Dustdevil

Yeah, seriously. I thought CDN Bacon was going bipolar on us or something. That was seriously confusing. But, minus 50 points for quoting a PRIVATE MESSAGE in the public forum. That's the lowest of lows, dude. You should be banned for that. You lost all my respect.

Deleted by author due to mistaken identity.

LMAO! I forgot about that one! That was beauty!

Agreed. This is just one example of why I roll my eyes when some low-time rookie EMT or medic says he wants to go work at a summer camp, or in the oilfields, or in some industrial setting. Without a tonne of experience, you are immediately in way over your head, both medically and operationally, when you try to be a one-man show.

Arlington National Cemetary is full of guys who felt "secure."

:-k Hmmm... I can't say I recall ever needing such a thing. But then again, necessity is the mother of invention, so I am quite sure that this arose from a need that somebody encountered. Seems logical and functional to me. But in the grand scheme of things, when it comes time to take the dead weight out of my already over-stuffed ALS bag, I'm going to be hard pressed to find a justification for keeping this item in there. But hey, I don't begrudge anybody using something that works for them!

"Graduation" from EMT school is nothing to celebrate. If you don't receive a degree at a college Baccalaureate ceremony, then your paramedic graduation is nothing to write home about either. My second paramedic graduation was a celebratory ceremony, with formal presentations, punch and finger foods, and family and friends invited. There was no ceremony or party for the first, or for the EMT classes. And I didn't attend any of my college graduation ceremonies. Or my HS graduation either. Who wants to hang out with those losers (and their feral kids) any longer than necessary?

Excellent points, LS. But... The scenario reads that the next oncoming medic DID catch the error. That is how it was discovered. There is no on-site medical supervision in this scenario. This is a REMOTE clinic with one person staffing it and supervision from afar. Those supervisors have to rely on the records of the solo medic being accurate. There can't be a supervisor at every site anymore than there could be a supervisor on every ambulance. And, of course, supervisors are humans who are also prone to errors, so who supervises them? Those are indeed two of the most important keys to success in this business. Without them, your education and intelligence are nothing.

Word.

