cdemt5710

:oops: Got to the scene of an assisted living home where a visitor had fallen and struck his head on a concrete floor and had swelling and a sizeable laceration. I was assessing him and asked if he was experiencing blurring of vision. One of my crewmates nudged me and said "hhhmm.. he's blind, remember?" Yeah, we had treated him in the past. Even worse was the fact that I knew him personally. He was not offended and ribbed me about it. Still felt like the numbest moron around for a bit....

Dust......I commend you for choosing a community which meets your EMS standards. That's plain smart and I hope you don't travel much..... not in the rural U Sof A anyway.... (or some remote parts of Canada.... like that would be anywhere off the Trans Canada Highway....) hmmm..... reminds of this one time I was in an MVA in BC (my youngest daughter suffered life threatening injuries).... 45 min. response time by both paid amb. services responding, we just happened to be mid way between the two cities..... another 45 min before we got to the ER..... etc. etc. etc. I thought the passerby with the cell phone was a GOD..... I was that grateful for ANY help at 11:30 at night on a relatively deserted highway. S... happens and it often doesn't happen where and when we want it to... (its habitually unpredictable)...... it is not a perfect world... EMS or otherwise. A lone volunteer firefighter showed up and provided scene lighting, radio contact with the ambulances... etc... I joined my fire department to pay that kindness forward.... and I would still like to get paid for the EMS work I do. Maybe, with enough effort on everyone's parts, volunteer and paid EMS alike, communities will move toward paying their EMS personnel (within a reasonable time) and pay rates will be equitable so an EMT can earn a decent wage no matter where they live ( ain't no one around here making $60,000.00/yr as a medic and only working 42 hrs/week that I know of.... not even FF/EMT-Ps). So, if I understand y'all correctly, your wish is that all communities within the US and Canada and Australia and .... all countries not mentioned yet... etc...... provide reliable and professional EMS service and do so by compensating EMS personnel with an amount of money reflecting their education and ability. If this is correct, then I have to say I support your endeavors. I don't agree with everything that has been said but essentially agree with the goals. I maintain the perspective that this will occur more readily if everyone works together to acheive the same goals ( kind of like the heart....... works much better when its not in V-Fib....) You've heard that saying.... tell me you have.... you can see it coming...... Aw c'mon. you know the one I mean okay.... United we stand blah blah blah Have a good week.... stay safe,

:-({|= So, this is on the verge of becoming boring....... Oh, sh.., I guess maybe it already is. Obviously the solution is for everyone to work toward developing a paid system in their community. I'm not keen on going on withdrawing services for a day to prove a point. Dust....that would be the day your mother went into cardiac arrest and then you would be really pissed.... So, back to the suggestion to stop blaming the volunteers who fill the niche created by the screwed up system. You know what its like when you are confrontational with a patient. They get defensive. So do I. So what about using some of the active listening skills that you might actually have, being paid and all, and use some creative thinking. Get the volunteers on your side. Sweet words work better than bitter ones. This is an obvious dilemna everywhere around here, except Canada with its socialized medicine paying for services folks have to fork out big time for here (didn't someone mention that socializing medicine is the only way this problem will be resolved). Every volunteer I know would rather be paid. So join forces with us instead of fighting us. Maybe you'll have better luck by sifting through and finding who your allies are before you make blanket statements about all volunteers....](*,) yaawwwnnnnn..... I feel like I'm having a deja vu.......... so sleepy....... z z z z z z z

Unthawed.... "wait until the ground is unthawed before planting..." When should I plant? next Dec.?

Just want to defend myself. I was quoting the person who originally said 'volunteers are the death of..." on the first page of this topic. I am a volunteer and am grateful that we have a kick ass department with highly skilled providers. I totally appreciate the career EMS personnel in our surrounding area and train and work with them regularly. And will reiterate..... it is an evolving profession. And evolution takes time. I am naive. Until now I had no idea that there are cities out there that have a solid tax base and still choose not to have paid EMS or Fire services. Our town of 2500 residents is working toward developing a paid department. Slowly. In the meantime our EMTs and Firefighters continue to go to our paying jobs and then spend much of our free time keeping our skills up and training. I will be thrilled when I begin receiving a paycheck for the calls I go on. And proud as I am of the training and education I have worked hard to acquire, I can see I will have to be careful who I share that pride with. What a shame that is. What about directing all your angst at the system which is so obviously flawed. Somehow blaming the people who are filling the niche created by the screwed up system seems counterproductive. Effect a change by lobbying in the places where your well thought out ideas will make an impact. Get together with your fellow EMS providers and develop and present your information and a plan that will work. Its understandable that you feel the need to vent, but maybe you could take all that energy and do something constructive with it. Like work to develop educational standards that raise you to the level of "Professional". However you choose to adress this will affect the climate in which the EMTs that follow you will work.

