suzeg487

There are a couple of BLS services in my area that have been trying for approximately the past five years to get a medic on the squad. The hold up seems to be that the powers-that-be can't agree on terms for placement, e.g., who pays for what, hospital vs. station, even where the squad would be stationed, etc. The politics of it all are beyond unbelievable.

You guys are right - this HAS grown pointless. It's painfully obvious that we both have a stance and neither one is about to change it any time soon. It's like trying to teach a pig to sing - all it does is annoy the pig.

I went back and looked at my previous posts, and gosh darn it, I can't find the word "awesome" used to describe myself anywhere - I can comfortably fit in the same room with my ego. And I do believe "drive" is one of those "character flaws" that can be taken off the shelf in due time, have the dust (no pun intended) knocked off of it and start using it productively again. I don't recall sharing any war stories either - must be losing my touch... Priorities shift through life. You of all people should know that, given what you've done. I think you have a fiancee? Wait till you get married and have kids - it takes more than the 20 seconds on your part to make them, to raise them. But that's neither here nor there. Time will tell what kind of student I'll be. I will be more than happy to share that info with you when it happens. It'll be like giving me a challenge to prove you wrong!

I just can't understand why it's not okay to not have the drive that some people have. I could have been a smart ass and not asked why Dust hasn't started medical school yet if he's so keen on not being complacent with where you are in life. I applaud that he's gone so far, but not everyone wants or needs that. As much as he reviles me for being where and who I am, I refuse to feel bad about it. I will progress as it fits into MY life, MY means, and MY schedule. I happen to love every facet of the other things I do, even though they don't fall under EMS. And those of you that have families know that your children and their education comes first - that's part of being a parent. My kid's finally in college so I can concentrate on myself. I just think it's a little narrow-minded not to accept that people are different, and shouldn't be put down for what they've done, or according to some - failed to do. Dust, if it makes ya feel good to keep slamming me for being an uneducated, undereducated, useless, lowly EMT, you go right ahead. Sticks and stones...

Call it what you want Dust, but some of don't want to be like you.

You've hit the nail on the head! That's exactly the reason I try not to get sucked up into the "debate"... Plus, I've got some friends that work the transports and I have yet to see them grow any humps or only come out at night...lol

Our situation is a little different. Depending on the call type (extremity pain; fall, etc.) and the town we're dispatched to, the first response is just the BLS squad. In the first-in bag we have bandaging supplies (including trauma) O2 with devices, oral and nasal airways, sterile water, pulse ox, glucose gel, CO monitor, BP cuff and defibrillator. If we need a backboard, splints or stairchair we run out and get it after the patient's been assessed. The medic is in a different unit and carries all of his ALS supplies separately. We don't always get a medic dispatched and sometimes have to ask for one if the call isn't what was originally stated or turns into an ALS call. Some of the towns we serve have us duel-dispatched with the medic for every call. Hope this helps.

People are probably going to think I should be out hugging trees and kissing whales, but I don't think a person, doesn't matter what level they're at but happy being there, should be slammed because they don't fit into the parameters that others set for them. I remember the cry of outrage among the medics when one of the local paramedic training institutes dispensed with the mandate that a student applying had to have at least one year of well-documented EMT experience, and several letters of recommendation prior to be accepted to the program. There have been several students that had never even been on an ambulance before going through the program. I'm still not sure whether or not I agree with that. From what I understand from a friend of mine in the Marines, the military operates differently so I'm not including them in this. Most of the hospitals around here used to run squads with both an EMT and a Paramedic on crew, but have gone to 2 medics for 911 calls. EMTs in this area have 2 options (not hospital-related, such as a tech) to provide service: either working for a fire company or working for a local transport company. And I have to smile at this bit of irony, because the firehouse EMTs think the transport EMTs are "lizard luggers" who don't do 911 calls, and therefore not real EMTs... It's been interesting hearing of Dwayne's experiences so far, as he's going through school now - I'm sorry that the EMT gave him such a hard way to go, but he handled it like a pro - kudos, Dwayne. I've also picked up a lot of really good stuff from reading the posts, not only here, but in the other sections as well. I won't even begin to pretend that I know everything; learning is such a constant process. The medics that I work with were happy that I'm finally making the leap to medic school and have offered me any help that I need - I'm beyond grateful to them for that, and look forward into tapping into their expertise. WelshMedic and I have had many long chats about EMS, over many beers and via email and IM. He's a wonderful provider and I have all the respect in the world for him and others like him.

I've already apologized for not using different verbage for the original topic, so I'm not going to again. As I stated before, it was NOT my intention to offend anyone. It just boggles my mind how blown out of proportion the subject became. Paramedics think EMTs are scum, Nurses (that haven't been paramedics prior to nursing) think paramedics are scum, and if a nurse shows up on a scene and asks what they can do to help, the paramedic (usually under their breath) is saying "tear sheets and boil water". Unfortunately, I don't seeing any of that changing any time soon - it seems like it's been that way forever. Yet somehow, in spite of all of the acrimony, the whole team consistently gets the job done. I don't feel the need to beat my chest and proclaim that I'm better than anyone else to secure my place on the team; performing my duties calmly, consistently and in conjunction with the rest of the team takes care of that for me. I work in an area where there are a lot of EMTs, medics, and hospitals, and while we may not always like who we're on a call with, or the hospital we have to transport to, we treat each other with courtesy and professionalism - no matter the place in the food chain. I also work for an oncologist, as well as with hospice patients, and there is nothing more humbling the seeing the hope and dignity these people display. I consider it a privilege and honor to be there with them when they take their last breath. I'm so glad I don't fit into the box that some of you have, and would, place me in.

