AV CPG

[melclin]

I didn't agree or disagree with the comment, just said it wasn't necessarily a smart move.

This actually cracks me up, first time i have heard of you guys to be called gherkins! I dont consider "gherkins" to be worthless at all. Dont make the assumption that you are somehow special in that you are doing a degree, you are the norm, as am I. I also have a degree, i did my 3 years, i did my placements, i sat next to people like you in class who sprouted "we will be your peers" BS. It was people like you who made the rest of us cringe, smart ass comments to and about roadies, insinuating you were better than them because you were doing a degree, the gherkins who sat in the loungerom chairs because doing a Sig 3 with the crew heading out the door was somehow beneath them. Reality is i am not that far ahead of you, im not one of the non degreed "roadies" you seem to hold in distain , but its precisely your attitude that gave us grads a bad name to begin with.

Thats why we were considered worthless, roadies were impressed at the level of clinical knowledge we had and horrifed at the attitude because people like yourself projected that arrogant image and we were all tarred with the same brush. When you wear a blue shirt fo a couple of years you start thinking "gee, i hope i didn't come across like that"

I mentioned I was venting my personal frustrations at uni and the way in which the

I know you think that you act in a different way and you probably do for the purpose of getting thorugh your placements, but once you get in and onto a branch, people will get a whiff of this attitude after a while. Im still amazed at how quick ambo's can smell a rat!

I didn't mean I was pretending to be a different person. People often have different personas in different contexts. When I'm talking to my grandmother, I'm different to how I am down the pub with my mates. What is this attitude you're talking about? Why can't I politely challenge you or anyone else? If I'm wrong, I'm happy to be shown why. As you said, you don't even necessarily disagree with what I'm saying, so are you just disagreeing with me saying it full stop? Am I not allowed to express these opinions as a student, or do you take issue with the way in which I've expressed the opinions. I'm not being nasty, I'm actually asking, because I have been told that I come across argumentative or rude sometimes, when I do not intend to be, and I'm wondering whether that is the issue here; the way I've said it or just that I've said it at all. Do you now take issue with the manner in which I, a student, am addressing you, a qualifed medic?

I know, i have these on my PDA, john (if i remeber the name correctly) has done an awesome job transposing these. I believe the author has been under considerable pressure in the past to discontinue this. the CRAP CD is a great tool! I was referring to the PDF file as released by AV

Isn't it! I loved the concept of MICA videos. Frank is a great lecturer.

Wow, you do have a chip on your shoulder, just another hard done by uni student eh?

Maybe you're misinterpreting my tone. You seem to think that I'm up on my soap box trying to tell the world that I'm perfect and that everybody owes me everything, because I'm a degree student and I'm hard done by, but I everything should go how I say. I was just having a lighthearted whinge.

Tell me, just what exactly do you feel that AV owes you? Where on AV's radar do you believe you should be?

Its not really about what they OWE me. Just my opinion on what feels like a common attitude held by a lot of the roadies

Well, just as I made some unfair assumption about you, you are doing the same for me. As it happens I'm fine with signal 3s. I'm a believer in the doc in the box theory of EMS. If a consultant emergency physician has the time to see people with skinned knees then surely we can and for a newbie like me it gives me a chance to practice the basics, like simply talking to a patient. I must have hit a bit of a nerve in something I said, as did you did vice versa. I don't know how what I said could reasonably be interpreted in itself to mean that I think I'm a super ambo because I'm doing the degree. Feels like some aspect of what I've written has been similar to something said by others you've disliked have said, and you are unfairly attaching opinion they've held to me. And frankly I think its a bit rude to be making personal criticisms, even if it is an internet forum. One of the paragraphs of your response was just dripping with disdain; and I don't understand what it is that I said that invoked such a response, help me improve, what about what I said p**sed you off so much. Maybe there is some other more negative meaning attached to the word "roadie", when used by someone in my position, that I wasn't aware of. I was under the impression it simply meant ambulance paramedic, as opposed to MICA, from the way it was used by lecturers. I apologise if I'm wrong.

