Just Plain Ruff

Anyone ever done this?

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I would hope we have all had situations we have handled similarly. Maybe not cooking a full meal for them, but going above and beyond the call. Thats why we signed up for this gig, wasn't it? 

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2 hours ago, brentoli said:

I would hope we have all had situations we have handled similarly. Maybe not cooking a full meal for them, but going above and beyond the call. Thats why we signed up for this gig, wasn't it? 

Amen brother.  

I have indeed cooked several full meals for patients, usually I would get them something to tide them over and then later in the day or the next day I would bring them over a full meal so at least they had something  in the fridge when they got hungry.  

There's a lot of need out there, we see it every day.  

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Cooked meals, made coffee, done laundry after a DOA in bed was taken away by the funeral home. Heck I've even fed cattle and unaddled horses. 

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Maybe its the urban setting, but I've never had that kind of downtime.  Also spending more than 20 minutes in NYC requires you to give you an update, as there have been potential times when EMTs done some bad things on scene involving patients.  You never want EMTs/medics to spend more than 30 minutes on scene of any emergency IMHO.

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On 10/14/2017 at 6:55 PM, Inf said:

Maybe its the urban setting, but I've never had that kind of downtime.  Also spending more than 20 minutes in NYC requires you to give you an update, as there have been potential times when EMTs done some bad things on scene involving patients.  You never want EMTs/medics to spend more than 30 minutes on scene of any emergency IMHO.

I tend to agree partially and disagree partially.  In a busy urban setting, of course you cannot spend a lot of time on scene to do this extra service but I believe that it's a case by case basis.  

 

If the person has family on scene or that can get there within a reasonable amount of time then by all means clear the scene but if they don't have anyone near, then in a rural setting with low call volume, I see nothing wrong with helping them out with a meal or something.  You have to have common sense and if you aren't responsible enough to know the boundaries to keep from doing bad things then that is a bigger issue than what we are talking about.  

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That is certainly the allure of a rural setting where you can almost be a part of the holistic healthcare that patients should get.  In the ideal world we would have medics provide most of the care that these patients receive in ERs, instead of hospitalizing these patients and charging their insurance thousands of dollars, subjecting them to undue stress of transport and potential risk associated with it.  Most paramedics should be able to insert GT tubes, perform debridement and other minor critical care procedures.   We should be pushing for more education and expanding the scope, as nurses are overwhelmed with the load and healthcare costs are prohibitively high.  EMS can certainly disrupt that market and provide high-quality just-in-time healthcare service that we all expect.  We need to start caring about people and society and stop putting profits as the highest priority.

 

And another thing.. why is AMA such a collection of scumbags?  Seriously.  Why?

Edited by Inf
i got urban with rural confused there lol

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11 hours ago, Inf said:

That is certainly the allure of a rural setting where you can almost be a part of the holistic healthcare that patients should get.  In the ideal world we would have medics provide most of the care that these patients receive in ERs, instead of hospitalizing these patients and charging their insurance thousands of dollars, subjecting them to undue stress of transport and potential risk associated with it.  Most paramedics should be able to insert GT tubes, perform debridement and other minor critical care procedures.   We should be pushing for more education and expanding the scope, as nurses are overwhelmed with the load and healthcare costs are prohibitively high.  EMS can certainly disrupt that market and provide high-quality just-in-time healthcare service that we all expect.  We need to start caring about people and society and stop putting profits as the highest priority.

 

And another thing.. why is AMA such a collection of scumbags?  Seriously.  Why?

I cannot answer your last question about the AMA but I can say I agree with what you posted.  I've inserted GI Tubes, foley caths, nasal packed a nose bleed in the ER, Gave enemas, performed bladder scan, debrided a burn and other wound, sutured a simple laceration under the supervision of a doc, gave every medication known to our formulary and even administered 12 units of blood to a AAA patient that was leaking and damn near at deaths door.  We as paramedics CAN do these types of things and we as an industry need to strive to be able to do them.  BUT caveat

Education is the key.  when cosmetologists have more hours of training and "internship hours" than we do and they cut our hair, then something is rotten in denmark.   

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Paramedics don't have the educational foundations to do the things mentioned.  Having worked in more than one arena within health care (paramedic and PA) I don't know that EMS providers are necessarily the best people for the interventions that are mentioned.  This isn't to say that paramedics can't do those things and more.  As Ruff mentioned education is ridiculously poor.  This lack of education is a significant barrier. 

Many of the PAs I work with currently are former EMS providers.  Several of them are current EMS providers outside of the ER setting where we work.  PAs, and to some extent NPs with an EMS background, would be best suited to work in that community health role doing the things needed to help reduce ER overcrowding and all of the complications that arise from that.

Unfortunately, there are barriers to this as well.  Who is going to pay for that PA to be out on the street?  I guarantee I'm more expensive as a PA than I am as a paramedic.  Will call volume change when people realize the "ER will come to them"?  How long until that becomes overburdened?  There are logistical issues involved, too, never mind the legal issues that need to be considered.

The EM group for whom I work has talked about doing a community medicine response with the local 911 providers (both BLS and ALS).  There has been talk about putting PAs into a street provider role to start providing care outside of the ER.  I'm fortunate to work for a group that employs the state ALS and BLS medical directors as well as the county medical directors who could help make this happen.  I've volunteered my services as have several of my colleagues with EMS backgrounds.  If anything comes of it I'll keep everyone posted.

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