Eydawn

Dust-- What? I (as someone who has studied journalism and taken journalistic writing courses) can't express displeasure with their modus operandi? I *hate* the media with a passion, and that photograph exemplifies the reason why. They insert themselves into people's intimate tragedies, pretend to be "apart from it all" in order to convey "a higher truth" but many are just arrogant and ignorant people. Give ME a break. You don't like what I posted, don't respond. At least I'm exactly who I say I am- no pretense, no buildup, no dodge-around-the-bushes. I'm entitled to my opinion just as much as anyone else, and I didn't say you had to agree with me. No likee? No readee. Brent, I appreciate the better worded response... and I understand the function of the media, but I also have extreme distaste for those who must question "at what point would I allow myself to help a child... mortal peril? Hunger? Injury?" (female writer who did immersion journalism in South America following children who had been separated from their parents.) I also hate the attitude of the media when they are told to move for reasons relating to patient safety or my ability to do my job... they're INVARIABLY assholes about it. So... my statement still stands. Wendy CO EMT-B

Be very open with your patient, explain everything you need to do or want to do and give your patient the power and control in the situation. This patient has just had control over their own body wrested from them; give them back their power by not forcing anything on them (unless it's a matter of imminent death or injury and they're too altered to give consent). Explain that you empathize, and that you will not touch them or do anything that makes them uncomfortable intentionally... ask them if they'd like to talk but emphasize that they don't have to, that this is their situation and you will do what makes them most comfortable. Then respond based on what they say or don't say. Ask before you touch them *every time* unless they say you don't need to ask. Explain that any questions you ask about what happened are just to help provide medical care and that it's strictly confidential between you, the patient, and the doc. (Unless they're a minor and you have to report abuse...) Not an easy situation. Just be very sensitive to how your patient is reacting to what you say and do, ask them what they'd prefer you to do to make them more comfortable, and be compassionate... Wendy CO EMT-B

The photo in section two of reporters surrounding that injured man, taking pictures of him, is why I hate the media. Good photos otherwise... Wendy CO EMT-B

How does one determine, without actually perpetrating a practical joke, that someone will be amenable to that particular joke? Jokes are best saved for really good, really well-known friends... coworkers are not always that easy to read and it is very easy to have a joke go from funny to being called on to the carpet. Don't get me wrong. If you know someone will take a joke well and you know it will increase camaraderie, by all means go for it. Just be wary of anything that involves screwing with someone's personal stuff, and be sure that the joke you're intending to do doesn't put them at risk. Poop in a bag in someone's car? Health hazard, nasty, and not really funny. KY on the door handle... can mean you can't get the door handle open. Funniest set of jokes I know of: war between the kitchen and one of the shelters at the cub scout camp I worked at. Involved staff wrapping serving utensils in several pounds of saran wrap for return to the kitchen for washing... and the cook retaliating by saran wrapping the shelter director's bike to the flagpole while she was on a day off. Best part... she was like "Oh look! Someone's bicycle got p3wned!" until she got back to her shelter... "Wait... where's my bike?!" Wendy CO EMT-B

It's all good until you have to tube me. Good luck with that attitude! Reminds me of the self-absorbed high school chicks and sorority women who "don't understand" why I just "can't deal" with a "little perfume" and just let them spray it everywhere... Heaven forbid you should actually have to think about the well-being or interests of someone else. Wendy CO EMT-B

On a similar note (and perhaps belonging in its own thread) does anyone have experience with Vagal Nerve Stimulators in refractory seizure patients and the proper use of VNS magnets? Wendy CO EMT-B

It's not so much whether the school is public, private or charter... it depends entirely on who is running the school, what kind of resources they have, and what the teachers are like. I agree... check out a school thoroughly before committing to any given one. Wendy CO EMT-B

