sevenball842

my old boss is some high mucky-muck running riverside AMR now. We still keep in touch, I'll do some digging and see what he says if you want.

I transported a psych once. P.D. cleared them after patting them down. When we got to the hospital, he pulled a 6" knife from his boot and proceeded to attack me and the nurse. Lucky enough I've taken a defensive tactics course and he didn't hurt either one of us before security tackled him. The point to all this? sometimes the police don't do their jobs all the time, and sometimes human error kicks in and you just can't catch it all.

couple of calls. One, called to the local elderly storage facility for the pt. who was given her new med. (ambien) and is now sleeping, need immediate transport for eval. Next, chronic caller at a previous job for the lady who needed: a glass of water her t.v. remote her shoes taken off she was crooked in bed her lights turned off the feeling as though she may get a headache I have more but you get the point

anyone else think it's a kick in the shorts that this conversations has to even take place. I know that its just stating the obvious, but really, have we become such a horrible society that even those who are put on this earth to help and heal become targets of violent random acts? That being said, poke him in the eyes, you can't fight if you can't see. On the non violent route, I wonder what the consiquences would be if we gave in and gave them our narcotics. Or even better, tell them that the sodium bicarb is the best sh**t we've got.

what's your treatment plan going to be?

I'm doing my part to change the system. I am extending the hours it takes to pass my class. I make the course harder to pass. I bounce those who fail to meet minimum requirements. Unfortunately, I am only one person. I can only do what I can do. From here, I haven't the slightest idea where to go. I am not bill brown. I do not sit on the national faculty. I do not have the types of connections that I would like to have. My question is, what's the next step? You say I fail to take the next step, yet that step has not been defined.

dust devil, my flip flopping my views is a result of educated debating. I conceded that if we were to make paramedic entry level, we should do something about education first. In lieu of that, the experience you get from being a basic will just have to do. I also said that my view of the situation comes from my area, where basics are utilized in 911 work. In your corner of the world, it may be different, causing your views to be different. Blank slates are just that, blank! What happens when you get the all too familiar scene of two brand new EMT's on a truck, just because your system needed bodies. Then what do you have. You can blame it all on the company you work for, or you can say I wish they had some sort of experience to back up their medicine. All I am trying to get across to you is that until the education system changes, we can't expect people to get the concept of paramedicine by being taught by individuals who are so closed minded that they don't think they can learn anything from someone who has a different patch on their shoulder. The day we say " you can't teach me something, your just a basic" is the day we can say we've seen it all. That is the day we need to hang up our scopes. I am sickened by those people who abandoned their basic skills long ago, yes. I sat on scene (as a basic) waiting for the over inflated, egomaniac paramedic to get his tube on a GSW to the head for 10 minutes. It wasn't until I put my foot down and said DUDE!! this guy needs a surgeon, not a medic, BLS his airway, we're gone!" And you know what? I was right. the guy lived. The paramedic had nothing to offer him that I, a basic, couldn't. In fact, had the medic gotten his way, he probably would have turned anoxic and boxed. Is this only one exaple, yes, can I come up with more times that is was my paramedic skills that saved the day, sure, but you gotta give it to me. Somewhere in our system, whether it be region specific or not, basics are important. As far as me keeping EMS from progressing, I whole heartedly disagree. In fact, the simple fact that I have allowed myself to change some of my views based on what is written here, would tell you that I am hyper progressive, and proactive in the field. I believe that closed minded individuals, those who cannot be convinced that their way isn't the only way, are the ones holding EMS back. Standing ground is commendable, but when that ground is built on a fault line, one has to have the humility and flexibility to step aside and let the ground rumble underneath. If you didn't catch the metaphor, when change comes at you headlong, understand that you don't own medicine. Old school, and new school will clash, move the heavens and earth, and positive, middle ground change will result.

So I think we all are in whole hearted agreement that the education lacks substance and distance. Especially the field internship of the medic. If we could somehow extend that quite a bit, then we would stop chasing our skills, ie. "I need 5 more I.V.'s, one intubation, electricity, and a drip". From there we would actually start gaining our true experience, and learning the difference between sick and not sick just by looking at someone. We would be able to tell if someone was yanking our chain to avoid the blue light special (P.D.). The only logical question left is....HOW? How do we change what is required of Medics, so that it becomes entry level, without losing the valuable experience of working the streets as a basic first. By the way, by my saying "working the streets", you have to understand that I worked in a multi-tiered system where the medics were non transporting. My experience as a basic differs greatly from those who rode systems where basics were glorified wheel chair operators, keep that in mind.

