Kiwiology Posted May 18, 2012 Posted May 18, 2012 (edited) Just confirm, Ben. You have some autonomy for your actions as what I would call Paramedic Scope of Practice, without needing to call in for On Line Medical Control, i e "Mother/Father, May I?" Due to distances, and possibility to need Helicopter EMS a bunch more than I would, due to my being "urban/metropolis (/Megalopolis?)" versus your "country/agricultural (/wilderness?)", it would make sense that Paramedics would, and should, be higher trained. Richard, in New Zealand all levels of Ambulance Officers have complete, total autonomy to deliver their scope of practice as they see fit on their own volition with one exception which is the need for Technician level Officers to consult for IM adrenaline in anaphylaxis however knock on wood that will vanish in 2013. In Australia, the UK and South Africa it is the same, no online control, no orders, no piss arsing around in the 1970s Johnny and Roy fantastyland As a professional practitioner why should you have to ring up and ask permission to practice your professional skill set? In the Autumn Issue of the Journal of the College of Emergency Nurses of NZ is a small piece on the various extended care roles Paramedics are performing now and some have called their local ED asking for advice. Staff have generally been unwilling to provide such advice because they have not physically examined the patient and there is some tricky legal complications of giving advice about treatment to somebody you have not even seen, how can you practice diagnosis at the end of the phone? Distance to hospital has nothing to do with education; a Paramedic is a professional practitioner and should be educated as such especially given the environment they are making complex medical decisions in and the disproportionate risk that is associated with such things as putting in chest drains, rapid sequence intubation, thrombolysis etc I am getting sick of this shite about paramedics whinning about registration, every other health sector provider in NZ has to be registered, what makes EMS so much different. And Ben, don't refer to technicians as the lowest form of staff, because at the end of the day, the achieved the qualification and skill set and got their arse on the ambulance seat. More than I can say about you, and just remember also, that when you finish the degree, you don't get to practice at ILS straight away, you spend a period of time consolidating your knowledge at an EMT level just like I had to do as a Level 1 nurse on registering. So don't you even think of refering to technicians is how you implied, because I know a few who would happily clip you upside the head for that crap! Paramedic registration is an important issue, but honestly, what is the point of spending all this money and fuck arseing around registering Paramedic and Intensive Care if they are still going out alone? It's really awesome that the guy who turns up to my life threatening event is you know registered and all that crap but hey he's working by himself! For fuck sake, we've been harping on and on and fucking on to death for decades to Ministry of Health and ACC for more money and they simply refuse to accept that full crewing is an absolute necessity and it makes me so enraged I think I've had a CVA ... sorry stroke can't call it a CVA no more The Ambulance Service is no different and Paramedics should be registered, St John has said that it supports registration as far back as I think 2008 in the annual report, when Clinical Excellence cropped up in 2008 it was aligned with the requirements for registration under HPCAA so it's not like it hasn't been thought about for years, the Ministry of Health was told as far back as 1992 that the sector recommended ACO's be registered and this was back in the day of the Advanced Ambulance Aid Certificate, pre dating even the bloody National Diploma (Paramedic). However, there are bigger fish to fry first my friend; sure, spend the money and the effort in getting the Paramedic under HPCAA and then send him out alone ... never mind if you get two volunteer Technician's who have no external accountability whatsoever because we wouldn't want to offend the volunteers by requiring them to be registered either. An enrolled nurse has to be registered and they require nearly the exact same qualification to a Technician (both require a Diploma at Level 5 except the 700 clinical hours thing which an EN requires) so if an enrolled nurse who essentially has no independent scope must be registered then shouldn't a Technician be registered? I mean they have access to independently dispense a dozen drugs (oxygen, entonox, paracetamol, aspirin, GTN, glucagon, glucose, salbutamol, ipatropium, ondansetron, loratadine, adrenaline .. and one more I am forgetting) surely somebody who can dish out drugs with some seriously harmful effects if used incorrectly should be registered? Anyway that is distracting from my other blood boiling rant about how we need to fix the other problems FIRST then worry about registering the ambos secondly. Oh, and new flash bro; Technician is the first step on the Clinical Education Pathway (the lowest form to use your words, not mine) now, that is not to say Technicians are not valuable, I mean lets be honest the requirement to put every volunteer through the Diploma is something I could get hard over, seriously it's fucking brilliant and I think the National Diploma is just the bee's knee's for educating the vollies, makes the National Certificate look like crap. You only have to look around the world to see that while the National Diploma does not have the same educational content as the Degree (which is to be expected) it's pretty damn good hey look at the EMS Education Agenda for the Future for fuck sake, pandering to the volunteers by still offering a reinvented 100 hour wonder ambo course (maybe up to 150 hours now?) that you come out of with an oxygen tank, some glucose paste (but no BGL!) and some aspirin; never mind if altered nana is not having a hypo but is having a stroke, that glucose is really going to help kill some more brain cells, hey lets give her some high flow oxygen too because 150 hour wonders are not allowed to use pulse oximetery! Oh and let's restrict GTN, glucose and entonox to "Advanced EMT" ... entonox? really? we've been using damn entonox since 1971, OVER FORTY YEARS AGO AND IT ONLY TOOK ONE BLOODY WEEK ELEMENTARY AMBULANCE AID CERTIFICATE TO USE IT .... Australia has used penthrane for decades and UK has probably used entonox for damn near as long as we have; but this widely heralded Agenda which has been in development since 1996 cant do any better in fact, do worse? Really? 