New Zeland medics.

[Kiwiology]

I like our AO scope, its quite good, much better than what else is out there internationally if we take the purist view of what should be "BLS".

Realities of local service provision aside, it would seem there is a trend towards moving away from the traditional boundaries of basic/intermediary/advanced level service tiers; the UK and Australia provide examples of this.

As to how that actually addresses what the original poster was asking I dno .... I think I might be daydreaming again

[BushyFromOz]

Secondly there is an expectation from them that they will be Intensive Care from the day they start, that they should not have to compete with everyone else & that they deserve it more than everyone else.

No kiddding. I believe that the universities are partly responsible for this in the way they approach education. There is an aweful lot of chest thumping BS that goes on about how "special" degree'd paramedics willl be, you know, way fo the future kinda rubbish. Throw that at a bunch of 18-19 y/o kids and we get an inflated sense of importance after 3 years.

Thirdly, many (before you jump on me, I did say many) have little or no life experience & lack the people skills to do this job properly. The system that my state currently has in place for general entry is 3 years to qualify, 4 years before you can apply to become a IC Paramedic. This allows time for people skills to develop, & with good training officers, problems can be seen & sorted to extend the careers of people.

This is entirely the fault of the ambulance services NOT having a proper post graduate training program. Uni's are interested in - making money - and as such will take as many applicants as they can, charge you a shit load of cash for less than 20 hours a week face to face teaching so you an go home and smash yourself in self directed learning. Mass produced.

Ambulance services are interested in sticking as many qualified asses on seats as possible to make their stats look good, and that means taking these mass prouced ambo's, throwing them in a truck and giving them their stripes as soon as possible. Here we had a 2 years GAP program, meaning you average uni student was 23 when they qualified after finishing uni. A loit can happen in 2 years as we all know. Since the great "merger" with Metro in melbourne, the official GAP course is now 12 months, but scuttlebut suggests that "near competent" students are being early exited formt he program at 9 months to make way for the next mass produced batch of students

Now we get 21 year old qualified ambo's, who cant cook a slice of toast because they left home at 18, lived on campus at uni with someone else cooking their food and cleaning their room for them while the pissed their spare cash up the wall with their mates at the pub every wednesday and friday night

I understand the shortcoming of the university model, and theres nothing phil could say i wont agree with. But there is not 1 ambulance service here that makes an attempt to cover those shortfalls either.

[Kiwiology]

Interesting. I'm curious to see if the clinical knowledge/skill level and patient care has gone up or down due to the introduction of the degree courses. I'd like to think up but you have to look at the people providing the care which in terms of the degree model their age tends to go down.

Now does that mean that because they are less worldly and experienced that they pose some sort of greater clinical or general risk; I could say yes but I don't know there is any objective evidence to prove that.

I agree with what you're saying Bushy but I must also note that 1) most uni grad's are green as grass and 2) there are a lot of people out there who can't cook dinner or do the washing coz mummy always done it for them so they live on fast food. Most nursing or other health professional degree grads are generally only 21 or 22; I don't hear other people bitch about them so why does the ambulance service bitch about it?

That said I wholeheartedly agree that being an ambo probably requires more critical thinking and clout than being a dietitian or a primary practice nurse in a nice comfy GP's office and not upside down in a ditch trying to crawl inside a car wreck or deciding whether or not to start working Grandpa who fell down in cardiac arrest.

[BushyFromOz]

Interesting. I'm curious to see if the clinical knowledge/skill level and patient care has gone up or down due to the introduction of the degree courses. I'd like to think up but you have to look at the people providing the care which in terms of the degree model their age tends to go down

I know this is anecdotal, but i have spent a great deal of time asking this question of people within our clinical department, particularly clinical managers and our frontline educators. the general reply i get back is that, yes, the clinical aspect developes much quicker in terms of skills and A&P and yes, grads understand their guidelines much quicker than the traditiona diploma entrants who were recruited off the street and placed through a 3 years training program. BUT they also feel that critical decision making and general self confidence is taking far longer to develope than before. The obvious reason why is that we are guided through decision making / scene management / differential diagnosis etc etc for a perid of 6 months and then weened of this support over the next 6 months. Under the traditional method of training and education this guidance lasted for 3 years.

Now does that mean that because they are less worldly and experienced that they pose some sort of greater clinical or general risk; I could say yes but I don't know there is any objective evidence to prove that.

I think the real issue is that although these people meet the standard to be "qualified paramedic" they are then placed in a position where they may then be working with junior oficers, which snowballs this loss of decision making skills. I guess another reason is we are taking on hundeds of grads a year partly due to workload increases, but more to do with baby boomers retiring in large number over the next 5-10 years, so we loose this experience, people who have been qualified for 20 years may not have the same A&P knowledge as a grad, but they are far superior in organisation, scene management, dealing with people and critical decision making. Its thier guidance that grads need, not another bloke like me who has been on the road for 2 years. It will take a decade or two to get this experience back. One instructor once told me that grads are generaly good clinically, but teaching them to figure out the best place to park the stretcher and not lifting very patient is hard work!