Made the paper many times. We try not to get caught. In my service, if you get recognized in the paper, or news, you have to buy the whole shift lunch. That can get expensive.

I am also a medic with Rock. Being a company man, I can say that rock is awesome. However, if it's 911 time you are seeking as a basic, go to mass. Lowell, Lawrence, Haverhill. They all use basics appropriately and you'll get fantastic experience from it.

Dust devil, although I appreciate your input into this topic, I fear that you completely mistook my words, causing you to chase your tail around in circles until you are dizzy. My experience spans 18 years, yes. My experience spans 4 states, and many services. Fire based, private, hospital based, and now one of the largest "paramedic only", 911 providers in my state, for which I am a supervisor in. Not patting myself in the back too hard, but that makes me well qualified to offer my opinion. Your argument, if I understand it correctly, only solidifies and validates what we were all saying. Education is lacking in the area of EMT-basics, thank you for proving me right. To quote myself as saying that if we could extend the hours that are required to become a medic, and extend the time needed to finish clinicals, I would completely support entry level medics. My comment about relying on our basic skills was misconstrued by you again. I wasn't talking about triage to basic emt's, I was talking about relying on our own skills that we learned as basics to continue pt. care. Too many times I have seen these arrogant, ALS focused, microwave medics, become so focused on their "skills", that they forget how to properly bag a patient, do competent CPR, or god forbid, hold the hand of that little old lady who's scared. All skills you solidify while riding as a basic. Should basics be allowed to ride a primary 911 truck alone? I agree that they should not. Should they ride with a medic? Absolutely! Being able to learn the difference between sick and not sick, hurt and not hurt, is not something that you can be taught in a classroom. On the same token, compassion is certainly something that cannot be taught. If we are so focused on our skills, we tend to overlook the more simple tasks. A good assessment, comfort measures (blankets, pillows, ect...), and most of all a kind soothing conversation. These are not things that I simply think, these are things that I witness on a day to day basis. Moving on, Speedygodzilla, kudos to you. Medics+Basics=Team, partners, EMS, care, etc... Brilliant!!! How's that for Kumbaya for you? ruffems, I couldn't agree with you more. Our education system is certainly sub-par. The need for better instructors, longer classes, and yes, more clinical hours, should put us right where we need to be. As for physicians, nurses, vets, ect..., look at how long their classes are. Look at how long their clinicals are in comparison to ours. That is where the difference lies. You substitute BLS experience with longer courses and more clinicals, then you have something there. But until then, the experience you gain from being a basic is invaluable in this field, and replaces the need for course reform. The final note on EMS vs. Physicians, vets, RN's is this. Because of the amount of schooling and amount of clinicals that are required, they are considered by society to be "professionals". As of right now, we are not considered to be in a profession, our field is still just a job.

Thank you for the support. I was feeling alone, standing on the sidelines after being picked last for kickball.

Agreed. I think I said that. If the education was there, and it was harder to pass (not harder to get into school), then we would have the cream of the crop. I said if those conditions were in place, I wouldn't have an issue with entry level education being Paramedic. You're right, its not "skill", it's education. This is something that our field lacks, this we agree on. What we don't have, is the testicular fortitude to bounce those candidates out that simply don't show proficiency. After doing all we can to work with those individuals, we simply should not just pass them through the class in hopes that the registry exam will weed them out, just because they are being sponsored by a fire dept. or have friends of friends who are influential. I fear that I may be speaking only from my own dealings as an instructor, and may be spouting off based on my own frustrations with the education system (or lack there of). There are times that I feel that my hands are tied, that I have a mile of red tape to cut before I am able to fail a student out. I'm digressing from the original topic, but this is a spin off of the education debate. In order to change the course, I feel we must be given the ability to govern and change our own field. After all, who knows us better than ourselves?

I do not think anyone is better than someone else. I do think all need better education, our patients deserve that. It would be great to see a day when entry level is paramedic so at least some actual medical care can be given to patients. It is not the fault of the EMT-B,I, or P that the laws and education system has failed them and more importantly failed the ones we are supposed to help. I have been in EMS many years and am only now in Paramedic school and I would fully agree with a Paramedic saying they would rather have another Paramedic helping them. It would be stupid not to want someone of equal education and skill to help on the bad calls. Sorry I took passion for an attacking attitude. Trust me if you read some of my posts that I am passionate about I to get overly blunt about them.

