akflightmedic

There has been much debate over pharmacists objecting to the morning after pill or even simple birth control pills and whether or not they have the right to refuse to dispense it due to their religous beliefs. However, now there are proposed bills that extend this right to refuse protection to all health workers. Is this fair? Is this right? I dont know but I would like to hear your views and possible pros and cons. For me, I dont like the idea that when I call 911, the paramedic that responds may decide not to treat me based on his or her personal beliefs. I should get the standard of care despite our opposing views.

For example, most of you know how I feel about christianity and organized religion. However, one time I delivered a full term baby in my rig that died minutes after being born. This was an expected death, the mother knew it would happen and they had requested no heroics be taken. After the delivery, the mother was insistent that the child be baptized before dying. What was I to do? She asked me to do it for her. So I obliged. I opened sterile water, sprinkled the baby and said a few words along with her. She was happy and thankful. The kid was baptized and now I was free to work on the mother. Now obviously, I was in no way obligated to do any of this for her, but I ask myself...why not? What I did, did not change my convictions one iota but it just made one patient eternally happy because her child was saved. I think sometimes in this world, we forget that it is not all about us....it is about the patient....AK

Laws would allow health employees faith to affect care

State measures may shield workers refusing to give certain treatments

By Rob Stein, Washington Post

WASHINGTON — More than a dozen states are considering new laws to protect health workers who do not want to provide care that conflicts with their personal beliefs, a surge of legislation that reflects the intensifying tension between asserting individual religious values and defending patients rights.

About half of the proposals would shield pharmacists who refuse to fill prescriptions for birth control and morning-after pills because they believe the drugs cause abortions. But many are far broader measures that would shelter any doctor, nurse, aide, technician or other employee who objects to any therapy. That might include in-vitro fertilization, physician-assisted suicide, embryonic stem cells, and perhaps even providing treatment to gays and lesbians.

Because many legislatures have just convened, advocates on both sides are predicting that the number debating such proposals will increase further. At least 18 states are already considering 36 bills.

Its already a very hot issue, said Edward Martin of the Americans United for Life, who is advising legislators around the country pushing such bills. I think its going to get even hotter, for lots of reasons and in lots of places.

The flurry of political activity is being welcomed by conservative groups that consider it crucial to prevent health workers from being coerced into participating in care they find morally repugnant — protecting their right of conscience or right of refusal.

This goes to the core of what it means to be an American, said David Stevens, executive director of the Christian Medical & Dental Associations. Conscience is the most sacred of all property. Doctors, dentists, nurses and other health care workers should not be forced to violate their consciences.

The swell of propositions is raising alarm among advocates for abortion rights, family planning, AIDS prevention, gays and

lesbians, the right to die and others who see the push as the latest manifestation of the growing political power of social conservatives.

This a very significant threat to patients rights in the United States, said Lois Uttley of the MergerWatch project, who is helping organize a conference in New York to plot a counterstrategy. We need to protect the patients right to use their own religious or ethical values to make medical decisions.

Both sides agree the struggle between personal beliefs and professional medical responsibilities is likely to escalate as more states consider approving physician-assisted suicide, as embryonic stem cell research speeds forward and other advances open more ethical fault lines.

We are moving into a brave new world of cloning, cyborgs, sex selection, genetic testing of embryos, Stevens said. The list of difficult ethical issues involving nurses, physicians, research scientists, pharmacists and other health care workers is just continuing to increase.

Most states have long had laws to protect doctors and nurses from being fired, disciplined, sued or facing other legal action if they do not want to perform abortions.

Conflicts over other health care workers emerged after the morning-after pill was approved and pharmacists began refusing to fill prescriptions for it, with the result that some lost their jobs, were reprimanded or were sanctioned by state licensing boards. That prompted a number of states last year to consider new laws that would either explicitly protect pharmacists or, alternately, require them to fill such prescriptions.

At least seven states are considering laws that would specifically protect pharmacists or pharmacies.

