letmesleep

Let me start off in saying that it doesn’t matter if your student is coming from a degree program, a fly-by-night program, or anything in between. Is anyone else out there sick and tired of MEDIC students that are getting to their clinical rotations and can’t handle simple pt care? How is this happening? Let me qualify the question a bit: A medic student is working at a department in a non-responding capacity; let’s say they are a secretary. This person decides to educate themselves by going to EMT school so they can improve their billing skills. After approx 10 years of this job choice they take further advantage of the educational bennies their department offers and they attend an accredited medic program, so they can make more money and transfer in to the field. Of course during these last 10 years they have made many friends along the way who have “helped” (and I use that word loosely) them along the way. Now they come to do a ride-a-long and can’t start a simple interview let alone run a call as expected of them. The above is a fictional story, but pretty damn close to reality. It seems to me that over the past few years numerous students are coming in to be precepted and have no clue about their meds, how to interview, perform skills, or any combination of such. Is it me? Am I getting old and crotchety? Why is it that my generation of medic is holding this generation of medic to a lower standard?

I like this line, and sometimes thats the only real reason.

I'm just curious why taxes are not supporting your department/ district. Are you a private service? Are there taxes in place? Do you bill insurance and/or the pt? I admit that I'm ignorant about MT laws, but with that said I also realize that there are numerous places out there that still rely on memberships and donations. WHY? In this area we have a helicopter service that sells memberships to the public for approx $50/ year. The problem with this is that we have a couple of these services available to call, and we (on the ground) will use the closest in a critical situation with NO concern of any membership. We have had pts who call this service for transport, but by state law, whatever ground service covers that residence has first response rights, and usually will cancel the inbound air craft for various reasons. I realize that this may be apples and oranges, but in my case, memberships make no sense, so I'm looking for clarification on the topic. Here we have property tax in place, and we have (in the past 3 years) a sales tax in place to cover the majority of our budget, but we still charge for services. Are these possibilities for you in MT? Why and/or why not?

Agreed, my point is that it isn't costing me directly, so a huge thanks to my taxpayers for the education. I do however believe that as a professional, it is our own responsibility to track and keep up with our own licensure with or without the benefits that come from your employer.

I must be really riding the "gravy train". Educational bennies pay for all my CEUs, including ACLS, PHTLS, PALS....ect. NR is not mandatory to relicense, and after getting your original from the state, we are seeing a lot of medics and EMTs letting the NR expire. Killing the Machine!

LOL, your a sick, sick man!

Off the topic a little and not looking to split hairs with you, but what is normal in regards to vital signs? I'd say this pt doesn’t sound completely rational at this point (at least to me, and based on the story). What sane person or rational person is going to drink that much vodka and eat that much ASA, and then admit it was done for attention? Now taking into consideration he is intoxicated, he can be labeled as impaired, therefore unable to make his own decision at this time, which is something that was recently discussed in another thread. I'd say that based on what I have read, I would have transported, but with that said.....I was NOT there. Anything we do can lead to a lawsuit, but in my opinion, this pt could have been transported. Documentation is your key, and statements about the ETOH consumption, the wavering story about how many pills and what his true intention was will certainly help. My question at this point is what advice did you receive from your medical direction? Any time you run into situations where you’re just not sure how to handle the pt, call for direction. Part of being good at what we do is knowing when we are stuck and what resources are available to us.

I'm just wondering where the "god syndrome" comment is coming from or is even warranted? I agree with Dustdevil, Bad start!

Cot Quilts are used in this area by a neighboring district during the cold winter months only. They are usually secured to the stretcher via Velcro, and then the pad is secured again with Velcro. After all the Velcro stacking is completed you then make your stretcher with sheets or whatever is used. My personal opinion with these quilts is that they would be no different than reusing sheets........it's just nasty! As the old saying goes, treat your pt as you would a family member, and I wouldn't place a family member (mine or yours) on used sheets.

Boondock Saints with Willem Dafoe, Sean Patrick Flanery, Norman Reedus.

My partner and I were tossing around the idea of a NON-disciplinary peer review to go hand in hand with our QI system. I was wondering if anyone has a peer review in place, and what you think about it. Our thoughts are based on a "self policing" idea, and not to be used as a means of discipline against each other. Basically I'm asking: Does it work? Is it worth the time? Pros and cons? Opinions? Open up, all of your thoughts are what I'm looking for. thanks

I'm not trying to pick on you, because as Vent stated, this is a learning experience for you. I have always told EMTs that working on a "basic transport truck" (for lack of a better term) is NO reason to be.......lazy. I'm not saying you are, just the mentality as a whole, just relax. This is an example of why every pt should be treated based on a clean slate, not just another transfer. Transfers can turn on you just as easy as the glory calls (<-----sarcasm) that come in 911. In this case you realized that the pt was in poor health by stating that the BP and HR were "low", that should tell you and/or your partner that monitoring this pt needs to be HARD CORE, and treat ALL changes correctly. Even if this pt had been stable all the way through the transfer, there is NEVER a reason to kick back and play solitare on your lap top or iPhone. I can't stand stories of EMTs and Medics that start their shifts by prewritting PCAs ect. Basic trucks/ transfers are ways to gain knowledge and experience, and should be treated as such. Take that BP with a real cuff, count the seconds when you check that HR and RR, heres an idea.....figure out SAO2 by checking cap refill and skin tone. Take the time to learn and be better at you career which will lead to respect that ALL of us demand we get. If we don't act like professionals, how in the hell can we expect to be treated like professionals? end rant!

