letmesleep

Hi all, it's been a while since I've visited the city, and here I'm asking for your opinions and maybe even a little help. First let me catch you all up on my life since I last posted. My wife and I were married last May, we bought our first house together, and 7 weeks ago my son was born health and happy. I've been a little busy to say the least. Now to my question..... Here at work, as I'm sure in many places nation wide, Management has challenged us to find ways and to come up with ideas to cut cost and to save money. We are almost entirely paper-free after approx 12 months of tiresome hard work, we have controlled water usage and electricity waste, phone lines have been condensed, supplies have been reduced to cut out the unnecessary items, and many other issues. I am in a group of 3 who are researching solar power to run our stations, and we are just getting started. I have done some looking online, and have found that we do not have an original idea with the use of solar power, but we are still pretty excited about the possibilities it may bring. That is where my questions pops up: 1) If you are using it at work, how is it working for you? 2) Is it reliable enough for what we do, will it power a station enough? 3) Has your employer seen a big difference in the electric bills? 4) Is it worth the cost with or without any state funding or grants? I have seen many articles about different departments implementing solar power, but can't seem to find much about how it is doing once it has been installed. It's your opinions, and hopefully your first hand knowledge that I'm looking for. We may be lucky enough to qualify for grant money from our local electric company considering we have a major power plant in our District (we're crossing our fingers). Quick FAQ's about my District: We staff 23 full-time medics and 1 EMT that is testing, and approx 40 part-time personnel (EMT and medic). We have 4 stations and run 4 trucks 24/7/365. We cover approx 244sq miles including 10 miles of interstate roadway, and average approx 3500 calls per year. Thanks

Unless I'm missing the entire point to this thread, it is my belief that it matters NOT what walk of life a provider comes from as long as they can perform their duties while working on an ambulance, or in a hospital for that matter. How many times have we seen the over weight medic or EMT that completely fills their half of the cab of the truck? How many times have women been questioned about doing the job because they are 5ft 2in and weigh 100lbs soaking wet? I am not bilingual, so am I worthless in the section of my response area because I can't proficiently communicate with a particular culture that I am treating? I work with an EMT at my part time job (on the street) who has an AKA to his left leg with a robotic prosthesis, anybody want to challenge me if on whether or not he can do his job? If there is such a problem with people who speak another language working in medicine, then how do you treat a pt that doesn't speak your version of the English language? My point is simple, as long as any of these providers can perform their job and be effective then why is it such an issue for anyone here? Does it really matter what language their test was in, or whether it says ambulance on the rear doors of their truck or ambulancia?

Our dispatch agency status checks us every 20 mins, unless we ask them to stop. If we are status checked with no response the appropriate PD is dispatched to secure us and our scene. We are equipped with 2 mounted radios in our trucks (front and back) and 2 portable radios (HT1250 in believe) which have panic buttons, however this has a problem. The problem with the panic button is the protocol that dispatch follows when the get a panic alarm. Dispatch will begin to call us, and in a stable/ accidental "set off" situation this is no issue, but in an unstable situation (hiding for instance) we would have to turn the radio off in order to remain safe. The biggest issue we may run into is that approx 75% of our District is covered by the county SD, and we have been known to stage for extended periods of time, for example: 40 min wait time on suicidal OBS is not unheard of. Therefore, if I am being held at gun point, I may be there (with my fingers crossed) with NO radio communications waiting for an undetermined amount of time for SD to arrive. The ambulances are also equipped with GPS that can be utilized by dispatch as well as our duty officers, so I have never felt the need to "fight" to keep my ambulance. Our rule is "if you have a weapon, then you now have my truck".

Ok, good catch! I agree with maintaining the pt's modesty from gawkers, as well as, their privacy. I truly didn't think I'd have to remind a "professional" of those issues. Honestly the OP's question doesn't seem complete to me (no offense). Vent, you seem a little pissy tonight.

Explain the procedure. Remove all clothing......this includes the bra. Find and follow your landmarks. Place your leads. Acquire your data. Is this what you were asking? Nothing should change just because your dealing with a woman......large or not. Let me know if your needing something other than my response.

Sorry, I was interupted before I completed my thought. the bold highlight is an edit.

We had a documentation class today, and it was your typical class about the subject as far as what we should and shouldn't be writing in our PCRs. During the class a few different types of documenting formats came up, such as: S.O.A.P. C.H.A.R.T. C.A.T. Do you use a format? Are you required to use a format? Is a format PCR a good idea (in your opinion)? At my place of employment we have no specific format to document, and we see good and bad results from this. I personally write a narrative that is specific to each call with numerous consistencies from one but I am interested to know if there is a way that I could better my PCR skills.

My thoughts exactly, a little comfort and compassion will go a long way!

Given the information noted above, I have 1 question for the pt and family........Do you want transport to the hospital?

LOL, agreed! They got those meth labs to protect don't ya know!

I will say that I honestly did NOT look up the FDNY Chief's salary, but I have a very hard time believing that it comes remotely close to the money being spent here in the fire services 5 horn club. Even if it was in dollar amounts, I would bet that the work load has NO comparison. The FD I noted above has 2 engine houses.....yes I said 2! With that said, it just goes to show that even in the Midwest, we through TONS of tax money at the powerhouse, and leave EMS which adds up to approx 80% of the FD's call volume hanging.