Every other day I hear from pharmacists who are being threatened or told they have to sign something that says they are willing to go along with government mandates, said Francis Manion of the American Center for Law & Justice, which is fighting an Illinois regulation implemented last year requiring pharmacies

OMG, I do that all the time...The crumbs compliment my buthole peanuts....

The person below me pees in the shower...

Partner 1 to partner 2: Where do you want to go for lunch?

Partner 2: Chinese?

Partner 1: No, I always get the sh its when we eat there.

Partner 2: Lets go to Arbys!! They always give us 50 % off too.

Partner 1: Great Idea, I am a little low on cash as well. Plus, thats where that hot chick works the counter. Man she is sweet.

Partner 2: Hell yeah, man she is smoking hot. I would do ....this and t...that, etc.

Phone rings in the background...

Partner 1: Hello..Hi Chief, whats up? Yes, we are almost at Arby's, how did you know? Oh shit! Oops I mean...

After mic is unkeyed, partner 1 says to partner 2: Umm, we have to go HQ after we grab our lunch. Chief wants to talk to us.

Yes people, I was there...one of these clowns was me. I had the mic laying on my seat and evidently my leg was depressing the key. This was pre 800 mhz days, so it was broadcast all over the county. Everyone heard it.

When are these 6-7 classes going to occur? Will they be scheduled around your school schedule? Sounds unlikely they would only have class days on your assigned shift which is predominately the weekend.

This schedule sounds very demanding...I would give it a lot of thought before jumping in...but only you know the answer.

For one- I can feel the vibration of the car, and two a loud screech in the background would make anyone jump.

WOW, not debating the extra senses of the hearing impaired but holy cow...How do you function feeling all those vibrations all the time. Very Impressive. Some women would never leave the house if they had that ability. To say you on a scene of a MVC and while tending to your patient, you can feel the vibrations of an approaching vehicle...How are you going to know if it is coming towards you or not? There are cars zooming by every second, seems like you would be looking around more than tending to your patient. As for the screeching of brakes, again I say I have video where there are collisions and the brakes are never touched until after the collision.

As for sue happy world world - no I would never sue my employer doing so would one- make it that much harder for the deaf to get jobs, even low-paying next to do nothing jobs. And two yes I understand that I am taking quite a risk with everyone involved, no I wouldnt hide my hearing-impairment from my emplyoyer, but I wouldnt outright just walk up to them and say - oh by the way Im deaf!

You never know what you might do until you are in that situation. I have done things I thought I would never do until forced to do so by life's curve balls. And not singling you out, but if an employer allows for one, he must allow for all...therefore an employer should set the precedent of standarized pre employment hearing exams. You state you wouldnt hide it, but you wont come up and volunteer unless asked. You are contradicting yourself. You have an obligation to let your employer know of anything that may inhibit your work which directly involves patient care. We are talking about people's lives..yours, your partners, patients, employers business when he or you get sued, etc. By remaining silent about your condition, you are in effect, LYING to your employer. I know it is a standard question on most applications that says "Do you have any disabilities that may hinder your ability to perform the work or duties..blah blah blah"...if you answer that dishonestly, and they find out later, they can terminate you. So , now do you sue, since you lied and are out of a job and the rent is due, your kid needs food, etc...

As for having sinus problems, and such, I think everyone has days like there where their own hearing isnt up to par. So could you be held liable if you missed something critical if you were having sinus congestion that day? Everyone should be held liable for missing a critical element in their asessments. Shoot Im sure there are days your congested enough that even you have trouble hearing.

As a matter of fact, YES. If I mss something due to an illness, I am still just as accountable as if I didnt have the illness. If I come to work, I am telling my employer that I am fit for duty that day and I have no problems performing my job. Illness is no excuse for missing a critical assessment. In fact, the county I used to work for in Florida, had it in our contract...It was a punishable offense to show up for work ill...you hear that? They wanted us to call out if we didn't feel up to par. If you came to work sick, you could and would be written up and sent home.

