DwayneEMTP

Welcome back! Good luck in your studies. Dwayne

Fixed it man... Dwayne

LS for someone that argues so many Republican causes sometimes you certainly sound liberal. I challenge you to support your argument that the vast majority of business/industry is paying minimum wage unless employees are protected by a union. I've not worked a minimum wage job in 25 years or more and I've never been part of a union. Unions support unions. They protect you so that you can pay your dues. They fight for your increased wages so that you can pay increased dues. Am I at the mercy of my employer because I don't belong to a union? Of course not. My employer paid me $7500 dollars to entice me to accept their offer of employment. Because if you pay good people then you get to use and retain good people. You can't run most sophisticated business on uneducated labor and most folks with an education or even significant experience won't work for minimum wage. If I create a job, create the position from whole cloth, I have the right to put anyone in it that I believe will make me money. If your shoe color costs me money then you're gone, and it's a liberal belief that someone should protect you from that. And it's a foolish argument to believe that successful businessmen are firing productive, money making employees on a whim. Perhaps the losers are doing such things, but if you make money for a winner you future is pretty much secure, unless you're a money maker and also an asshole. The unions are, and have been greedy bullies since their inception. What was that union...hmm....one of the biggies...that went to court, spent a gazillion dollars to block their janitorial staff from unionizing at their home office? They claimed that it would be a conflict of interest. It just shows you that even the unions believe that unions are bullshit. Are there good unions? Maybe...Have I ever heard of a union that makes sure that their demands won't damage the company that feeds their members? No...but I've heard a bunch of stories of them shutting businesses down and creating a bunch of unemployed people. Do a google search for the HBO documentary involving the last non unionized trucking businesses in the country.. I don't know why the nurses are striking, but I'm guessing that it's not because they're working in a sweat shop sewing Nikes for 3 bucks a day. But no worries LS, let the union kill the hospitals...the govt will come in and save the day..that's what they're for, right? Dwayne

Welcome back girl!! Dwayne

Fixed that for you as it's been making me a little batshit in this conversation. (teasing, not meaning to bust your balls.) venin - definition of venin by the Free Online Dictionary ... ven·in (v n n, v n n) also ve·nene (v -n n , v n n). n. Any of various toxic substances found in the venom of snakes. ... www.thefreedictionary.com/venin - Cached - Similar►

The post states specifically that they 'are the same age'. Who will the DA prosecute? If he goes, she goes too...so where is the crime? Dwayne Edit: Ooops, posting at the same time...disregard.

Crotchity, no need to apologize, disagreement is how we learn here. Again though, she is mentating normally, she has a right to refuse. I think that perhaps your argument is based more on trying to keep the newer, younger providers from getting jammed up by driving outside of their lane, but that will also blow smoke up their skirts. As she's mentating normally, do I believe that contacting medical control is a week, or stupid thing to do? Of course not. I do agree with you that if you have questions you should seek support. I just simply didn't have those questions as this case was presented. I as well am curious what the protocol states should happen after the doc denies their refusal? The more important element in my mind is whether or not I'm willing to cheat this person out of their right to control their own destiny when I believe that ability to understand all concerning that right is intact. Many of these people have survived two world wars, a gazillion 'actions', the great depression, built a huge part of the world that I now enjoy, and I refuse to take the removal of their right to be an autonomous human being from them lightly. I've got no beef with medcon, but if they want to refuse my refusal, then they'll need to come an do it in person. For me it still goes back to pt advocacy. We seem sometimes to be losing sight of the fact that that is at the very center of paramedic medicine. Am I safer if I trick or bully everyone over 70 into going to the hospital? Of course, but I'm safer at the cost of giving up being a good paramedic. Dwayne

Well, I do have to admit that I can't think of a single Canadian that would cause me to argue that point... Dwayne

Yeah man, you're fucked here. If the hospital has reached the end of the best care that they can provide, then the best chance that he has for survival is to get to another, better, hospital. I'm guessing that flying him is not an option, further care at this facility is not an option, or so it sounds, so it in your lap, right? Do you cover your ass and refuse..let him die at the hospital, or give him the best chance possible and transport? I know God damned good and well that you did play the CYA card. This guy is so ready to code that he's practically dead already. No blood running means, I'm guessing, no acceptable blood products at this hospital. Intubate/vent, get enroute, pour on the Os, open his fluids up a bit and see if you can get his pressure back up around the 80-90s range, light it up, don't let your partner freak out and kill you driving fast, and honor his DNR half way there when he dies. Being kind of a smart ass I know, but I'm willing to bet that I'm not far off. At my last gig we had to make these decisions sometimes and most times they worked out ok. But I'm willing to bet that this is not one of those times. Dwayne

