Prehospital command hierarchy, fitting it in with the regular medical community

[usafmedic45]

Its all good guys....this discussion has kinda gone in a argumentative direction. I'm not trying to sound arrogant I am just confident in the people I work with.

Well, you have to remember that just because you work with a good group, doesn't mean that it applies across the board so don't get so defensive when we are critical of the current state of things. There is nothing wrong with being critical as long as it is meant to spur change for the better.

I used to work with a really great group but I still won't trust anyone I haven't worked with further than I pick them up and throw them. The best advice I can give is that if you want to instill confidence in yourself and your service is to demonstrate why your approach is better in a quiet manner. Beating someone over the head with "WELL....EMS is GREAT! IT'S GREAT BECAUSE MY GROUP DOES THIS, THIS, THAT AND EVEN OCCASIONALLY PROVIDES A REACHAROUND TO THE CHARGE NURSE! IF YOU DON'T AGREE YOU HAVE AN ATTITUDE PROBLEM!" is pretty much the EMS equivalent of doing this to your career:

[YOUTUBE]http://www.youtube.com/watch?v=KDwODbl3muE[/YOUTUBE]

 

[usalsfyre]

Yeah I did, I just had my mind reading class this week. Its a new thing for us lower, moron prehospital people

I'm one of those prehospital morons. I'm not in med school, heck I don't even have a college degree.

The BASIC program is pretty well recognized by those with some familiarity of international EMS.

SmokeMedic, it's cool your excited about the profession. What's not so cool is that your truly clueless as to your limitations and knowledge gaps.

 

[ZootownMedic]

I'm one of those prehospital morons. I'm not in med school, heck I don't even have a college degree.

The BASIC program is pretty well recognized by those with some familiarity of international EMS.

SmokeMedic, it's cool your excited about the profession. What's not so cool is that your truly clueless as to your limitations and knowledge gaps.

Yeah well you guys have done a pretty good job of explaining them to me.

 

[ZootownMedic]

Well, you have to remember that just because you work with a good group, doesn't mean that it applies across the board so don't get so defensive when we are critical of the current state of things. There is nothing wrong with being critical as long as it is meant to spur change for the better.

I used to work with a really great group but I still won't trust anyone I haven't worked with further than I pick them up and throw them. The best advice I can give is that if you want to instill confidence in yourself and your service is to demonstrate why your approach is better in a quiet manner. Beating someone over the head with "WELL....EMS is GREAT! IT'S GREAT BECAUSE MY GROUP DOES THIS, THIS, THAT AND EVEN OCCASIONALLY PROVIDES A REACHAROUND TO THE CHARGE NURSE! IF YOU DON'T AGREE YOU HAVE AN ATTITUDE PROBLEM!" is pretty much the EMS equivalent of doing this to your career:

[YOUTUBE]http://www.youtube.com/watch?v=KDwODbl3muE[/YOUTUBE]

HAHAHA That was great....

 

[usafmedic45]

Yeah well you guys have done a pretty good job of explaining them to me.

One of the first things I was ever taught by my medical director was this: "The more someone says they know, the more scared of them you should be until proven otherwise." Just something to keep in mind.

 

[usafmedic45]

HAHAHA That was great....

You see my point though, right?

 

[usalsfyre]

Yeah well you guys have done a pretty good job of explaining them to me.

Crap, when did I become one of those crusty old arse holes peeing in the new guys cheerios?!? I'm too young for this!

That's why experienced folks are good to have around. I've bounced around EMS more than I would like (and I currently resemble a pinball) but it's made me a much more diverse, better schooled provider.

 

[JPINFV]

Yeah I did, I just had my mind reading class this week. Its a new thing for us lower, moron prehospital people

Stick around, you may learn something.

 

[Handsome Robb]

Crap, when did I become one of those crusty old arse holes peeing in the new guys cheerios?!? I'm too young for this!

If you pee in my cheerios I'll come kick your old crusty :censored: :censored: :censored: !

But until the pee is discovered I will continue to listen attentively.

 

[ZootownMedic]

Crap, when did I become one of those crusty old arse holes peeing in the new guys cheerios?!? I'm too young for this!

That's why experienced folks are good to have around. I've bounced around EMS more than I would like (and I currently resemble a pinball) but it's made me a much more diverse, better schooled provider.

