How we have improved in EMS per Dr Bledsoe.

[spenac]

Well Doc glad we can help keep inspiring you to write about and advocate advancement of the EMS profession.

[mrmeaner]

Come to EMStock September 25-28, 2008 (http://www.emstock.com) and we will make DD walk the plank (or tell old tales)!!!

Assuming he can keep himself out of trouble and on both legs that long!

Good article, Doc. :thumbright: The trick is getting these ideas out of EMS media and into EMS training.

[scott33]

I did not steal the idea off of DD, I stole it from all of ya'll!!

To be fair though, Dust needs the public recognition more than you :twisted: :wink:

[HellsBells]

Really good article. It reflects many of the things that I've been discussing lately with fellow paramedics. I think we need to start looking more at the idea of treat and release for patients (when possible), instead of the old "you call, we haul" mentality. Working in a large urban centre I can tell you that the wait times at hospitals are killing us and we need to change the way we think about treating patients.

[AnthonyM83]

What are some types of calls where we should be treating and releasing more than we're doing now? (I can think of some obvious ones, but I think we usually release for those already) Would this be different from evaluate and release?

[Ridryder 911]

Our biggest opposition is ourselves. We may blame the stagnancy on multiple reasons but the biggest opposition is truly from ourselves. A bitter pill that we must swallow.

The only way to begin to change is to change within our own first. Consider that there were a few of us that started out here and on multiple EMS forums that shared different ideas of thinking outside the norm. Dust is able to get attention easily by his arguments with knowledge, poignancy, sharpness and wit. Others and myself have been promoting here and on other forums the same or near ideas of not just increasing training but having the right and focusing upon the proper education. Again, most of us with that attitude catch much opposition not from outside sources but from our own because it is different. Something that frightens most EMT's new and those with experience.

Change is never easy, especially in EMS. EMS has always preferred to take the road of less opposition and follow the path of half arse ways and temporary fixes. It is hard to be considered professional by medical peers when we have and still continue to use the analogy of .."placing a band-aid on an arterial bleed"..methodology. Unfortunately, most EMT's much rather use this method because it is easy, quick, and does not take effort.

I agree we are a new profession in comparison to others, but that is not valid excuse not to proceed, grow and improve ourselves. We should embrace academia and those methods that have successfully changed and improved other allied health professions. Yet again it has to come from within. It is okay to have different ideas and approaches; but we must gather as one and agree that a change must occur and what we are currently doing is NOT working. This is the first hurdle.

So where do we start after this? Focusing is hard to do. I personally believe that educators have to firmly believe in education methods than the current normal standards of training. The mind set has to be taught from the beginning. Continuation of the norm will only promote the same ideas and changes will never occur. This first hurdle is going to be the hardest. When reviewing those that instruct EMS education, very few have a formal education and more important that they have an education in adult education or related studies. The mythical thinking that one is a good medic, they are automatically a good teacher/instructor has to change. We must realize that there is a line of separation of education profession. methods and the application of clinical practice. Again, something new and frightening to many.

Before we even attempt to start screening calls and attempting to treat and release we have to increase our level of knowledge and diagnostic skills. We are far, far from this level. Please still consider that most EMT's and Paramedics are still trained with no proper background sciences and definitely no differential diagnostic education methods. Let us be sure NOT to place the cart before the horse. Again, a definite goal; but let us achieve this goal by going about it the right way through proper education. A long process but let us do it the right way! This has to be performed at a national level, not as individual systems or states.

We are far from advancing our profession at this time. We have to clean up and modify our foundation on up. Changing and redefining the roles and levels of providers and thus changing the educational requirements. Starting at the beginning of requiring a screening process and then implementing those requirements for entering EMS programs. As mentioned change within our methodologies of what & how we teach and expectations delivered by our students.

Although I agree discussion is a great tool and promotion, talk is cheap!. Change will never really occur unless one takes true action.

How many on this site are involved in real change other than talk? How many take an active role at local, state and national levels? Even better; are members and actively participate in professional organizations that can promote and cause change? ..

Another fault of most of those in EMS we are all bark and no bite.

