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Just Plain Ruff

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Everything posted by Just Plain Ruff

  1. I agree. I was flabbergasted at what my pain management doctor did an how he treated this patient I brought to him. that is why I reported him with his refusal to treat the patient initially. thank goodness he relented and treated her appropriately in the end and I have to admit that she was treated very very appropriately and tolerated a very rough ride back to our facility with minimal pain as he wrote orders for pain relief on the trip. If she began to exhibit any pain on the trip back she had orders for meds.
  2. I second Dusts comment - from the grave But couldn't you call the receiving facility and ask them for orders? Tell them that the wussy doc sending the patient won't give orders and the patient needs them I'll tell a little story had a patient, history of brittle bone disease, going on a 2 hour transfer for a pain management consult. 2 lane roads all the way, terribly kept up roads. Was given a 10mg toradol PO pill and 15mg demerol prior to leaving the sending facility(it was the facility I worked at as a hospital based EMS medic). 1 hour prior to leaving she was given this huge dose of meds 20 minutes into the transfer, the roads get the best of her and she starts to cry out in pain. we are now out in the boonies, no cell service, we are also in the ambulance with the broken antenna so no radio service. So I go ahead and work via our standing orders for pain, start an IV, give her 25mcg's of fentanyl and some zofran. that does the trick for about an hour. I then dose her again. All the while trying to make contact with the receiving and the sending hospital with NO luck. When we get there, the pain management doc goes nuts, he says I specifically said no pain meds on the transfer so I could evaluate her pain when she got here. I told him the road condition and how much she was in pain. He in front of the patient said He didn't care and refused to see her. I told him that he would have to discuss that with her physician and that I would be making a complaint to the Missouri Medical Licensing board for his neglecting to treat the patients pain as well as making a complaint to the STATE. (I did this by the way). He did agree to treat her now that the pain meds were on board for 2 hours and he said he guesses that he could go ahead and see her since she was here. The patients family was really pissed off at the doctor, and myself and my partner were thanked by the family for making the patient as pain free as possible during the drive. We transferred her back to our hospital with new pain orders from the pain doctor after he saw what this patient had going on, I wrote all this up in my patient care report. Let my EMS medical director know what happened. Our director of nursing reported me to the State bureau of EMS for prescribing medications without a license (I gave med's based on standing orders - he(nursing director) didn't like that we had standing orders for anything). the state came in, investigated, found me without fault since my medical director backed me and my ED nurse manager and EMS supervisor backed me as well due to radio failure and cellular failure. I told the director that I could have easily have reported this to the State as well due to the poor medication orders given for this patient as we all know that JCAHO and Nursing care everywhere feels that pain control is the new 5th vital sign. 6 months down the road, there were mass layoff's (firings of 8 ER nurses and 6 paramedics - and I was the first to go on the day of the purge). I know why, but hey, it sometimes sucks to be a patient advocate against such shitty nursing/physician care. Tje state did find out about the failure to treat pain but it was a fall out of the complaint I made against the receiving pain physician and hospital she was transferred to, not the place I worked at but I don't believe my hospital was cited for this situation. I do k now that I had to sit with an investigator and my supervisor for about 2 hours going over my run report and the entire transfer. but the investigator was a nice lady and it wasn't too bad.
  3. I totally agree with you PM - (paramedicMike). it takes saving, possibly a company match or tuition assistance or assistance from family or a student loan. My example was extreme on the +30K that I'm still paying back after 10 years or so but the ROI for my investment has not been returned. My parents paid for my paramedic course which was 2400 total but I did not get a degree out of it but I already had one - it was a BA in Admin of Justice, or I was just finishing it up, can't remember that far back. Hell I cannot remember yesterday let alone 20+ years ago how things went. But I do remember the lifepack 5 and mast pants and how to put them on. I'm all for paramedic degree's be they associates or bachelors. I think for a run of the mill field medic an associates degree is appropriate but for someone who wants to be a supervisor/FTO/higher up manager then a Bachelors degree is essential. Just my .000000002 cents as my opinion be that I no longer truly practice is really worth just that. .0000002 cents. I wonder what dust would say on this thread.
  4. This I can't help but agree with but the thing I have to call into question is this, our pay already sucks big donkey balls and putting a loan payment on top of our responders already meager living(wages) could put some of them into deeper hock or debt. Do you also then embrace the programs that offer loan forgiveness (which almost no-one can qualify for - I know, I've tried to qualify for them) and saddle these providers for the next 20 years with payments that never ever ever ever ever seem to go away just so we as a profession can spout those hallowed words "our profession is a degreed profession" there is a great meme out there that shows two men side by side one guy it shows that he has student debt, a degree where it's hard to find a job and is in debt up to his eyeballs the other guy went to trade school, has no debt or minimal debt, got a trade, and just turned off the guy in the above sentences power. I know not a great analogy but I have 27K in student loans still after 12 years for a Masters in project management that I was given this really polished song and dance from Keller Graduate school of management that it would help me become a higher paid consultant but honestly it has not, I'm just paying 232.00 for the next 15 years.
