EMT-B Seeking Wisdom from Medics

[medic417]

... tell me, in your organization, do they get the "Go" from your FTO's to start leading ALS ambulances?

And that is the winner. To many organizations hire people then throw them to the wolves. They do not have FTO's. They do not do anything but say there's the ambulance don't screw up and we might pay you on Friday. Even experienced emt's and Paramedics have difficulty when done that way with a new company.

A proper FTO program will allow a green emt or Paramedic to develop confidence before casting them out. You know whats funny it doesn't take long and really doesn't cost much.

 

[JPINFV]

A proper FTO program will allow a green emt or Paramedic to develop confidence before casting them out. You know whats funny it doesn't take long and really doesn't cost much.

Especially compared to any billing problems that occur, regulatory issues (are people doing what they need to do), burn out (high turnover), etc. A little investment can go a long way.

 

[firetender]

There is more to EMS (and medicine in general) than just medicine. There is more to being a good provider than just knowing something in your head. Being able to function during stressful situations, recall the needed information, apply the needed information, evaluate the results and apply more information as needed, all while under stress and in controlled to chaotic environments takes time to learn. Being able to control a scene and direct multiple personnel. Being able to communicate and interact appropriately with pt's (and this includes different cultures and sub-cultures, ages, socioeconomic groups) family (sometimes distraught and/or hostile family), bystanders, coworkers, nurses, doctors, other medical personnel, police, FF's, drunks, crazy people and everyone else we come across is not something that can be learned in a brief internship. Being able to recognize when someone is lying or holding something back. Being able to recognize when a scene is unsafe (and I don't mean the glaringly obvious times) or has the potential to become so, being able to take in everything that is happening while still maintaining your focus on the pt, being able deal effectively with the multiple, non-medical issues that we come across regularly...the list can go on and on, but for all the fact remains the same: becoming truly proficient at these things takes more than 200 hours.

Wonderfully said and the thing that occurs to me is becoming a paramedic is presented as a Fast Track to acceptability and the system is designed to crank out bodies without taking into consideration that it takes years to develop many of the aforementioned skills.

The initial learning curve (whether didactic or clinical) is often overwhelming and some people just need a bit of extra time and patience to ease in to the work. Especially at the beginning.

 

[firetender]

Almost missed this one

Why were YOU watching them, Firetender? Were YOU the experienced medic in those situations? Were YOU the leader of the ALS unit in those situations?

This would likely be the result of scheduling. Yes, put an experienced medic with a Rookie. How about getting stuck with guys who've been working in the field for a half-year, and they can start IVs fine but in the basics they still don't have a clue? Beside providing ALS you need to play Watchdog to minimize the damage THEY can cause. How much more do you need to know to say it's a good thing to really train people for what they do, and start simple and then work in complexity? Many paramedic programs need to start from the bottom, really get the students rooted in, and then offer them the toys AFTER the medic is grounded.

 

[FLEMTP]

After reading this thread.. I have just a couple of simple statements to sum up my feelings about EMT experience prior to medic school.. and field experience vs. advanced education

1. Paramedics save lives.. EMT's save medics..


2. I (as a paramedic) would rather have an experienced EMT that is very competent and comfortable with their BLS skills ANY day over a new or relatively inexperienced Paramedic as a partner.

Dont get me wrong, I love to teach, but an inexperienced paramedic belongs in back, with me as a preceptor, and an awesome EMT to assist us and remind us of the little things.. like actually bagging a patient before we intubate, turning on the oxygen tanks so the patient actually GETS oxygen, and to remove the tourniquet before you begin running the IV

So, master your BLS skills..and be proud of it. The experience you get doing that will be invaluable to you as a medic student, when you know what a cardiac patient looks like and can recognize that before you ever touch your EKG monitor, or how a person circling the drain presents without ever needing to take a blood pressure. These are things a book or a mannequin or a classmate's acting can never teach you...

 

[medic417]

1. Paramedics save lives.. EMT's save medics..

QUOTE]

Horse crap. Why do people still spout this crap? Meter maids save cops and Nurses Aids save doctors.

 

[FLEMTP]

1. Paramedics save lives.. EMT's save medics..

Horse crap. Why do people still spout this crap? Meter maids save cops and Nurses Aids save doctors.

Why exactly do you feel this is "horse crap"? As I stated in my above post, sometimes EMT's can remind medics of basic things that may help them progress towards the hospital or towards providing good quality treatment for a patient, such as removing the tourniquet from the arm when an IV wont flow. I can admit personally, that sometimes as a paramedic you are focused on accomplishing certain treatment goals with a patient, and an EMT can remind you of things you may have overlooked or forgotten..or even remind you that its been 5 minutes since your last epinepherine during a code, or that you need to pull the laryngoscope out of the mouth and bag because you've been down their throat for more than 30 seconds.

I feel to say that the phrase is "horse :censored::censored::censored::censored:" is to overlook the importance of having someone on your team that stays focused on the basic level of care and can remind us of that, because, face it, at some point.. EVERY paramedic has had a lapse in their BLS skills and gone straight to ALS, or overlooked a much simpler BLS treatment. Its in our nature sometimes... especially as a new paramedic.

