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Just Plain Ruff

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Blog Comments posted by Just Plain Ruff

  1. I've read your blogs, I've never commented on them until now, I respect your posts and your blog.  But I really hope you do not need validation of blog respect to be considered respected?  I have a private blog that is open to only a few friends that never EVER respond to my blog posts.  I don't expect blog responses but I do know that they read my posts and they have been in my shoes before.  I am also on their list of blog recipients and I don't respond to their blogs but we all have been in the same situations that we blog about.  We do not need validation of what we blog about.  YOU DO NOT need validation as a medic or person in a blog.  Validation comes from friends and like minded people in the real world and friends flesh and bones real world.  I do see that your blog has been viewed 9100 times or so, to me that is VALIDATION that you have done something right.  Take it or leave it but 9100 views which means 9100 or so people have viewed your blog, thats a pretty good number,  my number is somewhat like 120.  

    9100 is your validation

  2. Ok, it sounds like your service sucks and doesn't care for quality medics, it doesn't cultivate medics and when mistakes are made they do not look to the reasons why they are made they just cut and run.  I've been there, I truly have.  I can say for the two places Ive been in this situation, I was truly better off without that place and I've truly become a better person and medic for the situation.  

    I also know that my last position, non-medic I am definately better off.  

    To quote myself  FUCK em.  

    I do feel your pain

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  3. Ok Lone, we've talked before and I'm not going to let you quit. Well I will let you but you better not let me find you. But then again buddy, I would completely respect your decision one way or the other whichever you decide.

    You gotta do what you gotta do but remember this, you always have my number and the phone is always on. It's never off. It rings and beeps when texts come in, even when it's from a bill collector that I don't want to talk to .

    I do want to tell you that I didn't save one thin dime on car insurance because I didn't switch to geico like I should have, I hate the gecko and the caveman. But I did see a commercial where the cavemen killed the pig and the gecko and ate both with a side of fava beans.

  4. Hey Lone, been there done that.

    Remember, I'll bet that at least one of those doctors who won't let students in has had a very bad experience with students.

    Hell one of my co-students went so far as to break the top front two teeth off in an aggressive intubation. The Anesthetist is probably still paying that lawsuit off.

    They have every right to be leery of someone that they do not know. But you stood there and listened to them, got some really good visual experience and I'll bet the next time that you see the docs or NA's you will be welcomed a little better. That was the way it was for me.

    I even pulled a couple of extra shifts with these same Nurse anesthetists and docs to get some extra experience. Once they felt comfortable with me they let me attempt intubating a malampati 4 with a huge bull neck. I got the tube, difficult tube but it showed them that I had learned a great deal from them.

    Keep your chin up, think of it this way, you now know what some baby medic students feel like when they first start out, you will never make those students when you are precepting them in the field feel like you felt in the OR the other day, am I right?

  5. These so called holidays are shams.

    I agree, the card companies and a bunch of bleeding hearts got together and said, what special group can we exploit next.

    Mothers, hell yeah, that's a great idea. Make every man out there buy their wives and mom's a card and also some silly trinket just to show them that they love them. The florists win here

    Fathers, yeah, get him a ugly tie - the tie makers win here

    Grandparents: Geritol wins here

    Valentines day - card companies, candy companies and flowers win here

    Presidents day - you saw how lincoln fared didn't you

    Veterans day - Maybe one of the good holidays

    Memorial day - where we remember our dead ancestors and buy plastic flowers to put on a grave that will only get mowed over by the groundskeepers at the cemetery

    Secretary day - WTF

    Boss's Day - you've got to be freaking kidding me.

    Pastor appreciation day - I'm good with this one

    There are other days out there that I failed to mention but seriously, do we need to be reminded to show the love? I don't think so but unfortunately - millions and millions need to be reminded about these things much to the detriment of their bank account.

  6. Good points. The clinic ideal has been tried at a few places and done away with as it was abused. Of course to me it is better they abuse the clinic and thus free up the ED for truly emergent calls.

    As to hiring 2 Paramedics for the cost of 1 nurse would not work in my area as Paramedics draw almost the same hourly wage as the RN's.

    Now on the Paramedic in the ED why not have Paramedics (who by design are able to treat independently until they can have hirer level take over) operate as if they are on an ambulance. They could actually begin tests and treatments based off broad guidelines. Thus patient is actually getting emergency care while eliminating many delays that are normally incurred while awaiting a doctor coming and saying start the same treatment the Paramedic already knows is needed. Of course I base this off my experience as a Paramedic with very aggressive guidelines and no mother may I system.

    hey, wow someone actually replied.

    You have to understand the hospital systems. Yes paramedics can work off guidelines and they do so very very well in the field but when you put a paramedic in the ED they become like a tech or in the hospital I work in they become autonomous providers with the nurse in the ER as their supervisor. What can be done in the field is thrown out in the hospital setting. All orders except for emergent orders must be written and signed by the doctor. We all know what most patients basically need, be they chest pain or headaches. But the hierarchy of a hospital precludes many times the nurses or providers from acting on their own.

    Are there facilities that have progressive standing orders in the ER? sure there are, I've seen a bunch of them first hand. Are there ER's that have regressive and even repressive procedures in the ER where a doctor "has to see them before treatment can begin" sure I've seen plenty of those too.

    A happy medium is where it's at. Progressive protocols or standing orders (hospital lingo) can be as simple as if a patient comes in with this, they get these tests. The good facilities will trust their nurses and staff to know that a patient with a headache isn't going to need some of the items on the standing orders but without that trust the hospital will say "All on the standing orders gets done regardless of the patient and their condition"

    What I'm seeing nowadays is that the major bog downs are two fold. Time for labs to come back and physician speed. If you have a methodical physician who mulls over every little nuance of the patient then those patients are going to be held in the ED longer than if a physician who looks at the big picture and treats that way.

    Labs, you can't do much about, but what you can do is perform POC testing at the bedside. They still need to get the actual lab tests done but you can at least treat and street the minor patients.

    I gotta run for now but I'm working on a second blog post on attitudes in the ER.

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