  5. So question, what are the true benefits of having a degree? Not sniping but do medics truly need american history and other similar courses or can we build a EMS bachelors or Associates degree that focuses specifically on what medics(not talking about EMT's here) need to be successful. I cannot cut and paste the screenshots here but here is the Johnson county community college paramedic curriculum for AAS in Paramedic. here's the link - http://catalog.jccc.edu/degreecertificates/emergencymedicalscience/emergency-med-science-aas/ If this was the norm - then this might not be a bad framework but to add all the extra's such as history, and sociology courses - it sort of loses it's luster. just my 2 cents which is often worth less than 2 cents.
  6. Oh here we go on this site. It's all over facebook - truly strong feelings about this subject. Let's keep it civil and factually appropriate - no emotions please. That's what has derailed most of the facebook threads - emotions and emotions don't make facts.
  7. who is the keeper of the tapes? who is the keeper of the privacy of these patients? Who has access to these tapes, does the legislature address this in the bill? I've known some truly shady providers and there are some douchebag shit heads out there and it's a shame that we now have to have this type of protection out there for the patient but I'm more a proponent of this bill for the provider's in case they get a accusation lodged against them that isn't true. It has always been the patients word against the medic/provider and on this site as well, we've always crucified the medic before the true facts have been known in some cases, that in essence the patient made it up. then the providers life is ruined. So as long as the tapes are kept private until needed, only authorized people can see the tapes and the media can't get them until the investigation is in full swing, then I'm for this legistation.
  8. No when I clicked on the words design ideas it linked me out to the crate and barrel site. see below screenshot This is what I get when I click the words design ideas - it sends me to crate and barrel's site. Me thinks that wasn't the purpose but maybe again it was.
  9. did you mean to link out to the crate and barrel site? if so, I cannot see how the crate and barrel site would translate to a EMS forum shell but I suspect you have an idea how it would. Go on and do your magic.
  10. Dust would have a field day with this one - but Dust is no longer here - so I'll take a stab DO NOT LISTEN OR TAKE THE ABOVE CRAPPY QUOTED ADVICE read why below!!!!!!! Papers Wizard is a Horrible suggestion. The website says that they will write your paper for you by professional writers but their website doesn't even have a professional writer proofread the crap that they put out on their own website. For example Every sentence below has at least one spelling or grammatical error except the last sentence. You should be ashamed of yourself for suggesting that people use this shithole of a site to do their schoolwork. This is the same type of shitty program that used to send catalogs to people or advertise in the back of popular mechanics back when I went to college and you could buy pre-written essays for 10bucks a page. Before they had the online programs that checked for plagiarism, which I bet each of the papers you get from these bright stars has been bought and sold more than once or twice and is on record in those plagiarism site. MartinSuperBoy - I don't really know who you are but your advice to use this site is horrible and goes against the spirit of this site. You are going to get Coal in your stocking this year and I hope that no one on this thread goes to the site you recommended and uses the service because you have given shitty advice to use this crappy internet "zero to hero writing" service. Terrible advice.
  11. Yes the degree will be your issue. Most of the companies that I have worked with will not talk with you unless you have the degree. I'm not sure why. If you can do the job without the degree then why do you need a degree.
  12. What kind of consulting do you want to do? Healthcare EMS computer? Let me know If it's healthcare - I have info that I can share with you. You can reach me directly at ruffems@gmail.com
  13. i Can see why you wear that watch you old relic.
  14. Funny thing you mentioned EMS Dinosaurs = theres an ems website out there called Dinosaurs of Ems, they sell stickers and other items celebrating those of us who have been in EMS for over 25 years. It's a neat site. I k now the owner of the site. I have several of their items that they sell.
