emtannie

Dust, again I will remind you - I backed my comments up with facts taken directly from the companies websites... you, on the other hand, have done nothing except tell me to shut up, and now add personal and compkletely inappropriate attacks to that.

I am disappointed that you refuse to discuss like an adult, or professionally. Attacking me personally is completely inappropriate and you should know better.

QUOTE (Dust): Again, put up or shut up. I say they are not, and you cannot prove a negative. It is therefore incumbent upon you to prove that they are or STFU.

Funny, I used facts from Halliburton and KBR's own websites and their own public announcements to back up my position, so I already proved it... if my brother and I weren't busy planning our mother's funeral tomorrow, I could get you the latest financial reports from both companies to provide you with further information... you have done f*** all to defend yours other than tell me to STFU... so, unless you can come up with something more tangible than STFU, don't waste my time.

QUOTE (Dust): "It's been seven years and they haven't taken a drop of oil from Iraq. Put up or shut up with you conspiracy theories."

LOL @ “Conspiracy theories.”

So, what exactly was the US reason for moving significantly more troops into Iraq than Afghanistan? The WMD theory was seriously flawed – we all know that…

Again, from an economical point of view – both wars and economies require oil.. and by dominating a major middle-Eastern country, the US sends a message to countries like China and Russia, that since the US can control a country like Iraq, it is most probably in their economic interests to not be put in the position where the US wants to attack them.

Dust, rather than just giving the “put up or shut up” comment, please provide your opinion on why the US moved into Iraq.

QUOTE (Dust): "KBR has zero involvement in oil matters in Iraq. They are a service company. Halliburton is the oil company. Halliburton is not in Iraq."

WRONG…. KBR used to be a subsidiary of Halliburton (until 2007), and the companies still maintain a number of joint contracts and have joint employees. Just because KBR is the service company, and Halliburton retained the refining and exploration part, does not mean that KBR is not in Iraq. KBR’s LOGCAP contract with the US government means that wherever the US military goes, KBR employees are also there.

A November 2009 editorial (which is on www.kbr.com newsroom editorial releases) states that KBR recently lowered its staffing in Iraq by 14%, or 2622 people, as military presence was decreasing. This would mean that there are still approximately 16,000 KBR employees in Iraq. Given that KBR is an oil service company, they definitely have involvement in Iraq.

Halliburton is still in Iraq… being a major oil player, and having numerous government contracts, and also numerous subsidiary companies, of course they are still in Iraq.

CM,

I was pointing out that your personal opinion was poorly stated as it was filled with gross generalizations that I took offense to. As a public forum, as it is your right to post your opinion, it is also my right to post mine, and argue against yours.

Thank you for your comment that I sound like a corporate attorney – I will take that as a compliment of my educational background.

You have stated in your most recent post in this thread that you are merely commenting that American citizens have paid a higher price – I am suggesting that should have been what you said in the first post, not “these cousins of ours safe across the border have so little idea of what it all costs." Oh we have a very good idea of what it costs… and when you get your Bachelors degree in Economics (which, by the way, I have) you will take courses that show that the American economy is built on war – the American government brought this on their own citizens. The USA has been in a major conflict every decade since WWII. The American citizen has paid a higher price because that is what their government has chosen, and their citizens through their voting – please do some research on the peace-keeping missions Canadian troops have been on in the last 6 decades.

Your comments showed that you think Canadians “have so little idea of what it all costs.” My point was that this is a gross generalization that is incorrect and inaccurate, and offensive to many of the Canadians on this site. I suspect that this is the comment that other Canadians are reacting to with their posts as well.

I suspect that if I said “Americans are ignorant of the sacrifices Canadians have made, and make, and think that Canada does nothing in the international arena,” many Americans would argue vehemently that this is not true. This comment is not an opinion, it is a generalization, and there is a big difference. Now, if I had said “I think that most Americans are ignorant of the sacrifices…” this is an opinion, not a generalization. You may say that this is semantics, but it does make a huge difference to interpretation.

I realize that you are supportive of Canadian healthcare. My argument was that unlike the one survey that Dust posted, many of us do not fit into that “We like Obama” category.

