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spelling and grammar in EMS run reports


Does poor spelling and grammar indicate poor patient care?  

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    • yes
      15
    • No
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Solutions? More competitive EMT and paramedic school entrance requirements. They aren't allowed in until they have completed the general education co-requirements. Period. And the more college hours they have, the higher on the list they go, ahead of the other candidates. Minimum SAT or other standardized testing scores. Essay entrance exams.

For those already in the field, you will improve yourself or you will be terminated. EMT's will be in paramedic school AND have their general educational requirements completed within two years of employment or be terminated. Paramedics will complete an associates degree within two years or be terminated. Those are all things they should have done BEFORE they entered the field in the first place, so I will accept no whining about being unable to do it in two years.

New employees, primary paramedics will not be hired without a college degree. Medics without degrees will be hired on an as-needed basis as secondary medics so long as they are actively enrolled in a degree program, which they have two years to complete.

And regardless of your educational level, if you have low grammar skills which are not showing noticeable improvement, you're out the door. I will not have my agency and all the good people who work there embarrassed by your lack of professionalism. Because no matter how good the rest of my people are, YOU are the one all the doctors and nurses are talking about. You are the weakest link. Goodbye!

SPELL CHECKED: one error found and corrected. :wink:

Ha! You might be able to pull those standards off in a small EMS system, if at all. I don't disagree with your ideas, if you could set that standard and enforce it, you would have the perfect system. I just don't believe that it's achievable in most places.

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Minimum SAT scores, Standardized testing required, college credits/diploma, all for an EMT-B who starts out at 10-12 dollars an hour? What's the draw to even get into the industry? You can't make EMS an exclusive country club. I agree in your Utopian views, have a Bachelor's degree in Business Administration, and did well on my SAT's, but I don't think that making them requirements is a feasible vision. If the starting pay in EMS was higher than your average burger flipper's pay, then maybe you could get away with those expectations.

Some of the best partners and pt care givers I've ever worked with have fairly deficient verbal/written/communicative ability. But I'd rather have them on my truck when the big one tones out than some smarmy, stuck-up "college boy" with a superiority complex because he had a 1300+ SAT score. That's why we have partners, one to look after and correct deficiencies in the other. If we as an industry focused more on teamwork, collaboration, and tolerance, we might be more respected in the long run.

Lastly, I don't give a vermin's pa-toot about what some Hospital MD/RN is saying about my partner who stuttered or repeated himself during a report. How was his patient care? Isn't that the important factor? When the Hospital staff makes mistakes, it gets covered up as an oversight, or an unforeseeable issue, when we make mistakes, we're stupid, uneducated rube's with a hero complex. I shudder when I see our own people prostrating themselves to the MD/RN and throwing their partners and Industry as a whole under the bus. Help your co-workers, don't berate them. Encourage them to improve themselves, don't impugn them if they haven't gotten to it yet.

All we have is us... you... me... everyone.

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Minimum SAT scores, Standardized testing required, college credits/diploma, all for an EMT-B who starts out at 10-12 dollars an hour? What's the draw to even get into the industry? You can't make EMS an exclusive country club. I agree in your Utopian views, have a Bachelor's degree in Business Administration, and did well on my SAT's, but I don't think that making them requirements is a feasible vision. If the starting pay in EMS was higher than your average burger flipper's pay, then maybe you could get away with those expectations.
But that is exactly the point! There are other threads on " Lousy pay for EMS " etc., so I won't get into that. But I feel the general consensus is that if we as an industry, raised the minimum education requirements THEN we would start getting the pay and respect we as an industry so richly deserve.

Spell checked, no corrections required 8)

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Jake is correct. Education and professionalism increases, and the profession elevates. And...

Lastly, I don't give a vermin's pa-toot about what some Hospital MD/RN is saying about my partner who stuttered or repeated himself during a report. How was his patient care? Isn't that the important factor?

No, it is not the important factor. It is an important factor. EMS is a multifaceted profession with multiple concerns. Patient care is our primary goal. However, it is not our single concern. The image of the profession, and of your organization, is of great concern. However shallow you may perceive doctors and nurses to be for judging your atrocious grammar, the fact is that they do it, and it reflects upon you, your agency, and your entire profession, keeping us exactly where we are now -- right next to the burger flippers -- on the professionalism scale.

