I do think that happens. And I think that it happens a great deal in EMS because of the structure of the current educational process in EMS. In EMS, the primary focus is on training, not education. And with little formal education behind themselves, those medics doing the precepting have little understanding of the educational process. The old adage about being a good medic does not necessarily make you a good teacher is very true. Way too many paramedics who are precepting students -- no matter how good they are at their jobs -- simply have no understanding of how to educate or relate their experience to others. But neither did those who precepted them, so it is a vicious cycle. That said, obviously not all field preceptors need to be professional educators. But they do have to have an understanding of how the educational process works. Look at how the medical school process works. See one, do one, teach one. Every student in medicine, whether a freshman, an intern, or a resident, is involved in teaching. Everybody comes out with experience on both sides, both as the student and as the teacher. Therefore, they are able to relate to both roles. This produces practitioners who are forever in educational mode, both as a student and as a teacher. With this outlook, nobody is threatened by the questions of students, because they too still understand what it is like to be a student. That's why you get such positive response from physicians, but not with many medics. This is what needs to happen in EMS in order to facilitate the educational process. But yeah... some people simply don't have the personality or temperament for teaching. That doesn't necessarily make them a bad medic. But those people -- regardless of their professional competence -- should not be in positions to precept students. I can't say I have ever heard it. Now, mind you, I have heard (and participated in) many a bitch session among nurses about medic students over the years. But it was the opposite of what you suggest. It was complaining about those under motivated students who did not show adequate motivation to participate or get involved. Aside from the obvious slugs who only want to sit at the nurses station and talk on their cellphones all night, there are a lot of medic students who think they are only there to get IV sticks and medication pushes, and show no interest in anything else. Two reasons seem to exist for this. First, they don't care enough to ask the kinds of questions you are describing. We wish they did! But a great many medic students seem to think that they don't have to make any effort to actually learn. They expect that everything they need will just be taught to them without them having to participate in the process. It's like, "I paid my money, so now make me a paramedic." And second, somehow these students are making it all the way to clinicals in medic school with their school still not having taught them that paramedic practice is about much, much more than just skills. Having read of your experiences, Dwayne, I know you know the kind of guys I am talking about and how common they are. Good question! Certainly one that we all have to deal with at one point or another, on both sides of the fence.

God, I love your uncanny ability to take pieces of the puzzle and clealy and accurately place them into the big picture for all to see! I just wish more people were capable of making the connexion. Good point. This is indeed one problem that I have had with fellow medic partners. I consider it more of an operational issue than a medical issue, but it is a maddening one for sure. I've had a few medic partners who were senior to me who liked to cherry pick their runs. We'd get on a scene, they'd jump out and do a full assessment and institute treatment, then we'd load the patient into the ambulance. Next thing I know, the back doors slam and my "partner" jumps behind the wheel and starts driving away even though it is HIS patient. There are several reasons why this happens. Most of the time it's because all the cool stuff is done (or because there was no cool stuff to do on this patient in the first place), so now he's not interested in the patient anymore, nor the paperwork that comes with it. Sometimes it's because they are all eat up with code-3 driving and don't want to miss that opportunity. Sometimes it's because they're over their head with that patient and want to run away. But the result is that I get stuck with a patient that I did not assess, and I am rolling down the road before I have even finished transferring the O[sub:4043228dd8]2[/sub:4043228dd8] to the wall. But this is really not a medical issue, or a medic-medic issue. It's simply one of those arsehole, "I've worked for this company for 2 more months than you have, so I am your boss" issues that even Basics will throw at a medic. For clarification, I don't believe all ambulances should be ALS. I only believe that all 911 emergency ambulances should be ALS. Valid debate, though.

Interesting question! This is an age old controversy that you think would have burned out years ago, yet it still seems to linger, even in the computerised charting age. Every EMS provider I have ever worked for since the mid 1970's has required that only black ink be used on official documents. As mentioned before, the argument that blue and other colours did not photocopy as well was always the reasoning behind it. There is some amount of technical logic behind that, but it isn't that significant anymore. Photocopiers are much better than they used to be. Still, there are states that make it a crime to fill out a cheque in red ink for that very reason. It doesn't copy well. Interestingly enough, I have worked in hospitals that would not accept your job application or any other official documentation on the job (lab slips, admission forms, etc...) in other than black ink, however had their nursing shifts charting in blue, red, and green ink to separate the different shifts' notes on the chart. Most hospitals stopped that colour coding thing many years before electronic charting came along though. I also worked for an EMS provider that required its job applications to be filled out in blue ink for two reasons; first, because it was a test to see if the applicant was reading and following the directions at the top of the page. And second, because since nobody carries a blue pen to a job interview, it forced them to take the application home and fill it out, resulting in a neater and more complete application. Incidentally, that was my idea. But yeah, it is extremely common for organisations to require that only black ink pen be used for official documentation. I'm surprised that anybody who has had more than one job in their career has not yet run into that.

