Should EMTs Have to Babysit Their Medics?

[JPINFV]

I'm feeling a bit froggy and would like to take a pot shot at this.

So here lies the question....Can anyone list ways of learning new things WITHOUT asking questions? I can see how this thread could easily go to hell in a hand basket which is why I'm trying to analyze and understand EXACTLY what the original poster is asking. The only way I know to do this, is off my own personal experience.

well, technically speaking, yes, you can learn without asking questions. Asking helps, though. Asking while being aware of the tone that you are using while asking that question [especially online where there isn't any non-verbal cues to help out] is golden though.

[suzeg487]

Hopefully I WILL be a paramedic in about 20 months. The reason I've been an EMT for this long without furthering my education is that I was content at that point in my life (along with working 3 jobs which left me no time for school). I have earned the respect of my peers and I would NEVER have the arrogance (or should I say audacity?) to cause a problem on-scene - it's neither the time or place. However, discussion has ensued once the patient was transferred to the staff at the ER. Most of our medics are very competent and I can be a complete pain in the arse asking bunches of questions because I WANT to know more.

This revolves around a few medics that have given care that did not seem appropriate and in a couple of cases the ER doc has spoken to their supervisors.

I'm still very new to the site and have been spending spare moments reading through past items, but it's going to take a while. Please bear with me as I get up to speed...

And Dust, I know I'm gonna be in your sights eventually...

[DwayneEMTP]

Man, what a disappointment. So many people I often respect taking the easy shots…

You know what I hate about these types of threads? Because of the bonehead title, every limp wee wee on the board gets their shot to come out of the woodwork and say, “Until you go to medic school you’re a loser and can’t question anything!”

Bite me. I’m a basic. It says so on the only NR card I own. And half the people that posted here don’t have the gonads to defend their opinions to me.

I question my family’s doctor about their care, which should stop because I’m not a doctor?

I question and argue local and national politics, which I’m no longer allowed to do as I’m not a politician?

I’ve questioned the Docs at the City numerous times without once being told to “come back when you’re a doctor!”

When the medic I’ve ridden with says for the umpteenth time “Don’t worry, we won’t drop you, we only drop people on Wednesdays! Oooops Today is Wednesday!” I can’t possibly know that that is idiotic because I’m not a medic?

You want to know how to tell I’m too stupid to be in EMS? Because I actually thought that those that I would some day like to earn the right to call my peers, would pass up the opportunity to take the easy way, to once again snipe the new person for an error in etiquette that couldn’t possibly be understood with a 4 post history.

Many of you like to call up Dust’s name here. You all think Dust would be proud of your idiotic bully behavior? I’ll bet you a months wages he would avoid this Waaaaa fest like the plague before aligning with a bunch of folks that could create a two page thread from a n00b’s post and NOT ONCE EVEN TOUCH ON HER QUESTION!

And Doc didn’t invalidate her scenarios, he simply offered alternative possibilities.

Ahhh…forget it.

Dwayne

Edit. Apologies to JPINFV and Jess. After rereading the thread after this little tantrum I see where you didn in fact address the questions.

[Scaramedic]

Sorry for not answering D-man but I've answered questions like this numerous times and it gets a little old. Plus I know where this thread is going. Hurt feelings, Basic vs Medic, snappy comebacks, LOCKED.

[DwayneEMTP]

Sorry for not answering D-man but I've answered questions like this numerous times and it gets a little old. Plus I know where this thread is going. Hurt feelings, Basic vs Medic, snappy comebacks, LOCKED.

Yeah, I hear you...and cheap shots aren't really your style. With just a few exceptions, you'd have hated this thread.

Besides, now that we've taken the fun out of the easy snipes this thread will die...

(By the way...What's up with all your new touchy-feeling avitars? I don't have to start being nice to you do I?....)

Dwayne

[Asysin2leads]

The doctor must have finally gotten my dose right because I'm going to try and make peace here for once and not take a cheap shot. First I'll say something that actually goes against something I've said in the past. Which means, could mean, could reasonably be construed as insinuating that I was possibly maybe incorrect on a previous instance. Maybe.

