emtannie

Man...one of the things that makes me crazy is not having the time to participate fully in these discussions like I'd like, though I’m not sure I’d have had a lot to add to Annie and Michael’s discussion.

Ironically the discussion between Michael and Annie reminded me of possibly the best thread ever here, which also wasn't EMS related, but was religion based.

I think, or hope at least, that one of the reasons Michael, and LetMeSleep were discouraged by the attacks as opposed to the exploration of such a ridiculous post is that attacking, by it's very nature, disallows this type of discussion. See what we might have missed simply by wallowing in self righteousness instead of benefitting from the mental exercise of the dissection?

When these things occur I think we all benefit by wondering, “How can we explore this and end up better, smarter?” Instead of, “How can I most poignantly display by indignity so that everyone can see that I am very much better than this person?”

Outstanding discussion all...

Dwayne

Dwayne, I hope I am misunderstanding both you and Michael in thinking that you assume I am part of the "attacking" and "self-righteous indignant". At no time did I present a personal opinion of Baron's post.

Michael asked a valid question - I gave a possible answer, which I felt was an example of people making assessments in general.

Dwayne, you are right in your "how can we explore this" idea. Unfortunately, I have attempted to ask questions of the individual who was the brunt of most of this discussion, without success. I am also aware of other members who have tried to contact this member, also without success. I wonder if you and Michael have also tried to contact Baron, in order to understand this poster better, and if you have had a response. It would appear that we have met a dead end in following up on this one.

I do feel that part of the success of the forums is that people who post should be willing to support their posts, and be open-minded enough that we can challenge other's opinions and discuss it reasonably. Where the forum discussion tends to break down is when we get to the "I am right, and you are wrong, and you are an idiot for not changing your opinion" attitude, or when someone posts something which generates discussion between others, but does not return to answer questions or clarify their original post. I also feel that sometimes we forget that it is ok to agree to disagree; our EMS type A personalities tend to make us want to win all arguments sometimes. This has been a fun discussion so far!

Interesting…. When it is a noob that posts something that has been covered numerous times, they get the “use the search function” response.

http://www.emtcity.com/phpBB2/viewtopic.ph...ghlight=#177706

When it is someone who has been here a while, they don’t…. just an observation…..

There have been several threads regarding tattoos:

http://www.emtcity.com/phpBB2/viewtopic.ph...ighlight=tattoo

http://www.emtcity.com/phpBB2/viewtopic.ph...ighlight=tattoo

However, as it is a topic that gets a lot of attention, and boe makes a valid point that there are probably new people who haven’t read the previous threads.

I agree with Ruff – I don’t care what your tatts are if you are doing a good job.

There are services that require all tatts to be hidden while on duty, and this should be taken into consideration when you get your tatt, or when you are applying for a job at a specific service.

Some people take offense to visible tatts, although tatts are much more socially acceptable than they were 10 or 20 years ago.

I agree with boe – a well done tatt is a work of art, but you should be checking what the regulations in your service are so that you are able to follow them.

Letmesleep – I like your initial post, and your reply above…

I do want to respond to some of Michael’s comments…

Baron also posted in the funny section, and may have followed the OP's instructions more successfully than some who reacted to his post.

In order to link his post to the OP’s he had no choice – to assume that he did so in order to be funny is quite a stretch of assumption.

Sounds like his post isn't being judged on its own merits. Is that charitable, fair, or even rational?

In your previous post, you asked why people may take offense at a post – I gave a possible reason why people took offense. I would hope that you replied in a spirit of discussion, not in a spirit of argument. I find your questioning of rational to be interesting. When someone makes an initial assessment, that is what it is – initial – based on the few facts they have. If more facts arise that influence that initial assessment, it changes. What is rational to one, may not be rational to another, because they weight certain factors differently.

What happened to keeping an open mind until sufficient evidence is in? Isn't this forum designed to advance logical thinking and scientific method?

Again, initial assessment is in play here. If further information is provided which is relevant, of course opinions could, and should change. Given that the information is not available, decisions are made based on the information at hand… the same as when dealing with a patient – you always deal with incomplete information, and make decisions based on that.

Or he could give up on the crowd here, which sounds like what some people would prefer.

I suspect that you are making the very assumption that you accuse others of making.

