Medicstudent vs Emt's

[medicp94dao]

Wow... Just recently myself and a couple of coworkers were all sitting in the squad room. I was talking about my classes with a friend. One of our wonderful all knowing paragod syndrome medic students began putting her foot in her mouth, by stating that EMT'S (basic & advanced) really dont know crap and are lucky they are not medics. They have a rude awakening as to how hard it really is. Mind you one of our co-workers has been a medic for years. I was a medic in the military and my focus was on combat and saving lives. I was also a Combat Life Saver Instructor. Some of her comments were "you emt's are only allowed to do basic first aid and make sure you dont screw up before we (medics) get there") The funny thing is She is a EMT-B in school to become a medic. I guess she must have forgot that to become a medic you need to be a EMT first.

All of us were kind of taken aback by her cockiness, but we also new that while she was just a student she could not practice out of her scope until she is certified. Most of my friends are medics and one of them is her instructor. We all just decided to let her have her soap box moment and just keep doing what we do. Maybe one day she will understand that we all are EMT's and we ALL provide Emergency and non-emergency care. I am not saying that being a medic is not hard, I am just saying she has never been on the street as a EMT-B, except at our job doing transports or doing her clinicals with a medic unit.

Yea doing transports are dull and boring and all we do most of the time is take vitals, But if it was such a d*mn cake walk why are ther EMT's doing transports and not just Joe Schmo.We still drop airways and once in a while when our patients are being transported they do code. Some make it and some dont. She has never lost a patient, some of us have. So I hope everyone knows being an EMT-B is just as stressful at times. I do plan on getting my re-cert as a medic but, i can honestly say I will get cocky at times ( we all do) but I will never forget that I am still an EMT.

 

[crash_cart]

You used the word "student" and it doesn't surprise me that it would come from a student. When a person is young and dumb, it's easy to have such elitist notions about those "lower" than you. I mean that term all inclusively, including myself. The simple fact of the matter is that people are needed at every level. We need first responders, we need EMTs, we need paramedics. We need CNAs, just as we need RNs and we need psych techs as much as we need psychologists. I have chosen to be an EMT as my level of commitment and interest fits that level. The problem with college programs that promise to fit you right into a given role, is that you don't understand how everything works, you don't understand how those who are "under" you are often times, those who know how to deal with people or certain professional situations better than you. I teach at a lock-down facility for juvenile girls. When I want to know how the girls are doing, I ask the psych techs, I don't ask anyone above them. The techs are around the clents more often, and they know individual "quirks" better than anyone else. Until you understand that, and utilize professionals around you, you won't be good at your given job title and level of training, period.

 

[Alexakat]

People who feel compelled to comment like she did are plain & simply insecure. They use comments like that to pump themselves up to make them feel superior to others.

 

[MMiz]

You think that's bad, try having a conversation with an insecure Law or Medical student. There was a time when I relied on my title to give me confidence and gain respect. Now I just rely on my actions.

 

[VentMedic]

Yea doing transports are dull and boring and all we do most of the time is take vitals, But if it was such a d*mn cake walk why are ther EMT's doing transports and not just Joe Schmo.We still drop airways and once in a while when our patients are being transported they do code. Some make it and some dont.

You can learn so much about those "dull transports". Read the chart. Learn to read a physician H&P. Check out the medications. See how they pertain to the medical history. Observe the different combinations of medications. EMTs at all levels have to be observant of meds and medical history. Practice your physical exam on the patient. Repetition will only improve your ability to do things automatically well when needed in a stressful situation. It is an embarrassing moment for EMTs of all levels to still fumble taking a BP after clinicals or even years of "experience" because they didn't take advantage of practice time. The "I was stuck on a BLS routine transport truck" doesn't fly as an excuse for poor assessment skills.

Also, too often when a patient does code in the back of the ambulance, the EMT and/or Paramedic have little information to offer the hospital because they only wrote down or looked at just a few things needed for their paperwork. If they had expressed an interest in the "dull and boring" patient during transport, they might have had some valuable input or found something that was just not "quite right" with the patient prior to the code.

Again, I can not emphasize how sick the dialysis patient is and how unstable they can become quickly.

Those "dull and boring" patients are placed in your care by one medical professional to another in hopes that you will continue the care and not think of the transport as just another "gomer call". Some of these patients may have been another EMS team's save.

A lot is not taught at the EMT-B level due to time constraints. Later when taking more classes, you realize there is so much you didn't know and yet you had the responsibilty of someone's life in front of you. Even after being a Paramedic for many years and "knowing it all", I was very humbled when I went back to school for more medical education and started clinicals again inside of a hospital. I realized then that my knowledge as a paramedic was just the beginning of a vast universe in the medical profession.