Now that is a very intelligent response, thank you for that. To begin, I do believe that education is key. However, instead of sending people to medic school right after basic class, why not extend class time. I find that when I teach basics, they have a harder time grasping basic skills and information. To flood these folks with even more information, and even more critical skills is dangerous if they don't fully grasp the basics, and have used them to some extent. Although I see your point when it comes to physicians, I refer to my comment about extending class time. Physicians go through many years of schooling, clinicals, and "practice" . They are expected to show proficiency in each skill before they are allowed to move on. Depending on the EMT class that you take, you may be allowed to fail a chapter or two, and still be allowed to test. I guess if you want to may an argument for moving straight to a medic class, lets elongate each education levels hour requirements, and bounce those less proficient candidates. Making this field harder to enter, will ensure that only the best providers survive. Lets face it, we work without a net, doing a what a physicians do only on a modified basis.

I fear you mistake my passion for attitude. I believe that if we do not stand up for what we believe, we have lost our field to glory hounds. I have a deep respect for medicine, and a deep respect for those who fight for it, even those whom I don't agree with. To think that any one of us are "better" than the other simply angers me, that is all I am trying to get across. I'm glad I've sparked such a debate. As long as there are "newbies" like me out there, and "seniors" like you to debate with me, then the topic never really is dead. Although I do concede that this post should have been place under a different, existing thread, the topic itself may never be resolved, and will always be highly debated, don't you?

It's all good folks. Having been in the field during the days when the rookies got hazed, and we were told to stand in the corner until spoken to, I have some pretty tough skin. I can take the hits with the best of them, as long as everyone is willing to catch some bullets back, I'm willing to get taken out back and flogged with a 14f whip suction catheter.

18 years, only one birth, girl. I'm not kidding you, mom was G-15!! P-2, has just finished some Meth about an hour before birth.

I will apologize now for the dead horse beating. I apologize for not using the search function, but having to sort through your words still does not allow my voice to be heard in a way that I think it should. If this is a dead issue, the postings would stop completely and we wouldn't find it necessary to continue these threads. This is the reason we are here, isn't it? So that EMT's have a voice. One that is not suppressed by state and local politicians? How about that thread. Lets change directions here. If you don't like the questions about basic versus medic, I will consider that battle fought, and since I'm arrogant enough, I will call it won. Do you believe that we should be run by the fire dept. at the state level? Do you believe that the local fire dept. should be scene command on medical, non-MVC calls? Try that one on for size, unless of course Thats been debated at length. If so, I've got more for ya.

I hear ya. I've actually been a member here for awhile, and although I never really got into posting bulletins or replying to them, I felt it my duty to defend the validity and honor of the basics that I work with. I'm sure that this topic has been discussed at horrible lengths, and have been involved in many of those discussions in the classes I've taught or taken, but it just never seems to dissipate. I suppose it is an argument for the ages.

I was reading an earlier post about someone who was taking an EMT course in High school, and he wanted to know if it was a good idea. He was able to pull from that discussion that yes it was. What I was reading though, was an argument that he should go straight to medic school afterwards. I was appalled to hear that there were a few people who discounted basics as inadequate and antiquated. Their argument was that there was no knowledge or skill gained by working the field as a basic, and that they were all but a useless body in the field of emergency medicine. I was sickened to hear that these individuals, some who had spent time as a basic, could feel as though emt basics had nothing to offer. I am a Paramedic, have been for some time, I was a basic for many many years. In all 18 years under my belt working in EMS. To this day, as both a Paramedic, and field Supervisor, I find my basic EMT's to be both valuable, and grossly under used by many systems. To those who truly believe that they are both better and smarter than basics, I say "SHAME ON YOU!!". We all started as a basic, and it is those "skills" that we rely upon when things go bad. If we miss a line, miss a tube, or miss a diagnosis, we fall back on the experiences we had as basics to care for that patient. When we hit those lines, tube that patient, and nail that diagnosis, it is the experiences we had as basics that allow us to do that. What's the difference between difficulty breathing, and anxiety. M.I. and anxiety? Whats the difference between a swollen reddened lower extremity, and a compound fracture of the tibia?....Experience!! Lets embrace our basics, and offer them the environment to gain very valuable street experience first before we encourage them to become Paramedics. Don't we owe it to our patients to be the very best at every level before moving on? Isn't that why the National registry created different levels who's skills are clearly defined and are vastly different?