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Should EMTs Have to Babysit Their Medics?


suzeg487

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Wow...bravo on your self-control. Although if that ends up being someone you work with on a regular basis and this continues to be a problem I'd start to think about losing that control around the third time you have to explain yourself. :( (joking...but not really)

How many times has it been said here that there isn't (or shouldn't be) a separation of care into BLS and ALS levels, just patient care? Sweet bleeding jesus hopping on a crutch, how hard is that to understand? The practise of medicine does not come from a cookbook; there is no single checklist to follow each and every time. Deviations will get made sometimes, and quite often because of how the patient is presenting or what the assessment revealed. With higher levels of knowledge and training most people seem to understand this; it's at lower levels (where cookbook medicine is taught and practised) that it becomes a problem. Especially when those people interact with someone further up the line and aren't willing to learn.

Kudos on doing the right thing and trying to explain why you did what you did; for someone who honestly didn't know any better and was willing to further their knowledge that kind of thing can be priceless. Unfortunately you got stuck with an undertrained, uneducated, cookbook practising asshole. (and for the record, from what you've said about it and making one or two assumptions, I don't see anything that you did that was wrong)

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Exactly. We can discuss patients all day long, but it has to be a discussion, not a lecture.

Of course, these people are idiots with neither the education, experience, nor common sense to have a clue what they are talking about, and I prefer not to waste my breath on them except to say "do it now or clock out." But really, they are not solely responsible for this mess. The "educational" (using the term very loosely) system at the basic level is failing them by not only failing to adequately prepare them for the job, but by feeding into their egos and making them think they really have learned something in 120 hours.

Get rid of the EMT course altogether. Eliminate it from the EMS system and prepare our providers with sound educational practice from the beginning. Zero to hero, but without the separate EMT and Paramedic steps. One long, two year course to enter practice. Everybody on the same level, and then we won't have to listen to all this turf-war posturing of insecure people who have to constantly pat themselves on the back to compensate for gross inadequacies in their education and knowledge. This sort of ignorant immaturity just brings the whole field down.

but doesn't that defeat the zero to hero concept we have now? Get rid of the EMT level and what are all the complacent people out there gonna do?

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Unfortunately you got stuck with an undertrained, uneducated, cookbook practising asshole.

Actually, this kid was trying to help me! He truly believed that I had ignorantly given this man substandard care. And as Dust pointed out, it's not completely his fault. He left school with the belief that he knew THE best way to care for trauma patients, and has worked the last two years with medics that have allowed him to continue to believe it.

It's funny, because it's not what I've come to expect from the basics in this system. They have no dilusions about where they are, what is expected of them, and their goals for the future.

I didn't really want to send this thread in this direction. I truly did want to try and show the offended basics the behavior that is sometimes offensive, but having done so now, I would like to make this clear.

The responses that have followed were in response to THIS basic and basics with ATTITIDES LIKE HIS.

If you are not this basic and/or don't share his attitude(s) then there is no reason you should be offended by the responses.

When someone says "they are under educated and don't know what they don't know!" that's not really a shot at you. When I passed the didactic portion of class and went to work the ambulance I spent the first several weeks saying to myself, "WTF! I paid a ton of money for my class, studied my ass off until I was sick to get my 3.54 average, how the hell did they let me through without teaching me this!!! (some simple concept that I, and many around me believed I should have been taught.)

No one is blaming you for not knowing you weren't going to save the world when you came out of basic class. Many of us didn't know either!! But we do/will hold you accountable if you choose to continue to believe the propoganda after many have taken the time to explain to you the truth.

You made it through basic class. You passed you tests. Shame on you if you're not proud of that!

When I was there I wanted to frame my cert...So it broke my heart, and hurt my ego when people here told me it was a small achievement in medical terms (it was a long time before I heard the "medical terms" part). It took me being introduced to the hospital and ambulance environment to make me realize that if Dust, and AK and others like them hadn't been kind enough to break my heart with the truth, the rest of the medical world would be laughing at me, because I would have continued to believe that I was something that I'm not. See what I mean?

Being a basic is cool! Be happy with that and not need to make it more/different than what it is. The same as I don't pretend to be a medic (I'm a student). And when I'm a medic, I won't pretend to be a doctor...I simply am what I am. (Esse quam videri)

I've probably made this whole subject worse than it was...that wasn't the spirit intended. You'll just need to read it and then try and translate it into something Eydawn or chbare would have said....Hopefully then it will make sense.

Dwayne

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it's not completely his fault. He left school with the belief that he knew THE best way to care for trauma patients, and has worked the last two years with medics that have allowed him to continue to believe it.

