Lone Star

The rule of thumb (and of course 'common sense') is "Take care of your family first, THEN respond to take care of someone else!". I know of no volunteer or part-paid on call organization that would advocate anything less. It can be said that volunteerism is a noble and honorable thing, but when it endangers your family; you lose all nobility and honor associated with it. We've all heard nightmare horror stories about 'The Terrible Twos'. With him having been through that stage of child development with his older child, you have to ask where his head was; thinking it was wise to leave those two little kids alone like that. One would think that by the time a person hits 27 years of age, SOME common sense would have sunk in!

Close enough for governtment work? LOL

The unfortunate 'side effect' of this behavior (revenge tactics) is that they can range from simple criminal mischief to outright assault. It's bad enough that the supervisor had to be callled into this petty childish squabble, but do we REALLY need to pursue a course of action that could potentially involve law enforcement?

First off let me ask this….how old ARE you? If I had to guess, I’d put you in your very early 20’s. I’ve seen this same “You can’t tell me what to do!” mentality on a motorcycle forum when it comes to mandatory helmet use. Your employment with that company is not a ‘right’; it’s a privilege, which means that they don’t HAVE to give you a job. You cause too many problems or ‘buck the system’ too much, and you won’t have that privilege for much longer! You stated that you have no problem getting the test done, and that you normally have it done annually. With that being said, what is the REAL issue at hand? Is it because your employer said you HAD to do it? If your employer stated that you HAD to wear black boots with orange toe caps and white laces, guess what? You WILL wear black boots with white laces and orange toe caps, or you won’t work there much longer! If this were a construction site, would you still be so defiant if they told you that you had to wear hard hats and eye protection at all times while on the jobsite? I could see it if your employer said that it was mandatory that you have your thumbs traumatically amputated to keep your job. The PPD test is a relatively painless test, and the biggest ‘inconvenience’ is having to go back to the clinic to get the results evaluated.

When in a situation where there's sleeping accommodations (and when sleeping on duty is allowed), I tend to ask my partner if there are any preferences to sleeping arrangements, (i.e.: which rack they prefer). Once that's dealt with, they must abide by their choice for the night. That’s the bottom line. I can’t believe that two alleged professionals would resort to throwing temper tantrums like a couple of spoiled kids. If I were the supervisor, I would have to reprimand the both of you. You state that you’re “getting to be over the hill”. I’m not sure how old you are, but it sounds by your choice of words that you’re considerably older than your partner, which means that you’ve had more ‘life experience’ available for conflict resolution. Would it REALLY have killed you to opt to crash out on the couch for the night? Without knowing the layout of the station, and where each of you were, if she HAD laid down on the couch, would your being on the computer have bothered her as she tried to sleep? To allow this to become an issue to the point of not speaking to each other for the whole night shows immaturity on BOTH parties. Obviously since such petty non-issues can elicit such behavior from the both of you, it’s apparent that a crew change is in order. You know the old saying, “If you can’t play nicely together, then you can’t play together”. I have to ask this: do you have children of your own? If this was a petty squabble between your children, how would you have handled it? Based on this type of petty bullsh*t, it’s no wonder that EMS is viewed as a child in the land of professionals!

And after the conversations we've had, I know that you'll still be looking for a reason to kick my head into mush! You, AK, Dust, Rid, Asys (I can't believe I just said that name), VS (this one too), Vent, Hammer and a host of others have influenced me in ways that I'll never be able to repay. You guys and gals weren't always 'politically correct' (or very nice for that matter) in pointing out the errors of my thinking...constantly pushing me (or beating me over the head) to make me defend my position until such point that you either saw my logic; or I was forced to see the errors within it. You know, when I made that comment; I was 'undereducated' then... now I know better. After all, isn't that what education is all about?

Of course I do, that's why I highlighted that particular phrase and was compelled to speak up.....if you remember correctly, I was also the one that offered the 'collegiate paramedic secret handshake' too....

