Dustdevil

The explanation is that you are utilising an AMERICAN spell checker. I am using an ENGLISH spell checker. My spell checker says everything was spelled correctly except for "oooh!"

Hmmm... I was thinking if the local administrative bodies could come to an agreement on what the standard should be, it would be a validation of NR, not a way to do away with it. After all, if everybody agreed on the standard, there would be no need for each and every state to pay the enormous expense of developing and administrating their own exam. That was the case with NCLEX and FLEX. To answer the original question, the concept of a National Registry is awesome. In fact, it is ideal. It works great for nursing, medicine, and most other licensed professions. Mobility is a snap for those professions. But NR is a long time from realising the dream here in the US where political forces across fifty states work to keep standards low and can never agree on what exactly the standards or scope should be. But remember, it was a very, very long time before national standards were adopted for nurses and doctors too! It's a long, bumpy road, but we can and must get there.

Agreed. The problem is, since NR has no legislated authority, they can't achieve the same things that NCLEX has achieved. NCLEX can raise its standards and the nursing schools will raise theirs. The nursing schools applaud elevated standards. They want their graduates to excel and graduate with more than the rock-bottom minimum level of knowledge. They take pride in it. The opposite is true in EMS. If NR raised its standards, the schools and fire departments would just cry and whine about it, forcing states to pull their participation. Consequently, while the concept of the NR is excellent, they still keep their standards way too low. And they also still have serious problems writing test questions that make sense. But again, none of that invalidates the concept of a National Registry.

When was the top rocker patch being issued anyhow? The first one I received in 1976 only had the Ambulance rocker. I wish I could quickly find my original AAOS book from the early 70's. I specifically remember in the first chapter there was a black and white photo of the NR patch, card, and certificate. I wouldn't swear to it, but it seems like the patch did not have the top rocker.

Those were SO much better looking! They totally screwed them up when they reduced the SOL size to cram in all that small print.

Yeah, I don't get the hostility either. I guess I am just not Neanderthal enough to see the opening when it presents itself. :? In the case of a non-traumatic patient, it is certainly not unusual that a weapon would go undiscovered. You didn't say where it was located, but abdominal and chest auscultation may very well have revealed the weapon. If not, I disagree that you should be doing a full body pat-down on each and every patient you encounter. You're just looking for trouble with that sort of policy. And, of course, how long did you even have the patient before EMS arrived? Only a certain level of exam is expected from first responders. I don't think you did anything wrong. For that matter, I don't think EMS necessarily did anything wrong either. I also don't see the big deal about finding weapons on each and every patient. Lots of people carry weapons. Lots of them are fully within their legal rights to do so. Not everybody with a weapon brought it along just to kill paramedics with. If he had come in there intending to use his gun, he would have already done so. Personally, I don't care. It is not contributory to their medical condition, so it is not high on my list of concerns. And if I were confined to a wheelchair, I think I might be taking extra self-defence precautions too. I do think I would take this incident and use it as ammunition (no pun intended) in a formal proposal that EMS personnel be taken out of security uniforms for obvious safety reasons. When you close in on this guy with your security uniform on, you're cornering a scared animal. He doesn't know you are there to help him. He just knows you're security. You may precipitate a violent encounter simply by the way you are dressed. There is absolutely no excuse for that, and your management should deal with the issue. The uniform issue aside, it sounds like your approach to the patient was a good one. You were obviously non-confrontational and put him at ease instead of copping the cop/security guard attitude and mindset that is so common among medics. Your attitude will go farther to "disarm" your patients than a pat-down will. Patting people down only makes them fear discovery and possibly make them take desperate measures to avoid it.

If by "old" you mean the ones that are just now being phased out, here's one that is on eBay right now: Here's one of the Intermediate patches that is being phased out: If you are looking for photos of the old, original NREMT patches (before they said NREMT or Basic on them, and still had the Ambulance rocker on them), I'm afraid I can't help you. I haven't seen one in years.

