Dustdevil

Idiocy and hypersensitivity. This is worse than a double-standard. This is like a quadruple standard. What is the difference between a psych patient and any other female patient? Are you going to get a female witness for every female patient? What about all those unconscious and altered mental status females who aren't psych patients? And then where do you draw the line? Do you get a witness for all females, or just those under age 65 and under 100kg? And what makes the female "witness'" word any better than yours? It's worthless. And a huge percentage of the female medics I know are lesbians anyhow. And yes, there have been instances of complaints of inappropriate contact made against female medics. Plenty of docs I know don't even bother with the "female chaperone" policy in their practices anymore simply because it hasn't proven particularly valuable. A witness is a witness, regardless of gender. And a nervous patient is reassured by professional demeanour, regardless of gender. The camera is certainly a good solution to this dilemma. Much better than any other suggestions I have seen. Other than the excellent suggestion of maintaining contact with your partner, the camera is about the only thing I would even bother with. Even with cameras and "witnesses," any public accusation is going to farq your reputation, so your effort is for nothing.

Actually, I don't think we differ much at all in our definitions. I agree with your definition wholeheartedly. I suppose that in the context of this particular discussion I was focusing on other, more field level and personnel related factors than on general systemic factors. I took the original question to be an attempt to find a service where the international visitor would find quality at the field level, as well as a pleasant experience. A rideout with most large metropolitan fire based systems isn't likely to impress the international visitor who is accustomed to a greater clinical sophistication. And I didn't think he would be looking to spend a day studying the dry statistics that are the only real evidence of the factors you mentioned. And most of all, I would hate to see an international visitor come here only to go back home with his lasting impression of American EMS being how a major urban FD breaks down paramedic education and practise into the lowest common denominator, and then staffs it with people who, for the most part, don't even want to be doing the job. While I certainly agree that all of the factors you mention are extremely important for a service to be "good," the two most important elements of any system will always be the two you didn't mention: Education and people.

Wow! I think you are the first person I have ever heard be honest enough to admit that! Personal responsibility. What a concept! :thumbleft: Anyhow, you have to take more into account than simple base rate. While they may be making three dollars an hour more than you in NYC, they are also paying a LOT more just to live there, so they're probably no better off than you. Same thing pretty much anywhere in California. And of course, there are large local variations too. I know AMR pays medics in one county two dollars an hour more than they pay their medics in the next county. Same employer. Same area. Two different pay rates. Texas certainly has its share of places paying in the $6 dollar range for EMT's. But we also have a few excellent services that pay their medics $40k to $50k a year and up, before overtime. Considering a great many EMT's in this country "work" for free, consider yourself lucky that anybody is willing to pay even $6 dollars an hour for your services.

That is excellent advice there. Probably the best. The original poster should see that nobody else came out of that class any better prepared than she is, yet most of them are already hitting the job market. So what's the difference? Self confidence. And if you broadcast to the world that you don't have self-confidence, you are forever marked with that label. Don't do it. Go straight to work. Now, I would definitely be very honest with my potential employer when interviewing and say, "I did well in school. And I believe I know the material as good as anybody. But quite honestly, the school offered very little in the way of practical experience, so I think I would need an experienced partner to show me the ropes and bring me up to an operationally confident level." Of course, your employer knows this already, because all new grads are in the same boat. But he will appreciate your ability to recognise your own weaknesses and address a plan to improve them. And, in fact, I am particularly unimpressed with those applicants who cannot do that. That's why almost every interviewer will ask you for your weaknesses.

The school should have given that experience. If it didn't, you got ripped off. And if your employer is hiring you knowing you lack that experience, it is then their responsibility to provide you with that experience in an environment that does not jeopardise patient care. Students are covered by insurance. Observers are not. Observation is not experience. It is merely exposure. And it's a waste of time, unless you are using it BEFORE school to determine if you really want this job. And employers are not impressed by the "eagerness" you display by riding along for free. Everybody who enters the field has that same enthusiasm. It doesn't make you special. In fact, it just makes you look like a whacker. I'd avoid it at all costs.

