What happened to paramedic students?
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Ridryder911
EMS Guru
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Nothing... it's been going on at least the past 34+ years. Unfortunately, it is one of our major pitfalls in this so called profession.
Ironically, it is this type of demeanor that displays immaturity, and a lack of professional behavior but also basically reflects ignorance. I used to call them Parapuppies or Greenhorn but; I have determined that could be as unprofessional and really did'nt get any point across to them.
Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "It's not my job (also another demonstration of ignorance of emergency medicine). All medicine is our job; we just specialize and should be better in certain areas.
I try not to LOL... seriously, and yes it is sometimes hard not to, but I have learned deal with them by patting them on the back and whisper to them .. Come see me in a year or two; that is; if your still in this profession and will discuss things then and see if you still have this attitude.
R/r 911
Ironically, it is this type of demeanor that displays immaturity, and a lack of professional behavior but also basically reflects ignorance. I used to call them Parapuppies or Greenhorn but; I have determined that could be as unprofessional and really did'nt get any point across to them.
Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "It's not my job (also another demonstration of ignorance of emergency medicine). All medicine is our job; we just specialize and should be better in certain areas.
I try not to LOL... seriously, and yes it is sometimes hard not to, but I have learned deal with them by patting them on the back and whisper to them .. Come see me in a year or two; that is; if your still in this profession and will discuss things then and see if you still have this attitude.
R/r 911
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The term paragod means a lot of different things to different people. I am often called a paragod after I call out an EMT or medic for saying or doing something stupid (that they cant back up). Sometimes it takes less than that.
fma08
Forum Asst. Chief
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After I graduated, I was under the impression I had learned what I needed to in school, and thus, was as qualified as someone working for 10 years because we had the same certs, passed the same tests, etc.
I was wrong and I try to keep that in mind as I continue my education. Hopefully they'll realize it too eventually.
I was wrong and I try to keep that in mind as I continue my education. Hopefully they'll realize it too eventually.
dixie_flatline
Forum Captain
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I have kind of the opposite problem. Anion gaps specifically came up recently and I was ridiculed for wanting to know things that don't need to be known. Those of us discussing this stuff are definitely in the minority, and are looked at as the paragods.
Anion gap ratio? What the hell is that? Are you talking about the delta ratio? I can tell you that not even medical students learn about that (anion gap, sure; delta ratio, no). I haven't even heard it brought up in EM lectures that I've attended. Jesus Christ, of all the things to cite as proof of ignorance... the delta ratio? *mind blown*
I thought the same thing. If I hadn't read more of RidRyder's posts, I would of guessed that he randomly picked out a medical sounding word just to make himself sound cool.
gotbeerz001
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We called those the Superfriends.
Knowing things above and beyond what you are expected to know is certainly commendable, but I've seen people go about it in a way that rubs me as very fake and non sincere. Like they are asking the questions just to sound smart.
TheLocalMedic
Grumpy Badger
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We hired a whole gaggle of newly minted medics and EMTs recently, and I have to keep reminding myself to play nice. Depending on the culture at their training academy they can sometimes come out with the misconception that they really have been taught everything they need to know. But don't worry, the real world is a nice cold wake up call.
neoclassicaljazz
Forum Crew Member
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I look forward to meeting some of these "paragods" when I start school and hopefully not becoming one. I'm so young and inexperienced compared to most (all) of EMTs and medics I run with, all I do is ask questions
Medic496
Show strength when weak, and humility when strong
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A good Paramedic needs shaping
I have found that the young newly minted Paramedics need leadership and guidance. Making up names such as paragon, newbie, or anything else does nothing to build up the new person. We are not the fire service, we do not need to create a culture of laughing and pointing the finger at those who have a deficiency. If that new person was with our organization, I would go over and help them learn and become competent by showing them personally.
EMS leaders need to lead. The FTO's, Supervisors and Management need to believe in the idea of a quality organization, with quality operations and competent field personnel. Upon initial hire set the expectation early. This is at will employment and those who do not perform to standards may not be invited back to play after about 30 to 60 days. We need to invest the effort to help a new grad develop, but the choice is theirs to succeed.
