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911 vs transfer medics/emts


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Back in the "real" old days a youing upstart gunslinger would attempt to pick a fight with a seasoned infamous gunslinger known all over for his quick draw. What the kid didn't realize was that if he killed the older gunslinger, he would become notorious as the man who killed him. Every upstart would then be gunning for him. No matter how fast the kid became, there was always going to be someone faster. Relating this to the EMS field, there are always going to be better medics than we are. We shouldn't compare ourselves in that way. Each of us have our own talents and abilities that make us the good medics that we have become. I have seen numerous (unfortunately too many) "cocky" medics that are so highstrung and egotistical that they would not turn a scene over to anyone other than their own fire service resulting in turmoil on the scene. I have heard derisive remarks made from FF medics to private ambulance services responding. After the particular FF medics assessed the patient, packaged him, and finished on the scene they would yell over to the private service to bring their cot. (The reference was to "cot jockey"). No one wins when this happens. We are professionals and should act accordingly. The way we conduct ourselves is of utmost importance. If we act and see ourselves as professionals others will see us as professionals also. I have never worked as a FF medic but have spent most of my time in a private owned ambulance service running 911 calls and transfer calls. Transfer medics / emts develop certain skill sets that include aspects of nursing as well as those taught in EMT and Paramedic school. When the FF medics actually transport, it is usually a short distance to the local ED. The Transfer medics/emts actually have a more involved transport with patient contact that can take hours. The medic must be alert to patient changes over the length of time and treatments given must be documented accordingly.

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  • 2 weeks later...

Well, whoever put it to you like that is an asshole. Like the private services, FD's also have assholes.

The privates are a good starting point to learn the ambo and the ins and outs of the equipment etc.

911 is another beast.....when I have students with no private experience I always cringe. I hate having to teach the stretcher/stair chair and the courtesy that is expected from the young guys in this field.

Don't dwell on it. Try not to argue with preceptors even if you have a big disagreement. You'll turn out just fine: this isn't the field for the thin skinned.

Good luck

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I have gotten better. And witnessing my first code on a fire rotation has helped me realize what he mightve meant when he said "private ambulance isnt box time". But having seen the fast pace of a true emergency versus the slower pace of a private it makes me nervous making the transition as a paramedic.

Edited by runswithneedles
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It is not where you work that makes you a good or bad provider -- it is how you handle yourself.

I worked for a private transfer service as a summer job when I was just out of high school. IT WAS A FANTASTIC EXPERIENCE. I learned stuff there that I could never dream of having the opportunity to learn as a 911 medic.

Yes, the patients are usually not very sick when you are doing a BLS transfer gig, but there are opportunities to learn literally EVERYWHERE.

Things I learned:

How to talk to patients (be curtious, value the small talk, take care of the littel things to make them ore comfortable),

How to move patients (a bed sheet can be your best friend),

I got exposed to TONS of healthcare environments (Not just the ER. This is possibly the single biggest downfall of EMS. So much goes on that many 911 providers are entirely ignorant of. How many are familiar with dialysis? With rehab? These things are important and have their own challanges)

I got to read progress and discharge notes from doctors.

I got to read med lists (look up every medication you come across...this will do more for you as a provider than you can possibly imagine)

I got to read detailed reports on medical problems, cath lab reports, surgery notes, lab values, you name it.

The list goes on and on. Transfer is much different than 911. I am a lot better 911 medic because I worked transfer, and if I were to go back I would be a lot better there because I worked 911.

It is all what you make of it. If you treat it like a taxi service, it will be a taxi service. If you treat it like the best opportunity to learn, it will be just that. These guys you are working with have no idea what they are missing, but the very fact that they are giving you a hard time about it shows that they are not the type to suck the marrow out of every opportunity to better themselves as a provider.

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