As for the comparison to glasses and deafness, no comparison...

You have gone back and forth in your argument about hearing imparied(deaf) and hard of hearing. Yes there is a difference. This post started about a DEAF person, not hard of hearing. You have called yourself deaf and hard of hearing. Which are you? Regardless of which, I am in favor of preemployment screenings which is quite the standard in most progressive departments.

Rid we are here for you man.....

I will start the countdown

362 MORE DAYS AND COUNTING....

I am proud of your accomplishments and adaptabillity to your situation. Now I must play devil's advocate...

What happens the one time you miss something? You totally miss some critical assessment or intervention due to your hearing not being up to snuff that day. You have a sinus infection and your ears are worse than normal or you just plain miss something. Who is liable? You are... for deceiving everyone by hiding the fact from your employers, coworkers and most importantly your patients. But in this sue happy world, the employer would also be held just as responsible for not administering a hearing test during the employment process. In the few states where I have been licensed, it is standard practice to gain admission to the EMT schools first and to most emplyers to complete a full hearing assessment along with vision and medical tests. The testing process serves a dual purpose, same as our back screening and hepatitis screen. It serves as a baseline for you upopn entering the career. Who is to say 10 years from now you may get a wild hair up your butt and decide to sue your employer for hearing loss incurred on the job. How can he defend himself? He can't cause he never established a baseline. But this screenig also protects you as an employee, vice versa.

What if we were working a wreck on the side of a highway and a car careens out of control and is heading for you. I shout, telling you to move but you dont hear me because you have learned to tune out background noise in order to serve your patient. This scenario happens a lot, I have the videos to prove it.

I could sit here and come up with many safety and situational awareness scenarios where limited or no hearing could be a major hinderance for you AND your partner. Remember, just because you are willing to compromise your safety to do what you love, does not mean your partner should as well. It isn't all about you and equal rights...

I knew you would have something more intelligent to say.

I chose 21 as an age limit for a MEDIC...not an EMT, in the hopes that setting that age would enourage those that really want to do it to become an EMT and get the experience before proceding to medic level.

That is my reasoning in a nutshell.

But yes, I agree wholeheartedly on the education issue...

Awesome reply Dust. Made me laugh and start the day off right. Good job!

Now as for the topic at hand, I agree with Dust...Finally, yes thats right..I said I AGREE with Dust.

I think a minimum age of 21 for paramedic is necessary(only exception being the US Military) Cause if you sign up, you deserve to get whatever training they provide.

As for a maximum age, there should not be one provided they can pass the same agility tests for the job and are able to function fully as part of a 2 man team. I have 2 examples of this situation.

There is a mobile home park retirement community in Florida(big surprise there) that is made up of very active seniors. They are on the outskirts of the ocunty, so for years they had slow response times. They raised money, bought an ambulance and started their own rescue squad with the counties blessing and some traiining. They do very well and I was impressed with the level of care they provided. They went back to school and became EMTs.

The other example is a great man that I enjoyed working with anytime he showed up. This man is the oldest registered active paramedic in Florida. He is a retired merchant marine and also retired from some other career. He became a PARAMEDIC at age 67. He is now in his mid 70s and runs calls all the time. He even participates in our quarterly physical testing exams and does quite well. I would hate to see an age cap prohibit someone like this from doing what is in their heart.

wow, Scotty started it. Digging up months old posts. We must be bored, have nothing new to talk about.

I am IMMORTAL>>>HAHAHHAHAHAHAHAHA

I am...Butt Whore.........lol

Everyone has contributed nicely to this debate. There have been excellent responses both for and against. But alas, time is up. We must not beat this dead horse any longer and we should move on.

We are getting off topic and beginning to attack.

Thread locked....AKflightmedic

I forgot racemic epi as well and tetracaine eyedrops and rocehpin.

Who is carrying Dilaudid??? Wow, they must have a hell of a service. Got some of that stuff when I had kidney stones, good drug,,,works very well.

