The practicality of EMT Basics as an emergecy responder

[MexDefender]

Besides the top brass who call the shots and keep things unchanged you would have to convince hundreds of thousands of EMS personnel to enact change by simply putting on a shirt saying change ems or some other big PR stunt that gets notice by national media. Another problem is an informed populace, almost everyone thinks if you work on an ambulance you must be a paramedic who saves lives and is "like a doctor".

The youth of EMS could battle this and maybe in time it could show results but everyone in the field is too complacent to do anything big instead just harp and talk about it.

 

[Jambi]

Change is not as easy as PR or media attention, nor does it lie on the desk of top brass as they're largely irrelevant.

Any meaningful change is with law makers and who gives them the most money. It's all about policy, and the rank-and-file just don't merit atttention. Just look at the mostly irrelevent occupy movement. What change did they effect, none. Currently EMS, and any change associated with it, is inexorably linked with fire, and since they're the dominant force (money, union, association, etc.), their interests are served first.

Now, since EMS is regulated at the state level multiply all that by 50 states.

There has been some headway made in california. All EMS training programs were mandated to be associated with colleges, this shut down most, if not all, fire-based programs. furthermore, standards were increased, hours upped, perfomance standards for medic (with yearly verification) was put in place.

The state and local ems and medical directors are gradually finding their teeth.

 

[hogwiley]

Everyone keeps talking about the lack of training for EMT Basics, but one problem Ive noticed is a general mentality in EMS, and in particular among new EMTs. Im not sure exactly how to describe it, but it basically seems to be an attitude that their job isnt really patient care.

For an example someone on here summed it up nicely when they mentioned a Paramedic having to wipe an incontinent patients butt. It was apparently hilarious that this almighty Paramedic would be reduced to performing such a mindless and unglamourous task. Nevermind you have BSNs in ICUs with far more education and training and making a lot more money doing it all shift long.

It really is a problem when patient care is considered embarrasing or something you are above, especially when you consider how little training EMTs have. It shows immaturity and a lack of professionalism. This seems to be less a problem with really experienced Paramedics, but a lot more with younger EMTs and medics. I was told by an ED nurse whose ED employs CNAs instead of EMTs as techs that THIS was the biggest reason.

I dont know if its the influence of Fire on EMS, where its all about lights and sirens and wearing a uniform with neat patches, instead of being about taking care of patients, but its been a glaring difference Ive noticed between EMS and other health care professionals.

 

[Aidey]

There is a very simple explanation for that. CNAs are taught personal hygeine care. EMTs are not. It isn't even mentioned. The embarrassment isn't just from immaturity and lack of professionalism, it is from being put in an position that they aren't trained for, and needs to be handled a certain way.

The reason you see experienced paramedics jumping in to help is very likely because they have observed enough over the years to make up for the lack of training in caring for a pts personal hygiene. I've had nurses show me what to do, and now I'm pretty comfortable with it. I didn't like cleaning pts before, not because I thought it was below me, but because I was worried about causing the patient discomfort because I was doing something incorrectly.

 

[RocketMedic]

My first part-time agency had our on-duty hours as para-CNAs. I didn't mind (still don't), but it was uncomfortable to be put in a position where I was first-out 911 and still immediately responsible for inpatient care (ie bathing). With no CNA training and crappy RN support, it wasn't optimal, and I quit for that reason among others.

That being said, I agree that many new EMTs seem to be "above" patient care. I'll stay on scene if patient presentation permits to change a diaper or make them comfortable. There's not much more humiliating than wearing your own poop to go see other people.

 

[Handsome Robb]

It really is a problem when patient care is considered embarrasing or something you are above, especially when you consider how little training EMTs have. It shows immaturity and a lack of professionalism. This seems to be less a problem with really experienced Paramedics, but a lot more with younger EMTs and medics. I was told by an ED nurse whose ED employs CNAs instead of EMTs as techs that THIS was the biggest reason.
.

Since all young EMTs and Medics are immature pricks, right?

 

[NomadicMedic]

Since all young EMTs and Medics are immature pricks, right?

Only you buttwiper.

 

[JPINFV]

Since all young EMTs and Medics are immature pricks, right?

Enough to argue, at a minimum, that it's a justified stereotype. How many 19, 20 year old EMTs would stick around to help roll a dialysis patient who had a BM during the transport?

 

[VFlutter]

Mini Rant

Since all young EMTs and Medics are immature pricks, right?

Not all have that mentality but a few do and unfortunately those are the ones you usually remember.

It is not a problem specific to EMS but medical professions as a whole. A lot of new people have tunnel vision for only the most exciting and glorious parts of the job. It takes experience to realize the importance of the little things.

How many times have you seen the mentality of "Why would I clean up my patient who just :censored::censored::censored::censored: themselves? That is the nurse's job. They can take care of it when they get to the hospital" What those people fail to see is that the "awesome" septic shock patient in the ICU vented and on pressors might have all started from an ulcer from laying in stool/urine. If you think it is above you to clean up a patient then you have no right to touch that patient in the ICU. That is why I do not take offense when people refer to nurses as "***-wipers", I just shrug it off as ignorance.

If you get into the medical field you have to realize that some-days you may have to be elbow deep in C. Diff. :censored::censored::censored::censored: happens

 

[hogwiley]

Since all young EMTs and Medics are immature pricks, right?

I never said all, but were not exactly talking about a tiny percentage either.

 

[rescue1]

On the subject of cleaning a patient if they made a whoopsie during transport, I can't see it being safe or effective for you to unrestrain the patient, roll the patient to the side and clean (all by yourself), and then re-restrain them. Wouldn't it make more sense to move them to the hospital bed first where there is little chance of being involved in an auto accident and so you have some extra hands?


I'm not advocating not cleaning our patients, and I'd certainly stick around the hospital if they needed help with cleaning a BM, but I feel like it is still a task best accomplished in a hospital rather then a moving ambulance.

 

[Zman6]

UCLA Expanded Scope Class Online

Has anyone taken the free LACo Expanded scope class online through UCLA?