I agree with what you're saying Bushy but I must also note that 1) most uni grad's are green as grass and 2) there are a lot of people out there who can't cook dinner or do the washing coz mummy always done it for them so they live on fast food. Most nursing or other health professional degree grads are generally only 21 or 22; I don't hear other people bitch about them so why does the ambulance service bitch about it?

My best mate and i both started uni at the same time, i did ambulance he did nursing. When we both graduated and and had been in our respective job for about 12 months, he told me he could probably get through his career while rarely making an autonomous decision, he thought we were nuts making provisional diagnosis and formulating treatment with not much in the way of facilities and on limited time. Now hes a 2nd year med student doing A&E placements at a major trauma centre and still thinks ambos' are nuts and wholly under supported by the health system Maybe this is a rural thing, but more often than not i feel we operate alone with probably less knowledge deffinately less diagnostic ability and probably more accountability than your average graduate nurse.

As a side note, guys in the peer support network have evidence there has been a massive increase in the amount of referrals for mental health issues since VIC went to a graduate only entry scheme. Problem is that the data is not specific, we dont know if this because younger people are more inclined to seek help than the "old hands" (cultural/generational thing) or that grads/young people find it far harder to deal with the stresses of this job. My guess is its a bit of both

[aussiephil]

No kiddding. I believe that the universities are partly responsible for this in the way they approach education. There is an aweful lot of chest thumping BS that goes on about how "special" degree'd paramedics willl be, you know, way fo the future kinda rubbish. Throw that at a bunch of 18-19 y/o kids and we get an inflated sense of importance after 3 years.

This is entirely the fault of the ambulance services NOT having a proper post graduate training program. Uni's are interested in - making money - and as such will take as many applicants as they can, charge you a shit load of cash for less than 20 hours a week face to face teaching so you an go home and smash yourself in self directed learning. Mass produced.

Ambulance services are interested in sticking as many qualified asses on seats as possible to make their stats look good, and that means taking these mass prouced ambo's, throwing them in a truck and giving them their stripes as soon as possible. Here we had a 2 years GAP program, meaning you average uni student was 23 when they qualified after finishing uni. A loit can happen in 2 years as we all know. Since the great "merger" with Metro in melbourne, the official GAP course is now 12 months, but scuttlebut suggests that "near competent" students are being early exited formt he program at 9 months to make way for the next mass produced batch of students

Now we get 21 year old qualified ambo's, who cant cook a slice of toast because they left home at 18, lived on campus at uni with someone else cooking their food and cleaning their room for them while the pissed their spare cash up the wall with their mates at the pub every wednesday and friday night

I understand the shortcoming of the university model, and theres nothing phil could say i wont agree with. But there is not 1 ambulance service here that makes an attempt to cover those shortfalls either.

In some ways yes, it is the fault of ambulance services, but the entire blame cannot be laid with them. The argument over Uni students/graduates expectations has been raging for many years, in many occupations. It is not unique to health.

There was talk I seem to recall a couple of years ago to force a 'gap'year to encourage school leavers to work & gain some life experience before starting university. I have also heard it discussed that conscription be reintroduced for the same reasons, but it would be run in conjunction with any studies undertaken for all 18-20 year olds.

Food for thought hey. The consription discussions I heard suggested that, for example, Paramedic students & medicine students would actually cover medical in their consripted service.

Maybe this has some merit.

[Kiwiology]

In some ways yes, it is the fault of ambulance services, but the entire blame cannot be laid with them. The argument over Uni students/graduates expectations has been raging for many years, in many occupations. It is not unique to health.

There was talk I seem to recall a couple of years ago to force a 'gap'year to encourage school leavers to work & gain some life experience before starting university. I have also heard it discussed that conscription be reintroduced for the same reasons, but it would be run in conjunction with any studies undertaken for all 18-20 year olds.

Food for thought hey. The consription discussions I heard suggested that, for example, Paramedic students & medicine students would actually cover medical in their consripted service.

Maybe this has some merit.

I quite like something like that; like some sort of incentive to go and work for a year or something and get out and deal with people in the real world. Not so hot in the idea of compulsory military service again but hey, some of these "youth" need a good swift kick up the arse and the Army is certainly the place to see that they get that!

[BushyFromOz]

I quite like something like that; like some sort of incentive to go and work for a year or something and get out and deal with people in the real world. Not so hot in the idea of compulsory military service again but hey, some of these "youth" need a good swift kick up the arse and the Army is certainly the place to see that they get that!

Yeah, is a great idea. Unfortunately the only thing ambulance services have absolute control of is the way in which graduates are recruited and inducted into the system. Its done on the principles of minimal cost and time to get "qualified" asses on seats and then wonder why grads are not as well adjusted as they could be.

