Timmy

The saying 'only in America' comes to mind...

The standard entry level to most ambulance services in Australia is a 3 year bachelor degree. Not so long ago the standard entry was a 3 year diploma, in some states this is still the case. To be accepted into the 3 year diploma you had to be 21 with life experience and have a good employment history. You were employed as a full time student paramedic working mostly on road with block units of theory/classes and distance education. Most services opted to make the degree standard entry for financial reasons, it was cheaper to make people pay 20 grand then recruit from a university than it was to recruit them from the street. In most services there’s really not much difference in regards to scope of practice, in some cases, with a little extra training your advanced diploma encumbers a greater scope than a degree. Who has the better deal? The on road diploma student who after 3 years will be a paramedic with on road experience and getting paid to learn or the degree paramedic who forked out 20 grand and has little on road experience. You also need to take into consideration the diploma student is guaranteed a job at the end and the degree student may have to fight for a job. Being a hospital based student nurse I’ve seen the graduate degree nurses come onto the floor with little understanding of what the job is really about and some struggle with some very basic tasks yet they went very well in tertiary education. There’s also story’s that float around the paramedics that new medics with degrees work for a few weeks then decide EMS is really not for them yet they’ve spent 20 grad on education. There’s always been a lot of debate as to which program is better. Some think the degree program was a backward step and some think the degree program is the way to go… Take your pick. As for me, I think there’s a fine line. It’s important to have a good combination of practical and theory but at the same time everyone learns in different ways. I probably have no right to comment on American EMS, I can only go with what’s been said on here. I find it bizarre that EMT basics are allowed to run emergency, even to the point of seeing them as pointless. Non emergency transport officers in Australia have better scopes and education that an EMTB and there job pretty much consists of pushing around stretchers all shift.

This was indeed my problem at High School. I was so busy doing everything but school work, I didn’t study and only did homework if it was required to pass the class. My end of year results also reflected this. I was heavily involved with EMS event standby, fire, football and social commitments. After school I’d find myself heading to football practice, going to fire and EMS training then spending my weekends at football matches, fire calls, standby events and going out with friends. School was the last of my worries. To be truthful I appsalutly despised high school to the point of even wagging a few classes. Lucky, the Australian Education system is so dilapidated with old, burnt out teachers and a less than impressive education department that produces brain dead high school graduates with no life skills or education what so ever. Having been in ‘higher education’ for the past 9 months I can say I’m having the time of my life, I’m motivated to study and immensely enjoy it. I can safely say that high school has not given me anything that would contribute to being a student paramedic or nurse. I did high school English and went pretty average, I learnt all I needed to know in the ‘writing at a tertiary level’ workshop at uni and went very well on the essays we’ve done thus far. The only down fall I have is my Math skills but high school math is nothing like what we do in nursing class.

Its quiet a shame that a man who can write so well can portray such a bleak view.

I believe hands on plays quiet an important part in ones education and learning. Australia is starting to bring back the old school nursing training which I’m partaking in a new pilot program. I currently work as a hospital based student nurse so I work 32 hours a week under the supervision of senior RNs in a hospital setting and spend around 8 hours a week in the classroom. I must say I’ve learn substantially more in the hospital than in the classroom. I’m one for visual learning; reading something just does my head in. The great thing about being hospital based is you study a certain thing then put it into practice the next day on a real patient under the supervision of someone who has years of experience and a wealth of knowledge. It’s very one on one and everyone I work with is more than happy if I bombard them with questions. I haven’t been thrown in the deep end as such but it is quiet challenging. They may ask me to go down to room 6 with the wound care nurse and observe how they assess 86 year old Mr Jones who has a decubitus ulcer to his right foot, his a type one diabetic and suffers with PVD. Then tomorrow I want you to go down re-assess the ulcer, devise a treatment plan, re write the wound care, treatment and care plan then present it to us at the wound care meeting on Friday, we’ll look at your plan, compare it to ours and change it to how we think it should be but also explain why we do it this way. To me this is the best way to learn. So I go home that night, read into decubitus ulcer, read into the pathophysiology and how PVD and diabetes will effect the situation and write a draft care plan. I find this type of learning much more motivating than ‘it may be on the next exam’ because I know I’m actually going to be doing it on a real patient. It’s pretty much the same drill everyday. They may send me home with a whole heap of info on IMI antibiotic, ask me a heap of questions the next day then let me give the injection. When ever a patient needs vital signs taken or a BGL or similar they always get the students to do it, I might take a blood pressure 7 times a shift or do 12 BGL’s. If something doesn’t seem right the RN may re do it but they always ask questions like if this patients BGL is this then what does it mean and explain what is happening and why its happening. If we don’t know they’ll make us go read up on it and ask again the next shift. A lot of our module assessments are done in the hospital setting, we only have a few classroom practical assessments. Of course we still have the theoretical side, most things we do in hospital are backed by classroom study, we do a fair few written assessments, essays, exams ect. Every module is assessed in 3 different ways, practical (in the hospital) written (exam, project, essay ect) and oral (class presentation ect) There are quiet a few things were not allowed to do until we’ve covered it in class but on the most part there pretty good. I love learning this way, nearly everything you learn in class you put into practice soon after.

