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We got an offer e-mailed to us to work at the Firefly music festival in Dover, but it turns out I'm already working my regular shift. Bummer...
the 100% directionless thread
- Thread starter KEVD18
- Start date
JPINFV
Gadfly
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RocketMedic
Californian, Lost in Texas
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Pics from the Moore area staging post at Chilis.
well, i guess not from the tablet.
well, i guess not from the tablet.
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8 hours in and only one call on this fantastic 16 hour SSM shift.
Gag me. So boring.
Gag me. So boring.
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NomadicMedic
I know a guy who knows a guy.
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Apparently. Last year was pretty good, I was told.
And, they've filled all the PT positions for this year. <_<
RocketMedic
Californian, Lost in Texas
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Snagged a copy of the incident management plan for posterity. Still loads of people coming in. Enid, OK has like 20 officers here.
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What you and Nate do on your off time is none of our business...h34r:
Bahahaha.
I love how poor fast gets dragged into our shenanigans even when he's barely active anymore.
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It's been a frustrating night. Keep in mind, this is my second to last shift in the new employee FTO process. I'm occupying a regular seat on the truck now, but my FTO has me running every call as if I'm a single medic as he hangs in the background and supervises (perfectly understandable).
We went on an "unconscious subject" that turned out to be a 79 YOM found on the ground behind his house by his neighbors. This was around 2100 and the last time anyone saw him was early afternoon. At this point, the patient was exhibiting clear, textbook signs of a stroke. Left sided neglect, left sided hemiplegia, pupillary changes, slurred speech, and hypertension. The man lived alone, so this was really (to me) a fairly clear cut case of a stroke patient that was outside the window for a stroke alert.
The patient was slow to respond to most questions and was confused about what was happening, but nothing that led me to believe everything he said was to be discredited. He was able to tell me his first name and where he was, and denied pain when I palpated his cervical spine and head. If anything, this was a ground level fall onto soft dirt. As I went to help him up and lift him to the stretcher, my FTO asked if I was certain I could clear his C-spine. I was perfectly comfortable not backboarding this guy, especially since he did have some secretions that needed to be suctioned and I didn't want him supine during transport.
After the call was over, I got a long lecture about how I failed to meet the standard of care my service expects on that call and it would be graded unsatisfactory if he were to review it. Furthermore, this was an even more egregious failure since "national standards" dictate every altered fall patient needs to be immediately backboarded. I asked him if most of our stroke patients should be backboarded then since most are altered in some way and found on the floor. Also, I was told that I must not understand the "new study" on spinal immobilization since I brought up its ineffectiveness and potential detrimental effects. Even when I brought up my desire to protect the airway, I was told that I could have tipped the backboard and suctioned from the side. The next point brought up was "How do I know this patient didn't fall, break his neck, and then have a stroke?" I thought about bringing up the concept of Occam's Razor but didn't think it would be well received.
I just can't wait to be completely done with this FTO period. Fighting about "is this worth losing my license over", "paramedics don't diagnose", and "defensive medicine backboarding" is beginning to get to me.
Sorry for the long post. Didn't realize it was going to be this extensive. Perhaps I should have started a different thread for this, but rant over for now.
We went on an "unconscious subject" that turned out to be a 79 YOM found on the ground behind his house by his neighbors. This was around 2100 and the last time anyone saw him was early afternoon. At this point, the patient was exhibiting clear, textbook signs of a stroke. Left sided neglect, left sided hemiplegia, pupillary changes, slurred speech, and hypertension. The man lived alone, so this was really (to me) a fairly clear cut case of a stroke patient that was outside the window for a stroke alert.
The patient was slow to respond to most questions and was confused about what was happening, but nothing that led me to believe everything he said was to be discredited. He was able to tell me his first name and where he was, and denied pain when I palpated his cervical spine and head. If anything, this was a ground level fall onto soft dirt. As I went to help him up and lift him to the stretcher, my FTO asked if I was certain I could clear his C-spine. I was perfectly comfortable not backboarding this guy, especially since he did have some secretions that needed to be suctioned and I didn't want him supine during transport.
After the call was over, I got a long lecture about how I failed to meet the standard of care my service expects on that call and it would be graded unsatisfactory if he were to review it. Furthermore, this was an even more egregious failure since "national standards" dictate every altered fall patient needs to be immediately backboarded. I asked him if most of our stroke patients should be backboarded then since most are altered in some way and found on the floor. Also, I was told that I must not understand the "new study" on spinal immobilization since I brought up its ineffectiveness and potential detrimental effects. Even when I brought up my desire to protect the airway, I was told that I could have tipped the backboard and suctioned from the side. The next point brought up was "How do I know this patient didn't fall, break his neck, and then have a stroke?" I thought about bringing up the concept of Occam's Razor but didn't think it would be well received.
I just can't wait to be completely done with this FTO period. Fighting about "is this worth losing my license over", "paramedics don't diagnose", and "defensive medicine backboarding" is beginning to get to me.
Sorry for the long post. Didn't realize it was going to be this extensive. Perhaps I should have started a different thread for this, but rant over for now.
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Wheel
Forum Asst. Chief
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I feel your pain, but it's almost over. Also, good choice on the Occam's razor thing. It is never well received.
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Sometimes you just can't win. We had a backboarding discussion the other day where I lost a lot of a credibility because I did not have personal anecdotes to supplement the research apparently. Half the crew basically discredited everything I said as "oh, it's the new part time rookie showing off that he went to college again."
If you can't change policy, change your practice I suppose, which is impossible during FTO time.
If you can't change policy, change your practice I suppose, which is impossible during FTO time.