Okay, here is my basic (pardon the pun) philosophy on Medic/Basic crewing. And, this is ONLY my philosophy. It is not my prescription for how all medic/basic teams should function. First and foremost, a basic has no business on an emergency ambulance. Period. But, of course, this world we live and work in is far from a perfect one. And if I am not running the agency, I don't get to say how the units are staffed. That being the case, I accept that my job is to provide a service utilising whatever help I am given, even if it is only a basic. Therefore, we are indeed a team, and should work together smoothly. But the medic is the captain of that team. And more than that, he is ultimately responsible for what BOTH of you do or do not do. Consequently, it is indeed my way or the highway. Now, this does not mean that my basic partner gets shat upon. Far from it. I am all about fairness, where possible. I go out of my way to assure that the workload is as equitably shared as possible. And, since the medic ultimately has greater responsibility, that means that I am always the one who ends up getting the greater bulk of the work. I believe in alternating positions after every run. That means if I took care of the last patient, you are taking care of the next one, and so forth. Of course, that rotation doesn't usually jibe with the needs of the patients. When it is your turn to take the patient, about half of the time, the patient will require ALS, meaning I have to take him. So, at the end of the day, I got stuck with more paperwork than you did, despite my efforts to be fair about it. So any basic partner of mine who whines about getting the shaft from me is simply a pissy little bitch who needs to go back to McDonalds. Aside from patient care, everything is shared. We check the truck together. We wash the truck together. We clean the station together. After a run, whoever was NOT taking care of the patient does ALL of the cleaning and restocking, no matter which one of us that is. It all evens out in the end. So, bottom line; my basic never gets screwed. Unless he bitches. Then he will find out what it is really like to be screwed. That's what it's all about! Excellent. That is exactly how it should work. Teamwork. But optimum teamwork requires a specific plan. Both of you have to know and understand what the other's role is going to be. No, you don't need to ask to take vitals. I encourage it. I want you to do it as soon as we get to the patient's side. But on the other hand, don't make me ask you to take vitals either. As for assessment, it depends upon whose patient it is. Don't start asking MY patient a bunch of questions. Taking a history is the job of only ONE person. It may be me this time. It may be you. But only one person needs to be asking the questions at a time, unless you are screwing up, or the patient is serious enough that I need to take over. You will not do any of that without my direction. I do not want anybody treating my patient with "protocols." If you do not know exactly what is wrong with the patient, what he needs, why he needs it, and how it works, then I don't want you doing it. If you go giving my costochondritis patient NTG and ASA, you will never work with me again. In fact, you will never work for that service again, if I have anything to say about it. ALS is for paramedics, and protocols are for monkeys. Period. Invasive measures of any kind, including ASA and "assist" medicines are ALS, regardless of who is administering them. I realise that YOUR personal education is exceptional, and that is great. But until you have the MEDICAL education to fully understand the five W's and pathophysiology of those drugs and the conditions that require them, you have no business administering them without direct orders from a higher level provider (and, of course, I maintain that most medics in the US don't have any business doing it either, but I will try not to digress). I think a lot of this has to do with the fact that, as you admit, you were lucky enough to work with a great partner. Had you been paired all that time with a 120 hour EMT-B who thought he knew it all (as most seem to think), you too would feel that way. You'd think, "Dude, these guys don't know dick! They need to just shut up and drive!" And since that is indeed the rule, not the exception, obviously that is going to create the feelings that so many of us have. So think of it this way... if you did not have all of the foundational education, experience, and understanding that you personally have, and all you had was the thirty-percent of knowledge that is typically retained from 120 hours of night school by the average moron, would YOU want you making medical decisions without direct supervision? I doubt it. I'd say that the vast majority of medics in the US need to be questioned constantly because they suck. Seriously. But, like you, I feel like I am smarter, more experienced, more educated, and have a little more on the ball than most of my peers. Consequently, I personally do NOT want to be questioned by my partner. And, since those medics who frequent this forum tend to be those who take a greater professional interest than other medics, it is not surprising that you will see this attitude here more often than on the streets. What you find here, for the most part, are secure, intelligent, experienced medics who don't suck. There are two types of medics that get all bent out of shape when questioned by their partners; there are those who are insecure and probably suck. And there are those who are not insecure and are exceptionally competent medics who simply do not want a lot of chatter going on in front of their patient when the chances of it being productive are slim to none. And all of us out here have experienced this from basics that are not nearly as tactful as you. Yes, I am sure that you have the social skills to discuss care options in an innocuous manner without alarming the patient, offending the medic, or simply being annoying to all. But, believe it or not, that seems to be a rare quality among basics. You've been here long enough to have read the horror stories about the things that basics say and do, despite direction from the medic. They're convinced that all the "protocol" they *think* they memorised from night school is the Holy Grail, and are willing to defy a medics orders in order to do their own thing. The list of all the stupid things I have had basics argue with me about is shockingly long and pointless. So really, don't blame medics for their attitudes. Blame your peers who, unfortunately, earned the reputation that you now are forced to live with. If it makes you feel any better, we all had to live with it at one point. Oh yes, some definitely do. As you have seen, I am certainly not here to defend medics. Not in the least. As many of them are arseholes as are basics. And as many of them are incompetent as are basics. No doubt about that. All I can do is speak for myself here. And yes, if I tell you to do something in the line of duty, I expect it done immediately without a lot of lip. If you have some sincere questions about it because you seek greater understanding, then by all means, ask away. But do NOT do it in front of the patient/family/cops/firemonkeys/news media/supervisor/other crews/ER doc, etc... And do not delay doing what I asked you to do in order to discuss it first. When the time is proper, I will happily discuss it with you to your complete satisfaction. Just remember, that I personally am not going to ask you to do something that is illegal, immoral, incompetent, or unfair. And just because you don't want to do it doesn't make it any of the above. As for our personal relationship on the job, I don't want to be bowed to. Yes, I have encountered some n00bs who worship the golden disco ball, on whatever shoulder it may hang. They walk lightly, call me 'sir' and generally kiss my arse because they believe that a paramedic is some sort of deity to be worshipped. And there are medics out there who eat that stuff up too. Not me. I want to spend my 12 or 24 hours with somebody whom I can be friends with. I'm not looking to boss anybody around, personally or professionally. If you're hott, of course, I have a whole 'nother set of expectations from you. But that does not include worship. When there is a basic on the crew, ultimately the partnership must be very much like a good marriage. We both have the same responsibilities to be concerned with, yet we have separate duties to perform to maintain those responsibilities. We must work to not only achieve our respective duties, but to assure we don't cause extra work or problems for the other in the process. We must be open in our thoughts and communications, but careful not to air our dirty laundry to others. We're both part of the team. And we both work hard to get the same job done. But ultimately, only one of us wears the pants in the family. That is me, the paramedic.

It shows up until somebody else replies. Only as long as your post is the last post can you delete it. Keeps people from changing their minds the next day and claiming, "I never said that!!"