The NH pt has me wondering.......were they unresponsive or just ignoring the "RN" that is in question? Seen it, love it! Just tossing that out there to be chewed on. As far as the ER situation, why did it take a Doc to notice that your pt had coded on YOUR stretcher? I'm going to side with the others here, maybe the "screaming" tactics were NOT the best way to get your pt the care they obviously needed. WE need to work with the ER staff for the betterment of the pts. find another way to communicate both en route, and standing at that door. This may actually get you a lot further than the way things are being done. Effect change, and the respect level will follow, maybe instead of getting laughed at (asking about the I.N.R), they may educate you upon request. just some thoughts!

If leaving his kids alone is an issue then maybe he should have been more responsible and NOT taken the "duty" for the shift. I also believe that there is some negligent behavior on behalf of this medic for NOT performing his job in this case (based on the info given that is). My question is that we are asking the same type of questions about the distance and time to the hospital, but I am wondering this: Was the FD ALS intercept made en route, or did this BLS crew sit and wait? Maybe I missed the answer to that question somewhere, but if the crew sat on the scene waiting for the FD to arrive, then isn't there a problem with that? How many times on this site do we get "basics" justifying their worth, but in this case where they recognized an urgent situation, they sat! Why? Does the distance really matter? There are basic trucks/ units/ buses (region specific, pick one) who run 911 calls all the time and "handle" CP calls by realizing and transporting based on their findings. My point is who cares that this "medic" (and I use the term loosely) refused to respond. I'd like to know why a crew of professionals where on the scene, and didn't just handle the pt once they found out that ALS care was unavailable. As a medic I don't make it my practice to transfer MY CP pts to basic level care, but why take the time to wait (if that was the case). Unless this FD was en route, and could meet them road-side I say they should have just transported.

St Louis FD, and it's old news. I think this made on this site quite some time ago. I do agree that it's truly a failure on their behalf.

Well, thats one way to avoid a write up for not checking out the truck at the start of your shift.

I would also like to pat you on the back for advancing your knowledge base, and furthering your education, but with your current cert you are "just an EMT", nothing more and nothing less. My question is this, what is the real issue here? I think there is a lot of truth being said by everyone here in that it could be personallity (your's and/or your partner's). Has there been any conversation with this partner about this issue, or is this your release? Age can play a factor in it as well, the partner is young, but is there any issue for you about working with a younger medic? my quick point of these question comes down to this, you have an issue with your partner........talk about and solve the issue, otherwise your not true partners and it sounds as if this may be a long term relationship at this point. Vent and Kaisu, both of you have valid points about each "job" (EMTP and RN). the truth is a lack of exposure and understanding from both to work side by side with each other. It's true that in EMS we hold the hands of family members when there is nothing left to do for our pt, but we don't know what its like to spend a month with that family, get to know them by name, and then have the "we need to pull the plug" speach. It's true that in the ER a RN may see up to (and even more at times) 20 pts in a 12hr shift, but how many times do they crawl around in the mud to treat those pts, start those IVs bouncing down the road, or go without respritory/ lab/ radiology/ etc? We all have our place, and need to try to understand each other (including the stressors) to get past all the crap between the ER and EMS (RN and EMTP). Please excuse my 4 day delay in responding As far as EMT v EMTP......get over it, get your education, and get on with life. The real insult would be if my partner was talking to perfect strangers about our problems without talking to me about it, or if you were a medic who was being called "just an EMT", just my opinion.

I'd have to agree with all the other responses, it sounds like you made the correct decision based off of your assessment. Sounds to me that your "boss" (for lack of a better term) had some tunnel vision, based off the statements of an off-duty medic who wasn't even sure of what he/ she was hearing. Talk to the MD and follow up with this "boss" to get things cleared up, we all know how hard slanderous statements can kill your reputation, and unfortunately that can destroy a career. The "boss" has NO right discussing this issue with others.

That happened in St Louis Co, and the FF won his case. I believe the cop was reprimanded. Always protect yourself.

