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Herbie, though I like many, many of your posts, I going to ask that you step back for a few days and assume that you're just not getting VentMedic. Of course, hopefully it goes without saying that perhaps you understand her perfectly and I'm the one that's confused, I'm just asking that you look at her posts through new eyes and see if maybe you've gone off in the ditch. One of the greatest gifts to me as a provider is to get to have conversations with 'realists', something that is too often a rarity in EMS. Vent, Dust, ak, Eydawn (though she's still just a kitten)..hell, a bunch of others, fit this profile for me. Many of my most closely held attitudes and opinions began with their council until I had the experience to verify their 'rightness' on my own. If you think Vent's opinions are harsh and aggressive, you would have really hated the 'old' Dustdevil. He's in a different place in his life now, but a few years back his opinions made vent's seem like a she's 'kind of on the fence..' As to the original topic, I think that perhaps (I haven't tracked it) half of my Medic Alert calls are accidents, maybe 25% "I just needed help with (my oxygen, getting back into bed, finding my medicines) and the last 25% people that are seriously acute and in trouble. I truly love to run calls. I don't care if the call is an emergency or not, I friggin hate sitting around quarters listening to the TV spew idiotic crap into my already questionable brain and take any excuse to get outside. One thing I've found inspiring is that one of the lady medics I respect a lot where I work started documenting the "I need help" Medic alert calls and dispersing that info to the other crews. I've started to follow suit. One that I got from her the other day went something like, "Martha, 86 y/o female on home O2 is having trouble changing her tanks or identifying when they are low or empty. Her health is beginning to fail so I believe that we'll see her much more often in the coming months. She lives at "xxxx", the best entry point is, "zzzz" her O2 is in the hall closet and her spare tanks are in the garage. Her normal delivery rate is X via NC secondary to COPD. No other significant pathologies. She's nearly deaf in her right ear and it takes her a while to get to the door. Mention her couch cover (a present from her grandson in Iraq) for cookies and stories!" I love the way she turned a common complaint into something healthy. We all look much more forward to running this call now, which we do once every week or two, as these details have made her 'real' to us, not simply another mistakenly pushed button. We're a low volume, rural service, (2-6 calls/day with a high percentage of significant acuity) so I'm not pretending that this would be so easy in many of your systems, but just suggesting that as this worked to brighten our days, there are likely ways to do so at your services as well. Anyway, just some thoughts after a pretty long week... Have a great day all... Dwayne

#$%&. Oops. My mistake. I honestly thought you were referring to the part about the impression, and I did not reread the part about the intent. However, measuring someone's intent can be subject to an individual's viewpoint, but, it seems obvious to most people that the intent is to promote a high standard. That being said, your sure got me on that one point, now how about the rest of my points and posts? Bold point # 1 Do you feel the same way about the tone of Dustdevil's (the old Dust, that is) posts? How about AK's? Ridryder's? From what I know of the first two and remember from the third, they were all honestly and blunt in what they say, many times echoing what each other posts, including Vent's. Bold point # 2 I agree that these probably should not be EMS calls. The fact is that we do respond to those calls and when doing such, we should provide a basic service of trying to provide the patients with resources to rectifying their situation. If someone is calling because they cannot care for themselves, we should be alerted that this small issue may be part of a bigger issue that needs addressed. If I receive a call through lifeline for sour milk, can't find their glasses, or the like, one of the first things going through my head is 'will this person be able to care from themselves if the situation is worse?' In essence, we are again a part of a link/chain/continuum of health care that is going to initially have to investigate the situation and direct the issues to the professionals who need to handle the situation. Herbie, disagreeing with somebody and directing personal attacks at them are different things. I honestly would not take someone's comments so personally. This, for the most part, is an anonymous forum, and as such I do not have anything to honestly prove to anyone, except that I can participate and grow with the rest of the posters. Ventmedic would not know me if I walked up to her on the street and slapped her. I do not expect her to know me any better on this website. There are a few folks I have met from this site, whom I would feel insulted if they attacked me as a person having known me, but that only includes a select few. But the people I have met have questioned my assumptions and helped me with many issues, but have been kind enough to leave out the personal attacks on character. One of the greatest things about this site is the feedback one can get on any slew of subjects. The feedback can be invaluable to help oneself question their practices and thoughts on matters. We get better together when we engage in beneficial argument that questions our ideas, assumptions, and presents facts. When Ventmedic says something along the line of 'The Paramedic does not have the education to....', it is not arrogance speaking, it is not a personal attack, but rather in a general sense, the truth. As others have said before, EMTCity has become relaxed in the past years to the point where all kinds of garbage passes by on the board, without being questioned. Many remember the olden days and wish to see it again, so expect for your posts to be scrutinized. Herbie, we will not be any better as a group if persons such as your self do not actively question the assumptions of others. As I said before, when someone does not post something you care for, bring it to their attention in a logical format and make them rethink their position so they can reply to you and make you rethink your position. I hope you stick with us, we can always benefit from various viewpoints. We can leave the drama for the chat room.

