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What should the Basic-Medic Partnership look like?


Should a Basic be allowed to function within his scope of practice without having to confirm every action with the medic and gaining the medics permission?  

54 members have voted

  1. 1.

    • Yes
      42
    • NO
      12


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I'm not in the habit of PM'ing people because I want to be confrontational. With that being said, I'll publicly answer a PM sent to me a few minutes ago. I won't divulge who the message was from, because I'm sure the more experienced of our group can figure it out.

I've been employed in EMS for nearly 12 years. Before that, I was a volunteer. You stated you have been an EMT less then a year, I can assure you I've been an ALS provider quite a bit longer than you have been a basic. I don't make excuses for my actions. I don't blame other people for my inadequacies. If I don't know the answer to a question, I seek out knowledge. I put myself through college, EMT-I and paramedic school. I worked in a large city for many years taking patients in and out of some of the nastiest homes imaginable, and I rarely came home from work looking as though I rolled around in garbage. I didn't use the excuse that because my job might get messy, I don't need to worry about my uniform or my ambulance being clean. I didn't use the excuse that because college courses were not required for my paramedic license that I wasn't going to bother with them. I don't confront people in PM because I don't agree with their views or I feel like I'll be a bigger person if I attempt to insult them.

Now, you began this post and poll. If you can't handle the opinion of others, I suggest you refrain from beginning any posts.

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OK. I am the one that sent you the PM, largely because I believe if I have something really disagreeable to say to someone it should be done in private. Maybe your mommy and daddy didnt teach you that. If you would like to get insulting in public, I would be perfectly happy to accomodate you. The fact is that I started this thread with the hope of meaningful dialogue which it appears that you are incapable of. That seems to be impossible given the topic with which I started the thread since this is an argument as old as the hills. What should EMT/Medics teams do? How should they function together.Obviously you cannot provide an intelligent answer to this question. This thread has been hijacked so many times by people who didnt bother to read my original post, that I dont even know whats its about anymore. Many, including you, have just run off on tangents based on the previous post and not on the intention of the thread. I have do it too, to try to maintain dicussion. Maybe its time to lock 'er down. This is just getting ridiculous. Thet next time you say something noxious, ill-informed and stupid I will just blast you in the forum instead of PM. You are right. If I am going to insult you, I should most definately do it in public. Thats the least I can do for someone of you caliber.

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Here is something that I should have written when I started this thread that might have made by position alot more clear. To a great extent, Basics are taught to function within the BLS/BLS rig model, at least here in IL. We are not taught how to interface with Medics, even though most of us will infact end up riding on a BLS/ALS rig. The reason that the powers that be say we are taught this way is that the EMS laws in IL state that there must be at least a Basic on each rig. Well Duh! With the exception of one private agency in town that is all ALS (I used to work for them before they went that route) all rigs are BLS/ALS. But to get back to my original point, we simply are not taught how to work with medics. We are taught all BLS skills and protocols, with very little knowledge of ALS protocol except to assume that it is anything that we arent allowed to do. I wanted to make sure that this wasnt just the way my class was taught so I have checked with alot of other basics and basic programs around the state to find the same thing being taught which is, in essence: Here is you BLS model and protocol (taught as if we will alway be on a BLS/BLS rig) and if you run into anything you think you cant handle, call for ALS backup to your scene or for an ALS intercept. I will be the first one to admit that this is foolish since we have no 2 BLS rigs running, at least in the city I work in. So take an example like we were given: A 2 BLS rig is dispatched to a chest pain call. We are then taught all the things we can do, as if we werent going to need ALS assistance with a chest pain run. Of course we do. We cant run EKGs, we cant give cardiovert drugs, start IVs, nada of any true importance to that chest pain call. So its very frustrating to me and those that trained with me that we were trained as if we would be running 24 hour shifts on BLS only rigs and only calling for help when we need it only to have to turn around when we get into the real world and re-work the model we were taught because now we are told by our ALS partners dont even give ASA or nitro without checking with me, when the training didnt say that, it just said, give ASA and nitro, put the patient on 15 lpm nrb and load and go. I mean I dont know if other states are like this but it was a real disservice as far as I can see and so I am my classmates are having to re-work the way we think and operate to be secondary to the medic. We were even taught this silly idea in my class about "Command Basics" meaning the basic with the most experience is in charge of making the decisions on that rig. Since we can push 5 drugs with standing orders, one of them being oxygen, the more I learn and gain experience, the more I feel like I would like to take my Basic course again and this time have someone teach it from the standpoint of "You will be working with a Medic and here is how." Even the NREMT Basic exam re-enforces this concept with things like: at what point during a child delivery would you call for an ALS intercept, etc. I mean we were basically taught that we were autonomous until such time as an ALS intervention was needed. I hope that explains alot of where I have been coming from over the last year. Its not that I want BLS and ALS to work in isolation, but that is the way the medical system in which I was trained taught us. A great disservice obviously.

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It's an Army thing. It's a utilitarian word that can be used as an affirmative reply, a greeting, or an exclamation. Kind of like the F word, it is useful in many situations. However, as much as I love the Army, I find the whole "hooha" thing to be just gay. :?

I'm familiar with the Army terminology. However, according to every single soldier I know, every single piece of Army referenced material I've seen, the spelling is "Hooah".

Hooha is slang for a certain part of the female anatomy. Further evidence that the poster in question fit's number 2 of Dust's possible scenarios.

The Air Force just says, "Dude!" :lol:

That's just funny!

-be safe

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If you want to read perfect posts, read Dustdevils. He has gained the composure over the years to be able to do the job he does in a place that got three stars from the International HellHole Society. And his posts are usually spell checked, well written and informative. And thats with mortars and RPGs flying over his head.

