Holding someones hand

[joemt]

The straw that broke THIS camel's back....

Guardian,
With all due respect, the very people that you are complaining about are the very people who put food on your table... if you don't like 99% of your job then get the heck out! You are a HEALTHCARE PROVIDER that happens to work on an AMBULANCE (a transport vehicle, no?) that just happens to be a part of EMS. Without the patients there's no job for us. I am going to go against my grain here, and be rude (something I try desperately not to do in open forums).... It's providers like you that I beg my students not to become. I'm not saying that you're a bad person, I'm saying that the viewpoints that you have expressed here are disappointing to me, and that if you think that your job is a joke, that you are being mistreated and put out by doing what you were hired to do (taking care of people), then it's time for you to find something else. Do you get paid by the hour, or by the number of Emergency Patients that you bring in? I think that if it was due to true emergency patient numbers that you would have found a different career long ago. So, by staying in EMS you are agreeing to running mediocre calls, don't :censored::censored::censored::censored::censored: to me about having to do your job! Geez.....

Ok, sorry all.. I had to get that out.
Peace Guardian,
Jo

Jo

 

[gradygirl]

I bet you've seen this before...

Here's the truth: if this job is getting to you so much that you're going to stop treating your patients 100%, then it really is time to hang up your boots. Yes, it sucks that so many of EMS calls are not emergencies, but it sounds like you've gotten past a point where you can accept that.

You asked for our opinions, we've given them to you. It's apparent that few to none are the agreements you were looking for. Our opinions are what they are, our opininons. Your opinions are yours. Period. I hope you can once again find yourself in a position where you can deal with all of the cons of the job.

 

[ffemt8978]

I think the point that Guardian was trying to make is that we are supposed to be EMERGENCY Medical Technicians, not ROUTINE Medical Technicians. There is a difference here.

Yes, the routine calls are 99% of our call volume, but why is this? Does anyone remember why EMS came to be? What the original focus of EMS was? Anyone remember the name of the paper that recommended creating a standarized EMS system?

EMS was never originally conceived to handle the routine calls. It was meant to be for emergencies only.

How did we go from there to here? Simple, we (as a healthcare system as a whole) have allowed non-emergent situations to continue to tie up our precious few resources. Why is this allowed?

1. Because 911 is a lot easier to remember and dial than your personal physician.
2. We're here 24/7/365, unlike your doc.
3. We have to provide you service even if you don't pay for it, unlike your doc.

I agree that the ability to pay should not factor in patient care for critical calls, but it aboslutely should factor in on the non-emergent / non-life threatening, I need a ride because I don't have a car calls.

 

[FF894]

You are underestimating people. People do come to expect certain things and there is a word for this, it's called culture. People see things on TV. People talk to aunt sally about her experience riding in the ambulance. People talk to each other. When we go and pick someone up, you can bet the family will be talking about and picking apart our visit for days to come.

I strive for perfection on every call even though I never achieve it.

Who wants to call 911 for a ride to the hospital? (BS) About 60,000 people a year where I work.

Here is the problem with your attitude. You are encouraging the misuse of EMS. You are catching little Johny with his hand in the cookie jar and you are saying thats OK, what you did was fine and here are some pointers on how not to get caught next time. I am starting to think some of you think EMS is a routine house call with a nice ride to the hospital. EMS is for EMERGENCIES ONLY! hence the name EMERGENCY medical service. I wish someone told me the truth early on, I wish someone said "being a paramedic is taking care of minor medical problems 99% of the time because people are to lazy and inconsiderate to take care of themselves."

Alright, don't get me wrong here. I agree partly with what you are saying. We touched on this in the "taxi" thread somewhere on here. If I determine that it is a frequent flyer abusing our system we do not transport. I call in a private company to handle the transport and I make it clear to the pt that in the future they should call the private company if they need a transport and call us if its an emergency. I think it sounds like you are burnt out :wacko: It happens. This is a tough job and it takes a toll on you after doing it for a while. Some people get burnt out sooner than others. The fact is though if you get in the mind set that are in when you post like you did here, you are treating your patients like they are just the next lazy and inconsiderate person who cant take care of themselves. There needs to be a balance. You need to be mindful or these people but dont expect every call you respond to is going to be these people. Respond with the benefit of doubt that your pt's well-being is at stake and you are the one thats going to make a difference.

