FL teen commits suicide on webcam...

[DwayneEMTP]

Cynical, I’ll give you my opinion as well. Though you may see it as bashing, I’ll ask you to believe that it’s simply blunt and honest, as I have limited ability to wrap things in velvet and still maintain a half way rational train of thought. It is not my intention of appear to be superior to you, or pretend that I know anything at all, but simply to try and give you an honest opinion of the way you’ve shown yourself to me so that you can use that in whatever way you find most productive, or not at all if you choose. I will ask that you believe that there is no anger or insult intended by my silly opinions. I’m hoping you can take this in the spirit intended.

You’re previous posts, which of course is all that I have to go on as I’m not pretending to know you, make you appear immature (The way you choose to spell) in some ways, and lost, I believe in others.

I do believe your posts show the very worst attitude to be found in EMS. The belief that you have the ability to decide who deserves compassion and who does not, is not only terribly arrogant, but the thinking behind it is very damaged when compared with those that choose to do good medicine.

Are there times that you need to speak differently to different patients? Sure. I’ve told a patient that it’s time to “Man the **** up and stop acting like a little girl.” Not because I believed that he was acting like a little girl, but because I needed him to become calm, as the anxiety from his trauma was causing him to create problems for himself. I believe that was compassionate. He was able to calm himself, control his breathing, answer my questions, relax some of the affected muscles that were increasing his pain, etc, until I was able to get pain control on board. Did he deserve to be hollered at and somewhat insulted? I believe so, but not because he fell below my compassion threshold by acting a baby, but because that was the best tool I believed I had at that moment to bring him mental and physical relief.

You and I are different in the fact that I don’t believe that I’ve ever carried a healthy person in my ambulance. Do I wish some would have chosen a different route to the hospital? Sure…hundreds of times. But they didn’t, and where you feel qualified to punish patients for abuse of the system, I only feel comfortable doing medicine to the best of my extremely limited ability.

The abdominal pain I’ve carried over and over and over without a diagnosis. Do I believe that he’s having terrible abdominal pain every night that the Dr.s just can’t find? It’s possible, but came to believe that it wasn’t a fact. But he was up at 3:00 am most mornings, and he was in some type of distress. Why wasn’t he sleeping? Why wasn’t he working? Why did he prefer the ambulance and the hospital, where he was often treated in a manner you might find appropriate, to his own warm bed? Shouldn’t those be part of the information you want when developing a plan for his care? I mean, nothing else has worked, right?

Alcoholism, depression, pseudo-suicide attempts, homelessness, drug use, all are symptoms. The issue I see here is that you feel qualified to put ‘Pathologic inferior intestinal fortitude’ at the top of your list of differentials, when you bother to develop such as list, which as a professional you are morally and ethically obligated to do.

You are obligated to add those symptoms to your differential toolbox, but you’ve come to the conclusion that those symptoms are beneath you as a provider. That you shouldn’t need to be bothered with such silliness. That is a terribly easy place to go in your head, but incredibly hard place to escape from once you’ve arrived. Many, if not most, if you could peek into their private brains, live there. They have matured to a point where they understand that to be respected as a professional that you must hide it and mime horror at the mere thought, but I see the symptoms in them as well.

Do I treat every pt seriously and compassionately because I’m a better, more important person than you? Not at all. If you live a long and healthy life it’s unlikely you’ll meet anyone less important than me, nor anyone that has to struggle to stay competent at a mediocre level. But this is how I roll, and what helps me sleep at night.

I’ve been tasked, as a medic and care provider, to increase the situation of those put in my care. Sometimes I can do that by large bites, but most often by small nibbles. When I pick up the patient that I truly believe did not need an ambulance, each time, I make a decision. I can give them a piece of my mind, which from my experience after living a few days on this planet has not been known to move mountains, or change minds, or I can assess them, using all of the signs and symptoms at my disposal to create a competent differential diagnosis, (Which most often in these cases will have “I don’t know” at the top of the list.)