Ok, I'm probably guilty of the highlighted quote, but I’ve learned that there is far more content and far more benefit to putting forth the effort and obtaining my degree. My school offers both the Paramedic Technology Diploma and Degree courses. The easy way out would have been to pursue the Diploma, (after all, it IS the same course; right?), and I could have avoided all of the extra bullshit courses like Intro to Psychology, Intro to Sociology, Abnormal Psychology and praise the powers that be…..I could have avoided ALGEBRA! The other side of that coin is this: without ever saying a word to my future employer, I will have convinced them that I really don’t like doing things ‘the right way’ when I can find a ‘shortcut’ along the way. Additionally, I would be cheating myself of having even half a chance to learn what makes the body ‘tick’ and how things work. (Sure, at this college, the Diploma course has a quarter of A&P; but not on the same level as the Degree course). Those that know my story know that although I got lucky (time wise) due to injuries that have kept me out of the field, but this ain’t been no cake walk! (double negative intentional) The whole point of my ramblings is this: While you may think that college is all ‘basket weaving 101’ and ‘music appreciation 1035’, every course I’ve taken (with the sole exception of Computer Concepts and Applications), all have some relevance to the field of EMS, and can benefit my patient and the care they receive. Before you ask, “How is learning algebra going to help my patient?”; algebra isn’t about the actual math problem, it’s about developing your critical thinking skills…and that WILL benefit your patients! No, the collegiate Paramedic doesn’t learn some ‘secret handshake’, nor do they teach some ‘college only skills’, but they DO give you a more ‘in depth’ understanding of WHAT we do; and WHY we do it. These ‘patch mill’ courses will NOT teach you much more than how to pass the NREMT testing, and 12 weeks is not NEARLY enough time to be able to cover anything to the point that you can actually RETAIN it. These schools are only good for one thing, and that is certification and possible licensure of ‘cook book EMTs’… those that cannot function much beyond ‘what the book says’, only because they don’t have the benefits of the other courses required for a college degree! Am I saying that all EMTs that come from these schools are inferior providers? Of course not! Some of the graduates from these schools have turned out to be good providers…but that’s it…’good’. You stand a better chance of becoming a ‘stellar provider’ from attending the college courses simply because of the prerequisites and required courses for that degree. I’ve heard the expression “You don’t know how much you don’t know.” So many times that it was about to drive me up the wall. That was until I actually started my journey from the bottom of EMS for the second time. Now, I can't believe how ill prepared I REALLY was to hold someone's life in the balance of what I did or didn't know!

Crotchity by his own successes and accomplishments has served to be his own Achilles’ heel. By making it through at least high school, he’s proven that the educational barriers he’s complained about are non-existent. He’s also proven that ‘standardized testing’ is also a non-existent ‘barrier’ because he’s overcome them as well. Unless Crotchity is some sort of ‘child prodigy’, I submit for consideration that the so-called argument of black people who claim to be at a disadvantage to whites and other races is pure, unadulterated bunk. There are far too many ‘success stories' that disprove each of the arguments that have been extended to this point. By his own successes against a system fraught with barriers and insurmountable obstacles, he’s only proven that the current system of ‘set asides’ and ‘compensations’ are more than adequate. By the number of blacks in professional arenas, they have collectively proven that the current system poses absolutely no challenge. With that being proven over and over, throughout the United States; the ‘excuses’ proffered by the black community that they cannot succeed in the ‘white world’ is nothing more than an attempt at self-victimization. Now that the self-victimization has been exposed, the claims for reparations and other entitlements is nothing more than an attempt at financial gains and social advantages through what equates to nothing more than extortion. Now that a logical argument has been offered against ‘lowering the bar’ any further, it’s time that we start raising the bar and expecting more from society as a whole. With the advances in technology making a wealth of education and information more accessible, there is no reason why we as a society (all races, nationalities and genders included) must continue to produce future generations of idiots.

There are those that will tell you to splurge and get a Littmann, and there are others who will tell you to 'go cheap' and get a sprague style for your clinicals. You can pick up the sprague style for about $20.00 at any uniform supply store. While I've heard outstanding reviews about Littmann stethoscopes, I just can't see spending $100.00 or more to own a stethoscope that will be bounced around in the back of a rig, and that my scope of practice will not allow me to use it to it's full potential.

I got 'blackballed' because I did 'the right thing'...Not only did I get fired over it, but I also stood by my actions based on the protocols at the time. Because I didnt just slink quietly into the shadows and lick my wounds, I was labeled a 'renegade' by that company. I can't prove what the company did after I was fired and had to list them as 'previous employment', but it seems VERY suspicious that a company who is dying to get manpower, wouldn't touch me with a 10 foot pole. I did what was right for the patient and by protocol and STILL got shafted because I wouldn't back down to a nurse at an ECF (Extended Care Facility). Would I do it the same way again? You bet your ass I would! No harm came to the patient, protocol was followed. The nurse wouldn't listen to the limitations I was under, and called the company saying that I was 'argumentative and unprofessional'(among other things). My hands were tied by protocols, and there was no other way of dealing with the situation. Keep in mind, if I HAD violated ANY state protocols, local protocols or somehow brought harm to the patient, the company was required by law to report it to the state licensing board, who would have investigated the formal complaint and taken the appropriate action. My license from the date of issue to the date of expiration (12 years later) was 'clear' with no charges or investigations. My concience is clear on this matter, and because no charges COULD be filed, I stand vindicated in my actions.