It's the old chicken vs. the egg argument. Are we undereducated because the profession sucks? Or does the profession suck because we are undereducated? I submit the latter. And if you honestly believe the former, you are either blind, or you simply have not been around long enough

SPELL CHECKED: No errors found. :(

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I carry a small medical dictionary with me for cases just like this. When we went to using ePCR's the software maker conveniently left out spell check. Does that make me a lousy paramedic? I don't think so. There are some of us who just never were good at spelling or grammar. Now, if I had poor grammar while talking to a patient or other medical professional then you can call me ignorant.

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To go further than what Dust noted (in my opinion correctly), if you or your partner present yourself as a less than effective communicator (whether in speech, writing or both), do you really think the doc is going to approve requests for orders when you call?

The doc won't deny the request for orders simply because s/he doesn't think the request is appropriate. If the doc thinks you're a bumbling, uneducated idiot, why should you be trusted? And if you present yourself in a manner such that you stutter and bumble your way through a report and follow it up with a poorly written PCR (complete with spelling and grammatical mistakes) then you've demonstrated yourself not to be worthy of the trust with regards to extra patient care.

And in the end, it's not the doc who suffers. It's the patient. Patient care suffers because you've demonstrated yourself, through your presentation in person and in writing, incapable of the trust to properly handle the care of the patient outside the realm of protocol. With that, you prevent the rest of us from being able to provide prudent care because now the doc thinks the rest of us are just as bumbling as you. And it's not the doc's fault. That comes back to you.

Present yourself as an idiot and it's only the patient who suffers. Not the doc. You do to the extent that people think you're an uneducated buffoon. But ultimately it's the patient who gets less than reasonable care simply because your professional image presents someone who isn't trustworthy of the responsibility of patient care. Which makes you a taxi driver. Which makes the rest of us look bad.

See the circle that's forming?

Do us all a favor. Speak well. Write well. It'll help you and your patient in the long run.

-be safe.

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Minimum SAT scores, Standardized testing required, college credits/diploma, all for an EMT-B who starts out at 10-12 dollars an hour? What's the draw to even get into the industry? You can't make EMS an exclusive country club. I agree in your Utopian views, have a Bachelor's degree in Business Administration, and did well on my SAT's, but I don't think that making them requirements is a feasible vision. If the starting pay in EMS was higher than your average burger flipper's pay, then maybe you could get away with those expectations.

in the Uk were Ambulance technician pay is considerably higher than the average burger flipper, entry standards are high - but not excessively so - on paper - but due to competition for lobs it's the exceptional candidate who gets in with the minimum qualification not the norm

Paramedics, as registered healthProfessionals have pay and status parity with other Health Professionals , despite not having to have a university levle education - although that is chanaging as we speak

Some of the best partners and pt care givers I've ever worked with have fairly deficient verbal/written/communicative ability. But I'd rather have them on my truck when the big one tones out than some smarmy, stuck-up "college boy" with a superiority complex because he had a 1300+ SAT score. That's why we have partners, one to look after and correct deficiencies in the other. If we as an industry focused more on teamwork, collaboration, and tolerance, we might be more respected in the long run.

rather hard to develop collaborative working when part of the collaboration doesn't have the necessary critical thinking skills to actively involve themselves in the decision amking process?

Lastly, I don't give a vermin's pa-toot about what some Hospital MD/RN is saying about my partner who stuttered or repeated himself during a report. How was his patient care? Isn't that the important factor?

it's a total package good,pretient and professionally appropriate handovers are part of the role ....

When the Hospital staff makes mistakes, it gets covered up as an oversight, or an unforeseeable issue,

you genuinely believe that , you must be so naive - however Hospitals as a rule are a little more sophisticated in their disciplinary systems other than just " you f***ed up " here's your P45, don't let the door hit your backside on the way out "

when we make mistakes, we're stupid, uneducated rube's with a hero complex. I shudder when I see our own people prostrating themselves to the MD/RN and throwing their partners and Industry as a whole under the bus. Help your co-workers, don't berate them. Encourage them to improve themselves, don't impugn them if they haven't gotten to it yet.

All we have is us... you... me... everyone.

and a culture which doesn't support development won't do you any benefit ?

30 years ago Uk ambulance staff were paid a low level municipal manual workers, now they are paid the same a Nurses, and therapists ... wioth the same benefits, same development opportunties ...

