Calgary EMS HIRING FREEZE?

[SA_Medic]

(1) on a tough call, they find it far too easy to hand the call completely over to the medic, and not do any thinking or assessing on their own. (2) they find it easy to be "the driver" and not take any responsibilty for how the call went, other than getting the medic to scene, and getting the medic and patient to the hospital (3) they haven't developed patient communication skills - their only patient experience was on their EMT practicum, which really does not give them a well rounded exposure to patients - they don't know how to talk to elderly patients to keep them calm, or an agitated patient to get the information they need. (4) working for an ALS service, they do not spend enough time developing their basic skills (basic assessment, vital signs, history taking) (5) overall, they get used to the security blanket of having ALS always available, and unless they are actively moving towards being a medic, they end up backsliding on the skills they do have.

Just a quick and short hijack of this thread, on the quote above. I arrived here to basics and intermediates doing exactly what is being described above. The current ALS staff simply allowed this to happen, I however refuse to have this done. When I arrive on scene, I will stand back and let them do their job first, should advanced intervention be needed, I will step in and do my bit. It seriously gets under my skin when people do this type of thing, it makes people lazy to think and forget what their work is and what's expected of them. How on earth do they expect to advance if they can not even work their own protocols? I asked this question to the staff here and got met with blank stares....

Hijack finished.

[emtannie]

Just a quick and short hijack of this thread, on the quote above. I arrived here to basics and intermediates doing exactly what is being described above. The current ALS staff simply allowed this to happen, I however refuse to have this done. When I arrive on scene, I will stand back and let them do their job first, should advanced intervention be needed, I will step in and do my bit. It seriously gets under my skin when people do this type of thing, it makes people lazy to think and forget what their work is and what's expected of them. How on earth do they expect to advance if they can not even work their own protocols? I asked this question to the staff here and got met with blank stares....

Hijack finished.

SA..... I think I love you.... can I come work with you????? Or send some of my co-workers to work with you so that they don't think I am just being an evil b***h when I force them to use their brains?

[Siffaliss]

A word of warning... do not be the EMT who thinks that just because you have that tiny piece of paper that ACP sent you (for all the money you spent, that little card isn't even laminated) you should be able to walk into the job of your dreams instantly. It rarely happens. If you show that you are willing to work, and willing to learn, and are willing to make some sacrifices for your career, doors will open. Some of my students worked 2 and 3 casual positions at a time, at various rural centres, to get the skills and experience they needed before they moved on to larger centres. Some of my students went to larger centres right away, and given the two, I would hire the first ones in a heartbeat, and not the second, as I know the first ones have a wider range of experience and knowledge. The students who show the commitment to getting the experience and working on their skills will do better in the long run.

Judith, I am not trying to scare you... I am trying to get you to look at a bigger picture, and the possibility that short term pain (I get the feeling you don't want to be anywhere but Calgary) may lead you to long term gain.

Again, best wishes in your endeavors.

I don't think anyone could have PAID for a better assessment on today's newbies. You've been doing this a long time Annie and know how to tell it like it is. A reg # is not a right it is a privilege (and an expensive one at that). It gives one the ability to use and build on the skills they learned in school. It does NOT mean one can walk into a job and figure everyone should bow down because they just got out of school. It gives you the opportunity to (hopefully) be a good practitioner and EARN the respect of your co-workers, some of which could have been doing the job before you were born. Be confident, not cocky, and WHEN you don't know something, ask.

Judith, it sounds like you might not have done an e-call in a while (practicum perhaps?) if you've been doing industrial for the last year. It would be in your best interest to build up your skills again and get on with a rural service. Sure it can be inconvenient driving the distance. Even though I do work for a large urban service now, I wouldn't have traded my rural days for anything. I ran calls with EMR's that in the city I'd never get to run due to 3 or 4 paramedics being all over it. There is an advantage to the patient (and your learning) having ALS in certain situations, but paramedics always start with their BLS first. I recommend the same for you as it's truly an invaluable experience. And if you're looking to eventually get to paramedicine, it's good to have a couple years of good experience under your belt.

Edited November 23, 2009 by Siffaliss

[mobey]

Once again the idea of "we eat our young" has been scattered across these boards...

Pfft... Are you even comprehending what you guys are typing or just spewing the same old crap you have been fed over the last few years by our closed-minded veterans here in Ab (no offence tniuqs).

So to summarize: New EMT's (not paramedics??) Should spend time in the rural ambulance services as some sort of "right of passage" into the city services???

Where the heck did this come from?

How bout we take a look at my current service.

We have a small hospital with 1 on-call GP. We have 2 nurses staffing our ER that see a true emergency maybe 5 times a year.

We have NO ALS backup.

We have NO BLS backup.

We have a volly Fire service that may or may not respond.

We are 3.5hrs away from the City hospital.

We have NO helecopter.... fixed wing is about 1.5hrs out.

So, by your guys ideals, THIS is the place for Newbie EMT's??

