Kiwiology Posted May 9, 2012 Share Posted May 9, 2012 Where is my fee? One of the dumbshit Mexicans who was laying bricks yesterday and moved into committing Medicare fraud this morning hopefully will buy a bulk list of 10,000 patients for a grand off a crooked healthcare professional and mine will be in there so there's your fee; even tho you don't get to see it Medicare will pay for it so um yeah How can I ever take you seriously when you use a graphic from "The Daily Show"? What, the Daily Show is not news? Link to comment Share on other sites More sharing options...
Arctickat Posted May 10, 2012 Share Posted May 10, 2012 Well, it is for me I suppose Link to comment Share on other sites More sharing options...
Arctickat Posted May 18, 2012 Share Posted May 18, 2012 Looks like kiwi is gonna have to hang up his hat. http://tvnz.co.nz/national-news/support-regulation-cowboy-paramedics-4892992 Link to comment Share on other sites More sharing options...
Kiwiology Posted May 18, 2012 Share Posted May 18, 2012 (edited) Although slightly factually incorrect the article is right, finally after over twenty years of trying Ambulance Officers at Paramedic and Intensive Care levels are being included under the HPCAA It's a step in the right direction but seriously, other things are far more important namely fixing the continuing underlying financial deficit and getting decent vehicles (how about using a design that was not introduced in 1980s?) and uniforms that are actually practical like a jumpsuit or two piece cargo and polo? What inclusion under the HPCAA will do is restrict the titles "Paramedic" and "Intensive Care Paramedic" to those who have a prescribed qualification (Bachelors Degree and Graduate Diploma respectively) and a practising certificate with the responsible authority - we're not sure who that will be yet but it would seem logical to join up with the newest regulated profession of Anaesthetic Technology and come under the auspices of the Health Science Council (who also regulate Medical Laboratory Science) Honestly, the fine for breaking the using a restricted title law is so pathetic it's not funny but at least now it will give the Ambulance Service some legal teeth to pursue those who blatantly falsify themselves as being a Paramedic. Truth be told I don't know of any of the private operators who use the word "Paramedic" but I'm sure there are some muppets out there with delusions of grandeur. Like I said, a good step but more important things come first Oh Trev, take a look here http://www.stjohn.or...-Video-Archive/ under the archive video, specifically "111 club" and "A Night with St John" - I think you'll recognise the period from when you visited New Zealand; some things have changed notably the uniform and patches, practice level titles, equipment and that $280 cost for each call (I think this would be about ~1993) is now over $600. But nertz to progress, get my ass in the back of a Chevvy with a Lifepak 10 and a big black suitcase of drugs and IV gear I say. Donna Austin the ACO (Paramedic) on one of those videos is still with the Ambulance Service, 20 years later, looks a bit older now, if you watch closely you'll notice she is the one giving the old lady GTN it has only been in the last ten years that GTN dropped down from a Paramedic (ACO) drug; my how things have changed! Edited May 18, 2012 by Kiwiology Link to comment Share on other sites More sharing options...
chbare Posted May 18, 2012 Share Posted May 18, 2012 Didn't you say NZ medics were completely autonomous? What is this whole supervision by medical practitioners concept discussed in the article? Link to comment Share on other sites More sharing options...
Kiwiology Posted May 18, 2012 Share Posted May 18, 2012 Didn't you say NZ medics were completely autonomous? What is this whole supervision by medical practitioners concept discussed in the article? Again, that article is not totally accurate. The National Ambulance Sector Clinical Working Group consists of a gaggle of emergency physicians, the director of Defence Force Health who is a GP (stupid bloody idea to include the military, seriously) and some senior paramedic managers; they develop the Clinical Practice Guidelines which are used by the sector. They are used totally autonomously (i.e. no "online control") and there is considerable freedom around patient management however technically under the Medicines Act they are a standing order allowing the possession and administration of prescription drugs to patients by somebody who is not a legislated prescriber (which in NZ are doctors, dentists, midwives, opticians and nurse practitioners) In the future there may be a move towards what the UK has done to allow Paramedics to posses and administer certain drugs without a standing order however I am not sure how that would look in reality Link to comment Share on other sites More sharing options...
chbare Posted May 18, 2012 Share Posted May 18, 2012 Okay, so there does exist some form of "medical direction?" Link to comment Share on other sites More sharing options...
Kiwiology Posted May 18, 2012 Share Posted May 18, 2012 Okay, so there does exist some form of "medical direction?" Sort of but nobody here would ever dare call it that and personally I hate that term as it implies the ambos just do whatever the doctor says or must look to physicians for leadership and nothing here could be further from the truth; I know that wasn't your intention to imply that because it's just the term you are used to using in your part of the world but it's just pet peeve of mine. There is significant leadership by the profession itself but obviously there has to be some sort of body which takes overall clinical responsibility and nationally this is the Clinical Working Group; St John has their own Clinical Management Group which looks after St John specific matters and WFA has the ACE Committee. Anything national like scope of practice or the actual clinical procedures (and in the future the national electronic PRF and some other things) goes to the CWG whereas anything specific to the particular service goes to their relevant group. With the registration of Paramedic and Intensive Care Paramedic and the requirement for a responsible body I am not sure how this will all marry up but I strongly suspect there will be a national move towards clinical governance given that the two hospital based services are now dead and we only have two providers. Link to comment Share on other sites More sharing options...
celticcare Posted May 18, 2012 Share Posted May 18, 2012 Ok the registration of Paramedics is a good thing and in the reality Ben, I would rather have a registered Paramedic looking after me who is accountable for his skills and updates as I have to be as an RN than someone who isnt'. What is the point of having double crewing or better trucks *which hell you refer to as a faggoty sprinter* if the officers providing the care aren't up to a standard. With the progression of the degrees and skill sets, the in house methodology of EMS education wont exist any more, just like it doesn't exist for nursing here in New Zealand any more. Ch - the general running is as said above, basically the medics do their training, get an authority to practice which is signed off by the EMS agency and their medical director. Its the medical director for the region that basically lets the medics use the drugs under his license. if that medic screws up, then they have to report to the medical director and sort it out and make sure everything is in line and if anything needs to change for that individual staff member. I am getting sick of this shite about paramedics whinning about registration, every other health sector provider in NZ has to be registered, what makes EMS so much different. And Ben, don't refer to technicians as the lowest form of staff, because at the end of the day, the achieved the qualification and skill set and got their arse on the ambulance seat. More than I can say about you, and just remember also, that when you finish the degree, you don't get to practice at ILS straight away, you spend a period of time consolidating your knowledge at an EMT level just like I had to do as a Level 1 nurse on registering. So don't you even think of refering to technicians is how you implied, because I know a few who would happily clip you upside the head for that crap! Link to comment Share on other sites More sharing options...
Richard B the EMT Posted May 18, 2012 Share Posted May 18, 2012 (edited) Just confirm, Ben. You have some autonomy for your actions as what I would call Paramedic Scope of Practice, without needing to call in for On Line Medical Control, i e "Mother/Father, May I?" Due to distances, and possibility to need Helicopter EMS a bunch more than I would, due to my being "urban/metropolis (/Megalopolis?)" versus your "country/agricultural (/wilderness?)", it would make sense that Paramedics would, and should, be higher trained. Edited May 18, 2012 by Richard B the EMT Link to comment Share on other sites More sharing options...
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