Getting it on my uniform isn't the problem. Inhaling scented powder, getting it into my lungs, is a very good way to trigger bronchoconstriction in me. I'm sensitive to fragrances. I cope just fine with the hazards of my job, thank you, I don't need bored coworkers adding another one. I shouldn't be anywhere near toxic smoke, or if I must be, I should be wearing the proper PPE. As for chemical hazards, I shouldn't be on a hazmat site that hasn't been cleared. See above statement. As far as pooping into a bag and putting it in your crew-mate's car goes, that's a health hazard! Jesus Christ! What is wrong with you? How in hell could you even BEGIN to consider that funny? We're not too tightly wound- we want our profession to be PROFESSIONAL. Does that mean I'm going to be anal about jokes on shift? You betcha. Am I going to get huffy if someone's cracking dirty jokes around me? No... but anything that involves physical manipulation or entrapment without knowledge is STUPID! That's it. I'm done playing the game. You're a troll, and that's all there is to it. You double talk and try to pretend you didn't really say what you said and you never back down from any position, no matter how ridiculously moronic it is. Keep it up- you're well on your way to being banished back to under the bridge that you snuck out from under. Wendy CO EMT-B

Now I'm convinced. You just can't read. I did not suggest any sort of joke as being appropriate, but I did delineate between a joke and hazing. And just so we are crystal clear on this, I condemned the Arby's sauce move, I condemn the saran wrap move, the talcum powder in the vent move (that could very likely trigger a severe asthma attack in me, creating another patient and putting my life in jeopardy), the KY on the handle move, and pretty much anything but putting ice down your beloved partner's back (and that better be a partner you hang out with outside of your shifts.) Practical jokes can relieve stress, or they can create undue amounts when they go awry. Save it for OFF THE SHIFT. Wendy CO EMT-B

We've advanced from being a bunch of F*cking teenagers (hopefully) in EMS to wanting to be professional adults. Jokes are one thing. Hazing is another. Arby's sauce in the gloves-- how do you know you didn't contaminate the rest of the gloves in the box? You've got sauce on your hands now... now it's a bitch to clean up and get your new set of gloves on so you can provide patient care . It's a workplace, not a playground. Play jokes on your drinking buddies. As far as having one's testicles painted or similar harassment, that's very good grounds for firing now. It's not a what if. And it's moronic, no matter *when* it happened. Wendy CO EMT-B

And all your backboards done fell out on some back country road! Wendy CO EMT-B

You gonna whine about mobey's post, or actually respond to mine? Just curious. Wendy CO EMT-B

In order to effectively play devil's advocate without pissing people off, you need to IDENTIFY that you are playing devil's advocate FROM THE OUTSET. No one is impugning your character. You can be a person of fine outstanding character and still post like a troll! You make broad generalizations and use the novice debate tactic of setting up straw men or positions where an individual's only three response choices are agree with you, disagree with you and be "morally inferior" by the grounds you have set up, or ignore you completely. Or call bullshit on the tactics you're using, which many people have to your obvious displeasure. Unfortunately, your little tendency to play devil's advocate, as you claim, without stating that you are doing so, (as well as your annoying "holier than thou" stances and tendency to selectively respond only to snippets of people's counterarguments) has convinced many people that you are a troll. You also show that you have been out of the field for a while... because a lot of what you speak about or demonstrate seems to indicate that you are not aware of the current system and you also seem to have no desire to rectify that knowledge lag... Sorry. I'm calling it like I see it. You put up stats without references. You try to say that anyone who doesn't agree with you is morally inferior and a poor provider, while showing those of us currently actively working in prehospital EMS that you're way out of touch with how it actually works now. Just because you worked in EMS for 20 years doesn't mean you know everything about it, or that your experience should be any sort of benchmark for how EMS should be... see the thread on Age vs EMS where I outline my theory on life experience vs informed perspective... I'm sure you're a wonderful person, great pillar in your community, nice guy to have a drink at the bar with... but your interactions here on the forum aren't showing it. If everyone is saying something about you, perhaps you should look in the mirror? After all, that's the attitude you espoused in the paragod thread... Think about it. Wendy CO EMT-B