Why not Calgary again? Because you are within 10min of a major hospital, have an entire Fire Dept available, as much ALS backup as you could ask for, and you need how much experience before you "deserve" to enter this system?

Is that idea based on call volume?

Why the hell would I get a green EMT fresh out of school,and it is just me and the newbie, when RedDeer responds with up to 6 Paramedics at a "Delta" level call??

I cannot wait for this old "pay your dues" mentality is deleted from our profession.

[emtannie]

Once again the idea of "we eat our young" has been scattered across these boards...

Pfft... Are you even comprehending what you guys are typing or just spewing the same old crap you have been fed over the last few years by our closed-minded veterans here in Ab (no offence tniuqs).

So to summarize: New EMT's (not paramedics??) Should spend time in the rural ambulance services as some sort of "right of passage" into the city services???

Where the heck did this come from?

How bout we take a look at my current service.

We have a small hospital with 1 on-call GP. We have 2 nurses staffing our ER that see a true emergency maybe 5 times a year.

We have NO ALS backup.

We have NO BLS backup.

We have a volly Fire service that may or may not respond.

We are 3.5hrs away from the City hospital.

We have NO helecopter.... fixed wing is about 1.5hrs out.

So, by your guys ideals, THIS is the place for Newbie EMT's??

Why not Calgary again? Because you are within 10min of a major hospital, have an entire Fire Dept available, as much ALS backup as you could ask for, and you need how much experience before you "deserve" to enter this system?

Is that idea based on call volume?

Why the hell would I get a green EMT fresh out of school,and it is just me and the newbie, when RedDeer responds with up to 6 Paramedics at a "Delta" level call??

I cannot wait for this old "pay your dues" mentality is deleted from our profession.

WHOA mobey....

For clarification - my comments were not a "pay your dues" or "eat our young" mentality. I backed up my comments with specific examples, and specific experiences....

And don't forget, I work in a remote service as well, so I know the routine. You completely misunderstood the point I was making, and whether deliberate or not, I ask you to go back and re-read my posts.

My personal experience with the city service is that the EMT's are allowed to be "ambulance drivers" and they don't improve their skills... where on a rural service, they HAVE to keep their skills sharp, and in tough situations, they learn to trust their own judgment, not rely on a medic.

So, yeah - I want a newbie EMT in a rural service - where they can hone their skills, and build confidence. Yeah - I would love ALS in rural services, but you and I know it isn't going to happen soon. What I don't want, and what I see, is EMT's going straight from the classroom to urban services where they don't hone their skills, don't expand their knowledge, and don't build confidence because it is too easy to use ALS as their security blanket... tell me how this is an "eat our young" mentality.....

And, personally, I do not buy the "I can't find a job" line when you aren't willing to look farther than your front step.

I have responded more times than I can count, where it has been me, and a newbie EMR (not even an EMT) to a Delta level call.... and ALS ground service is not available for more than an hour, if at all.. It happens... and, I fully expect that my EMR will work with me as best they can... and they expect that I will guide them through what I need them to do, and walk them through anything they are having difficulty with. THAT IS MY JOB as the attending. It is NOT my job to "eat my young"... it is my job to guide them and get them more confident and improve their skills.

Do not judge me with the "eat our young" mentality when I have pulled students from practicums because I have found their preceptors to have exactly that attitude, and have placed them where they will get more guidance and chances to build their skills and confidence. Do not judge me with the "eat our young" attitude when I do my very best to be a mentor and role model to those newbies that enter my rural service.

I would venture to state that you are a far more well-rounded EMT (or are you a medic now, I can't remember - I know you were in classes) than MOST.. because of your rural experience. You have had to use your knowledge and your skills, and you have built confidence from being in those situations where you didn't have backup. That experience took time. What our profession needs is well-rounded EMT's and medics... and my point is that those who only work urban GENERALLY don't get as well rounded experiences.

Edited November 23, 2009 by emtannie

[mobey]

Sorry Annie... Completly misunderstood

As you may be able to tell, i have debated my side a few times, and may have even been the brunt of a few "Can't sling it the city" jokes.

i may be a little sensitive on the the subject.

Friends?

[emtannie]

Sorry Annie... Completly misunderstood

As you may be able to tell, i have debated my side a few times, and may have even been the brunt of a few "Can't sling it the city" jokes.

i may be a little sensitive on the the subject.

Friends?

Mobey, you are a good man, and of course we are still friends...

I completely understand. I get frustrated and angry with EMS employees who use that "can't sling it in the city" when they have never worked rural. You have every right to be sensitive about it. I have the benefit of working both city and rural... and my rural is similar to yours... and in the city, I work with a lot of crew that have no idea what it is like to not have ALS or backup for an extended period.

Maybe EMS practicums should be more like a physician residency. Just as physicians have to do a rural rotation, it would be nice to see all EMS have to as well, so they can be more well-rounded. Just a thought...

[Siffaliss]

Mobey, you are a good man, and of course we are still friends...