See what I mean about girls in EMS!? :twisted:

How could you possibly know in the acute stages whether your patient had a basilar skull fracture? And why do you "always" remove the helmet? What are you accomplishing by this? Do you remove their underwear too? There is about as much justification for one as the other.

Okay, a little more info on the scenario: Although the medic involved did report the error immediatly upon discovering it, she didn't discover it until a month after the accidental wasting. Another medic coming in to relieve her did the count and discovered it. So, the original medic did not notice her mistake for over a month, even though she signed every day during that time for accountability of the wasted drugs. Does this change how you would handle the situation? How and why?

Maybe it's just an Aussie thing. Actual certified athletic trainers (AT-C) here are a pretty knowledgable group, and generally know their stuff. The problem is with all the wannabes running around calling themselves an "athletic trainer," like all the wanker CNAs that call themselves nurses.

Well, on the surface, it seems like a no-brainer. But in reality, the business world doesn't commonly function like that. There are plenty of hospitals out there that pay ADNs and BSNs the same salary, with no differentiation. Same thing in the business world. Most companies hire for a specific position, and that position is allocated a certain salary range, regardless of the person's bona fides. While a lot of police and fire departments pay extra for educational achievement, many do not. The federal government is one of the few places where education is always taken into consideration in wages. Well, I say "always," but really, if your job tops out at GS9, then no amount of education is going to get you above that level. But at least you will get to GS9 quicker with a PhD than without it. But, I digress... So no, I do not think that education should always be compensated for in salaries. Many times, the education is simply irrelevant to the position. And even that education which is relevant must be exercised in order to be valuable to the employer. In other words, it is not so much the education itself which is important; it is what the individual does with that education that makes the difference for the employer. If you utilise your education to better your performance and benefit the employer, then that should indeed be compensated. But it is reasonable that the compensation would be in the form of promotions and merit raises, or getting the job in the first place, not simply extra money for extra hours of college. And really, with a better employer, that is how it happens. Those who perform superbly are rewarded. But, of course, if you work for an employer who is stupid enough to reward incompetence and arse kissing instead of intelligent and educated performance, then you are an idiot for staying there, which does not speak well for the quality of your education (not speaking of "you" personally, of course). Now I have a headache too. :?

Don't be. The chart must be viewed within it's total context. PA is a stan-alone education. NP education is a continuum, built upon four previous years of nursing education, as well as a great deal of patient patient care experience. Consequently, the numbers on that chart do not give an accurate picture of the total educational requirements. Simply put, it takes longer to train somebody from the ground up than it does to transition them to a new role within their field. That's why PA school obviously must involve more contact time than NP specialisation.

Very true. Unfortunately, that's how it is in today's world. Hell, even this war is being fought based upon PR concerns instead of training, experience, and soldier safety. Welcome to the pussified world.

Ditto. :roll: Who wants to see a nude soccer player anyhow?

Yes. He made clear his intention to resist the officers. Their choice was to fight him or taze him. Choice A means somebody is getting hurt, and the chances of it escalating dangerously are profound. Choice B means nobody gets hurt and the situation ends. We WANT people to be worried about the cops escalating. That's what keeps people from resisting. It's a no brainer.

Well, you have to admit that it makes at least as much sense as saying that because your runs are in the city, your experience makes you more effective or competent than the next guy. If you aren't getting that, then YOU are nuts. Word. Would you care to guess Whit's reaction if you were to go into his home and start talking $hit? What do you think the chances are that he would happily support your "freedom of speech" rights in front of his family? Nil. I hate hypocrites.

I ask them not to volunteer at all. Issue solved.

I am very pleased with the quality of these replies! Very well thought out and well stated. Although, I am underwhelmed by the quantity. Such is the risk of posting in the proper forum instead of throwing everything into the "EMS Discussion" catch-all. :? So, just to clarify the scenario, you, the manager, are absolutely confident that there was no hanky panky. You have no concerns that there was abuse or theft involved. You have no doubts that it was simply an unfortunate, but careless mistake. Given this scenario, it seems that you all believe it to not be a serious disciplinary issue worthy of suspension or termination, correct? And you believe that established procedures, as well as the lack of same, are partially to blame for the incident, right? Any other thoughts or comments? I would like to see a few more opinions on this topic from other forum members before I throw in just a little more pertinent info to see how that would affect your decisions. By the by, this is not a trick question. I am not attempting to lead anybody into anything here. This is just a situation which I recently witnessed, and I would like to know how the attitudes of management compare to the conventional wisdom of others in the field.

The darker it is, the less lights you need to be seen. Elementary physics.

Okay, now that we've got that straight... are you hott?