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If you could change one thing in EMS .......................


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BBB, I think you miss the reason you are doing ER rotations. It is not to learn what nurses, doctors, RTs, janitors or anyone else does. It is to get a better understanding of the disease that your pt has. You get to see what is being done to work them up and what is being done to treat them so that you have a better understanding of the pathophysiology of the diseases you are seeing. Persoanlly, for someone in a medic class, I think your time would be better spent shadowing the doctor than the nurses (no offense towards the nurses).

You are making assumptions Doc. I never said I was still in school. I have been on the streets for years as a matter of fact. I also never said I was 'shadowing' nurses and I did spend an entire year working specifically with a physician, not with nurses. I know why we do hospital clinicals, but just because we are supposed to learn about as many disease types as possible doesn't mean we should self-restrict our education to only that. During my clinicals I made an effort to get to know some of the nurses at some of the hospitals I was at, and because of that when I bring a patient in now years later the nurses don't treat me like some kind of nameless/faceless medic who brought them more work. They recognize me and what I have done for that patient, and I have found that the patient care transitions are better handled.

Mutual respect is what I am striving for. I am sure that you appreciate it when the nurses give you respect at work instead of treating you like the only reason you exist is to get their patients out of there as fast as possible. I would appreciate it if fewer of them act as if I went trolling for that patient no one wants just so I could bring them to the ER to make their life miserable. I would also appreciate it if some of my fellow EMT's would take the time to look around and realize that the ER is overflowing and that they may have to wait a few minutes until a nurse is free instead of getting angry.

Mutual respect. Not an impossible thing to work towards for all of us.

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Thats not a bad idea. At one of the private services I worked at, everyone had to walk in the others shoes - disptachers, medics, billing staff. It made for a better work environment and patience among all staffers. I have also seen it work when we were having a problem with one ER, we invited their manager to come ride with us, and after 6 hours of getting diverted and hearing the attitude of her staff on the radio, things changed in that ER. I think it is a great trade off if you can get nurses and medics to swap shoes for a few hours.

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I know I'm getting in on this late, but...I wouldn't know where to begin. Just one thing is a pretty wide spectrum that would effect so many other things. I don't think there's just one thing that can be changed without effecting numerous other subjects. It's sort of like the "butterfly effect."

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OK, after reading another post, i have to change my answer. having an ISTAT machine (for those that do not know, it is a handheld lab machine that is accurate but expensive) on my truck so that i can get troponin levels, H&H, or a white count. That would definitely change the quality of care provided in the field.

Why use an expensive machine like the Istat? I'm using an invitro diagnostic device that provides qualitative results for cTnI, Myoglobin and CK-MB. They are 100% accurate and provide positive results if the trops are over 1.5mcg/ml. It takes about 4 drops of whole blood and gives a result in about 5 minutes.

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