FDNY EMS - Basic to Medic and More...

[mediccjh]

Can someone please explain to me how this thread started from a simple question about FDNY*EMS to the typical BLS vs. ALS vs. Education argument, AGAIN??!!!

I've been on this site for almost 5 years now, and I'm sick and tired of seeing the same shit.

Grow up, people.

To the OP: Listen to Richard B; he's been at NYC*EMS longer than most of us have been alive.

[WolfmanHarris]

You guys just don't get what I'm saying. I'm not bashing medics. I know they can do much more than I can. Just like a doctor can do so much more then they can. But for someone to say to me go back to school EMT's are useless. That I resent. I'm a EMT for 20yrs now and I love it. You can say all you want that I'm not doing anything for the patient and I'll say you dead wrong. I've seen a lot of good outcome because of what I know and i've been able to help alot of people. Sure I'm limitted to what I can do as a tech,but what I can do I do the best I can. The best compliment I ever got was from a medic co-worker. No one can ever say to me that I don't pull my own weight. So save that BS about the patient would have been fine for someone who hates there job cause I don't. And the way you sound it seems anyone under the title of doctor is useless to you. Fine doc get in an ambulance and do it yourself.

Okay full disclosure first of all. I suck at picking screen names. I was given the nick name "Doc" years ago by a friend, picked it as a screen name back in 2002 and have used it since. Didn't have any problems until I came here and low and behold there are actual Physicians around. And the more this happens the more I'm thinking it's time to get a new name.

Anyways, I am a recent grad from Primary Care Paramedic school here in Ontario (recent as in three days since classes ended) and still consolidating. I am a BLS provider. I love this profession, loved school and can't wait to work. I also thing long term the best thing for the profession is to phase my level out all together and replace it with a single four year degree with a post-grad program for our Critical Care Paramedics (already an 18 month program on top of the three years total to be an Advanced Care Paramedic). I am not an ALS provider looking my nose down at BLS, I am a BLS provider who sees significant room for improvement in our system. We're not going to get any where is we become so entrenched in our own little corner that we can't see the big picture.

I wasn't going to take another kick at this horse, but I needed to make sure I wasn't misrepresenting myself. I know you're new here and this probably isn't the best start to the EMTCity experience, but use that search function real quick and you'll see how brutal this issues has gotten in the past. My best advice is keep an open mind, try not to take it personnally and you might have your assumptions shaken up. No one's questioning your individual dedication as a provider. What is being argued, quite regularly these days, is that the system (BLS/ALS education) you and all of us are working in is flawed and doing our profession and the public a disservice. Give it a chance. I did.

Cheers,

- Matt

[JPINFV]

Medic students spend some time in the ED, but most of what they do there is practicing IVs. They also go to ORs to practice intubation. I don't know the exact figure, but I think they spend < 200 hours riding with various paramedic services in the area, some of which don't do a whole lot of ALS calls. Having had medic students riding with me and my partner, I can say they don't get a whole lot of experience this way.

I can't speak for other services, but the commercial ambulance I work for require new medics to ride as a third with a paramedic preceptor for one or two months, and experience varies. Keep in mind that I work for a commercial for-profit ambulance service, so precepting medics aren't immune to interfacility transfers, even when they and their preceptors throw a huge fit.

Even if they have very productive ride time during school, and their precepting goes well, they have about three or four months of practice before being let loose on the unsuspecting public. While for some people this is enough oversight, and we do get some good medics right out of the gate, it still doesn't compare to the support a new nurse or physician can expect.

...but some how working on 110 hours of training and being able to administer 5 or so drugs, including patient assist medications, of which only 1 gets any serious use, is supposed to make up for medic schools apparently not having a long enough field internship?

Edited April 24, 2009 by JPINFV

[ERDoc]

So the truth comes out. To you we're just ambulance drivers. I guess you didn't work in a place where EMT's made a difference. I do and the babies I delivered and cardiac arrest That I brought to the hospital breathing would agree.

I've got no problem staying as an EMT. Sure I'd like to be a medic. I'd also like to be a doctor. But I'm not and I don't let that stop me from doing the best I can in what I love doing.