My partner today is a part-time EMT with my district, but works full-time for a Fire Department that does NOT run an ambulance. This AM we started discussing EMS v. Fire based EMS which led to a statement that he made......."Money has destroyed the FD!" His example was the difference in pay between the Chief of FDNY v. the Batt Chief of Creve Couer FPD ( http://www.ccfire.org/ ) staffing, stations, apparatus, etc. The Batt Chief of Creve Couer manages so much less than the Chief of the FDNY, but takes home an annual salary of approx $166,000. http://www.stltoday.com/stltoday/news/special/firedistricts.nsf/0/585415870E5B797086256EF7006E1EB3?OpenDocument All of this got me thinking if this is another reason why the FD should stay out of EMS......you know, in order to save the FD, and bring them back to reality. Thoughts?

Average is approx 20mins ALS or BLS, but with no expectation, as long as we are within reason. We restock, clean, and write PCRs after returning to the District. We also try to carry enough supplies and equipment to catch another call upon returning in service, but this will depend on how "out of whack" the truck is, i.e., major cleaning to be done. With the use of computerized dispatching and ePCR, we can start our reports en route back to quarters and fax copies to the receiving facility, but I have the remainder of my shift to complete this task. At the hospital we get insurance info when available, two signatures, give a report, and hit the road (not in that order). On average our calls (with transport) last approx 1.5hrs, which is down from the 2.5hrs prior to ePCR and computerized dispatching.

At my part-time job information is sent to alpha pagers if you’re on the list. They will include address and complaint, but that’s all. It is a nicety at this job because of the mumbling and/or screaming that goes on during the dispatch, just depends on the type off call. At my full-time job we don't do any of this because of the onboard computers which provide damn near everything you could ever want and more as far as info. This includes run cards, GPS mapping, call back numbers, so on and so forth. It's a good system, and does have some issues, but over all pretty good. somebody please subtract a point for this drivel...........geez!

I don't want to sound negative by saying this because the theory is interesting, but I'm curious to see what the yearly stats turn out to look like. There are tons of positioning systems out there, and they all have their bugs, but this one seems to be more "high tech" (for lack of a better term) than anything I've ever seen. It’s been a while since I have worked in an area that moved trucks based on potential calls. The one thing that I have a hard time believing is that they are going to add 2 years to the life of the trucks. The mileage is still going to be there, isn't it?

Good catch, Thanks

I found some more information about this story. http://www.ajc.com/news/north-fulton/officer-facebook-postings-didn-235017.html Looks like an attempt at justification to me.

I got this in an e-mail yesterday.......When will it ever sink in that work related discussions on "Facebook" and "MYSPACE" are just NOT a good idea? Facebook comments cost another officer his job From The Atlanta Journal-Constitution, December 9 SANDY SPRINGS, GA – An attorney for a Sandy Springs police officer who was fired for a Facebook posting says what happened to his client could happen to anyone. "Not only is it a censorship issue that everyone needs to know about," said Mike Puglise. "They are not only saying that you can't write it, but also that they can interpret what the content means." O.J. Concepcion, 33, of Morrow says he was fired from a job he held for nearly four years because of comments he posted on the social networking Web site Facebook. Some of those posts included details about his police work, he said, such as the fact he was working with the FBI on a drug case. One of the posts said, "I'm going to be working in plain clothes tonight," Puglise said. Another post mentioned that Concepcion was frustrated at work. But Concepcion said he was just excited about his job, and never released confidential information. He says other officers have posted racially insensitive information, but have not faced any disciplinary action. "Nothing was derogatory," said Concepcion, who spent seven years with the DeKalb County police force. "I posted that stuff for my friends and family to read, not for the public." The Sandy Springs police department cannot comment about the incident because it is a personnel issue, according to Lt. Steve Rose and Wendell Willard, the city attorney. The AJC has submitted an Open Records Request to obtain Concepcion's employment file. Concepcion's Facebook profile is private, meaning only those who are "friends" with him have access to his information. Most of those friends are fellow officers and relatives, he said. But it was one of the friends, someone Concepcion said he knew prior to working in Sandy Springs, that apparently thought the Facebook postings were not appropriate. That person complained to supervisors, Concepcion said. On Nov. 16, he was placed on administrative leave with pay. On Dec. 2, he was terminated. He was never given a warning about Facebook comments, Concepcion said. Concepcion will ask for a grievance hearing, according to Puglise, and will likely file an EEOC complaint. Puglise, who spent 16 years as an officer before becoming a lawyer, says Concepcion may also be a victim of racial discrimination, since he is Latino. Additionally, Puglise said the Sandy Springs police department currently does not have a policy in place addressing social media. Puglise and Concepcion contend the postings were misinterpreted. Many other metro Atlanta police departments also don't have policies about Facebook-type Web sites. But some are in the process of addressing the issue of social media. In Gwinnett County, members of the police department are prohibited from posting on a social media site anything that relates him or her to the department, according to Cpl. David Schiralli. The department implemented its policy before any major problems arose from employees using the sites. The Atlanta police department is currently working on a policy to address electronic communication, according to Sgt. Lisa Keyes. The Smyrna police department is also in the process of developing a social media policy, Officer Michael Smith said. Although there isn't a specific policy regarding Facebook for Marietta police, the release of sensitive information is not allowed, according to Officer Jenny Murphy. Joe Hernandez, Cobb County police spokesman, said the same is true for his force. But with more and more people relying on sites such as Facebook to share information, employers may have to institute specific policies regarding what individuals are allowed to post online. "Where do they draw the line?" Concepcion asked. "Everyone is using it."