Dwayne

Im sorry Dwayne - but it is his fault - if he asked any questions whatsoever (with an open mind) he would have learned how much he didn't know. The fact that he has worked for 2 years without pulling his head out of his ass is his problem. You asked him to hang a bag and he didn't do it - the next time you ask for help with a critical intervention will he do it? or will he think he knows better? How can any human being smart enough to brush his teeth in the morning listen to a couple of medics discuss a patient, condition, call and not understand that they are talking a language he/she doesn't understand. My first 4 hour ride time shift as a basic showed me that there was a ton of stuff I didnt have a clue about.

If you look over my last post, you will see that I clearly stated that I love working with the basics I work with. It doesn't change the fact that the specific person you describe is an asshole...

Just my humble opinion....

PS - did you ever ever ever in your career as a basic talk to a paramedic the way he did to you? Did you EVER not understand that they knew more than you? Did you ever not hang a bag when asked?

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Wow...great points.

His behavior certainly wouldn't be acceptable when I become a full fledged medic. There is so much gray area as a student when it comes to responsibility sometimes.

And no. I realized during basic class that there was a whole different world out there where medicine was concerned...and it made me crazy! Thus medic school... :D

I've never had a tendency to believe I was better than most people, and wouldn't refuse to hang the bag...I only meant that I can understand their misunderstandings when they first leave school...No argument that his kid should have known better...

You're such a peach...

Dwayne

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Actually, this kid was trying to help me! He truly believed that I had ignorantly given this man substandard care. And as Dust pointed out, it's not completely his fault. He left school with the belief that he knew THE best way to care for trauma patients, and has worked the last two years with medics that have allowed him to continue to believe it.

Yes and no. I still stand by what I said completely. Is that kid undertrained, uneducated and practises cookbook medicine? Yes. No, it's not entirely his fault but another symptom of how bad a shape EMS is in. It is his fault that he has never expanded on what he originally learned and moved on. Is he an asshole? Based on what you described, absolutely. When given the opportunity to learn something and actually be given an explanation for why something was done, did he take it? Nope. Blew it off and probably still believes that you screwed up. So he's an asshole. He may have been trying to help you; it doesn't change the fact that when you explained why he wasn't actually helping and what your reasons were the response was...not the best. Honestly, he's been a Basic on a ambulance for 2 years and still has this attitude...do you see the problem?

I don't think what you posted is hijacking the thread or moving it away from where it's gone; what you experienced isn't an unusual occurence, and it happens because people don't know any better, they have been allowed to continue to not expand their knowledge, and they refuse to accept what someone of a higher education tells them. Again, it's another symptom of how screwed up EMS is in the US.

To be able to realize that you don't know that much is hard to do. To be able to realize that you NEED to know more and actually set about learning it is even harder. You've been able to recognize those things; good. Unfortunately, as you've seen, many don't, and become very defensive when their lack of knowledge is pointed out. Nobody wants to think, after spending the time/money to become a basic that they don't have much of a place in EMS and are relatively useless; that's just human nature. Not a lot of people are willing or able to see all that and be comfortable with it; a whole lot just get defensive to and try to justify their existence with shite.

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Sometimes it isn't worth arguing. It just makes you mad, brings you down to their level, and the person remains just as ignorant as when you started. Dwayne, I really applaud you on how you handled the situation.

Sometimes though, as crass as it may sound, the best response to "Yeah, the problem with you new medics..." is "What the hell did you just say to me?" That usually stops the conversation right there.

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Not to beat this topic to death, but I should have mentioned this earlier. If you haven't done so already, this is something that needs to be brought up with your preceptor. Not the kid (I'm just guessing that he's relatively young) asking what happened after the call, but him refusing to do what you told him during the call.

That is unacceptable. If it get's ignored it's telling him that, essentially, it is ok for him to do that and his behavior will continue. (maybe that has already happened) If that is what happens, and nobody is willing to confront him, explain why what he did was wrong, what should have been done, what he needs to do to fix the problem, and what will happen if he continues with the same actions, then everyone (including you) have failed HIM. You are allowing something that is a detriment to your work, your patient care and his own potential career to continue unimpeded. That is wrong.

It isn't just our own knowledge and care that we can't allow complacency in.

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this is something that needs to be brought up with your preceptor. ... him refusing to do what you told him during the call.

That is unacceptable.

I totally agree... this would have been the major point of the aforementioned ass kicking.. If I didn't think that my point was made and the behaviour would NEVER be repeated, then I would take it up the chain...

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