You can be offended and angry at my response, and I am ok with that - even angry dialogue is still dialogue and we can all learn from it. I learn from your posts (and I really enjoy most of your posts), and I hope you learn from mine.

I've been in Canada for the last 2 weeks and I remember a lot of stuff about Canadians that I had forgotten.

They are really really nice. Toronto is the most multicultural city in the world. Every language and culture you can imagine is represented. They are extremely educated and literate. The quality of the magazines, documentaries and literature available to (and ** gasp ** actually being read) by the general public is superb.

That being said, Canadians are for a large part, homogeneous in their standards of living. A good school is a good school regardless if it is Nova Scotia or Alberta. They personally will argue that they have regional/ethnic issues and many resent the dominance of Toronto over the national dialogue but the huge fiefdoms (that Americans call states) are not a part of the political structure. The federal government has a lot of power setting standards and controlling the purse strings in spheres that would have Americans marching on Washington to burn the bastards out.

They admire intelligence and the majority of people are what we in the states would consider left of center. I always thought I was a small c conservative (as opposed to the political right in Canada, the captial C Conservative) until I came to the US when I discovered I was a flaming pinko

These people are not afraid. They don't have the crime or the personal connection to war that Americans have and thus see the world as essentially a safe place. (This view was greatly shaken by 9-11 btw.) Most firmly believe that if we all sit down and talk about things, the whole world will play nice.

The general Canadian impression of the red-neck American with a bible under one arm, a bottle of whiskey under the other and a 45 frightens them. They consider themselves more sophisticated and intelligent.

It's a tribute to the American fighting man/woman and his/her willingness to sacrifice for freedom that these cousins of ours safe across the border have so little idea of what it all costs.

PS.. Their health care system and access to it is superb. It takes a lot of fear out of people when they don't have to worry about medical care.

**edited to add the PS **

CM, although I realize you are a Canadian citizen, by your own admission, you have not lived in Canada for many years.

I would like to respond to several of your comments.

"The general Canadian impression of the red-neck American with a bible under one arm, a bottle of whiskey under the other and a 45 frightens them."

I would argue not so. I suspect you are speaking from a Toronto point of view, which, as a Western Canadian, just reinforces why the western provinces don't think as highly of Toronto as Toronto thinks they should. You come to my neck of the woods, and that comment you just made would describe most of the people for 100 miles here. Afraid? Afraid of what? Please do not speak of the "general Canadian impression" - that is a gross generalization that is completely inaccurate.

"It's a tribute to the American fighting man/woman and his/her willingness to sacrifice for freedom that these cousins of ours safe across the border have so little idea of what it all costs."

I am COMPLETLY offended by this statement - this statement sounds like it comes out of an American citizen's mouth, not a Canadian's, and you should be ashamed.

Please do your research on the contributions Canadian forces have made throught the years, and the sacrifices that Canadian soldiers have made, including the number of times that they were on the front lines of major battles where the US troops were non-existant.

I would like to remind you of the number of Canadian troops that are currently serving in Afghanistan - and oh yeah - where have the US troops been? The US government decided that Osama was a secondary target and they had to protect their oil interests in Iraq instead - so who was taking care of business in Afghanistan? CANADIANS and other countries. It has only been recently that the US has returned its focus to Afghanistan.

Don't you DARE tell me I don't know what it all costs. I have lost relatives serving in the military - I have friends serving in Afghanistan right now.

Again, you make a completely biased, uneducated blanket statement.

The original post by Dust was based on one article, where I would suspect that the majority of the people surveyed were in only 1 part of Canada - again a gross generalization and misrepresentation of the Canadian population. You have chosen to continue that generalization with your comments.

Yes, Canadians are protective of their health care system. It has served them very well - I have friends in the US who are in the process of remortgaging everything they own, and working sevferal jobs, so their son can have surgery (yes, they have insurance, but it will only cover 75% of the cost of a $300,000 heart surgery)..... this would NEVER happen in Canada. When I compare that isolated incident to the care that I receive, I am glad to be where I am.

I wouldn't be nearly so angry about your post if you had said "from my point of view" rather than "Canadians for the large part" and "the general Canadian impression." Do not generalize, and do not speak for me.

You couldn't have picked an easier project, could you....

