Whose responsible in your opinion foryour pre-hospital care

[AZCEP]

The individual is responsible for everything good and bad that happens to themselves.

The generation of entitlement that we are currently struggling through doesn't seem to be able to grasp this concept. Part of the problem may very well be too many wanting to make things easier for them. When this begins to happen it very quickly snowballs out of control.

Let me make this very clear to all that are reading.

I am responsible for what I do on a scene, I am responsible for what you do on a scene. If you decide to do something stupid, don't be surprised when I ask you to leave. I will not willingly give up my safety so that the uninitiated can feel good about themselves.

[whit72]

I take full responsibility for any decision I make.

Hopefully I have the experience and the knowledge to make the right one. Sometimes we have been up all night, sometimes you have 20 seconds to make that decision and those consequences could last a lifetime. I also made the decision to work in EMS knowing the possible consequences it could have. That's why it angers me to see people in our field so quick to judge the decisions made by our co-workers. Without knowing the complete story.

[Asysin2leads]

I am. It may sound corny, and for all my cynicism, a bit hypocritical, but I really firmly believe that everytime I put on my uniform with that funny looking patch on the side its saying "I am going to do everything I can and do it to the best of my abilities."

Some people have the epiphany and, realize the gravity of their actions, but most don't. I had responsibility drilled into my head all through my life, so much so that I think I go over board and feel guilty and responsible when I shouldn't.

Heck, my tag line pretty much says it all, but either you see why you should do a good job everytime, or you don't. It's too bad we can't have a truth-o-meter, and ask someone a question like "If it won't affect your monetary reward, should you do your job well or just enough to not get fired?"

[Just Plain Ruff]

So who chose the "NOT ME" Its everyone elses responsibility choice? Hopefully you were joking.

[Ace844]

So who chose the "NOT ME" Its everyone elses responsibility choice? Hopefully you were joking.

Sadly, I don't think the person who made that vote, has the cajones, to step and explain that choice.....Par for the course really.

Now back to the thread, here are some statements made by various people who post here which take different perspectives on the issue. Thios is kind of what got me thinking about this. here you see the beginnings of different excuses and explanantions for 'why' we do or don't do certain things. I find it interesting that with the sheer volume of posts which are expressing similar and a wide range of opinions that so few of you newer people have responded! For all who have participated thus far thank you for taking the time and sharing your wisdom.

I am sick of hearing about studies, WHAT DO YOUR PROTOCOLS STATE?

Until the protocols change that’s how they are handled regardless of my own personal opinions.

The protocols are law in the certified state, in the lic. state they are guidelines that can be deviated from.

Well practicing medicine is not with holding a medication that effectively treats the problem at hand, and is accepted in my protocols and then speeding to a hospital.

If there were continual disastrous effects from the administration of this medicine, do you think maybe it would have been removed?

No offense but the people who write these protocols have significantly more education, and experience with this, then either of us, they are to blame.

Do you know the circumstances surrounding the call.

Maybe there could be a-thousand reasons.

Ma'am, we regret to inform you your husband is paralyzed, because HE is stupid and should not have to tried to blow himself up in a building, requiring firefighters to have to risk their own safety in trying to rescue him, in that rescue attempt they were pulled from the building prematurely due to a collapse warning. They understandably were not able to immobilize him properly due to the scene not being safe. So when you are on the phone with your attorney planning how you would like to sue the departments involved. Maybe you should place a call to the fire dept. and EMS agency an kindly apologize to them for having to put themselves in harms way because you husband is an idiot. Now kindly go back and sit in your chair, and if the knucklehead lives, you might want to think about a donation to the fallen firefighters charity.

If you see someone you want to help. Do your best for the pt. and if anyone asks, tell them you saw it on ER, or you stayed at a holiday inn last night. Don't offer information that could cause you a problem in the future. If the person dies they will remember you were the one with the badge and the ID.

In your case, sounds like your friend was a bit panicky and probably wasn't able to think properly...

So a lot of stuff we deal with more on our own. Not to mention we are never more than 10 minutes to the farthest hospital, so in a number of cases it is quicker and easier, as well as the patients best interest to just go to the hospital.

When it comes to the rubber meeting the road...we are a specilaized transport service--read movers of valuable goods--we are not doctors--as many would like to think they are--we initiate care for people who are ill and take them to seek the care they need while performing skills taught during training.

If you think that you need to be a paramedic to provide quality care you belong on the private ambulance that you most likely work on. As I am sure you know being a "pro-medic", 90% of EMS calls require no care at all. Just a ride to the hospital.

That is ridiculous!! How could you even begin to show your face and continue to practice after you did something like this?

We all should have an sense of right and wrong in this profession. That being said; I think that there are many of us who have been on calls which we were very glad that there wasn't a camera, or other 'trained' observers around during it. I also think that there are many situations in which when one is 'in the moment' makes decisions where later we look back and say 'What was I thinking, or not as the case may be'.

It is part of human nature to err, and make mistakes. At least, have the decency though to stand up and admit that 'Hey, I made a mistake, and face the consequences.' Also, at some point you as an individual provider need to take responsibilty for your care, actions, performance, and 'ensure' that you will do the right thing, provide the proper care, and 'not allow yourself to be swept up in the moment react to the adrenaline, or make rash decisions.'

