EMTs and EMT-Is speak out!

[Kiwiology]

The "Paragods" (nobody here in particular) need to get thier heads out thier ass. Simple.

[sirduke]

Thanks first off to Sleep for starting this thread, he and I have bumped heads quite often, and I will admit, I tend to get riled easy, but I would have to say it is because of the ParaGODS I've had to deal with. And the fact that I take pride in my job.

As an EMT-I, I'm expected to take care of the BLS part so that he or she can deal with the Advanced stuff. While my paramedic is getting the patient on the monitor, deciding on what interventions, what meds, etc. are needed, I take care of establishing the IV, getting them on O2 if needed, splinting or bleeding control, etc. Vital signs, securing the meds from family members, what ever he needs done. At the same time, I am observing the patient, learning from him if he is a good medic, and further learning what I need to know for the day I am the medic.

Is this not important? I think its. Would the patient be better served with two paramedics? Yes, they would, larger knowledge base to provide for differental diagnosis. Is this feasible where I work, no, not really. There is a shortage of paramedics here.

But again, somebody has to start the IV, put the patient on O2, collect the meds and vitals, and all the little things, can somebody say Good ALS begins with Good BLS???

Am I content with my current level? No, that is the reason I am in the final quarter of Paramedic school, thats why I spend hours of my personal time researching questions that arise in the course of my job.

Do I feel like I am a glorified gofer, or a useless level whacker as has been suggested? No, I am competent in my level of knowledge and skill, and do provide quality care to my patients. My interventions have saved limb and life before. And I'm sure will again.

Do I think that I "save" paramedics? I have before, with a fresh out of school zero to hero who freaked out on his first code. Not with my superior knowledge, but by virtue of having worked several codes with older seasoned medics who taught me, knowing the sequence of events, and being a calming effect on him which allowed him time to regroup. And, to give him credit, the little sucker recovered, ran the code, and thanked me later for helping him regain his composure.

Does this make me feel superior, No, just glad I could be there and help him. I have worked a MVC fatality with a green paramedic who freaked out because the fatality was a child. I didn't feel smug or superior to her, just glad that I was able to help the other patients while she recovered.

Have paramedics saved my ass, HELL YES, more than once. And I'm damn glad I had them there. Thankfully it was a paramedic and not a ParaGOD, who after pulling my nuts out of the fire, was good enough to explain what I'd missed, and teach me something I needed to know.

I guess the point of all this is to say that we have a definite place in EMS, and will continue to be needed.

All the knowledge in the world doesn't mean dick if it can't be brought into action. Experience and maturity count a long way. Taking a person straight from the street, putting him through a paramedic course, and throwing him on the truck as the lead man/woman doesn't really work. Without seasoning or if you prefer, experience, you don't have a good medic.

I am a stout advocate of taking a EMT and letting them get experience working with a good medic, then putting them through school, and at the end of this pipeline, you have a new medic, who has the knowledge and has the experience to draw on.

Anyway, enough said, as I stated in a much earlier post, just one man's opinion.

Oh, and since I'm sure it is coming, yes Dust, I understand the medical reasoning for the interventions I am allowed to do, I'm not just a monkey stabbing a needle in someone's arm or shoving a tube down their throat.

[Asysin2leads]

Maybe an EMT can answer me this. Paramedics are always raked over the coals for their supposed "arrogance", but someone tell me, how arrogant is it to say "I know what's really going on, I don't need that book stuff." To me, that is the absolute height of arrogance, to put one's own opinion or desires over everyone else, no matter what the facts may say. I run into it all the time, and yes, more at a BLS level than at an ALS level. Being an ALS provider has an incredibly humbling effect on people. I've never had a paramedic accuse me of nearly killing someone because the NRB bag wasn't completely inflated. Its happened plenty of times with BLS, and to me, that is arrogance.

[Asysin2leads]

All the knowledge in the world doesn't mean dick if it can't be brought into action. Experience and maturity count a long way. Taking a person straight from the street, putting him through a paramedic course, and throwing him on the truck as the lead man/woman doesn't really work. Without seasoning or if you prefer, experience, you don't have a good medic.