Re the "people like you" comments. I don't think I need to point out how unfair a generalization that is. Also, you would be mistaken to take the way I'm talking to you now to be the way I address CIs/whoever I end up on placement with. But it is not unreasonable to expect them to treat us with the same respect they would show any other human being, which sometimes doesn't happen. Don't get me wrong, most that I've met are nice enough, I'm complaining about a minority (although this " Every roadie always seems shocked when they learn that the uni is not teaching their particular way of doing things, and naturally it is our fault as students" appears to be true of far more medics. It is the most common complaint for most students that the tutors at uni all have differing opinions on things and that they are not open to other interpretations, such that we end up confused about the right course of action, esp for the exam. And that's the uni's own tutors, on the road is worse). Also, it feels like anytime we are confident in ourselves, or stand up for ourselves, however politely, or even have any kind of opinion, it gets misconstrued, like I feel it has here, as arrogance. It is not unreasonable to question our roadie/CI/tutor/QAP, it doesn't mean we think we're better than them, its just how we consolidate what we learn at uni with what we see on the road, which are often very different. It would be nice to be able to do that without getting remonstrated for being an arrogant uni student who thinks they know better and is better than non-degree roadies. I'm not that guy and I'm not sure I know any who are. Everyone I know is too scared s**tless/eager to do any job, to do any of the stuff you're talking about. Not saying it doesn't happen, just saying, I'm not that guy, and I don't know many who are in our cohort. I'm displeased but not entirely surprised to hear that it does happen.

Re the "we will be your peers comment", well again, I must have hit some nerve and it must have taken on some meaning that I wasn't aware of. It is, after all, technically true. My point was that we will end up being the paramedics that staff the ambulances one day (you know, our children are our future sort of thing) and it is unwise to neglect the education process if you want those kids to be anything but incompetent. Hence I feel that we should be a little closer to the higher priority end of the list for AV, because it certainly feels like we are expected by AV and uni to be perfect once we hit the road, but that they couldn't care less about the process leading up to that (placements). Maybe I'm wrong, but it wasn't really a statement of fact or policy, its just how we are sometimes made to feel as students. It would have been nice of them to have considered us when ordering the first round of prints of the CPGs, for example, or work better at providing more educational environments for students on placements.

I still enjoy placements more than just about anything else at the moment, I'm not saying I'm hard done by. Its hardly a tragedy. I just think it would be nice to get rid of the atmosphere that is common on placements where you just feel like there is nothing you can do that is right. I don't think, and I am not alone (its a widely acknowledged, and even published, problem) that it is in the interests of a good education. If anything I think that 'sending the apprentice out for a left handed hammer' type stuff is immature.

Regarding the separate matter of your point about the wisdom of criticizing a future employer, your are entitled to it, as I am to disagreeing with it. I'm happy to take the risk in making a lighthearted, mildly derogatory remark expressed in the context of having a whinge on an anonymous internet forum, especially in an environment where paramedics are openly criticizing AV far more seriously than I am.

This is not sarcastic at all, I am actually asking to learn: How do you feel students should handle those situations where what they've learned at uni and what they are being told to do on the road are different? Do we ask about it after handover but let it happen? Do we nod and smile, and just not incorporate their poor practice into our own? How do you reckon we go about that in a way that doesn't come across arrogantly but still allows us to reconcile the difference between uni and road experience. How do you think they should act in general?

[BushyFromOz]

Ahh i see whats going on here...

"roadies" is a derogatory term used to described QAP's, you may have heard the term "road scum" before? while QAP's may refer to themselves as "roadies", its generally seen as a put down coming from anywhere else

Im sorry of my post is dripping with disdain, you must understand though that i have a generalisation because this actually happens on a regular basis. we do get students who go to sleep on the lounge, refuse Sig3's, tell MICA paramedics how to tube, cut QAP's off in the middle of their assessments, interject during our hand overs, tell me im putting that cannula in wrong, tell me im going outside a CPG. And we do get students telling us that they will be our managers because they have a degree (aka we will be your peers) This doesn't really effect me, but for anyone who did DAPS or the old certificate of applied science this is a huge insult, the introduction of a graduate based system also pulled the rug out from under a lot of senior ambo's career progressions, and many of them are now my closest friends. Unfortunately for you the worst seem to come from monash, which is sort of understandable, lets face it, the course there is so freaking good

I understand you guys want to be there and want to learn, and yes the service does accept you for placement, but, there is no obligation on my part to have you on my truck. My priorities changed after putting on the blue shirt, i couldn't understand the ambivalence we were sometimes subjected to, but now i know why, its because you will be gone tomorrow, i probably wont remember your name, im on day 3 of 4, its 3 hours past my lunch window and 2 weeks from annual leave, ive been working with a BLS guy for 2 months and ive had to do most of the work with no backup and more often then not the ride-along are just one more thing i have to keep track of and worry about, regardless of how well meaning you are

You have asked heaps of Q's in your post, ill try and answer them tomorrow (or later today as it turns out!)

peace..

[melclin]

"roadies" is a derogatory term used to described QAP's, you may have heard the term "road scum" before? while QAP's may refer to themselves as "roadies", its generally seen as a put down coming from anywhere else

Ohhhh S**T. My bad. I feel like I've been calling people n**ger without realising white people can't do that....Don't I feel like a gallah.