I had a preceptor who ended up having to admit that he had to 'reconsider his initial impression about me' because of an MVA. When asked what drew me to EMS, I explained that I had been an EMT for 12 years prior to this, and I wasn't going to be his 'average student'. He went on to admit that he initally thought my claims of prior experience were bullsh*t. Boy, did he get proven WRONG!! He's the only one that admitted to his lapse, but I've seen the looks in all my preceptors faces when they ask the same question; and get the same response. Then the look on their faces when I can jump in and run a call (at least to the level of EMT-B)is priceless! I'm pretty sure that it's going to happen during my clinical rotations for Medic, but hopefully I'll have a better class of preceptors.... The point is, there's far too much of the 'paragod syndrome' running rampant in EMS (apparently it's a world-wide affliction). EMS needs to remember that they're only a PART of the allied healthcare team, not the team in its entirety, and certain members of that team need to realize that they are NOT ‘God’s gift to EMS’ no matter how many times they’ve convinced themselves of it! You were directly involved in patient assessment and treatment. Isn’t part of your code of ethics including patient advocacy? If it is, then you’re obligated to report this because the treatment received by the responding medics was NOT in the patient’s best interest. Additionally, you’re someone who is trained to higher medical standards than this medic obviously was, and you KNOW that what they did wasn’t proper! Even if the worst that they did was have the patient flex the injured extremity to ‘verify’ that there was pain, unless your protocols or ‘clinical practise guidelines are so poorly written as to support this type of action, that is NOT accepted treatment for a suspected fracture. Furthermore, by submitting a written incident report and/or formal written complaint, you’ll be lending credence to the father’s complaint as a secondary benefit.

Timmy, I don't know exactly what your scope of practice is, but based on the conversations we've had and the quality of your posts, I can pretty well presume that stupidity is not your problem here. Based on the information given, I would have done pretty much the same thing. I can understand your hesitancy on full spinal immobilization. Even though my protocols do not allow for selective spinal immobilization, if yours does, then I would have to concur with your actions based on the MOI. It’s a shame that so many in this field are ‘protocol driven’, even when faced with evidence to the contrary. I seriously hope that the father of this patient files a written complaint against the attending medic! Considering that you had splinted the affected extremity, and not only did they remove the splint, but manually manipulated the fracture, I’m sure that they didn’t do the kid any good at all. As far as you filing a written complaint, I would. This is one example of why having a medical director is a ‘good thing’. The medic's actions were reprehensible at best, and if I were in that situation, I would not only file a written complaint with the local medical director, but I would also file a written complaint with the supervisory staff at their station as well. Not only were the medic’s actions unprofessional, but they were negligent as well. Can that medic REALLY say with any certainty that her manipulation of the fractured extremity didn’t exacerbate the injury, and thereby cause the need for surgical intervention? Here in the States, her actions could find her in a world of sh*t facing possible malpractice charges.... Since you’re not only experienced in first aid in this arena, but also have participated in this particular event, you are far more qualified to understand the potential mechanisms of injury that these riders face each time they get on the track.

When I took my EMT-B/EMT-I, we used Brady's Emergency Care 11th Edition (Limmer/O'Keefe) This was our EMT-I book (Bledsoe, Porter, Cherry, Snyder): I would be willing to bet that the PCAT is very similar to the NREMT exam. *Edited to add second image*

Maybe I can still get a refund on the rental of the stained glass window in the background....

I grew up poor, never went to college until my40's.....and I don't have an Ivy League education, went to public schools.....what 'benefits' have I been reaping for years? I've had to work my ass off for what little I have. I've been cleaned out at least twice by thieves... I've worked in manual labor jobs, job shops and never been able to own my own business....hell, I've even lived in 'the projects'! No, my people didnt do the whipping..nor did we burn any crosses.....but by the same token, we never passed any laws to keep blacks as 'second class citizens' either! Here's an actual picture of my whopping 952 square foot house. As you see, it's not even NEAR any section of town that would be considered 'affluent' by any means! Tell me again, what 'benefits' I'm reaping?

