How do you stay "sharp"?

[JB Rotten]

First, nobody slammed you. You're imagining things, probably out of a sense of guilt because your old enough and smart enough to know we are right.

And second, you do have control over your personal behaviour. You can do the right thing, regardless of whether everybody else around you does. Mature adults don't keep doing something just because it's fun and everybody else is doing it. They look at the big picture and decide if this is what is best for all concerned, not just themselves.

I was quite sure I was doing the right thing by asking for advice to help me better myself. I don't do this for fun or glory like several vollies do, and if I can gain the knowlege to at bare minimum be the one to know exactly what to do, be it calling for the Air Cav. or a rapid package and transport, so it isn't left up to the chest thumping supermen don't kill one of my friends. If I am able to be the level headed knowlegeable member of something that should not be (but is) and not have a snot nosed 18 year old (with enough blue lights on his car to land planes at a major airstrip) thinking that his meager 120 hours of learning makes him a lifesaver I think that I am doing something better.

As for us being less than thrilled at your altruistic sacrifice to your community, I notice you haven't bothered to tell us how you would feel if you lost your ability to make a living because nobody was willing to pay for HVAC service anymore. Come on, man. You're smarter than this. This is not a complicated issue. I know you understand exactly what we are talking about. You just don't have the integrity to admit it because you don't want to give up your hobby.

Feel free to set up shop here, as long as you afford me the same respect and courtesy that we do the local Flight Medics(60 miles away) when we know we are out of our league. We are not a "gung ho super crew", we know well and full that we are nothing more than a big box of bandaids with a great supply of oxygen. I never ever hesitate to call for MedStar for our serious calls. 90% of the time we are nothing more than a taxi with pretty little flashing lights, and the other 10% we call for the people with the training and tools needed to provide for the PT. You do the same for me in HVAC and you can move in tomorrow. Change the filters and clean the dust out of the system for free all you want, but when it is truly broken I can show up and fix it.

Kudos to you for making an honest attempt to be better at your hobby than the average wanker. I respect that. But it's still just a hobby to you, and apparently, that's all you want it to be. Can you honestly not see how people might take offence to that? How about if we told you that we didn't need all that education to fix air conditioners, and that people with 120 hours of night school should be able to open up shop and compete with your business at a fraction of the price? Are you honestly going to tell me you wouldn't show up at the city or state meetings to raise hell about that? Of course you would! Now, tell me this; when was the last time you went to a city/county/state meeting to demand better EMS for your community? What's that you say.... never? But wait... I thought you were concerned about your community! See where I'm going with this?

As I stated earlier we have tried at the city level to get it changed, no dice. We don't respond to pages, other vollie EMS from neighboring towns paged to handle call. The county has trouble funding LE and could care less about EMS education level problems, the county hospital is manned by EMT's who complain about being on call and at times never show up. My unit has been paged out to handle calls for them because they didn't have anybody willing to work that shift.(these people are paid by the way, and are all EMT-B's)

You're not blind to the obvious answer. You're just ignoring it and hoping it will go away and not interfere with your fun. I'm as much about fun as the next guy. But, as a professional, I have a responsibility to be more committed to the profession than to my personal quest for fun.

Are you a professional? If so, prove it. If not, are you willing to tell your patients that?

And, by the way, plus 5 for an awesome screen name. :wink:

Honestly I would love for a full time paid "professional" EMS unit to be set up here. I could focus on my work and let somebody else haul all of the people I know to the hospital, or stand there and comfort the family of my friend while waiting for the coroner to arrive.

If I lived in a bigger city I would have a very hard time deciding between EMS or HVAC as a profession. Both are very challenging and make you learn every day. A mistake in either could very easily cost somebody their life. HVAC has the potential for causing a greater loss of life, but that is another subject altogether.

I honestly don't do this for fun or as a hobby. I am trying to get it changed, but it takes time and I cannot justify leaving everybody in this little town flopping like fish out of water until it gets changed. I want to be the best possible provider for these people that I can until it is changed. If I am wrong in this desire, I guess I should just become one of the vollie sheeple that everyone loves to hate and do it to make myself feel like a hero.

Thanks for your honesty Dustdevil.

[Dustdevil]

Thanks for your honesty Dustdevil.

No Sir. Thank you for recognising my honesty in the spirit in which it was intended! I knew I had not misunderestimated you. It is not at all my intent to attack or degrade you personally. It is very obvious that you are an intelligent and dedicated guy, or I wouldn't still be trying. I wish you the very best of luck with what you are trying to do. And it appears that you do have at least a fundamental grasp of the big picture, so let's move on back to your question.