So if Dust can do it under those conditions, why can't it be expected that others do it as well? If you blame your poor spelling and grammar on lack of sleep that tells me a few things. Chief among those things is that you didn't pay attention in school well enough to have the habit of writing properly. If you cared enough in school to make it a habit then it wouldn't show through when under stress. What's more, if you didn't care enough about it then to make it a habit, what does that say of your other so-called "educational experience"? It tells me that you don't care about your schooling. Which tells me that I don't want you taking care of me or my family.

I know of no other profession that uses "Oh, I was tired" as an excuse. It's not accepted anywhere else. It shouldn't be accepted here.

If we're talking about being professional, this is one of the first places at which it needs to start. Stop making excuses. If it's worth doing, it's worth doing right. If it's worth doing right, it's worth doing right the first time.

And you people wonder why we aren't viewed as a profession. I don't have to wonder. I just have to read some of the posts here to this forum. :roll: Unfortunately, that tells me more than I really want to think about when it comes to my coworkers. :shock: :lol:

-be safe

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About appearance. Yeah, we do get down and dirty and work our asses off with little time in between to look good. However, that doesn't mean we shouldn't TRY to look good. It should be a goal that should be strived for if not always achieved. Do I look my best at 3 a.m. after working 12 hours? No, I do not. Sometimes my eyes are blurry, I may have beginnings of a 5 o'clock shadow, and you could put groceries in the bags under my eyes. However, there is a BIG difference between being worn down and being just plain dirty. There really is no excuse to walk into work with a dirty shirt on. If you can't get home to attend to basic hygenic needs, you are not fit to work your next shift. If you don't have time to clean yourself off between calls, then you need to go out of service. There are times when our appearance takes second to our job, but its not as much as people make it out to be. There are no situations encountered in EMS that knock your baseball hat backwards, untuck your shirt, or suck the deodorant off your body. If you have a locker, it should have some clean clothes and some underarm deodorant in it.

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What your post tells me about your education is that while you may write competently, you have not had the appropriate education to learn not to make logical fallacies and false assumptions. My family has been going to one of the country's top heart specialists for the last 20 years. He was one of the developers of the angiogram/plasty procedures. That man, for all his education and skill as a specialist and surgeon, cannot spell worth anything. What you have done is compare poorly written posts to my educational level and that is where you have made your fundamental mistake. While you are a medic, I would be willing to bet that I have at least as much formal education as you have if not more. I've had articles published in academic journals while working on my master's degree. And if you honestly believe that the way a person writes is directly linked to their abilities in EMS, then it is you who are possessed of gaps in your education. There is no correlation between the two where as you seem to want to make it a one to one relationship. I never said that I would be too tired to treat patients. What I indicated was that there may be those amongst us, who after working long shifts but still wishing to respond and share their knowledge with us, have greater concerns than spell checking. Your post is so full of faulty reasoning that it wouldn't pass muster in a high school debate. If you wish to compare educational levels, abilities to write, etc. I would be more than happy to do so. If you think that the way posts are written is indicative of the my abilities as an EMS responder or worse yet, that other posters to this site may not be worthy of "taking care of your family" then by all means do not hide behind thinly veiled insults. Have the courage to name those who you think write poorly and hence are not properly qualified to work in the field of EMS. Lets have some specifics. Lack of specifics, by the way, is also another point in which your post is lacking. Should we assume that since there are more logical holes in your post than one could shake a stick at that you are not qualified to work in the field of EMS. And if you should be worried about someone who doesn't bother to spell check working on your family, you should have them wear tags which read "if you write poorly, please do not help me if I am hit by a car." Shame on you. If you want to insult me with your logical blunderings, you are free to do so, but to bash other people while doing so is the mark of a coward...either that or one who has no real data to support his points and so instead makes broad sweeping generalizations. PS- Your grammar could use some work as well.

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Always excuses. You know who has to ask me for permission to do anything? A partner that I know constantly makes excuses for all their short-comings. How am I to trust a person like that? I see a lot of excuses here. Two hundred and forty-five reasons why a person can't go to paramedic school. Twenty-five reasons why my uniform is dirty, and the fact that the public shouldn't care. After all, if it weren't for the public, my uniform would be clean. More excuses then I can count on why it is perfectly acceptable to post as though you have only two neurons working correctly inside your cranium.

Turn the energy for making excuses into something productive and see how far you soar.

Post of the year.

Well done :wink:

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This thread has gotten crazy even trying to keep up with, OK the horse is dead, call in the Basics and the students to move it out of the road so we can continue on to something else please. :lol: Joke people be willing to laugh

Laugh guys, I am 2 days away from registry and and I have no idea what it will be like in the "real EMS world" but I do know this, you will have the occasional people that think you will never be as smart, good looking, charming, educated as they are, so what who cares, what matters is that you display your abilitys in a manner that is confident and not cocky, that you listen to what your paramedic would like, as it IS their ass on the line, and have a personality that someone can live with for 24 hours straight. I am again a intermediate student getting ready to take my exam on Friday so what do I know, only that respect is earned not given out freely by the person in charge of you, especially since we are in the business of letting people live another day, that is a HUGE HUGE responsibility, so if the medic I will be partnered up with wants to know what med I am giving a patient, they have every right to ask, and I have no excuse for not asking before I do it until we have trust established between us.

I guess I do not see the reason for you going on and on and on through posts and PM's to prove this point, EMS reality in most things are the same as life reality. Do the best job you can, learn from your more experienced partner (most times) and develop trust, don't demand it from the get go.

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you will have the occasional people that think you will never be as smart, good looking, charming, educated as they are, so what who cares,

Yeah, but the thing is no one WILL be as smart, good looking, charming, or educated as I am, and most of all, they won't be as humble as I am. Thats not my fault! :lol:

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