 

[Guardian]

Guardian,
With all due respect, the very people that you are complaining about are the very people who put food on your table... if you don't like 99% of your job then get the heck out! You are a HEALTHCARE PROVIDER that happens to work on an AMBULANCE (a transport vehicle, no?) that just happens to be a part of EMS. Without the patients there's no job for us. I am going to go against my grain here, and be rude (something I try desperately not to do in open forums).... It's providers like you that I beg my students not to become. I'm not saying that you're a bad person, I'm saying that the viewpoints that you have expressed here are disappointing to me, and that if you think that your job is a joke, that you are being mistreated and put out by doing what you were hired to do (taking care of people), then it's time for you to find something else. Do you get paid by the hour, or by the number of Emergency Patients that you bring in? I think that if it was due to true emergency patient numbers that you would have found a different career long ago. So, by staying in EMS you are agreeing to running mediocre calls, don't :censored::censored::censored::censored::censored: to me about having to do your job! Geez.....

Ok, sorry all.. I had to get that out.
Peace Guardian,
Jo

Jo

I dont even know where to start. I disagree with almost every sentence in your post...lol.

These people are taking food off my table (taxes). They don't pay for our services.

I don't plan on quitting anytime soon.

EMS should not be providing routine health care to people.

It sounds like you might work for a private transport company (taxi with bed and flashing lights), in which case, a lot of what you say is true. We cannot continue to operate publicly funded EMS this way.

If my hunch is correct, you should come to a poor city and transport primary illness calls all day without getting payed like we do and your view point may change. Oh, and your company would probably go out of business the first week.

I do think my current job is a joke.

So what your saying is, if i don't like my job, i should quit. Sorry, i'm not a quitter. I'm one of those pesky think-for-yourselfers that wants to make a change in ems. It's obvious to me now that I have a long way to go. Not only do I have to convince the public of what a joke ems has become, but i also have to convince my fellow ems providers.

On a side note, medicaid and medicare is up to about 52% of the national budget (i think). This dwarfs defense and other spending. We have serious issues in this county with health care.

 

[Guardian]

I think the point that Guardian was trying to make is that we are supposed to be EMERGENCY Medical Technicians, not ROUTINE Medical Technicians. There is a difference here.

Yes, the routine calls are 99% of our call volume, but why is this? Does anyone remember why EMS came to be? What the original focus of EMS was? Anyone remember the name of the paper that recommended creating a standarized EMS system?

EMS was never originally conceived to handle the routine calls. It was meant to be for emergencies only.

How did we go from there to here? Simple, we (as a health care system as a whole) have allowed non-emergent situations to continue to tie up our precious few resources. Why is this allowed?

1. Because 911 is a lot easier to remember and dial than your personal physician.
2. We're here 24/7/365, unlike your doc.
3. We have to provide you service even if you don't pay for it, unlike your doc.

I agree that the ability to pay should not factor in patient care for critical calls, but it aboslutely should factor in on the non-emergent / non-life threatening, I need a ride because I don't have a car calls.

Great post. To tie this back into hand holding, I feel like we are holding to many peoples hands both metaphorically and physically. It pisses me off that they call for some BS reason and then expect me to hold their hand too.

This is a hard problem to fix. We are not doctors with x-rays and blood labs and therefore we can't rule out major issues. Someone could call for a stomach ache and we would have to take them. In my system, we can't call for a private transport truck because they don't want to come anywhere near us (violence and 0% chance of getting paid). The only way to fix the problem as I see it is to change the public perception of EMS and stop encouraging them to take advantage of us.

 

[Guardian]

I bet you've seen this before...

Here's the truth: if this job is getting to you so much that you're going to stop treating your patients 100%, then it really is time to hang up your boots. Yes, it sucks that so many of EMS calls are not emergencies, but it sounds like you've gotten past a point where you can accept that.

