RavEMTGun

How do you personally make a determination between the two?

Ask: "do you really mean that"

I think some of the focus is due to a different in cultural values. For many of the later generation, spit-shined boots and polished chrome are not signs of being a good fire fighter. I had a Chief who demanded a full clean after EVERY time a unit left the barn. He used to say "I don't have any working trucks. All my trucks are parade trucks all the time." Who cares if you knew you had one hour before you would go out on your next call, get to scrubbing. The wheel wells had better bet clean too!

Did that make us good EMTs? Did that lead to better patient care? Not only no, but HELL NO! Spending 30 minutes cleaning road grime off the ambulance in the middle of a snow storm at 0200 was not a good use of crew time. They should have been trying to rest so they could be fresher for their next call. During the day, what makes a more professional EMT? Spending 30 minutes squeegeeing and shining the rig or spending 30 minutes reviewing cardiology?

The EMS mindset doesn't fit all that well with the paramilitary mindset except in those who are already instilled with it. EMS is flexible and dynamic and focused on the patient. The rig is a tool, not a decoration.

The above does NOT excuse what I saw to be TRUE unprofessionalism: not caring about the patient, not caring about understanding the patient, not caring about understand what was wrong with the patient, not caring about improving ones knowledge and skills, not inventorying/stocking, not deconning, leaving things for the next crew... That was from people who were burned out, in the field for the wrong reasons, or otherwise just of poor character.

I think 'crotchitymedic1986 makes excellent points.

I would say that pride in the people we serve is a very large part of professional pride. I admit, I have not been a good example in this area in the past, and I still find myself sometimes slipping into the mindset, but I think it's imperative that people in EMS work undergo a major attitude shift. How many times have you heard EMTs and Paramedics groan when dispatched to an address in a predominantly immigrant area of town? What about jokes about the "trailer trash" we often find ourselves serving? Griping about going into nursing homes, even though the vast majority of our patients are elderly? Treating people who don't speak English or geriatrics as if they are children, or too stupid to know what's going on? I did quite a bit of thinking about this last night, and I came to the conclusion that lots of our EMS slang is actually very disrespectful to our patients - "frequent flyer" for example. Sure, you could argue that it is supposed to reference people who call all the time for very minor difficulties, but I've never seen it used for someone like that. In my experience, the term has been used for addicts, the poor (who have no way to get to a hospital, and no way to pay for non-emergency care), people with mental disabilities, elderly individuals with chronic conditions, in short: the forgotten of our society. Personally, I'm going to work to purge that term from my vocabulary.

Here's a short list off the top of my head of things I have heart EMS and Fire Service workers either state in person or write about in various Internet media:

-Joking about sexually assaulting minors in the back of the ambulance.

-Joking about taking Spanish-speaking patients across the border and leaving them in Mexico.

-Saying that a homeless "frequent flier" should just die already.

-Saying that an incontinent elderly gay man must have been "quite a bitch" in his younger days.

We all have our moments of ugliness, when a cruel thought comes into our heads (yes, it's a natural human reaction to frustration and weariness, but that doesn't mean it's right), but EMS seems to be an echo-chamber for those thoughts and words. If the industry truly had pride in who it serves, such attitudes and language would be unheard of, and regarded as utter nonsense. In addition, an attitude shift to one of service and pride would undoubtedly bring a trend of EMS/Fire clamoring for more education. After all, with pride invested in our patients, we would want to be able to give them the best care possible, not just "good enough" care.

Yes a truly bad attitude that affects patient care must be changed, but you need to understand that offcolor humor and dark humor is a natural and healthy response to stress and keeps human beings mentally healthy instead of keeping them dwelling on difficulties. You don't say it in front of the patient or the public. THAT is unprofessional. Joking about that dead guy on the last call with your partner, that is a stress reliever and makes sure you are going to last mentally in the profession. When your mind wears out, all your other ideas of professionalism will wear out shortly thereafter.

Do many feel differently that I do when giving/taking points? That it's not based (as it is for me) on the quality of the post, or whether or not an opinion is expressed to the best of the posters ability, but that it's based on the popularity of the opinion??

I'm finding that many of the posts I see that have been given negative numbers simply have ideas that may not be popular, but that the posts themselves fulfill the standard set down by the Admin as well as the standards of many of us here. If this is KooK's experience, then why should s/he not say so that we can be exposed to this point of view and discuss it? And, if the above has been this poster's experience, then I believe that the opinion certainly belongs in a thread based on professionalism, right?