I really don't know why I'm even feeding into this Medic v. EMT conversation, but....... Why wouldn't a dual medic crew be as good at lifting and carrying pts? If you stop trying to (as Mateo pointed out) justify your worth on a truck, and think about what your saying, who is going to carry the pt if your a 2 medic crew? I tried doing the math, and somehow I keep coming up with......the medics. Last time I checked, as a medic, I am expected to take care of my pt's BASIC needs first, or has that changed? Are we not EMTs first (EMT-P)? What about, when in doubt, refer back to the basics? If insulting EMTs is what your trying to do (which is what all EMTs reading your post should feel), why not call them ambulance drivers? The point of this thread is about 2 medics who were obviously (at least in what I read) too lazy to do their job, and now they have to answer for it. Let us agree to keep this thread on topic instead of turning it into a Medic v EMT BS argument.

I'm not real sure how it is that having 2 medics on the truck causes poor outcomes for pts, or why it is that EMTs would be the only ones that would carry a pt to the truck. Unfortunately these types of stories exist and continue to happen all the time in this field. Irregardless of what the ranks, titles, licensures are it happens all the time with the one continuing factor being laziness, period. I also agree with the statements that we don't have both sides of the story, but how much more info do we need? following an investigation it was found that, and the medics admitted too, FALSIFYING their report, this leads me to believe that we know what happened, and this pt was not carried by choice, anything else woulda/ shoulda/ coulda been documented. I doubt seriously that the walk caused this pt's death, based on stats related to this type of STEMI, however it still comes down to 1 thing..........LAZY!

It seems that any thread I read that crotchitymedic1986 responds to is nothing more than somebody who is looking for pity for African Americans v. an EMS provider who really has something to add, WHY? crotchitymedic1986, could the stats your using be due to the fact that EMS is used as a drive-by clinic in the urban setting? Is it possible that those stats are generalized over all of EMS and not broke down to different regions and populations? Not everything has to be a conspiracy against the "Black Man" or have anything really to do with race at all. Make the complaint and do whats best for the community your serving.

I couldn't agree more Mike, but it sounds as if this is the standard of practice if the COP did a high speed 180 with tires spinning and tons of smoke filling the air as described by the poster. Sounds to me that both of these responders need a refresher in EVO!

The problem with that theory is that I and my family are being lumped together with those whites whose families and forefathers may have actually done the "damage" to your family and forefathers solely based on the color of my skin. My family arrived from Germany and Ireland in the 20th century. There is NO owed debt. I will say for the record that I disagree with this court ruling, and it being a "victory" for these fire fighters. In my opinion this is NO difference than the government setting hiring "quotas". So lets level the "playing field", and change the way this job and the FD promotes, instead of pointing the finger and using excuses in a court of law to climb the ladder. Educate yourself in the career that you chose to join and add a brick for the next generation, instead of dwelling on the past.

Ignorance is bliss! Racism obviously knows NO boundaries! crotchitymedic1986, by your own admission throughout what I read, (and please correct me if I'm wrong) your 40ish. This tells me that you may have grown up during the civil rights movement, but wouldn't it be safe to say that you may have been too young to understand what was going on? This tells me that you (as I did) LEARNED about this movement from your family and/or in school.......history class I'm guessing. Beyond that, I am guessing that you were able to attend school, and received an education......as I did. I will and do admit that we (more than likely) went to different schools, but the opportunities were similar. With that said, I have to state that I am more than disappointed in your statements that minorities are unable to pass tests because of only being allowed in the school systems for 30 to 40 years. My question in regards to that theory is this: Why do you feel that an entire race (in this country...America) is dumb? Based on your statements, you are expecting me to believe that African Americans have NO drive to be educated, or to expect anything more than what their parents were able to provide for them. I DISAGREE WITH YOU! I will give you a couple of examples that your statement is a farce: George W. Carver (January 1864– January 5, 1943), and how about Vivien Thomas August 29, 1910 – November 26, 1985? Both of these MEN pushed to educate themselves, and be influential to our lives to this day, and look at that.....both were born before the civil rights movement. If I am following your time frame wrong then I would have to say that being 40ish that you couldn't have been more than 10ish during this era in American history. Now with that said, if you do remember and did comprehend what was going on because you "lived it", then it would be fair for me to say that you are a very intelligent person with NO reason to make excuses for failing, in regards to the afore mentioned statements. Let me add to this thread that I am a Caucasian, 38 y/o male, a state licensed paramedic, working for an EMS system and carrying the rank of private. I did grow up with the opportunity to become higher educated, but as a younger man, I made my own decisions and chose to go to a community college.....a choice that I regret at this point in my life, but one that I will correct......again by my own choice. Don't blame anyone, in this day and age, but yourself for your level of education! I don't think that the two MEN listed above allowed their social surroundings to hold them back and nor should any of us. It is amazing to me how strong racism remains in this day and age, but I cannot help to think that it is because of those who are more proud of their race, instead of their own accomplishments. Racism is nothing more than different fish living in different ponds, and once in a while one of those fish take the leap to see what’s going on in the pond next to their own. How that fish is welcomed, equates to racism. We all need to get past this issue as medical providers......after all, we all bleed RED!