I make the decision this way. I can do what immediately satisfies and makes me feel smart, or I can protect the integrity of my paramedic soul. I can haul them a hundred times, love them, treat them with dignity and respect and attempt to find the ‘zebra’ that might have sneaked into their herd of horses this time. Or I can be selfish and self-righteous and move forward with the ignorant, arrogant believe that if I just give them a tongue lashing laced with plenty of my amazing knowledge and wonderfulness, they will not call tomorrow night. How has the latter worked for you in the past? Yeah, my record sucks too.

Should I choose that latter, on even a single patient, how do I come back from that? How do I then stand amongst the incredible healthcare providers I’ve known and someday consider them my peers? I can continue to wear my patches and speak of the amazing things I’ve done, but inside I’ll always know that I’m a faker. That when I got tired, and disgusted, and frustrated by frequent fliers, that I bailed on medicine and became just another run of the mill shitty medic.

That’s just too high a price for me to pay today. Maybe tomorrow I'll find some bullshit excuse that allows me to take the easy way out and still sleep at night, but, knock on wood, that doesn't work for me today.

Good luck to you girl. I hope you find your way….

Dwayne

[cynical_as_hell]

This is to DwayneEMPT

I will take this one paragraph at a time, so that i don't loose my place, or anyone else's.

The way you chose to phrase things and the words you chose to use, your input did not come off as offensive or bashing at all. I thank you for that.

You are right in the fact that you cannot judge someone based off of posts. The only thing I will tell you is that I am actually more mature than most of my coworkers when it comes to life in general. I write poetry for a hobby and have been quite successful at it. The only reason why I mention that is because that is my normal way of communicating when it comes to writing or typing, anything that isn't verbal. My own partner, well semi-partner, kaisu has even admitted that I am wise beyond my years. She has had the oppertunity to actually work with me and see what I'm like. She can defend me in the fact that I am not anything less than professional to the patients I have to run on. One last thing, I know I kind of went off subject for a moment there....What does spelling have to do with anything? The posts here are not formal in any way and make no bit of difference in the real world in the event of rather we all still have jobs or not.

I truly do fail to understand why you believe that you must have compassion in order to be good at your job, regardless of level. Compassion is not a requirement, nor is it detrimental to you if you choose to not access that particular part of you. Some of the best paramedics we have in the area I work in, are the burnt out, here to collect a paycheck, im just doing my job, kind of perception. And yet, they still out perform the touchy feely paramedics. I do agree that some emotion needs to be felt for the patients, but to what extent? If you did everything you were taught to do, and your patient still dies on you, is it ultimately going to have a negative affect on you? Now here me out on this...Yes, it will have an affect on you. You will go over the entire event again and again and pick yourself apart, trying to figure out what you could have done different and what those outcomes could have been. In doing that, you learn, and you grow. In the end, you will be better for it. But are you retracing and reprocessing everything because you're upset and feel bad for your patient, or because your ultimant goal is to always learn and do better each time around?

You are right in the statement that you do have to talk differently to different patients. Not every patient is going to respond to the same verbal communications. Some patients require you to use a soft, non threatening voice. Some patients require you to be a drill sergant. Some patients flat out need you to show them who is in charge. Children, depending on age, need to be talked down to. There is no contest with your statement in regards to this.

Now in regards to a healthy patient being in the ambulance. What exactly dictates what's considered healthy and what's not. People run around all the time with medical problems and are still classified as healthy. Just because someone has slightly high blood pressure, does that make them unhealthy? Just because someone may have a medical condition, that does not make them unhealthy. Let's use me for an example...And please, give me your honest opinion....I am a 22 y/o female with a history of high blood pressure secondary to renal disease. We discovered the entire problem when I was 13, getting a physical for school so that I could run cross country. I never had any symptoms of any problems, I was very active as a child, and when I was taken to the ER, I had a blood pressure of 200/180. Almost ten years later, I'm doing fine. I don't take medication for my blood pressure and the one kidney I have works at about an 80%. Would you say that I am an unhealthy person?