Maybe I'm just in the dark ages of assessment skills, but it seems to me that a good way to begin learning what one doesn't know is to ask questions of the subject, which no one here has done.

I beg to differ… I had already asked for clarification on his blog, which at time of my prior post, there had been no response. I had also referred to that in my previous post. So to say that “no one” has done that, is incorrect.

Baron has every right to post here, as does everyone else. However, like everyone else, if he is going to post, he should be able to support and discuss his position and ideas, as you and I are doing. If he is unable, or unwilling to support his posts, then that defeats the spirit of the threads as areas of discussion and learning, and in some cases, just good entertainment.

How is taking offense at Baron's post different from taking offense at the first post?

The OP prefaced the thread with "have a sense of humor" and posted this in the funny section. The OP has over 100 posts, most of which are well thought out medical discussion. Many on this site have had discussions of both a medical and non-medical nature with the OP and realize that this was truly posted as a joke.

Baron has 2 posts, neither of which are related to EMS in any way. His blog gives no true background of him, and given the information in the blog, there is a significant discrepancy between what he writes in his blog, and what is on his profile (for which I have already asked for some clarification in his blog).

Baron also makes several sweeping generalizations in his post:

"The trouble with American men...." and "the "little Ladies"" as well as a comment which is considered by most to be offensive "To obtain sex upon demand and own a women who will obey meakly all your demands, take heed of the following rules (Its called the English system)." At no time did he add an emoticon or comment to show that his post was meant in jest.

You only get one chance to make a first impression..... so, not knowing this person, people base their impressions on what information they have, and many have taken offense, given the limited information provided. Baron could continue to post, which would provide the other members here the opportunity to get to know him better, or he could just prove to be the troll that he appears to be from his initial contributions. Until we see more of him, we won't know.

As those of you who deal with practicum coordination know, some students have completely different views of what their practicum should be than what is expected.

I have started a draft "Top 10" list for students.... of course, only partially tongue in cheek.... but feel free to add as you see fit.... My hope is to come up with an entertaining, yet effective list to post in the classroom for students to read on a regular basis....

Top 10 rules regarding student practicums:

10. Always show up on time, which means EARLY

9. your uniform is just that – a uniform – do not show up in running shoes, old t-shirts, ripped jeans, or ragged baseball caps – professionalism is part of your duties

8. Do not refer to your preceptor publicly as a “b*tch” “cow” “jerk” bastard” or any other derogatory term – it does get back to them faster than you can you can say DCAPBTLS

7. Do not book holidays during your practicum and then expect time off to go to the beach with your friends - during your practicum, you have no social life – get used to it.

6. Do not call with excuses why you cannot attend your practicum like “I don’t have enough gas money for my car” – this is not my problem, and shows a lack of planning on your part.

5. If you don’t know something, admit it – don’t make something up – it just makes you look worse. Then, learn it so it doesn’t happen again.

4. Make sure that you re-stock the ambulance as it is supposed to be done, and right after your call is completed, not after you go for coffee.

3. Part of your job is hall duties. If the rest of the staff is cleaning, you had better be cleaning. If you see something that needs to be done, do it. Sitting on the couch while others work is a guarantee your practicum will be over that day.

2. You should be spending any “free” time during shifts studying or reviewing areas you need work on with your preceptor. Students who do not spend their time wisely will be considered to know everything and will be treated as such until you realize you do not know everything.

1. Do not ask to be assigned to the location where your boyfriend/girlfriend/significant other works. It will not happen. And, do not sleep with your preceptor, any other staff member, the chief, or anyone else at your site including office and janitorial staff. If they are remotely related to EMS, Fire, or law enforcement, they are off limits until your practicum is over.

Any other ideas? Thanks!

I am not sure if this is the one you are looking for..... but enjoy anyways......

You and your son are in my prayers. I hope for a speedy recovery for him.

$550 for books.... is just part of the cost of education. I spent more than that each semester of university, and that was a long time ago....

You can pay the cost of education now, or you can pay for the rest of your life to be uneducated. In the long run, the short term pain of school expenses is worth it..

I don't think that AK is admin.... I think AK is admin's evil twin and they were separated at birth....