Im sorry of my post is dripping with disdain, you must understand though that i have a generalisation because this actually happens on a regular basis. we do get students who go to sleep on the lounge, refuse Sig3's, tell MICA paramedics how to tube, cut QAP's off in the middle of their assessments, interject during our hand overs, tell me im putting that cannula in wrong, tell me im going outside a CPG. And we do get students telling us that they will be our managers because they have a degree (aka we will be your peers) This doesn't really effect me, but for anyone who did DAPS or the old certificate of applied science this is a huge insult, the introduction of a graduate based system also pulled the rug out from under a lot of senior ambo's career progressions, and many of them are now my closest friends. Unfortunately for you the worst seem to come from monash, which is sort of understandable, lets face it, the course there is so freaking good

That truly astonishes me. I can't imagine anyone I know (except maybe one guy) in my course doing that. We're so petrified on placements. It must change further down the track, we get more cocky with more classes or something...evidently it does/we do.

(Just as an aside, were you being sarcastic when you said "so freaking good" meaning that the grads are rubbish-->rude; or that it is actually good -->smart grads-->arrogant grads. Sorry, I can't read sarcasm on the internet )

I understand you guys want to be there and want to learn, and yes the service does accept you for placement, but, there is no obligation on my part to have you on my truck. My priorities changed after putting on the blue shirt, i couldn't understand the ambivalence we were sometimes subjected to, but now i know why, its because you will be gone tomorrow, i probably wont remember your name, im on day 3 of 4, its 3 hours past my lunch window and 2 weeks from annual leave, ive been working with a BLS guy for 2 months and ive had to do most of the work with no backup and more often then not the ride-along are just one more thing i have to keep track of and worry about, regardless of how well meaning you are

Its funny, I already knew that, and really, it should be fairly obvious to me, but you putting it like that makes it clearer. Thanks.

You have asked heaps of Q's in your post, ill try and answer them tomorrow (or later today as it turns out!)

peace..

Oh pretty much everything is clearer now, I got my back up a little after your first reply because I thought I smelt some "your not worth the air you breath because you wear a green suit" type sentiment, my mistake; so don't waste too much of your time. I would still be interested in how you think students should address those issues on placements though (I have 4 weeks coming up), and I'm sure the information would be useful for chaser too.

[High Speed Chaser]

Im sorry of my post is dripping with disdain, you must understand though that i have a generalisation because this actually happens on a regular basis. we do get students who go to sleep on the lounge, refuse Sig3's, tell MICA paramedics how to tube, cut QAP's off in the middle of their assessments, interject during our hand overs, tell me im putting that cannula in wrong, tell me im going outside a CPG. And we do get students telling us that they will be our managers because they have a degree (aka we will be your peers) This doesn't really effect me, but for anyone who did DAPS or the old certificate of applied science this is a huge insult, the introduction of a graduate based system also pulled the rug out from under a lot of senior ambo's career progressions, and many of them are now my closest friends. Unfortunately for you the worst seem to come from monash, which is sort of understandable, lets face it, the course there is so freaking good

I understand you guys want to be there and want to learn, and yes the service does accept you for placement, but, there is no obligation on my part to have you on my truck. My priorities changed after putting on the blue shirt, i couldn't understand the ambivalence we were sometimes subjected to, but now i know why, its because you will be gone tomorrow, i probably wont remember your name, im on day 3 of 4, its 3 hours past my lunch window and 2 weeks from annual leave, ive been working with a BLS guy for 2 months and ive had to do most of the work with no backup and more often then not the ride-along are just one more thing i have to keep track of and worry about, regardless of how well meaning you are

You have asked heaps of Q's in your post, ill try and answer them tomorrow (or later today as it turns out!)

peace..

I would never argue with some one who has been working as a Paramedic longer the me for one reason and that is experience. I believe that this is a key part to any successful Paramedic/EMT and rest assured, If I was in you Sprinter (or any other ambulance), I would follow your lead, take signal 3s, and most of all listen to all your advice, stories and learn from you in the lounge and not tell MICA what to do. I would never tell some one, I have a degree so therefore I should be promoted ahead of you and if someone takes the time to teach and mentor me, I like to think that I have gained a friend.

[aussiephil]

I would never argue with some one who has been working as a Paramedic longer the me for one reason and that is experience. I believe that this is a key part to any successful Paramedic/EMT and rest assured, If I was in you Sprinter (or any other ambulance), I would follow your lead, take signal 3s, and most of all listen to all your advice, stories and learn from you in the lounge and not tell MICA what to do. I would never tell some one, I have a degree so therefore I should be promoted ahead of you and if someone takes the time to teach and mentor me, I like to think that I have gained a friend.