As long as we have volunteers that make up a great portion of this job, it will never be considered a profession. It can't be. Volunteers are the death of this profession.. it has been seen and proven. We could put the shoe on the other foot and say that Paid services are the death of volunteerism and are creating a situation where all us dedicated volunteers are losing opportnities to keep our skills up in a profession where we have also paid out of pocket for our training and spend many hours getting CE credits above and beyond our 40 hr/week jobs.. whew..All a matter of perspective, isn't it... :wink: As a volunteer I can't be the death of this profession.... it is going to continue to grow at its own pace. Consider the age of EMS as a profession in this country. (And I am referring to volunteer and paid EMTs and Medics as professionals. Whether you are paid or not does not make you a professional.... we've all seen this.) This topic reminds me of my teenagers when they were new drivers. The impatience, the eagerness, the frustration. The unavailbaility of the car was the source of much consternation. What about ditching the blame game. EMS is evolving. Rural departments, such as mine, rely on volunteers due to low call volume. (We cannot afford to staff the station for 5-8 calls/ per week, with many being non-transports or good intent calls etc. etc.) Response times are long, due to the Sq. Mi. we cover. Our town is accepting that they have to pay us something, so we will be paid per call. Maybe that would be the next step for these larger services, which would make the transition to being a paid service more palatable. Early on someone mentioned Grants. There are monies out there to help services take that next step. What I see is an evolution. We will all eventually be paid in areas where the tax base is able to provide the monies. And certainly no volunteer service should keep their heads in the sand about this. That there is such divisiveness between paid EMS and volunteers is a real shame because we are all doing the same job. We all get up out of our nice warm beds to help people we may or may not know. Hopefully we all do this with respect and some compassion. I am very fortunate here in my neck of the woods. We work with many paid departments. Most of the members of those departments volunteer in their own towns. We work together on mutual aid calls. We are members of the same association and we respect each other's work because we have an understanding of the challenges we all face. That is probably the key. Trying to see the other person's point of view. (Kinda like being back in KG and learning how to get along with all the other little kids...)

:toothy8: Or maybe we could send the cops to school to become surgeons and then that would be that! just kidding. Probably that small town hospital that can't justify a surgeon on staff all night is located in a municipality and can't afford a bigger PD just in case the surgeon needs a lift. Could be the PD is tied up with the MVA that caused the ruptured spleen. Could be a tad unreliable..... just a thought.

:headbang: Lots of interesting comments generated. I guess I'm very fortunate in my service. There doesn't seem to be alot of discussion about who's job is more effective. There's respect for everyone's level of training from 1st responder on up. The paramedics rely on the Basics and I's to get things happening in a timely fashion. Everyone understands that BLS comes before ALS. We're a volunteer service so we don't always have a medic in town and ALS providers rely on the Basics to assess well and, yes, assist with nitro, administer ASA and everything else that has already been mentioned. Without a doubt, I would prefer good ALS if I had the chest pain. Good ALS.... oh, did I repeat that? Do Basics know a good ALS provider from a bad one? One would hope they would eventually. I have worked with a medic who spent 10 extra minutes on scene to start 2 large bore IVs on a trauma patient (she almost lost her life due to her internal injuries). I was a fairly new basic and I knew that was not good ALS. I've worked with excellent providers and slackers. I observe all the skills they use (naturally curious) and maybe I don't know if they administered the right med at the right time (but we'll hear about ift after), but I do notice when they do other things well. Because I get to ride with 2 excellent medics, and I have seen their assessments and because they teach as they go along, all of have us have some clue about what they are doing. And I pay attention to the way a provider will clean up their rig. If they're sloppy about that I'm going to assume they're sloppy about everything else. Lots of hints when someone is an "iffy" provider. We also tend to go over each call discussing what was done (if ALS), why and what can be improved on. Critical to do with a low volume volunteer department. Yup, I'm a lucky gal.

Personally, I wouldn't want ANY EMT-B dealing with my chest pain. Chest Pain is not a Basic call, and there is little of consequence they can do. And as a Basic, I don't feel that I'm slapping myself in the face, only apprpriately sizing up my abilities (and protocols).

Well, he's a naughty man, isn't he?!