Its like standing in the rain and whinging your getting wet.

[tniuqs]

Whoa Nelly almost a missed opportunity in the spirit of Jeff Foxworthy

So after reading this topic and you understand half of what is being stated You must be from the Southern Hemisphere.

If you believe a "uni" is a place of higher learning: You must be from the Southern Hemisphere.

If you believe that white flakes falling from the sky are from Bush Fires: You must be from the Southern Hemisphere.

If you believe that "I" stands for anything other than Intermediate: You must be from the Southern Hemisphere.

If you know the difference between an ABO and an AMBO: You must be from the Southern Hemisphere.

If you believe that WANK is a term in the Webster Merriam: You must be from the Southern Hemisphere.

If you believe that freezing level is COLD: You must be from the Southern Hemisphere.

If you believe that any marsupial is naturally occurring: You must be from the Southern Hemisphere.

If you use a flightless "cartoon character" bird is a good idea for a national emblem: You must be from the Southern Hemisphere.

If your standing in the rain and whinging your getting wet: You must be from the Southern Hemisphere.

If you believe putting some thing IN or ON a Barbie is not sex: You must be from the Southern Hemisphere.

If you believe getting pissed their spare cash up the wall with their mates at the pub every wednesday and friday night is a good way to study: You must be from the Southern Hemisphere.

If you know what "panadol" is: You must be from the Southern Hemisphere.

If you need a BOAT to visit the closest country: You must be from the Southern Hemisphere.

If you believe that EMS and Fire should be separated (like religion and affairs of state): You must be from the Southern Hemisphere.

If you believe mate is a term for a male friend and has nothing to do with procreation: You must be from the Southern Hemisphere.

And just because I'm finished poking fun (and am hungry) the TOP of the hit parade, drum roll please .....

IF YOU BELIEVE that actually getting higher educational to deliver Paramedicine is a good idea: YOU MUST be from the Southern Hemisphere.

And to whoever asked why NZ thread was under the UK forum: You must NOT be from the Commonwealth of Nations !

ta ta, te he.

Edited December 8, 2009 by tniuqs

[BushyFromOz]

Whoa Nelly almost a missed opportunity in the spirit of Jeff Foxworthy

So after reading this topic and you understand half of what is being stated You must be from the Southern Hemisphere.

If you believe a "uni" is a place of higher learning: You must be from the Southern Hemisphere.

If you believe that white flakes falling from the sky are from Bush Fires: You must be from the Southern Hemisphere.

If you believe that "I" stands for anything other than Intermediate: You must be from the Southern Hemisphere.

If you know the difference between an ABO and an AMBO: You must be from the Southern Hemisphere.

If you believe that WANK is a term in the Webster Merriam: You must be from the Southern Hemisphere.

If you believe that freezing level is COLD: You must be from the Southern Hemisphere.

If you believe that any marsupial is naturally occurring: You must be from the Southern Hemisphere.

If you use a flightless "cartoon character" bird is a good idea for a national emblem: You must be from the Southern Hemisphere.

If your standing in the rain and whinging your getting wet: You must be from the Southern Hemisphere.

If you believe putting some thing IN or ON a Barbie is not sex: You must be from the Southern Hemisphere.

If you believe getting pissed their spare cash up the wall with their mates at the pub every wednesday and friday night is a good way to study: You must be from the Southern Hemisphere.

If you know what "panadol" is: You must be from the Southern Hemisphere.

If you need a BOAT to visit the closest country: You must be from the Southern Hemisphere.

If you believe that EMS and Fire should be separated (like religion and affairs of state): You must be from the Southern Hemisphere.

If you believe mate is a term for a male friend and has nothing to do with procreation: You must be from the Southern Hemisphere.

And just because I'm finished poking fun (and am hungry) the TOP of the hit parade, drum roll please .....

IF YOU BELIEVE that actually getting higher educational to deliver Paramedicine is a good idea: YOU MUST be from the Southern Hemisphere.

And to whoever asked why NZ thread was under the UK forum: You must NOT be from the Commonwealth of Nations !

ta ta, te he.

Having fun today turnip?

Actually, a lor of what you posted there also applies to South Africans...its actually pretty scary hgow similar aussies and south africans are.

No wonder we hate each others rugby teams so much

[tniuqs]

Having fun today turnip?

Some days my evil twin brother shows up at the door .... I dunno.

Actually, a lor of what you posted there also applies to South Africans...its actually pretty scary hgow similar aussies and south africans are.

No thats the: You must be from Deep Dark ContinentThread ... stay tuned until my evil twin comes back to play, no he cant be called he always shows up uninvited

No wonder we hate each others rugby teams so much

Ah food for thought.

If you call soccer, football then : You must NOT be on the continent of North America