What should the Basic-Medic Partnership look like?

[somedic]

NREMT: Here is some well established advice:

Quit typing so many long posts on here.

Consider being a basic emt as just the first step..towards being a Paramedic.

Enroll in the next Paramedic class in your area.

Study and focus on more important issues in EMS than worrying about how basic emts are treated by Paramedics.

Do not become a career basic emt. You will become a drag to your peers and your agency if it is ALS. In most agencies Im familiar with you will never advance in rank.

Attitudes, egos, and personalities aside. Paramedics are the standard of care. I never have and never will let a emt basic go "lone ranger" on me and compromise my licence, job, reputation and most importantly my patient's life.

Somedic

[NREMT-Basic]

Somedic- you could have been more condescening and pompous but Im not sure how. Just as you feel that you as a medic are the standard of care, I find your attitude to be symbolic of the attitude which is all too common among medics. I dont need your permission to say or do anything as far as my opinions or anything else are concerned. And quite frankly, I find your egotism so distasteful that if we were ever to be put in the same rig with you, I would request a new partner or leave the service if I couldnt be reassigned. Tell you what...next time you go on a call BLS or ALS, leave your basic partner back in quarters and make the run yourself. Where I come from they call that an attitude adjustment. I have seen many basics refuse to work with medics with the very same attitude you have.

As for Asysin- I appreciate your thoughtful and considered opinions and would work for free if necessary to have a partner who is as open minded and analytical as you. You clearly show the difference between Paramedics and self appointed Paragods.

I dont intend to post any further on this thread. I opened it and have made my opinions known. I look forward to the input of many others.

[nsmedic393]

I answered YES to the poll question. Typically on a call with a BLS partner I will rotate call for call if the patient doesn't need any interventions that I can provide for them. If it is the basic's tearn to attend I will get vitals, attach O2 and monitor (if required) while they do the assesment. However I always want to be present for the assesment to be sure that they are not missing anything and to make sure that their treatment plan matches up to their assesment/diagnosis of the patients condition.

This is not because of a lack of trust but a concern that if they miss something and screw up its my license on the line. As far as treatments, if the patient doesn't require any ALS interventions and the Basic has an appropriate treatment plan than they are more than welcome to carry out their treatment plan within their scope of practice until we arrive at the hospital. I just want to know if anything changes and if they ever have any doubts to run the situation by me. When the call is over they do the paperwork and I restock the ambulance.

If its my turn to attend its in reverse. I do the assesment and they do the busy work, they stock the truck. If the patient requires a drug that is in the basics scope of practice than I may ask the basic to give it before we transport if it fits into how the call is going.

This is a happy go lucky scenario and doesn't always happen. Some exceptions to this happyu scenario are...

The basic misses something on his assesment and I have to throw a couple of question in to get the full picture. If this happens than I may also need to consider that the basic doesn't have a grasp on the situation and I need to pay particular attention to their treatment plan or take the call. This would all be done in a respectfull manner and I would never tell the basic that I was taking the call in front of the patient to make them look like they were undermined.

If I am doing a assesment on a patient I don't want the basic asking any questions at all. If you ( used in general statment meaning the basic) think I missed something on the assesment tell me in private and I will take it into consideration. My treatment plan is mine and mine alone. If its to the point of giving drugs and performing ALS procedures than I have already applied my knowledge to the situation and don't need to be questioned about it.

call, finish later.

[somedic]

NREMTB:

You need to grow up and educate yourself on what condescension and pomp really are.

I gave you solid advice on how to overcome your apparent inferiority complex about being just a basic emt .

The fact you would try to "request an new partner" or "leave the system" if you ended up on my rig indicates your lack of maturity and testicular fortitude . In my department you would be viewed as a p*ssy if you got punked that easily.

As for your little "I'll tell you what" scenario: I've treated patients by myself over the the years on several incidents military and civilian. I have ran across many worthless emt basics that I was better off not having around. If I can get a Fireman to drive me to a hospital, I don't need a emt basic. I'd go so far as to say that I would rather have a well trained Combat Life Saver certified soldier with me rather than a numbnut emt basic on any call.

Face the fact that you are not going to change things. Improve yourself from being an ambulance driver. Don't mess with people who may be of help to you on here.

Somedic

[BushyFromOz]

your lack of maturity and testicular fortitude

I dont give a rats about the argument at hand or who its directed at but this is a steller line

[nsmedic393]

To continue my previous post.....

Although I don't want my partner questioning my treatment decisions while on the call I would be more than happy to answer any questions you have about what I did or why i did it after the call is through. I am a big fan of being a patient adocate and carrying the best interests of the patient close to your heart. If you think i am doing something that is so wrong that you feel the need to speak up immediatly than you better be prepared to back it up. If you were right and I was doing something that needed to be immediatly corrected than I will thank you for speaking up but if you are wrong or doing it to try and make me look stupid to make yourself look better (it has happened) than I'm gonna come down on you like a ton of bricks.