Good stuff! :thumbright:

Yes, but does she have.... Oh, nevermind. 8)

Any professional agency with half a brain would have a written policy specifically forbidding any observer, regardless of training, from participating in any aspect of patient care. If the agency you are riding with does not, it's probably a bad service to be learning from.

Not impressed. The typical EMT devotes all his time to that sort of crap -- spiking bags, tearing tape, and running strips -- in the mistaken belief that it is helping him (cuz few of them are really interested in helping anybody but themselves), and lets his EMT book gather dust at home, never again opening it up to study MEDICINE and truly improve himself. Does it help me to do all those silly little monkey tasks for me? Sure. Thanks. But I will be MUCH more impressed with you if I see you actually studying on duty and taking college classes off duty rather than constantly hounding me about learning some other skill you don't have the education to use.

Wow. :shock: CSR, I had a lot of respect for you before that last post. :?

Yeah, that'll happen right after they pass a law requiring people to pay their ambulance bills.

Minus 5 for using an oxymoron.

LMAO!!! What a drama queen. That should be required viewing by all applicants to EMT school.

Maybe it's just me, but all of this seems a lot simpler than the researchers and consultants want to make it. If your response times are too slow, you don't have enough ambulances. Period. What's hard about that? We can whine and moan about abusers and mutual aid responses all day, but the bottom line is that you need more ambulances. While Rid's "too many chefs" theory is a valid one, it does not absolutely preclude individual communities from having their own services and not giving up their local control to a county-wide system. What almost always happens in those cases is those communities end up with worse service and RT's because now their dedicated service is busy making crap runs in the big city. It's robbing Peter to pay Paul. The consultants are morons.

Isn't Tom Cruise still doing that? By Patrick Mulchrone Tom Cruise yesterday revealed his latest bizarre mission..to eat his new baby's placenta. Cruise vowed he would tuck in straight after girlfriend Katie Holmes gives birth, saying he thought it would be "very nutritious". The Mission Impossible star, 43, said: "I'm gonna eat the placenta. I thought that would be good. Very nutritious. I'm gonna eat the cord and the placenta right there." It is the latest in a series of increasingly strange outbursts from Cruise in the run-up to the birth. He has claimed the baby, due any day, will be delivered in total silence. The Top Gun star also insisted he "sensed" fianc?e Katie was pregnant before she told him. And he has blurted out details of the couple's sex life, saying: "It's spectacular." The actor, who recently also claimed he has the power to cure drug addicts, has even been carrying out his own medical scans on the foetus after buying himself an ultrasound machine. Silent birth is one of the rules of the cult of Scientology, which Cruise is devoted to. The cult - founded by the late sci-fi writer L Ron Hubbard - claims that 75 million years ago aliens came to earth and their spirits now infest our bodies. Cruise told GQ magazine Hubbard had discovered making a noise had a "negative spiritual effect" on someone giving birth. He insisted that 27-year-old Katie would be allowed to scream, adding cryptically: "It is really about respecting the woman. It's not about her screaming. "And scientifically it is proven. Now there are medical research papers that say when a woman's giving birth everyone should be quiet." Cruise also revealed he and Katie have been preparing for the birth by holding classes at their Beverly Hills home. He said: "We've been studying what a woman goes through. What happens to her body. It's just kind of becoming this fun game of learning." Cruise said his sex life with Batman Begins star Katie had made him realise one-night stands were "horrible". He added: "Great sex is a by-product for me of a great relationship, where you have communication. It's an extension of that. If you're not in good communication with your partner, it sucks." Cruise, who has two adopted children with ex-wife Nicole Kidman, will not be the first star to make a meal out of his baby's placenta. Rod Stewart and girlfriend Penny Lancaster took home their baby's placenta, sprinkled it with tee tree oil and buried it in the garden. In 1998, Channel 4 chef Hugh Fearnley-Whittingstall fried a placenta with shallots and garlic and served it up to 20 guests, including the baby's mum and dad. TV watchdogs later criticised the show, branding it "disagreeable". But placenta-eating is considered normal in some cultures. Various recipes include one for placenta lasagne. Some say eating it helps avoid post-natal depression. p.mulchrone@mirror.co.uk

Good start. I can relate to all of those. You know what that means? It means that the medics with those issues have them even if their partner is a medic. EMT's shouldn't get all defensive about this situation, because usually their cert level has nothing to do with it. Those medics are lazy jerks no matter who their partner is. I've experienced the same issues with medics who had half my experience. Jerks are jerks.

