The kind of people in EMS

[MSDeltaFlt]

Do you ever get sick of the people who obviously don't belong in EMS? I am still in awe the kind of personalities it attracts for such an important job. We strive to be medical professionals yet there is no screening process, it's not hard or even mildly challenging to get into. We accept anyone with a pulse. Don't you think there's something wrong with that?

Today we went to pick up a patient who had a bowel movement, the nurse came out "I have to find someone to help me change the diaper" And of course, I offered to help. My partner.. My PARAMEDIC partner went "Eww gross"

Ew gross? Grow up! We are trying to be medical professionals yet we "Eww gross!" at poo?

This is just one instance of what I have been noticing lately, and I guess this thread is a kind of rant. But I really think to be considered a profession we need to start and work on the kind of people and attitudes that are allowed in EMS.

Oookaaaaay, back on topic. Yes, Sasha, it does amaze me at some of the personality types that we keep getting in this profession. There are many of those who have no place in this field. And I'm not referring to those who are easily grossed out. I'm referring to those who don't care about doing the right thing. Broad statement I know, but bare with me.

Everyone of us as one time or another has done, or still does, things that might be interpreted as unprofessional. The misinterpretation of protocols to include barbarism, unkept clothing/hygiene, uncouth verbage (profanity), you name it it's been done by the best of us. We have all screwed up. Guess what. We're all going to screw up.

Every now and then it's going to happen. Usually it's uncalled for. But what truely gets me is when there are those who frequently and continually do these and more/worse who just don't give a rat's harry arse.

I'm not the best. Far from it. My personal foul-ups are stuff of legend. But being a patient advocate all boils down to just one thing... doing the right thing. So long as you do the right thing, the forementioned will very infrequent and more than likely easily overlooked.

Just my humble thoughts, dear.

 

[Epi-do]

Yep, it still says EMTLife at the top of the page.... Wonder how I ended up in RT-world?

No disrespect meant guys, but could you please move the RT debate to PM? It makes it difficult to follow the original topic of the thread.

 

[usafmedic45]

Perfusionist is good. ECMO Specialist is part of RTs' job description in many places. I guess you haven't worked many places that must run the RT technology inside the OR.

Perfusionist is also a separate program, often requiring a master's degree. Trust me, I've thought about going that route myself.

Even at the level I trauma center I worked at, we handed over anything going into the OR to the anesthesia department and ECMO was run by a combination of RTs/RNs separate from the rest of us, even the regular ICU staff. We were taught the basics, but for the most part we weren't that involved with them. I don't believe the ECMO techs went into the ORs though- I recall asking once- as the perfusionists handled the cases in the OR that had ECMO going in. As for anything else, the anesthestiologists or nurse anesthetists took over fully at the red line (the "Do Not Enter" mark for the operating rooms hallway).

You mean you haven't noticed the number of RTs that have Bachelors or Master degrees?

Yes, but it's not a requirement to enter the field (yet). That is where we seem to be sticking here....you paint it like you can waltz in and just because you have an RT credential and degree (which for most people means an associate's, although the number of BSRTs is increasing) walk into practice in other fields because of some limited overlap.

I am also very limited by scope of practice working as a Paramedic on Flight, CCT or Specialty. I am not as an RRT. Thus, you will not see me use both credentials on the same name badge.

Thanks for clarifying. My apologies for the misunderstanding. I was quite confused when I was told that so that is why I brought it up.

Research tech?

What do you call the person who isn't the PI or a co-PI and does most of the work in the lab? Most places- even according to universities- that's a research tech. I don't find that insulting in the slightest. Maybe if one has an ego that requires a fancy title it might be, but for most people they realize that the title often doesn't full describe your contribution.

Yes RTs can get education and higher degrees and many are motivated to do so.

Did I say they are not? Can you please stop trying to take what I said out of context when no one seems to have a problem understanding what I am saying.

No you do not have to be a Paramedic. Florida Hospital's team does NOT have any Paramedics. Please update yourself.

I didn't not say HAVE to be. I said most I know are. Big difference.

You believe just about everything is out of the scope of practice for an RT.

What are you talking about? Just because I recognize the fact that other credentialing boards have authority over other areas of practice does not mean I have any dislike

probably would not be the best motivator as an educator for RT.