When I was still in banking, we did something similar with our staff, and it was quite successful. I think I have some of my old reports still, but it will take me a little time to dig through my files and find them (and I won't have time for a little while).

If you wish, send me a pm with an email contact, and when things settle down here, I will find the files I have and send them to you.

Annie

Thanks, for the patient I specifically mentioned to begin with an IV S/L was established.

Tsk, I was referring to the post by 1-EMT-P where they indicated that they wouldn't use a lock:

1EMT-P, on 16 January 2010 - 08:37 AM, said:

"I am not a big fan of starting saline locks only on CVA patients, especially if they are neurosurgical patients & going to be going to the OR. I can tell you from experience that during neurosurgical cases for cerebral aneurysms that they will sometimes induce moderate hypothermia by rapidly infusing IV fluids for cerebral protection."

(I should have used "reply" on my other post, so that it would have made more sense - sorry)

So, I am still wondering: Like Herbie, I am wondering why a lock would prevent providing IV fluids once in hospital.

I am a little confused..

Like Herbie, I am wondering why a lock would prevent providing IV fluids once in hospital. Our locks are "Interlink" so you can attach an IV line instantly without having to start a new IV.

I agree with other posters who have said that IV fluids in a stroke patient are not needed; in the case of the original poster, there appears to be no immediate need for additional fluids, so I think it was a good call not to IV. I would have started a lock so that IV access is already available when the hospital needs it.

Good thread!

Everyone has excellent advice for you!

I would like to add my two cents.

Try to be prepared for the introductory "Tell me about yourself.." Know what you are going to say without rambling for 20 minutes. Cover a quick educational and experience history, and why you are interested in EMS.

Expect behavioral type questions. More and more employers are going to this format of interview, and it can be quite hard if you are unprepared for it. I have been both the interviewer, and the candidate in these types of interviews, and they can catch you off guard.

I found a link to cover some of the basics of behavioral interviews for you:

http://www.emsresponder.com/web/online/Management/Innovative-Interviewing-Techniques/3$11664

Be polite, smile, and try not to show how nervous you are! Best of luck in this interview - wish you well!

Annie

Should any government be able to dictate how you dress? Should they for example, be able to stipulate the length of a skirt (minimum or maximum)? How tight jeans can be? or how low cut a top can or cant be?

Governments already do dictate dress to an extent.. for example, nudity and provacative dress.

I agree with AK - the issue isn't so much the Burqa, but the fact that it hides identity. Recent history has specific examples of misuse of this cultural/religious clothing item.

I don't think it is a generalization if evaluation of terrorist events show a significant number of events include someone concealing their identity by wearing a burqa in order to gain access to an area. Given these events, in order to provide protection for its citizens, I can see why the French government is considering this. Again, the grey area is the freedom of the individual vs the freedom/safety/opinions of the majority.

I can only speak for the area I work in…

Our ambulances are staffed with either EMT/medic or medic/medic… and all of our ambulances are stocked identically so they can be switched with another unit if necessary…

We have 2 kits… one kit we refer to as the assessment kit, and it contains our IV supplies, all meds, and BP cuff, thermometer, SpO2 monitor, and small sharps container. We use the Pacific Emergency Products A-500 trauma bag for this kit.

The second kit we refer to as our airway kit, and this one contains a D size O2 tank and regulator, and all airway adjuncts we use (OPA’s, King LT’s, intubation kit) as well as nasal cannulas, NRB’s, BVM’s, nebulizer masks.. The only meds we carry in this bag are salbutamol and combivent. We use the Pacific Emergency Products A-1000 bag for this.

It seems to work for us. We also have a D size O2 tank on our stretcher (Styker Rugged) and the attachment on it that has nasal cannulas, NRB's, and extra gloves, so if we didn't grab our airway kit initially, we still have O2 until we can grab that kit. I can't think of a call in recent history where we have gone "damn, I wish we had brought the airway kit, and you, go get it NOW." When in doubt, we bring it with us to the patient anyways...

We use backpack style bags in our helis, but not on our ground units.

Any questions, let me know!

Annie

Hmmmmm..... nice ethical debate you have opened up Phil....