It might even be something as simple as to keep an eye on the scene while you are securing your intubation or starting your IV, so that you dont get hit by a car that didnt stop for your lights, or you dont get hit by the guy that slipped by the police and is now hell bent on hurting someone.

There is way more to that statement than meets the eye...and I feel its very valid!

 

[JPINFV]

The problem is that if you are making those mistakes with any regularity that you need someone whose sole job is to keep you from making those mistakes, then you need some serious remediation. If it's a once in a while thing (mistakes do happen), then I fail to see how a basic is any better than a paramedic for noticing those things.

 

[firetender]

I fail to see how a basic is any better than a paramedic for noticing those things.

Ultimately, it boils down to teamwork and developing a working relationship where each of you can trust the other to cover your back instead of sticking a knife in it.

 

[rescue99]

ultimately, it boils down to teamwork and developing a working relationship where each of you can trust the other to cover your back instead of sticking a knife in it.

amen...

 

[DrParasite]

Horse crap. Why do people still spout this crap? Meter maids save cops and Nurses Aids save doctors.

actually, it should be nurses save doctors, not nurses aids.

and if you walk into almost any ER in the county, it is the Nurses who are actually running the ER, not the doctors. not only that, but many nurses do check the doctors orders, and have questioned when doctors something doesn't look right, and often do catch mistakes.

but yeah, a lesser educated person can never ever catch the mistakes of a higher educated person... thats just an absurd concept

 

[JPINFV]

but yeah, a lesser educated person can never ever catch the mistakes of a higher educated person... thats just an absurd concept

 

[medic417]

but yeah, a lesser educated person can never ever catch the mistakes of a higher educated person... thats just an absurd concept

Never said a lesser educated person could not catch a mistake. They are less likely to catch a mistake though than an equally educated person.

The only thing a basic partner saves a Paramedic is steps back and forth to the ambulance.

At least a green Paramedic has the education basis to actually help with patient care.

 

[FLEMTP]

Never said a lesser educated person could not catch a mistake. They are less likely to catch a mistake though than an equally educated person.

The only thing a basic partner saves a Paramedic is steps back and forth to the ambulance.

At least a green Paramedic has the education basis to actually help with patient care.

And its a shame that you are an educator, or claim to be. Shame on you for thinking this, and shame on you if you actually repeat that statement to your students.

In fact, would you mind sharing which educational institution you are affiliated with so that I can pass this tidbit of close minded thinking on to them?

Thanks

 

[Sasha]

Everytime I skim past this thread I could swear it reads 'EMT-B seeking Women'

 

[JPINFV]

Hmm... "EMT-B seeking women..." Idea for a new thread?

 

[TransportJockey]

Everytime I skim past this thread I could swear it reads 'EMT-B seeking Women'

You're not the only one. I avoided it for a while cause that's exactly what I thought it said

 

[medic417]

Darn double post.

 

[medic417]

And its a shame that you are an educator, or claim to be. Shame on you for thinking this, and shame on you if you actually repeat that statement to your students.

In fact, would you mind sharing which educational institution you are affiliated with so that I can pass this tidbit of close minded thinking on to them?

Thanks

As an educator I explain to the emt students the limitations and work to get them started on the road to being successful Paramedics.

And what did I say wrong? The majority of paid 911 services only allow the basic to be a gopher and a driver. Why do so many here like to try and blow smoke up the new emt's butt? Lying is the worst thing you can do to someone and probably another large reason for the high burn out rate seen in EMS.

 

[FLEMTP]

As an educator I explain to the emt students the limitations and work to get them started on the road to being successful Paramedics.

And what did I say wrong? The majority of paid 911 services only allow the basic to be a gopher and a driver. Why do so many here like to try and blow smoke up the new emt's butt? Lying is the worst thing you can do to someone and probably another large reason for the high burn out rate seen in EMS.

The problem is with your logic is this.. in order to be a good paramedic.. i feel that one should have a firm grasp on the BLS skills.. and a good level of experience dealing with patients and having patient contact. Explaining to your students "limitations" of an EMT is doing them a dis-service. EMT is an important role, especially if one has plans to move on to paramedic, and should never be looked at as a "limitation". Ive worked for many agencies in my 12 years in EMS, and I have only ever encountered ONE agency that would not allow EMT's to attend solo on a patient. They were allowed to perform any skill they wanted on scene or with a medic in back, and that was an agency that wrote their protocols in blood, and mother-may-I'ed their medics to death. Every where else I've worked values the experience and knowledge you gain as an EMT, and plenty of places in the US still have BLS 911 trucks. True, your treatment options are not the same as a paramedic, and paramedics can provide an advanced level of care.. but being an EMT should NEVER EVER be looked at as a limitation... ever.


As I said above.. shame on you for even putting that idea in your students head. You're doing yourself, your students, and the general public a major dis-service by spreading that line of thinking... and I'll tell you, if I EVER hear a paramedic sharing that type of sentiment with an EMT or another Medic for that matter, I'd be pulling that person aside for a serious heart to heart chat and refer them to administration for an attitude adjustment.