I'm more of the Maker's Mark and coke kinda guy....but 7:1.....wow....

Asking questions is how people gain new tidbits of information and that leads to increasing knowledge. If they feel you're second guessing them, then they need to step up and ask questions as well. It doesn't have to end up developing into an argument, fisticuffs or other methods of fighting. As far as socializing, I tend to keep my distance from socializing with coworkers. I don't need stories and rumors circulating around the workplace about what I did 'out at the bar last night'. I'm a firm believer that I didn't apply to the company to be able to fill in my social calendar. Not only that, but my 'socializing time' is just that; I don't want to fill my off duty hours with company gossip, 'talking shop' or anything else even remotely involving my job. The whole purpose of socializing is to get away from all the daily B/S and meet people that have nothing to do with what I do for a living. Yes, randomly picking up and moving to an unknown area can be daunting by itself, but you CAN get through it, and even make new friends. There is no rule that says you can only socialize with the people you work with. Find something YOU like to do, find out where it's being done and go there....meet new friends.....you ARE allowed to have 'non EMS friends' too!

I personally would include all information you've shared here. Part of being a preceptor is being able to lead by example. If you're not professional enough to treat your student any better than this, maybe you're not 'preceptor material' and I surely wouldn't want you as a 'shining example' of professionalism within my company! The very fact that they asked you to 'go easy on the review' is a red flag in my eyes that they knew what they were doing was unprofessional, and wasn't behavior that they would be proud of if it ever came to light. No, the crew cannot help how many calls you get or don't get during a shift, but their actions between calls is well within their control. As it's part of their job to honestly evaluate your performance, it's yours to honestly evaluate them. I wholeheartedly concur with your evaluation, Dwayne. Glossing over a bad review because it might reflect poorly in their company performance report accomplishes nothing. This only keeps bad preceptors on the road, and gives them no incentive to maintain a professional demeanor and bearing ESPECIALLY when training students. Do you REALLY think that they would have done the same thing for you if you were a lousy student, just so you can look good in the eyes of your instructor?

Of course he's not going to directly address those issues and questions, because it's far easier to sit back and cry "UNFAIR!"; rather than roll up his sleeves and actually produce any type of solution to the problem! The point remains that you're engaging in the very same behaviors that you're rallying against (even if it's directed at a particular lifestyle as opposed as a race). Either way, it's the same behavior that you're accusing us all of. You claim how much whites OWE you. YOU were never a slave, YOU weren't part of the segregated schools, therefore the ONLY one that OWES you anything is YOU! You're not entitled to anything more than anyone else is.... you got a free education up to the age of 16, or graduation. How you took advantage of that opportunity (or didn't) is all on YOU. Whether you actually do the work to make something of your life is all on YOUR shoulders, not the whites, not the other minorities, women or whomever you wish to blame for not being as successful as you'd like to be. Want something more than what you've got? Do it like the rest of us and actually get your hands dirty doing the work it takes to improve your lot in life! Lao Tzu is credited with the Chinese proverb: "Give a man a fish and you feed him for a day. Teach a man to fish, and you feed him for a lifetime." You have been given the tools and taught to fish. If you're still hungry for more, then its up to YOU to cut bait and fish, or shut up!

You're quick to throw around terms like 'bigot' and 'racist', and yet you admit to suffering from the same mentality you accuse others of having. Could this be why you're branded with such terms as 'troll'? You've been able to insinuate race into most of the topics you reply to. How are you doing anything to help put an end to it? How long should we make 'allowances' for blacks not attaining the same educational levels as other minorities and whites? How long should we allow you to scream 'disadvantaged' when you are given the same educational and social opportunities as whites and other races? How is it that immigrants that come to America for an education acutally make something of themselves in far less than the 40 or so years that segregation has been abolished? How many generations must pass before blacks can be judged by the same criteria that whites are? If you don't take advantage of the educational opportunities and actually put forth an honest effort to succeed, you are condemning yourself to failure. Unfortunately, there are far too many that are willing to take the 'easy way out' and then sit back and cry because they aren't doing as well as those who have worked their asses off to get ahead. To me, there is no sympathy for them. Just because I'm white doesn't mean that everything has come easy for me. I've had to work my tail off to get where I am. The biggest difference between me and 'them' is the fact that I realize that I'm only going to get out of my education what I put into it, and that I realize no one is going to do it for me, nor are they going to just hand it to me. If things were so great for whites, we'd all have an Ivy league education. This is obviously not the case. Why are only some races 'entitled' while all others must do things the 'old fashsioned way'; achieving success because of honest hard work? This is where an expression that has been handed down from generation to generation comes into full play: "If you don't like where you're at ...DO SOMETHING TO CHANGE IT!" It's very apparent that if you're not going to put forth an honest effort to change your situation, then you've got no right to sit back and complain about it; you're nothing more than a contributor to the 'problem', as opposed to being a part of the solution.