So what's your solution? Tell the patient to get bent? Any ambulance service provider -- large or small -- existes to take care of patients, not your son. It's just too bad there are so many employees who don't have the same interest. *roll eyes*

I always love it when, on some soap opera, somebody who is intubated and on a ventilator starts moaning and talking in a raspy voice. Uhhh... time to check that tube placement, guys! Not that I watch soap operas. :oops:

NOTE: I am asking for input only from Paramedics on this question. No observations from Basics or Intermediates, please. When discussing the pros and cons of dual Medic units, a theory that commonly comes forth is that having two Medics on a truck creates conflict when there are differing opinions on the assessment or plan. Interestingly enough, everytime I have heard this theory, it came from a Basic or Intermediate, and not from a Medic. And perhaps I am simply blessed with incredibly good luck and good partners, but I have to say that I have never once encountered this in thirty-something years of practice. However, my head explodes recalling all the times that I have had Basics (never an Intermediate) argue with me on scenes regarding patient care. This is not to say that there is no conflict between Medic partners about everything from when to eat to what street corner to hang out on. That is a constant, regardless of who your partner is. But I am speaking very strictly of medical issues. My question to my fellow medics is, do you ever actually see this happening? If so, how often? Is it usually easily resolved, or does it indeed become a significant problem? Is there any common denominator you see, as far as when it is most likely to happen (i.e. experience levels, age of partner, gender of partner, type of patient, etc...) that we can attribute most of these incidents to? And, as a follow-up question, do you experience this problem with Basic or Intermediate partners? Again, how often, and are there any common denominators? Is it more or less common than conflict with a Paramedic partner?

How do you figure? MDs/DOs have a single licence system, yet that doesn't seem to stop them from becoming brain surgeons.

No way! I enjoy them! A lot of us have been pretty removed from the classroom for quite awhile. It's nice to see an honest insight into the process through the eyes of somebody there for the first time. I enjoy it! I intend to read this one through to the end!

http://www.emtcity.com/phpBB2/viewtopic.php?t=9711

Good times! Thanks for the recap! :thumbright: How's the weather on the Cape now?

I know and respect Debbie Cason. She's been running that programme for nearly thirty years now. But it should be noted that the programme is a ninety-day wonder school for urban firemonkeys, and a certain bias comes with that. It's probably one of the very best firemonkey programmes in the country, but it's still just a tech school that caters to the lowest common denominator. When that is your milestone, then making "everyone happy" is no problem. But this does nothing to advance the profession. At least it doesn't appear that they are taking us backwards. But at the very best, they are only marching in place. This is certainly not forward progress. That's why Dr. Bledsoe bailed on this organisation and project. Screw making everyone happy. You have to break a few eggs to make fruit salad.

Valid point, but unfortunately, most states have incorporated EMT into the basic fire certification curriculum. If somebody wants to be a firefighter, they have to be an EMT also, even if their department does not run EMS. And even in those states that do not require it, individual departments are more likely to hire somebody with EMT than somebody who is not. This, my friends, is why fire based EMS usually ends up substandard to non-fire based. There is no motivation. They don't care. It's not what they want to be doing. But they (the departments) continue to do it for the money, knowing that their community could not care less about quality of service. The individuals are not to be blamed for this. The idiot adminstrators and politicians who push off the job on people who aren't interested in it are the ones screwing it up. I am all for firefighters being trained to a high degree of proficiency in first aid, which is basically all EMT is. And yes, it should be a requirement of firefighter certification. But they should devise a curriculum for this that is more applicable to firefighters. There is just way too much crap in the EMT curriculum that has no application to non-ambulance based providers. That time could be much better spent on other skills. Actually, just getting rid of this whole EMT nonsense altogether would solve both of our problems.

QUALITY first post! :thumbright:

LOL! We should have an "amnesty thread" where people can come confess their sins and not have it held against them in the future. Now that's entertainment!

Obviously not. I asked Chuck Norris about SOMEDIC, and he flat out told me he'd never heard of the guy. But he's looking for him!

Wait... before we get too carried away with all this -- and for the sake of accuracy and credibility -- what exactly is this revelation, and what is the source?

:shock:

I fear anybody who isn't smart enough to wear a clip-on tie. You take that brief moment that the patient is sitting there confused, staring at the loose tie in his hand, as your opportnunity to punch him in the throat with everything you have.

EMT school was nothing like the fire academy for me, because the fire academy was five times as long and ten times as hard. It was longer than paramedic school too, and at least twice as hard. Although, it seems that most fire academies are a joke compared to mine too. So yeah, I can see why people -- especially those who have no interest in it in the first place -- would not be motivated to take EMT school seriously. Someday, maybe EMT school will actually involve enough stimulating education that people will either take it seriously or flunk. Not anytime soon though.