I am a little surprised that in this day and age we're still assuming that the boy somehow molested the girl. Maybe she was tearfully reporting to the nurse that she felt bad for raping the boy? I know what the statistics say, but, maybe you see my point. The only victim as the scenario is played out is perhaps the innocence of one or both of the kids that got laid. There is no crime here, at least not any way that I can see. So no reporting from me unless I see that she's been victimized in some way. I am there to be a patient advocate, not to teach youngsters that when they need help that I'm the wrong person to call as I'm going to take their personal stuff to mom and dad. With the supposed drugs? Same answer. The soul of EMS is patient advocacy. I am there to care for the man with chest pain, the legal status of the shit on his coffee table holds no interest for me as long as there are no minors in the environment. We are not police, we are not spies, we are medical care providers. I think that the opposite of what was posited in the OP should be true. If you call the police and report the cocaine you should lose your right to practice as you've shown that ethically, and possibly morally, you are not mature enough to protect your patients. Dwayne

Prizes are away! Why can't Canadians have regular addresses like normal people?? Thanks for doing that Wendy...That's cool as hell. I hated being a judge but I would love to see this continued. I think it's really healthy for all. Thanks again to everyone for participating! Dwayne

Absolutely no question that based on your description that ak's response is what you're looking for. A question, and meant in the spirit of friendship...why are you considering furthering your education in a low paying, limited option field when it's already obvious to you that you will not be able to work there for long? Dwayne

Thanks everybody.... Umm...Not sure if you all think that I'm psychic? But I really, really need some addresses to send you your stuff! And is anyone getting with Wendy, or Wendy with you for your bio? Any chance we can get pics with it? I think that would be cool as hell... Just sayin..... :-) Dwayne Edit. Has anyone seen Mobey, and/or know if he knows he's on this list?

I don't see a need for either medical control or my supervisor in this situation, as it truly is relatively straight forward if you've been taught critical thinking skills. I think that this thread is an awesome idea. As I've said many times in the past, I believe the vast majority of my most difficult decisions have been moral/ethical, not medical. And I don't think that I see a lot of this being taught, and very seldom see it practiced. I think we need a forum just for moral/ethical scenarios. When I state that the above scenario is relatively straight forward what I mean is that if I begin at the beginning, the fact that I am there not to cover my ass, but to be a patient advocate, then forcing this woman out of her house if she's mentating properly is going to be so far down on my list of possible options that it's unlikely that I will ever get there. She has a support system in place and is healthy enough to choose to rely on it instead of going to the hospital. Educate her and the neighbor to watch the bruises as they can become a significant health risk in a pt of this age, help her to the bathroom, get her comfy, make sure her telephone is within reach, remind her that I would like nothing more than to come over and help again if she needs it, and then document the shit out the call in case something goes sideways. Easy, right? I'm not sure at what point MC or a supervisor would have become useful unless I believed her to be significantly damaged and I couldn't change her mind about transport. Great thread. It would be fun if everyone posted their 'weird' calls, right? So we can flex our brains a little bit down this logic path. Dwayne

Yeah, don't want to take a chance on getting hung up on all of those silly college credits! Good luck. Dwayne

Welcome Steven! And congratulations on stepping up to the plate and getting your medic!! Participation is the key to success here brother. Jump right in. I look forward to your thoughts. Dwayne

Yeah, except for MG no one really gave you what you were asking for...but, one thing that did come to mind..Is there a chance that you can get a list and description of the snakes that will be present at the standby? That might at least allow a Google search for current thinking on species specific envenomation management? Just a thought.. And Beiber I swear to God if your 'forthcoming' story involves a gazillion people crying and going out of their minds trying to save a snake bitten cat or some such shit I will kick your nuts right up next to your tonsils! Of course I mean that with love... Dwayne

Hey man, welcome to the City! And good on you for your decision to continue on to medic. What kind of a program are you taking? Jump in, be brave, ask, answer, learn, teach. The value here is very much diluted if you are simply a bystander. Good to have you.. Dwayne