I think sometimes countries have leaned so far to the rights of the individual that the rights of the majority are lost. I don't mean that minorities should be completely excluded... but I mean that if you know a country is not open to your religion or culture, you should consider not moving there, rather than move there and try to force them to accept your ideations.

With all the political correctness of language and allowances made, and having to have signs, and instructions, and all printed matter in so many languages.. at what point do we become like the people of Babel, where we can't communicate at all?

my teacher in sixth form food tech married some dude and became mrs beaver, she never lived it down :D

Hopefully her first name wasn't Anita....

Wow – I read this thread, which appears to have become a stone-throwing contest, with much dismay.

Siff posted a news thread as information, not as an opinion – I didn’t know an opinion was required to post an informational item…

When people post, sarcasm, and true meaning are sometimes lost in the words. A post in this thread by someone fairly new to this site was misinterpreted by me. I am well known, even to myself, to be very pessimistic, and when I read that post, I did not interpret it as a “we should all thank our EMS workers” post. A post following that had sarcasm in it that was, I think, missed by many. I am positive I did not interpret things in exactly the same manner as others did; I suspect others did not either; however, throwing stones is not the answer. Misinterpretation happens…. Both have tried to explain the intent of their posts, and both have taken their share of abuse in this thread.

Rather than throwing stones at who was more rude, who said what, who didn’t say what, who didn’t post right, who has how much experience or not, who sent who a nasty pm (isn’t that the point of pm, so that things stay between the 2 individuals, and out of the threads???)… how about we look at the original intent of this thread – the sadness of the situation, and the things people will or will not do in an extreme situation like that. How about we all say a small prayer to the diety of our choice for the family of the deceased, and to those who have been affected by it. How about intead of questioning the intent of posters on this thread to insult others, or try to put others in their place, we focus on the original news article, and reflect on how we may have handled it, and be glad that we haven’t been put in that situation.

ROFLMAO Phil.... you know, as I was typing the original post, I was thinking of you, and wondering what you would post to this thread... thank you for never disappointing me!

And yes Phil, the latex fetish is definitely out... but there are sooooo many other fetishes which are so much fun.... (and Phil, if you shop carefully, there are some very nice silicone alternatives to latex.....)

Very good friends of mine have a 16 month old daughter who has been having serious seizures since the age of 7 months. Sometimes her seizures last 1 1/2 to 2 hours, despite medical interventions. Valium, ativan, phenobarb, versed, and numerous other medications have been used to try to control her seizures, with limited success.

I have attended at least 7 calls where we have transported this little one to hospital while she has been having generalized status epilepticus. It is scary to not be able to bring her seizures under control sometimes, and this little one hits close to home, because I am good friends with her parents.

After a multitude of MRI's, CT's, EEG's, spinal taps, and blood tests, all of which came back with no reason for the seizures, blood samples were sent to the Mayo Clinic, where genetics testing was completed, and the diagnosis of Dravet Syndrome was given to the parents. This is a very rare disorder, and they were given the following website for more information: www.idealeague.org

They have also spent significant time looking at other websites, and trying to learn as much as possible about this disorder.

This little one was fortunate to have a run of 128 days seizure free, and two days ago, she again had a major seizure episode. One of the frustrations of her parents is that all the websites have lots of stories about children who have lots of seizures, but no information on children who have remission periods; the doctor they are currently dealing with has not been very open with information either. None of the contributors to the websites seem very willing to talk about "good days" or small successes.

All they are looking for is some positive information, an experience of another parent who has had a child with periods of no seizures. What they see on the websites is just the worst case scenarios, which is incredibly depressing. They are fully aware that the road is going to be mostly uphill with this child, and the outlook is not good, and they are prepared for that. They are not blind to the long term outlook. They just want to find other parents who have had small successes like them, where their child has had a seizure-free period. In their eyes, every day without a seizure is a good day, and should be celebrated, and they want to find other parents in the same situation.

So, after my long-winded introduction, I am asking - is there anyone in the city who is familiar with this rare disorder? Do you know of any groups or organizations in your area that support families with a Dravet child? It would be nice for them to have contact with other parents who are seeing some successes, no matter how small, so they can celebrate the good days, no matter how few they may be.

Thanks for any information you can provide.

