The Lowest Common Denominator

[skyemt]

As i have read and participated in these threads for many many months now,
i have often wondered why threads often deteriorate into Medic vs. Basic, etc.

many basics out here are motivated, competent and desire to learn more...

here's the thing... one theme among everyone is that the public often doesn't know the difference between basic, medic, etc...

so essentially, the reputation and perception of medics is held hostage by the lowest common denominator, the lowest level basics (least educated, motivated and skilled). if that is what the public sees, it can't help but associate that with all emt's and medics alike...

i can see the problem there... i can see why the debates go the directions they go...

and we all know that lower level of basic, and probably feel the same way...

so the question is, if you assume that the basic can serve a useful purpose (let's not debate that part here, please) , shouldn't there be a way to get rid of that lowest level?

perhaps some sort of recert exam, showing a minimum level of competence and knowledge?

some method of ridding the system of the lowest common denominator?

 

[Outbac1]

If you upgrade the minimum requirement, a lot of the minimalists will fade away. They won't be motavated to take the upgraded training. Those that are left will have a better understanding on how best to help their patients.
That and it takes ongoing public education. Even here where we upgraded basic service many years ago, we still have to educate the public. There are still people who think all we can do is scoop and run. Its frustrating but we are winning the battle.

 

[Ops Paramedic]

Consider yourself lucky, should your public's opinion of you be that of basic. I can't recall how many times i have been called an ambulance driver (implying you have no abilities to treat the patient), or get the: "Is someone really going to sit in the back with the patient??". Whos fault is that then?? OURS. As outback mentioned, we have to educate the public about OUR profession, becuase i promise you that no one will do it, other than ourselves. It is up to us.

I can see your point of Basic vs Advanced when reading some of the posts. FYI is was a Basic , then moved onto Intermediate, & completed my three years at the university to become Advanced. Currently i am fininshing up with my 5th year of study and hoping to walk out with our degree qualification soon. Hence me being able to often say to some of the crews (or chancers) i encounter, no matter what service: "You cannot bullsh... a bulls..tter" The point i am trying to get across is that we all started somewhere and is currently at some some level or the the other. As long as you do your best and live up to your level, there should be no need to rid the system of the lowest common demoninator. Think about it this way: Did you gradute from school as a grade 12 directly, or did you start off at grade 1, working your way up through the system...

I believe (and hoping i am speaking for the majority of us) that the posts as posted by the various levels are not in order to launch full scale attacks between the different levels, but rather to educate and share knowledge to futher the profession, it would only be in our own best interest as well as that of the patient's. It is my aim to do the latter, and if i have offended someone with my posts, i do apoligise sincerly, it was not the intention.

 

[paramedix]

I was a basic and proud of it. Yip, I'm still that "ambulance driver" or that "paramedic"...(I'm not a paramedic and being called that frustrates a lot of paramedics that studied for their ALS)

I'm an ILS now and proud of it, but will never degrade a BLS - I was there. Had days of hell and days of joy.

Our BLS consists of the BAC (Basic Ambulance Course) and some medics love to call the BLS guys "Bring And Carry's".

I know where you coming from, but I have learned - and up till today - can learn something from a BLS.

We learn from each other, thats why we "practice" medicine.

 

[Vizior]

I don't think anyone is really attacking basics in general. It's mostly the idea of basics who are content with being a basic, and feeling that that is good enough for their patients. It's kinda like the basics that will automatically cancel ALS on just about any call, before even seeing the patient.

 

[daedalus]

You need to remember that there is a workforce of EMTs that do BLS transports, from treatment back to nursing home and so forth, and that this workforce will be compromised should any standards be raised....

Its not about training for these companies but the billing for the transports.

I can see the training that basics have now as more than enough to handle BLS IF transports. However, when we get into 911 or prehospital response, it becomes very important to have educated providers who are competent in their skillsets and knowledge. I do think that a properly trained and well read EMT, who has continued her education, and who is properly equipped with a progressive scope and a paramedic with her, is an excellent prehospital provider.

If we had medics bringing crazy johnny from the PD to the pysch hosp, burnout would be a huge issue. EMTs are even overkill. And yes, i do rule out medical causes for crazies. Most are ETOH plus coke and Hx psychosis. Boring...

 

[JPINFV]

I can see the training that basics have now as more than enough to handle BLS IF transports.

Of course then the problem is when these providers are used to transfer patients from a SNF to an ER for treatment. There's nothing like walking in on a patient with a 5 page med list that has been in respiratory failure for the past hour. Just like I think it's a pretty clear sign that a facility should have called 911 when a patient is intubated before the interfacility crew has a chance to finish giving report at the ER (short transport times=most serious calls are transported by basics instead of calling for paramedics).

 

[firecoins]

Of course then the problem is when these providers are used to transfer patients from a SNF to an ER for treatment. There's nothing like walking in on a patient with a 5 page med list that has been in respiratory failure for the past hour. Just like I think it's a pretty clear sign that a facility should have called 911 when a patient is intubated before the interfacility crew has a chance to finish giving report at the ER (short transport times=most serious calls are transported by basics instead of calling for paramedics).

many transport cos have ALS buses as well.

 

[JPINFV]

many transport cos have ALS buses as well.

I had the distinct pleasure of working in an area where the only paramedics were with the fire department. So, it was either a CCT, call 911, or use EMT-Basics. It is of serious note that, while the system was bass ackwards, the area is one of the most populated areas of California. Unless the patient needed an RT (e.g. ventilator patients), most SNFs just called their contracted provider for a set of EMT-Basics. That said, I was on a handful of RN SNF->ER calls, but those patients tended to be more stable than some of the calls handled by basics.

 

[firecoins]

Transport companies can bill insurance and medicare for ALS calls. the medics at the FD could make extra income. Looks like something that needs to be taken care of.