I have found that the young newly minted Paramedics need leadership and guidance. Making up names such as paragon, newbie, or anything else does nothing to build up the new person. We are not the fire service, we do not need to create a culture of laughing and pointing the finger at those who have a deficiency. If that new person was with our organization, I would go over and help them learn and become competent by showing them personally.
EMS leaders need to lead. The FTO's, Supervisors and Management need to believe in the idea of a quality organization, with quality operations and competent field personnel. Upon initial hire set the expectation early. This is at will employment and those who do not perform to standards may not be invited back to play after about 30 to 60 days. We need to invest the effort to help a new grad develop, but the choice is theirs to succeed.
Burritomedic1127
Forum Captain
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Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "It's not my job (also another demonstration of ignorance of emergency medicine). All medicine is our job; we just specialize and should be better in certain areas.
R/r 911[/QUOTE]
Well said
Its funny that people complain of lack of respect for EMS and being called ambulance drivers when people don't want to go above and beyond "their job" and just drive pt's to the hospital. Maybe just maybe if EMS workers went above and beyond "their job" and tried to advance their knowledge on subjects higher than the NR standards, then we might just get that respect and, hold your breath, increased salary.
The power is in our hands...or minds... However you read it
R/r 911[/QUOTE]
Well said
Its funny that people complain of lack of respect for EMS and being called ambulance drivers when people don't want to go above and beyond "their job" and just drive pt's to the hospital. Maybe just maybe if EMS workers went above and beyond "their job" and tried to advance their knowledge on subjects higher than the NR standards, then we might just get that respect and, hold your breath, increased salary.
The power is in our hands...or minds... However you read it
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This is not new, and it happens in many career fields, particularly in healthcare.
If I could introduce you to some of the people I am fixing to start medical school with, who feel like they have some extraordinary amount of clinical experience because they have been a scribe for 2 years part time in a busy ER, you would understand that this phenomenon is not limited solely to EMS.
We will all be humbled at some point. Some people will actually gain humility from the experience, and others will simply continue to live life, utterly oblivious to the fact that they in fact do not know everything.
If I could introduce you to some of the people I am fixing to start medical school with, who feel like they have some extraordinary amount of clinical experience because they have been a scribe for 2 years part time in a busy ER, you would understand that this phenomenon is not limited solely to EMS.
We will all be humbled at some point. Some people will actually gain humility from the experience, and others will simply continue to live life, utterly oblivious to the fact that they in fact do not know everything.
gotbeerz001
Forum Deputy Chief
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This is true to an extent. The bottom line is that there are roles to play. When you are new, you need to be the sponge. You need to listen to those that have been doing the job that you are just now starting. That doesn't mean that we are intentionally going to squash the good that the individual brings to the table. Someone who is unteachable is a problem.
Also, the quip about the fire service is unfounded. A seasoned fireman wants to pass on the tools of the trade to the next generation. That being said, thick skin is cultural reality and not a bad thing. The fact is, if you are being f#$@ed with*, people like you. The people that are liked get every possible chance to succeed. If you are "not liked", you probably did not display the adaptability required to thrive in the firehouse setting. You probably respond to advice with "I know" or some excuse. This attitude is detrimental to self and team. Frankly it is easier to spend 48 hours with this person in a house than it is to spend 12 hours in the bus. New guys should be given the opportunity to thrive, but the responsibility falls on them to remain teachable.
* It is true that some people just screw with the new guy out of malice. Everyone knows who they are and no one listens to them. They were usually the ones who didn't "get it" when they were hired.
Instead of talking about the anion gap ratio, which the majority of medics will not know, try testing them with simpler questions:
Why will the patient's ETCO2 be normal to low if they are in DKA? If they get that, ask them how to (reasonably) rule in a STEMI in the presence of LBBB or a paced rhythm.