Thank you, Patch. And thanks again to everybody for caring and taking a moment to express it. This board has become a second home to me. It has changed my life. I have met so many great people here that I am happy and honoured to call friends. The good people here have helped me both personally and professionally in ways I can never repay. I deeply appreciate your kindness. I am committed to living up to your faith and expectations, then coming back to the world a much better nurse and medic, and giving the rest of my career to helping prepare the next generation. I salute you all.

Don't flatter yourself. It's less than 200 hours of night school that can be completed in less than a month. It's not rocket surgery. What exactly do you think that should pay? :? Yep. The U.S. Military. I highly encourage it. :wink:

I wholeheartedly encourage it. In fact, when I am making admissions choices, those students will receive preference. I like people who are serious about the profession from day one, focus on a career plan and pursue it. I am less than impressed with those who dicked around as an ambulance driver for three to five years until they finally decided they wanted to make a little more money. I don't want to be the one to have to break them of their bad habits either. And I'll make a freaking killing off of taking all those young students that the other schools reject too!

Unfortunately, what Spock sees in his local system is still pretty darn common in this country. And the current trend towards giving advanced skills to basics with a month of night school will only perpetuate the long outdated theory of cookbook protocols such as the so-called "coma cocktail." I remember when it became all the rage in the mid 1980's. I remember very progressive systems adopting such protocol as the holy grail and in fact mandating it be followed to the letter, just as Fire_911 suggested. If you decided to give D[sub:da04ab7df6]50[/sub:da04ab7df6] and not Narcan and Thiamine, or any combination thereof, they would question your competency and threaten to decertify you as an idiot. I'd love to think that we have outgrown such lunacy as a profession. But the sad truth is, it still flourishes and will continue to do so in many parts of the country for years to come. And if your system still insists on such "protocols," your system sucks! Either your MD is an idiot, or he simply doesn't trust you because he thinks you are idiots. Either way, I would be looking for a better place to work.

The main problem I see with electronic PCR's is that, although you are given the capability to narrate, a great many services and medics choose not to. Like so many medics do in every aspect of EMS, they do only the very minimum they are required to do to get by. And the electronic PCR encourages that by basically telling you you've done "enough" by filling in the blanks. Not to mention that many electronic PCR systems don't give you a very convenient way to narrate since there is no keyboard on many of them. There are definitely important benefits to electronic PCR's that cannot be discounted: * Data storage takes much less space. * Data retrieval takes much less time. * Statistical analysis is greatly simplified. * Eliminates problems deciphering bad handwriting. * Ensures minimum baseline of essential information on each PCR. * Makes QA a breeze. There are probably others too, I'm sure. But unfortunately, as I said, it encourages laziness and poor documentation. An organisation who adopts electronic PCR's should simultaneously institute a strict policy to ensure that the completeness of documentation does not suffer from the laziness that will almost certainly ensue. Basically, I feel that electronic PCR's are the documentary equivalent of teaching paramedics to administer drugs based on the colour of the boxes they come in. It's lazy, inadequate, and bound to create a legal problem sooner or later.

Yep. All a student need do is read his or her own textbook to see the inadequacy of the education they are receiving. When you realise that all that physiology in the textbook was glossed over by your instructors and never tested upon, that should be a pretty clear indication that there is much more to the job. The problem is, they simply don't care. They don't want an education. They just want a patch and a job. And the very minimum they can get by with in order to achieve that is exactly what they are more than willing to settle for. Consequently, I have no hesitation or remorse for giving those slackers a rude awakening when they swagger into my station with their shiny new patch and know-it-all attitude. If they have the proper attitude to succeed as a medical professional, they will answer that wakeup bell and improve themselves. If not, they'll simply hit their professional snooze button and continue to merely "get by." Some of you mistake "eating our young" for simple tough love. It's a test of their commitment to the profession. And I don't lose a moments sleep over those who fail that test. Unless they're hott.

Eh? :?