I don't think that Dust is admin.... Dust's conflict resolution techniques in threads are significantly different than admin's are.... and Dust pays to stay and play.... if he was admin, he wouldn't have to.

I can guarantee that I am not admin... I am far too trigger happy, and would have banned all the people who have annoyed me on this site.... (which is also why I don't carry a gun in my car - I have anger issues)..

Sis wouldn't tell a lie.... so I am considering the paramedicmike theory..... it has great potential....

REmember the volly service in Kentucky that shut their doors because the county would not buy them a new rig????

A bunch of whiners if you ask me.

Well they won, they got 30K out of the county for purchase of the new truck. The other 60K will be raised by donations.

It really does help if you whine really really loud.

I agree with mobey - this sounds like a union move. Arguing this just because they were vollies doesn't cut it - paid employees do this all the time.

I don't know about other regions, but it seems like the nurses here either threaten strike, or do strike about every 24 months. Support staff strike.. cafeteria staff strike. Don't airlines and postal workers tend to wait until December to negotiate so that they can use the holidays as a bargaining tool?

So this group decided that the only way to be taken seriously was to walk... I suspect they had tried to negotiate in good faith, and got nowhere... so they tried this.

The fact that they are vollies is a completely different issue...

Of course I missed you, you crazy nut! YOU STILL HAVEN'T SENT ME THAT WOMBAT :angryfire:

Glad you are back....

Has anyone other than me wondered why Phil hasn't been struck by lightning yet?

(although I will admit - I laughed at the joke....)

Actually I think that your job does require holding hands and allowing for someone to cry on your shoulder if you will allow it.

It's not in the job description but if you ask everyone on here if they have held someone's hand or let them cry on your shoulder then it should be.

I agree - I answered yes, because I included holding hands, or hugging a patient or a family member who needed reassurance. I believe part of my job is not just dealing with the physical issues a patient has, but also providing comfort to the patient and family members as best I can.

I also agree - anyone who touches a patient inappropriately should be taken out behind the barn and (insert appropriate punishment here)...

I think a sign that most of us see is the deterioration of enthusiasm for the job, and the lack of self-gratification for the work we do.

Most of us have probably worked with the partner who, when the tones go, responds with a loud sigh and groan, and upon hearing the nature of the call, mutters "geez.... another @#$%%$# old person" or similar comment. Upon arrival on scene, they go through the motions of providing care, but show no compassion or empathy for the patient, and give no comforting words or gestures to ease the stress of the patient. They show impatience when the patient cannot answer questions quickly or clearly, or the patient is slow to move when requested. The quality of their call reports has deteriorated from what they used to write, and their care and attention to the cleanliness and stocking of the unit is lacking. This person needs to evaluate why they are still in EMS, and consider a change in career.

I am researching different brands and models of AED's for public access use. They are to be installed in several locations in my community - the seniors centre, the pool, the arena, and the community hall.

I am familiar with the Medtronic CR+ and LP500, and the Philips Heartstart OnSite and FR2+.

Has anyone else used these models? Are there any Zoll or Cardiac Science models that you would recommend, or another brand?

Of the models you are familiar with, what do you like? What don't you like?

Thanks for your input.

Too funny.... gotta admit - his mom is a lot more open-minded than mine was.... I just got the "if you are living under my roof, you will behave... or else" lecture.....

I have shown the clip that Anthony posted to a number of my students, especially when I have high school students in my class.

I think the one that the OP posted is a good one too - unfortunately, shock value is the only thing some people will understand. If that is what it takes to convince people to slow down, and to buckle up, it is worth it...

Teens tend to think that they are immortal, and have that "it can't happen to me" attitude. I can't blame them... I was that way a thousand years ago too.... and the biggest deterrent was "I'm your mother, that's why."

I just hope that videos like this reach more kids.

Thanks for the links!

Within 10 minutes the "entire group" of employees, that's 6 crews sit down at table (am. change over) and they all have the opportunity to review the resume you have submitted. You have not been asked for your permission to share and unknowing that prior to this group interview that ALL would have access to all the information you have provided in confidence to the employer.

People have already commented on some of the other areas, but this is a paragraph that caught my eye.

