Ride Along

[spenac]

I appreciate what appears to be an attack. Awsome. Just out of curiosity, are you saying that ff's can't be medical professionals? I know many people who would disagree with that...including myself. I don't believe going straight through is a good thing. I'm not saying you need to be an EMT on the streets for years...just enough to get your feet wet. How many medic students do you know of who have gone straight through, paid for the EMT class (in AZ around $800), paid for their medic class (in AZ around $4,500.00), stepped out onto the street, and said "it's not for me." What a waste of $5k+. Not to include the time and effort by everyone else involved with the training. It just makes for a more well-rounded medic, with a little bit of experience.

In regards to interfacility vs 911 as a newbie, both are without question needed. But interfacility (in my opinion) is the best way to start for previously stated reasons. Ideally, getting on a truck where both are run is best, I would think. It creates a good mix. Besides, you can have some really good conversations with these people (not medically related, but a good conversation is still a good conversation).

I do not believe EMS and fire should be together. They are two totally different monsters. To be the best at either you need to focus on one. If required to be both one or both will suffer. I was a FF before I became a Medical Professional. I now am only a Medical Professional.

As to getting a taste before wasting money EMS needs to develope like many hospitals a way for people to go with us to get a taste of what we do so they can invest their money wisely. No other healthcare profession asks its people to stop at any point and try it before continuing. Actually this is why EMS should be a degree program so when a person finishes and decides nope don't want EMS they can easily use those university hours to go into another profession.

[letmesleep]

There is NO guarantees in LIFE. It is going to be up to the individual to make the most out of their own experiences. If the OP chooses to go in to this transfer truck, and NOT preform their duties as a medical provider by doing an "on going" assessment on every Pt taken back and forth from the NH, then they aren't worth their weight in gold as far as I'm concerned. It is VERY VERY easy to fall in to that rut as discussed on the previous page, but one has to make a choice in the back of that truck to either do the right thing or be a lazy EMT and sit there on the bench with a thumb in the a**. I will restate that I am all for continuing to go to school and getting the medic training if that is what is desired, but working at this service can be beneficial AS LONG AS THE OP CHOOSES TO LET IT. I do feel that this can be a valuable way for this newbie and others to practice basic skills learned about in their "extensive" (lol) EMT training to carry them through medic class. I also precept new EMTs and medics (students), and I will take the time to teach and show one of them to obtain a complete set of VS if they struggle, thats part of precepting, teaching. If a medic student comes to me with some knowledge and/or experience as far as VS are concerned then we can focus on something else like, i don't know, advanced airway management, IV technique, scene management, medications. My point is this, continue with your education! If your wanting to be a medic, then keep going, but take this job (with a transfer service) and use it to your benefit. Practice on your Pts so you don't waste time during your medic clinicals learning how to take a BP or measure a pupil or any basic skill involved in a basic Pt assessment.

I don't foresee the OP making a life decision off of ONE single third person ride. First time on a truck, first time picking up G-ma for a trans, first time smelling the inside of a NH. The OP was probably to excited about being there to even hear what the preceptor was telling them what they needed to know in order to work there.

[Just Plain Ruff]

I agree but for many they only require one ride to make their decision, is that the wrong way to go about it, probably but many will make the decision based on that single ride along.

For a transfer service that runs transfers day in and day out I believe one 12 or 24 hour shift would be enough to make the decision.

not rocket science here, the person looks at the service, sees that allthey run are non-emergency transfers and that it's not likely to be any different any other day of the week, month or year and yes a decision can be made based on one shift.

But what the OP never has said is if they have the means to go back to medic school right now or in the very near future. If they have the means then why wait for a year or 6 months when they could be both working at this service and honing that very very elusive bls patient evaluation and assessment on Gramma who is just going back to the nursing home and also gaining valuable medical knowledge to get there medic license.

it can be a two way street here, the OP can work for this service, do the best they can and also learn ALS in medic school. It's not a all or none proposition.

what I don't understand is the resistence to the idea that You can't be a good medic without getting that all important year of experience under your belt.

so let me put it another way, would you recommend that same year of experience to the new EMT if you knew that all they were going to do was to be the driver of a transfer truck? I would be curious as to what experience you think they would gain if they were simply the driver of the truck?