:tweety: So, I was reading these posts, thinking..Hey, i know this term, I've heard it used before by a British friend...so I went to the best online encyclopedia and this is what I found.... Hmmmmm.... Dr. Bledsoe might not want to use this in England!!!! From Wikipedia, the free encyclopedia Jump to: navigation, search Look up wanker in Wiktionary, the free dictionary. Wanker is a pejorative term of British origin, also common in Australia and New Zealand, literally meaning one who wanks (masturbates). It is particularly used of someone (usually male) who is self-obsessed or a show-off. It has the similar meanings and overtones to the American "jerk" or "jerk-off". Although masturbation is now seen as a widespread and acceptable practice, the insulting properties of these terms still remain. The idea is not to draw attention to the fact that a male masturbates, but to emphasise that he has little sexual interaction with others and is left only with the option to masturbate. As with many profanities it is considered much less shocking today than before, but is nevertheless an insult. The idea can also be conveyed using a hand gesture involving curling the fingers of the (usually right) hand into a loose fist and moving the hand back and forth in symbolic imitation of the act of male masturbation. This is probably most common during altercations between motorists. Various jocular rhyming slang terms exist for wanker and wank, including merchant banker, Sherman (short for Sherman Tank), J. Arthur (J. Arthur Rank) and Jodrell (Jodrell Bank). Non-rhyming terms include 'five-knuckle shuffle' or 'spanking the monkey' [edit] Usage and social acceptability As with the word "jerk", the level of insult is dependent upon the situation. However, the use of the word in a potentially aggressive situation such as a football match can lead to much more serious consequences. The term wanker has not been considered profane in the United States because of its British origins, though most Americans nowadays are familiar with the term, as they are with the mildly profane Britishism "bloody". In the ribald American sitcom Married... with Children, the character Peggy's maiden name was Wanker; Al Bundy's in-laws were therefore the Wankers. An episode of Mork & Mindy also included a character called Arnold Wanker, though this aired before the understanding of the term was common throughout the U.S. and was less likely to be intentional, as the Married... with Children usage was. As most Americans are familiar with the term nowadays, such "incidental" uses as the Mork & Mindy example have declined. However, there remains an American brand of bottled beer named Wanker. In the UK, the term would not generally be acceptable for use in front of minors, and would most likely lead to some form of discipline for those who were to say it during daytime television in the United Kingdom. That said, an infamous out-take from the word game Countdown records a moment when both contestants offered the word wankers as their answer, much to the embarrassment of the host of the show, the late Richard Whiteley. A common use is in the phrase "The Referee's a Wanker", commonly chanted by football supporters to express disapproval towards a refree, almost invariably following a decision unfavourable to their team. Humorous uses are common; a notable example being the song I'm a wanker in the cult TV comedy Men Behaving Badly, or the line "[i'm] not a wanker or a banker" in Devo's Triumph of the Will. There is an obvious separation between the insult and the reality of the act. The term wanker has also been extended as a generic insult to cover self-aggrandizement or overly showy performance, specifically where the performer's impression of their own talent manifestly exceeds that of the audience. By extension, "wanking" can describe any activity which is showy but gives pleasure mainly to the participant, such as playing air guitar, free-form guitar playing or progressive jazz saxophone solos. A related but less common slang term is wankered to mean "drunk". This usage is almost exclusively found in the UK, primarily in youth culture. [edit] Other uses According to the 1990 Census, "Wanker" is the 53,492nd most common surname in the United States. [1] Retrieved from "http://en.wikipedia.org/wiki/Wanker" Categories: Profanity | Sexual slang

:tweety: Well, this is a loaded topic and there are alot of cynics out there! I can totally relate to emtek's dilemna. After 22 years of being a stay at home mom, raising 4 wonderful daughters and supporting my husband's career choices, I became an EMT-B and joined our volunteer fire department. This was a blow to my husband. Me, the organic gardener, granola muncher, nurturer, LLL Leader, lover of reclining with a good book and doing things my way. Now I was polishing my boots, going to training, quoting SOPs, talking about "the chain of command", leaving the family to make their own meals AND I wasn't getting paid anything to do it. (Still eating granola, though) He had a really hard time. He made negative comments, he scoffed at my department members because they weren't "educated" and he belittled the hard work I was doing saying it wasn't going to contribute anything. I almost left him. Not for the job. It usually never is about the job or the dress or the kids or the whatever. I think it is about the underlying stuff. Like he didn't know I had this penchant to polish boots (my army vet dad taught me how... reminds me of him), he resented the time I spent and enjoyed with people he didn't know, he felt left out but didn't want to be involved. Mostly he realized he didn't know me all that well. So it was the underlying issue that was the problem. After 22 (now 27) years of marriage, we didn't want to throw in the towel. We found ways to communicate. I set some boundries. I gave a little back (You're not going to go play that silly little piano piece in front of an audience, are you????) (it didn't work). I called him on his comments and made him explain them thoroughly. Its been rough but we are a stronger couple for it. My 24 yr. old took the EMT-B class and stood up for me. My other 3 daughters respect the stand I took and they respect him for becoming supportive. It took time. I learned to compromise. I stopped going on every call. I started turning my pager off when we were going somewhere. I'm still on the department, am just finishing an EMT-I class and started a full time paying job in another field. He knows that I have worked hard and given alot of myself because I believe in my department and believe in giving to the community. He rarely makes a neg. comment and is actually proud of me. We are evolving. Its a give and take and a marriage takes two commited people. Good luck. You've had kids...you know that nothing really good comes easily, there's usually a bit of hard work involved.

