Just Plain Ruff

Whats the droplet precaution for? Suspect Active nastiness. Don't tell me you went in the room without precautions did you?

Why not have post-it notes or little business cards printed up with a link to your protocols and the studies supporting your protocols. Then when a bitchy nurse who doesnt' have a clue yells at you, you can pull out the card, tell her to stop yammering and go to these websites and then if she still wants to yell at you to come back and yell. More than likely she'll go to her manager complaining about how rude you were to her. But yeah, just retort back to her and say "I followed my protocols so call my service if you have an issue with it, you know the number, 911"

What about the Kaplan EMT study guide? I have a couple of emt's who used that book for their test and they scored very high on the registry.

When I first started as a wayward student I learned from some really good ones and some really bad ones. One bad one that stands out in my mind was a preceptor that restrained a patient, was so viciously nasty to the guy that the patient broke the kerlex restraints and began to whoop the medics ass. This was after the medic had hit him with a mag light three times causing a couple of small lacerations. This patient, after the ambulance was stopped, opened the back doors and ran off into the darkness. The medic then closed up the doors, put us out of service and we drove to headquarters where he just up and said F it and he quit. I learned that everyone has their breaking point and this psych patient was my preceptors breaking point. It was really a eye opening time for me when I was able to see someone get to rock bottom and snap. He did eventually get the help he needed and he's working in another state doing I don't know what. On the flip side, I have watched another group of medics/care givers talk jumpers off ledges and patients who we did not at the time know had guns, put them down. The compassion that those providers is how I have built my ems career. Long story but short point. I have transported maybe a handful of psyche or suicidal patients restrained. I have initiated most of all the restraints. In my earlier newbie days, I used restraints not out of an abundance of caution but as a new guy with the EMTP patch, and with the protocols to back me. After a few months of experience in the field, I realized that many times, albeit most if not all the time, a soothing voice and calm demeanor would most always do more for a suicidal patient or psyche patient than brute force ever does. You learn that after a time, you really do because most psyche patients, that are really ramped up, are definately stronger than you and your partner if you are alone or if you are with one or two police officers. Yes, I worked in an area where we often had NO backup for that crucial time where we had to decide with patient contact time whether to restrain or talk. (one deputy for 800 square miles). After a year or so on the job, i became astutely aware of who would be one to have to get restrained and I got pretty good at it. Of course there were the ones who blind side you but those were few and far between. Like I said, a calm voice and no fast moves or moves that could be considered threatening to the patient often would do wonders. If restraints were needed, telling the patient what was going to happen would often defuse the situation as well. You learn after a while unless you enjoy restraining patients, that the act of NOT having to restrain is an ART and it's much more preferable to the act of restraining. Less paper work, less monitoring and often times, less time with the police having to write incident reports when you have an injury. Why do I write this? Because with practice and continuing education, there are ways to defuse situations that may end up as restraint situations down into situations where you and the psych patient get along fine and you can transport them to the ER without incident. Self defense courses only go so far, verbal and mental defense courses are also important. knowing the signs of impending violence is very very important. Knowing when to walk away and wait for assistance is tantamount to keeping your ass safe and realizing that if the patient does something to themselves in that period of time between you waiting on backup and you getting that assistance is not your fault, and getting to go home to your family IS your responsibility and to me that's worth it. If you can find the book "When violence erupts" Is a great book to get. You can purchase it from Barnes and noble http://www.barnesandnoble.com/w/when-violence-erupts-dennis-r-krebs/1101795118?ean=9780801661952 it ranges in price from 1.99 to nearly 200bucks. Don't be stupid and pay 200 bucks for it. It's a used book as it's not in print anymore, it's version 1 and published in 2002 but the info in the book is priceless. It's not an EBOOK though. Buy it and read it, then share it with your colleagues. Ruff.

There is a saying, "sometimes it's better to leave well enough alone"

And most of them taste nasty in the process. I have a few posers in mind from the past on this site.

Thank goodness someone is going to blow up this stupid game.

Chris, I studied for my Project management professional exam over the past year or so. There are numerous processes involved in the study each of them having the same type of breakdown as you are having to do. I never did figure out how to get them all in my head because each process builds upon the other which the builds upon the first and then the third and then the 9th and so on and so on. It was by far the hardest test that I've ever had to take. If I had a worst enemy, I would wish this test on them. I will never attempt this test again.

