defib_wizard Posted October 3, 2008 Posted October 3, 2008 Kaisu yes it is business as usual here. Part of the problem is there is a shortage of paramedics in the rural areas. I do agree that the other people on here that amr not giving you at least a shirt is total BS. Where I work is based with FMC. We have offline medical control and a very progressive medical director. ( for az) He is a former medic. We can give up to 14 mg of morphine without patching. If you are interested I can give you the phone number of the service 30 miles from here. ( we just filled our last 2 spots ) We have 12 leads and carry versed. Just pm me. But I'm warning you it is very rural you will transport primarily to the hospital in my town. I think they do 1400-1700 calls a year.
defib_wizard Posted October 3, 2008 Posted October 3, 2008 I think guardian ground is testing om Oct 5 ( saturday ). they are in flagstaff. Williams is ran by lifeline out of prescott. Let me know I'll try to help.
Kaisu Posted October 3, 2008 Author Posted October 3, 2008 Hey all. I had a better day yesterday. Another brand new preceptor, but this guy is a marine combat vet and a flight medic. He was called in to fill a spot. (I'm thinking one of the brighter bulbs that jumped ship when the sale came through). We got along like a house on fire. It was a quiet day and I personally wound up on only 4 calls - 2 refusals, 1 cancellation and 1 BS. The first thing I did was my rig check. Then I went through every item in the drug box (again) with indications, contraindications, side effects and adult and pediatric dosages. I got the station copy of the protocols and made a flash card for each one. (there are 61). Get this - the general manager came in on a surprise visit. He didn't know what protocols were. He looked at the book and said - o wow - somebody spent a lot of time on this. :shock: Guess what? In the protocols there are spots for 12 lead. If I don't do a 12 lead (and I can't), then I don't say I did a 12 lead. If we put a patient on a cardiac monitor, that qualifies as ALS. If we start an IV, that is ALS. This company is making money hand over fist - Also - the protocols allow administration of morphine prior to contacting med control in suspect ACS BUT verbally I have been told that we have to contact med control before ANYWAY. (I guess someone screwed up and now everyone is suspect.) I am going to Wisconsin on Sunday to pick up my husband and bring him here. (hopefully we will have a house to go to) That will take me a week. I will use the time for soul searching and decision making. Thank you again for your generous help. PS - a rural service with 1400 - 1700 calls per year sounds like heaven right about now. PPS - I did the PCR on the BS call in about 20 minutes and did NOT write my narrative on a draft. The preceptor made no changes to it - just said "why do I have to sign this - you're a paramedic?" DAMN STRAIGHT!! - no more draft narratives. 8)
defib_wizard Posted October 3, 2008 Posted October 3, 2008 Well first things first I'm real glad you had a better shift. Second I got the date wrong saturday is the 4th. ( But I had just finished my last call and was lying down & the post before that I had to submit quickly because thats when the first call of 6 in a row came in 3 assaults 1 altered loc 1 drunk and a head & an injury rollover on I 40 ) 2 had to be picked up by the bls crew. I'll see if the other service has any openings if you want then I will pm you with the info and where it is at. If this is something you want to do let me know. i want to be upfront with you about it because there will be a definite culture shock from back east and it is different from kingman. Per Az rules the co has to charge for the highest level of care no matter what. The pt will get billed for als even if you didn't do an als procedure. But it is good form to put everyone on the monitor, emts can't do that so they have to bill for als. Again I'm glad you had a better day with a better fto .
defib_wizard Posted October 3, 2008 Posted October 3, 2008 I just looked at the rate schedule at the dhs site and amr is not listed yet so they should be going with the rate river was charging. If so there is no difference in the rate from als to bls with no charge for supplies.
CBEMT Posted October 5, 2008 Posted October 5, 2008 My protocols say something along the lines of, specifically, "12 lead EKG's must be performed on all stable chest pain or cardiac patients," and from I know it is pretty much the standard of care. It is possible your area has not gotten in line with the national standard More places than you think. 12-leads were never mentioned in my state protocols until the summer of 2007. And even then, "If available." 12-lead machines are not required equipment, nor is the training to operate them. Hence, even the protocol that now contains the reference does not explicitly state that using it is required for chest pain or anything else. Now, does every 911 service in the state have 12s? Yes. Are they used? Irregularly. They are least likely to be found on private ambulances.
firedoc5 Posted October 5, 2008 Posted October 5, 2008 Glad you had a better preceptor and shift. The main word I can come up with for your service, which others have too, is unprofessional. If you are hired as a Paramedic, then you get everything a Paramedic gets up front. Uniform wise, proper ID, etc. Personally I'd refuse the fanny pack. Never could get comfortable wearing one. Not only should you not have full access to the protocols, but get your own personal copy of them. And a big thing, r-e-s-p-e-c-t! You are a Paramedic. I was fortunate to have been with my system long enough that everyone already knew me. On some of our BLS calls the Paramedic would step back and give the whole thing to me (or another). So once I became a Paramedic I didn't have all the "pay the dues" type attitude. Other than experience, what does a Paramedic with 10 yrs. experience have that you don't? Nothing! It may get frustrating at times knowing that you are going through your "provisional" stage, but hang in there. It'll be over with before you know it. And remember, all those preceptors were "Probies" at one time too.
Happiness Posted October 6, 2008 Posted October 6, 2008 Kaisu Sounds like things are getting better. When you are dealing with new preceptors or what ever you call them dont try to conform to them as it will drive you crazy. You pass what ever testing you need to and you should have the abilty to think outside the box. If they give you grief then document it. You don't have to do anything with it but have it written in your little black book. I would hope that the ones you are working with would be able to sit with you and discuss everything from start to finish. You will develop confidence as you become more experienced with all of the calls you will come across. I have been doing this for 13 years and I still learn something new everyday. I don't know if anyone mentioned this because I didn't read each post.... Remember when someone is training a new person (And they aren't a dick head) how you perform is a reflection of them. You maybe a trainer someday and you want to be proud of the people that have learned from you. Good luck on everything and I hope all the best for you. Remember probation will soon end. Happiness
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