Calls to the hospital may be a courtesy, but you're very liable to get your heinie chewed if you don't call in to the hospital... by the nurses, your doc, your supervisor and your QA/QI officer. It's very important to let the hospital know what you're coming in with and what resources may be required... and to check that there will be a bed there for your patient when you get there. As far as cell phones go, I have to say that the most egregious personal phone use has been from folks old enough to be my parents. Hell, some of them are medics old enough to have DELIVERED me. So don't label this as a generational thing... it most certainly is not. It's a personal thing. As far as having one on duty... it's a good safety backup in case you can't get to the truck cell phone and your radio goes kapustky on you... and it's very easy to put your phone on silent or vibrate and check messages between calls, or make short personal calls while you've got down time and all your duties are taken care of. The whole "back in the day we only" argument doesn't fly-- this isn't back in the day, and it's a matter of personal sanity for some people to be able to contact loved ones while they're on shift and be reassured that everything's ok. Driving while texting or talking is a big mistake... and a stupid one that I've seen many of my coworkers make. I refuse to make that mistake. My phone stays in my pocket until I'm not busy with something. And I'm 22, and an avid texter... so... *shrugs* it all comes down to whether you choose to act professionally or not while you're on shift. I don't have a problem with it, and can't really understand why some of my elder coworkers do, but I'm too new on the totem pole to make waves yet. Wendy CO EMT-B

It is more difficult to run a code with two people and then again, it cuts down on confusion. More hands on scene = more likely that you're going to have a cluster. We always have fire with us... we're a county service and fire automatically comes to scene with us. It can be useful when we have one of their intermediates with us... another set of hands to draw up drugs... and everyone else kind of stands around as human IV poles, waiting to help lift if we get pulses back and all that... Are they absolutely necessary? No. If you have a good working relationship with your FD, are they helpful? I would have to say yes, without wanting to get into the Fire vs EMS debate. I have been very grateful for the FD in my area, and have started to see that there is a lot of crossover, some of them also work strictly medical with us. Wendy CO EMT-B

Here's a disclaimer before I get started... Believe me when I say that I have the utmost respect for age and life experience. There are things that an individual learns simply by existing on this big rock we call home... things that one cannot really comprehend until one also reaches that age. However! (Knew that was coming by this point, didn't ya... because you're all older than me...) Age and life experience may sometimes hinder someone by cementing them into their preconceptions and patterns. I believe firmly that this is why it is so damn difficult to get older medics to change their treatments or their ways of thinking about things. There are many who stubbornly cling to "we've done it this way and I know this way works" and we've all complained about them at some point. Tell me I'm wrong here. Let's look at the example of dealing with someone who is transitioning between genders, as a starting point... this concept is very foreign to anyone over the age of 40. It just wasn't something that happened, and anyone who did this procedure was automatically labeled as a freak and ostracized from normal society. In my generation it is a much less foreign concept... many of us know people who are undergoing transition, or know others who do. It is still viewed as different, but it is much more accepted. Tell me that the 55 y/o medic, married for 30 years, straight as an arrow, will be able to relate to the gender-transitioning patient better than a 25 year old medic who went to a nice liberal college? The point I'm trying to make here is that it is not necessarily the number of minutes in someone's existence that magically confers the ability to relate to patients on the interpersonal level and provide not only medically savvy care, but good emotional care as well... it is the perspective of the individual involved and the effort they put forth in trying to relate. Sure, I can't relate to an older lady as mother-to-mother... but I can relate as woman-to-woman and younger-woman-to-older-woman. I can make my best attempt to put myself into her shoes, and better yet--she can teach me something that I don't already know! Also, not everyone's life experience is equivalent. I would venture to say that I know some younger individuals with much more significant experiences and insight than people two or three times their age... just because they're still in their twenties doesn't mean that they don't have relevant life experience. Conversely, there are some older folks who have absorbed and learned NOTHING... who really don't know how to communicate. Some of them are in EMS. Let the smack-downs because I'm only 22 begin... Wendy CO EMT-B