I have latex allergy, and was using nitrile gloves long before anyone else was. My latex allergy is severe enough that it is triggered by latex paint fumes if someone has freshly painted in their home, latex balloons, etc (breathing difficulties, hives), and heaven forbid someone touch me with latex gloves...

In the last few weeks, I have been developing a rash on my hands during and after my shifts, even though I am using nitrile gloves. We have not changed brands at work, so the gloves are no different than what I have been using for years. It is the same small raised red itchy rash that my latex allergy started out as.

So far, hydrocortisone cream does help.... but I am wondering... has anyone else here at the city developed a sensitivity to nitrile? Any ideas (other than quitting my job) on other glove options?

I saw this on EMSResponder today, and was a little surprised that this EMT was allowed to drive the ambulance with his medical history of narcolepsy and epilepsy. Although I know people who have both, and do drive, they also have some restrictions on their licenses. I suspect the fact that he had just come off a 24 hour shift and was starting another shift with a different service contributed as well, as well as the texting while driving (AARRGGHHHH).

Are there driving restrictions at your service? Just curious how a staff member like this would have been handled elsewhere - would he have been allowed to drive, given his medical hx?

http://www.emsresponder.com/article/article.jsp?id=11577&siteSection=1

Reported by Sara Dorsey

Story by wsmv.com

NASHVILLE, Tenn. --

New information released on Monday suggests that a Franklin firefighter's medical history may have been a factor that resulted in a fatal interstate crash in October.

Franklin firefighter David Cline was killed when the ambulance he was driving rear ended a Tennessee Department of Transportation truck.

The patient he was transporting, Sue Bly, also died in the crash.

A report released late Monday afternoon shows Cline had a history of seizures.

After speaking to Cline's widow, crash investigators learned that Cline had been diagnosed with narcolepsy and epilepsy and was prescribed medications for both.

Cline had just finished a 24-hour shift at the Franklin Fire Department on Oct. 22 when he began a shift with the privately run Rural Metro Ambulance Service.

He was transporting Bly, who had just received dialysis treatment, back to her home when he rear ended the TDOT truck, which was parked on the shoulder of Interstate 65 near the Wedgewood Avenue exit.

According to toxicology reports, Cline had a high level of amphetamines in his system, likely caused by the Adderall he took for narcolepsy. But the toxicology report didn't show any traces of the drug he took for epilepsy in Cline's system.

The report also shows that Cline had a similar crash in 1999, where he swerved off the road after having a seizure. His license was suspended after that crash and reinstated in 2000.

A co-worker at the Franklin Fire Department also told investigators that Cline had a seizure three or four years ago.

A check of phone records also revealed Cline was sending or receiving text messages at the time of the crash.

However, investigators believe given Cline's medical history that some type of medical condition is to blame for the wreck.

According to the Department of Safety's Web site, a person has to be seizure free for a full year to get a license and also must get a doctor's permission if you are on controlled medications.

Ummm Sis? Whose hands are you wearing with that Santa suit? Or is there someone in that suit with you??????

Merry Christmas to everyone at EMTCity, and I hope that you find time to spend some of the Christmas season with family and friends. I also wish that 2010 brings more smiles and joy than 2009 did.

Be safe out there..

Annie

Can I vote for myself? Pick me pick me pick me pick me pick me!!!!

Lets all be honest here shoulder straps are far from practical.

Are you meaning shoulder straps for the person attending in the back, or the patient?

If you mean the patient, I disagree. As mobey said, those straps keep the patient from sliding off the strethcer in a front end collision, and I have been in the back when my partner has slammed on the brakes and watched my patient slide.... luckily, there were no injuries, but since that time, I have been very compliant with putting the shoulder straps on patients. You can adjust the straps to make them relatively comfortable, and you do get used to working around them.

If you mean for the person attending in the back, yeah, that isn't the most practical... I seem to remember a documentary a few years ago about Acadia ambulance where they wore a 5 point harness that was clipped to a bar on the ceiling, so they could still move around, but would only fly so far if there was an accident... I don't exactly remember .....

Sorry Annie... Completly misunderstood

As you may be able to tell, i have debated my side a few times, and may have even been the brunt of a few "Can't sling it the city" jokes.

i may be a little sensitive on the the subject.

