Do we diagnose, rule in/out, or just load and go.

[VentMedic]

I was more trying to comment on the fact that the following was happening:

Person #1: Apples are red.

Person #2: Apples are horrible because I choked on one once.

Person #1: That doesn't change the fact that apples are red does it?

Person #2: Aren't you listening? Apples are HORRIBLE.

Repeat

Okay, I give up. My mistake because Education is horrible for EMS. Education is horrible for EMS. Education is horrible for EMS. Repeat.

Is there truly something wrong with informing people that there are might more ways to approach something if they come across the same situation? Obiviously there is and education is horrible for EMS. There are more people reading these posts than the one EMT involved here. Some might actually see some value from a different approach that they hadn't thought of regardless of some of the closed minds here who know all there is with their EMT certification. Patients and situations will be different and there will be times so just the way this one scenario was handled does not mean it should be applied to all patients who present similarly.

But for the sake of peace: Education is horrible and no one in EMS should be made to learn more.

[akroeze]

Okay, I give up. My mistake because Education is horrible for EMS. Education is horrible for EMS. Education is horrible for EMS. Repeat.

Is there truly something wrong with informing people that there are might more ways to approach something if they come across the same situation? Obiviously there is and education is horrible for EMS. There are more people reading these posts than the one EMT involved here. Some might actually see some value from a different approach that they hadn't thought of regardless of some of the closed minds here who know all there is with their EMT certification. Patients and situations will be different and there will be times so just the way this one scenario was handled does not mean it should be applied to all patients who present similarly.

But for the sake of peace: Education is horrible and no one in EMS should be made to learn more.

:roll:

Point out to me where I said anything about education being horrible for EMS? If you look at my history here I'm a HUGE advocate for furthering education. I have 2 years of BLS education and another year of ALS education and I feel it should be a degree at the BLS level (if we are going to continue to separate the levels at all).

I am simply trying to illustrate why CB is frustrated. He is saying that he did his best to inform the patients of the risks of refusing transport and you are jumping down his throat insulting him. Insulting people is not a good way to sway someone to your side just FYI.

[VentMedic]

Point out to me where I said anything about education being horrible for EMS? If you look at my history here I'm a HUGE advocate for furthering education. I have 2 years of BLS education and another year of ALS education and I feel it should be a degree at the BLS level (if we are going to continue to separate the levels at all).

I am simply trying to illustrate why CB is frustrated. He is saying that he did his best to inform the patients of the risks of refusing transport and you are jumping down his throat insulting him. Insulting people is not a good way to sway someone to your side just FYI.

If he gets insulted so easily when someone suggests he could have more to learn and experience to gain, then any medical profession will be too much for him to handle. Pointing out things to learn is not insulting unless one is too insecure about their status to realize there might be more to learn. If one can not handle suggestions or criticisms on an anonymous forum, I hate to see what happens when a doctor or nurse says something to him in the ED.

[CBEMT]

The reason I get insulted is because you assume that the patient used some buzzwords, convinced me that she knew what she was talking about, and outmaneuvered me. Because you're the all-knowing VentMedic, you assume I'm some half-wit who can't out-debate someone on the medical severity of their condition because I'm just some schmuck without the VentMedic Seal of Approval.

Newsflash, missy. I have a degree, I know how to talk to patients, and I know how to get someone into the truck. I also know that there comes a point when none of that is going to budge an old battleaxe who'd rather sit in her apartment and wheeze than be transported.

The difference between us is I know what I don't know. I fully realize I'm not an RRT or even a full paramedic (yet), but I can tell you as THE ONE WHO WAS THERE- this broad was NOT MOVING. Not for me, not for you.

This thread would've gone quite nicely if you weren't such a judgmental @#$%ing know it all.

[spenac]

CBEMT your right only you know what went on. Vent you know we can not force treatment or transport just as in the hospital you can not force treatment. Yes you can try as CBEMT did to convince but some times you just have to accept the refusal and leave.

[CBEMT]

How could I have accepted her refusal? I'm too uneducated to know better. :roll:

[WelshMedic]

I'd like to add my perspective here as an ALS provider in mainland europe.

First of all, it's wrong to make blanket statements about Europe as a whole. Europe is a group of entirely independent countries, not states. Each one has its own form of EMS. IN the southern half of Europe ALS intercepts from hospital staff are used widely, in Germany there are trained EMS physicians that respond from a central location.

That's not the whole of the story though, in most of the scandanavian countries and the Netherlands (where I am) EMS is nurse led. We are critical care trained nurses that have a great deal of autonomy, I really can tell someone that they are not getting into my ambulance without having to refer to any sort of higher power. We also have no form of medical control. Everything is also standardized within national protocols.

I would certainly hope that there are NP's and PA's here in the Netherlands. It would certainly make my Masters in Advanced Nursing Practice, that I'm starting in September, otherwise obsolete. We actually have a new breed of nurse practitioner here that is trained in EMS and primary care. One minute you could be suturing an elderly patient at home, the next sedating and intubating a head-injury patient. (something akin to the ECP in the UK).

Last but not least, education is the key to advancement. We refuse transport, advise on alternative pathways and treat at home because we are trained to do so. We are degree level entry, no if's or but's. And have been for the last 10 years. If the pursuit of knowledge isn't enough motivation, then try this: $62,000 a year for a 36 hr week and 7 weeks paid holidays a year.

Now who's up for that BSN?

WM

[scott33]

So let me get this straight. Europe isn't a town?

[VentMedic]

The reason I get insulted is because you assume that the patient used some buzzwords, convinced me that she knew what she was talking about, and outmaneuvered me. Because you're the all-knowing VentMedic, you assume I'm some half-wit who can't out-debate someone on the medical severity of their condition because I'm just some schmuck without the VentMedic Seal of Approval.

Newsflash, missy. I have a degree, I know how to talk to patients, and I know how to get someone into the truck. I also know that there comes a point when none of that is going to budge an old battleaxe who'd rather sit in her apartment and wheeze than be transported.

The difference between us is I know what I don't know. I fully realize I'm not an RRT or even a full paramedic (yet), but I can tell you as THE ONE WHO WAS THERE- this broad was NOT MOVING. Not for me, not for you.

This thread would've gone quite nicely if you weren't such a judgmental @#$%ing know it all.

Thank you. I can use your posts as more reasons why ALS should be the standard for 911. Again, if the patient knows more than you, presenting an effective and convincing argument will be difficult.

[CBEMT]

And you're so sure she knew more than me because...........? I mean, if you were there, tell me!