You asked for our opinions, we've given them to you. It's apparent that few to none are the agreements you were looking for. Our opinions are what they are, our opininons. Your opinions are yours. Period. I hope you can once again find yourself in a position where you can deal with all of the cons of the job.

lol, I already got screamed at by my supervisor for putting something similar on my ambulance. To my credit, I only drove it around our headquarter parking lot and not out in public. I am very conscious about public image. In my mind, I do treat all of my pts 100%.

 

[gradygirl]

Someone could call for a stomach ache and we would have to take them. In my system, we can't call for a private transport truck because they don't want to come anywhere near us (violence and 0% chance of getting paid). The only way to fix the problem as I see it is to change the public perception of EMS and stop encouraging them to take advantage of us.

Excellent point. Wouldn't it be heavenly if someone could figure out how to set up a definitive dispatching system so that emergency calls could get screened out of the BS that constantly comes through? Haha, and all of the "issue" EMT/medics could be stuck on the BS calls while the quality EMT/medics could be used on the good calls...

It's amazing how under-informed most (esp. minority immigrant) populations can be. So many are told to call 911 for anything and do not understand that 911=emergency. Hartford's got HUGE issues with this, as most of the population is made up of differing generations of immigrant families. But heck, even you're average Joe will try to explain to you how them not having their meds at 3a (and the drug store opens at 9a) is an emergency. -shakes head-

In my mind, I do treat all of my pts 100%.

Good enough.

 

[Firechic]

I'm one of those pesky think-for-yourselfers that wants to make a change in ems. It's obvious to me now that I have a long way to go. Not only do I have to convince the public of what a joke ems has become, but i also have to convince my fellow ems providers.

So, what is your game plan??

 

[MMiz]

I hate to jump in late in the game, but here goes...

I think it's just plain ignorant to blame the current state of EMS on any one race, population group, or socioeconomic level. While it may be the immigrants in one region, the poor people in another, and the wussified folks in yet another region, the truth is that as a whole our EMS system is broken, and it would be wrong to blame just one group.

I work for a private service, so I can expect that crap calls that the public services don't want. I respond RLS when needed, pick up my patient, and treat them with 100% respect. I know that the ambulance service will never see a dime for the transport, and I do my job. I once had a hospital in a rough area call my unit back 5 times during a midnight shift to transport their poor non-insurance patients while their local favorite private ambulance service waited outside all night for a paying call. It sucked, but I did it.

But the truth is, how long can a person be expected to respond to BS calls and provide amazing patient care. The truth is, even I believe that one's compassion is truly limited, and after x many BS calls, EMS just isn't the same anymore.

I'm not going to call anyone out of the forum, but I am going to say that it's more than funny that some of us are accusing others of not having compassion, when our idea of EMS is far different than someone elses. I worked one shift a week, and I loved that shift. But when I worked five shifts a week doing the daily BLS transfers, I couldn't stand my job by the end of the week. Hm.

Some of you work for public services, in wealthy neighborhoods, or even for college EMS systems. How you or I can get mad at someone for disliking the BS crap of an abused private or urban EMS system?

The problem with EMS isn't the immigrants, poor, or pissed off EMTs, but frustration with a system that has come to serve populations that should be seeking care elsewhere.

 

[Guardian]

So, what is your game plan??

My game plan is to open your eyes to this problem. Hopefully, if all of my fellow emsers get upset and demand a change, then maybe someone with political skills and power can make a change and bring us back to doing what we are supposed to be doing. I think I read somewhere you were a RN, maybe not, but in any case, I know how pissed off nurses get when we bring in the bs pts. I also know that nurses as a whole are more powerful than god (yes people, nurses do run hospitals) and I think they would back us up on this issue, then again maybe not, they are pretty egotistical. Anyway, I'm not sure what my game plan is but anythings better than what we have now.

 

[Guardian]

great post MMiz although I would add that when it comes time to fix the problem, we shouldn't be afraid to identify areas that abuse ems systems more than others. I warn you, these areas tend to be high minority areas, low socioeconomic areas, and wussy areas. We can't be afraid to shed light on these areas because of political correctness. Facts are facts. When all the money left new orleans during katrina, america got a good look at what I deal with every day (poor people). We should not be afraid to shed some light on these problem areas if we are truly going to make a change.