Friends?

Mobey, you are a good man, and of course we are still friends...

I completely understand. I get frustrated and angry with EMS employees who use that "can't sling it in the city" when they have never worked rural. You have every right to be sensitive about it. I have the benefit of working both city and rural... and my rural is similar to yours... and in the city, I work with a lot of crew that have no idea what it is like to not have ALS or backup for an extended period.

Maybe EMS practicums should be more like a physician residency. Just as physicians have to do a rural rotation, it would be nice to see all EMS have to as well, so they can be more well-rounded. Just a thought...

Once again the idea of "we eat our young" has been scattered across these boards...

Pfft... Are you even comprehending what you guys are typing or just spewing the same old crap you have been fed over the last few years by our closed-minded veterans here in Ab (no offence tniuqs).

So to summarize: New EMT's (not paramedics??) Should spend time in the rural ambulance services as some sort of "right of passage" into the city services???

Where the heck did this come from?

How bout we take a look at my current service.

We have a small hospital with 1 on-call GP. We have 2 nurses staffing our ER that see a true emergency maybe 5 times a year.

We have NO ALS backup.

We have NO BLS backup.

We have a volly Fire service that may or may not respond.

We are 3.5hrs away from the City hospital.

We have NO helecopter.... fixed wing is about 1.5hrs out.

So, by your guys ideals, THIS is the place for Newbie EMT's??

Why not Calgary again? Because you are within 10min of a major hospital, have an entire Fire Dept available, as much ALS backup as you could ask for, and you need how much experience before you "deserve" to enter this system?

Is that idea based on call volume?

Why the hell would I get a green EMT fresh out of school,and it is just me and the newbie, when RedDeer responds with up to 6 Paramedics at a "Delta" level call??

I cannot wait for this old "pay your dues" mentality is deleted from our profession.

WHOA mobey....

For clarification - my comments were not a "pay your dues" or "eat our young" mentality. I backed up my comments with specific examples, and specific experiences....

And don't forget, I work in a remote service as well, so I know the routine. You completely misunderstood the point I was making, and whether deliberate or not, I ask you to go back and re-read my posts.

My personal experience with the city service is that the EMT's are allowed to be "ambulance drivers" and they don't improve their skills... where on a rural service, they HAVE to keep their skills sharp, and in tough situations, they learn to trust their own judgment, not rely on a medic.

So, yeah - I want a newbie EMT in a rural service - where they can hone their skills, and build confidence. Yeah - I would love ALS in rural services, but you and I know it isn't going to happen soon. What I don't want, and what I see, is EMT's going straight from the classroom to urban services where they don't hone their skills, don't expand their knowledge, and don't build confidence because it is too easy to use ALS as their security blanket... tell me how this is an "eat our young" mentality.....

And, personally, I do not buy the "I can't find a job" line when you aren't willing to look farther than your front step.

I have responded more times than I can count, where it has been me, and a newbie EMR (not even an EMT) to a Delta level call.... and ALS ground service is not available for more than an hour, if at all.. It happens... and, I fully expect that my EMR will work with me as best they can... and they expect that I will guide them through what I need them to do, and walk them through anything they are having difficulty with. THAT IS MY JOB as the attending. It is NOT my job to "eat my young"... it is my job to guide them and get them more confident and improve their skills.

Do not judge me with the "eat our young" mentality when I have pulled students from practicums because I have found their preceptors to have exactly that attitude, and have placed them where they will get more guidance and chances to build their skills and confidence. Do not judge me with the "eat our young" attitude when I do my very best to be a mentor and role model to those newbies that enter my rural service.

I would venture to state that you are a far more well-rounded EMT (or are you a medic now, I can't remember - I know you were in classes) than MOST.. because of your rural experience. You have had to use your knowledge and your skills, and you have built confidence from being in those situations where you didn't have backup. That experience took time. What our profession needs is well-rounded EMT's and medics... and my point is that those who only work urban GENERALLY don't get as well rounded experiences.