Oooh! The force is strong in this one! The fact that you just typed a coherent paragraph, complete with punctuation, capitalisation, and proper spelling is a very positive factor in your favour. And yes, I am being quite serious. Not only does it demonstrate literacy, but it clearly demonstrates that you took your high school education at least half-way serious and that you recognise the importance of clear and intelligent communications. You will probably be an exception within your class. :thumbright: Both of the above pieces of advice are excellent, and really cover the question quite well. Do remember that studying a topic is not the same as simply memorising facts and terms. It is more important that you actually understand concepts. You can't pass the NR exam just memorising protocols and drug names. You have to clearly understand physiological functions and pharmacological actions in order to make intelligent clinical judgements. Consequently, Lithium's advice is spot on. Spend at least as much time understanding organ functions and physiology as you do simply memorising anatomy. And I hope you are planning to take formal A&P courses, and not simply read the book and hope for osmosis. That one effort will put you WAY ahead of your peers. Don't waste any time at all trying to learn EKG's or IV's or Intubations or any other monkey skill ahead of time. They are simple and given more than adequate time and attention in class. Getting ahead of yourself skill-wise offers you zero benefit in the long run. Concentrate on theory. That is where medics are made or broken. That is what fails students out of class. Best of luck!

You're wrong, and I am disappointed in you. As well as offended.

Oh, I think basics should get all those drugs too! So long as their school is at least two years long. :wink:

That's what I thought at first, but that would mean the PE and the Dx would be in the same block, which is tres confusing. Yeah, I'm with you. I don't like it. SOAP remains the best format I have ever encountered. Although, I changed it to HEAT at one service where I designed the PCR. istory Examination Assessment Treatment "Plan" just doesn't quite work in the field where we will always have already done everything before we get around to charting. And "History" and "Treatment" keeps us from having to explain the difference between subjective and objective to the mental midgets coming out of EMT schools these days.

That totally omits the physical examination. That can't be a good thing. :?

At the risk of repeating myself all over again, WTF are you talking about? Nowhere in this entire topic did I ever make any such statement. We seem to have a real reading comprehension problem on this board. :?

LMAO!! That's beauty, eh?

Good riddance to the TM thermos. They're a useless waste of time and money. Even the little disposable TempaDot strips are more reliable than the TM thermometers. Fire anybody who insists on putting them on an ambulance because they obviously are clueless.

And you also have the responsibility to explain them. Why is it that you "feel" your way is better?

My thoughts exactly, Zilla. I just don't see any clinical justification for this thing. It simply does not offer any significant benefit to the doctor. And even if it did, would they really want to sit in front of a television in their busy ER and watch a patient that was already being watched by a paramedic? I really doubt they have the time or the inclination. That leaves me with three possible theories here: 1. Some technology company who hasn't the slightest clue about EMS is trying to sell us a bill of goods and justify it with spurious claims of medical benefit. 2. Some EMS systems who do not trust their medics abilities are trying to compensate for poor education with additional oversight. After all, this is ultimately cheaper than educating their medics better. 3. Some EMS systems who do not trust their medics behaviour are trying to justify putting big brother in the ambulance on medical grounds so as to not incurr the wrath of the idiot unions who would oppose it otherwise. I just don't believe anybody promoting this idea is doing so out of any sincere concern improving medical care. There is an ulterior motive.

I agree with that. What are they giving you in the way of field experience and internship? Is it seriously inadequate, or do you just want more? I definitely believe that a medic school should provide you with hundreds, if not thousands of hours of field experience before cutting you loose to practise. But I can't envision many campus situations where it would be feasible to create that experience within the campus environment. College students just don't get hurt or sick often enough to keep an ambulance or first responder squad busy. Certainly not enough for a whole class full of students to get any of the action. Just seems like you'd spend hundreds of hours sitting around waiting for the alarm that never comes, with only one or two of your students ever actually responding to anything. And administration would have to be crazy to shell out thousands of dollars to provide something they already get for free from experienced, full-time providers. Again, I just don't see how this thing could ever be justified on any level whatsoever on any campus.