Just Plain Ruff

Are you going to behave this time Kiwi or do we need to retrain you????? :)

And doc, don't forget the evac via the local helicopter crew to the level 1 trauma center to fix that papercut.

We had patients like that, those same patients also lived in a 2 room house, no running water and an outhouse, wood stove for cooking and heat and a dirt floor. And NO I'm not kidding. There were a small number of these folks and whenever we went to their homes on calls, they would be very very very sick, because they just didn't call the ambulance or go to the hospital for anything other then one of them dying. Had a diabetic call at one of those houses and the sugar was so low the word low didn't even register. I ran out of D-50 in my drug bag - we gave 3 amps with no appreciable raising of the level. We then used all the ambulance stock. In the ER they maxed him out of their stock as well. He ended up dying. Turns out that some tumor on his pancreas was spitting so much insulin into his system that no matter what we tried to do was not enough. His brain just died due to the low sugar. Our staff felt helpless because our normal modes of bringing sugar up didn't work. He was flown to a major teaching hospital but it was too late by then, he had been down too long and his brain was basically jelly or something like that. About a week later, we got a batch of Wood stove chocolate chip cookies and a card from the family thanking us for helping him. He was a really good guy, very much loved in his neighborhood and it was a shame that this is what took him out when Vietnam didn't.

Have you tasted the tubed frosting lately? MY wife's a cake decorator(she's freaking awesome) and she uses some of that cake frosting in a tube sometimes and to me, it tastes like a combination of D-50 and lard with sugar all rolled into one. Way Way too sweet. But it's also less messy than me drooling on my shirt with the instaglucose bright red gel. I'll take the cake icing over instaglucose anyday.

The offer is open to anyone. I've helped a fair share from the city as well to tweak their resume. But you are right, it doesn't hurt to have another eye look at your resume

Another prepared diabetic, but dang, our ambulance response logs would be much shorter if all diabetics were as prepared.

That day was a bad day. Had the patient not have been semi drugged then I fear that that scenario would have ended very very differently. And had there not have been 5 additional people along with my newbie having his hands on the hand with the knife, I'm afraid the the police would possibly have shot the guy and again it would have ended very very differently. This changed the way that I precepted/FTO'd new people. I sat them down and laid it out. Told them that if they wandered off without telling me even to go to the bathroom unless we were at the station or at post, then they were off the truck. I got much more lax further out from that incident but for several years it was "Don't go anywhere without tellng me where you are going, end of discussion" If they asked me why I was so distrusting or anal about it, I told them about the situation. Usually they would say "I would never do anything like that" and I said, "That's what the other guy said as well". But that call is one of the calls that I have packed away in my closet in my head which only rears it's ugly head every once in a while and it's usually in a dream with the newbie getting killed and the patient getting shot. Nightmares to say the least.

My parents keep telling me that my childrens giving me gray hair is just payback for my giving me theirs. The supervisor ride is only good as long as there is a supervisor to ride with. If no supervisor, then the medic/emt crew really needs to be on the top of their game to make sure that this rider comes home safe and sound, not like the dumb ass who was riding with us as a new employee. He didn't last long at our service. He was a problem child from the get go. Needless to say, he was put with another FTO and did some other stupid crap too.

A favor after chastising him like Scuba said she did, with it being pretty embarassing for everyone involved. That's pretty rich. You're just an ER Doc, doc, "You don't know nothin bout birthin no babies"

I'm all for letting Cad, get out on the trucks but strictly speaking liability wise, I'm not sure it's a wise idea but my alternative suggestion of having her ride with a supervisor would be a very viable alternative. There are so many things that happen on scene that having a medic watch a teenager (who I believe to be mature but we only see what we see in her forum posts) as well as control the scene puts just another variable in a very fluid situation. The medic will have the distraction of keeping her in his view finder constantly which might in the end compromise patient care. I have full faith that Cad will do what she is told but that is NOT a guarantee and to have to control a teenager, who may or may not be beyond her years in maturity, is not something that should be thrown into the mix. So if the option is there, why not allow her on with the supervisor, I mean really , they don't actually do anything on scene except try to steal tubes and just get in the way, having a teenager to babysit(no offense) would take the supervisoritis out of the mix. Of course my barbs at supervisors is just that, Barbs because at one time I was one of em and I welcomed ride-alongs of 16 year olds up to 80 year olds. Plus the riders can go to the BEST restaurants out there to eat at.

Ok, let me give you a real life example of the above. I'm precepting a very gung ho new emt. We get a call to an overdose. On arrival we cannot find the guy. Police are looking, myself and my emt partner are looking and we are thinking that our new guy is right behind us. Well he wasn't. He went down in the basement looking for the patient, didn't tell us where he went. Next thing we know we hear screaming and yelling and the five of us, three cops and me and my partner are rushing downstairs. We find the overdose patient and our new guy in a wrestling match with the new guy holding the overdose patients hand which has a 6 inch bladed knife. My new guy has already been cut on the arm and he's screaming "help help help". We are able to subdue the patient and then treat both patients until a 2nd ambulance gets there. I have a long talk with my new guy including the part where I told him emphatically at the beginning of our shift together "NOT TO F'ing leave on scene without telling me" and then I transported him to the ER. Once done, we had to go to the supervisor's office and we both got a ass chewing that actually still hurts if I think about it too long. This is what can happen on scene if we forget you. And with you being 16, your safety is tantamount. Can you see the headlines in the papers and Facebook "EMS Agency allows 16 year old to ride-along which resulted in injury to said 16 year old" That would be bad. I for one would not really want the added responsibility of having to watch you and take care of my patients. BUT--------------- Why not ask if you can ride with a supervisor, that way you get to go to all the best calls and can bypass the routine calls that are a dime a dozen.