Chaser,

that is you. I can speak afrom experience & I am sure Bushy will support me on this, there is an attitude that presents from many (I said many & not all) uni students that they are better than those of us without a degree. I have seen many officers who, without a degree are great operators, that have been questioned, in front of patients by a graduate. I have even seen it by a student on placment do it.

I have seen graduated that I wouldnt want anywhere near me if I needed an ambulance. I have also seen others without a degree that are the same. The issue here is that any form of EMS is primarily about 3 things.

1. Knowledge - this is the basis that will allow you to undertake the basis of your career, it includes anatomy, physiology & pathophisiology, as well as pharmacology, pharmacokinetics & pharmacodynamics.

2. Experience - you can have as many degrees as you like, but, there is nothing like the experience you gain from wortking on road & learning from those who have been around for a long time. They have the ability to make a decision that is grey, like most of medicine, there is very little black & white. Experience can be not rushing into giving a drug, but with holding it for more information.

3. People Skills - This, again only comes through experience, in this case life experience, not work experience. Unfortunatley, I have come across a large number of graduates who have great knowledge, are good at developing their experience, but cannot communicate with patients at their level. These same officers still expect to then progress, without any consideration for anyone else, to IC status, just because they have a degree, with minimal experience in the job.

Again, i must emphasise this is not all, but sadly it appears that it is those with 'the attitude' that are not helping the overall reputation of uni grads.

[Kiwiology]

Phil;

I agree with you 1000% here mate. I've seen some Graduates who are really good people and just as good clinically as well as some who are excellent clinically but either have the people skills of a rock or this "Holier than Thou" attitude that makes you want to take to 'em with an oxygen tank.

Personally I think the University model is the way to go but the University system seems to have different foci than the Ambulance service. Peter O'Merra from Charles Sturt University talked about this when I had the opportunity to hear him speak and basically ran parallel with what I've thought all along: the University looks at your suitability to succeed academically while the old vocational programs ran by the Ambulance service were largely geared towards personal traits without a lot of regard for academics.

You can teach a rock about cardiology but you cannot teach somebody to be mature, to laterally think, to problem solve, to communicate and how to work in a team. I have worked with gang members I'd rather have on a truck with me than some of the Graduates I have encountered because they can talk their way out of a sticky spot and are dependable; may not know all the cardiology in the world but that's not important if you're in a tight corner trying to get your patient's mates to stop trying to shank you.

I would be supportive of a degree program that is run in conjunction with the Ambulance service where you do say a semester of sciences and praxis to get you up to an entry level step then put you on road full time while completing the rest of the degree over say 2-3 years so you can get a proper amount of experience and consolidate what you are learning.

[BushyFromOz]

Pete Omeara is a heck of a good guy, a real academic man. the observed difference between universities goals and ambulance services i dont think can be understated, and seeing neither has any real jurisdiction over the other, its not likelynto change anytime soon. Back to my previous statement though that we do a VERY poor job of bringing these grads into the system though. I strongly feel that with a better post graduate program many of these issues could be nipped in the bud so to speak, and those who are unsuitable for the job should be weeded out.

A interesting thing happened here recently where after a recruitng drive it was found that the service was short of the "required number" in order to make the shortfall up, candidates who were unsucessful were coached and re-interviewed so that they passed!

A clear indication of just wanting "bums on seats" rather than suitable candidates.

the selection and post grad year/s is the one part of this process we have true control over, yet we dont capitalise on it.

Edited December 10, 2009 by BushyFromOz

[melclin]

I would be supportive of a degree program that is run in conjunction with the Ambulance service where you do say a semester of sciences and praxis to get you up to an entry level step then put you on road full time while completing the rest of the degree over say 2-3 years so you can get a proper amount of experience and consolidate what you are learning.

That does happen, except the six months is three years. The bit where grads consolidate their training is in their grad year/s, why aren't they viewed as trainees just as a person who had done six months would be? Whats the difference between putting a trainee with no people skills on the road after six months to continue their training, compared to after three years? The point here is that I think, and it certainly feels this way from our perspective, is with the move to the uni model, all of a sudden the service seemed to expect graduates to pop out as ready made paramedics. No university degree specifically prepares any graduate for the real world of employment in a particular role - it simply gives you the knowledge base required to begin at the bottom rung and begin the climb in the given area of education.