Just a quick and short hijack of this thread, on the quote above. I arrived here to basics and intermediates doing exactly what is being described above. The current ALS staff simply allowed this to happen, I however refuse to have this done. When I arrive on scene, I will stand back and let them do their job first, should advanced intervention be needed, I will step in and do my bit. It seriously gets under my skin when people do this type of thing, it makes people lazy to think and forget what their work is and what's expected of them. How on earth do they expect to advance if they can not even work their own protocols? I asked this question to the staff here and got met with blank stares....

Hijack finished.

SA..... I think I love you.... can I come work with you????? Or send some of my co-workers to work with you so that they don't think I am just being an evil b***h when I force them to use their brains?

Annie you are a smart lady

Perhaps whomever is giving Duckett this bonuses should consider putting the money back into the health care system where it's actually NEEDED? He doesn't care where the cuts are or what they do to us, look at the money he's getting!

When I did my EMT program, I left Edmonton to live in Calgary for the summer. My school didn't have a program running in their local office. When I didn't have classes I drove from Calgary to 170km north of Edmonton to work for the rural service I was at during my earlier EMS days. (Yeah, 4 years in and I'm still green). I was hired during my practicum and stayed with that service for a while, and it was a 200km drive away.

I dunno, seems like even as recent as 2006/2007 working rural was a right of passage into busier places. Now? Well ... so many people seem like things should just be given to them because they passed ACP and have a reg number ...

Annie, your thoughts on that? (Not like I don't already know!)

Ahh Siff, I thought you would never ask.....

Judith, these are my personal opinions only, and remember, you get what you pay for....

I work for both a rural service and a city service; I am also an instructor and have supervised EMT practicum placements, and have followed the careers of a number of my students.... and I see a number of fresh EMTs straight out of school who have been hired as casuals for the city service I work for... I see a number of areas where these newbies need a lot of work... (1) on a tough call, they find it far too easy to hand the call completely over to the medic, and not do any thinking or assessing on their own. (2) they find it easy to be "the driver" and not take any responsibilty for how the call went, other than getting the medic to scene, and getting the medic and patient to the hospital (3) they haven't developed patient communication skills - their only patient experience was on their EMT practicum, which really does not give them a well rounded exposure to patients - they don't know how to talk to elderly patients to keep them calm, or an agitated patient to get the information they need. (4) working for an ALS service, they do not spend enough time developing their basic skills (basic assessment, vital signs, history taking) (5) overall, they get used to the security blanket of having ALS always available, and unless they are actively moving towards being a medic, they end up backsliding on the skills they do have.

Now... on to rural services. Of course there are drawbacks here.. you may be working with volunteers, who may or may not have their skills up to date either. Yes, it may be inconvenient for you, as you may have to commute, but, on the other hand, some services do provide housing for those staff who come in from out of town, for no cost or a very small cost. You may not get a high call volume. You may be working a BLS service, where ALS may be more than an hour away. However, there are positives to this as well. You will get to attend often, if not most of the time, which will improve your skills, and your confidence. Having to deal with patients for more than 10 minutes will allow you to see if your interventions work or don't work, and force you to review your assessment and interventions to see what you could be doing to better help your patient. It forces you to be a thinker, and not use ALS as your security blanket. Many times, doctors in smaller centres are very happy to answer any questions you may have, and allow you to assist in procedures that you wouldn't have the opportunity to assist with in a larger centre. You will get the opportunity to follow up on patients more, and see long term effects.

A word of warning... do not be the EMT who thinks that just because you have that tiny piece of paper that ACP sent you (for all the money you spent, that little card isn't even laminated) you should be able to walk into the job of your dreams instantly. It rarely happens. If you show that you are willing to work, and willing to learn, and are willing to make some sacrifices for your career, doors will open. Some of my students worked 2 and 3 casual positions at a time, at various rural centres, to get the skills and experience they needed before they moved on to larger centres. Some of my students went to larger centres right away, and given the two, I would hire the first ones in a heartbeat, and not the second, as I know the first ones have a wider range of experience and knowledge. The students who show the commitment to getting the experience and working on their skills will do better in the long run.

Judith, I am not trying to scare you... I am trying to get you to look at a bigger picture, and the possibility that short term pain (I get the feeling you don't want to be anywhere but Calgary) may lead you to long term gain.

Again, best wishes in your endeavors.