The way we can avoid the typical name calling and mud slinging that goes on this thread is by doing what EMS needs much more of, going about it rationally and professionally.

Basically your post states that you've seen mistakes that a higher level provider has made and you are wondering about how to handle it. Fine. Good. Perfectly acceptable question. However, when you start using terms like "Babysit", that's when people start going to the mattresses.

Anyway, with a really big qualifier, despite what I've said in the past, I'll say it IS acceptable for a basic or any other lower level provider to question a paramedic's decision. If a janitor sees a doctor punch a patient in the face, he has full right to report him, and I hope he does. The qualifier, however, is simple, do it the right way, the professional way, and be prepared to take it as far as it needs to go. If you don't feel confident enough with your concern to sit in front of the medical director with who you are accusing and repeat your concern verbatim as you did on the scene, then plain and simple, shut the f--- up.

The real problem is that we have petty little whiners on this job who want to nit pick everything but don't have the balls or female equivalent to stand by their convictions. If you think I'm doing something wrong, tell me why. Go ahead. Challenge me. Tell me why the medication I'm giving is wrong. Quote me the protocol. Tell me the anatomy and physiology, pathophysiology, and pharmacology of what is occuring and tell me the flaw in the logic of my conclusion. Don't roll your eyes, elbow your buddy, and then write about it on a message board, write a statement, send it to the medical director, we'll go over it. If you feel that strongly about it, be an adult, be a professional, and do the right thing.

Commander Hunter of the USS Alabama gives a great example of what I'm talking about at about 2:12 or so in this clip. Watch and learn.

[ccmedoc]

Is it an EMT's place to question a medic's judgement that seems askew?

I believe that whether you are a basic, nurse, another medic, physician, or hold no medical license at all..you have the right to question decisions made in patient care. I also think there is a constructive to do so. I would suggest that if you critique someone else's decision, whatever it is, it is on the basis of strong evidence and not opinion or hearsay.

I do not believe that EMTs need to babysit their medics, or the other way around...I do have to say though..the question asked was a bit offensive, and if this is the way you (generic you) ask questions about treatment rendered..the answers may be just as offensive or demeaning.

Formulate educated, tactful, constructive questions or critique, and educated well thought answers may ensue..

I stand by my first post in that if it bothers you (specific you) so much to work with these medics, go to school, become a paramedic, and lead, by example, to the level of quality you believe the service needs to be held to.

...Another opinion

[Lone Star]

I believe that whether you are a basic, nurse, another medic, physician, or hold no medical license at all..you have the right to question decisions made in patient care.

I would have to agree with that statement....

I've had doctors order tests that I have flat out told them weren't going to happen. It's clear that the doctor didn't take the time to review the patients (my) past medical history, and therefore in my opinion, ordered a test without considering all the factors involved.

For those that hang out in the chat room, you know that I was involved in a motorcycle accident last March. During the treatment for those injuries, I had two doctors order an MRI to which I politely and professionally told them it wasn't going to happen.

The reason I refused to allow the MRIs to be performed is because I have two stainless steel clips in my brain, neatly installed by a neurosurgeon in response to having been diagnosed with a giant cerebral aneurysm in the right posterior communicating artery at the circle of willis.

Having done my homework on the particular model number and lot number (which I can't remember to save my life), I came across an article written by another doctor who tested that particular batch of clips in a MRI machine, and found that these particular clips demonstrated ferromagnetic tendencies. These results were able to be duplicated several times in front of witnesses. Since the clips in question showed ferromagnetic properties, this means they would align to the magnets in the MRI device. I'm not ready to have them ripped out because they were responding to the magnetic pull of the MRI machine!

Had the doctors read my past history, they would have known that I had that surgery, and wouldnt have been so dumbfounded when they ordered the MRI and I responded simply by saying, "No." Then and only then did they 'realize' that I had the crainiotomy, and the potential bad side effects of putting metal into a giant magnet.