I was actually also referring to other threads not just this one.

yeah, especially since many times our tendencies for initial posters is to eat them alive if we dont' like them. But like I said, it really is just a dream, and like most dreams they don't come true and just remain that, dreams. Hey, hows' the GPS working out for ya?

Here is my dream here on the city, that in posts like these, when someone posts a situation like this and we spend valuable time responding to said post, that the OP would come back and discuss with us what we spent that time responding to. But my suspicion is that the OP decided that he should not post anymore because it might come back and bite him because he posted information about a pending lawsuit and maybe his employer found out or he just decided he didn't want to participate any more I'm getting discouraged

I was just listening to the radio and heard a song with the lyrics "how much does it cost, cause I'm buyin" well not really.

But the week started on Sunday.

Jeff, why not work for a dual role type agency where they do both? You could request to work the transfer trucks and if they need you to work the 911 units you could jump in and get the adrenaline fix so to say?/ That would keep your skills fresh but also keep you out of the limelight so to speak? There are quite a few of those hybrid services out there. Just a thought. Why limit yourself?

I have taken the FISDAP before, I think my score was around the 93% range if I remember but that was quite a while ago or maybe the test I took was some other alphabet soup variety test. But I'm pretty sure it was the FISDAP unless the FISDAP was not around in 2006 or 08 which is the last time I took my registry solely to get my Kansas licensure. edit edit edit, I believe my FISDAP test was administered by Johnson County MedACT in their placement test or at least a form of the FISDAP, I could be wrong but this really rings true in my head. I could be wrong, I've not been wrong this week so this could be the one time for the week I am wrong.

Yes I was quite suspect. This same service under threat of termination had me rewrite a report to make it look like a patient was bed-ridden and required an ambulance when in fact the patient was able to ambulate to the cot without incident. Needless to say, I didn't work for them for very long. Too many cases of this type of shit going on. I'm not sure who gave a quick call to Medicare and medicaid about this, I know who it was but I can't say publicly.

Doc, I truly believe that the intent of having me make the addendum was to make changes to the document in order to cover a lawsuit. I was given writing points on what to write and how to write them. I told them that I was very uncomfortable doing it but was threatened with suspension. I refused and requested a meeting with the service's attorneys in order to see what the legality of all of it was and I heard nothing more about it. That only reinforced my suspicion that they were trying to get me to change some items in a report that was in front of a plaintiff's attorney at the time.

One thing I will add, one service (not naming any but it was one I worked for) required me ( I did not fulfill that request) to update my run ticket after a particularly bad and nasty call. They said it was to clear up some inconsistencies but they were requesting that I write an addendum some 11 months after the call happened. I refused and was threatened with suspension if I did not and I told them I would not write an addendum as I thought it would be fraudulent and stuck to my guns. NOthing came of it, and no suspension was forthcoming but it did make me wonder it they were trying to get me to add to a call they were getting sued on??? Do not go back and update your run ticket after the fact, that is just asking for trouble.

And that should scare the HELL and bejeebers out of you in all honesty.( on some of them at least)

You know, the Health insurance benefits alone outweigh the benefits of working in EMS alone. Along with only having to be at work from 8 to 5 and having every single weekend off (with rare exceptions) and every holiday, I would say that I'm happier than I was working EMS.

The thing is, I'm not Nationally registered so getting a medic license up here in maryland is not a feasible possibility. In all actuality, I'm not really interested anymore in working in EMS, I sort of like my current high paying job with the super duper title.

Well Mike, this kind of snuck up on me, since I wasn't currently actively using my medic card since I can't use a Missouri card in the lame state of Maryland, I just wasn't practicing and I knew that the time was coming shortly but I didn't really think about it until I was cleaning out my wallet and saw the expiration date.

As for the physical fitness aspect, I sure wish I knew at the time that strengthening my addominal and lower back muscles would be a key success marker for my not having significant back problems now that I'm 46.

As of December 30, 2013 my paramedic license officially lapsed in the State of Missouri. Still a paramedic at heart but no longer able to practice. Honestly, I can say, I'm not sad about this turn of events. It was time. So I'm holding a sort of a license(card) burning party over this weekend. I now consider myself a retired paramedic (officially), started in 1987 as a lowly emt dispatcher and moved up to medic over next three years. Anyone need some EMS pants?

My emt license was emt-d and I was one of the first graduating emt classes that got the EMT-D designation. I'm don't think Missouri still uses EMT-D, I guess if I was still an emt in missouri my licensure would probably show EMT-D instead of the newer EMT-B but i'm not sure.. That was a very very long time ago.