I am the driver of an ambulance. I never have patient care. I'm there on scene with my medic and I put the patient in the back of the ambulance, and outside of that, I dont know a whole lot that goes on. My company runs an EMT/Paramedic unit, so the paramedics get all the patient care. All they really need us for is to drive. Sure, I do listen in while Im driving, but that's not enough. So when it comes to finding out all the particulars you were asking in this paragraph, that's not my place. Now before you get mad that I said that, understand that we are taught that only one person at a time should speak to the patient so that you dont confuse that patient. With 3 paramedics on scene(including ones from the fire department) at what point do I realisticly take an active role with this patient?

I am appearantly lost in the fact that you think you are more important than me and that you are better than me. I could be misunderstanding what you're saying here, however, as far as I'm concerned, no one is better than anyone else here. I'm thinking that I'm lost on this one.

I completely agree that with you being a paramedic, you have seen more and done more than me. Again, there is no contest there either. But I continue to fail to understand why it is that all of you guys on here truly feel that I am wrong in the way I think. Compassion is not a requirement of the job, and if you do your job as you are taught to do, then where is the problem? Most of the time, what we do, is only comforting the patient for the time they are with us. What we do doesnt mean anything to the hospital because they do all of their own stuff. At least, that's how it is here. The hospital doesnt trust anything our medics do, and the medical director is severly holding back our medics. And by no means is any of this a result of rather our medics know what they are doing or not.

[akflightmedic]

I am appearantly lost in the fact that you think you are more important than me and that you are better than me. I could be misunderstanding what you're saying here, however, as far as I'm concerned, no one is better than anyone else here. I'm thinking that I'm lost on this one.

Yeppers, you missed it on this one. I will go ahead and clarify this one for ya...

You wrote the above in regards to Dwayne saying the below:

Do I treat every pt seriously and compassionately because I’m a better, more important person than you? Not at all. If you live a long and healthy life it’s unlikely you’ll meet anyone less important than me, nor anyone that has to struggle to stay competent at a mediocre level. But this is how I roll, and what helps me sleep at night.

I bolded the important part that you missed.

For clarification, he has said you will not meet anyone who is less, as in lower than him. He is at the bottom, everyone you meet is above...understand yet? Also, says he struggles to maintain that bottom level whereas others would not or do not.

[itku2er]

Cynical, do you deserve compassion?

Can I vote here? I say NO maybe we should show her the compassion she has shown this thread. Well eventually this attitude will come back and bite her in BUTT. Because one thing you can take to the bank and cash is that KARMA is a bigger bitch than I am. But seriously Cynical you need to adjust your attitude and have some compassion, the one thing I hate about this is that you are a very dear friend of mines partner and for that I wish her all the best and hope that she never adapts to your way of thinking. Reguardless of the way you feel Cynical that was someones child, grandchild, brother, and friend and if that doesn't deserve a little respect right there in its self then honey you need to go back to the rock you crawled out from under you are no good, to ems or your community.

[Ridryder 911]

The only thing I will tell you is that I am actually I truly do fail to understand why you believe that you must have compassion in order to be good at your job, regardless of level. Compassion is not a requirement, nor is it detrimental to you if you choose to not access that particular part of you. Some of the best paramedics we have in the area I work in, are the burnt out, here to collect a paycheck, im just doing my job, kind of perception. And yet, they still out perform the touchy feely paramedics.

I am the driver of an ambulance. I never have patient care. I'm there on scene with my medic and I put the patient in the back of the ambulance, and outside of that, I dont know a whole lot that goes on. My company runs an EMT/Paramedic unit, so the paramedics get all the patient care.

But I continue to fail to understand why it is that all of you guys on here truly feel that I am wrong in the way I think. Compassion is not a requirement of the job, and if you do your job as you are taught to do, then where is the problem? Most of the time, what we do, is only comforting the patient for the time they are with us. What we do doesnt mean anything to the hospital because they do all of their own stuff. At least, that's how it is here. The hospital doesnt trust anything our medics do, and the medical director is severly holding back our medics. And by no means is any of this a result of rather our medics know what they are doing or not.

Hence the problem, compassion is a requirement of the job! Where you never taught this in Basic EMT? Being empathetic is an important trait. By whom opinion is those that are just "doing their job" actually providing good care? Please, just because your service sucks, does not mean the whole profession should be modeled alike that. Would you like a physician to care for you because its just a paycheck? How well and in detail do you think they will be? Yep, just enough to CYA and that's it. Yeah, I bet the care is outstanding huh? Now, do you see why the hospital may have the opinion of "not trusting your medics?" .. And you actually wonder why?