I do enjoy quizzing the EMTs and Paramedics about the routine transport patients they bring us at the hospital. Most of the time they have to refer to the paperwork to tell me any part of the name, age or reason for transport other then the nursing home requested it. I especially love it when the reason is Altered Mental Status and they did not do a simple neuro assessment during transport as they would have done if it was a 911 call. Nor, can they tell us much about the patient's response prior to and during transport because they just "u called, we hauled". "Uh dah, it was a direct admit", "not like we were going to the ER or something". Sometimes they don't realize that the ER can be bypassed if the physician knows the patient's history and what to expect. The doctor phones in all of the diagnostic orders without the need of occupying an ER bed. Sometimes the EMT and/or Paramedic can also know what to expect if they know a little about the patient.

When the EMTs/Paramedics approach the nursing station, may times we hear "Smith from NH X, where do you want him?" Sometimes it that was phrased just a little differently of if you make contact with the nurse or even CNA with some tidbit of information, it might make the hospital workers slow down long enough to realize that it a human being and not a piece of furniture you're hauling.

The patient being transported would probably feel sicker if they thought they were inconveniencing you with their dull and boring transport. The elderly especially don't like to feel helpless and bothersome to others. Even if you don't directly tell a patient that they are just a dull and boring transport, your lack of interest to their needs will speak volumes. Many "professionals" have yet to learn how their words and actions affect the patient. This includes everyone from the receptionist to the physican.

Apologies for using this thread for my soapbox.

 

[medicp94dao]

You can learn so much about those "dull transports". Read the chart. Learn to read a physician H&P. Check out the medications. See how they pertain to the medical history. Observe the different combinations of medications. EMTs at all levels have to be observant of meds and medical history. Practice your physical exam on the patient. Repetition will only improve your ability to do things automatically well when needed in a stressful situation. It is an embarrassing moment for EMTs of all levels to still fumble taking a BP after clinicals or even years of "experience" because they didn't take advantage of practice time. The "I was stuck on a BLS routine transport truck" doesn't fly as an excuse for poor assessment skills.

Also, too often when a patient does code in the back of the ambulance, the EMT and/or Paramedic have little information to offer the hospital because they only wrote down or looked at just a few things needed for their paperwork. If they had expressed an interest in the "dull and boring" patient during transport, they might have had some valuable input or found something that was just not "quite right" with the patient prior to the code.

Again, I can not emphasize how sick the dialysis patient is and how unstable they can become quickly.

Those "dull and boring" patients are placed in your care by one medical professional to another in hopes that you will continue the care and not think of the transport as just another "gomer call". Some of these patients may have been another EMS team's save.

A lot is not taught at the EMT-B level due to time constraints. Later when taking more classes, you realize there is so much you didn't know and yet you had the responsibilty of someone's life in front of you. Even after being a Paramedic for many years and "knowing it all", I was very humbled when I went back to school for more medical education and started clinicals again inside of a hospital. I realized then that my knowledge as a paramedic was just the beginning of a vast universe in the medical profession.

I do enjoy quizzing the EMTs and Paramedics about the routine transport patients they bring us at the hospital. Most of the time they have to refer to the paperwork to tell me any part of the name, age or reason for transport other then the nursing home requested it. I especially love it when the reason is Altered Mental Status and they did not do a simple neuro assessment during transport as they would have done if it was a 911 call. Nor, can they tell us much about the patient's response prior to and during transport because they just "u called, we hauled". "Uh dah, it was a direct admit", "not like we were going to the ER or something". Sometimes they don't realize that the ER can be bypassed if the physician knows the patient's history and what to expect. The doctor phones in all of the diagnostic orders without the need of occupying an ER bed. Sometimes the EMT and/or Paramedic can also know what to expect if they know a little about the patient.

When the EMTs/Paramedics approach the nursing station, may times we hear "Smith from NH X, where do you want him?" Sometimes it that was phrased just a little differently of if you make contact with the nurse or even CNA with some tidbit of information, it might make the hospital workers slow down long enough to realize that it a human being and not a piece of furniture you're hauling.

The patient being transported would probably feel sicker if they thought they were inconveniencing you with their dull and boring transport. The elderly especially don't like to feel helpless and bothersome to others. Even if you don't directly tell a patient that they are just a dull and boring transport, your lack of interest to their needs will speak volumes. Many "professionals" have yet to learn how their words and actions affect the patient. This includes everyone from the receptionist to the physican.

Apologies for using this thread for my soapbox.

All I have to say is BRAVO!!!! I love everything you said. I love the fact that those dull transports are always someone who is worse off medically wise than i am yet they still have a great disposition on life. I am one of the people who like to get to know the COMPLETE medical HX of my patients, so I know if i can do them any good or ask another Tech to help. I have also learned that to alot of our patients, we (EMT's,Nurses, Dialysis Techs) are the only contact they have left with anyone. It saddens me, but it also touches me to know that when we arrive to transport them and take them to dialysis they will have someone to talk to and have some sort of interaction. A couple of the techs I work with view this as just a job... I view it as an ever growing learning experience both in life and in knowledge.