 

[joemt]

One of the Great things about America is that everyone is allowed a right to their opinion... I respect your right to have an opionion, that doesn't mean that I have to agree with it.

I DO agree that there has to be a change in EMS....but I think that we need to be thinking of starting at the base of the problems, and working our way up from there. Just MY opinion, which I'm sure that you respect as well.

Take care my friend!
Jo

 

[Ridryder911]

Wow.. what a bunch of whiners!.. Geez, like every patient seen in ER is a true emergency. Just think, if medicare or medicaid, did not pay.. would you have job? Each person that calls you is a consumer. Payer or not.. your boss gets to right off a portion, and reimburse. Want to know something, it is the emergency calls that usually does not pay.. people who get shot or stabbed, usually do not carry blue cross and blue shield. I had a bumper sticker once made that said...." medicare bought this car"...

True, there is an abuse .. and yet who's fault is it really? Does your EMS have public service announcements in print, t.v., radio on when it is is proper to notify 911 and how to call for EMS?.. Do you speak at civic organizations and groups routinely? Do you teach CPR and first-aid to the public, and when to call EMS as well? Do you participate in policy and protocol development, to develop protocols to not transport non injured and ill patients. If you don't then you are just as much as part of the problem.

Yes, I hate it when there are b.s. calls, and even more so when they are informed and knowledgeable of what an true emergency is and then abuse it Who doesn't ... every job has its' down-point.

But, this has nothing to do with compassion and "hand holding" of patients..90% of this job has nothing to do with performing emergency procedures and calls, never has and guess what never will. Nationally, medical care is only needed 18-20% of the time in EMS, ALS is only needed in 10% of the time and that even may be greatly exaggerated. If you didn't realize that when you were in school, then and clinicals, then you were the foolish one...it didn't change, because you entered the workforce.If emergency care was needed all the time on every call, the population would be 10% lower...

Now, do you actually think they call EMS for medical care.. or more because they don't know what to do in that predicament..? Trust me, general population does not consider an ambulance an health care facility.

If one think they are above "hand holding" or giving compassionate care really needs to get a reality check.. so you attended a couple of nights a week for a year training program and few hundred hour clinicals, and you are above this? really, who do or what do you think you are?... Give me a break! Even surgeons should not be above this.. and if they are, they to need to get the hell out as well.. that is part of the job, don't like it, there are many other professions out there, may I suggest a non-health care profession.

This is a "human" business, with physical, psychological and emotional needs..can't perform to treat these.. leave.. you won't be missed, trust me there is always someone to fill your shoes.

 

[joemt]

My point(s) exactly Rid.. thanks for watching my back!

 

[ResTech]

I just caught this thread and really cant believe a provider would have a no hand holding policy. Thatz really mind blowing.

I also think we should stop encouraging this behavior which is what we do every time we gratuitously hold their hands.

I get the impression Guardian that you think pt's. that are treated by EMS get together for group meetings and tell each other about how they got to hold their providers hand and conspire to start a hand holding epidemic. Thatz crazy. Holding someones hand doesnt encourage someones future desire to want to hold a hand when they are scared or want comforting. This is called HUMAN NATURE! Its instinctive to reach out to other human beings when we are hurt to find our comfort when we arent in control to comfort ourselves. And when in the back of the ambulance, laying flat on your back on a stretcher, holding your caregivers hand is the best way to obtain some comfort and reassurance that everything is going to be ok.

With that said, I guess its really important to point out that some people while although human, are lacking the most important human characteristics of compassion and empathy. I dont know you, but sense you are lacking these and that you can be a very cold and selfish person. Putting your own desire over your pt's. is clearly selfish.

They're isnt much else to say as every other point has pretty much been made here. You have some serious issues if you feel holding a pt's. hand isnt providing CARE to your pt. Hopefully you will reevaluate yor "hand holding policy" for your pt's. sake.

