Dustdevil

Now you have my attention!

Not bashing at all. I'm tipping you off with valuable information. If you google it and find the info on your own, you will retain it better than if it is handed to you. Trying to help you learn. People did the same for me, and I am giving back.

Do you care enough to Google it? :wink:

I do like the extrapolated conclusion of the piece, which is basically, a refusal should generate so much patient assessment and documentation work that it becomes no easier to no-ride them than it is to simply transport them. Since the rationale for medic initiated refusals is usually laziness, this takes the incentive out of no-riding people, and consequently, the no-ride ratio drops dramatically.

Wow, you made some really serious misjudgments of what I have said. Uhhh... that is exactly what I suggested. They have two years to improve themselves. That is hardly throwing them under the bus. And there is NOBODY employed in EMS who does not have the resources to participate in higher education. Yes, and I don't want him on my ambulance either. Great. You work on improving the competency of northeastern MD's. Meanwhile, we're working on improving EMS here. Frankly, you miss the point. The point is, it doesn't matter which came first. Personal growth and development is up to YOU and you alone. YOU are responsible for achieving education. Nobody has to give it to you. It's there. Either go get it or sit on the sidelines with the rest of the GED's. Doesn't matter to me. There are plenty of medics out there who are willing to put personal effort into being all they can be. Especially if they know it is the standard for employment. How can you not see that I do see that? I have made that very same observation here time and time again since joining the board. It seems that at least once a day I observe how totally inadequate the educational standards are in EMS. No kidding! Tell me something I don't already know! Three paragraphs of utter nonsense. Who do you think the system is? WE ARE THE SYSTEM! We can change it! Nobody has to wait to be told that education is important before they choose to improve themselves and be all they can be. Nobody had to pass a law to make me wear my seatbelts. I was smart enough to figure out it was a good idea all on my own. Professionalism is contagious. Elvevate your game, and people around you will be motivated to elevate their own. That's where it all starts. The only thing you are correct about is that it is indeed a very long road until EMS ever gets where it needs to be in the US. If you are waiting for the man to force you to improve yourself, then you will end your career as cluelessly as you began it.

It's sort of like paying your child's life insurance premiums religiously, but neglecting to feed her. Sort of back asswards. :roll:

I just can't help but wonder how many lives would be saved by taking all that money and putting it into educating and hiring paramedics in under-served areas instead of planning for an unlikely Armageddon.

Okay, so far we have NYS and Maine. Hmmm... maybe it's just my math, but it still sounds like "very few" to me.

You had 911 when you were a kid? :shock: You're younger than I thought! When I was a kid, if you had an emergency you had to saddle up and ride into town and find the sheriff. AND WE LIKED IT!!!

The scene was unsafe. She stayed. Sounds cut and dried to me.

Jake is correct. Education and professionalism increases, and the profession elevates. And... No, it is not the important factor. It is an important factor. EMS is a multifaceted profession with multiple concerns. Patient care is our primary goal. However, it is not our single concern. The image of the profession, and of your organization, is of great concern. However shallow you may perceive doctors and nurses to be for judging your atrocious grammar, the fact is that they do it, and it reflects upon you, your agency, and your entire profession, keeping us exactly where we are now -- right next to the burger flippers -- on the professionalism scale. It's the old chicken vs. the egg argument. Are we undereducated because the profession sucks? Or does the profession suck because we are undereducated? I submit the latter. And if you honestly believe the former, you are either blind, or you simply have not been around long enough SPELL CHECKED: No errors found.

That is a possibility. It was my understanding that you were describing an injury which did indeed require treatment at the hospital, and that you were saying it was perfectly okay to tell them they should get a friend to drive them or to drive themselves. In that case, I stand by my statement of disagreement. But if you were talking about somebody who does not at all require medical evaluation or treatment -- no stitches, no nothing -- just a bandaid, then yes, I agree with you.

Yes, and Hitler didn't actually fight WWII. He simply authorized it. :roll:

It should probably be noted for the purposes of your research that there are very few states who, like New York, control their EMS scope of practice from the top down. Most states leave SOP completely up to local medical control. Therefore, your question, as currently asked, really isn't going to get you the results you are looking for. Because the truth is, almost every state "allows" fentanyl or any other drug the local medical control approves. Good luck.

Great point, AZ. I would hate for the results of current research calling for better pain management to be oversimplified into a call for nothing more than more narcotics. To do so would be a disservice to our patients.