I am a stout advocate of taking a EMT and letting them get experience working with a good medic, then putting them through school, and at the end of this pipeline, you have a new medic, who has the knowledge and has the experience to draw on.

You see? This is exactly the arrogance I'm talking about. Sirduke, maybe you should correct me if I'm wrong here, but if you're making a statement like that, shouldn't you have like, 15-20 years of experience at a paramedic level, and have precepted many different types of students, and can say, with authority "Oh, you definitely need BLS experience to be a good paramedic..." I mean, the fact that you haven't passed paramedic class yet, doesn't that mean you really don't know WHAT it takes to be a good paramedic? Or are you just that special? Are you just so on the ball and sharp that despite what colleges and universities say, you know the real deal? You don't see me on here talking about what it takes to be a good cardiothoracic surgeon do you? You know why? Because I don't know anything about cardiothoracic surgery! I don't! I wouldn't know where to start on a coronary artery bypass graft.

To be blunt, if you were my student, I wouldn't let you near any of the drugs with an attitude like that, because you would be just the type of person, who, if I blinked, would be administering something he shouldn't because he "knew" better. Maybe you should stick with NS and backboards. You can't really screw those up.

[ninjaemtff]

I've been in the shoes of Sir Duke and the others who get pissed when AK, Dust, let me sleep, etc "bash" basics intermediates, vollies, what have you. I got pissed, complained, what have you. But then I finally pulled my head out of my ass and realized what they were saying. And I've learned a lot from it. I am still a basic, but I am returning to school in July to get my paramedic. Why? Because I love EMS. I want it to be my profession. And I want to do whatever it takes to make the profession as a whole grow. I don't want to be part of the reason why it is held back.

I think if those of you who get offended by the as they are being referred "paragods" would take some time, listen to them, take what they say as constructive ccritisim and learn. Those want EMS as a profession to grow. They want what is best for it. They want educated people, because lets face it, this stuff isn't easy, and it's not for everyone. You need education, I will fight for education until I am blue in the face. And I will fight to help this profession grow until I can't possibly fight anymore.

I don't know what the rest of you may think, or what you are doing to better yourself or the profession. But I know I personally am going to do everything that I possibly can to better myself that way I can help better this.

On that note, I want to thank Dust and AK, they've helped me through a lot of this stuff. Though at first I didn't realize it. I've learned a lot from you two. Thank you.

[sirduke]

Just what I was referring to in my previous post, you want to slap me down, yet you did'nt digest a thing I wrote.

I guess it is a good thing I'm not your student then.

Lets recap what I said, or rather the intention of what I said.

Experience counts, being able to maintain your composure counts, these things come with maturity.

Will you concede me this point? Probably not.

As for exceeding my scope of practice, no, not my idea of a good time. Where did I suggest that I would do that?

What I said, simply stated, was that by having experience prior to going to medic school, gives you a better chance, In my humble opinion, at maintaining your composure on scene, and there by being able to think clearly, which leads to better patient care.

And out of this, you assume that I am an arrogant fool? Man, you are good aren't you?

Nowhere in my post did I state that I knew the "real" deal, nor did I come across with any stupid ass blanket statements like, "we don't need paramedics," or "EMTs save paramedics" or any other of that ignorant babble.

I said, and I guess this is what torqued your nuts, was I have been on scene with a paramedic who lost it, which is true, but if you read further down, I also said I had been on scene where a paramedic pulled my butt out of the fire by keeping me from doing something wrong. I was green, and overlooked something that I should have noticed. The medic I was referring to earlier, was also green and very young, 22 years old to be exact. He was/is one of the smartest people I've ever met, but was overwhelmed at the moment.

Does that make me arrogant? If so, please be so kind as to explain why.

Hell, I just ran a call a few minutes ago with my paramedic preceptor in which I had to take over a procedure because she started gagging and ended up throwing up in the trash can. Does this make me arrogant because I did something she couldn't? No, does this make her a bad medic, not in my opinion, she just had a weak stomach moment. It didn't bother me, it did her, so I took over and suctioned the blood out of the trach.