1. I'm guessing that "I run with a fire company" means she's a low-time volunteer. No paid professional uses that kind of terminology. In the area where I work, this is exactly the terminology that gets used. We work at a hospital and run with a fire company. Most of the fire companies have paid crews to begin with. 2. Quality patient care is NOT your number one concern if you have FAILED to progress your education in fifteen years of practice. I start paramedic school in the fall. I have been keeping up on any classes I can in the meantime. If you'd read my earlier post you would have known that. 3. Rehashing the same old weekend-long card courses every few years does not count as education. For that matter, neither does EMT school. ACLS is not going to give you anything of value until you have an educational foundation, which you seem to believe is out of your reach. All I stated was to take it for the theory - one would think that something would be better than nothing at all. 4. As stated, if you really think paramedic education is important, you will find a way like the rest of us did. Trust me, few of us were rich either, but we figured it out. I guess you just don't want it bad enough. Or else, quality patient care simply isn't as big a priority as you say it is. Money had nothing to do with it, time did. In addition to working multiple jobs, I'm also a Hospice volunteer and head up our Youth Aid Panel (in addition to taking care of house and raising a daughter....yeah, I know, WAH) 5. Paramedic practice is not about "skills," and your liberal use of the word in this context -- as if they were the Holy Grail -- is indicative that you have learned very little in fifteen years. How do you figure? 6. As ERdoc and others pointed out, just because you took a few hours to read the ALS protocol book does not mean you really have the slightest clue what you are talking about. Just like paramedic practice is not about skills, it is also not practised from a cookbook. The medics you are questioning know a lot more than what the cookbook says. They know how to fully and properly evaluate an individual patient's condition and needs, and judge what is appropriate for them. Sometimes that isn't exactly what the book appears to say. If you decide to question this, you are treading VERY thin ice, because there is nothing more annoying or disposable than an EMT who thinks she knows more than she does. The ER doc was reprimanding the MEDIC, not me. And I was not the one to point the medic's error out - he did it himself when he gave report. 7. Medics do indeed make mistakes. And sometimes those mistakes can be so blatant that even a n00b EMT can see it. If this is within your scope of knowledge (based upon what, a whole 120 hours of night school a decade and a half ago?), and you feel strongly that this will be adverse for the patient, it's time to mention it. If you are incapable of doing that diplomatically, then again, you aren't half the provider that you think you are. There is a darn good reason that most paramedic degree programmes include a speech-communications course in their curriculum. I have no problem communicating with most the folks I interact with. The two that I do have a hard time with, ALL of us have a hard time with. 8. When in doubt, STFU. Taking ACLS and reading the ALS protocol book is about as useful as taking a week of karate. It's just enough knowledge to get you or someone else seriously hurt. And if you freak my patient out by questioning my judgement based upon that, you're definitely not going to be able to afford medic school, because unemployment doesn't pay that well. Discussions aren't taken in front of the patient. If something needs to be talked about, we leave one crew member with the patient, and go out of earshot to discuss.

Well-stated, Dwayne!

Okay, enquiring minds want to know... What is a regimental bath? I have a picture in my mind, but please say it isn't so...lol

I understand exactly what you're saying Anthony. I'm just a huge proponent of there are a ton of opportunities out there, both educational and career-wise, just waiting to be taken advange of. I guess it depends on the comfort level of the student how far they want to take things. I'm almost ashamed to say that it's taken this long for the medics to "bully" me into going through paramedic school. But that doesn't mean I haven't been trying to better my skills in the meantime. I'm ready and looking forward to the challenge!

"incognitogirl, I do have a simple question that will determine much in this discussion. Do you believe that 110 hours of training with 2 hours of anatomy and physiology and 1 hour of pharmacology is enough time to make, what is in essence (i.e. highest medical provider providing care to a patient without direct oversight), an independent medical provider?" Okay, since I started this mess, it's time to jump back into the fray again... To be fair, I can understand the frustration that Incognitogirl feels - even though I'm not one of them, I know a lot of BLS providers that feel the same way. Being an EMS instructor, I feel that the standard EMT class is enough to get a student started out in the field. It's the student's responsibility to keep learning new skills, such as taking PHTLS, BTLS, GEMS, etc. I'll probably get crucified at this point, but I've begged one of the EMS chiefs that runs the ALCS and PALS courses at our local hospital to allow EMTs to sit in on them - not to be able to practice the skills, of course, but just to have MORE knowledge and understanding of the theory behind the skills. If your skills are that good that you're getting noticed and encouraged by the medics to do something about it - DO IT!

I would like to sincerely apologize for unintentionally offending (for the title) - that was not my intent. I have a stack of paper about an inch thick with various classes, courses and any other offerings I could get my hands on to better myself as an EMT and provider. I have asked, in a polite way, why a certain treatment is being performed only to be told that "you're ONLY an EMT and should stick to what you know." I am not an FEOE, and at the risk of sounding unlady-like, I don't get into "pissing matches" with paramedics or anyone else - I know my boundaries and I think it's unprofessional to do so. The medics I had asked about are the dregs that even the other medics don't like working with due to their reputations. Unfortunately here, probably like everywhere else, there is such a shortage of medics, employers hold on to whomever they can, be it good, bad or indifferent. But that's a different topic all together. I was merely asking if anyone had a different or more effective way to handle situations like this.