Valid question and one that no matter how old you are or how much experience you have, should be asked on a regular basis. Its how we will be prepared to evolve as professionals. I've seen a change in 5 years. More pressure to provide a higher level of care, more pressure to get a higher level of certification, more training hours required with less time and more media exposure, looming threats of bioterrorism, patients with home pharmacies via the internet, high tech recreational drugs, etc...etc...etc... The biggest challenge in the US, I think, is the threat of the big Lawsuit, so there is even greater pressure to document, document, document.

:tweety: Old, Schmold. 36 is YOUNG! Your skin doesn't sag, bones don't creak, not all stiff for the first ten minutes when you get out of bed. I remember 36. I was running after a 3 year old. This is easy compared to running after a 3 year old. I think 36 is a great age to start in EMS. A little bit of life under the belt. The motivation of an adult student. Maybe by now people have thrown up on you and bled all over in front of you so you know you can handle it. Still young enough to be up half the night.... I don't think anyone JUMPS into this career at 36. Certainly don't at 44... age I started. Chances are by the time someone is 36 they've done a few different things and watched tons of rescue 911 episodes.

:tweety: Medicnorth: I don't think those docs who ride on ambulances in Europe get paid what docs here get. So its not so expensive to pay them over there. Here, on the other hand..... but to the question of docs using L&S to get to the ER..... it might be a good idea, if they did all the training that's required to minimize the risk. Sometimes that light can save a LOT of time, like the day I was stuck behind a very slow moving car. I had a five mile drive to the station and was able to pass the car because the driver pulled over when she saw my lights on my aging Forester. Saved me almost 5 minutes responding to GET the ambulance (rural area). This might be the case for the surgeon and in areas where the only hospital for 50 miles can't staff a surgeon to sit around all night, it might be a good idea. Important to remember that a doc is not on call all the time, so keeping his EVO skills honed could be a problem. And there's the probationary period to consider. Who's going to supervise said doc as he learns the EVO skills. Its not about driving fast, its about the way we drive fast, and sometimes its not about driving fast at all... When I joined my dep't I couldn't have a light on my car until I had taken the EVOC class, been driving with supervision for 6 mo. and had proven that I understood the skills involved. I don't think there is a system in place to provide the same skills training for the docs. Besides, most of us might be in this business because we're adrenaline junkies and get a thrill out of the response. In the small hospitals I've been to the surgeons have to take a call rotation whether they want to or not. They like their scheduled surgeries and take the rotation so they can keep their privileges. So maybe its a moot point and just a great way to discuss why we can drive in emerg. mode and they can't. What about a Spyder with lights and sirens..... or a Lamborghini....just like in the movies....

:tweety: I agree with medibrat. And no one wants to be lied to if their loved one is deceased. When one of my daughters was critically injured (she survived), I wanted the straight goods. No lies. No false hopes. Just the truth. I think we're the ones who need to feel that we did everything possible. And in the case of definite death, everything possible is making sure the parents get what they need to deal with the loss of their child.

:tweety: A couple of good web sites are out there, including www.trauma.org. The best, I thought, was www.nyerrn.com, but it doesn't appear to be up and running for some reason. There are a few ER nursing sites which have links to lung sound sites, etc. I like them for the exposure to things I never see or rarely deal with in our low volume department. In our neck of the woods, far from any big centres, going to an EMS conference is a great way to learn and network. Getting together with neighboring departments for training and skills days is another way to stay current. Being self motivated is critical. No one makes us keep learning, but I found that getting with friends who are committed to keeping their skills up challenges all of us to work at being better providers. Plus, its a great excuse to ditch household chores.......did I say that outloud????

:tweety: Can't forget that some excellent providers are not good test takers. Some of the best EMTs I know with the best situational awareness suck at taking written tests. I have worked with them in the field and they are more competent than some of the better scorers on tests. As many people have pointed out in the past, the written test will tell us how good we are at taking the test. But a good provider it does not make. I would rather work with someone who failed the written test 3 times and is excellent in the field than the person who scores 98% but freezes when faced with numerous patients or is unable to control the scene or applies an NRB to bag someone.............