Oh man. That had to be difficult! Dwayne, I'm going to send you a care package with a case of Vick's Vapo-Rub in it. It masks the smell of nasty... It can be challenging not to vomit in that sort of situation! You must have guts of steel! Wendy CO EMT-B

Godspeed to the good doctor, and my condolences to his family and friends. Wendy CO EMT-B

The comments that I decided to keep a lid on weren't directed at you. And I take no offense, nor bruises, from the interchange we've had here. You just don't argue well, is all. That's what is so frustrating. You use classic debate follies... that were beaten out of me when I was 17 and in high school. *sighs* Did you read the part where I gave you props? Or did you just ignore the meat again? The potato thing was meant more in levity than anything else... Wendy CO EMT-B

Not at all... I really do need to keep a lid on it, it was going to be something very nasty directed at specific individuals, and since I can't excuse it with PMS this time, I better not. Spenac, you're fine. Wendy CO EMT-B

Considering the company? Wow. I better keep my mouth shut. I'm about to say something that I'll severely regret. Wendy CO EMT-B

My license will NEVER be more important than my partner's life. The problem is you can set up all these hypothetical, philosophical what-if's all you like... one can be CONVINCED that one will react in a certain way until they're actually put into the situation and then the cards are on the table. You haven't called anyone nasty names, or dissed anyone's momma, or anything like that; you have instead maintained a position of arrogance, that you have the answer no matter what-- and you have not attempted to concede any points to those who are concerned about doing proper medicine, rather than psyching themselves up for a what-if that is very statistically unlikely! It gets old to watch someone steadfastly maintain their position and engage in one-sided conversation. Many of us have detailed how we feel and why, why we feel that field C-section by an untrained person is risky and not to be considered lightly, etc. You have selected bits and pieces of our replies to further your own self-aggrandizing "I will never let another human die rules be damned" schtick. We get it. You're the hero, you feel that you are morally superior for stating you will always opt to ignore protocols or rules or education or whatever it is, and you want to see us fall into step with you. We're not going to do it! This is something that cannot be effectively decided by bickering on a forum! It is always going to come down to the individual situation and the individual provider, so why don't you give it a rest already? Props to you for standing up for a moral belief. I would remind you that those who stand up and toot their own trumpet have the tendency to be classed with the Pharisees, whether they really belong there or not. I stand firm on my moral beliefs... but medicine is a field that challenges personal ethics, no matter what topic you look at. Trying to convince everyone that your ethic is superior is fine... but the tone of the dialogue will always shape whether people actually listen to you, or just get annoyed because they're being preached at again by a holier-than-thou. It is important to stand up for what you believe in. But I firmly believe that you have a much more productive discussion if you remain more open to considering alternative ideas. It doesn't mean you have to go for them wholesale... but if you can put yourself into the thinking frame of those you are trying to convince, you can find common ground and tailor your arguments to the audience. That's all I'm saying. Wendy CO EMT-B

Cameras protect those who do their job correctly and cream those who screw up. I say, as long as you document your screw-ups and the camera backs you, you should be in the clear, so why be afraid of cameras? They're everywhere. My service is about to get drive cams... so any vehicular fubars will have concrete irrefutable evidence as to what really happened. I have a feeling a few people with cell phone driving habits will end up hating it... Wendy CO EMT-B

I agree with akroeze. Note the potato comment a few pages back... that attitude is what prompted it. Wendy CO EMT-B

Is this a partner, or a field preceptor? If it's a preceptor, you need to go to the head of your program and file a complaint. No way in hell this guy should be precepting. If this is a work shift, you need to talk to management and get yourself switched to be with someone else. Yes, age does make a difference in terms of comparative life experience and judgment; no, age does not make a difference where learning to be a competent paramedic is concerned. He's being discriminatory. It's called ageism. It is not a good thing. Call him on it. Tell him that if he has this much of an issue with you, he should not be working with you and that his derogatory attitudes are not going to further the profession at all. Don't even joke about the lasix; that would be a criminal case of assault right there.... Wendy CO EMT-B