I think the truth has been out there since I joined this site many years ago, just have a look at some old posts of mine. Sorry to take away your epiphany. I have nothing against EMTs as people. I know some great EMTs who can do the job really well. In the touchy-feely-kumbyah-WilliamShatnerRescue911 world you live in I'm glad you can make a difference. In the real world where there are sick patients, they need medical care which EMTs cannot provide. The only ones able to provide this in the field is the paramedics. This is not a dig at EMTs but at the idea of an EMT level. There are many EMTs that I think would make great medics. When you have a pt in cardiac arrest or someone who is circling the drain they need medical care which paramedics can provide. I spent 10 years as an EMT and can tell you the level should be done away with. I agree that there are many pts that do not need ALS level care, but there are plenty of people in the ER who do not need a doctor, but they get one. I'm glad you do the best you can and love your job, but this is not about you. It is about the pts and providing the highest, most competent level of care possible.

[NYCEMS]

I think the truth has been out there since I joined this site many years ago, just have a look at some old posts of mine. Sorry to take away your epiphany. I have nothing against EMTs as people. I know some great EMTs who can do the job really well. In the touchy-feely-kumbyah-WilliamShatnerRescue911 world you live in I'm glad you can make a difference. In the real world where there are sick patients, they need medical care which EMTs cannot provide. The only ones able to provide this in the field is the paramedics. This is not a dig at EMTs but at the idea of an EMT level. There are many EMTs that I think would make great medics. When you have a pt in cardiac arrest or someone who is circling the drain they need medical care which paramedics can provide. I spent 10 years as an EMT and can tell you the level should be done away with. I agree that there are many pts that do not need ALS level care, but there are plenty of people in the ER who do not need a doctor, but they get one. I'm glad you do the best you can and love your job, but this is not about you. It is about the pts and providing the highest, most competent level of care possible.

OK lets have things your way. Let's have doctors in the ambulance. Then we won't need medic's, and while your at it tell the next guy who wants to learn CPR to be a doctor or stay out of the field. To you unless you have a PHD your useless.

Yeah the system is messed up. But the people who want to help others should be congatulated not put down because there not at the top of the ems chain. I don't know why your in the field. I'm sure you complain about all the bs calls we get or how your world isn't touchy-feely. The real world. We live in the real world. Wake up. Save your Sci-Fi bs for TV. Everything I'm talking about here is actually happening. I know it's not just about me but I'm in the field your bashing and I have a problem with that. If you want to say you don't like EMT'S say it, but save all that other garbage about us not being useful. Or go somewhere else. This is called EMTCITY.

End of story. I'm out of this revolving discussion. I'm more mad at myself for debating with you. "Emt's as people", what do you think we are aliens.

[mobey]

OK lets have things your way. Let's have doctors in the ambulance. Then we won't need medic's, and while your at it tell the next guy who wants to learn CPR to be a doctor or stay out of the field. To you unless you have a PHD your useless.

Yeah the system is messed up. But the people who want to help others should be congatulated not put down because there not at the top of the ems chain. I don't know why your in the field. I'm sure you complain about all the bs calls we get or how your world isn't touchy-feely. The real world. We live in the real world. Wake up. Save your Sci-Fi bs for TV. Everything I'm talking about here is actually happening. I know it's not just about me but I'm in the field your bashing and I have a problem with that. If you want to say you don't like EMT'S say it, but save all that other garbage about us not being useful. Or go somewhere else. This is called EMTCITY.

End of story. I'm out of this revolving discussion. I'm more mad at myself for debating with you. "Emt's as people", what do you think we are aliens.

[JPINFV]

"Emt's as people", what do you think we are aliens.

What, you didn't get the memo? Heck, better to be an alien than be some lazy EM physician swine.

/me looks at signature.

Oh crap.

[Richard B the EMT]

Someone mentioned the time I've been at this (being an EMT, not a member of EMT City, although that in itself has been a long time), from the fall of 1973, and municipal EMS from 1985. In that time, I can say, with a good deal of conviction, that the calls require ALL levels of care.

