Paramedic internship

[DrParasite]

Discussion is great. A poster shutting members with years of experience down because people disagree with him isn’t.

I agree. What you and @NomadicMedic are doing is wrong, because you are trying to "[shut a] member with years of experience down because people disagree with [you]" simply because a person with years of experience disagrees with you.

Discussion is great, but this isn't an echo chamber, where everyone has to agree with you. or me. and just because you have been doing it for x years doesn't mean you are right because you say so. State your reasons. support your claims with objective facts. Don't just stomp your feet when someone pokes holes in your weak claims. After all, every ones opinion is equally valid, but the fact are the facts.

I receive complaints from paramedic candidates related to these type of issues in my office, and those are all documented via mail to the paramedic program with copies of the letter forwarded to CAAHEP. Failure of a paramedic education program to provide a consistent, objective paramedic field internship program can cause some big issues at reaccreditation time.

And was there reaccreditation request denied? Did your office investigate the complaints, find they had merit, and work with the paramedic program to develop a corrective action? Or did the program investigate the complaints, and find they were less than credible?

Complaints are one thing, but only part of the story. Recently, I was subjected to a complaint filed with OEMS. They investigated, found it was completely baseless, and closed the complaint with no action taken. Didn't stop the complainer from contacting my spouses employer to get her fired from her job, because I was "being investigated by OEMS", nor did it stop my employer from requesting a copy of said complaint. Again, completely baseless and without merit, but an investigation happened.

This warrants a call to the paramedic program clinical coordinator.

I actually agree with my nomadic friend on this one. @ickyvicky, did you end up speaking to your paramedic program clinical coordinator about this? I'm not saying they are right or wrong (I'm leaning towards the latter), but they can advise you on what is appropriate for your area. Should the paramedic have been in the back with the BLS patient? idk, that might be a judgement call and up to the preceptor, if their EMT partner could handle it with you During my clinical time, I had several instances where I was in the back with a BLS patient, while my preceptor drove. The snide remarks being made are DEFINATELY inappropriate, and should be addressed, regardless of if the person was a formal preceptor or not. But you shouldn't be addressing them with that person, that's what your paramedic program staff should be handling. Some preceptors suck. Ok, some formal preceptors/FTOs suck and are horrible at their job. Let people above your paygrade investigate and provide you guidance on how to proceed.

 

[FiremanMike]

Quote 'I understand what you’re saying about paramedics needing to assess BLS patients, but that’s done at the beginning of the call and if the patient is downgraded to BLS, the paramedic intern should have no further obligation.'

WRONG...the whole idea of ride-a-longs/preceptorship is to learn, 'Oh it's only a BLS patient, I'll sit this one out' ain't gonna learn ya nuffink!

The idea of paramedic preceptorships is to learn and perform ALS assessment and treatment modalities. While it isn't necessarily a "waste of time" to observe on BLS runs (there's always something to learn), the fact of the matter is that it's NOT the intended purpose of ride-alongs for paramedic students. As as matter of fact, the paramedic programs in my area won't allow students to count BLS runs towards their total number of patient transports required for graduation (and tossing on a monitor/dropping a line on a broken leg does not turn a BLS run into an ALS run)

EMS is pretty much the last hold-out when it comes to this traditional (outdated) idea that one must be competent at the next level down or they won't be competent as a paramedic. RNs aren't required to work so many years as an STNA then LPN before they can be considered competent RNs. Doctors don't need to spend so many years as MAs before they can be competent doctors, even PA's "clinical requirement" for admission is so watered down they might as well scrap it.

I mean really, what are these mystical BLS skills that must be mastered before paramedic school? Splinting? Applying oxygen? Interpreting vital signs? Before anyone says "patient assessment" - patient assessment is different at the ALS level, it just is, and it's re-taught in paramedic school anyway.

 

[Tigger]

I do think there is more than a little value in learning what is appropriate to downgrade to BLS and what is not. Any time my intern rides in with the EMT we’ll talk about why that was appropriate and what would have made it cross the line.

I am not sure how I feel about BLS calls not counting toward required patient contacts. Mostly I think having a set number of patient contacts is arbitrary and silly. I don’t let my interns out early if they hit the required patient categories. Oh you’ve already had 25 chest painers? You’re still attending the 26th.

But on the other side, I don’t want any held up from finishing because they didn’t see enough OB patients or something like that. Seems like most “early labor” patients go BLS and I am fine with the intern getting credit for that so long as they assess the patient properly.