Acetazolamide

Acetylcysteine (Mucomyst)

Adenosine (Adenocard)

Albuterol (Proventil, Ventolin, salbutamol)

Aminophylline --no

Amiodarone (Cordarone)

Amrinone (Inocor) --No

Amyl Nitrite

Ancef

Aspirin

Atropine Sulfate

Calcium Chloride

Dexamethasone (Decadron, Hexadrol)

Dextrose 50%

Diazepam (Valium)

Diltiazem (Cardizem)

Diphenhydramine (Benadryl)

Dobutamine (Dobutrex) --NO

Dopamine (Intropin)

Droperidol(inapsine)

Epinephrine (adrenaline)

Etomidate (Amidate)

Fentanyl (Sublimaze)

Flumazenil (Romazicon, Mazicon)

Furosemide (Lasix)

Glucagon

Haloperidol (Haldol)--no-but ground service in FL did

Hydroxyzine (Vistaril) --no

Ipatropium (Atrovent)

Ipatropium/Fenoterol (Duovent) --no

Ipatropium/Albuterol (Combivent) no

Isoproterenol (Isuprel) no

Ketorolac (Toradol)

Labetalol (Trandate, Normodyne)

Levalbuterol (Xopenex) no

Lidocaine (xylocaine)

Lorazepam (Ativan)

Magnesium Sulfate

Mannitol (Osmotrol)

Meperidine (Demerol)

Methylprednisolone (Solu Medrol)

Metoprolol (Lopressor)

Midazolam (Versed)

Morphine Sulfate

Nalbuphine (Nubain) --no, service in SC did

Naloxone (Narcan)

Nifedipine (Procardia)

Nitroglycerine (NitroStat tablets, Nitrobid paste, Nitrolingual spray)

Norepinephrine (Levophed)

Oxytocin (Pitocin)

Pralidoxime (Protopam, 2-Pam) --no

Procainamide (Pronestyl)

Prochlorperazine (Compazine)

Promethazine (Phenergan)

Propranolol (Inderal)

Rocurnium (Zemuron)

Sodium Bicarbonate

Succinylcholine (Anectine)

Terbutaline (Brethine, Bricanyl)

Thiamine (vitamin B1)

Vasopressin (Pitressin)

Vecuronium (Norcuron)

Verapamil (Isoptin, Calan)

Also carry Zofran, sodium thiosulfate, tenecteplase, Heparin, aggrastat, insulin activated charcoal, digoxin, lovenox,cerebyx,nipride,pitocin, ..I think that is all I have ever carried with any of my jobs....I put No beside any of the ones that I had not carried, so all the ones unmarked I have or do carry.

WHO ADMINISTERS THE NATIONAL CERTIFICATION??

Ummm, how about the National Registry.

http://www.nremt.org/about/nremt_news.asp

Here is their link and surprisingly enough, it has all the information you need. I say this again to anyone who reads this. DO not rely on secondhand information in forums with regards to your certification when obviously you have a computer and internet and can access the cold hard truth with a simple click of the mouse.

The site tells you which states do and do not accept NREMt, if you need to redo the course or not, and if that doesnt help, they also have email and phone contact information so you can call yourself.

My recommendation is that you redo the course, you have been out too long. Of course, I dont know where you could go anyways without redoing having been expired that long, but hey I dont know for sure, so I would suggest looking at the site.

Click on the link in the first post and you will see the dates...

BUMP...BUmp BUMP

Now that Xmas is over, start saving again for the trip[!!!]