Whether it is illegal or breaks any confidentiality laws or not, I feel that the passing around of resumes is not professional. An application provided in confidence should be reviewed by the supervisor and human resources, not the entire staff. Management and Human resources personnel are generally held to a higher standard of care, and responsibility regarding personnel issues than "regular staff". It only takes one slip for an employee to mention to a friend that "so and so" applied for a position, and then the friend mentions it to someone, and it gets back to so and so's current employer, possibly causing issues there.

And, to add my two cents to the group dynamic thing... if the entire staff is allowed to be in on the decision, who decides what the criteria is for hiring? There is the danger of the staff wanting to hire someone who is good at making coffee, brings donuts every day, or for the women to want the guy who looks great in uniform, or the guys to want the girl with big ****... I know this is presenting shallowness to the extreme, but it is possible. The wants of employees may be completely different than the wants of management. Perhaps management wants someone who can come in and be a leader, be a mentor, and push the other staff to improve their professionalism and skills. Perhaps the staff are happy with the status quo and don't want anyone who will disrupt their current situation. If this is the case, the group decision may not go well regardless of who gets hired, and the new hire will be the scapegoat for anything that happens.

I agree with MIke's comment - if it doesn't feel right, it's not... trust your gut...

WOW.... that is amazing....

First, document everything. Write down dates, times, and specific things that have happened. Ensure that you also write down who else was witness to any events. Make sure you document her taking the paperwork, that this nurse "as much as admitted it to me at the end of my 12 hour last night." Whatever she said or did that makes you believe she took it should be in your notes.

You have said that you are going to leave it with your preceptor for now. Now is the time to develop your plan of action for if, or when, you need to take action.

Is confronting her directly an option? I realize you don't want to do that at the moment, but if this doesn't get resolved, you may not have anything to lose. If you do talk to her, make sure you have several witnesses so that it doesn't become a "he said/she said/they said" kind of thing. If you decide to go this route, write down ahead of time the specific items you want to cover, and specific questions you want to ask. Make sure you have all your notes, so that if she denies things, you can say "on this date, this happened, and you said this, and so and so was a witness to it."

Is there someone other than the head doc that you can go to? Even head docs have supervisors. Is there an EMS supervisor above your preceptor? THe EMS supervisor may be able to give you advice, and work on your behalf.

I wonder if part of the reason she is doing this is because she is intimidated by your abilities, and possibly intimidated that the head doc is aware of your capabilities, and to make herself look better, she is trying to make you look bad. That is usually the underlying reason for events like this.

Keep your head up, remain professional, and don't walk up and punch her in the head even if you are tempted to. In the long run, she will do something to expose her true colors..

I wish you the best of luck - this must be incredibly stressful for you right now.

should all EMS training in its initial phases be purely didactic, or should they contain some form of hands on training & assessment as well - ie. with real patients, under supervision.

I definitely feel all education should have some hands on training and assessment. From Basic to Medic, there are always things that can be learned from hands on that can't be learned in a purely didactic setting. Hands on should not be limited to the scenarios that are in the classroom... you know the ones "you are called to a single vehicle rollover... yada.. yada.. yada.." That isn't hands on. I do feel that the classroom education is the basis for the hands on. Students should be learning the why, and the reasoning, not just "the textbook tells me I have to do this." Students need to see the practical application to their learning.

For example... I am currently teaching an EMT course with several other instructors (EMT here is the approximate equivalent to EMT-I in the US). The students had completed a lecture portion on MCI's earlier in the week. On Friday, we set up an MCI scenario on a back lot of the college, complete with injured and dead patients, and hazards. We have two complete ambulances at the college for training use. The students were assigned jobs, so we had 4 EMT's (2 per ambulance) and the remaining students were considered firefighters and EMR's. We started the scenario across campus so they had to arrive on scene, evaluate the situation, assess the patients, and delegate and deal with the patients as best they could, including transport back to the "hospital" (an area we had set up somewhere else on campus). A two hour hands on brought to life the lecture portion, and brought understanding to a topic that the lecture alone could never have accomplished.

Further, should this be repeated as each clinical level is obtained?

Absolutely. Each level has its own increased demands on your understanding, so that has to be tested in a field environment. For example... starting an IV on a practice arm is easy... starting one on the 86 year old female who is diabetic and dehydrated may not be. Students need to see that to respect and understand it for fully.

