medics with attitudes

[JPINFV]

You dont say.. I also think anyone who has spent any time isn this field recognises if a life is saved it will take a team of players not just the lead off hitters.

True, but there's a reason the CNAs aren't speaking at the news conference regarding Representative Giffords.

There's also a reason why malpractice insurance premiums are different for CNAs than physicians.

There's also no "I" in "team" until the lawyers come out.

 

[ffemt8978]

You dont say.. I also think anyone who has spent any time isn this field recognises if a life is saved it will take a team of players not just the lead off hitters.

Anyone who has spent anytime in this field realizes that the past 40 years of EMS in this country have been more orientated to not killing anybody than actually treating them.

Thankfully, this is starting to change but it is going to be a long, hard trip to get to the point that EMS actually saves lives on a regular basis.

 

[Shishkabob]

There's also no "I" in "team" until the lawyers come out.

There's a "me" hidden in there!

What I say goes, period.

Well, they did say you sure did take charge at the code the other day

 

[MrBrown]

Brown gives them an award for being a Parathinktheyare

 

[usafmedic45]

True, but there's a reason the CNAs aren't speaking at the news conference regarding Representative Giffords.

Besides the fact most neuro ICUs don't have them?

Brown gives them an award for being a Parathinktheyare

Is that anything like a parakeet? Like the New Zealand version of a budgerigar or something?

 

[MrBrown]

Parathinktheyare: A provider of prehospital emergent medical treatment and transport whos education and modalities of clinical praxis are disproportinatly rudimentary when compared with comparable systems in other jurisdictions. May be the product of a patch factory (which may or may not predominantly serve the needs of the barely homeostasasasing who inturn may or may not be Fire Service employees or candidates) without comprehensive understanding of basic sciences (biological and/or clinical) and rationale-driven modalities of praxis avaliable elsewhere evidenced by best practice applicable to his or her level of clinical certification. Most likely has a high reliance upon delegated protocols and potential for extremely high levels of recourse to online medical direction and justifies clinical praxis based upon orders recieved by online direction. Fails to understand limitations of practice modalities and education as witnessed by others. Most often found in the USA.

 

[Aidey]

Yes because they. Key word they should have known. So it is the medic fault to. But could a fellow medic made the same mistake? Yes. Nobody is perfect. Your post is arrogant.

I'm sorry you think my post is arrogant, but I really don't see how it is. I used "they" because I was avoiding using he or she. My post was simply an example of a case where a Paramedic was held more responsible for the EMT I's mistake than the EMT I was. The line could have also be written "Even though the emt had started the line the medic was held responsible because the paramedic should have known the line was bad".

The real kicker in that case is that the paramedic figured out the line was bad when the pushed the med, and d/c it immediately, it wasn't like the medic dumped 500cc of saline in before figuring it out. But since the damage was done, it didn't really matter.

 

[CANMAN]

USAFmedic.... My post about the license vs. certification isn't strictly talking about the fact that in a legal case THEY WILL come after the person with the license over the provider with a certification.

As far the volunteers who are a RN, MD, RRT, horse doctor, whatever I guess to each their own. I have yet to meet someone who works in healthcare as something other then a EMT/EMT-P who is exceptional at field EMS in a volunteer capacity. Like I said previously I will put a GOOD MEDIC who does it day in and day out as a career up against a ER RN who volunteers and rides a unit any day....And I work with RN's who have ER and ICU background on a critical care transport team as well.

 

[Veneficus]

USAFmedic.... My post about the license vs. certification isn't strictly talking about the fact that in a legal case THEY WILL come after the person with the license over the provider with a certification.

As far the volunteers who are a RN, MD, RRT, horse doctor, whatever I guess to each their own. I have yet to meet someone who works in healthcare as something other then a EMT/EMT-P who is exceptional at field EMS in a volunteer capacity. Like I said previously I will put a GOOD MEDIC who does it day in and day out as a career up against a ER RN who volunteers and rides a unit any day....And I work with RN's who have ER and ICU background on a critical care transport team as well.