1996? In 1996 an Intermediate Care Officer with their fancy ass eight or ten week Post Proficiency Ambulance Aid Certificate (on top of that magic six week Proficiency Ambulance Aid Certificate) could do more and this is the BEST they could come up with in nearly TWENTY YEARS? Version 4 of the National Diploma is currently being written, and I never said there was anything wrong with it, it's not the qualification let somebody loose putting drips into people and sporting a hip pouch full of suxamethonium with and we both know that but it is fit for purpose I hear WFA is now giving students at the end of Degree Year 2 Technician ATP (they have to do the viva voce) and graduates can apply for ILS ATP after six to nine months of mentoring, not unlike the NETP programs for Level 1 RN. AUT is still teaching to ICP level but I imagine that will change at some point. Anyway I hear rumours the Degree will become mandatory for paid employment anyway soon, about bloody time. @ CC - have a look at the NZNO website; they are taking names for feedback submissions on the 2013 CPG Edited May 18, 2012 by Kiwiology
Lone Star Posted May 20, 2012 Posted May 20, 2012 This thread has given me so much room to comment...... Best of luck bro. Hopefully you will be part of the brotherhood soon. I will teach you the secret handshake. Doc, the bestyou can co is TRY to teach him the secret handshake and password....you know how he is. Remember, you can't teacch an old dog new tricks, and you can't teach THAT kiwi anything!! Great, now Emergentologist thinks I am bisexual .... Fist off, you spelled that word wrong....its proper spelling is "B-U-Y-S-E-X-U-A-L". By your own admissions, the only time you are able to get sex, you have to buy it; and the usual outcome is that even the 'previously enjoyed companions' that you employ tend to refuse service to you.... Far as I know it's called Teratology of Fallot oh look its a case of shut the hell up and dont say things to make Kiwi look stupid We don't have to say anything, you're doing a bang up job of accomplishing that goal all by yourself. It's clear you don't need our help! How can I ever take you seriously when you use a graphic from "The Daily Show"? Remember Arctickat, this IS the same guy who cites Wikipedia as a credible source (when he's not referring to it as an 'absolute authority'.... 1
Kiwiology Posted May 20, 2012 Posted May 20, 2012 You do realise all I have to do is push the red button by your bed old man and the crash team will come in and sedate you? 2
Lone Star Posted May 21, 2012 Posted May 21, 2012 If you're gonna do that, the very least you can do is wait until after 'pudding time' here at Shady Pines! Not only that, but the red button causes the 'Go, go Gadget bed" to fold up into a really hot sports car......
Kiwiology Posted May 21, 2012 Posted May 21, 2012 (edited) If you're gonna do that, the very least you can do is wait until after 'pudding time' here at Shady Pines!. Shady Pines? I didn't know you'd been moved into the nursing home already But hey on the bright side they have awesome pudding cup eh ... Edited May 21, 2012 by Kiwiology
Richard B the EMT Posted May 21, 2012 Posted May 21, 2012 Not only that, but the red button causes the 'Go, go Gadget bed" to fold up into a really hot sports car...... Best reread the manual. That red button activates the Go Go Gadget Helicopter.
Kiwiology Posted May 21, 2012 Posted May 21, 2012 (edited) Best reread the manual. That red button activates the Go Go Gadget Helicopter. Hmm looks like some bloke who got crushed by a stage needs to be collected from Small Town Jericho Health Clinic Start checks complete, go go big red chopper, Sugarland traffic helicopter mike oscar lifting southbound. Ambulance, Medevac airborne, about ten minutes until the overhead .... Kiwi - proud survivor of the 2011 Indiana State Fair Edited May 21, 2012 by Kiwiology
Kiwiology Posted May 27, 2012 Posted May 27, 2012 (edited) So this just turned up Application for Entry to Second-Year Classes in Medicine via the ‘Other’ Category. Thank you for submitting an application for Medicine through the ‘Other’ category for 2013. We appreciate the time and effort that has gone into preparing your application. Your application has been reviewed by the Medical Admissions Sub-Committee and regretfully has not been selected to proceed to interview. This year we received approximately five times as many applications than we have places for in Medicine via this category of admission. Consequently, many applicants, such as yourself, who may have been suitable for a career in Medicine, have not been invited to proceed to interview... Yours sincerely Division of Health Sciences University of Otago Well, that's me fucked, I used my once-in-a-lifetime shot and it fell over so I might as well crawl into a hole and rot Damn it to the bowels of bloody hell I should be living it up with fellow rednecks at the Indy 500 this weekend, not in this toxic fucking depressing shithole having spent the last ten months trying to get my massive failure of a life back together (not that I'm getting anywhere) Oh well who the fuck cares I'm off to get really fucking drunk and wasted on valiums Edited May 27, 2012 by Kiwiology
chbare Posted May 27, 2012 Posted May 27, 2012 I recently had a major setback and was not able to get into a graduate progrmme that I've wanted to do for quite some time. Best case scenario will have me looking at it in a year. However, if you want something bad enough, you will stick with it. Also, this may be a good thing. As you've stated several times, your life situation is rather chaotic. Perhaps you can take some time and get yourself together. I know little of NZ medical school, but assume it is reasonably intense and fairly stressful. Perhaps it would be better to start later on with a clear mind and good coping mechanisms? I believe you are still relatively young and have plenty of time to look at other options and work toward your goal. Good luck mate. 1
Richard B the EMT Posted May 28, 2012 Posted May 28, 2012 Believe it or not, it took me 8 years of trying, before I was accepted to the NYC Health and Hospitals Corporation EMS. Although it may take longer than your personal calendar originally intended, keep at it, and persevere.
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