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Grammar and proper usage of words as well as documenting such not only represents your ideas and actions, but your representation of patient care. Sorry, I know of people with a PhD making little more than $10-12 dollars an hour, so how much should one make going to a few hundred hour class.

So the opinion I have gathered from some, unless the pay us more, we need to continue to be ignorant and stupid... hmm yet, again maybe that is why we still do not get high pay ? It should be a requirement that before applying to EMT school or advanced level EMS courses one should have reading & writing skills of least high school level for basic and college for advanced level. Like any other professional classes, (even with 3 college degrees) I was still required to take a writing test. If had not scored high enough, I would had to take a supplemental course & retake the test or not be accepted. The same should be true in EMS.

If one cannot read or write or even talk then this person has poor communication skills. Communication skills is one of the essential requirements to be able to portray a picture or present an accurate assessment. Those that are not able to meet those requirements should be given the option to either increase their skills in such or be discharged. No variances should be allowed.

Since documentation is a representation of the care administered and the legal record of the care, there can be no variations. One must remember, that they are not just representing themselves, but the company and the profession

as well. Unfortunately, it does not matter if they are a "supermedic ", if they cannot back that up with proper documentation & effective communication.

For those that seem not to care.or want to remain ignorant .... remember it will people like me & others that YOU will be judged against...

Be safe,

R/R 911

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Everyone has made very salient arguments, and I don't disagree with most of them. I would love for there to be an educational standard that promoted proper communicative and written skills, but the plain and simple fact that it is a long road to hoe. As some of you have pointed out, we are beginning to make those strides toward higher education and professionalism. My point is that until we reach that point, we need to not throw our co-workers and new EMT's with only a GED or HS diploma under the bus. In some cases these are people without the affluent background, or familial support needed to participate in "higher education." Many of these people have great potential, and if you encourage them to look forward rather than to stand still, and not throw them out with the bathwater so quickly when they haven't had the opportunity, then you may see some of the desired effect on the industry.

Call me naive, call me inexperienced (although I don't know how you could garner that from a simple perspective difference, unless you are the omnipresent puller of the heavenly strings), but I vehemently disagree that it is the fault of the EMT that the hospital staff can't tell the difference between proper pt care, and someone with a social development issue. As someone (AZCEP) earlier on in this argument pointed out, it's not always the fault of the person (i.e. he of the Autistic son). I will not agree with any policy that discriminates against perspective personnel because of a speech impediment or a social aversion. If you think that that sort of policy is appropriate, then you might not be naive, but you may be a monster.

This elitism is frightening, ZippyRN's response to part of my previous narrative questions the "critical thinking" of those who don't speak well. Since when has ability to speak have anything to do with critical thinking? Ever hear of a man by the name of Stephen Hawking. One of the great critical thinkers of our time, but I guess because of his affliction, not good enough to collaborate with... I wouldn't want him on my ambulance, but that's because of his complete lack of physical ability, but not for his critical thinking skills. Don't judge every book by its cover, remember, a cursory physical assessment doesn't always tell the story of your pt's condition, so don't do it with other people. I will also submit that we live in completely different communities and I will assume that the dynamic between hospital staff and EMS is probably different. I've seen MD's in the Northeast USA get away with dreadful mis-diagnoses and plans of care without the slightest recrimination. I live here, I work here, we hear everything.

Dust Wrote:

"It's the old chicken vs. the egg argument. Are we undereducated because the profession sucks? Or does the profession suck because we are undereducated? I submit the latter. And if you honestly believe the former, you are either blind, or you simply have not been around long enough"

Again, I love how you generalize MY experience level and expertise from one post. So if I say "chicken", while you say "egg", that makes me blind or inexperienced. Frankly, I do believe that we are undereducated because the profession sucks. Our EMS education services that are charged with putting out these EMT's that you have a problem with are still putting them (EMT's) out!!!! That's not the EMT's fault for passing a rudimentary curriculum... it's the curriculum!!! How can you not see that? Your argument that it's the EMT's fault for not seeking further education is counterpointed by YOUR own argument that there needs to be higher educational requirements. If the profession was pulling its' own weight, then these people you believe are sub-standard would not be allowed to practice. Our educational system sucks, our recognition of the problem sucks, and the industries failure to fix the problem sucks. Not always the EMT's that suck (although sometimes that is the case).