 

[Guardian]

Wow.. what a bunch of whiners!.. Geez, like every patient seen in ER is a true emergency. Just think, if medicare or medicaid, did not pay.. would you have job? Each person that calls you is a consumer. Payer or not.. your boss gets to right off a portion, and reimburse. Want to know something, it is the emergency calls that usually does not pay.. people who get shot or stabbed, usually do not carry blue cross and blue shield. I had a bumper sticker once made that said...." medicare bought this car"...

True, there is an abuse .. and yet who's fault is it really? Does your EMS have public service announcements in print, t.v., radio on when it is is proper to notify 911 and how to call for EMS?.. Do you speak at civic organizations and groups routinely? Do you teach CPR and first-aid to the public, and when to call EMS as well? Do you participate in policy and protocol development, to develop protocols to not transport non injured and ill patients. If you don't then you are just as much as part of the problem.

Yes, I hate it when there are b.s. calls, and even more so when they are informed and knowledgeable of what an true emergency is and then abuse it Who doesn't ... every job has its' down-point.

But, this has nothing to do with compassion and "hand holding" of patients..90% of this job has nothing to do with performing emergency procedures and calls, never has and guess what never will. Nationally, medical care is only needed 18-20% of the time in EMS, ALS is only needed in 10% of the time and that even may be greatly exaggerated. If you didn't realize that when you were in school, then and clinicals, then you were the foolish one...it didn't change, because you entered the workforce.If emergency care was needed all the time on every call, the population would be 10% lower...

Now, do you actually think they call EMS for medical care.. or more because they don't know what to do in that predicament..? Trust me, general population does not consider an ambulance an health care facility.

If one think they are above "hand holding" or giving compassionate care really needs to get a reality check.. so you attended a couple of nights a week for a year training program and few hundred hour clinicals, and you are above this? really, who do or what do you think you are?... Give me a break! Even surgeons should not be above this.. and if they are, they to need to get the hell out as well.. that is part of the job, don't like it, there are many other professions out there, may I suggest a non-health care profession.

This is a "human" business, with physical, psychological and emotional needs..can't perform to treat these.. leave.. you won't be missed, trust me there is always someone to fill your shoes.

Q. If medicare or medicaid didn't pay, would I have a job? A. I sure hope so, I would hope that someone would see the importance of having EMS and see that it got funded. Look at the bigger picture and try to stay with me on this. If Bush came on tv and said he was starting a new government program to transport lazy and poor people to the hospital for free and was going to raise taxes to do it, there would be widespread outrage. People would say, let these bums get a job and take care of themselves. Politically it would never work because this is a democracy. To get around this, we are lying to the public. We say we provide EMS when all we really provide is ROUTINE MEDICAL CARE >90% of the time. Tell me what is cheaper, having 20 ambulances responding to 25 ems calls/day funded by _____ or having 48 ambulances in the same city responding to 130 routine calls funded by medi___. When EMS is transformed into a routine medical system (RMS), the quality of care goes down (quality of provider, equipment, training, response time, resources in general). We were not created to be mobile free clinics.

You are right, routine calls pay and ems calls don't. This is the fundamental difference in our beliefs. You think ems is a routine medical service much like the hospitals you've worked in while I equate EMS to critical public services like the fire service, police department, and military. I have seen very successful private (for profit) ems agencies so I'm not against that idea if done honestly and providing good care. I am against stretching our resources to the limit to run routine calls and lying to the public about the services we provide for money. Cities have done this for years but now rural ems agencies are having to cope with the ever growing number of BS calls that are turning their ems system into a rms system and ruining ems as a whole.

You say "90% of this job has nothing to do with performing emergency procedures and calls".....funny, I thought that was exactly what ems was originally set up to do. This is clear evidence to me that we've lost focus on our true mission. Go back and watch an episode of the tv show emergency!, that is what we are supposed to be doing. Now, we are nothing but a bunch of hand holders who provide a free shuttle service and justify charging the public ridiculous amounts of money by calling ourselves paramedics.