  15. So Tyler and I met about 5 years ago at the hotel restaurant that he was staying at in the D.C. Area. I was living in Baltimore and he was travelling in for a National red cross training gig. So we meet up for a marathon chat session. He walks over and I'm thinking Man what a presence. He tells me "I hope I can fit in there" meaning the booth. I said "if I can so can you brother" and he did fit. We had a great laugh at our girth's expense.(I do know that 3 years ago he sent me a picture of him in a train car in a booth where he was fitting with room to spare and he said "remember the booth at the hotel?") We had drinks, a great steak, laughs at the cities most reverent members expense(Dust, Ace, Dwayne, Mike, Eydawn, some others I cannot remember), he told me that he was going to marry that lovely woman in his life, I talked to him about my SUCK's donkey balls job where he told me to quit if I didn't like it and stop bitching(I quit 6 weeks later) and everything in between. He told me something that I remember well, he said that Life only happens once, it happens to the best of us and you just have to grab it and hope that it treats you kindly. Tyler was always available to me, I could call him and he would answer, he called me a couple of times with personal and job related issues and we always had each others backs. Tyler, you will be missed - you were a true friend, if I was able I'd be at your funeral but trust me when I say, I'll be there in spirit to ride that supply logistics train one last time with you to heaven because heaven doesn't get resupplied by just any silly amateur, they need a pro and they picked you my friend. Stay the course, we got it down here, your job is done on Earth, it's only beginning upstairs. Ruff
  16. oh yeah I want to add one thing though, do NOT get a smart watch if you think that it's going to be super cool and be able to bring up all this cool data the same way that a smart phone is goign to be able to. You will be a fool that is parted with your money very quickly. The display of a smart watch is no more than 1 inch or so, you will have no way of directly typing on the watch so you won't be able to do a web search or any type of texting except in some extreme circumstances and it just will NOT NOT NOT be like a smart phone experience. it just WILL NOT People I know who have bought the smart watches because they think they will be like a smart phone are the ones who take the watches back. Dont be one of those people.
  17. I have a samsung gear watch, you can have any watch screen you want. the one I'm using now is a digital clock but you can upload a analog watchface with a second hand It can also go dark when you aren't using it but when you turn it to look at it, it will light up(you can turn that feature off). Most smart watches have that feature. I have had it for 5 years, it's glass screen has held up to normal wear and tear, it is nearly scratch non-existent. Plus - feature - if you use your cell phone to call the hospitals, you can actually use the watch to call the hopsitals and not have to get your cell phone covered in nasty germs. it's a pretty and practical watch. I recommend these types of watches. But a run of the mill timex or 10 dollar dollar tree watch will get the job done as well too. The watch I had cost my wife 249.00 for my birthday. Your mileage will vary. I'm getting ready to upgrade to the newest gear watch which will allow me to make cell calls without having to pair it with my current S9+ phone.
  18. Probably, any way to go back and get this amended via the courts? You should be able to go to emt school and then discuss this with your prospective employers. Let them know what happened. It's all going to depend on the company you apply to.
  19. If the EMT was never on site, never took care of the patient and was just speaking of the incident in a passing manner, then there is no HIPAA violation. But....did the EMT act like he/she was on site or took care of the patient, like he/she was there? If so then there may be a mis-representation issue going on here and that needs to be nipped in the bud.
  20. too many times to count, only once did the prosecuting attorney do a damn thing about it. The rest of the time was told, the guy was drunk, on drugs, a psych patient or myriads of other reasons why he wouldn't be charged. But assault a cop or a firefighter and they get the book thrown at them. NO WAY am I discounting those charges against the officers or firefighters. If you understood my history and family history of assaults on police officers you would understand why I have NO problem with throwing the book, digging a hole and burying the suspect 6 feet under with as much fucking cement that the 6 foot deep hole can hold. ruff
  21. so we have to dumb it down for people in 2018????
  22. I really didn't mean to poke the walrus.  His post was confusing and he left a lot to be interpreted to guesswork.  I think I hurt his feelings.  No offense was intended in my post.  

  23. Your post is confusing, how are you going to get better as a driver except to drive? I don't know of many EMT jobs that don't require driving as part of their duties. Plus, what medical knowledge are you not keeping sharp while in nursing school. If I were you, I would concentrate on learning the nursing school part and leaving EMT behind because in Nursing School you will be learning so much more than what an EMT will learn. CEVO/EVO is not a bad thing to take, it will make you a better emergency operations driver but if you really are that crappy of a driver in real life, it won't make up for the lack of you being a crappy driver. I would personally start out with maybe a drivers education course to begin with. Of course this depends on why you have such a bad driving record - is it tickets or speeding or wrecks or what exactly is your issue? If you are going to come back with DWI - don't bother responding.
  24. So I did some research on Money Orders and I think your money is good to go. Since Money orders are paid for either with CASH or a credit or debit card, the money is already been paid to get the money order. Unless they just got a program that prints out fake money orders which hopefully the guy didn't do. Here's where I got the info - Motley fool is sometimes a crazy stupid site but they do have some good advice and I think this is good advice here. https://www.fool.com/investing/general/2015/06/12/how-do-money-orders-work.aspx
  25. let's hope the money order isn't one of those craigslist scam things.
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