Additionally, at some point you need to realize that these decision have REAL EFFECTS on your patients and can potentially CHANGE AND ALTER THIER LIFE OR BODIES PERMENANTLY! So this is why you are 'duty bound, compelled, or whatever other adjective you want to use,' to do your job and duty correctly. Sometimes there are mitagating circumstances which make this impossible to do at that 'IMMEDIATE TIME', but once that situation has been resolved and it is safe to do so, you must step up and act appropriately, fix or re-do the interventions and the things you did hastely 'in the moment', as it has now passed. You need to do the best you can for you and your patient. Any thing less is unacceptable.

Now what have you to say?

Out here,

ACE844

[AZCEP]

I will go so far as to say that those of us that are responsible for our own actions just might be responsible for those that don't want to take responsibility for theirs.

As crazy as it may sound, if you go to work each day knowing that your agency will take care of all the CEU's, QA/QI, equipment supply, etc., then why would you take it upon yourself to do these things? The management of resources from the top down creates this type of mindset. When the individual provider comes to the realization that the department is not going to ensure that each piece of equipment is where it should be, only then do they decide they have to make sure of it for themself.

The classes that I've taught over the last few years, make this pretty obvious. The students don't want to take responsibility for what they have to learn, and more and more seem to believe that it is the instructor's job to give them the information to pass a test. I continue to refuse to give the answers to their questions directly. When a question is asked, I force them to think about the mechanisms at work. Hopefully, when they are placed in this position later, they will be able to work the problem on their own. Some appreciate this approach, some wish on a daily basis for me to come to great bodily harm.

Sorry, I'm not here to make your life easy. Take it upon yourself to learn the material, ask questions about said material, understand the process inside out, and then you will be able to pass any test that is given to you.

[Just Plain Ruff]

I haven't thought of it that way Azcep. you make a really valid point.

I too have been an instructor and let's take ACLS for example. The people I taught acls with would discuss the test before hand and go over each question and answer. I for one did not agree with this practice but it was directed down to the instructors thru the class coordinator.

The participants would at times in certain classes be given the pre-test that was the exact same test as the actual exam.

The class test was even open book.

How do you learn material that you need to know when the test is open book open neighbor.

This is a prime example of dumbing down the material.

In my paramedic class, we were given the answers to the test only after every took the test. If someone failed a test no-one got the answers to the test until that person passed the test. Many times the test taker was given all the answers to the test between when they took the first test and failed and when they retested. There were no reserve tests that were available so the failing student was given the same test.

One final item - before Missouri became a NREMT exam state there was a computer file floating around that had all the test questions and answers to the state exam. I will not admit that I had a copy, nope nope nope. But I do know that before each test many test takers got together and divided the questions up 5 questions per person, 1-5 to test taker 1, 6-10 to test taker 2 and so on. Their job was to somehow remember or surreptitiously write down somewhere the question and the 4 possible answers. The test bank of questions was quite complete.

I had also heard that it was done the same way with the NREMT exams in Missouri.

We are all responsible for our own education and if you are given the answers to the questions or given a hand holding to keep your certs up with education and such, then did you really learn anything?

[Ace844]

well said, Rid and Ruff... Anyone else?

Come one people, here's your chance to justify yourself and explain your POV and why you have the opinion on this you have...!!!!!!

ACE844

[whit72]

Who else would be responsible? You have no one to blame or commend for your actions but yourself. If you screw the pooch, take responsibility for it. This really isn't a difficult question.

I agree with ruff who do you have to blame but your self, Your responsible in these classes for the information, no one else if you choose to skate past and due the minimum required. When you get your arse handed to you out there, you have no one to blame but yourself. If you choose to take the easy way out and cheat on an exam. I don't understand cheating on a medic exam, who do you think your fooling, Its not an ancient western civ class (god that class sucked). How long can you last out there making it up as you go along.

I agree taking the usual classes after a while becomes mundane, but you have a responsibility to your Pt's to be the best you can be. Oh that sounds corny. Although its fitting.

I have seen so many smart, articulate, and intelligent people get tossed or have their tickets revoked because they got lazy, began to look for the easy way, and not the best way. Its too bad. They were once assets to this field.

Hey if your not growing your dying.

[mediccjh]

1.) I am responsible. and I do my best to learn and further myself and take this with the utmost seriousness, I do the best I can for every patient.

In EMT and EMT-P class, one is merely taught the foundation, fundamentals, and building blocks of paramedicine, and EMS as a whole. It is up to the individual provider to better themselves, to make them a smarter and better provider. It is also one's own responsibility to learn how to think outside of the box.

A monkey can be a paramedic. It can be taught when to give a certain drug and when to do a certain procedure. It can also be taught protocols. However, the monkey does not know why to give the drug or do the procedure, and does not know what to do when a situation from "outside the box" occurs.

EMS is not cookbook medicine. It is dynamic, ever evolving and changing. To be a good provider, one must be able to change also. And most importantly, learn every day.