I was trying to be nice and diplomatic on my original post on this but my concern is that there is a lot more going on with the OP than what has been shared. I have found that in my many years of counselling and assisting other EMT/medics in trying to help them procure a job, in trying to review their resume which I'm pretty good at reviewing (my tweaks just got a colleague a 110K job in my industry and they said some of it was based on his resume standing out in the crowd) that I suspect that there are dynamics we are not privy to. The resume advice and help offline offer is open to anyone who wants a critical eye to review their resume. Remember, the resume is often the first thing(apart from the application) that a employer's HR department sees. If you fail the 30 second resume test, you fail the chance of getting into the mix of being in the 2nd round. I read a statistic that a HR person will see over 500 - 5000 resumes for a single position in this job market. That is why your resume has to stand out in the crowd. If it sucks, you don't get a second chance.

Yeah, Mike, The three other hospitals that I had access to representatives from, all say that their numbers are far fewer than what were quoted originally. And these hospitals all get patients from the EMS Systems that the original hospital gets, probably more so than the original hospital.

I am not going to be able to answer any of those questions for you Rock_shoes, my numbers are strictly from a conversation with the nurse manager and I have no info from the EMS systems in the area. But I do have a fire station that houses 2 ambulances in the station that I might just drop by and strike up a conversation. Discuss it with them in passing. If they are like any other EMS staff, they like to talk about their jobs with a out of stater who just moved up here and actually might want to do some part time work in the area. Good questions to ask. Now if I can only get my registry back.

yeah, actually we can all be jerks at times. I'm not immune either, just ask my wife or kids.

I actually told a doctor one day after we had been chastised up and down by him for being idiots and jerks and the like, we stabilized the patient and when we were out of the room he proceeded to yell at us for making him look incompetent, and then he asked me for help on his computer. I then said "When you can talk to us here like professionals and not treat us like dirt, I would consider helping you, but until then, you are on your own, good luck with your charting, and by the way, the only one making you look incompetent in there was you yelling at us in front of the patient and the family" and I walked away.

You know doc, I dated a medical student for a long time in the early 90's and she became a resident at the tail end of our relationship and I can't begin to tell you the horror stories of what nurses in some of the departments felt they could say to the residents. Usually Kristie(that was her name) would usually nip the nurses behaviour in the bud without the involvement of anyone else but there were times where she did have to involve Nursing administration and often times, that nurse would be out looking for another job. I know hundreds of nurses and I don't know any of them who would feel comfortable or powerhungry enough to "chew out" a resident. I know Scuba and believe you me, if she said it was a chewing out, then by golly, I'd take that to the bank.

Only if the medic is a slow medic.

2 interviews after applying to a dozen ambulance companies - Would be interested in seeing your resume. Could it use some tweaking, is the resume in a format that is acceptable to most HR departments or is your Resume making a quick diversion to the proverbial circular file. Do not take offense at this but is your resume professionally written or is it in the jargon of a high schooler? Again don't take offense but HR departments look at resume's every single day and they quickly throw away resumes that are poorly written or look like "sh(*(&&T" if you forgive my french. Are you under or over the age of 21? That might affect your eligibility for insurance as well for their insurance carrier. If you are willing, send me your resume, ruffems@gmail.com and I'll take a look at it. There is a reason why you have only gotten 2 interviews after applying to 12 or more companies. One other thing, just a question to ponder, do you have anything in your past that could have a direct bearing on why you are not getting calls for interviews. Take this case for example A very good friend of mine applied to the KC MO police department, he got through the first several steps in the process. He was told by a Captain that he was a shoe in for the academy and then came the polygraph. He told the truth on the polygraph that he had taken money from a previous employer. He got the denial letter in the mail 10 days later. He attempted to get on with about 10 other police departments but on the applications they ask have you applied at other departments and he wrote down which ones. Apparantly, those departments talk amongst each other and he was told by a honest police department HR person that there was something in his KC MO PD hiring process that will keep him from getting on at any police department in a 100 mile radius. He said that he knew what that "something" was. So I would look inward (again don't take this the wrong way) and see if there is something that you can do to improve your chances at getting even an interview other than the tried and true response of "Volunteer work" because you may not have that option in your area. And again, don't take this as a personal insult but how did you apply to those companies? did you take the application in person or via the internet? If you took it in, in person, how were you dressed? Were you dressed shabbily and looking like a beatnik(again not personal), or did you go there with at least a shirt and tie on with nice slacks?, was your hair combed and did you not smell? If you sent it in via the internet, are you sure that you attached all documentation correctly, they may not have gotten all your paperwork. NOW, for your future job hunt. 1. When you drop off a resume/application/data packet - do it in at least a shirt and tie and slacks and dress shoes. Dress to look the part. 2. Call each of those agencies that you did not get an interview with but you filled an application out at, and ask to talk to the hiring person, HR or whoever. Tell them who you are and talk to them about any future positions or current positions. Let them know you filled an application out and you were wondering the status. (if you've done this, they may have already told you why you weren't hireable). 3. Keep good records of calls and who you talk to, never hurts to name drop when you are talking to someone who can make or break your future. If you talk to Jim Jones at the HR department and you have also talked to Janet Jones at the same HR department make sure you tell them that, they will then be able to talk to one another about you. 4. When you send your resume/application in to the next agency, follow up with a phone call to HR in 5-7 days just to make sure that your packet made it to them. Just because you send the package to them or dropped it off to them, DOES NOT mean that they got it. And last but not least, for the ambulance service that you REALLY REALLY want to work with, why not call their HR department and see if you can come in and sit down and talk to the HR person about the jobs open and what you can do to stand out. That's a first step of standing out and showing that you have the initiative in wanting the job. If you just say "oh hell, I'll just send this package in and wait,and wait and wait, and when I don't get a call, I'll just wonder what happened to it" You don't want to be that guy do you???? Of course not. Take care and send me your resume - Ruff