And to be completely honest with you, regardless of how I have come off on this forum I am actually one of the quietest people in class. I KNOW that I KNOW next to nothing. I do learn new things everyday though and do the best I can at everything I do. And I do have the benefit of being in a great medic school surrounded by great instructors and medics. Im spoiled I guess....but I will heed what many of you have said.

 

[JPINFV]

If you pee in my cheerios I'll come kick your old crusty :censored: :censored: :censored: !

But until the pee is discovered I will continue to listen attentively.

 

[ZootownMedic]

And yes, now that is a good one as well. "I think I see a squirrel down there next to the wack-a-mole...perhaps I can fashion and sharpen one of the screws from this playground apparatus into a arrowhead..."

 

[usalsfyre]

If you pee in my cheerios I'll come kick your old crusty :censored: :censored: :censored: !

But until the pee is discovered I will continue to listen attentively.

I'm just trying to figure out how I started sounding like this before I've completed three decades on this rock. I SWORE at 20 I wouldn't be one of those guys.

Plus now I have to admit maybe the old guys were right...d@mnit this is turning into a bad night .

 

[ZootownMedic]

I'm just trying to figure out how I started sounding like this before I've completed three decades on this rock. I SWORE at 20 I wouldn't be one of those guys.

Plus now I have to admit maybe the old guys were right...d@mnit this is turning into a bad night .

Just don't be one of the guys that forgets what it was like when you were first starting out. Im 27, which is by no means old but Im not a young pup idiot either. I am pretty new to EMS and medicine in general but I served 3 combat tours overseas, have 2 daughters and a wife. Just remember that just because someone is inexperienced in something doesn't mean they don't have something to offer. Not saying your that person, but I've ran into more than a few in the fire, ems, healthcare arenas.......

 

[systemet]

I respect your passion for EMS. But I think you also need to look around at what some of the other healthcare occupations / professions do, in terms of practice and education / training.

* I find it hard to believe that a EM physician is going to miss a clinically significant tension pneumothorax, even in the back of an ambulance.

* I find it hard to believe that you work in a system where a critical neonate needing IV access and BVM ventilation is a daily event for any provider. If so, your community needs better prenatal / antenatal care.

* I have a hard time believing that a paramedic is going to be better at airway management than an EM physician, though I accept that intubating in the field might be a bit of a surprise (and a very good experience) for any EM physician to have.

EMS is a fantastic field. It may one day become a profession. But we have some fundamental educational problems that need to be resolved first. In my opinion.

 

[CAOX3]

Haha exactly. When was the last time a regular doc started a 20 gauge IV, bagged, and intubated on a little baby whos mom is screaming in your face? But because they are a Doc they can do anything right? gimme a break.....

An ounce of humility is going to do wonders for both you and your patients.

 

[LondonMedic]

The "I know where all the equipment in my ambulance is" argument is surely an argument against you ever progressing, let alone being employed by a different company as much as it's an argument against doctors doing pre-hospital care. I would tactfully suggest that it wouldn't take too long to show a physician around the back of an ambulance.

I would further suggest that SmokeMedic would take a lot longer to adapt to work in an emergency department, even if they succeeded in developing some of the necessary interpersonal skills.

 

[abckidsmom]

I'm just trying to figure out how I started sounding like this before I've completed three decades on this rock. I SWORE at 20 I wouldn't be one of those guys.

Plus now I have to admit maybe the old guys were right...d@mnit this is turning into a bad night .

Wait till you're all 32 and stuff, like me. These guys I'm working with all seem like they're 14.

They're smart, most of them learn quickly, but DANG they're young! They remind me so much of myself at the same point, and it's increasingly embarassing for ME!!!!

My grandma has a cross-stitch that her mom made hanging on her wall: "We grow too soon olde, and too late schmart."

Glad I've got 40-50 years left, cause this is just starting to get fun!

 

[JPINFV]

Does it even matter if the physician knows his way around the back of an ambulance? It's like complaining because a physician doesn't know his way around a Pyxis.

 

[Shishkabob]

Does it even matter if the physician knows his way around the back of an ambulance? It's like complaining because a physician doesn't know his way around a Pyxis.

If a doctor doesn't know how walk around something, I'd be slightly concerned as to their ability.