 

[bstone]

I'll post it here for good measure.

When I become a doc and you all see me in the ER, if I ever act nasty to an EMT/medic please tell me to turn my backside to you and you kick me real hard in the rear.

Thank you.

 

[Airwaygoddess]

Roots!

Bravo Vent Medic!! It does not matter if it is the little old lady to the nursing home call, to the multi-system trauma going code three to the hospital. It is about the compassion, knowledge and professional attitude and actions that make our job a profession. We must always remember where our roots come from, we tend to rely on them more than we think!!

 

[emtvestsquad1]

no matter what level of care you are it all still says EMT-whatever somewhere on your card..... im a paramedic graduate now but ill always be a student even after i get my medic cert. cause even now i still learn something new every single day im at work, or class, or clinicals. as a matter of fact i was taking a pepp class and we got off subject about chf patients, i was told about a study that was done on chf and the elderly, there is a 53% mortality rate if lasix and morphine are used on that pt. i had no idea i was actually harming pts. when i was just trying to make them feel better. but now i know. point is no one including medics, docs, nurses, whatever are perfect in any way, just remember the old addage...medics may save lives but emt's save medics.

 

[RALS504]

I think that study might be a little slanted. If we are using morphine and lasix it is because our pt is in bad shape. It is kind of like epi have you notice a side effect of epi is cardiac arrest and death depending on the drug book. That is because most codes do not go well not because I give epi to a health pt and they suddenly go into cardiac arrest. This could also be from anaphalaxis progressing to a code. Just food for though. For me my treatment of significant pulmonary edema secondary to CHF is CPAP-lasix-nitro-morphine, but that is me. emtvestsquad1 congradualations on your medic school completion, I feel your pain I'm in my last 2 months of medic school. I'm not trying to single you out, just continue the learning process.

 

[Ridryder911]

One can tell if a person is really comfortable in their position by their outlook. As Dr. Phil describes.. "...some people either get it or they don't"... Even, if one is able to articulate medical verbiage, and is able to demonstrate skills as fine as intubating a gnat, it does not matter if cannot see the whole picture.

I see those type that assume getting a little training, or increasing their position, do not really "get it". Usually, it those that get the portrayed with the "Paragod" syndrome, and usually only last a few years until the supposed "burn out" occurs.

I see more and more have the wrong intent that the patients are there for us instead the opposite of us being there for the patient. It is those as well, that does not understand the routine, mundane calls is the ones you learn from. To be able to determine normal from abnormal, one has to see many "norms" before you can detect diseased or ill deficits.

Now, with that saying I would like some clarification. First, one does NOT always have to be an EMT before being a Paramedic. Personally, I never have worked as a basic... yes, I went straight into Paramedic school before I was even taught basic.. and that was 30 years ago. I also know many very outstanding Paramedics that went from nothing to Paramedic.

I personally hate the statement.." Paramedic saves lives, EMT saves Paramedics" .. It was only developed to sell whacker T-shirts, belt buckles, etc. I have yet seen any EMT save a Paramedic, rather I have seen EMT's perform what they are supposed to do, inform and treat the patient appropriately assist Paramedics and perform their job (paid or not). I have seen Paramedics "save" EMT's, due to inappropriate treatment, informing patients of wrong or harmful information, and misdiagnosing. Again, they are doing what they are supposed to be doing their job.

R/r 911

 

[medicp94dao]

Now, with that saying I would like some clarification. First, one does NOT always have to be an EMT before being a Paramedic.

R/r 911

I do agree with you on most levels Rid but, it is my understanding in Indiana that even if you go from nothing to paramedic school, you must still take the EMT-B course in order to go on to medic training. They are all part of the same curriculum in our local Technical School. I have checked on this with my instructors as well. Even though you are not becoming an EMT-B first they must take all that is required of EMT-B to move on. The person in the main story line of this thread is a medic student yes, I will her that. But on the other hand she is working as an EMT-B doing BLS Transports. She did have to get a stae cert and had to pass all pre-reqs to continue her traing as an medic student.

I know at least a few people (in other states) who do not have their certs as EMT-B's but have finished medic school w/out them. I should have made myself more clear at the beginning.. my apology. I should have stated "that as far as I understand in Indiana, one must hold a valid EMT cert to go through medic school. Even if they get that cert while going to Medic school. If they fail to get their cert as an EMT than they cannot finish medic school until they recieve their state certification as an EMT."

 

[Operator 37]

We are all one....

Remember that CFRs and EMTs may be the first medically trained personnel on scene and by being there may be the person responsible for saving the persons life. Providing CPR within the first few minutes of a person going down allows time for the ALS crew to arrive and to provide the needed meds to stabilize the pt for the trip to the ER where the recovery hopefully can continue. This talk of one level being better than another is bull as we all comprise a team of trained medical personnel providing the best care anywhere.

What I am now you once were. Someday I will be where you are and I hope I treat everyone with the same professionalism as you showed me.