This post has good spelling, punctuation, decent grammar, actually used the accurate word 'derided' instead of resorting to 'treated shitty' or some such language, and expressed an opinion on behavior that is too often exhibited in EMS.

Can someone that gave a negative rating please take a moment and explain why you chose to do so? I'm not saying it was an incorrect thing to do, only that I don't understand it.

Thanks in advance.

Dwayne

Note: If I could vote for myself I immediately give this post a -1 for lousy sentence structure, but then give it right back for breaking the world record for the most commas used in a single post. But it's late, and I'm lazy, and I'm willing to take my beating rather than reword everything.

You were right on for a while... the reputation system enforces Group Think. Think like the group, get +1s. Think unpopularly, get -1. WE ought to be dealing with differences in ideas via responses with counterpoint, not votes as that is mental laziness. However, I'm not grading people on their english, either, so long as it is understandable and not painful to read.

I guess you, like me, aren't sure where to comment on this since the Reputation System thread was locked for I don't know what reason. I guess it makes sense to talk about it in the thread where questionable ratings are occurring.

Mom and Dad have different attorneys? One denies, the other confesses? These idiots are going to get hosed. I'd laugh, but I feel sorry for the kids.

but... but... but... Canada is supposed to EMS perfected or something! State run! The answer to all our problems!

Crap... now what do we aim for...

Whistler isn't a designated ALS community anyway. The only time you will see an ALS provider in Whistler is if they are there for a pick-up as a flight crew or are in as "Special Operations". ALS coverage in BC is abysmal at best with the north having the worst coverage of all. The last ALS unit as you head north in BC is in Prince George which is actually in the centre of the province.

Well I see that... but Whistler is just outside of Van by an hour... no ALS? Really?

What about Golden? Can I be an ACP there?

But yeah... this sounds like a typical day in nursing school.

That's not encouraging... can you expand on that?

Happy Mole Day everyone.

"Celebrated annually on October 23 from 6:02 a.m. to 6:02 p.m., Mole Day commemorates Avogadro's Number (6.02 x 10^23), which is a basic measuring unit in chemistry. Mole Day was created as a way to foster interest in chemistry. Schools throughout the United States and around the world celebrate Mole Day with various activities related to chemistry and/or moles.

For a given molecule, one mole is a mass (in grams) whose number is equal to the atomic mass of the molecule. For example, the water molecule has an atomic mass of 18, therefore one mole of water weighs 18 grams. An atom of neon has an atomic mass of 20, therefore one mole of neon weighs 20 grams. In general, one mole of any substance contains Avogadro's Number of molecules or atoms of that substance. This relationship was first discovered by Amadeo Avogadro (1776-1858) and he received credit for this after his death."

http://en.wikipedia.org/wiki/Mole_Day

Why would you take a class from an instructor you knew was bad?

I once drove 60 miles to a class to avoid having to take it locally from a known terrible instructor.

The results are getting more interesting! Either there is a selection bias with this forum or there is a response motivation bias to this survey. I'm guessing a little of both... sample size is still small...

I'm working on a baccalaureate degree in history. Although I fall in the 2-year degree paramedic category, I don't love EMS like I love studying history. I'm sure that will offend hard-core EMSer's but at least I'm honest.

How can anyone be offended by that? We should pursue our passions if we can!

It is alarming that you have those inadequacies in an instructor. I think firflymedics approach is the best way to handle it and p instructor's first post describes perfectly how your instructor OUGHT to respond.

Have you tried talking to her at all? What is it that makes you certain that you risk being booted from the course for asking questions?

I think the issue for some is education WITHIN the EMS field. Personally, my thought is that in order to address the problems we have in EMS require knowledge that is NOT unique to EMS- like management and leadership training. All the certifications in the world will not make you politically savvy or understand the processes involved in pushing an agenda.

Agendas are not easily pushed on vapor. If you want to win a political fight, begin the fray with as much ammunition as you can.

I'm not asking about specific EMS degrees, but about any higher education. My point goes more to the idea that some think higher education is too much of a burden for EMS. I hope to illustrate that many in the field already have higher education and so the leap may not be so far as some think.

51 views and only 7 survey responses...

However the responses so far are interesting!

I figured this would be interesting in light of recent education debates.

A truly educational and enlightening thread, if a bit sad.

I rather liked Saved. It died after one season... or a half season.

Wow... what at terrifying look into your system... and yet I still would love to be an ACP in Whistler.