[Eydawn]

Here's the rub. Were our education better, the experience that one gains from working on a 911 car as an EMT would be integrated into the paramedic degree. However, it is not. Therefore, based upon the learning style of the individual, the adequacy of the Basic class, the life status of the individual, and the surrounding environment, there may be pros and cons to both going zero to hero and working in the field prior to entering medic school.

I'm telling you... if you had surrounded me with individuals pushing for me to go zero to hero instead of staying in traditional college after getting my basic, I never would have decided to try for nursing school. Why would I, when I can work in the field of choice with only 2 years of education? Crap, I'm in my 5th year undergrad (due to a transfer and major change) and have at least another 2 years ahead of me for nursing...

I would also like to say that I don't think I would have been as good a provider at age 20 (which is how old I'd have been if I'd gone straight through paramedic) as I am now at 22 (still a Basic) and will be at 25 when I finish nursing school. I was a smart 18... but I was an inexperienced 18, in every sense of the word. While it is true that the educational foundation gained in school gives you some of the tools with which to approach patient care, it is also true that common sense can't be taught, nor the ability to use good judgment in those tricky scenarios that fall outside our pretty lines...

Let's put it this way... if you're mature enough to know that you're enough of a n00b that you don't think you should go straight through without figuring some things (like yourself) out, then you're mature enough to go for it. Find yourself a job and work your way through school... you can gain that experience concurrently with pursuing your education.

If you think you're the kind of person who needs to understand the deeper picture in order to give patient care, and are not comfortable practicing with the level of education you've been given as a Basic, then you're also ready to go for it.

If you're just going straight through to medic because the more vociferous of us are advocating education above all else... sit back a couple months and think about it real hard. No other medical professions push people to get a taste of what they'll be doing, but I know a *lot* of doctors in my personal world who regret having stuck it through and gone to medical school, straight out of undergrad. They feel locked in and like they wasted 8-9 years becoming something they don't really want to be now. So if you have any doubts, if you're not sure that medicine is your passion, then yes, please get a taste of it somehow. Ride third rider with someone and be a go-fer. If your gut says "well, I could do it, BUT..." then consider bailing. If you force yourself to do this because you don't know what else to do, you'll become another jaded, inefficient lackluster provider.

Let's leave the fire vs EMS for yet another thread, so this one doesn't get locked, mmkay Spenacky? :wink:

Wendy

CO EMT-B

[letmesleep]

Ruff, I do agree that it is A) a two way street, and I think we have both come together on that issue. I will also concede that IF all this or any other newbie is going to do is drive, then they can spend their time more wisely by going to school without bothering with this type of job for any other reason than a paycheck.

Funny how we aren't usually to far off from each other in regards to our opinions, just takes us a page or two to get there......lol

Again tho Ruff, where did your freaking dog go?

[Just Plain Ruff]

he ran away. I'm working on getting a new avatar.

[JPINFV]

This is true. However, typically, new grad nurses need to work on the "floor" for awhile, before they can transfer to a higher acutity unit, such as the ICU or the ED, or specialize even further with NP or nurse anesthetist. Even for flight...they must have, at least in Arizona, typically 2-3 years ICU/ED experience before they will even look at their resume.

As far as doctors are concerned, once they graduate med school, they go into a residency program. Typically, the medical doctor has at least a 3 year residency, while the surgical doctor typically has a 5 year, plus a 1-2 year fellowship for their specialty. So...In essence they start out as interns (lowest on the ladder) and eventually become "attendings" after they graduate their residency and fellowship. How does that translate into paramedicine? As medics, once we graduate, our employer has us ride 3rd person for...how long? A week? A month? 6 months? Where as doctors are "3rd person" so to speak for at least 3 years, honing their craft, whereas by comparison, we are "thrown to the wolves."

What I am getting at is not just being able to take a basic set of vitals. That's relatively easy. But it is a key part of being a basic AND a medic. This is also where you get to practice assessment skills and learn to build on them. Also, you get a chance to build up not only your confidence but also your interview skills to at least a basic understanding of how to do it. There are a couple of little "tricks" taught in medic class, but mostly it's a learning WHAT to ask, and when you get that new information, how to interpret it and WHAT it means to best treat the patient.