No one is saying anything is wrong with an IO.

Yea IStater, I work on a project where one of our key measures is making sure that the ED clinicians have all the tools that they need in the medical records system (EPIC) that I give them, to be able to do just what you say on the medical history and medications. For those who do not know the terms it's called medication reconciliation. When the meds are reconciled, they are compared with what is in the hospital system to what the patient says they are taking, this occurs in triage or during bedside triage. Once the patient is discharged, they may be given prescriptions, so the nurse is required to reconcile again the meds with the prescriptions. Can you say that nurses don't like this process - you bet your sweet patootie that they don't like this process, the common complaint I hear is "It takes to much time" But unfortunately it's not my fault that they have to do this, it's one of the great mandates that have come down from above. But anywho, Yes, the best med list/history list is going to come from the most recent ER visit as long as the nurses in that ED/Hospital are doing the required steps and doing the med reconciliation. You can just take that shieet that they give you and put it in the kit. Any time the patient gets a new drug or prescription refill it's a good idea to update the list to make sure things are good to go.

Thanks IStater, I'd much rather not do the glucose gel. I'll take a look at my kit the next couple of days. Funny thing is that the peanut butter and jelly was a suggestion from my Endocrinologist. Cad, seems that you may have been on to something but in my case, my sugar came back up without an issue after the Pb&J's and the chocolate/milk as well. It stayed just fine for the rest of the evening. So let's pull this out a little and let's put a kit together then. What would the group recommend that I put in my kit - to replace my Pb&J?? I do NOT want to put in the glucose jelly but I will purchase a tube or two when I go to CVS in the next week or so though. Suggestions wanted: But remember, the items have to have a long shelf life and they have to be able to be put together by either myself who's sugar may be low but not low enough to be unconscious or they have to be able to be put together by a 11 year old or a 4 year old (I would just tell my little girl to go get daddy's diabetic kit) Thankfully my sugar only goes that low when I make a ID10T mistake like the other night.

CAd, I would suggest that your family put together a bag of items that would help Dear old Granpa out in an emergency. Bottled water and sugary drink mixes, quick easy sugar fix, Peanut butter jar, jelly jar and some wrapped crackers, you can whip up a quick PB&cracker sandwich for him. Get some of the sugar replacement pills that they have at CVS or Walgreens in the diabetic Aisle and also get some chocolate and or other types of candy. Buy a cheap cooler or tote for all the items and you should be fine. None of the items will go bad in the bag unless you let them go past their expiration date. One other thing,you should put together a medical sheet with his medications, medical history and allergies to give to the EMS crews if you ever have to call them. Doing this NOW will keep you from forgetting something important about his history/meds when you are super stressed when and if he ever goes down unresponsive. Put that medical sheet in a ziplock bag and seal it so if anything spills in the bag of grandpa's diabetic stuff, you have a sealed container that won't get wet. Make sense?

I contributed to a Indiegogo campaign just in the last couple of months that provides some semblance of 911 in undeveloped or under developed countries. It's called http://www.indiegogo.com/projects/beacon-911-where-there-is-none I felt it offered a semblence of promise and they are not near ready but they do have a great idea. I believe their first major push to provide services is in Haiti. I am pretty sure that their goal is to be in at least three countries with very minimal EMS systems by the end of next year. It's a pretty neat system that they are putting together but I don't know if 41K is going to get them into 3 countries, let alone Haiti. But they have a vision and a mission and I hope it's successful. Ruff.

I'm hoping to get some solid numbers but I'm not holding my breath. I may be able to run a report on IOs documented prehospitally via my EMR system but that would take some real work on my end and I'm not just that into it. so I guess my question is this What are the numbers in your neck of the woods? How many iv's versus IO's are you seeing? Just questions.