Every person on earth should be in the "human business" and we as ems providers are no exception. We should be polite and nice and warm and fuzzy to other human beings, emergency or no emergency. The exception is when someone tries to take advantage of you. Then you have to stick up for yourself and not be so warm and fuzzy. When someone comes up and punches me in the head, I don't hold their hand and go skipping off into the sunset. When someone comes up and demands my services for bs and takes resources away from those who actually need it, I don't feel like holding their hand, get over it!

If my dream ever comes true and ems is really EMERGENCY medical services, our profession will change drastically. We will downsize. Unwanted deadweight will be cut off. We wont need all these extra ambulances running routine crap. Instead, we will be a lean, mean, life saving machine. Only the best paramedics will get hired. Volunteers will again be able to staff their stations. When paramedics walk into a hospital, everyone will stop and take note because chances are good there has been a real emergency and they will want to hear this true professional give his/her report.

You say "Now, do you actually think they call EMS for medical care.. or more because they don't know what to do in that predicament..?"

Yea, they have a major predicament, they can't scrape together the 10 bucks for a cab, but you know its funny, they all seem to have cable tv. You know, if they didn't all have cable tv, I might be a little more understanding...give me a break!

I can understand some of the newer people on this site disagreeing with me for various reasons. Rid, you however have worked in systems like mine. You know the kind of bs we have to put up with. I remember you wrote in an earlier post that you went back to working in the field instead of the ED because you got tired of babysitting and routine abuse of the ED. I would think you of all people should be able to understand my views.

Whose fault is ems abuse? It is everyones fault. Keep in mind that EMS is still a relatively new concept and we should make sure it is kept on the right path. We should protect it.

 

[Flight-LP]

Go back and watch an episode of the tv show emergency!, that is what we are supposed to be doing. Now, we are nothing but a bunch of hand holders who provide a free shuttle service and justify charging the public ridiculous amounts of money by calling ourselves paramedics.

OMG, did you actually just compare our career field with a television show??

I applaud your efforts and beliefs, but the bottom line in todays society and tomorrows future, IT ISN'T GOING TO CHANGE! In fact I believe it will even get worse. We can educate the public all day long, we can require payment up front, we can flat out refuse to transport people, but it is not going to change and will only cause further headaches. To me the choice is simple, I CHOOSE to perform in this career realizing the limited need and use of my scope of practice. If the BS calls are too much for you, then you need to make a choice. Ranting an 8 page thread isn't going to do it for you......

And please, if you are going to compare us to a TV show, find one with better looking (and younger) women and one that has an up to date plot, thanks..........

 

[Ridryder911]

I do understand Guardian of you feelings, however let's look at the true EMS, not one fictionalized as on television, magazines, or Rickey Rangers Gall Magazines. I do understand there is a far abuse of the system, again these need to be addressed by the service and set protocols in place for dealing with such abusers. (in JEMS, this month has such article). Fortunately, my system has had protocols to give permission to determine value if transport by stretcher is needed or not. After discussion with medical director, other options of transport can be explored... cab, van, wheel chair transport, etc..

But to assume the public will continue paying for EMS as it is unrealistic.

A brief history of EMS, was developed by accident, not purpose in 1965 during the re-development of issues during LBJ presidency. I believe it was #46, on things to do "reduce mortality and morbidity, in automobile accidents" thus emergency medical services was born, the initial idea was to place surgeons in ambulances.. of course this never caught on, so the next thing was to train ambulance attendants (usually funeral home) and fireman, on rescue squads, cardiac and medical was never thought of at that time.. until about 1968, when some pre-hospital treatment was done by various hospitals and FD's. Then the medical portion caught on.

I grew up watching "emergency" and yes, was a Paramedic product from it, like so many other veterans. Sure life would be nice, if it was like on t.v. were grandma and the single girls would thank-you and bring cookies responding to nothing but emergencies.. but, alas that is what script writers are for, that is television. Sorry, if that was your perception, but you should had known that during your research of a career, or at least exposure on clinicals, reality versus television.