As far as paragods, maybe these new providers are working in an all-ALS system, where they are the only medic on the bus, and are the highest medical authority. In my experience though, new medics are typically scared of their own shadow, and very hesitant to make a provisional Dx/run a protocol. The rookie paragods that I run into were typically EMT-I's before becoming medics, or EMT-E's riding with a medic, so they have the attitude that they've already seen everything.
Why will the patient's ETCO2 be normal to low if they are in DKA? If they get that, ask them how to (reasonably) rule in a STEMI in the presence of LBBB or a paced rhythm.
As far as paragods, maybe these new providers are working in an all-ALS system, where they are the only medic on the bus, and are the highest medical authority. In my experience though, new medics are typically scared of their own shadow, and very hesitant to make a provisional Dx/run a protocol. The rookie paragods that I run into were typically EMT-I's before becoming medics, or EMT-E's riding with a medic, so they have the attitude that they've already seen everything.
The problem that I'm finding is that many systems are all-ALS, where the medics run all of the BLS as well as the ALS. In this type of system, the good calls are few and far between, and most calls are just diagnostics and txp. In these systems, your critical thinking skills and medical knowledge are rarely tested. After a number of years (or sooner), you become indifferent to EMS, and begin to lose interest in improving your clinical knowledge.
In my case, I went from a busy, tiered system (NYC), where I was using my protocols 3-5 times a day, to an all-ALS system, where I might see two or three patients in a month, who need more than vitals, 12-lead and maybe O2. I have some college level A&P/pharm courses, I go to whatever symposiums and conferences my employer will cover, but I rarely get to use what I've learned. Really, I could just do vitals, a BGL, 12-lead/15 lead, ETCO2, a stroke assessment, and maybe a line, and be fully covered for 90%+ of the patients I typically run in an all-ALS system.
I've been finding myself becoming increasingly indifferent towards EMS. It's really easy work, it pays really well (I'm fire based), but there's no challenge. We could educate up to a point where we rival PA's, but I'm still going to run 90% non-acute patients when I get back to the field. I'm sure that Attending MD's have similar frustrations, dealing with all of the nonsense that come into the ED. This is one of the reasons why I sold out and went to fire based EMS. Txp becomes increasingly boring and non-fufilling, but there are many other job functions to slide into. I've been in EMS for over 11 years now, and I don't see how I could do 25+ years in 911 txp. I have a genuine interest in medicine, but in EMS, most of that knowledge is not used, or not even necessary. For example, I can't think of even one time in my career (on the 911 side) that it was important to understand what the anion gap ratio/Delta Ratio is, much less use that understanding to change a patient outcome. We don't do labs in the back of the ambulance.
Burritomedic1127
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Higher education standards will decrease the amount of medics which will raise salaries and respect for those who went the extra mile.
Take for example a pt who has a syncopal episode on exertion, you can have a medic that will scoop them into their office aka the back of the bus and get vitals and look for signs of ischemia or infarct on the 12, and if the vitals were fine and no elevations/depressions are noted just monitor and transport the pt. Or you could have a medic that picks up the same pt and recognizes hypertrophic cardiomyopathy on the EKG that suggest you tell your PCP and schedule an appt. with a cardiologist because they recognize theyre more susceptible to sudden cardiac death. Yeah this is a pretty specific case and there's no protocol for hypertrophic cardiomyopathy but this is an example of going above and beyond for THE PT.
Doing more for the pt's after and outside of the ambulance adventure is what EMS should strive for
Just my two cents
Take for example a pt who has a syncopal episode on exertion, you can have a medic that will scoop them into their office aka the back of the bus and get vitals and look for signs of ischemia or infarct on the 12, and if the vitals were fine and no elevations/depressions are noted just monitor and transport the pt. Or you could have a medic that picks up the same pt and recognizes hypertrophic cardiomyopathy on the EKG that suggest you tell your PCP and schedule an appt. with a cardiologist because they recognize theyre more susceptible to sudden cardiac death. Yeah this is a pretty specific case and there's no protocol for hypertrophic cardiomyopathy but this is an example of going above and beyond for THE PT.
Doing more for the pt's after and outside of the ambulance adventure is what EMS should strive for
Just my two cents