I could say the same because of the hateful tone you take with anyone who you perceive as disagreeing with you even when they agree but are just looking at it from a different point of view. I'm not disagreeing with you for the most part. It is simply you believe that RT is the end all, be all and I think it is simply not the case. The NBRC doesn't have a credential for ultrasound (that would be the ARDMS' turf and to a lesser extent CCI although with CCI you have a hard time finding hospitals that will take it in lieu of ARDMS), etc so technically, no it's not an RT's scope of practice and will become literally so as licensing takes effect. Does that mean there are not cross qualified RTs? No it doesn't because you're talking to one.

Yes everything takes a little extra training but nothing mentioned here is beyond the scope of RT since in most states the scope of practice is open ending./QUOTE]

The state may not require the additional credential but all the hospitals and clinics that I've seen pretty much insist you've taken the hyperbaric medical technician course from the USMS (or do within six months of hire) if not actually sat for the credentialing exam . In fact, I was talking to one of my physician colleagues who runs a hyperbaric program and he said there is some talk that it will become mandatory as an edict from the hospital accrediting bodies.

Cath Lab is part of CardioPulmonary or RT Science degrees which the RT student can take a semester as an electrive. Hemodynamics are us which actually makes RTs better prepared then nurses.

Uh....it's an elective, meaning it's not required and even then it's not even an option at all programs.

Also that is not going to allow you to sit for the RCIS exam which a lot of hospitals require, especially for non-RNs trying to get into the cath lab. The test requires:

A graduate of a NON-CAAHEP accredited Invasive Cardiovascular
Technology educational program which has a minimum of one (1) year of specialty training and includes a minimum of 800 clinical hours in the cardiac catheterization
laboratory.

Source: http://www.cci-online.org/2009 App Book-FINAL.pdf see page 14; by the way, the options to grandfather in through work experience are being done away in the next couple of years according to one of my colleagues at CCI. The only reason it hasn't already been done away with is that there is some grief from the nurses who are arguing they should be allowed to sit because of their "extensive backgrounds" (his words, not mine).

However, I do agree that RTs are better prepared to take on the additional training required.

Read the license requirements and see where the RT fits. Don't just spout off. Again, RTs have that option.

How about you reading one of the licensing acts for the field we're talking about....New Mexico for instance states national credentialing by one of the diagnostic imaging bodies, not the NBRC. Basically you'd have to jump through all the hoops of the ARDMS just to be able to work....so the option of just working shooting echos and grandfathering in will be going away much like the OJT option for CRTs.

Because if you move on to PA and MD, you are no longer practicing as an RT. I only mentioned those that are very easily obtainable.

When I work as an echocardiographer, even at the same hospital, I'm not practicing as an RT either. And that is the opinion of the Indiana State Respiratory Care Committee because I've asked. Once you move out of the things that the NBRC says we can do and the state agrees we can, guess what? You're no longer practicing as an RT either. Most states (Indiana included) view that if it's governed by a different credentialing body, it's a different field.

Again, if EMS is where your heart is, that is what you should do.

I am about equally passionate about both fields. You just don't see or hear my involvement with RT on here unless you make assumptions about me that force me to bring it up since this isn't an RT forum.

What I find odd is that you get fired up and accuse me of "bashing RT" for saying the same things about that field that I say about EMS. Yet, no one else seems to take offense at that. By the way, there are at least two other RTs on this forum that I am aware of and neither of them has called me on anything I've said when you've gone ballistic on me for not painting RT as this field where the options are limitless and there is nothing ahead but unfettered growth. No one would be particularly ticked off I don't think if I said EMT-Ps have no business running transport ventilators (which they can legally do in several states) or that they have their limits to their practice by law and regulation (be it state, local, or even just system based) just as we in RT do at the state and local levels. Why the disparity? Why the vitriole?

 

[VentMedic]

Yep, it still says EMTLife at the top of the page.... Wonder how I ended up in RT-world?

No disrespect meant guys, but could you please move the RT debate to PM? It makes it difficult to follow the original topic of the thread.

Actually that discussion I just had with usafmedic45 can be related to EMS.

RT has advanced and left behind some who didn't take the opportunity to advance their credentials. usafmedic45 is an example of one of those. Essentially this is similar to an EMT vs Paramedic argument in the RT world. EMS should also start thinking about what happens when things do start changing and the profession finally gets moving in the right direction. Yes, EMS will have those that miss the grandfathering or don't upgrade their certs also. You've just gotten a preview of what RT went through and is still going through as we attempt to get everyone on the same page. Fortunately, we did set a time limit for advancing their credentials and those that got left behind were well aware of it.