It's a tough situation you are in. There are all sorts of ways to keep up continuing education, even in the sticks. Online educational opportunities abound, so long as you are willing to pay for them and devote the time and effort. But you are right. That doesn't totally compensate for a lack of patient exposure. Especially at the EMT B level. It is actually a little easier at the paramedic level, because the focus is on recognisable scientific concepts, not repetitive monkey skills. But, that kind of non-contact continuing ed is very definitely a start, and something that should not be discounted as useless. Your hospital may even have con ed that you can sit in on. If they have EMTs, then I would bet they have a programme set up for keeping them up to date. Check into it. What about spending time riding with the hospital? What about spending time riding with the nearest big city agency once or twice a month?

Although, I have not heard of a hospital based EMS running EMTs since the late 1970s. :? It doesn't sound like they have a lot on the ball, so they may not be your answer either.

This is a problem in areas where each and every little rural community has their own vollie service. Nobody ends up with a run volume sufficient to keep current. If the hospital were to step up and provide a serious, multiple unit service, each community could have reasonably close service, full-time paid professionals, and people getting regular experience. If the money each community is spending on their volly service was put into one big pot at the hospital, you could have that. Fragmentation is a major problem, not just in your community, but in EMS as a whole.

I am a drummer. I sometimes go years without picking up a pair of sticks. Zero practice for five years at a time. You would think that after five years, I would have a hard time starting to play again, wouldn't you? After all, it's one hell of a lot harder than anything an EMT-B learns. But no. It's no problem at all. Two reasons why: first, because I was serious enough about drumming at one point to devote my full attention and efforts to learning it to the point that it became part of me. And second, because everytime I hear a song on the radio or iPod, I am drumming to that song in my head. No, I am not physically drumming. Just drumming in my mind. I guarantee you that it helps, and helps a great deal. There is nothing so difficult about EMT-B "skills" that physical repetition is necessary for retention. You can do this all in your head if you have the commitment to doing so. So shell out some money for con ed, even if it is only online. Spend a crapload of time on Google researching medical topics. Case studies about heart attacks, pneumonia, diabetes, strokes, hyperventilation, COPD, burns, etc... Come post scenarios here at EMT City and watch everybody work their way through them, then compare that to your own thought processes. Quite honestly, this forum here is the very best continuing ed I have ever found in thirty-four years of practice. Don't get hung up on "skills" and "protocols," and don't get hung up on simple trauma which require nothing but those skills and protocols. Be a thinking man. Focus on medicine, human physiology, and pathology to keep your mind sharp and developing. Aside from memory, there is only one "skill" in EMS that is really important. That is assessment. Focus all your energy there and everything else comes easy.

Best of luck!

[spenac]

Thank you for the link spenac.

In that post I mention that 3 services are going paid. One of the services only did 17 calls last year. Town is less than 200 people. You are paid for every hour on duty. Pay B=$13hr, I=$15hr, P=$18hr originally was supposed to be higher but we worked it out. I go there and spend 48 hours I'm paid 48 hours. So how did this happen. All the small towns and the county got together. We now will be a county wide service. This county a year ago had one paid staffed ambulance, with an on call crew for second ambulance. Currently 3 staffed 24 hour ALS ambulances. On Jan 1 there will be 5 staffed 24hrs ALS ambulances county wide. The 3 towns that were volly each have an ambulance or ambulances and station, but often nobody responds. All equipment is there just needed money to fund salarys. The towns and county decided that many of the fun things they paid for are not needed as much as an ambulance services. I actually think somebody with money dialed 911 and no ambulance came because no vollys in town, but have not confirmed this. Now you say what a waste, well guess what all ambulances will float, in other words if town A has to go out of town to get to the hospital Town B ambulance will drive out part way so they can make reasonable response to both locations. Also now instead of taking all 6 trauma patients in my 1 ambulance by the time we get them triaged another of our ambulances should be arriving. This lightly populated county has gone not only paid but will be ALS at all locations and the towns and county budgets have not really increased.

[AnthonyM83]

In reply to original posts, I would at least do monthly ride-alongs with your closest big city.

[trents289]

Maybe I can help you in this area. Set up a monthly training for your department. One key point is to do skills checks twice a year. Make sure when you make up this training it goes with your state guidelines for CEU's.

Another way is to talk with your medical director and get permission to do ER time. It takes commitment on your part but it is well worth it.

[mobey]

there is only one "skill" in EMS that is really important. That is assessment. Focus all your energy there and everything else comes easy.

I had to pull this out and read it twice...I think this will be my new favorite saying.

Well said Dust!

(I hope I don't have to pay royalties!!)

[litteratissimus_medic]

Est formosior loquella, dustdevil.

I'm going to write it in one of my books right now.

[AnthonyM83]

Frame it on the wall.

That's the one thing Dust still needs. Members to start sending in Dust-shrines. That's when you know you've made it big