firetender
Community Leader Emeritus
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(This was part of another thread, was probably a bit off-topic, so I figured it'd be a good thing to put it at the center of its own bulls-eye!)
Depending on the call area, the paramedic has different percentages of emergency, non-emergency, evaluation of medical status, routine transport, critical calls, trauma, basic intervention, triage and on and on. Every area is different, but only in the proportions.
In some areas, it appears all about serious medical cases. In others, mostly about the horizontal taxi game. But regardless, in MOST areas a disproportionate amount of calls involve providing the kinds of reassurance or medical guidance that the people once had available to them through connections with relatives, the family doctor, or extended families who provided folk wisdom and intervention.
It's not their fault; medical care has been institutionalized and human beings are dispensed drugs when what their humanness calls out for is connection. Our society has relegated the burden of care for the sick and injured to a cadre of professionals where once the burdens were more evenly spread out amongst the citizenry as a whole.
Ambulance personnel are at the bottom of the food chain, getting eaten up by the assault of desperate people seeking help for what ails them, NOT by those needing emergency treatment.
What is not being acknowledged is that more and more, the ambulance delivers the hope of human compassion and technical skill to someone's scene of unbearable stress.
In reality, rather than being a Specialist, the paramedic is called on to be a Generalist who sometimes uses his/her specialist skills. The bottom line is paramedics deal with people in distress who do not have access to, cannot afford, or are not aware of other options in meeting their (perceived) immediate health care needs. As a sideline, sometimes medics intervene in serious medical emergencies.
The educational, technical, emotional, spiritual, interpersonal, moral and philosophical territory a medic must traverse is far more broad than is covered in manuals of emergency care.
It is my position that if the field is going to develop as a profession, it is going to have to broaden its perspective of itself and base it on reality. It is not and never has been strictly about the delivery of emergency medical care in much the same way as Nursing was never about bedpans.
In the real world it involves mastery of multiple modes of communication; extensive observation; multi-level discernments (where does this person best belong?), tact, diplomacy, and, if the job is to be done right, extensive knowledge of available local resources.
In an ideal world, the ambulance would be a triage unit, arriving at the scene and handling any immediate emergencies while mobilizing back-up services to follow, like EMT transport, social services evaluation teams, or psychiatric referral. As the EMS system stands, there are few services supporting IT; paramedics are flying without a net and then end up feeling guilty and somewhat ineffectual because most of the time, there are few whom they can really help.
WHY NOT TRAIN PARAMEDICS TO ACTUALLY HELP THE PEOPLE THEY SERVE?
So in looking over what I just wrote I'd have to conclude paramedics need to broaden their perspectives of themselves and the role they play in this society. They need to design a curricula for themselves that honestly prepares them for the reality, not the fantasy, of the job.
That means legitimization through a degree program (Read it and weep!) and that means a longer commitment to the profession. EMS is predominately a relatively young, transient's profession because it prepares its practitioners for only one-tenth of what they do.
Any hiring authority will tell you it is accepted that burnout is the major cause of medics leaving the field. It is a numbers game designed to keep fresh meat coming in.
Of course it is accepted as such, it's designed that way. If there will be change it's got to come from the personnel that can actually understand the role they really play in our society.
Depending on the call area, the paramedic has different percentages of emergency, non-emergency, evaluation of medical status, routine transport, critical calls, trauma, basic intervention, triage and on and on. Every area is different, but only in the proportions.
In some areas, it appears all about serious medical cases. In others, mostly about the horizontal taxi game. But regardless, in MOST areas a disproportionate amount of calls involve providing the kinds of reassurance or medical guidance that the people once had available to them through connections with relatives, the family doctor, or extended families who provided folk wisdom and intervention.
It's not their fault; medical care has been institutionalized and human beings are dispensed drugs when what their humanness calls out for is connection. Our society has relegated the burden of care for the sick and injured to a cadre of professionals where once the burdens were more evenly spread out amongst the citizenry as a whole.
Ambulance personnel are at the bottom of the food chain, getting eaten up by the assault of desperate people seeking help for what ails them, NOT by those needing emergency treatment.
What is not being acknowledged is that more and more, the ambulance delivers the hope of human compassion and technical skill to someone's scene of unbearable stress.
In reality, rather than being a Specialist, the paramedic is called on to be a Generalist who sometimes uses his/her specialist skills. The bottom line is paramedics deal with people in distress who do not have access to, cannot afford, or are not aware of other options in meeting their (perceived) immediate health care needs. As a sideline, sometimes medics intervene in serious medical emergencies.
The educational, technical, emotional, spiritual, interpersonal, moral and philosophical territory a medic must traverse is far more broad than is covered in manuals of emergency care.
It is my position that if the field is going to develop as a profession, it is going to have to broaden its perspective of itself and base it on reality. It is not and never has been strictly about the delivery of emergency medical care in much the same way as Nursing was never about bedpans.
In the real world it involves mastery of multiple modes of communication; extensive observation; multi-level discernments (where does this person best belong?), tact, diplomacy, and, if the job is to be done right, extensive knowledge of available local resources.
In an ideal world, the ambulance would be a triage unit, arriving at the scene and handling any immediate emergencies while mobilizing back-up services to follow, like EMT transport, social services evaluation teams, or psychiatric referral. As the EMS system stands, there are few services supporting IT; paramedics are flying without a net and then end up feeling guilty and somewhat ineffectual because most of the time, there are few whom they can really help.
WHY NOT TRAIN PARAMEDICS TO ACTUALLY HELP THE PEOPLE THEY SERVE?
So in looking over what I just wrote I'd have to conclude paramedics need to broaden their perspectives of themselves and the role they play in this society. They need to design a curricula for themselves that honestly prepares them for the reality, not the fantasy, of the job.
That means legitimization through a degree program (Read it and weep!) and that means a longer commitment to the profession. EMS is predominately a relatively young, transient's profession because it prepares its practitioners for only one-tenth of what they do.
Any hiring authority will tell you it is accepted that burnout is the major cause of medics leaving the field. It is a numbers game designed to keep fresh meat coming in.
Of course it is accepted as such, it's designed that way. If there will be change it's got to come from the personnel that can actually understand the role they really play in our society.