All that being said, Basics here in Nova Scotia have a much higher level of education. The average basic course is 1600 hours of classroom time and 500-800 hours of clinicals.

the medic must hold in mind that the basic has a degree of training (for me 176 classroom hours and 50 clinical) and once that basic has proven him/herself, he should be allowed to function in the capacity for which he is trained.

Without trying to be condescending; I have never understood how you could learn what you need to know to work effectivly in a pre-hospital care role with such little training. Since I am used to working in my system and not yours I don't know if I could be comfortable with a EMT-B assesing and making treatment decisions for a patient. They would definatly have to proove themselves first.

[EMS49393]

I was a basic for quite a while before I went to paramedic school. I was a good basic that paramedics like to work with because I knew my place. I was the task master. I did vitals, put patients on the monitor, ran the 12-lead (which I promptly handed over to my medic), put on the oxygen, set up the IV, and asked if there was anything else that was needed to get the patient ready for transport. I talked to the patients and families, very minimally, enough to tell them what I was doing before I touched them. I also took the role of tracking down all the medication bottles or lists for the paramedic. When the call was over, I cleaned the truck, including the bench seat, action area, and floor. I made a mean cot, you could bounce a quarter off it. I wasn't being paid to "think," I was being paid to do. I was a partner, and most of the time I was treated very well by the paramedics because I knew what I needed to do to make their life easier during the call.

I see a lot of basics rolling out of basic school with their 120 to 200 hours of training thinking they know it all and should be afforded luxuries I was never afforded. Don't get me wrong, I could "assess" a patient as a basic, however understanding the assessment was a whole other story. I relied on the SAMPLE, OPQRST, and the other monkey terms to assess the patient. As a paramedic. I rarely follow those acronyms. Honestly, my first thought when I see a patient is LOC, ABC's. When I establish those, the rest of my assessment is just a conversation between my patient and myself. What I need my basic to do is the same thing I did when I was a basic. Perform tasks. Make my job easier, not harder. I shouldn't have to tell a basic that I want oxygen, a 12-lead, an IV set up. I really shouldn't have to tell them the patient compartment is filthy. I establish how I treat patients early on in the shift. I clean up pretty well after myself on calls. I also don't need a basic that is going to complain because I won't let them have any calls. I like to do the patient care, period. If you want to do the patient care, go to paramedic school.

As for giving medications such as patient prescribed NTG, or ASA. A basic better never give any drug other then oxygen when I am with them and the patient. Firstly, I don't use the patients medications. I carry drugs that I use. Secondly, you're not assessing the patient, therefore you are not treating the patient. That is my job. There have been times when I deviated from protocol and not given a drug based on the assessment of my patient. I am not a protocol monkey. I use them as guidelines. I am able to explain every action or inaction I take with regards to caring for my patient. I've gone so far as to consult with a doctor for drugs I have protocol to give without consult just because I like to have the second, more highly educated opinion on whether it's truly the correct course of treatment.

I know your big gripe on here is "treat me with respect." Well, I can tell you now that if you act they way you act, whining about how you are "trained" to do this and that and the mean old paramedic won't let you, you'll never earn any respect. If you perform as a basic, and act very much they way I explained that I acted, you'll be invaluable as a basic partner. You have to remember the major difference between paramedics and basics. Paramedics have undergone an education (hopefully), and basics have undergone training. Ultimately, I'm licensed at the higher level, and I'm responsible for everything that happens on that truck. Before you get a bug up your drawers about how you're treated, remember that if you mess up, I'm the one in trouble for letting you do it. You don't want to be a task master anymore? Become a paramedic. Until then, pay your dues like the rest of us have.

[NREMT-Basic]

When I started this thread, I had honestly hoped that there would be constructive dialogues that all parties concerned could learn from and perhaps even improve their working with their basic or medic partner. As the basic vs. medic conversations always do, however, this has turned into a p***ing contest and about that I am truly sorry. With a singular exception, all medic posters have said hey, i have some pretty clear cut expectations, I am more trained, I make the decisions, etc and that is the way that the ALS system is set up. I have no problem with that. I do have a problem with medics who cannot seem to understand that if something goes wrong in the box with the patient, it has just as much potential to damage the career of the basic as it does the medic. Medics are not the only ones licensed and therefore are not the only one whose licenses can be pulled.

