kitkat

Lots of good advise on here, and the underlying message being, when you take any course, as an adult learner you put into it as much as you want. Classroom training at the best of times is just that, classroom. As for field precepting, that is where you can start putting the pieces together, but the disadvantage can rest on a few things. As a student it is overwhelming to know what to do, and just the sight, smell of a real life sick or injured person can put your brain in freeze mode. Another hitch is having a preceptor that will guide you through the practical world of EMS. Preceptors can play as big a role in developing critical thinking skills, they are not there to teach you the whole program, but to assit you in putting the "puzzle" together. Just take every expereince you encounter now and build on it, enjoy the journey of learning. Really, it will take time, as well as your willingness to listen and learn, ask questions, and keep up with reviewing when the questions come up. So can you be a good paramedic, why not? The best tool we carry is ourselves and the ability to critical think, keep developing that, and always do the best that you can do with what you know, as well utilize the resources you have avalible to assist you. Again, as previous posters have mentioned, keep in mind who you take advise from as well, and being new, that can be a tough one too.

horrible at name picking, but what a darling. What's the "barn" name going to be? Out of my 4 I only have 2 that go by names that are only slightly close to their registered names. :-)

Research projects have now become a part of our professionalism component in our ACP program, we also then have to present the project in a 10 minute presentation to our Medical directors and some "special guests" and 5 minutes of questions/feedback. I think it is a very relevant addition to the program.

I would encourage you to take it, found it was a very practical course, and I really enjoyed it. Make the most of it, you will find something useful in it, and fall back on your what you learn in there whatever your level.

The politics of the profession. What disheartens me is when I see my "leaders" not trying to progress to changes for the future. I guess I am of the theory -How do you eat an elephant?.... one bite at a time. Change takes time. Peoples' bad attitudes I can deal with, biaeching and whining, not trying to offer a valid solution, neutralizes your right to complain, I won't tolerate it. I'll challenge you on offering a solution since you seem to know what is all wrong with everything, educate, ask questions, knowledge is power. (won't say I am getting very weary of the constant whining at my work) but, one way to shut down a negative conversation is with something positive, hey where did everybody go?? If I ever say that I am the end all / be all in this field, take me out in a "whitejacket" as I know I will have gone off the deep end.

Now that was fun, send it to Letterman.

I would say at 2 of our major hospitals, if you don't have a "red" they wouldn't even hear the "patch" just a big sigh and a 10-4, then you can expect to wait, ... to be triaged, after the other 4, or so, ambulances, then wait for a bed, oh did I say wait, for a bed?? yeah, bring a book, your ipod, or whatever. They may only start showing intrest if a supervisor shows up. So, how do we patch? -Red, Amber, Green-C/U/R-and (# code) for medical/trauma/pregnancy/burns/cardio/resp

So once again, Jack of all trades Master of none.

So, back on pg 2 I had posted some questions about whether you services have set criteria for pecepting/mentoring. Anyone else have any comments on this? MedicAR had responded quite nicely to this, and I am thinking this is the trend, that as long as there is a warm body available to "shape" the new recruit, that should be enough of a qualification. I am thinking this is an area that could be developed for making the profession a bit more professional? Thoughts?

At this time we precept student that come in after there total classroom time and some hospital time in ER. What I find both as an instuctor/preceptor, is when doing scenarios, these students don't have a hot clue on what to expect or how to even communicate with pts in a real setting. I would love to see the program intergrate time on the ambulance during the program, just so they have an idea of how things are run, let alone smell, touching/lifting pts. (eg:, not do an interview halfway across a room in a whisper, shaking in their boots) that are actually sick instead of practiceing B/P's on their healthy classmates. So in that way of thinking, after let's say a module of V/S assessment, just have them preform that skill for a few days, and observe the rest of the call, and get familiar with the concept of how to manage a pt. or run a call with the rest of the crew. It has been interesting to hear the other side of this situation. There would need to be a very clear layout to the preceptor of what the students expectations are at each time of evaluation.

Yes, last week, in of course sticky wet snow at 0200, and what happens, try to clean the wiper blades and the driver side flies off, so I figure I will take the passenger side one and put it on the driver side, at least be able to see to drive to the hospital, and now realize that the arm of the wiper is actually broken,(while fighting with the blade and getting totally soaked!!) well, too bad, I made it work, and made it safely to the hospital, everyone entacted!! Then proceeded to get another ambulance as mantienace hours were closed.

Thank-you for the response Medic AR, there are some definite similarities here as well. Just thought I would troll for some ideas/solutions to some of these issues. Anyone else willing to share??

So, in regards to this situation , which by the sounds of it, we all have experienced this to some degree. Would you care to answer a few questions? How many of you are invovled with a service/company that have something like a: *lead hand *crew chief *mentor *preceptor *field training officer *clinical team leader **Whatever term you want to call it** How do you earn this title in your company? What is the criteria that you must meet? Is it pure seniority? Level of training? Warm body? Any adult education training courses? Formal instructor program? Personal integrity/and work ethic (ie CQI, CME, Performance reviews?) Is this something that is kept in peer groups or management? (ie: union groups) Does your service/company offer any professional development planning/programs? Is there a "path to leadership" ? (other than what may be discussed in the professionalism component of a paramedic program) How do you get promoted? Other than an application process. *criteria?* How, or does the company compensate you for this "title"? Renumiration/promotion? Both? If you do have this type of "program" How is it regulated? Who is responsible to whom? What is that retention plan for employees, within the service/company? Is this a personal issue or is it a management issue? I hope that you can wade through all these questions.

my fav for abdominal pain not yet diagnosed is FCS (fart caught sideways)

We have a review board made up of our training officers and street paramedics, our Med. Director and the assistant Med director, this was specially made group that would be able to bring better clarity to the old protocols, and bring new ones forward. Has been a great working group. The intent being that we have the protocols ready and basically present the protocols ready to go, to the Medical Advisory Committee, which our MD is chair of.