So how much are you worth? $20k, 30K, 50k, uh.. 75k a year? Wow, that's a lot for someone to respond to only "true" emergencies, that occur very rarely.. if ever. So you spent a couple of nights a week for what 6 months, maybe a year.. with a few hundred hours of clinical.. Now, compare that with the beautician, that spent longer in training in comparison. But, that is right.. you are special and are only capable of providing one service.

Medicine is changing.. do you think ER doc's that spent 8 years, + 3-5 years in residency trained to be in fast track? Guess what that is part of the business now.. You think they like it as well? private doc's don't want to see medicaid, non-payers, or even take call.. bump to ER. We have not yet seen anything yet.. the baby boomers which turned 60 this year, will increase call volumes almost 2-3 fold.. so, yes, we will be responding more and more to non-emergencies.

The days of "checker board" and sitting around and awaiting for the emergencies in EMS and Fire Departments are OVER! The public, consumer, client, whatever you call patients.. want and demand more and will get more for their money. Medicare. (which will dictate insurance companies payment) are at this time reviewing optional payment regimes for EMS. Managers, will follow whatever will bring them money. Medicare and other insurance companies, do not and will not continue to pay $800 or more for a glorified taxi ride to a hospital. Don't believe me check the American Ambulance Association web site..

Therefore, more and more medical care will be performed (similar to homecare) in the field, by EMS to justify its' means.
This will help in several ways:

1) Triage to those, that truly need an ER visit (triage) due to the large numbers of ER patients, and lack of hospital beds.

2) Expansion of the Paramedic role as a health care provider.. really, we are medical not a public service utility. The term EMS is really changing and about dead, have you not heard of "mobile health care systems"?. This will allow those that are really serious about medical care to expand their role and secure a comfortable position to make the appropriate salary, and those that will not have to work 2 jobs, or work horrible shift hours and still provide emergency care, when and if needed.

3) Emergencies will always be a part of the system, but only part of the system; like ER.. not the general rule. ......"That is part of the problem, we are still trying to manage ER and EMS, like it was in the 70's (when Emergency t.v. show was on) and it is not like that anymore.. . and never will be, our patients are different now"..... (paraphrase mine). This comment was made by the director of San Francisco General ER, when discussing managing failing emergency departments and emergency services and the delay in care....

Generally, wake up ... the days of sitting around for the "good one" are dead. and gone. EMS, is no longer and can no longer be a system feeding off the people for the "what if theory".. I suggest to research programs such as.. "shots across Texas program" where Paramedics were providing immunizations on their downtime...again, multitasking and thinking outside the box.

Again, finances will dictate the way EMS will go. Cities are cutting back and as they should, people are tired of paying for things and they expect more for their money. As well, it is foolish to pay large amounts of salaries for those that can only provide one type of service, when they can provide more.

So to summarize it, EMS is a health care industry. It is going to have to expand and provide more to keep itself alive. The days of "emergencies and only emergencies" are gone (and actually never were there). The industry is looking to expand in any form they can to provide services to keep this business alive itself..albeit to be a municipal, county, or private system. Money, and resources have to come in to have it go out....

The choices are simple .....

p.s. I am a full time Paramedic, part time RN. I have worked several EMS systems from hospital, private, muncipal, air..even as a consultant on many State, and municipal systems, so my experience is varied.

R/r 911

 

[rescuecpt]

Guardian - In my area, the whole doing "EMS" rather than social work is alive and well, however, there is a certain amount of social work/transport work involved with any 911 system. Last night I was hanging out at the squad and a woman crossed the street from the ER and told us she just got kicked out of the ER but is homeless. We called the County and got her into a shelter for the night (the ER told her the shelters were closed and she was out of luck - this was 11pm)... the shelter sent a taxi for her. If they didn't, we were totally prepared to give her a lift. No, it's not exactly in our job description - but she had a need, and we are there to help. None of us could just let this 60 year old woman spend the night sleeping on the corner when she came to us asking for help.

That's the nature of what we do. If you don't have compassion for everyone that needs your help, whether because they were in an MVA or because they don't have anyone else to care for them, then you probably don't belong. The best technical provider is worth nothing if he forgets that he is caring for people, with feelings, fears, and needs.