There will be calls that would not need the skills of a Paramedic, such as the panicking mom calling in for the "road rash" of her 4 year old falling off his bicycle and severely scraping his knee, and calls where EMTs need backing by paramedics, as in recognizing a dehydration patient that could use fluid replenishment via IV, which, in my geopolitical area, is above and outside of scope of EMTs.

Come on, people (and the aliens hidden amongst us, lol), respect yourself by respecting everyone else.

[Emtgirl101]

You say you have no intentions of being ff but here in ny alot of the vol ff companys will acually put you threw the emt basic training or whatever training there department requires to be a memeber, but alot of them also require you at least take your ff one course and extractions ya know.... so I know if you join a vol company your not going to get just the basic training,, u'll prob get a insite of ff training as well. Unless you want to be just a paid medic or emt then I know rural metro offers a course for free but they have to accept you first or you have to pay for your own course which is around 700 bucks out here and find a service to apply to., out here in buffalo , ur options are Rural metro, Twin city ( tonawanda , amherst area only), Tri Comunity.... and few others I don't rember right now those are the paid companys but its mostly Vol out here.

[ERDoc]

OK lets have things your way. Let's have doctors in the ambulance. Then we won't need medic's, and while your at it tell the next guy who wants to learn CPR to be a doctor or stay out of the field. To you unless you have a PHD your useless.

Yeah the system is messed up. But the people who want to help others should be congatulated not put down because there not at the top of the ems chain. I don't know why your in the field. I'm sure you complain about all the bs calls we get or how your world isn't touchy-feely. The real world. We live in the real world. Wake up. Save your Sci-Fi bs for TV. Everything I'm talking about here is actually happening. I know it's not just about me but I'm in the field your bashing and I have a problem with that. If you want to say you don't like EMT'S say it, but save all that other garbage about us not being useful. Or go somewhere else. This is called EMTCITY.

End of story. I'm out of this revolving discussion. I'm more mad at myself for debating with you. "Emt's as people", what do you think we are aliens.

You just don't get it. I never said we should put doctors on ambulances. There is no need for it. Yes, I said that the pts should get the highest level of care, but logistically you are limited to the amount of care you can provide. You need properly EDUCATED paramedics. Ideally, I would like to see medics brought up to the level of PAs that can write scripts and do simple procedures such as suturing. This would take a huge burden off of the ER so that we can take care of the people who really are sick. Why would we discourage people from becoming first aid/CPR certified? They are a vital to provide care until the paramedics arrive. I wish we could get more people certified.

I agree, people without PhDs are useless. Who wants an MD or DO taking care of them? Certainly not me. I am glad that there are people that want to help others. They should be commended and congratulated. Should the pts (remember, the people that this whole thing is about) have a crap shoot on the level of provider that they get? It's playing Russian Roulette. If you trip and twist your ankle, then does it really matter what level of provider shows up (do they even really need an ambulance)? If you are in severe CHF and on the verge of resp arrest do you want to be the one that is going to have a long ambulance ride with someone who can only put oxygen on you? If you are doing this because you want to help people but are not willing to strive for the highest level of care then maybe you should consider some other way of helping people. There are plenty of other volunteer activities that would help people/help your community and wouldn't require putting lives at risk. Volunteer at a nursing home, help with an adopt-a-highway program, you get the point. I am in this field because I want to help people and was willing to put in the extra time to provide the highest level of care. I did my 110 hours of EMT class and realized how little I was actually able to do for my pts, other than drive them to the hospital. My uselessness to pts (at least the ones that needed medical care) is what motivated me to go through medical school.

Would you mind pointing out my Sci-Fi BS? I don't remember mentioning tricorders but if you can prove otherwise, I am willing to concede on this point. Again, I have nothing against EMTs (I was one for 10 years). I think it is just a flawed system that doesn't guarantee the highest level of care.

I know this is EMTcity. I have been here for a few years and noticed the name a few months ago. What relevance does the name of a website have on providing quality care to pts? I don't know if you have noticed, but a large portion of the members are ALS providers. Should they be banned because they are not EMTs? You seriously have a major hero complex. Get over it and realize the problems with what you are saying.