paramistress

Reply to 4kids - to clarify - Paid services are certainly allowed in NJ, but they CANNOT have ALS EMS units. Their ALS units can only be Specialty Care Transport or Air Medical.

To reply to Fifthkid - if you read read the regs on the NJ DHSS site, it refers to medics working as specialty care transport, air medical and mobile intensive care programs. Medics can transport under the first 2 conditions, but to work EMS must work through an MICU...which is strictly hospital based. As far as volunteers, most squads do not charge the patients anything. Most of us are self supporting through fund-raising, and some of us receive a stipend or maybe a truck every now and again from our towns. To reply to those of you that would like us to walk out....if you can get thousands of people to do that at one time...be my guest. But on the other hand...what happens to all the patients while the state is working out a new system??? Do you really think any government is going to solve that over night? We are all working to improve the system...patience is a virtue and if we are going to make changes, we want to make damn sure it is done right the first time!

In our system, the 911 Dispatcher makes the decision of BLS/ALS. In NJ Paramedics can only work out of a hospital. Joe Blow cannot start a paid service or AMR cannot come into NJ and put an ALS truck on the road, it is ILLEGAL! Also, Medics must ride 2 to a truck and (with a few exceptions) cannot transport. So the Medics meet the (usually volly) BLS truck and one gets on to treat and the other medic follows the bus to the hospital. Do we think that this is the best systesm, ABSOLUTELY NOT! Many of us have worked and will continue to work to improve our system, but for the time being, it is what we have and we make the best of it. I am not taking jobs from other people, the state is...and I am working to change that. But for the time being, without volunteer EMT's, the EMS system in NJ would be nonexistant!

Dwayne, thank you for some well thought out input. I started out trying to respond to this thread, but was taken back by the insults such as: I am not dedicated because I am JUST an EMT, I am screwing my profession, this is just a hobby to me, I lie and I am a selfish, unprofessional Klingon. All of that is completely unnecessary. I have tried to explain that the EMS system in NJ is different than every other state. I don't say it's good, bad, right or wrong, just different. Would I object if they tried to replace me in one of my jobs with a volunteer? Of course I would! But that is not what has happened in NJ. Volunteer EMT's have been the state standard since before Medics even existed. Because of the way our system is set up, paid services do not want to cover most of the podunk municipalities in my area...there is no money to be made. And if they offer to cover, their idea of coverage is to put ONE ambulance in place to cover multiple municipalities, over large areas, thus SEVERELY compromising patient care. I know this for a fact because I have had access to many of the negotiations over the years. I am taking a job from NOONE in this state. As far as volunteering, I believe most professions have some kind of volunteer services. Doctors, nurses, police all have access to some kind of volunteer work. Is a physician who volunteers at a clinic or a school ruining the life of some other physician? What about someone who volunteers time to educate others? Are they evil and unprofessional? As far as getting rid of EMT's period...WHY? What is wrong with having EMT's handle BLS calls and allowing Medics to attend to ALS calls? Or having EMT's assist the Medics? And why is someone who doesn't get a higher cert than EMT less dedicated or unprofessional? Would you say the same about a nurse who is only an LPN? Or a physician who is in family practice and doesn't want to be a cardiologist? I am all for the sharing of ideas and even a heated discussion, but there is never a need to resort to insults and name calling.

Why can't you all just stop the kindergarten name calling, and act like the professionals that you claim to be. Learn to accept the fact that other people have opinions that may be different from yours and move on!

I am sorry that so many of you feel threatened by the volunteers. You may think whatever you like, but we know that we are professional and educated. And we are VERY PROUD of the work that we do!!! Maybe you would feel the same way if you stopped whining for a while!! I am not going to argue about the NJ system, it has it's flaws as does any system. I am well aware of what goes on in NJ because, although I do not Ride as a paid EMT, I work for several paid and volunteer agencies in the state. When all agencies work TOGETHER we, as a profession, know no bounds!!!

I am just amazed at what I am reading here. The medical community is a tiered system. Physicians, nurses, medics, techs, EMT's. Do you think there is something wrong with a tech who does not want to be a nurse or a nurse who does not want to be a doctor? And you wonder why EMS gets no respect??? You don't even support your own! Why do you assume that an EMT who does not want to be a medic is lazy or ignorant? There could be hundreds of reasons not to persue a medic cert. And no, I am not taking a job away from ANYONE. NJ is a volunteer state...all I am doing is saving the citizens of this great state a great deal of money. And YES...I am as professional as anyone else in medicine, I just don't have as high a certification as others. If you spent as much time supporting one another in EMS rather than complaining about them, we might just become a well-respected profession.

EMS to me is NOT a hobby. It is a rewarding and important way for me to give back to my community. Just because I choose not to become a medic does not make me any less of a medical professional than anyone else. In fact, one could argue that volunteers are more dedicated than those getting paid to work in the field. Some of you need to realize that different states have different needs...one size does not fit all!

In response to letmesleep..I choose to be an EMT lifer. In my state (NJ and I don't want to hear comments about how awful the EMS system is in NJ, it works for us!) I ride strictly as a volunteer. I don't want to be a medic. I work in a job that pays much better than medics make in this state and I am happy to volunteer my time as an EMT. Because of our system, if Medic was the only certification, they would be wasting their time transporting the sprained ankles and head colds.

A vest-style extrication device, such as a Kendrick Extrication Device (KED), can be used to immobilize the head, neck, and spine. In infants and toddlers, the KED may be more effective than a spine board, as it helps to immobilize the child’s trunk. It can be adjusted to fit any small child. Place padding under the child’s back from the shoulders to the buttocks. Fold the side pieces of the KED along the sides of the child’s head and tape them in place across the forehead. Leave the forehead exposed. Never tape across the neck, as this can interfere with the child’s airway and breathing. I usually use the KED for peds immobilization becasue the idiot that used the pedi board before me never puts it away correctly and the velcro straps are usually all tangled up! The KED is also great for hip immobilization. Just put it on upside down.

Transporting 2 unrelated patients (when it's not an MCI situation)? What ever happened to patient privacy?

In NJ, the ambulance must take the patient that they are dispatched for (the exception would be multi injuries from the same accident, then triage would dictate transport order). And let's face it, just by MOI, the ped vs. car has a higher risk of serious injury, and we have all picked up walking wounded who turned out to be more more seriously injured than they appeared on scene. And I can almost guarentee that the kid is going to end up waiting hours hours in the ED for a plastics doc to come and stitch him up anyway! I have to agree with Dustdevil on this one!

I agree with Ruff. In my hospital, your first call is to Security, request that they call the PD. Then I would demand a secure place to keep your belongings. I am sure the hospital staff has lockers, there is no reason why the students cannot have some secure place to keep their personal items. If they can prove that she stole your papers, she should be terminated and escorted out of the hospital immediately, if not, that is not a hospital I would ever want to work for!

Classes that have been popular with my students: Street Drugs, Asthma, Behavioral Emergencies. Watch for new medical information and develop a class, The Bariatric Patient has been very popular, there are many complications we see from Bariatric Surgeries. Legal and documentation classes are always needed and they love large CEU classes like PHTLS. Check out the class Sick Not Sick (I think it was an AAOS class). You can purchase it and it is very good!

The song is actually Smile a Little Smile for Me, Rosemarie and Dream A Little Dream of Me is by Mama Cass.