Hang in there. I wouldve done the same as you. This wouldve fallen in a gray area of our Spinal Immob Protocol to not board and I can document it to fall in or out. The local ERs wouldnt have thought twice about them not being boarded.
Word is getting around that our medical director chewed up and spit out a crew for trying to reboard someone prior to being transferred to a trauma center. Their response was "it's trauma" and "they get mad us at if trauma isnt boarded". Our med director said if the receiving facility had a problem they can call her and she'd take care of it.
I havnt been reboarding people for years. I love dropping the "radiologically cleared" line on the trauma centers.
Others are gonna stick by the old standard treatments for awhile because they were taught that deviation from that is bad. Shouldve seen the looks I got from an FD first responder EMT when I said to take the non-rebreather off a patient having a panic attack post minor car wreck.
FR: But shes having difficulty breathing. And an asthma history.
Me:Your point? room air sat was 99. Lungs are clear. Take it off.
FR: But asthma and shes short of breath
Me: Its anxiety. Off it goes
FR: But shortness of breath
Me: Take it off now
FR: But O2 wont hurt
Me: I said take it off
FR: No. She needs it.
Me: Remove it now. Its not needed, quit arguing with me
FR: Fine. reluctantly and with much drama removes mask
patient then calms down and thanks me since the mask was making her more anxious. She was nearly immediately calm after it was off.
Really surprised I didnt get called into the principles office for not playing nice.
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I just need to figure out who thinks like I do. I'd like to think that fellow medics would be on my side in following new research and attempting to adapt practices to improve patient care, but that's not always the case. Like everywhere else, you get some people who are content with the status quo and just do things the way they've always been done. The BLS crew didn't help my mood on that call either. Both brand new to the area and EMS, their house suction didn't work properly, and the EMT in the back with me didn't know how to do a 12 lead or set up my IV supplies for me. Some nights are just like that I guess.
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Oh, I completely agree it's a little bit of a gray area. I did the same thing with careful documentation, and I feel comfortable defending my decision on this all day, every day. Our ED didn't bat an eye either that he wasn't boarded and probably would have had more questions if he were. Thing is, I'd do the exact same thing in retrospect. It's hard to apologize and say you'll do better next time when you don't recognize that you made an error the first time around. I don't mean for that to sound egotistical. I am new and have much to learn about everything, but I'm confident and unapologetic for that decision.
That's annoying to deal with. You can always go back after the call and show them how to do those things
I know of a handful of people here that think like me. Our hangup is we have so many newly graduated medics that are still stuck in "OMG if I dont do this monkey skill Ill get sued and lose my cert ZOMG". Oh and a few old timers stuck in tradition.
Uphill battle that Im losing the will to fight lol.
RocketMedic
Californian, Lost in Texas
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So the night shift didnt volunteer, which meant that our supervisor was asking crews to stay later. This started as a day off, voluntary call in. Most of the company did not volunteer to come in. Quite calmly, when asked if I could stay past my original 1900, I asked if it was a bonus-eligible shift (extra $20 an hour on top of overtime pay). One of the Tulsa supervisors got really pissy and said "it's not appropriate to do this for pay. This is a disaster, you should want to do it for free. If you're here for pay, you need to leave". I looked at her and quite reasonably asked "then why did we clock in before we came down here?".
The real supervisor confirmed that it was a bonus shift, and that idiotic woman lost every ounce of professional consideration I ever may have given her. She left in a puff.
$517 dollar day!
The real supervisor confirmed that it was a bonus shift, and that idiotic woman lost every ounce of professional consideration I ever may have given her. She left in a puff.
$517 dollar day!
NomadicMedic
I know a guy who knows a guy.
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You'll learn quickly who's with it and who's not. I would say that most medics here think like you do.
Your FTO does not. Along with several of the FTOs here. Appearing to "progressive" here will get you a bad reputation quickly. Also, be careful... If you piss of the BLS folks, you're gonna hear about it, and BLS almost always wins that battle.
Just remember, it's almost over.
Your FTO does not. Along with several of the FTOs here. Appearing to "progressive" here will get you a bad reputation quickly. Also, be careful... If you piss of the BLS folks, you're gonna hear about it, and BLS almost always wins that battle.
Just remember, it's almost over.
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JPINFV
Gadfly
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So the company isn't charging anyone for this and you're working for free too, right?
JPINFV
Gadfly
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My sister posted this on Facebook...
Sigh, for someone so uppidity over 2nd amendment rights and the Constitution, she shows so much respect for the other amendments and enumerated rights.
Sigh, for someone so uppidity over 2nd amendment rights and the Constitution, she shows so much respect for the other amendments and enumerated rights.
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Feel quite dumb for almost hitting the passenger side on the bay opening while backing in. Received a nice chew out from my supervisor partner. Received another one for not knowing proper late-night radio procedure.
I want to improve my performance here but it's been an uphill battle. Half the policies I get chided for are not written down anywhere, so I don't find out I am violating them until after it's happened. I am furious with my driving. I rarely had any issues working in Boston, but put me in a Type I with no driver training and narrow bay doors, issues are inevitable. I would love an EVOC class or at least some time spent practicing backing, but no one's interested. I work nights so when I show up no one is interested in doing any teaching.
I want to improve my performance here but it's been an uphill battle. Half the policies I get chided for are not written down anywhere, so I don't find out I am violating them until after it's happened. I am furious with my driving. I rarely had any issues working in Boston, but put me in a Type I with no driver training and narrow bay doors, issues are inevitable. I would love an EVOC class or at least some time spent practicing backing, but no one's interested. I work nights so when I show up no one is interested in doing any teaching.