Who is the highest level of care?

[captainstandup]

OK I haven't been around EMT City long enough to understand the hieroglyphics, just slam me in a PM or on the thread and get it over with. I was on a rant about this ridiculous local nursing school. I just haven't figured out who to bribe to get in yet. Considering that everyone who applies has a 4.0 and they already hate Paramedics, they can discriminate at will and routinely do.

[Dustdevil]

Move south. Down in Texas, they actually give admission preference to men and medics. Not because they like us, but because if they don't let us in, they won't get the pleasure of making the next four years of our lives miserable! They wouldn't want to deprive themselves of the thrill of driving us out of nursing.

You've got it easy. At my school, they didn't like men, medics, straights, or white people either.

[captainstandup]

Wow that’s a relief, I just knew you would be busting my chops over this one Dust! I really don’t mind four years of living hell, I do mind being so discriminated against in this godforsaken redneck state that it isn’t even worth applying unless you are female, gay male or a minority. This isn’t a sexist, racist or homophobic statement, just an irrefutable fact.

[Asysin2leads]

You've got it easy. At my school, they didn't like men, medics, straights, or white people either.

You mean there's gay male nurses? What sayeth you, man?

[Doczilla]

You mean there's gay male nurses? What sayeth you, man?

Just Dust! :boxing: :laughing3:

[ncmedic309]

It might be done different elsewhere, but here the lead medic on scene is in charge of the patient, even with flight services on the ground. It's obvious if flight services is on scene, the intent to transfer care is present, but it's still the lead medics responsibility until there has been a formal transfer of care. In some situations, we might not utilize their services even when present on scene but more times than none, if they are there, we're giving them care. It's fairly simple and easily understood and we don't have any issues with it. We work well as a team and get the job done, that's the most important aspect of it all.

[chbare]

That has been my experience. In nearly every case I can remember, the ground crew cancels us enroute or prior to us launching. We simply turn around and cancel the mission. No fuss, very simple. I am at a loss to see why we have so many pages of fuss.

Take care,

chbare.

[Freshmeat]

Interesting stuff.

To answer a few questions and toss in a few mindless thoughts as well ( I am just a basic after all )

My medic, nor any other medic at our station, actually has a base hospital or a medical director specifically; We work under state guidelines, and when they call for orders they simply ask for whatever Doc is present & document. I have no idea how normal this is outside AZ, but its not generally they way things run in Phoenix. We pretty much do things the only way we can, and work with what we have been given; sucks at times but such is life. I know of one specific instance where a medic (not one of ours) amputated a dudes leg, wasn't even medical direction possible as there was no phone service (crush injury involving a train); the guy died in flight and there was a shitstorm that hasn't been settled as far as I know. Hell its usually an interesting and entertaining little sitcom when my partner asks a hospital pharmacy for restock.

Our ALS ground transports are generally about $1,200.00 as far as I know. A helicopter ride is about $18,000.00; and of course patient condition is always the primary concern, with post transport monetary problems being secondary. The Choppers are usually put on standby, if it sounds serious and launched once we have reached the patient, so we're definitely not dispatched at the same time usually. Occasionally...& this is where my questions comes from, DPS (state police) dispatches helicopters. Other times we have arrived on scene at the same time, because an overzealous, volunteer firefighter launched a chopper before reaching the scene themselves. If I ask this question to five medics, I get five different answers. So I guess we will just continue to do what we think is best for the patient hell with the unknown.

Personally, I have found the flight crews staffed with highly qualified people, and we truly NEVER have had a single issue with one. They carry more drugs (RSI ect) than we do and sure as hell have a faster ride.

Anyhow, interesting reading and thanks for the input. :wink:

[boneknuckleskin]

I'm not understanding the professional inequality. RT, RN, EMTP, they're all associate degree programs, and even the non-degree paramedic certificates generally require 24 months of college time on the clock. Lets not forget that a good majority of the RT's are certified and not registered. All have the option of a higher degree. So forget Ventmedic with his exaggerations and embellished tales. An off duty associate degreed RN, licensed Paramedic, and degreed RT all roll up on a scene, who is the highest level of provider?

[JPINFV]

An off duty associate degreed RN, licensed Paramedic, and degreed RT all roll up on a scene, who is the highest level of provider?

If they're all off duty then the highest level provider is who ever is on the ambulance once it arrives.