I will put up with a certain amount of BS. When I reach my limit, I respond in the same manner I am addressed. As for obnoxious- "you ain't seen nothin yet". Believe it or not, I am being restrained. Not worth getting worked up about this. Childish? Maybe, but I never claimed to have the patience of Jobe. The system is NOT fine, but BS patients are not the problem- the system is. The only way someone can take advantage of a situation is if they are allowed to do it. The rules are made to protect a patient, but in doing so, loopholes remain, and are exploited by some. That's life, but I won't pretend to like it, nor will I idly take abuse when I comment on it. I've been in this business for a long time- in multiple capacities- management, supervisory, and street work. I teach, I attend classes for personal enrichment as well as improving my knowledge and skills. You need to find your niche and exert your time, energy, and skills in a way most appropriate for you and your circumstances, which may be quite different than mine, or someone else's. "Right" can also be a very subjective thing. Keep the idealism as long as you can, Kaisu. I hope your situation- call volume, work environment, personal and professional life, and mother nature allow you to remain that way. It's not easy to do.

Well let's see where do I start...I'm Bree and 21 y/o EMT, CNA and pilot. I absolutly love what I do and can't wait to go to paramedic school after I graduate college. I'm working on my assossciates degree in Pre-Physical Therapy. I have a lot of great EMT stories and would love to share with anyone who will lisen...

Hi, im a returned city junkie, i used to frequent tthis place intensely but have not been here for over a year due to some overly complicated personal matters. The fact that the aussie/USD conversion rate is a little better makes paying a bit easier too Anyway, hi to people i dont know and to the people i do know, Suck it, im back

OMG! I generally defer from reading topics that do not appeal to me when it gets to the topic itself. In this case, "Lifeline" is something that has no meaning to me since we do not have anything similar to it where I am from. Then I started "hearing" the chatter about this topic in the chat rooms and decided to read it. In my honest opinion it was a complete waste of time. The first few posts actually had something to do with the original posting then it just turned into the usual "I am this" and "You are that" posting. It always seems to be the same people that hi jack threads and turn into their own little personal kingdom and domain. Why is it so hard to stick to the original posting? Why does someone always have to start questioning the others methods, professionalism, ethics, training or ideas on this job? When will you people actually start realising that we are in the same business, however we do not work according to the same protocols nor do we work according to the same set of rules. Freaking hell, this is supposed to be a site for adults and professionals to discuss issues relevant to the job.

Regarding religion ... people need something to argue about right? There will never be peace as long as there is religion so I totally agree with what ak said here ... As for cows, I love them. ... especially medium rare with a baked potato

From one lost and found soul to the next, Welcome back dude... Oh and sorry about the tri nations and super 14...

Welcome to the city. Always nice to see another PA person come around.. we dominate this place

Bill 60 See "5 Schedule 18 is amended in section 2" on page 4 of the PDF. Health Professions Act See - Page 159 - Part 10 Profession‑Specific Provisions Schedule 18 - Profession of Paramedics It appears they are amending the HPA to allow the inclusion of PCP, ACP and CCP as titles able to be used, not to replace previous titles EMT, EMT-P, etc. (Formatting and emphasis mine)

OK - so 9% of police officers, 10% of firefighters and 20% of EMS. EMS service levels have been affected. This is the situation in Canada. If 20% of our staff is out, we would be in deep doodoo.... I am going to get the vaccine if it ever becomes available.

