You are absolutely correct...I learned the pathophys behind exacerbated COPD, the hypoxic drive and its role in COPD patients, as well as the role 100% O2 has on these particular patients over an extended period of time. My experience as an EMT taught me how to deal with this RN. As a brand new medic, I'm sure most of us still have difficulty talking back to an RN or Doc, especially since such an action can get you in trouble with the big dogs of your company. Becuase I learned how to deal with this situation as an EMT, I won't be forced to look like an idiot as a paramedic, and already know how to respectfully argue my point with an RN. I understand that this type of knowledge could be gained during a paramedic field internship, but i learned it much earlier on in my career.
Which COPD patients? Even RNs are learning their textbooks have been rewritten to dispel certain myths about this.
We have debates all the time in healthcare about treatment. What you learned about COPD is probably more "hearsay" than medical science or you may be equating medical science to that one paragraph in an EMT text. A good paramedic with a proper education would understand the difference.
A Paramedic may also have other options for providing oxygen or protocols that don't have a NRBM stuck on every patient. Thus, any discussion in the ED could be more patient care focused rather than a debate about an EMT's protocols.
You don't talk back or argue with other healthcare professionals. You discuss your treatment and criteria for what you have done. If you can give a valid reason for your treatment, it will be accepted or not. What they continue to do as treatment in the ED is up to them. If you are "talking back" to medical staff to where it would get you in trouble, you have learned little in the field about communication and may be relying more on emotions or "street smarts" than the medical aspects of patient care.
A newly educated Paramedic would have more education to understand what point they are trying to make and more protocols to support their decisions in treatment. If the clinicals are done appropriately they would have much more quality patient contact experience that what can be obtained working as an EMT-B. The basics are not that hard to pick up once you have the hows, whys and whats to understand when to apply that bandage.
An EMT class is essentially a prerequisite for Paramedic in that it teaches a few basic technical skills. It should be no more than a skills checkoff for the beginning of Paramedic class.
Other allied heathcare professions also have a class similiar to this but it part of their degree program. Almost all start with a short class that teaches basic assessment and vitals. It is little more than an introduction to give some foundational skills to get started. One could equate it to CNA for RN which could be challenged after the class but most know their 1200+ hours of clinicals obtained in just a two year degree will give them experience while they are learning to actually know what they are doing when it is time for hands on. Most in other professions also know their education does not stop with the degree. A well educated Paramedic would also be aware of this after seeing how much more that is to learn. Neither the EMT or most Paramedic programs give any indication that there is more to learn. If some saw the limitations of the educational standards or their own training, we wouldn't be having this discussion.
You would not hear too many others discuss why they should remain a CNA or tech instead of going on to become licensed. If they do wait it may be only until their benefits kick in but most will start taking college classes toward the degree at their first chance.