The simple fact of the matter is that the "profession" benefits from keeping us uneducated, we cost less as just "ambulance drivers." They don't want us to have the education that they need to eventually pay for.

The problem is that WE are not in control. The companies, the services, the hospitals, the medical control, the municipalities.... everyone else dictates what our requirements are. Until you can get them to change the requirements, your pipe-dream will be just that.

I am a believer that change comes from the people. We can't change the educational requirements, but we can change our attitudes and our respect levels. While I respect the combined experience of everyone in this community, I think that we become desensitized as we gain experience. It doesn't hurt to be tolerant of the new people, and maybe read a couple chapters before you pass judgment on the book.

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Wow, you made some really serious misjudgments of what I have said.

My point is that until we reach that point, we need to not throw our co-workers and new EMT's with only a GED or HS diploma under the bus. In some cases these are people without the affluent background, or familial support needed to participate in "higher education." Many of these people have great potential, and if you encourage them to look forward rather than to stand still, and not throw them out with the bathwater so quickly when they haven't had the opportunity, then you may see some of the desired effect on the industry.

Uhhh... that is exactly what I suggested. They have two years to improve themselves. That is hardly throwing them under the bus. And there is NOBODY employed in EMS who does not have the resources to participate in higher education.

This elitism is frightening, ZippyRN's response to part of my previous narrative questions the "critical thinking" of those who don't speak well. Since when has ability to speak have anything to do with critical thinking? Ever hear of a man by the name of Stephen Hawking.

Yes, and I don't want him on my ambulance either.

I will also submit that we live in completely different communities and I will assume that the dynamic between hospital staff and EMS is probably different. I've seen MD's in the Northeast USA get away with dreadful mis-diagnoses and plans of care without the slightest recrimination. I live here, I work here, we hear everything.

Great. You work on improving the competency of northeastern MD's. Meanwhile, we're working on improving EMS here.

Frankly, I do believe that we are undereducated because the profession sucks.

Frankly, you miss the point. The point is, it doesn't matter which came first. Personal growth and development is up to YOU and you alone. YOU are responsible for achieving education. Nobody has to give it to you. It's there. Either go get it or sit on the sidelines with the rest of the GED's. Doesn't matter to me. There are plenty of medics out there who are willing to put personal effort into being all they can be. Especially if they know it is the standard for employment.

Our EMS education services that are charged with putting out these EMT's that you have a problem with are still putting them (EMT's) out!!!! That's not the EMT's fault for passing a rudimentary curriculum... it's the curriculum!!! How can you not see that?

How can you not see that I do see that? I have made that very same observation here time and time again since joining the board. It seems that at least once a day I observe how totally inadequate the educational standards are in EMS.

Your argument that it's the EMT's fault for not seeking further education is counterpointed by YOUR own argument that there needs to be higher educational requirements. If the profession was pulling its' own weight, then these people you believe are sub-standard would not be allowed to practice. Our educational system sucks, our recognition of the problem sucks, and the industries failure to fix the problem sucks. Not always the EMT's that suck (although sometimes that is the case).

No kidding! Tell me something I don't already know!

The simple fact of the matter is that the "profession" benefits from keeping us uneducated, we cost less as just "ambulance drivers." They don't want us to have the education that they need to eventually pay for.

The problem is that WE are not in control. The companies, the services, the hospitals, the medical control, the municipalities.... everyone else dictates what our requirements are. Until you can get them to change the requirements, your pipe-dream will be just that.

I am a believer that change comes from the people. We can't change the educational requirements, but we can change our attitudes and our respect levels. While I respect the combined experience of everyone in this community, I think that we become desensitized as we gain experience. It doesn't hurt to be tolerant of the new people, and maybe read a couple chapters before you pass judgment on the book.

Three paragraphs of utter nonsense. Who do you think the system is? WE ARE THE SYSTEM! We can change it! Nobody has to wait to be told that education is important before they choose to improve themselves and be all they can be. Nobody had to pass a law to make me wear my seatbelts. I was smart enough to figure out it was a good idea all on my own. Professionalism is contagious. Elvevate your game, and people around you will be motivated to elevate their own. That's where it all starts. The only thing you are correct about is that it is indeed a very long road until EMS ever gets where it needs to be in the US. If you are waiting for the man to force you to improve yourself, then you will end your career as cluelessly as you began it.

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