Everyone is entitled to their opinion. The problem is does that opinion have merit and weight? Yourself admitted that you do not perform clinical care nor have the educational level for that position, yet you posted an apathetic attitude for those with obvious mental illness and clinical depression. Would you seriously expect anyone that chose and continue to choose to be in this health care profession to have another attitude? It does not matter if the illness is physical or mental, an illness is a illness.

[Michael]

Cynical, do you deserve compassion?

[DwayneEMTP]

A couple of things, though I can't at the moment give Cynical the reply I believe her honest reply deserves.

One thing I misunderstood was that she considers herself, and is considered in her system, (if I understand correctly) an "ambulance driver" and has no real affect on pt's or pt care. If that is the case then I think it's very possible that I've been talking out my ass. If the opinion she gives is her opinion of the care that medics 'should' or are giving, then perhaps she's entitled to have whatever opinion she wishes to have. I don't know....I'm going to have to think on that.

Also, is compassion necessary to do a healthcare job? Again, I don't know. I'm sure we've all heard the stories, and might have even met people such as "house" that would perhaps cease to function effectively with compassion clouding their judgement. In fact, I can honestly say that in the begining of a traumatic call that I have very little, if any compassion. I have only a picture of signs, affected anatomy and my thoughts on how that effects physiology in my head, very little, if anything, in my heart. Those things come, for me, later. If I can do decent medicine when things are hinky without compassion, is it possible others can do good medicine throughout patient contact without compassion? Again, I have to wait until I've had a chance to think about it before commenting further.

My question is this to all. Witholding you personal feelings about Cynical's previous comments, would you feel the same professionally if she is simply tasked with helping to carry equipment, load the cot, and drive?

Dwayne

[ladybear]

Dwayne.. she has patient contact obviously.. she needs to show a semblance of compassion, even if she doesn't feel it. I do it all the time because I work in an ER at a hospital with a psych ward. Some of the patients actually piss me off but I do my level best to treat them professionally even if I can't feel a whole lot of compassion for them. A good example is the patient who spent five hours offering to rip my head off and kill me while spitting at me. He was provided professional care but no..I didn't have a whole lot of compassion for him.

[Michael]

perhaps she's entitled to have whatever opinion she wishes to have. I don't know....I'm going to have to think on that.

Don't think too long, Dwayne. One can be entitled to hold incorrect opinions.

is compassion necessary to do a healthcare job? Again, I don't know.

Yes you do. Compassion is necessary in order to do the job of being human.

people such as "house" that would perhaps cease to function effectively with compassion clouding their judgement.

Help me here, please. Who is "house"? Likely I missed something upthread or elsewhere.

in the begining of a traumatic call that I have very little, if any compassion. I have only a picture of signs, affected anatomy and my thoughts on how that effects physiology in my head, very little, if anything, in my heart. Those things come, for me, later.

She posted "later."

If I can do decent medicine when things are hinky without compassion, is it possible others can do good medicine throughout patient contact without compassion?

I suspect you may be confusing showing compassion with having compassion. While playing poker, I can hold a royal flush without showing it. Compassion is the royal flush of humanity. In fact, it's the substantive value of any card you can hold.

Witholding you personal feelings about Cynical's previous comments, would you feel the same professionally if she is simply tasked with helping to carry equipment, load the cot, and drive?

I wouldn't want someone driving a nail into my wallboard who's not interested in deveoping compassion. It's why we're on earth.

[akflightmedic]

House is a medical TV drama...great show!!

However, Dr.House does indeed have and display compassion, he has done it in many different episodes and got in trouble for it a few times as well.

Michael, Dr.House is typically "cynical as hell" , a very dedicated, driven man who is able to overcome/discover/treat many rare and difficult diseases and disorders with some heavy thinking within himself and his equally talented underlings.

Dr.house also struggles with his own personal issues, such as prescription drug abuse, unorthodox therapies/treatments, lack of interpersonal relationships outside of hookers, etc.

Great show however!!