Interesting enough doc......the photo remains! Reading some of the replies on this thread makes me wonder when you have time to "snap a picture" in a critical situation? I'm not calling anyone out on this because I understand that there may be or just is a need to "prove" to the ER staff how bad things were on a scene. I just don't understand when the time is taken in those cases to stop pt care to take that photo. Even with cell phones, you have to maneuver through your menu to get to the camera. Like I said I understand the argument about using the photo for documentation, but this leads me to ask those who are thrill seeking to prove their worth online......Is it worth it to your pt that you stop working on them, so your ego can be stroked?

Fake or real, I see this photo being used as an example of what seems to be happening more and more often online. The use of "Myspace" and "Facebook" has changed EMS in a negative light (in my opinion). We are seeing more photos, call situations, work related stories being shared with the entire world. The real issue is that more information is slipping through the cracks, and is killing us as professionals. When pictures like this hit the "world wide web" there is a question of being real or not, which forces the public to decide. Do they know if this is a training photo? It would seem to be that the question being asked is if this is a HIPPA or HIPAA (depending if your the OP, or the rest of us.......just joking ellis8934, relax) if the photo is a real pt. I agree that there may be a lot to consider, but my question is it worth the risk to your career, the pt, the pt's family? We need to take more care presenting on the web.

Just wondering how this wouldn't be a pt. Not knowing the details of the call, lets call it a GSW to the head. Do you not still assess this person to determine their status? Would that not make them your pt?

"12 Leads are worthless" "12 Leads save lives" "SPo2 should be....." “My protocols say this" "My protocols say that" Come on, you are all very intelligent people, right? Treat your pt, not your monitor. If the pt is in no real or immediate distress then use your brain about o2 v. 12 Lead. If your pt is gasping for their last breath.....we may need some o2 at the minimum, but use the skills (education or experience) you have. I stopped reading after page 3 because I couldn't take it any more. Even with thrombolytic therapy available on a truck, are you not going to move forward with good old MONA? TREAT YOUR PT!

Now Ruff, I know you’re a very intelligent person and this statement (of yours) may have an oversight. As a Catholic let me just through out the Spanish Inquisition and the Salem witch trails as examples. I'm just saying!

I don't know how I missed this yesterday, but let me just say, REALLY? THANKS! I think that only a couple of you have understood what my original complaint really is, so let me try to straighten it out a little. My problem is really only with MEDIC students. EMT and intermediates really have no experience and/or knowledge when they come to their ride-a-longs, they are just starting out, we all know this, and these are the students that need hand holding with everything. MEDIC students however, have done time in the hospital setting and have had more exposure by the time they get to their clinical rotations (which are part of the educational program, as pointed out above). By this point they should be able to start a basic assessment on any pt even if it is NOT fine tuned. If a trauma pt needs an oral airway for instance, they should be able to see this and maybe even preform the insertion of said airway, after all they are an EMT at this point. I totally agree with finding out how they learn and as a preceptor, that becomes MY job, otherwise I am wasting their time as well as mine. The issue that I am having is that we have an abundance of these students making it to their clinicals by BSing their way through, and expecting everybody out there to spoon feed them their education. The last time I checked, this is a college course, which means it is ADULT education. Teaching them is one thing, but spoon feeding and handing them everything is NOT what preceptors are for (in my opinion). We are fine tuning what they have already learned and showing them how to use it in the street. I have NO problem with giving a student every oz of knowledge in my head if they take the bull by the horns when it comes to learning. As far as compensation goes, in my case neither the District nor I get any compensation from any of the colleges in this area. This is ALL done to educate the future of our careers, and to insure that the next generation hits the street ready to handle anything that they may see. I guess that is my real issue.

Agreed!!!! I understand this and have NO issues with being a preceptor, but isn't my job as that preceptor too teach them how to use what they should have learned in school? I do agree with Dust when he says to teach them everything as well, but what is the classroom for if they are coming to me without know there basic drug calcs? Is this still my failure, or the primary educator's? Being able to do a set of VS is something they should learn in the classroom, I will teach them how to do VS in the back of an ambulance that is rolling down the HWY. Am I wrong or mislead? I don't expect them to be 5 year vets, but they should have learned the basic knowledge of the job in the classroom, otherwise aren't we wasting their time with college courses? We come here and bitch about needing to raise the education standards, but then we don't hold them to any higher level than the bare curriculum. WHY?