NSMEDIC- I truly learned alot from your posting and I thank you for it. Like you, I think that Basics should have much more didactic and hands on time than they do. I am all for the NREMT taking it over, and having Basics and Medics be licensed on the national level. I agree that American basics for the most part are undertrained and this is do in no small part to a broken EMT educational system. I think that Basics should have the level of education raised to a two year degree across the board in each and every state. That being said, I also believe that we cannot set one educational standard for Basics and another for medics and I hold and have for sometime that if a Basic should be trained over the course of two years, then a Medic should be required to complete a course of study and practicals that takes a full four years and is the EMS equivalent to a bachelors degree. I hear lots of medics wanted to up the edcuational requirements for Basics but these same medics will cringe and spit if it is proposed that they should also be held to a much greater educational level than they now are. Its not about turn about being fair play, but rather that it logically follows that a longer programs for Basics would make them better and train the to be able to participate more fully in patient care, and the same would hold true for Medics. When I signed up for emt school, i was surprised that it only took 5 months, but i was even more surprised to learn that with all that a medic must be able to do at the drop of a hat, that it is commonly held, at least in the US, that a medic can be fully trained and prepared to take on the full responsibility for patient care in a year or 18 months. Something just doesnt track correctly there. Also NSMEDIC, in case I have led you to believe i meant something to the contrary, I want to make it clear that the ONLY circumstance under which I would point out an error on your (meaning any medics)part is if i was as you indicate one hundred percent certain and beyond any doubt that you (medic) are about to perform an intervention or give a drug which I KNOW is incorrect and will hurt or god forbid kill a patient. If the circumstance did not meet that criteria however or if i turned out to be wrong and had questioned you during patient care, I would expect to get hit with both barrels both by the medic and the ops manager and I would not see it as out of line as being grounds for the basic getting suspended or in the case of a constant pattern of this sort of thing, getting fired. I dont agree that that the Basic shouldnt talk to the medic at all while the medic is carrying out his interventions with the patient so long as that exchange back and forth has to do ONLY with the situation at hand, as in "Can I hold that for you? Do You need more light would it help you if I held that instrument in place for you. Im not talking about sports or tv conversations or blabbing about women or cars. It seems that if a surgeon can do his job and be talked to and give answers at the same time, a medic should also be able to do this. As for small talk, there is plenty of time for that in quarters between calls.

Now...Somedic. I have no inferiority complex about being a basic and my fortitude is just fine thank you. Again you do not seem to be able to participate in a quality conversation about the topic at hand, but rather compensate for what I can only assume are some feelings of inferiority on your part which you need to make up for by insulting others and degrading them. In the end, you dont accomplish anything and to the people who are interested in constructive dialogue you seem like a petty, bitter, self-loathing over compensator who is trying to make up for deficiencies i shudder to think about by belittling others. And for the record I will write posts that are as long as i wish them to be unless admin asks me to keep them shorter. You should hardly talk about longwinded posts. So take your special operations tactics and your fireman driver and go away. thank you. I suppose next you will be singlehandedly managing a mass casualty incident. Oh well. You really arnt worth the time it would take to write anything further. Have a nice day.

[somedic]

Congradulations basic: you have proven to be what a lot of people on here PMed me about. And thaks for your dramatic PMs yourself. You should become a script writer for daytime television. Ive seen drama queens on here but wow you are at the center of the EMTcity catwalk now sister.

Im glad you think being a secretary is helpful to you in our world. Im trying not to laugh while I'm typing. It sounds so much like O-f-f-i-c-e B-i-t-ch.

You probably have had your rump paddled by paramedics because of your sissy attitude.

You are an ambualnce driver trained in first aid You would be the first person terminated if you worked for a private system and they made personnel cuts. You have at best completed the minimum requirements to work EMS. No one owes you anything and by the looks of it you are in for a hard time. I suggest you stay with the girls and sip cafe lattes and get manicures and enjoy the gentle life.

If you want respect do like NSmedic told you and pay your dues.

Put your barbie away and go sit in time out now madam secretary.

Somedic

[nsmedic393]

If you want respect do like NSmedic told you and pay your dues.

I didn't say anything of the sort.

Also NSMEDIC, in case I have led you to believe i meant something to the contrary, I want to make it clear that the ONLY circumstance under which I would point out an error on your (meaning any medics)part is if i was as you indicate one hundred percent certain and beyond any doubt that you (medic) are about to perform an intervention or give a drug which I KNOW is incorrect and will hurt or god forbid kill a patient. If the circumstance did not meet that criteria however or if i turned out to be wrong and had questioned you during patient care, I would expect to get hit with both barrels both by the medic and the ops manager and I would not see it as out of line as being grounds for the basic getting suspended or in the case of a constant pattern of this sort of thing, getting fired.

We are on the same page then... Although involving the supervisor and possibly getting the basic suspended or fired would not be my style either. If the basic actually walked away from the verbal tirade I unleashed on them after such a occurance and had the balls to do it again, then it would be time for a chat with the supervisor and they would go on the "black list".

I prefer to deal with people in house... I know basics aren't really people but I could probably do the same thing for them too.....