You know Herbie, I appreciate the remarks in your last post. Speaking personally, when someone offends or enrages me, its almost inevitably because I have a secret fear that what they say is true. It is truly frustrating to be an idealist in this field. I've only been running for 13 months, (although I have over 1200 calls) and I am still idealistic. I can only imagine what all the years of experience and all the BS has done to you. Not withstanding, I do what I can, and what we can do is dictated by the volume and type of calls we run. I think the important thing is the mindset. Someone who is posted for 12 hours in a car running 1 call per hour is going to be intolerant of what they consider BS calls. The problem is that the issue is displaced onto the patient as opposed to a system that thinks 12 calls/12 hours is acceptable delivery of health care. I personally work 48 hour shifts, and standup 48s (where we never get to bed) are not uncommon. I spend the first day of my 4 day beached on a couch recovering. I think what enrages Vent is the simple minded idiots who think that the system is fine if only those BS patients would go away. You are obviously not one of them, but lets face it, your responses to her were pretty obnoxious. I understand that you were defensive. I suggest you ask yourself why. Respectfully Kaisu

I appreciate the reasoned response, Dwayne. My problem is- and it's nothing new- I too am a realist as well as being pragmatic, which means I do my job, follow the rules, but also understand how the process really works. When I hear an idea, program, or initiative that sounds too good to be true, I know that it usually is. My political views reflect a similar sensibility. In many ways, I am jealous of idealistic people- of how they can remain true to their views, despite a mountain of evidence that may contradict the wisdom of such a stance. The frustration would drive me insane. We need both types of people in the world, but I think for many in this business, idealistic is a tough route to take. I do my job, I've been doing it well for 30 years, and I still do whatever I can, within reason, to help people- patients and family members alike. When accused of being burnt out, apathetic, or somehow falling short of some utopian ideal, I will fight back.

So I am not allowed to have a tone but herb can? You don't have to read my posts. However, you should not criticize patient care issues that you do not have much information about or very experience with. Herbie has taken this to a very personal level and has bashed me on almost every thread I have posted on this forum for the past year. So yes, my tone with him will be cold. And yes, when I am discussing various quotes from the literature and formulas, the post is dry and not exactly warm and fuzzy. I also don't care to dumb down all of my posts as there are mature and intelligent people on this forum who can handle a discussion that is full of medical, government and welfare issues. We have had numerous discussions here about treating and leaving patients at scene but yet some are not willing to even tell the ED RN to check the "consult Social Sevices" box on his/her paperwork or fill out a little piece of paper in the ED. Thus, it appears some are not ready for EMS providers to take the next step in the numerous health care issues this country has and it isn't because of inadequate training but more the attitudes that continue to prevail. Thus, instead of being a health care provider, some will always have the "tech" mentality of just doing A task. Eventually, EMS providers will be recognized as health care professionals but there will always be those opposed to change and will continue to just destroy the patient's equipment rarely than doing a little "thinking" to find the correct channels to find a solution. Of course once one has destroyed the patient's LifeLine property, you can not follow the correct channels to correct anything. For this reason some in EMS will always have recipes to follow instead of guidelines. For some, there will also always be a union to tell you how to vote or think a certain way.

See now, you can take a few words out of the context of the entire statement and score "points" in the debate. You would score a lot more points if you attempt to understand the meaning of the entire post in the context of the discussion. You are upset with the tone of Vent's posts. Matty is suggesting you look beyond that tone and perhaps learn and grow. Fundamentally, that is what this site is for. The lady knows waaaaaaaaay more than you do about respiratory pathology AND has spent more years than you've been alive trying to get to real solutions to the delivery of emergency health problems. Use the information to become a better provider.