I think we have made our points and like I said before in a previous post, for every procedure, medication, intervention, or whatever, we can find a dozen studies for and a dozen studies against. WHo is right or who is wrong...who knows? But it certainly isn't the first time we have proceded with flawed knowledge. I personally think the ends justifies the means in this case. The CISD has benefited me and I have seen it benefit close friends/co workers. Will it help everyone, probably not, I never made that claim. Another claim I never made was the use of amatuers in this sensitive area. Several times you said amatuer this or amatuer that. I agree with you, an amatuer should not handle a CISD. Here are a couple of links for your reading pleasure. There are just as many studies here promoting CISD as you can produce debating it. Guess it depends which side of the fence you are on. The studies range from the early 70's to the current times. No matter what study you produce, I personally will never change my opinion because I have benefited first hand from a properly handled CISD. Never is a strong word for me to use, but I know that I will stand fast by this treatment regimen for my lifespan. Other than us bouncing back and forth studies that is going to change neither of our minds, I think we should let it die as it does nothing but form negative impressions of the entire process in newbie's minds and may prevent them from reaching out at a time when they truly need it.

http://www.icisf.org/articles/

http://www.icisf.org/articles/Acrobat%20Do...se_of_Field.pdf

I will post my questions and comments with the understanding that I have absolutely no clinical psychological training nor do I have any hard stats, studies or figures to quote at this very moment. I for one am pro-CISD, I have seen it work many times in my personal experience and I have seen people who were unsure of it at first become very thankful that they did it later on.

now the questions I will ask purely to stimulate conversation not debate are:

A quote was made of treating the pt and not the disease. Do we want to wait until the disease is present before we try to fix it, or do we want to prevent it from ever happening?

Not saying CISD will prevent all bad things from occurring, but do we want to lose even one coworker to ETOH abuse, drugs, suicide or even something that seems as benign as "marriage problems' , all becasue we didnt feel it was neccessary to help them out mentally.

It seems to me that this is a nice prophylactic treatment and like all vaccines or drugs, some people will experience adverse reactions, however this is a minimal percentage of the population so it is safe or recommended for most.

How do we quanitfy whether or not a CISD helped or didn't help. Since we are possibly preventing a series of misfortunate events secondary to PTSD, how can we say it didn't help. If the treatment actually worked, we can not say it didn't help because there is no way to know what may or may not have happened had we not treated.

So basically, I think it should always be made readily avaliable and encouraged. Those that need it will use it and hopefully those that have not used it will try it.

Just a small comment, but the presentaion of the CISD is most critical. It sounds as if many of you have had some bad experiences which unfortunatley has left a sour taste in your mouth with regards to CISDs. The ones you guys have described have sounded most inappropriate and I would probably feel the same had it occurred to me. However, I do not think you should criticize anyone that requests one nor should you think any lesser of them for choosing to do so. If your partner asks for one and you were on the call and you feel fine, you should still attend and support your partner. We need to take care of each other out there cause no one else is going to.

For those of you that have trotted over and through dead bodies, babies and just been to hell and back....we all have been there one time or another in some form or fashion of our own personal hell, I am glad that you are ok and do not need anything to assist you--some people are just not as strong as you and nor should they be. We can not all be perfect...

If you want to have a happy marriage, never come home early without calling and never check to see if the hood of the car is hot when you get home....

I just want to bump this one. If you read closely, you will see this is three different venues merging. EMS expo has been the largest expo in the country. It is normally held in New Orleans, but due to obvious reasons, it is now moving to Las Vegas. This event is going to be huge!

Hey Guys and Gals

Fire Expo and EMS Expo are merging for 2006. This is going to be huge. Plenty of time to save for the trip, plus you can write it off. No excuses this time. Put in your vacation requests, stop buying lattes from Starbucks, skip a movie or dinner a few times a month and save your money!!

http://cms.firehouse.com/content/article/a...46&id=45692

I want to see everyone there...that includes Admin!!!

???????????

What's NASCAR????????

I too have purposely chosen to not comment on this post. I want people to like me for the jerk I am, not what I do or do not believe. While I thoroughly enjoy a good debate and will even take the losing argument just for the sake of a debate, this thread is a BAD IDEA.

PLEASE let me be the thread killer for this topic.

I still have respect for everyone here and I wish us to remain friends. This is not a topic to be discussed here.

PLEASE< NO MORE RESPONSES!!!