Now, for the downside of this.....

We all know medics/nurses/doctors/medical "professionals" who should never be put in charge of another person's learning experience. Finding quality placement of students can be incredibly difficult. Some of the best medics do not make the best preceptors. Colleges and universities have to walk a fine line in finding quality placements for those students. Overloading EMS services with students causes stress for the preceptors, burnout (aarrgghh... I can't take ANOTHER student"), and does more harm than good to both the service and the student. In our region, almost every service is in dire need of more medics. One of the problems we are facing is that colleges can't find enough quality placements for practicum rotations, and although we need more medics, we can't increase enrollment into programs because there just aren't enough places to put the students for their hands on portion of their education.

Speak for yourself. No agency worth a shyte schedules their people for those kinds of shifts. This is the twenty-first goddamn century. Only complete idiots have not progressed past the firemonkey roots of 24 hour shifts. If you are running those kinds of shifts, you probably work for idiots.

I was speaking in general terms... My service does NOT allow 24 hour shifts - the longest shift is a 14 hour; however, I have spoken to many on this site who work 24, 48, and even 96 hour shifts. It would appear to be not nearly as rare as we would like it to be. I never said I agreed with those types of shifts. My point was where do you draw the line at impairment? And how do you single out "impairment" as being only medication related?

I don't ever recall saying I was reciting scientific fact. We were asked for our opinions here. You have a problem with that?

Wow - the aggression tactic is less than professional. We are all entitled to our opinions here. We are also allowed to question others on their opinions in an effort to discuss a topic as adults. Relax Dust... Trying to get you to expand on your opinion and provide your ideas of solutions in more detail and practical application, other than "not hiring undesirables" is what I am aiming for.

Now, if you think I have a "problem" with you voicing your opinion, no, I do not. If you expect me to just blindly agree with everything you post on these forums, I will not. When I want more information, or you to expand on your opinions, I will ask. If you see that as "having a problem" then any respect I have for you and your opinions will deteriorate significantly.

I would rather have a medic who was on neither one of those. Why do our patients have to choose between levels of impaired providers?

So again I will ask.... where do we draw the line? Anything that alters brain chemistry makes someone unfit for EMS? Just consider... a partner who was at a wedding or a bachelor party yesterday and shows up today hung over/dehydrated/ill.... probably has altered his/her brain chemistry.. do we send them home? A female on birth control pills... or at "that time of the month".. all PMS jokes aside... quite possibly has a different emotional level than before... do we refuse to employ females? The guy who has decided to quit smoking... and is more than a bit edgy because of it... is that altered brain chemistry? Do we refuse to let them treat a patient?

It is easy to stand in judgment and point fingers, saying this person or that person is unfit... when it comes to patients choosing between levels of "impairment"... whether we want to admit it or not, our own services create this, regardless of medication. Consider the medic who has been on a 24 or 48 hour shift, and hasn't had any sleep yet. Impaired? Probably...

Singling out those who are on anti-depressant medications as impaired seems a little narrow-minded. If you have factual evidence that they can't do their job, that is a completely different story... but to just categorize them into "impaired" or "unfit" is a judgment which appears to be based more on opinion than fact.

OK, back to the original poster's request...

So I would like to see a series of well thought out posts from both EMT's and Paramedics. I am in a service where the general consensus is "A good EMT is as good as any Paramedic". Believe me i deal with it everyday, and I can tell you it comes down to the fact that these people have no idea what a paramedic is. Perhaps if I could get some well thought out opinions/facts from some experienced members here, I could help them understand why we need to go ALS, and some basics here could learn a thing or two as well.

Perhaps if we don't direct these posts at eachother, and just post generally, this will not turn into a mud slinging contest.

The point of this thread is to have a link to some quality posts, where we can direct newbies when they put their foot in their mouth, instead of derailing and locking every freaking quality thread that hits this forum.

Having worked in management, and working closely with the current management at my service, I suspect that some of the issue comes from the top. EMT's are told that they are every bit as good as medics from the top brass....

I realize that some of you are sucking in a great gulp of air right now... but let me explain further...