Truly professional experience with the education to back it up is what I am talking about. Where is the condescending attitude. Consider yourself an equal to whoever is condescending, that way it doesn't feel so bad. This paragraph honestly does not makes sense. Regarding assumptions, I am assuming you are in reference to the post about the South American medic who discussed a possible case of neglect by a doctor. You should go review the thread, it turned out quite interesting. And how do I know you are not lying, since this is an anonymous forum? Some things you just have to accept as being the truth, even though it may not be (and no, this quote cannot me used against me in the court of religion, whenever that debate comes up ) I do not claim to be an expert either. You said "when someone tells me what will or will not work in a busy urban system, they had better be familiar with the what goes on in such a place.". Why? What if I am not familiar? You gonna be condescending to me? Huh, Huh? I do not believe anybody said for you to make it your job to solve 'complex social service issues'. I believe the intent of Vent's posting was to one, make everyone consider how the patient feels and two, consider ways to help your system reduce these calls, which probably includes more work than a normal everyday shift (and of course griping about it). This may mean doing some extra work for your agency's benefit by contacting the necessary people to correct the issue. Maybe it is just a difference in viewpoint, but my impression of Vent's posts is that they are upfront and truthful. Maybe Vent does have to heighten her ego every so often. It does not really matter. Grow some thick skin, gain knowledge from the posts, study up on it, and come back with something that will make her think, so that she can come back with something to make you think. Matty

I agree we shouldn't be social workers...but part of our job is prevention is it not? Do we not help install child safety seats to protect children? Do we not go around and help check smoke detectors (my county started this last year of going door to door and checking every single smoke detector after a string of deaths related to malfunctioning smoke detectors)? Do we not have slogans to buckle up? Or wear a helmet to school aged kids? Part of our jobs is to prevent injury and death. If this also includes service calls to help someone into bed to prevent them from falling and breaking a hip or worse...then so be it. It is part of the job. If you don't like it, work to fix the system instead of complain about it. Work with the patients who call once a day or week to find a better solution. When I was in EMS we had numerous frequent fliers, whenever we did transport the patient, I would make sure the hospital got a social work consult for them. If we didn't transport and it was serious like they were falling or continuously unable to get out of bed on their own or walk to their bed then I would call the elder abuse hot line to get social services involved. Be proactive. We are often the only advocates for these patients. EMS isn't all about the glory and saving that code or running that big trauma. It's often about making a difference in peoples lives sometimes on the most basic of levels. This isn't all to say that there isn't abuse of the system, but unless we do something to educate and solve the problem the abuse is going to continue and probably get worse. WOAH... I just saw this... When is it EVER okay to damage an alarm box for a patient???? It's the Boy Who Cried Wolf Story...and in my eyes as the patient...they have every right to sue those medics! Also, why is it the higher ups job to get them into a nursing home...why not be proactive and take the steps yourself?? Patients always need our respect. Unless you yourself have been disabled and faced what they face you have no right to judge them and treat them with a lack of respect.

Au contraire mon frere... On Saturday we had our annual 25 hour day... I hope you used the extra hour to advance EMS, and advocate for your patients. Vent- I sincerely believe that your vision of what EMS should be is what we should all strive for (in spirit, if not in practice). You advocate education, training, well-rounded understanding of not only medicine, and emergency care, but core values of the human provider. No issue can be taken with your ideals. The thing that continues to befuddle me is the possible implementation of these ideals, and your insistence that everyone subscribe to them. Yes, change is coming, and I welcome it, it will force many a provider to poop or remove oneself from the proverbial pot. However, the changes you want are not plausible. If we all, everyone of us in EMS, increased our education 4 fold, became masters of medicine and politics, and spent the amount of time it would take to lobby and participate at local, regional, and national levels... who would work the street? Who would do the transfers? Who would respond to these Life-line calls for the quadriplegic who can't reach her glasses? Clearly not someone with the education, training, political savvy, and connection to the bourgeoisie of EMS and Medical muckity mucks. If I decide to take the route you propose, and am successful in doing so, I'm not going to want to still ride the truck... what would be the point? Then you would decry that I was wasting all of my education and knowledge when I could be in a conference room advocating for even more change. We still need people to work the trenches. Go ahead and educate us to a higher standard, but there is nothing wrong with being happy and content with what we do. I love my job at the *gasp* Basic level, I truly feel that I make a difference every day I pull on my uniform and bend to fate's will. If I could guarantee that my aging body could continue to work on the road for the rest of my working life, I probably would, and I would probably be more inclined to raise up a couple notches on the certification hierarchy. Unfortunately for me, I see a finite road ahead of me in EMS, and I have no desire to enter the administrative world anymore. Scoobykate, for instance had to cut her street career short because of health concerns that were out of her control. While she is continuing her love of medicine in other arenas, would she be less commendable if she pursued non-medical arenas that interest her? Of course not. While I am not trying to say that you, Vent, are implying that argument (I actually recognize that you appreciate hard work and education in all fields, not just EMS), I don't think that people that like their jobs and only do what is required of them to meet the industry standard are blights on the system. The system NEEDS them too. Those are my thoughts... I tried so hard to stay away from this one too...