I myself have became actively involved in legislation changes, and getting into the nasty business of the bureaucracy again. Finding out that there are changes occurring from all levels but they are not from those in the field and most not from EMS. Many will be blindsided of changes until it is too late. Then again, until those that actively work in EMS actually become involved, nothing will change to promote our profession. We will whine, gripe and then take it because it is the "easiest route" again the norm of an EMT. Until we grow a backbone and actually take a stand for our own profession and develop true standards there will be no positive changes. It is not going to be easy, then again anything that is really worthwhile or successful has ever been easy.. a new concept for most in EMS

R/r 911

[tniuqs]

Come to EMStock September 25-28, 2008 (http://www.emstock.com) and we will make DD walk the plank (or tell old tales)!!!

BEB

Well personally I am very relieved to see that BEBs writing skills have improved and this open invitation to emstock is most enticing, I do love a good Pirate theme.

Perhaps I should bring some Moose to show these Texans how to make real chilli, possum is just wrong in so many ways.

cheers

The Man with the Yellow Hat ... squint.

[mrmeaner]

Good points Rid. Part of the problem in trying to change the standard in EMS is that there is no standard EMS.

EMS is the red-headed stepchild of healthcare. In hospital based EMS, staff is used as transporters, CNA's and maintanence. The only time EMS is brought up in advertisements is when a hospital gets a new helicopter or critical care unit. In fire based EMS, the job is tacked on to a job that has a lot of downtime. Private EMS is the only sect that is completely independent. In any of these cases, it's hard to see getting support to increase the standards of professionalism and education especially when they're afraid they'll have to pay us more.

Joe taxpayer is not likely to go to bat for us either. The average person has limited knowledge of what we do. We show up at car crashes and take people to the hospital. Little difference between us and your local taxi service.

I can't speak for every state, but our local legislature is not giving much support either. In our state EMS office, staff members are dropping like flys. The state EMS director has been here for a little over a year which is a miracle in my opinion. The EMS department doesn't see much monitary support unless in comes in the form of a grant.

It's not that we don't have supporters. Medical professionals like Dr. Bledsoe, some of your local legislatures and some average Joe's do want to see us succede. But, they're not going to do it for us.

I'm not saying this because I don't think there's any point to try. Quite the opposite. If you look at some of our surrounding professions like nursing and fire, they had to come up the same way. The advantage we have is we can look to see what they did right and wrong. Any change, I agree, is going to be internally driven.

Start with your own appearance, education and demeanor. Encourage others that you work with to do the same. If nothing else, creating competition in the job market will help. Around here, most of the full time services and some of the on call services are becoming paramedic services. It's actually pretty hard for an EMT-B to get a job here. 5 years ago, it would have easily been enough. Maybe it's not where we need to be, but it's in the right direction.

My question is whether or not there is an association that has these goals in mind? Most of the ones I know of sound like they are either driven by money more than advancement or are too small or disorganized to do much at a national level.

[brentoli]

I don't know if this appilies to this discussion or not, but I found it interesting after reading Rid's comment on lobbying. Note, no similar bill was filed for this years session:

House Bill 1673

ARCHIVE (2007)

Latest Information

DIGEST OF INTRODUCED BILL

Emergency ambulance services. Requires a certified provider of emergency ambulance services to include a paramedic as part of the personnel on each ambulance, beginning July 1, 2010. Allows a county, city, or town to request permission to impose an ad valorem property tax levy if the county, city, or town needs the increase to pay for training for paramedics for emergency ambulance services

The bill never got past comittee last year.

[WANTYNU]

Our biggest opposition is ourselves. ……

Although I agree discussion is a great tool and promotion, talk is cheap!. Change will never really occur unless one takes true action.

…….

Another fault of most of those in EMS we are all bark and no bite.

R/r 911

Great Rant Ridryder, But the truth is Talk IS CHEAP…. I’ve been saying that for awhile, see my previous posts on this subject, and I’ve asked the question that must be asked before and been ignored.

If talk is cheap, HOW MUCH IS ACTION WORTH to you?

How much are you willing to spend (and where would you spend it) to see us out of this situation?

There are many organizations, but none that have produced any measurable results, should we really join a existing group, or start from scratch?

In my opinion, we need a least three things to get going, We need a Group, we need a mission statement that would work as the basis of forming a plan with timeline and definable set of goals, and the biggest hurdle we need MONEY to meet those goals.

IMHO, as long as Medic’s in some parts of the country get barely above minimum wage, the last part will be the hardest.

Again good post, this is a subject always worth discussing and bringing to the attention to others.

Be Safe,

WANTYNU