I don't want an assistant. I want a partner.

There is a theory in the martial arts about students learning just enough to be dangerous. Mostly to themselves. This theory very much applies to EMT school. As our new friend from WV has told us, most are interested only in learning hands-on skills, and simply don't think that the scientific foundation that comes from all that "book learnin'" is really important. And yes, EMT schools tend to perpetuate that fallacy by teaching under the same theory. Consequently, the great majority of EMT's in the US come out of school with just enough knowledge to be dangerous. They are taught all sorts of skills that, if inappropriately applied, can cause harm or death. And yet, the knowledge base they are given with which to make their clinical decisions is horrible, even in the very best schools who provide double the minimum required hours of instruction. Examples? EMT argues with paramedic who chooses a scoop stretcher to move a patient instead of a long board. EMT argues with medic who places a nasal cannula on a mouth breathing patient. EMT argues with medic who places high flow oxygen on a distressed COPD patient. EMT argues with medic who places oxygen on a baby. EMT argues with medic who gives only D50 to the unconscious diabetic instead of the whole "coma cocktail." EMT argues with medic who intubates a patient who is not in full arrest. EMT argues with medic who runs a non-rebreather at 12 lpm instead of 15 lpm. EMT argues with medic who does not run a strip on an obviously dead body. EMT argues with medic who doesn't let him drive hot to the hospital with non-critical patients. EMT argues with medic who refuses to stay and play with critical trauma patients. EMT argues with medic who stays and plays with critical medical patients. And those are just the medically related things I have had EMT's argue with me about. I won't even get into all the operational issues from when to refuel to what siren tones to use. Need I say anymore? Obviously, the problem is huge. As has been universally agreed to by the respected professionals here, EDUCATION is the definitive answer to each and every problem in EMS. Period. Not only do we have to change what we are teaching in EMT school, we have to change what we are NOT teaching in EMT school. We have to stop feeding the monster. We have to stop blowing so much rah-rah smoke up newbies arses and convincing them that they are something special. They come into school with that attitude, and schools only make it worse with all their "public safety" uniforms and bloused boots and the superiour attitudes of the instructors. Funny, I never had an instructor in nursing or respiratory therapy school who copped that sort of attitude. The change in both the attitude and the curriculum of EMT school would go a very long way towards shaping a new breed of provider that eliminated a lot of the current lunacy. Eliminating the basic level from 911 ambulance EMS would be a very, very good step in the right direction. The current level of training is wholly inappropriate for somebody who has ultimate transporting responsibility for emergency patients. It's just first aid. It's appropriate for first responders, and that's it. Contrary to popular and idiotic belief, simply elevating the skillset for the EMT-B (as Tennessee appears to be doing) is certainly not the answer, or even a sane option. Again, the problem is not skills. The problem is education. The problem is that too many in EMS do not receive adequate medical education to have the knowledge base necessary to make clinical diagnoses and treatment decisions, regardless of the monkey skills they learned. Consequently, simply eliminating EMT-B's is not in itself an answer either, because EMT-I's are just as poorly educated as EMT-B's. So, again it brings us back to education. Prepare people from the very beginning with adequate education to function safely and independently, and assure with a lengthy internship that they are capable of doing so, before they ever receive a patch. That means a significant increase in school time for ALL levels of providers. And, it probably means that the absolute lowest entry level for a 911 ambulance EMS provider should be no lower than the current paramedic level of education, then work our way up from there until it becomes a medical profession instead of a job. And of course, changes in education have to affect ALL levels of personnel involved in EMS. Instructors need to be real teachers, with formal education in the educational process, taught by education professionals. We don't need more burnouts with no formal education who thought teaching would be fun and never had any training beyond a 16 hour course in instructional techniques. Supervisors have to be more than simple senior medics. They need EDUCATION in supervision, management, and human relations. Remember some of the absolutely horrible responses we got in the topic a few weeks ago about "punishing" the medic who forgot to report defective equipment for a few hours? That's all the proof we need that the deficiencies of EMS are much deeper than inadequate field practitioners. And if our instructors and supervisors were themselves adequately educated, it would be a lot easier to shape and train our newbies. That's it, folks. Education. Education. Education. There is no other solution. There is no other answer. In fact, there is no other problem.