Here's a news flash for you Herb, the new education standards are coming out whether you like it or not. Having 4 -7 different levels for EMS providers each state and each state different from each other is of no benefit to EMS, the patient or the individual who tries to move from state to state. I grew up, got an education and starting working with those who didn't just sit in the easy chair at the station spewing complaints about their patients, their job and their life. Read you own negative comments on this forum and use those as an example to what I am talking about. There are some secret ways to staying in a profession for over 30 years and that is not to stop learning and not to put up with crap from burnt out EMT(P)s who have long ago stopped caring. I continued my education to make a difference and some can't handle change. I think your arguments for the many different levels and that everything is fine in EMS have demonstrated that attitude greatly. It is time some in EMS decide if they want to be part of the future or it they should just get out and shut up if they have nothing productive left to offer this profession and the public they serve. Change is coming whether you like it or not. Maybe you should also broaden your reading opinions from more than just an anonymous EMS forum. Have you even been to a regional, state or national education meeting to discuss anything pertaining to EMS? You actually know a few people on this forum that have and it is a shame you consider all of them "out of touch". I'm sure Dr. Bledsoe likes hearing he is out of touch. How about Rid? What about our two ED doctors that take time to educate those in EMS and support the providers? You generalize and bash way too many things and people you know very little about.

Woe is me. Feeling a bit persecuted? You're over the top because it's easy to talk the talk when you aren't working in the real world. What you ask are social services tasks, NOT EMS. People get advanced degrees and devote their careers to solving problems like these. If someone wishes to take it a step further and contact a company, discuss patient advocacy issues, that is far over and above the responsibilities of an EMS provider. More arrogance. I'm consistent because I'm not trying to BS anyone. What happened to you in your career that you seem to have such a dim view of EMS providers? If you started spouting your personal opinions and generalizations about EMS around 99% of the people I work with, you would be quickly shown the door- if you were lucky. Other professions have professional, paid lobbyists and arms of their groups to push their agendas. IT is also their FULL TIME JOB. Again, another generalization I completely disagree with. Based on my experiences- and from people even on this board, I see nothing to back up your claim. People here are looking to exchange ideas, obtain information, and verify things. They want to be able to do a better job and help their patients. You need to separate street level providers from administration. Very few providers have the time, resources, or connections to lobby on the behalf of their profession, especially when many work OT and second jobs just to make ends meet. The administration/leaders of the industry are the ones tasked with these functions, and many are in those positions by default- they've risen through the ranks and attained a certain level of accomplishment, but not necessarily the knowledge needed to lobby or push legislation. Often they base their opinions and efforts on experiences when they worked the streets 25 years ago or more. Every one of these folks that I have met or read opinions from is out of touch. Save you faux outrage for the people you claim to rub elbows with- the leaders and administrators. THEY make the policies, not a street level provider. It's easy to blame someone else, but in order to effect change, you need to have the proper "vehicle" to get it done. The different levels of certification are not a convenience, they are based on the needs of an individual area. You can trumpet how you think every EMS provider should have 12 years post grad under their belts before they can ever touch a patient, but yours is an unreasonable opinion, with no basis in reality. You think providers should be more educated- so do I, but I also see the value of a volunteer EMTB in an area that cannot afford anything else. Your smug claim as a "patient advocate" does not wash if you cannot see the value of having any provider vs having nothing at all, because a community cannot afford to hire an EMTP(and all the other costs associated with ALS care) with a college degree and 12 initials behind their name. That college education would be far more valuable if it concentrated on management, leadership, and business, as this is the real need if we want to move forward from here. Like it or not, EMS is in the health care BUSINESS, and needs to be treated as such. Again- talk to someone in a busy area. They could operate out of the nicest firehouse, station, garage, ER in the world, but if you run back to back calls, how much time do you have to enjoy the perks and amenities you speak of? As for busy providers being glad to have a nonemergent call like a Lifeline alert- I call more BS. Most providers in busy areas LIKE to be busy and do the jobs they were trained to do. Although nonemergent calls are part of the game, belittling an EMS PROVIDER because they haven't solved all their nonemergent patient's social service needs is nothing more than arrogance and shows a lack of understanding of the basic issues involved in this problem.