If I see a medic administer a 'questionable treatment', I feel its MY responsibility to start gathering information. Not to 'hang the medic', but to find out if its so 'questionable' in the first place. I may find out that I don't know as much as I thought I did!

If in fact the medic DID make a 'mistake', then I'm legally, morally and ethically bound to report it. Chances are, while I may not understand the medics choice of treatments, it may be I don't understand them because I don't know as much as the medic!

[NREMT-Basic]

So why have you not done the decent thing and become a Paramedic? Then you would be in no doubt that the interventions your medic is performing is the correct one.

Being an EMT-B for 15 years is like saying I have not advanced or increased my prehospital knowledge in 15 years. . The only way to learn is to move up the ladder (and I don't mean Lieutenant or Captain), not by observing paramedics and drawing your own conclusions.

Welcome.

Well, I had hoped not to feel compelled to post in this thread, but this one started my water boiling. When I came out of EMT school, I had the bear bones basics that EMT-Bs are taught. Now, I haven't been an EMT-B for 15 years and since my emergency services priorities change, I may or may not become a paramedic. But to say that as an EMT-B you cant learn without becoming a paramedic indicates a very closed mind. Does it them follow that if you become a paramedic with 15 years of experience the only way you get any better at patient care is to become a critical care nurse or an MD or even a physician's assistant. Sorry but this one just doesn't wash.

When I was getting my EMT-B, I was taught about mass casualty incidents and triage, as an example. Since becoming an EMT, I have joined a response organization which only deals with mass casualty incidents. And not just car accidents or the like but incidents of terrorism, accidental or intentional chemical or nuclear releases, etc. So I haven't become a paramedic, but I took a topic that I learned precious little about in EMT school and expanded upon through further training and education and am now better prepared to deal with patients in these kinds of situations (again I use MCIs as an example).

Im trying to turn over a new leaf and not just post flaming responses out of anger or frustration. I dont always succeed but I am trying. But this kind of ignorant response does make me angry. And I use the word ignorant not as an insult, but to indicate perhaps narrow thinking and an attention to reality. In addition to coursework on bio-terrorism, I have also taken much of the main NIMS/ICS sequence, courses that dealt specifically with what I as a basic can to when treating a gunshot wound and also learned how in much greater detail how to work with a paramedic, any paramedic and not just my partner, to be more highly skilled and valuable as a member of the patient care team and not just a maker of cots and driver of ambulances.

I guess I just dont understand the mindset that says that within the framework and protocol of a specific job, you can never get any better without getting a different job. While I know there are alot of paramedics and others who believe that a Basic shouldnt be doing things like combi-tubes, I recently read a study published in Japan that said that combi-tubes should be the first line of defense in terms of an emergency airway adjunct. Now, whether one agrees with that or not, I felt that since it is an opinion shared by segments of the EMS community of which I am part, it behooves me to learn what advances have been made in the use of this intervention and to learn how to implement them should I be called upon to perform this intervention.

We can always get better at what we do and there is ALWAYS more than one way to get better. Some people may want to spend their entire career as a secretary, but they can always be learning about new technologies and policies, etc in the field of office management.

I know I am a better EMS provider now than when I got my EMT-B and I havent started paramedic school yet (if ever). The improvement in my skills is measurable. I think this argument is just entirely based on a false assertion that different ALWAYS equals better.

[suzeg487]

I would like to sincerely apologize for unintentionally offending (for the title) - that was not my intent.

I have a stack of paper about an inch thick with various classes, courses and any other offerings I could get my hands on to better myself as an EMT and provider. I have asked, in a polite way, why a certain treatment is being performed only to be told that "you're ONLY an EMT and should stick to what you know." I am not an FEOE, and at the risk of sounding unlady-like, I don't get into "pissing matches" with paramedics or anyone else - I know my boundaries and I think it's unprofessional to do so.

The medics I had asked about are the dregs that even the other medics don't like working with due to their reputations. Unfortunately here, probably like everywhere else, there is such a shortage of medics, employers hold on to whomever they can, be it good, bad or indifferent. But that's a different topic all together.

I was merely asking if anyone had a different or more effective way to handle situations like this.