I have a packet of little white ones that I 'temporarily borrowed'. You keep them in the fridge to keep them charged up, they have the pupil sizes on the side, I use them as night lights and best of all they were free lol

With my Nursing Course there were 19? things we needed to be immunised against. We had to pay for it.

Last time the patient had bowels open?

Possible Aneurysm???

So his had fluids with nill output, c/o headache, brady and unusual spasmodic muscle contractions. Something funky going on with his electrolyte levels? Otherwise I'm with EMT322 on the treatment options. May also have some atropine on hand if the brady continues to decline

Also, what's his skin turgor? Urine Output? Appearance of urine in cath bag?

Hmmm... Any neuro problems? Pupil reaction/size? Motor-sensory issues? I'd say the headache may be caused from the hypertension. Is the brady normal?

How long has he been on movicol and lansoprazole for? What’s wrong with his stomach? How long has the catheter been in for? Has he experienced any discharge/redness/swelling/tenderness around the insertion site? Is he normally hypertensive? What’s his temp? What’s the ECG looking like?

In this day and age I would not consider becoming a police officer. Dealing with all the crap they deal with on a daily basis is not my cup of tea. Besides, I don’t have the right personality to be a cop.

What’s our temperature? Any sign of diaphoresis? Been overseas lately?

Depending on the urgency I normally ask if they have ambulance membership. Most paramedics I deal with will ask the same. If they don’t the ambos just make sure the patient is aware of the costs associated.

Depending on the urgency I normally ask if they have ambulance membership. Most paramedics I deal with will ask the same.

In Australia we have: Personal Care Attendance (PCA) – 3 Month course. They primarily work in aged care and home help type jobs. Medical scope is pretty limited to basic vitals, basic patient care and medications administration via a Webster pack. Registered Nurse Division 2 – Diploma Course. Its a little longer than one year full time class room or 2 years hospital based. There's really not a massive difference between Div 2s and Div 1s. They can give meds, IMI, can't cannulate but can maintain the drip and administer meds. These guys are the team leaders of high care aged care facilities but also work in ED, Acute, Surgical. Your suppose to be under supervision of RN 1s but that hardly happens due to nursing shortages. There's also mini post grad courses you need to do to work in another area Registered Nurse Division 1 – 3 Year degree course. Can do it all pretty much. Can work in most areas but there pushing for post grads to work in specialised areas. I'm doing the hospital based diploma which I love. I'm employed by the hospital, they pay for the course and so on. I work 5 shifts a week with one day in class. We do 4 month rotations in different departments. I rotate between Aged Care, Community Health and Acute/ED. We also do placement in other hospitals in specialised departments like oncology ect because my hospital doesn't offer these services, only down side I don't get paid for 5 weeks. I plan on doing my degree after the diploma, it's only an extra year.

Good Job Terri!

Interesting. I haven’t really put much thought into it. I guess witnessing an arrest is not an everyday occurrence. But you learn something everyday! Thanks guys.

Witnessed or not get the defib on ASAP is my rational.

This is common practice in Australia. Everyone wears a vest.

I’m a firm believer that very service has there own job. It’s quiet simple: EMS provide prehospital care and transport. Fire provide suppression and prevention. Rescue provide rescue. Police provide law and order. All these services are unique and provide an entirely different service, they all have different outcomes and objectives.

I did an essay on him. What a great man.

That’s just Sydney... Will leave them over in the corner