Well, where are you located? Orlando has a number of CNA classes within driving distance. There are also two-weekend versions of the class. The one week version is 6 to 10 p.m. Monday through Friday. Costs about $300. I think the two weekend version one is both Saturday and Sunday, for two weekends. The CNA class itself probably wouldn't help you much on BSN application, but if you get your CNA license and work even part time, that gives you some healthcare experience. And when I talked to the admissions people at several nursing schools they said that one of the things that helps an applicant is prior healthcare experience.

Also of course - once you go apply for a job - it doesn't hurt to have references from the place you worked as a CNA. And that place might even hire you as a nurse.

The 16 week programs probably include phlebotomy and EKG, which the one week programs don't have. Not a bad idea to have those two skills!

It's a 56 hour classroom program in my state (+24 hours of clinicals). I guess that is why it takes longer here.

I wish I could find a one week CNA class here. I think it would look good on a BSN application... maybe?

Most of the programs here are 4-16 weeks long. I'd almost be worth it to fly somewhere for a week program because the amount of driving I'd do in the 4 week program... ugh!

The research shows that CISD on the whole is not recommended because while it may benefit a few, for most it does nothing or actually causes harm! Look for bbledsoe's article on the subject.

Been there. Done that. Got NOTHING good to say about it.

Fail.

You are making $14 dollars an hour because the Paramedic has not achieved professional recognition in legislative issues that concern the insurances. With over 50 different certs in EMS and all of them at a technician status there is no way for the legislators to even figure out what exactly a Paramedic is or does. This is not about advertisement. This is about achieving professional status that is recognized by the insurances. Do you realize that for the "tech" health care programs, there are only the Medical Assistants, Nursing Assistants and Paramedics left. The EKG techs have moved on to the 2 year CVT and the Massage Therapists are now petitioning for the 2 year degree in many states.

For goodness sakes it is only a 2 year degree that some are discussing for the Paramedic. But, it seems that it will be a long time with the reluctance that exists. Do you realize even nursing and RT are embarrassed by having a mere 2 year degree for entry into their profession? Thus, both professions are pushing for as many of their students to get the Bachelors. RT long ago saw the 2 year was going to be the minimum and started pushing people in that direction long before the change took place.

RT, SLP, OT, RN, PA, PT, NP and MDs are not crazy for getting degrees and lavishing in their professional status for reimbursment. How many of them still make $14/hour since their profession achieved that? And, while times are rough, do you know the number of people that are still willing to make the sacrifice to get a decent education?

You could also look at any other profession. Bookkeeping cert from a tech school or Accountant with a degree? How about teachers? Most require at least a 4 year degree to teach 1st grade and usually a Masters. But yet for the Paramedic we are content with 700 clock hours of training from a tech school. Cosmotologists, Massage Therapists, pet groomers and manicurists require 2x more clock hours than that for their tech schools. The fact that some even want to argue that is "best" for the patient gives the wrong message about EMS to those that hold the purse strings of reimbursement.

+100000000000

WTH is a semester hour? Every college I know of in the US uses semester credits... so a typical class is 3 credits meaning you meet for 3 hours a week...

Semantics. "semester hour" = "semester credit"

Most colleges operate on a 16 week semester and therefor, 1 credit = 16 contact hours. That is excepting labs where you usually get half credit for time spent... or less...

But I agree with Dusty... hours don't mean jack shyt if the instruction is piss poor. I know some colleges who I wouldn't trust the quality of their degrees at all but they're still universities and colleges.

No debate there. And certainly, poor instructor quality is a major issue in EMS.

But is time a worthless measure? ABSOLUTELY NOT

Take two equal professors and give one 48 hours to teach his students Algebra and one 16 hours to teach his students Algebra, guess whose students are going to be better (assuming the students are equal).

Now take two equal EMS educators and give one 200 hours and another 400 hours. I bet they can take that extra 200 and put a lot good information to help their students understand WHY they are doing what they are doing in the protocols which will make them better care givers. As well, they'll have more time for their students to do proctored practice. So all students being equal, which class is going to create the more competent provider? I'd place money on the longer one.

As it is EMS classes are too short to cover, for example, in depth pathophysiology. Wouldn't TIME to teach that be a GOOD THING? Or more advanced A&P? Or pharmokinetics?

And why are you opposed to 300 hours of education being the minimum standard? Is it not better than 120?

Great question. Actually, I said:

I'd rather see an EMT-B class that was 300 hours long instead of making the basic level of EMS a 300 hour EMT-I99.

I preferred 300 hours, but I'd rather have the 300 hours spent creating a provider with a smaller scope, but who understands their medicine better vs a provider with a larger scope who understands it less.

Of course the ultimate goal is to get the provider with the larger scope who understands it better. But that takes even more TIME, effort, intelligence, and ultimately money.