Hello EMS friends,
I will be traveling to the UK and Ireland in June 2019 (next month!) and I am hoping to learn more about the EMS systems in England, Wales, Scottland, and Ireland first hand. The process of cold contacting all these agencies seems overwhelming (although I will if needed). My excitement was dashed a bit when I read on their website that London Ambulance Service does not do ride alongs. But they will allow other healthcare providers to visit with the proper paperwork.
To my colleagues across the pond: Can you give me any insight into how to approach this? Do you know of any 911 agencies that would allow an international ride along? Where should I start?
A bit about me. I am a paramedic of over ten years and an EMS instructor. I am also a nurse practitioner specializing in emergency medicine and a former ER nurse. I can provide all manner of background checks and letters of introduction/recommendation from my employers and faculty.
Is this realistic? Can it be done? Thank you in advance.
Well I'm not sure how my new job will want my narrative. It's been 9 years since I wrote one and I'm getting back into the swing of things starting May 15th.
But my reports when I used to write them were hand written on a paper report form. yeah, it was before computers got in our way of writing reports and before we had to tick off all those legal mumbo jumbo boxes to make the bean counters happy. So I'll give you a idea of what my narrative was like. Remember this was a long time ago so I'm sure others have better ways of doing things now. But I can tell you, my narratives never pulled me into court.
1st paragraph - What happened - why you were called, what you found, what bystanders said, what patient said, what you observed. etc
patient exam/assessment - the formatting of this site makes it hard to put it all down line by line but here goes
Heent(head, ears, eyes, nose, throat); Neck; Chest; Lungs; Heart; Back; Abdomen; Pelvis; Gi/GU; Extrems; Neuro/GCS/RTS/ (all of these go on their own lines with what your exam findings are)
What is your Impression/Impact - what did you really decide is wrong with this patient - they say we don't diagnose but we really do. So don't be afraid to say if they are having chest pain to say chest pain or if their 12 lead shows elevation in II, III and AVF to say that. What is your impression or suspicions.
And now your treatment - Number them sequentially - from when you got there to when you dropped them off at the hospital - make sure you put down if they got better or if they got worse. Don't be afraid to say that if your treatment made them worse - say it because sometimes your treatments make them worse. Sometimes your treatment like Synchronize cardioversion causes them to go into v-fib. that makes them worse. Or you give them Lidocaine to a paced rhythm (honestly I didn't see the pacer spikes- really i didnt' and you nearly code them) put that in the report. (man I felt like crap on that one - but I was a brand new medic and I learn from my mistakes and teach from those mistakes).
That's all I got.
Oh yeah there's one more thing - there is a very obscure book out there, if you can find it, buy it and never let it go - I did and the person lost it. It's called "The Missing Protocol-A Legally Defensible Report" by Denise Graham It doesn't tell you how to write a report but it does tell you how to write a report that will keep you out of court if you do it correctly. It's out of print so I'm not sure if you can find it, I haven't been able to find it. May the person who lost my copy be crapped upon by a thousand camels with IBS and C-diff.
I hope this helped.
So, I'm a year into being an EMT and I feel like I've at least started to settle into a narrative style that works for me. But, I'm always looking to do better. Recently, I've wondered if there are any books out there or just personal experience that could help me. The main thing I'm looking for would be sentence structure and word choice. What helps you break down your call and how do you create a story of what happened so that the person reading gets the full picture?
sorry you haven't gotten a response but this is my advice
1. do not allow him to retake the test until you speak directly with the registry.
2. Talk to them about what accomodations they can give him and what he qualifies for.
3. Ask them what kind of study guides or assistance they can offer for him to prep for the next attempt at the test.
4. DO NOT ALLOW HIM TO TAKE THE TEST AGAIN until you have done all 3 of the above.
He only gets 2 more times before he has to I believe take a refresher course and you don't want him to do that. Just call the registry and talk to them. We can give you advice here but please go to the source and call them directly, they are the experts about their testing process and what accomodations that they can offer someone with a disability.
That's my advice.
I am writing this in hope of feedback, I have a nephew that has passed the EMT class, he passed his practicals.. The problem now comes with the actual National Registry test. He has failed 4 times, the kid does legitimately have a learning disability and qualifies for special accommodations . As I am helping him fill out the papers I am not sure what to request. Other than more time maybe ?
This is really heartbreaking to my family he worked so hard and knows the material, he just does not test good..