EMT school takes only slightly longer than training a new employee at Taco Bell. And, unlike Taco Bell workers, there is no shortage of EMT's. In fact, there is a tremendous glut. Why should they make any more?

So, you're saying you IGNORED the "Terms Of Service" that you agreed to when you signed up here? When you clicked the button that said you had read and agreed to the forum rules, you lied? Please say it isn't so! :roll: Now I more fully understand your post about not being much a book learner and preferring to learn things "hands on." You'd rather learn things -- like being a medic -- through trial and error rather than just reading the instructions first, eh? What the heck, it's only human lives, right? Not like there is a population shortage. Killing a few patients is no big deal. So, when you screw up in the field, is this how you take constructive criticism? [stream:0d92d34567]http://www.darryl.com/badges/bsbadges.wav[/stream:0d92d34567]

I went to FreeTranslation.com and ran that post through about 5 different languages and I still can't decipher it. :? Kristina, you literally have to go right past the "Spell Check" button in order to click on the "Submit" button when you post. It really could not possibly get any easier. Consequently, it shouldn't be shocking to you that those who consider this a profession of educated and intelligent, detail minded professionals might find your cavalier disregard for civility -- as well as the forum rules you never bothered to read -- at least mildly annoying. If you're not interested in fitting in here, then you're not interested in fitting in with our profession. Think about it. :wink:

Other than the rare nightmare, I never really dream about work. I have had tonnes of dreams about school, even decades after graduation. But not about work. We'd make great partners. We wouldn't ever have to worry about competing for the same women!

Sorry Kristina, but I have to say that too many students use that as a cop out. Hand's on teaches you first aid. Hand's on doesn't teach you physiology, and pharmacology, and pulmonology, and neurology, and endocrinology, and orthopaedics, and paediatrics, and cardiology, and gynaecology, and psychology, and all the other things that are absolutely crucial to being a pre-hospital medical professional, even at the EMT-B level. All the bandaging and splinting in the world is useless if you lack the educational foundation necessary to make sound clinical judgements. If all you are about is first aid, you could have saved yourself a lot of time and money by going to the Red Cross instead of EMT school.

LMAO! Dude, I would pay to see that!

I don't believe they can, and that is my point. That's like saying that if a nurse performs surgery, it's not really surgery. The certification level of a provider does not affect the classification of an intervention. If a procedure requires a certification -- be it EMT or Paramedic or whatever -- it is an advanced procedure. Advanced = ALS. Call it an EMT skill or an EMT drug if you like. That is fully appropriate. I have no argument with that. But it is very definitely NOT a BLS skill or drug. In fact, "BLS drug" is an oxymoron. To synonymously equate EMT's with only BLS skills is a categorisation that is an insult to EMT's. And it completely ignores the emerging reality that EMT's are more commonly being called upon as ALS providers. And, most dangerously, it cheapens the ALS functions being performed by those EMT's to a point that they will start to take it for granted as "no big deal" because it is "just BLS." And we all know where that leads. Is it just semantics? Probably so. But, in this case, it is semantics that make a real difference in our perception. And, that erroneous perception can have a very negative effect on our practise. Let's try to respect the medical responsibilities we are being entrusted with instead of taking them for granted as nothing more than standard first aid.