If you are a PCP starting in Winnipeg, min. 2 years on the emergency division. (as it stands now?) The way it is now, they take go by senority, but....there is a selection process to get into the ACP program. This includes a written testing componant, and then if you have a high enough mark, you have an interview. There is a marked interview with training staff and the Medical Director. Now, with the ACP program, they have divided it into essentially a 2 year program, the 1st year, is called ICP (intermediate)** you are taking classes while you are still working, booked off for paid class days, or paid on your days off if on clinicals, or class,** after completing year 1 you work min. a year as ICP on the emergency units (or up to 6 years grace) and then head into year 2 called ACP. They have taken ACP's from other provinces, they get evaluated by the M.D, and training staff, and the M.D deceides if they will practice at full scope. Keep in mind that Winnipeg does not offer ACP's full scope of NOCP's, as in pediactrics. They have Medical Supervisors that do "high risk/low volume" calls. CQI. etc. They are in chase Tahoes and respond if these calls require their assistance, or if a PCP crew requires ALS, and another ALS unit is not avalible.

You are not required to be cross-trained as a FF any longer to be hired for the EMS division. To be hired on fire side you must be a PCP. Winnipeg has essentially come to their senses and realized rentetion on EMS side was not working with x-trained individuals. They would use EMS to hang out in for a while then make a lateral move to the fire side. Long story of a botched amalgamation. yada yada, We now have 26 paramedics hired as PCP's most with experience, mostly coming out of the rural services. Therefore the openings all over Manitoba, take your pick. Winnipeg EMS does in house training for ACP at this time, and they are running a pilot PCP project in conjuntion with Manitoba Emergency Services College(Brandon, Manitoba) otherwise they do not have a academy for the public at this time.

2 attempts, (each) if we have the training levels avalible, but, take in time consideration and situation. IO for adult cardiac arrest, after 2 IV attempts, we just implemented IO's. Peds get IO's but stays restriticted to specific group of providers. (high risk-low volume)

okay, I'll wade into the fray.... only because I had a similar situation the other day. female seizure, witnessed grand mal 1-2 min (bystander time) engine on scene, pt sitting upright postical, awake, confused, tells us she feels disorientated, was incontinat of feces, NRB 10lpm / BS (normal) radials, weak/faint, tachy, FM tells me has difficulty getting BP. ( BP was 130/70 ish- Onto the stretcher we go, onto the monitor, bigeminy, long, 15 sec, settles into a sinus tach with frequent PVS's, 124-130bpm perfusing PVS's, quick 12 lead, nothing jumping out. can maybe make it into lateral ischemia in V5 if I really stretch it, does have another run of bigeminy, no change in pt status. no c/o C/P pre-post, But how reliable with altered LOC?? Bystander state 2nd seizure today, has been c/o headaches? PMHx unreliable. So.... what came first? seizure caused arrhythmia vrs arrhythmia caused seizure? was pretty interesting, IV started, o2 contiuned monitor, and 5 min form hospital. Again reverts to sinus tach with frequent PVC.

THis topic brought this question to mind... *I did do a quick search for this question (wouldn't want to peeve anybody)*. .. so how many IV attempts are you allowed in the field? admin, you can move this question to another thread if you need too.

I have several co-workers that have their BN, when they are working as paramedics on the ambulance, they stay in the scope of practice that they are in at their level of paramedic training. I have never noted that they have "lorded" their education as better, or tried to advance themselves due to their nursing degree.

Shortly after the 911 situation, when we were called to an airport transport, we were required to show picture id from our place of employment to even be allowed on the tar-mack, to be able to off-load the pt. I believe we are required to have our licence us at all times of pt contact.

PCP=Primary Care Paramedic= No intubations According to NOCP=National Occupational Competency Profiles PCP are only required to have an awareness or the practitioner must have demonstrated an academic understanding of the competency. Individual evaluation is required. it would be under Area 5 therapeutics-5.1.f, 5.1.g,5.1.h You can check it out on the Paramedic of Canada website. (PAC) hope that helps

Hey, I have tried a search, but either I can't find this topic, or give me some guidelines to find it but..... it's about uniform pants, does anybody know of, or tried pants with some Lycra in them? Or "does it give such?" Again, sorry if the subject has come up, then please give me the threads to find it.

I was at a call, just the "gopher", as my partner had the student that day, our Medical Supervisor shows up..... super guy, but has a habit of saying "beautiful" in response to a story, comment, gesture etc. (beat saying *$%#@) anyways.... we have a 20something year old female, c/o CP. no cardiac Hx, but far too many key words to not do a 12 lead. She's a lovely healthy girl in the mammary department, and seeing that I am the only female in the room, I offer to assist her with the brazier. My MS is standing behind me, So, being female and having much experience (with my own mind you!!!!) I unlatch it very smoothly, at which my MS responds with "beautiful" I just about passed out, and had to leave the room for a moment of giggles, nobody else really knew what was going on, ( The student con't the call) but 2x's as funny as he didn't realize what he had said, as we are removing the pt., MS and I are walking down the hallway, (away from the pt. earshot) and told him what he said, he just about died of embarassment, and i never let him forget it!!! thanks for this topic I can sooo relate to sooo many things( giggle) I do have a few more for later!!!