Hey! Welcome to the City! And congratulations on your decision to continue on to paramedic. I'm afraid that I have no advice specific to that school, but in general? Relax, take a deep breath. Be careful to manage your time, get lots of rest when you can, and build study groups. Your groups, not the ones built by others if you can help it...you want to be able to kick the slackers/hangers on. Good luck! Let us know how it's going, ok? Dwayne

Ok, so here goes.... 1. Old Guard. chbare. This was really close to tell the truth. Paramedicmike, Richard B, akflightmedic, tniuqs, Doc, and Herbie were all discussed here. I made this decision based on the fact that chbare was present on every list that was sent to me on this category. He's certainly one of the most intelligent posters that we've been blessed with at the City, and continues to post despite his busy schedule. I'm grateful that he hasn't moved on like so many others. 2. Outstanding BLSer. UglyEMT. It was a knock down drag out fight between Ugly and Eydawn, but I ultimately made the decision based simply on the fact that Ugly is working in the field while Wendy continues her already impressive education. She is also my dear friend. :-) Not fair perhaps, but I just really didn't know what to do here. There are truly so many deserving... 3. Most improved poster. Lonestar. Kate, Mikey were in here too, and I really agree with them as a nominees, but LS is more prolific, and when we stay out of the political arena I've gone from truly hating every single one of his posts to actively seeking out his posts now in the medical forums. 4. Most inspiring up and commer. Beiber. This was truly not terribly difficult. Though Tcripp came up a lot as a new medic, and rightfully so, Beiber was the number one pic on every single list. Witty, brave, intelligent, political, skin as thick as an gator...He inspires me every day to be better. And I'm confident that he inspires others too. I have noticed that we are sometimes a little easy on him because we like him so much...so this is my call to arms...kick his ass and make him start flexing his muscles in the forums! I'm confident that he can take it... 5. The soul of EMS/EMTCity. Mobey. I really hated this category after I got to speaking to people about it. Like Fiz (I think) told me, "The heart of EMS/EMTCity isn't found complete in any one person, but in the strength and completeness we find as a group. Each person that participates is strong where another is week, and of course the reverse is true also." (Paraphrasing) I do love Mobey for this spot though. He's smart, and strong, and kind. I see him argue with those that are his seniors, and mentor those that are junior to him in both experience and education. He seems to feel that he has learned here and should now feel an obligation to teach. And I believe that this is the heart of EMS and the City. He's not a hand holder, not even for the hot chicks, but teaches those that need their hands held to learn to stand on their own two feet. He is a perfect fit here. That's the 5!! But.... I'm going to send out the necklace that was sent to me. For two reasons, in the spirit of all that is foundation here this person deserves it more than I do. Also, It is pretty heavy and would make my necklace too heavy and wouldn't be worn. (Yeah, I know, cause I tried) I'm going to send mine to fiznat in the category of Soul of EMS/EMTCity. He's smart, kind, amazingly introspective, and is willing to post his call review naked, warts and all to allow himself and others to learn from them. His blog, Baby Medic , inspired me through medic school, and continues to inspire me today. If he ever turns it into a book I'll pay a kings ransom for the first copy as it will be huge and should be made mandatory reading for every new medic class. I have never seen fiz blink when it comes to honesty, or curiosity, and he was even fully committed to helping me flesh out the folks that won these categories, though the final decisions were mine alone. If the winners would be so kind as to get with Wendy so she can do her bios, and send me the address that you want your necklace mailed to, that would be awesome! Thanks to all that participated, and most of all to the winners for being the leaders, and teachers, and friends that make this such a rewarding place to come. And thanks also to Tribal Hollywood for these cool necklaces and the inspiration for this contest! Dwayne Edit. I was mentioned by several that we make this a regular thing..? Say, every six months or so? I can't remember if we've tried it before or not, but would sure love to give it a go!!

In PM Ruffster... Ok...going to decide this by tomorrow as it's making me batshit crazy, in a very good way though. I was at first disappointed in myself that these answers didn't come easily to me. It seems that if I've been paying attention that they should. But then I began recieving answers from those much smarter than myself and found that it didn't come easy for them either. I feel better now... I so very proud to be a part of this group of providers. Truly. Dwayne

Done!!! I was so hoping you were going to volunteer!!! :-) Dwayne