Completely irrelevant to your own point. While somebody with arachnophobia may indeed experience a syncopal episode, they do not require medical treatment BEFORE that episode. Therefore, transporting them is not even a factor, unless they specifically ask for it. Conversely, the patient you began this conversation about in the first place has an existing, acute injury and does require medical treatment. Therefore, transporting is a factor. And therefore, your analogy is invalid. Absolutely, and that was my point. It is their choice. But it is not up to you to "encourage" them to find their own conveyance.

I think the bigger issue is not grammar itself. After all, thanks to public education, most of us leave high school with some weakness or another. For some it is math, for some it is the sciences, and for some it is the language arts. We have to remember, public education is there to cater to a minimum functional level of human knowledge and performance. A lowest common denominator. Those with exceptional math or language skills after high school are the exception, not the rule. They are anomalies. It isn't until a couple years of college that I reasonably expect somebody to be literate at either. Between high entrance requirements and college co-requirements for graduation, we simply should not be turning out a single medic in this country who is not proficient at both math and language skills any more than we should be turning out physicians without them. Now, back here in the real world, where any GED chimpanzee that can squeeze his fat ass into a fireman's uniform is accepted and graduated into paramedic school without any entrance exams or general educational co-requirements, the above concept is but a pipe dream. Consequently, we are going to have some good medics whose language skills are simply horrible. In those people, the measure of their professionalism is their efforts to improve themselves. To finish medic school and start churning out horrible documentation is one thing. To not make a single effort to improve yourself through self study, tutoring, or better yet, attending college, is unforgivable. Unfortunately, it is probably the most common outcome that I see. Once they have that patch on their shoulder and start hitting IV's and tubes consistently, they cop the attitude that nothing else makes a difference. Those are the guys I have zero professional respect for. That is something that I would not tolerate. Solutions? More competitive EMT and paramedic school entrance requirements. They aren't allowed in until they have completed the general education co-requirements. Period. And the more college hours they have, the higher on the list they go, ahead of the other candidates. Minimum SAT or other standardized testing scores. Essay entrance exams. For those already in the field, you will improve yourself or you will be terminated. EMT's will be in paramedic school AND have their general educational requirements completed within two years of employment or be terminated. Paramedics will complete an associates degree within two years or be terminated. Those are all things they should have done BEFORE they entered the field in the first place, so I will accept no whining about being unable to do it in two years. New employees, primary paramedics will not be hired without a college degree. Medics without degrees will be hired on an as-needed basis as secondary medics so long as they are actively enrolled in a degree program, which they have two years to complete. And regardless of your educational level, if you have low grammar skills which are not showing noticeable improvement, you're out the door. I will not have my agency and all the good people who work there embarrassed by your lack of professionalism. Because no matter how good the rest of my people are, YOU are the one all the doctors and nurses are talking about. You are the weakest link. Goodbye! SPELL CHECKED: one error found and corrected. :wink:

Obviously in your limited experience you have never encountered the people I am talking about, because you clearly do not understand. They don't have to be losing a lot of blood. It can be extremely minor. And they commonly do not pass out immediately. It is often times a delayed reaction. And it happens probably more often in adults than minors. A properly educated medical professional knows this and takes it into account when evaluating his patients. Yes, to hold EMS responsible for all of this is absurd. But if you don't understand that absurdity gets you sued as easily as malpractice, then you didn't read the article.

Balls my ass. She crossed the line between brave and stupid. She violated the principle of scene safety. I'd fire her.

No. It would be what King James claims that John claims is God's word. Who says John wasn't just hearing voices?

Because a lot of people faint at the sight of their own blood. Some people faint at the very thought of their own blood. I've seen it hundreds of times. If they do that while driving to the clinic, after you told them they could, the liability is on you.

The dictionary is a good point, Rid. When I was a cop, I noticed that every guy I worked with had a dictionary in his briefcase. And they all used them frequently when writing reports. In fact, it was stressed in the police academy. Your partner would be the first medic I have ever known to carry one. It's pretty damn sad that cops are more professional about their documentation than us so-called medical professionals. Again, I would not tolerate it from my medics. They are too easily replaced. Sure enough, spell check caught two in the above post!

Of course, here in the forum, there is no excuse for it. One literally has to go out of their way to scroll past the "Spell Check" button to hit the "Submit" button. It is literally easier to post a spell-checked message here than to post without it, yet people still do it. So, my point is that poor grammar is usually a sign of much, much more than poor writing skills. It is frequently a sign of ignorance, laziness, a refusal to abide to established standards, a willingness to settle for substandard performance, and just an all around poor attitude. I wouldn't tolerate it form my medics.

Just now getting into the first article, but I already found something I really like. Well, no kidding! And by extrapolation, I believe that also tells us they are incapable of adequately assessing whether or not the patient needs ALS or not! Back to reading...

Minus five for using ten codes. 8)