I completely understand. I get frustrated and angry with EMS employees who use that "can't sling it in the city" when they have never worked rural. You have every right to be sensitive about it. I have the benefit of working both city and rural... and my rural is similar to yours... and in the city, I work with a lot of crew that have no idea what it is like to not have ALS or backup for an extended period.

Maybe EMS practicums should be more like a physician residency. Just as physicians have to do a rural rotation, it would be nice to see all EMS have to as well, so they can be more well-rounded. Just a thought...

I agree Annie, and from personal experience I feel I am likely more of a well rounded practitioner for having worked rural. It's a different world out there as you've both detailed; hours from the nearest major facility, brand spankin' new EMR with you and crap, you have a code and NO other backup ... rural such as this gives one the ability to learn how to think on their toes, without having the "luxury" of ALS or even another BLS crew. Having to think for one's self (and do so effectively and to the best of their ability) is what betters especially a new individual. Hey, if a paramedic has say done a zero to hero type program, never done a call outside of practicum, they might benefit from some time out of town as well. Being a paramedic doesn't automatically mean they're the shiznit just because they're a medic. (This coming from a second year medic student).

Perhaps a lengthy extension of EMT practicums would be a positive step?

[ukcanuck]

I think that there are many elements at play here.

I have worked rural, remote, semi rural, semi urban, and urban and each has it's own advantages and disadvantages. You might get to look after your pt for longer when you are rural but you get A LOT less pts so your exposure to the different types is limited. In Urban you see more pts but have them for less time so you will do less interventions and the ones you do do are done at the speed of light as you are trying to do them before you hit the ER. The list goes on and you have to benefit where and when you can. I do not believe that any one type of exposure makes you a better practitioner but rather a blend of everything. I felt that I was OK when I transferred to urban but quickly realised that I was really slow but I had better communication skills then those who had been urban the whole time. etc ad nauseum

What we have to do is stop thinking ALS/BLS and start thinking TEAM.

You are an ALS skilled team not individuals providing care at our level.

I work on the premise that my BLS partner can and will do his/her job when required. If the pt does not require ALS intervention it is not an ALS call so effectively I am a BLS paramedic. If the skills ain't needed then they stay in the box till they are needed.

I do not "take over" pts but rather provide a higher level of care then my partner can. If that means I have to stay in the back then so be it but if my partner can stay in the back then that is the way it is.

A lot comes done to the confidence the ALS provider has in their own skills and abilities and the confidence and trust they have in their BLS partner.

If the ALS guy is looking for skills to build their portfolio or is a skills hound then the BLS guy might as well be just a driver. But those guys would be the first to complain if his partner was downgraded to driver. You can't have it both ways. They are either your PARTNER or your driver.

One of the responsibilities paramedics have is to develope the skills of students and those less experienced/skilled than ourselves. That includes the BLS guy you work with everyday. Let them have responsibility when it is safe and legal to do so and your day gets easier. Not every pt is a ALS skills dummy. you might even help develope one of the paramedics of the future.

I also know that you can learn a lot from those old time EMRs and EMTs who have worked the same patch for the last twenty years. As a practitiooner you are supposed to learn from ALL sources and that includes your partner. If he is doing something wrong then work to get it right. You can learn tricks and tips on ways to get pts out of spots and little things that make a call go smoother.

And to those ALS paramedics who think they know it all been there done that got the t shirt worn the t shirt out..... after nearly twenty years I have not seen it all. Seen most of it but I know that there will be a call sometime somewhere that will trip me up. The guy who will get me out of that mess will be my partner whether he is BLS or ALS. Its about pt care not who gives it.

[Siffaliss]

I was really slow but I had better communication skills then those who had been urban the whole time.

(This generally comes from having that extra pt contact time in a slower, rural setting)

What we have to do is stop thinking ALS/BLS and start thinking TEAM.

(True, but if one member frequently cannot function due to lack of life or road experience ...)

You are an ALS skilled team not individuals providing care at our level.

(Each team member has a certain set of skills; if one cannot provide those skills ... see above)

I work on the premise that my BLS partner can and will do his/her job when required.

(Again, see above)

I also know that you can learn a lot from those old time EMRs and EMTs who have worked the same patch for the last twenty years.

(You don't mean the oil patch, do you?)

And to those ALS paramedics who think they know it all been there done that got the t shirt worn the t shirt out..... after nearly twenty years I have not seen it all. Seen most of it but I know that there will be a call sometime somewhere that will trip me up. The guy who will get me out of that mess will be my partner whether he is BLS or ALS. Its about pt care not who gives it.

(I can't say I know one medic who feels they know it all; I work with several with 30+ years, however I know there are many out there who are narrow minded. As for 'getting out of a mess', I've seen the brand new EMT malfunction in a super busy situation and CANNOT do this, never mind start their partner's IV or differentiate between a canula and end tidal CO2.)

Edited November 23, 2009 by Siffaliss