First order of business is to stop, take a deep breath, hold it for a 3 count and exhale slowly... (Feel free to resume breathing at a slower rate at any time.). The acronyms you're being taught right now are simply to teach you to cover all your bases when it comes to assessment. Once you get a handle on them, you can put the acronyms on the shelf. You CAN create your own acronyms and pneumonics, just as long as you stick to the concept of what they're trying to get you to remember. There is no 'absolute, written in stone, sealed in concrete method' of patient assessment. After you've been in the field for a while, you will develop your own particular style. This is acceptable, as long as your 'style' covers all the bases. Are you in a study group? Those work well for simply because it gives you a chance outside of class to practice patient assessment, and treatments. Repetition breeds familiarity, and with familiarity comes competence. You're only half way through your classes, don't panic because your 'Aha! moment' hasn't happened yet. Not all 'Aha! moments' show up with a bolt of lightning and a chorus of angels singing "Hallelujah". EMT-B is just that, BASIC. It's not rocket science here, its the absolute basic building blocks for the higher licenses.

A long held adage states that in order to figure out where you're going one must be aware of where they've been. This is true, so that the mistakes of the past won't be repeated in the future. But it's also a double edge sword, with the back stroke being "As long as you hold onto the past with both hands, you cannot reach out to embrace the future". Yes, we realize that there were slaves; we realize that there were atrocities perpetrated. Hanging onto the anger for 140+ years is counterproductive. I am in no way suggesting that what happened in that time frame in American history be forgotten, no more than I would suggest the Jewish people forget about what happened during the Third Reich. The problem, as I see it; is that it’s only the black community in the United States that still expects the keys to the kingdom simply because of the color of their skin. No, Africans were NOT the only race/nationality to be mistreated throughout history, but their descendants are the only ones who will not stand on their own two feet and take charge of their own destiny! Rather than complain how standardized testing is ‘culturally biased’, how about doing something about it (like every other successful non-white has done before you? Study your ass off like the rest of us, be proactive in your educational opportunities and actually make something of yourself rather than expect everything to be handed to you on a silver platter! My Great Grandfather left Germany around the time that WWI broke out, came to America and became a naturalized citizen, joined the United States Army and was sent back to Germany. No, my people didn’t have slaves; because that era in time was long over by then. After growing up poor, I decided that I was going to make something of myself. By doing so, I set myself up to be able to get through school without quitting, I stayed away from the gang mentality and dedicated myself to obtaining a ‘quality education’ in a predominantly black school, so don’t sit there on your self –righteous soapbox and tell me it cant be done! No; it wasn’t easy, but it WAS an attainable goal. I am the ONLY one who is responsible for my actions, and I will NOT use the past to justify a ‘free ride’ through life!

Clearly, the skinny kid was the aggressor, and his actions have been going on for a while. I was taught as a kid that there are other ways to deal with situations like this rather than resorting to fisticuffs, but ‘real life’ has proven time and time again that there are times where you have no recourse but to reach out and punch the snot out of someone who insists on pushing you past your limits. By suspending the bigger kid, the only lessons that were taught is that the skinny kid can pretty much do what he wants , and the bigger kid can only ‘suck it up’. I believe that since the skinny kid was the instigator, he should have been suspended from school just as fast as the bigger kid was. The ‘cameraman’ is obviously a friend of the instigator and between the two of them thought it was great sport to pick on someone else; why else would he be recording this incident? If you ask me, the skinny whelp got just what he deserved! I’ve been in the shoes of the bigger kid, and have been pushed around by those that thought they were tougher than me. While I still think that resorting to throwing punches is barbaric, I WILL stand up for myself and if it means I’ve got to knock some arrogant jerk on his ass in the process, oh well….!