 

[usafmedic45]

No disrespect meant guys, but could you please move the RT debate to PM? It makes it difficult to follow the original topic of the thread.

I think the matter is settled since there is not going to be any middle ground reached because....sorry for the thread hijack, but my original analogy of EMS to RT was not intended to provoke the personal attack that VentMedic responded with and I didn't want to just report her to the mods for it. I've asked her in PMs (which I will forward you if you're interested) to not do this, but apparently she feels the need to interject such posts.

 

[VentMedic]

The state may not require the additional credential but all the hospitals and clinics that I've seen pretty much insist you've taken the hyperbaric medical technician course from the USMS (or do within six months of hire) if not actually sat for the credentialing exam . In fact, I was talking to one of my physician colleagues who runs a hyperbaric program and he said there is some talk that it will become mandatory as an edict from the hospital accrediting bodies.

For any of the courses mentioned, US, HBO or whatever, it is not that much to take a few extra hours of education and training to get a cert for the job. HBO tech is 40 hours. Do you honestly think an RRT is going to complain about another 40 horus after a 4 year degree? Even if they need a Paramedic cert, it takes less than 150 hours to get since many of the things in RT overlap.

You need to seriously come to grips with the RT profession since you understand very little about it or just concentrate on EMS.

As far as "research tech", my name and credentials go on the grant requests. My name and credentials go on the completed project for publication. At NO time do I or any of my colleagues refer to ourselves as "techs". Some of the university or larger RT departments have RRTs that just do research. Many manufacturers and drug companies are anxious to get their products trialed so it can be a full time job.

 

[VentMedic]

I think the matter is settled since there is not going to be any middle ground reached because....sorry for the thread hijack, but my original analogy of EMS to RT was not intended to provoke the personal attack that VentMedic responded with and I didn't want to just report her to the mods for it. I've asked her in PMs (which I will forward you if you're interested) to not do this, but apparently she feels the need to interject such posts.

Your PMs have been not been very friendly which is why I keep the argument in the open. You seem to have a problem with RRTs and have been constantly hounding me both on the forum and in PMs. Since you are also constantly going to the "mods" whining that I am picking on you I guess I can expect another warning from them soon.

In reference to this thread, even the RT profession is stuck with a few that won't advance and will agrue against anything that even remotely seems like there might be more work involved. It is unfortunate that those like usaafmedic would rather degrade a profession than see what opportunites exist. However, that argument is all too familar in EMS.

I've asked her in PMs (which I will forward you if you're interested) to not do this, but apparently she feels the need to interject such posts.

You honestly want me to PM you after you have stated you will send them out to anyone interested?

 

[usafmedic45]

RT has advanced and left behind some who didn't take the opportunity to advance their credentials. usafmedic45 is an example of one of those

No, I'm not but thanks for the personal attack. I simply took an alternate route to licensure and having my RRT credential doesn't make that much difference to me or the hospitals I've worked for. Most don't even offer a significant pay increase for passing the RRT exam. Please don't make it sound like I'm the runt of the litter because I think it's a waste of several hundred dollars.

Before she paints me as some form of relic, let me explain how I wound up being assessed that way: I was originally trained through a program that allowed me to sit only for the CRT exam. I had to jump through a bunch of hoops (mostly general education classes). There are some differences between what's on the exam (the RRT has a lot of hemodynamics on it that the CRT doesn't being the big difference) but once you get to work the differences are minimal in terms of scope of practice except at a few hospitals. The only reason there are two levels of RT anymore is because the NBRC (the credentialing body) would lose money if they stopped credentialing new CRTs since you take the CRT exam before the RRT exam.

To give you an idea how much difference there is between a CRT and an RRT in the eyes of the national credentialing agency, the only thing I had do to earn permission to sit for the exam was take an English class, a microbiology class, two college math courses, a history course and a couple of other non-RT courses. Huge difference eh?

Fortunately, we did set a time limit for advancing their credentials and those that got left behind were well aware of it.

Not that it's any of your business (hence why I didn't tell you) but I'm sitting for my RRT exam in two weeks. Don't paint it as though you left anyone here behind. The only reason I'm taking the test is that my boss offered to pay for it when he learned I've been eligible to test for over a year and haven't bothered to since it doesn't change what I can do as an RT. It was his wedding present to me. I would have just prefered a $0.50 per hour pay raise.

