crotchitymedic1986 Posted December 9, 2008 Share Posted December 9, 2008 Where are your patient values ? Do you ever put patient advocacy above your certs ? Link to comment Share on other sites More sharing options...
Eydawn Posted December 9, 2008 Share Posted December 9, 2008 Those of us who enjoy practicing medicine and not throwing away the investment of education generally care about not losing certification or licensure. Maybe if you're a renegade and feel it's appropriate to throw away that investment, or worse, you decide to practice with false certification or under false pretenses (like that paramedic here in CO not too long ago.. I think that guy should be shot!) it doesn't matter... Wendy CO EMT-B Link to comment Share on other sites More sharing options...
fiznat Posted December 9, 2008 Share Posted December 9, 2008 What about advocating for your future patients? I mean, the ones you'll never see if you get your license taken away for pulling some stupid stunt trying to be a hero. Don't those people matter too? Link to comment Share on other sites More sharing options...
Arctickat Posted December 9, 2008 Share Posted December 9, 2008 Me, my wife, my kids, my parents, my instructors, my co-workers, and anyone else who has assisted/supported my careerchoice. Not to mention the untold numbers of patients who would have benefited from your assistance and won't. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 9, 2008 Share Posted December 9, 2008 If you would rather let an infant die because you are too scared to do a procedure that medical control has authorized you to do, and you have a physician standing next to you to assist or perform the procedure, then I would say your future patients are better off. Who knows how many you would let die, to stay certified ? I dont let lawyers dictate how i treat my patients. I would be ashamed to wear a paramedic patch in the future, if i let this child die. Link to comment Share on other sites More sharing options...
WolfmanHarris Posted December 9, 2008 Share Posted December 9, 2008 Okay. Couple of things. Part of this disagreement might come from the various system we work in and the relationships that are had between the providers and medical direction. For example, if you have a very good relationship with your medical director on top of experience and a good education (like Dust) you're going to feel more comfortable in this environment as you come from a system where operating outside your usual scope is comfortable. (like Dust) If you come from a system where this makes you think that your ass would be grass and that the province/state would hand you out to dry then you're not going to feel comfortable with this at all. This may be a case where education aside, our systems and experience are going to have more influence on our opinions and hypothetical action than what is said here as that's what we're filtering through. Might also explain why I can't seem to pick a side on this; as I don't have that context yet to filter through. Crotchity, drawing that parallel between Lifeguarding and this is quite possibly the most asinine straw man argument that's graced this thread so far. They don't compare one bit beyond a surface similarity. Also, the idea that you as someone with no rescue training would jump into any rescue situation you saw rather than wait puts you into that category of people who kinda scare me as potential partners. People who makes these unqualified assertions and then follow through with them end up in one of two categories; in the paper as a hero or dead. There's a time to break rules (including scene safety), but to admit off the bat that you're unwilling to choose inaction over action regardless of the risk/cost. So of course you'd perform the C-section. You'd likely consider the bic pen and pocket knife in a pinch, running into the fully involved building with no turnouts, or be heard responding "Dammit, there's no time!" This attitude is rarely about the patient and more often about the rescuer. Link to comment Share on other sites More sharing options...
Arctickat Posted December 9, 2008 Share Posted December 9, 2008 First of all, you are confusing the term "infant' for "fetus" It is not an infant and it is technically not alive until it is born. See the Born-Alive Infants Protection Act, P.L. 107-207. Although I suppose that is also debatable in your mind. I don't believe providers are too scared to perform the procedure, they are simply understanding the repercussions and weighing benefit vs risk. For some, the risk is simply to high for the benefit. Doc also raises a good point..indirectly. Who's ass is going to be in a sling, when, after your medical control tells you to go ahead, his ass also ends up in a sling for telling you to do it? Now, he is in trouble and your defense of "He told me to do it." will be torn to shreds because he didn't have the authority to tell you that and you should have known better. I had days of yore where I was a puppet medic, thinking my medical director could do no wrong, and that I was bound to do as he told. I quickly learned this was not the case, and it was my responsibility to keep him in check. There are limits to what Medical Control can approve, and they can not "have my back" After I almost ended up strung up before a disciplinary committee for functioning outside my scope of practise because my medical director told me to, I soon changed my ways. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 9, 2008 Share Posted December 9, 2008 What if I told you that a podiatrist and his LPN, neither of which were certified in CPR, were eating at a restaurant, when a child began to choke and turn purple. Neither has emergency or CPR experience (the doc remembers taking it once back in the 70s), but there is a heimlich poster on the wall that instructs you how to do it. But the podiatrist and his nurse do nothing and just sit at their table out of fear that they will be sued if the boy dies, or gets a broken rib. In the paper the next day, the headline is "Boy dies at restaurant, Doctor says if I had tried to save him, I could have lost my license" . He goes on to explain that he has no emergency training, and to render aid in this situation is outside his scope of foot care. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 9, 2008 Share Posted December 9, 2008 They also have a term called fetuscide for those who kill unborn fetuses through violence while it is still in the womb --- and most states dont allow third trimester abortions for a reason. But if it helps you sleep at night to say you let a fetus die instead of an infant, that is cool. Link to comment Share on other sites More sharing options...
WolfmanHarris Posted December 9, 2008 Share Posted December 9, 2008 CPR is not a controlled medical act in Ontario. Thus no certification needed. Can't speak to the rest of the world. Seriously man stop trying to convince with these analogies, slippery slope arguments and the like. I think everyone here understands all the factors and considerations but still disagrees. These aren't going to get anyone closer to one side or another. And if I cared about what it said about me in the paper, I'd have become a Firefighter. (oh. That's nasty.) Link to comment Share on other sites More sharing options...
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