It truly sucks to be a patient advocate in EMS. You can always expect to be bashed if you offer the views from the patient, hospital or HHA's side on some situations. Tell us about your experience with disabled patients and home care situations. Have you done anything to improve the situation? Have you talked to quads, paras and the elderly about their frustrations? Have you talked with the reps from LifeLine or whatever company in your area? Have you offered training to the home health agencies? It may sound like I'm over the top because I provide additional information and not just find someone or something to blame. Seeing the situation in only one dimension does not give you a full view of the problems. Blaming the patient is the easy way out. Of course, some in EMS would rather just piss and moan on an EMS forum about their dislikes about the system and patients rather than attempting to assist companies to find a better solution for their clients and patients. Thus, you become as much of the problem as those that "abuse" the system. As least HERBIE is consistent. However, he doesn't consider the budget cuts that have put patients into home care situations with inadequate resources. I seriously doubt if he has participated in any petitions to get more funding for Medicare. EMS is a "me first" profession which is also why it doesn't get much support from other healthcare professions in some of their efforts for better funding. Other professions (NP, PA, RT, OT, SLP, RN, PT, MD) include the patients when they are lobbying for better reimbursement and funding. They don't criticize medical needs patients or the agencies that attempt to provide the with care. They try to work with these companies to see how the patient can be benefited and in turn, it usually benefits them as well. But for some opinions here, it would probably be easier just to build large nursing homes warehouse style instead of trying to work out some home care situations. Now, for those who want to say "I'm over the top" again, please for to the national association websites for any of the professions I mentioned and see what legislative actions they are working on. I don't just pull this stuff out of thin air. It comes from many years of being active in both of my chosen professions. Unfortunately, EMS has been the toughest for legislative issues largely because of the "me first and only" attitudes that exist in this profession. This is true for some individuals and the many different agencies that do EMS. It is also evident by the 50+ different certs this profession has just to please some and not for the benefit of either the profession or the patient. The new big screen TVs, patio furniture and barbecue sets are a pretty nice also. I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

Who said anything about making derogatory comments about a patient? The crew responded to the call. The crew and FD assisted the patient. The crew and the FD asked the patient if he wanted medical attention. The patient/Lifeline requested assistance for a patient who needed to find his glasses. Was it an emergency that required the lights and siren response of an ALS fire apparatus and an ALS ambulance? Not in my book. Did the patient need help- yep, and he received it. Did anyone refuse to respond? Did anyone refuse to help this person? Were there any claims of verbal abuse by any responders on the scene? Maybe he had no other choice- no neighbor or family member to help him. If the area's service provides this type of help, fine. If you think it's an appropriate use of an EMERGENCY service, that's your opinion. I strongly disagree.

Guys... Gupta here seems to exhibit the same annoying sentence structure of our favorite "kevbutnobacon" supposed Englishman. His syntax and stereotypical writing is not fooling me... and he has been banned. I would imagine that he was exposed at the admin level. Thanks for patrolling the waters Admin.

But of course I voted: What do you think I am , An airheaded canuckistanian???? [just kidding]

Clearly I have dared to step on a senior poster's toes here. As with most forums, this one has a hierarchy, and most folks seem to defer to this person's expertise on every subject. I violated that protocol. As was noted, too many threads have dissolved into personal attacks and I sincerely apologize for my part in them, but when someone makes implications or inferences about my character or professionalism, I will not ignore them. This is a good place to learn and exchange ideas, but the drama and BS isn't worth it.