The bean counters look at the bottom line... They want the most for the least dollars. When Joe Bean Counter can put 2 EMT's on the road instead of 1 medic, Joe BC is quite proud of himself for doing his job and providing a service for less money. He has a degree in accounting, not a B.Sc. in paramedicine. He has no clue what the difference is, and at the moment, he really doesn't care.

Joe BC then comments to EMT Bob "You are just as important as paramedics" which Bob interprets as "EMT's are just as good as paramedics."

I have worked with medics who were less useful than a burnt out highway flare. I have worked with EMT's who were less useful than a burnt out highway flare under a snowdrift. I have worked with medics who I found to be amazing, insightful, compassionate providers who were more than willing to answer any questions I have had after the call. I have worked with EMT's who were also amazing; yes, they don't have the education, knowledge, background, and skills of a medic, but they are still very good at what they do. So don't get me wrong - I'm not saying EMT's are useless.

Part of going to a full medic system isn't just getting past the excuses listed by the original poster. It is changing management, budget committees, whoever the board or council is that controls funding.... we need to change them from looking at EMS as "we can put more bodies out there for less money" to looking at it as "we can provide better care if we have medics on trucks." Having fought for funding, I have met numerous administrators who have no clue what the difference between a medic and EMT is - they only know an EMT is cheaper to pay for.

Given the choice, would you want a medic or an EMT taking care of your loved one in a critical situation? We should always be striving to provide the best we can. We should always be pushing ourselves to learn more, understand more, and teach others more. We should always be educating the public, the community we are in, so that they understand we are more than just "ambulance drivers" and that there is a difference between EMT's and paramedics.

Being satisfied with the status quo eventually means that we slide backwards... we have to continually move forward and try to improve. For EMT's this means being the best we can be as EMT's, and learning everything we can from the medics we work with rather than bashing them, and hopefully, eventually becoming a medic. For medics, this means also being the best we can be, not bashing EMT's, and always trying to educate those who are trying to learn more.

And Wendy - phenomenal post... everything I wish I could have said and didn't have the words....

I have been watching this thread for a few days... and thinking about the varied responses.

I think all agree that prescribing meds as the OP was referring to is inappropriate.

Prescribing to "prevent burnout" is absurd.

I find some of the other posts thought-provoking. I don't agree with some, and one caused me to consider the ripple effect...

If someone is currently taking a potentially altering medication, then they should not be performing front line work in EMS. Put them in dispatch, put them in education, or put them behind a desk...........

This comment bothers me... put them in dispatch?????? And you worry about EMS people taking a potentially altering medication, and yet you are willing to have those same people be in dispatch? I disagree.. If your argument is that you don't want them in EMS because the medication may cloud their judgment, you blew the argument with this comment. Dispatch is also about judgment calls.

But when you attempt to play with brain chemistry, then you have too high of a potential to not make sound judgement calls.

So where do we draw the line? Anything that alters brain chemistry makes someone unfit for EMS? Just consider... a partner who was at a wedding or a bachelor party yesterday and shows up today hung over/dehydrated/ill.... probably has altered his/her brain chemistry.. do we send them home? A female on birth control pills... or at "that time of the month".. all PMS jokes aside... quite possibly has a different emotional level than before... do we refuse to employ females? The guy who has decided to quit smoking... and is more than a bit edgy because of it... is that altered brain chemistry? Do we refuse to let them treat a patient?

The ripple effect, although you could say that is absurd, is possible... and possibly heading back into the dark ages.

A truly personal opinion... I would far prefer the partner who has recognized that they have depression, have sought out professional help, and are working towards solutions, including medications, and are aware of their own limitations, over the partner who parties constantly, shows up hung over, and is generally far less responsible for his or her own health and the health of the rest of the crew and patient by showing up to work at less than 100%.

Just my two cents...

I snorted my Coke (the liquid, not the powder) out of my nose when I read "I am a bit of a whacker" followed by "My personal vehicle is an 1993 GMC Medium Duty Ambulance, and is FULLY Equipped with everything we have on the work rig and Then some."

A BIT??? A BIT OF A WHACKER?????

Has this person considered their OCD tendencies and that collecting hordes of medical supplies and equipment may apply?

This person needs more therapy than one couch can provide... although, I have to say thanks for the laugh today... I can appreciate that they are passionate about what they do... but there is passionate, and then there is certifiable....