Massachusetts FAIL

[cosgrojo]

How so? In my basic class we did, I think, about 160 hours. How is the DOT limiting his ability to make strong basics?

Unfortunately the DOT in New Hampshire controls the curriculum, and the class hours. You can increase the hours only if the additional hours are approved by the State and they have had a chance to rule on the curriculum. The most problematic issue when contemplating adding onto what the state mandates is from a business perspective. Adding hours adds the need for more resources, additional instructors, and eventually price hikes for the students. As we all know, most that are interested in EMS do not come from a wealthy background, and higher prices tends to lead to students going to other schools. No students, no school. Also most students without any real life perspective or understanding of the future benefits of more education will choose a shorter class in order to just "get it over with." It is a fine line between what we want and what is reality (see the proliferation of accelerated programs and "zero to hero" classes).

I have heard, and now found for myself, that often the more experienced basics have the least value. The vast majority are under educated, though because they had been behind the yellow tape, soon felt that their experience trumped the education of others, giving them value that they didn't truly have, and respect that they had never really earned. As Dust has asked many times, if experience before knowledge is a good thing, then why is EMS the only medical body that does it?

There is nothing that you have ever said that I agree more with than those first two sentences. It is tiresome working with 20 plus year EMT's that haven't updated their skills in 15 years expecting that you treat them like Gods because of their tenure. As to the last sentence, I don't see why these two attributes have to be mutually exclusive... can't I have both experience AND knowledge? I don't want a partner that I have to rely on that only has one of the two. And Dust may say that... and know that he has... but he also is a man that understands (and have read posts that strongly advocates) that providers have to have a strong set of core values to be all that they can be. So brush aside his cranky veneer, and you have a bleeding heart idealist standing by the door ready to offer you a hug for a job well done.

Now if what you are saying by "better basic" is that the cream of the crop of basics, those educated well beyond necessary minimums, professional, hard working, healthy, that if they were to become I's and then Medics that that would be a good thing, perhaps I can get on board with that. But they, in my experience, are terribly, terribly rare.

Yes... remember... utopia. And yes... exceedingly rare. But wouldn't it be nice!?

You are absolutely right. I meant ignorance and education. Certainly a lower certification doesn't denote inferior intelligence any more than the reverse would be true. It was a silly error, thank you for giving me the benefit of the doubt.

Thought so, your welcome.

Ok for now, but I can't promise for ever.

You could have at least given me two paragraphs!!!

I see your point, but don't agree that it's valid from a cost benefit point of view. If you could create a Physician in as little as three months? Absolutely I would think that only Docs belonged in ERs. How does having a less educated nurse there improve pt care? I can only see one way, and that is because there are duties that some begin to feel are 'below' them, and others, if educated less, and paid less don't feel the same. Can a nurse clean a bottom, document, administer medications better than a doctor? Certainly not if we hold to your 'everyone is competent' rules.

It is exactly because of a cost-benefit equation that you can not have an ER full of MD's. They would either have to start paying MD's less, or increase payroll by a significant factor. And I've never seen a MD clean a bottom before, so I don't know if they can do it as well as an RN... RN certainly has a leg up in the experience category.

It doesn't fit, where I can see, in the EMS that I have worked, again, simply because I haven't worked with medics that are 'too good' to do menial labor. When the basics I work with now tech a call I do all of the basic work. Clean and restock the rig, make the cot, chase down the necessary paperwork from the office...I have no issues with it nor have I seen any sign that the other medics do either.

My first 4 weeks at this service I worked with another medic full time. When I teched calls he asissted, as did I on his calls. The only side effect that I noticed is that he and I both wanted the rigs cleaner than any of the basics normally kept them, and that each pt had the benefit of two educations and streams of experience instead of one. (Meaning somewhat more advanced educations/experiences)Well, that and the fact that if I wanted narcs he had them avail and loaded before I needed to call for them.

Clearly we all need to move to Colorado, for you make it sound as if it is Utopia. No one balks at doing calls, no one is lazy, everybody lifts without complaint, the grass is green, and the girls are pretty.... oh please, oh please, won't you take me home. I'd be closer to AMR corporate as well!! It does sound like paradise!

What skill set does the nurse bring that the Dr. doesn't posses with the exception of a lower educational level and the willingness to work for less money? What else is she capable of that the doctor isn't?

It's not about a "better" skill set, rather about delineation of skill sets so that providers can focus on specific goals, thus increasing efficiency. If a MD is providing care and consulting with a specialist, I don't want him/her to have to interrupt those tasks because the linen cart needs re-stocking. And I certainly don't want to pay a MD their salary for them to only be in charge of re-stocking and other tasks usually accomplished by ED techs.

(Have to continue in another post as there seems to be a new posting limit)

Hey Cos, I'm going to dump the rest in your email, if you want to PM an address.

I can't post the rest of this as I continue to get a [the following errors () were found] message. On the back of the [too many quoted texts] or some such crap errors, I'm giving up. (Actually, this was a separate post that somehow got attached to my last post...no idea what the hell is going on.)

I'll look for your response and send the rest privately if you like.

Have a good day.

Dwayne

There have been a lot of glitches on the site lately... maybe it is from all the format changes... Honestly Admin, these monthly changes of format are going to cause me to have a technological aneurysm.

I look forward to any reply, if you want to e-mail it, that is fine with me. It doesn't appear that anyone wants to play with us... Are we the smelly kids at school?