Essentially this is similar to an EMT vs Paramedic argument in the RT world.

The analogy should probably be the difference between a state certified EMT-P and an NREMT-P in state that doesn't use the NREMT exams since the decision as to whether someone can practice the same scope as a CRT and an RRT is finally left to the individual hospital. It's nice to have but doesn't do much for you unless you have to have it to work at a particular hospital.

 

[VentMedic]

The analogy should probably be the difference between a state certified EMT-P and an NREMT-P in state that doesn't use the NREMT exams since the decision as to whether someone can practice the same scope as a CRT and an RRT is finally left to the individual hospital. It's nice to have but doesn't do much for you unless you have to have it to work at a particular hospital.

The national certification for RT is required. Period.

Iin many states there are separate licenses and CRTs will not be working in the ICUs. They will be floors and clinics. It is not always left to the hospitals. CRTs do have a limited scope as they can not intubate, do Specialty transport,CCT, Flight or ECMO. Again, you need to learn more about the RT profession before you attempt any type of discussion. The fact that you don't know about the other opportunities is because you are still viewing the profession as a CRT.

I interjected on your posts about RTs because they were full of misinformation. And here is more misinformation. Did you even compare the 2 exams? They are totally different and at different levels of thinking. Anyone that wants to confirm that can go to the NBRC website.

The only reason there are two levels of RT anymore is because the NBRC (the credentialing body) would lose money if they stopped credentialing new CRTs since you take the CRT exam before the RRT exam.

BTW, calling you a CRT is NOT a personal attack. That is your credential.

 

[ResTech]

Agreed... it would be nice to not have to hear about RRT all the time... personally I dont care what RRT's do in the hospital.

In regards to the original topic, I have observed all types over the past decade and a half and some are very embarrassing to say the least. But EMS surely is not unique in that. I blame the organizations for not having anymore stringent standards then they do and for allowing them to enter the field.

EMS is healthcare but it is really a separate entity of healthcare. So many things make it different than traditional healthcare in a hospital or clinic. Not too many hospital personnel will be fond off intubating in the middle of a farm field in 100 degree weather, or crawling into a overturned vehicle in pouring down rain, or having to provide care in deplorable living conditions in the slums of the city. So naturally it is going to attract a different breed of people who want to do the job.

EMS is exciting... I'd be lying if I said it wasnt. I like the "sub-culture" of the emergency services and the dynamics present in it. To me its much better than being stuck inside a hospital for 12hrs at a time.

And on a side note.....
It bugs the hell out of me to hear people come down on the volunteer provider. What constitutes a "professional" is not defined by a paycheck.

 

[ffemt8978]

Knock it off, both of you!

 

[usafmedic45]

Knock it off, both of you!

OK....I already sent a PM to Venty....hopefully that will stop this bad blood between us.


BTW, Vent, you have my word that I won't forward anything to anyone unless it's to a moderator to settle something that gets out of hand. If I forward anything you send me to anyone, they can send it right back to a moderator and I'll gladly assume the position for punishment.

 

[PapaBear434]

People, people, people... How about we all just calm down, and agree that we are all horrible people and should ALL be ashamed of ourselves?

 

[SeeNoMore]

Certainly no one is perfect. But we should all aim to be as close as possible. I think getting to the point where you are not constantly searching for a way to better your care and knowledge would be very unfortunate.

 

[usafmedic45]

People, people, people... How about we all just calm down, and agree that we are all horrible people and should ALL be ashamed of ourselves?

:lol: :lol: :lol: :lol:

I will agree that you're a horrible person and so am I. Beyond that, I plead the Fifth.

 

[usafmedic45]

Certainly no one is perfect. But we should all aim to be as close as possible. I think getting to the point where you are not constantly searching for a way to better your care and knowledge would be very unfortunate.

I agree....the day I stop learning and trying to figure out how I can do better by my patients is the day I will retire.

 

[Mountain Res-Q]

Certainly no one is perfect.

Speak for yourself.

But take it from me... it isn’t all it is cracked up to be; the pressure is too much after 26 years. Then about 4 months ago I found EMTLIFE, saw the massive imperfection, and thought I would give the fallible life a try... ^_^

 

[usafmedic45]

I will agree that you're a horrible person and so am I

Meant to post this with the original comment.....

 

[ffemt8978]

Thread closed due to invocation of Godwin's Law.