Again, please explain exactly what I said that makes you so angry, and makes you leap to the conclusion that I am saying I know everything.

Why, if anyone does anything but agree with everything you say, do you feel the need to go into attack mode?

[ERDoc]

can somebody say Good ALS begins with Good BLS???

No, absolutely not. We should not be talking about ALS or BLS. We should be talking about medical care. Enough with this division of levels crap. Everyone should be working at the same level and providing the highest level possible (read: paramedic). Experience means nothing without education. All it means is you just keep doing things wrong and don't know you are doing it wrong. A proper education involves learning the diadactics first and then having a sufficient number of clinical hours to gain the experience. This is exactly what would be obtained from making the paramedic a four year college degree. It could be set up similiar to a medical school model. Your first 2 year are didactics and your second 2 years are clinicals. You come out with a BS in paramedicine (or whatever nifty title you want to give it) and a LISCENSE to practice. This would raise the bar on quality by keeping out those that should not be doing the job (whackers, buffs, firemonkeys, etc), which in turn would help make the pay better. It would also help EMS get more respect in the medical profession. You don't become better by making it easier. Why is it so hard to understand this?

[Eydawn]

I think ERDoc has hit a vital point here... the division of levels of care like this is killing us. And our patients.

It's time to stop seeing this as an us vs them issue... and look at it as paramedicine as a whole. See my previous post on how we convince our workforce peers that this is not only necessary, but will benefit everyone...

Wendy

CO EMT-B

[Asysin2leads]

What I said, simply stated, was that by having experience prior to going to medic school, gives you a better chance, In my humble opinion, at maintaining your composure on scene, and there by being able to think clearly, which leads to better patient care.

And out of this, you assume that I am an arrogant fool? Man, you are good aren't you?

I said, and I guess this is what torqued your nuts, was I have been on scene with a paramedic who lost it, which is true, but if you read further down, I also said I had been on scene where a paramedic pulled my butt out of the fire by keeping me from doing something wrong. I was green, and overlooked something that I should have noticed. The medic I was referring to earlier, was also green and very young, 22 years old to be exact. He was/is one of the smartest people I've ever met, but was overwhelmed at the moment.

Does that make me arrogant? If so, please be so kind as to explain why.

Let's get back to basics here. You said "Being an experienced EMT will make you a better paramedic." I said, "You know, isn't it really the height arrogance to say something like that before you know exactly what it takes to be a good paramedic? Shouldn't you have several years of practice and instruction under your belt before you can speak intelligently about that?"

The reason I go into "attack" mode is because I have heard this exact same goddamn story about "The book learning paramedic who 'froze' up and was saved by the EMT who had some years under his belt and blahdidly blahdidly blah." I've heard it several times on this site, in fact. In fact, this story just happens to come up every single time by every single person who had gone the "yeah, its all about the experience" route. So when I read these tales of heroism, I tend to do one of these :roll:

and know that if someone is arguing from far fetched anecdotal evidence, they tend to be full of crap.

So let me ask you again, for the record, If you do not fully understand what qualities are necessary for to be a good paramedic, why do you think you are qualified to talk intelligently about what it takes to be a good paramedic? Where does that idea come from? Do you think that if you go into paramedic class with preconceived notions of what it "really" takes to do this job, you might not do that well in class? And how in my class, the EMT's who were always talking about their war stories and how well they knew this stuff and how many times they had saved a paramedic were the first ones to fail out? Hmmmmm? And while we're at it, how does your preceptor feel about you talking at length on the internet about you "took over" when she couldn't handle it? Because I would see it as being incredibly disrespectful, immature, and insubordinate, which, being such a knowledgeable guy, you should know makes for a really BAD paramedic. Maybe all those years as an EMT-I weren't so good for you after all.

[akroeze]

I would like to point out that the post count is 19 as of my post. The request was to allow 20 posts until a medic got involved. Why am I not surprised this didn't happen?