It's always good (in my opinion) to go into a medic class with a certain amount of "tools" in your "toolbox." The class should enlarge the toolbox and expand on what is "carried" in it.

On a similar strand of thought, this is why I always recommend that new basics and medics work interfacility for a little while, if given the choice, before going to 911. No, there isn't a lot of "action" on those calls. No there isn't usually a lot to do, because typically most of the work has been done. So, what does it give? An amazing learning expereince. For instance...how many different medical problems do you see on those patients? Besides, usually they are fairly compliant and usually patient people (no pun intended). How can an emt of any level benifit from this? First, start with assessment skills. Doesn't matter what or why they are being transported, if they will let you...do a WHOLE assessment on them! Look at everything. Touch everything (well...ok almost everything...don't get arrested ), ask everything. What's nice about this is that this gives the new basic/medic time to assciate different findings with the medical conditions. It also gives a chance to hone assessment skills, which is really the backbone of what we do. Without a good assessment skill base, you can't have a good basic/medic.

The problem, though, is that intership/residency (3-4 years for emergency medicine, depending on the program) is more akin to clinicals/field training and not working as a lower level. Someone who works as an EMT-B for 3 years is going to have the exact same scope, supervision, and responsibility on day one after training as he is going to have at the end of year 3. A provider going through clinicals (of any serious duration), residency, or field training are going to see an increase in their scope (in essence what they're preceptor will allow them to do, even if it ramps up quickly to full scope) and responsibility decrease while the oversight provided decrease as training progresses.

As far as 3-4 years vs months (thrown to the wolves), your also looking at completely different expectations. A paramedic isn't going to decide to admit vs transfer care vs discharge in most places or cases (I'd say 90% of providers are required to choose option 2). Similarly, the range of skills performed is vastly different between medics and physicians. No one is expecting most paramedics to read x-rays or decide which laboratory tests (ignoring d-sticks) are needed or which specific drug would fit best for this patient (most medics don't really have all that much of a choice between medications).

Besides, shouldn't learning to collect, distill, and interpret a patient assessment something that should be done during clinical time as a paramedic student? Physicians are expected to be able to do assessments before they graduate medical school. It's not something that's learned during their residency, but instead taught over the first two years (as a note, interviewing is taught to first year medical students at my grad school).

As far as IFT v 911, I will agree that IFT work can provide a wealth of information for medical patients (especially when dealing with chronic conditions). After all, a self motivated provider working the worst IFT job would get more out of the IFT job than the laziest provider working the best 911 job. It's definitely all about what you (generic "you") put into it. That said, it can be challenging to take a job seriously if the employee culture (as cultivated by management) is completely against any sort of thought past making the SNF happy.

[letmesleep]

Ok, I'll keep my eyes open for him tho........damn dogs!

[Just Plain Ruff]

absolutly letmesleep we are not really that far away on most things.

[AndyJames87]

thats just ducky, what did you gain from this experience? Did it make you decide either which way to go for the job or go back to medic school.

From this experience did you see whether you will get any valuable experience doing transfers on Gramma going from the ER to the nursing home or back to her home or to the doctor's office or do you think it will be just a job.

Hopefully this experience as well as the postings of recommendations will point you in the right direction.

If all you gained was a fun ride along and you take nothing from it you are no closer to where you need to be than you were when you hopped out of your car inthe services parking lot?

I'm curious as to what you think now.

Well i have read your posts and i appreciate your recommendations. To answer your question it did teach me something. In class we only read about stair chairs, stretchers, lifting techniques, taking vitals and so on but its much different reading about it compared to doing it. We helped moved a 75 y.o pt up a flight of about 20 steeps small stairs. i learned how to move patients without hurting my back. A the beginning of the day i had no clue how to bring the stretcher up or down by the end of the day i had a good grasp on it. I understand what your saying but i think the experience for a newbie is pretty good for the time being. If i get the chance to go work for a 911 privet later on cool! by then ill have a good ideal on how to take vitals and all the other little things that make a good EMT a good EMT. THANKS!