While I don't disagree with the things said about the graduates, its not different in any other 'higher' profession (the main ones that come to mind are law and medicine). You get an intern who finishes a medical degree after 5.5-6 years, and they are notorious for their lack of people skills and arrogance. But they are not fully fledged doctors and nobody expects them to be. As you all know, it takes many years of further experience and concurrent study to become a consultant physician. The deal should be the same with becoming a QAP, but it feels like there is an unreasonable expectation put on grads, akin to expecting med students to pop out of med school as consultant specialists.

At the same time, the fact that there is arrogance and narcissism, and that it is common in other professions, doesn't mean we have to put up with it. The strategy our uni is taking is similar to med schools and other vocationally specific course all over: more on the ground experience, even as just an observer, from as early on as possible. But here's where it gets complicated, we try to get as many placements as possible, we are in a sense trying to work towards a model more something like what Kiwimedic mentions, but AV jerks us around to no end because of administrative problems and staff shortages and consequently, getting even the minimum required placement hours is like pulling teeth. Chickens and eggs come to mind.

and seeing neither has any real jurisdiction over the other, its not likelynto change anytime soon. Back to my previous statement though that we do a VERY poor job of bringing these grads into the system though. I strongly feel that with a better post graduate program many of these issues could be nipped in the bud so to speak, and those who are unsuitable for the job should be weeded out.

PRECISELY. Exactly what I was getting at in my last post.

A interesting thing happened here recently where after a recruitng drive it was found that the service was short of the "required number" in order to make the shortfall up, candidates who were unsucessful were coached and re-interviewed so that they passed!

A clear indication of just wanting "bums on seats" rather than suitable candidates.

the selection and post grad year/s is the one part of this process we have true control over, yet we dont capitalise on it.

Another stake holder that I don't think has been mentioned yet is the state government. I was told by a MICA paramedic a while back during a similar discussion to this, that something like 85% of grads were not ready to qualify but pressure was put on AV to push them through anyway, which is probably the same process as you mention here. Just what I heard, thought I'd throw it in the mix.

[Kiwiology]

While I hate to say it; I think a big improvement in the quality of graduates would come from not taking 18 year old's out of school and perhaps shifting back to taking people a few years older who have done something out there in the big wide world; work, travel etc so they know how to talk to people and have general life skills which I know first hand, school-leavers just don't have.

[BushyFromOz]

all of a sudden the service seemed to expect graduates to pop out as ready made paramedics

I guess this really is the crux of the problem, Universities advocate that degreed students are "qualified" but "not yet road ready"

No university degree specifically prepares any graduate for the real world of employment in a particular role - it simply gives you the knowledge base required to begin at the bottom rung and begin the climb in the given area of education.

touche.

But here's where it gets complicated, we try to get as many placements as possible, we are in a sense trying to work towards a model more something like what Kiwimedic mentions, but AV jerks us around to no end because of administrative problems and staff shortages and consequently, getting even the minimum required placement hours is like pulling teeth. Chickens and eggs come to mind.

I think you need to seperate your ride along time and the AV GAP program. Your ride alongs are nothing more than a fimiliarisation. The GAP program is where you are expected to develope as an ambo. You must remember that academic knowledge is the only thing expected of you when you get a job, and that you meet your 16 and 24 week targets. most new grads come unstuck at 16 weeks when they STILL dont know their CPG's.

As to being jerked around by AV, dont take it personally. Its just typical large government department dysfunction. We are chronically short of CI's for our own students, we are understaffed and our rosters are a mess because of the increasing workloads and changing demographics. We can barely maintain a training capacity to train QAP's, unfortunately in this regard you guys will always be a lower priority. While "ride hours" may be compulsory requirment for VU or Monash, its certainly not a requirement for us.

As to the VIC GOVT being a stakeholder that should be consulted with, the real issue is that AV is apuppet, we dont consult with them, we get told what to do, quite evident in the last EB

In fact a great example of this is the transion program that was suposed to be done away with. It was regularly noted by the clinical department that taking grads at the end of their second year while they finished their degree idea SEEMED like a good idea, in reality did not work nearly as well as it was hoped. The reality is that SPT's were spending all their energy on uni subjects that they were failing in their clinical practice. RAV did away with this program, only to be MADE to bring it back when VIC GOVT made a public announcement about recruiting numbers that they could not meet, and it was quickly re-instated.

this was wholly appropriate at the time because the RAV GAP program was 2 years long, making a total of 5 years to become a QAP (uni included), under the new AV (read MAS) GAP program, its less than 12 months.

RAV was far ahead of MAS in the way its students were brought into the system, and its very frustrating we have regressed because of this "merger"

Edited December 10, 2009 by BushyFromOz