I have met several RNs who volunteer as EMS providers. Another handful who are paid EMS providers, I do not know of any intrisic shortcomings they have other medics don't.

As for the bolded part.

Why?

 

[CANMAN]

Well I am not trying to start another topic but I feel like we function totally different. From thought process to skill set etc... In over 5 years of working with a RN every shift I have realized there are so many differences in what we do and think. While you can crosstrain both providers I am just saying I would personally take a strong medic over another provider. Not everyone will agree and I accept that. I am also speaking about my particular system, state, experiences...

 

[jjesusfreak01]

Well, by that definition MrBrown, I am not a Parathinktheyare. I have a bachelors degree in Biology, had a 180 hour EMT-B class, and am currently in the process of completing a few months of third rider field training. I work with experienced paramedics so calling for online medical direction is never necessary, and do not plan on staying at this level of practice for more than a year (EMT-I or med school is in my immediate future).

I was understanding parathinktheyare to refer to people who fancy themselves as paramedics when they aren't, which I may be somewhat guilty of (says Brad, as he picks up his copy of Dubin's Rapid Interpretation of EKGs).

 

[JPINFV]

Well, by that definition MrBrown, I am not a Parathinktheyare. I have a bachelors degree in Biology, had a 180 hour EMT-B class, and am currently in the process of completing a few months of third rider field training. I work with experienced paramedics so calling for online medical direction is never necessary, and do not plan on staying at this level of practice for more than a year (EMT-I or med school is in my immediate future).

I was understanding parathinktheyare to refer to people who fancy themselves as paramedics when they aren't, which I may be somewhat guilty of (says Brad, as he picks up his copy of Dubin's Rapid Interpretation of EKGs).

1. Based on Brown's definition, "parathinktheyares" include the level of paramedic in most US states.

2. Congrats on being different from the average EMS provider. If your education far exceeds what most people have, then you lose the right to complain about people talking poorly about the average provider. There's a reason I don't take offense to comments like those, and that's because I recognize that they aren't directed towards the EMT (I'm still active for another few months...) with a BS, MS, and 3/8ths of the way through medical school. Even with just the BS, it's simply not comparable to the education of most EMTs and paramedics.

 

[MrBrown]

Lets not forget another key trait of the Parathinktheyare: They justify themselves, often too highly, based upon principles not supported by the medical literature such as "the medical director told me", "I know I am right", "it always helps", "the textbook says" and "its always been this way".

 

[Bosco578]

How do you and your squad deal with medics who think they are flawless and nothing BLS does is good enough?

Point,laugh, walk away.........:deadhorse:

 

[supergirl534]

personally i deal with way to much. i work and volenteer with both my agencies being als. the als providers that think they are higher then GOD and think that i as a BLS provider am on scene to carry there stuff and be their goffer...... there is an easy way to deal with that. after the call i simply take them aside and talk to them. i usually take one of the things that they said that were condisending and through it beack in their face and in my exsperience they have realized how much of a jerk that they sounded like. for those who are still standing on their milk crete thinking they are better than anyone who has walked the earth i go out of my way to prove them wrong. some people call me a :censored::censored::censored::censored::censored: for it but im okay with that because im not losing any sleep over their ignorence....... but if they really think that they are that good they will lose sleep over the fact that you came to them and talked to them about it .

good luck some people refuse change!

 

[NREMTroe]

Going back to the license and certification thing, didn't they change the EMT "certification" to a license now? I mean I don't want to start anything because believe me I won't be staying an EMT for long, paramedic school starts in August and I will be in that class. It just seems like there is a lot of bickering lately, and it shouldn't be like that.

 

[JPINFV]

Going back to the license and certification thing, didn't they change the EMT "certification" to a license now? I mean I don't want to start anything because believe me I won't be staying an EMT for long, paramedic school starts in August and I will be in that class. It just seems like there is a lot of bickering lately, and it shouldn't be like that.

The only entity that can issue a license is the government, so it all depends on what the state wants to call it's EMT/paramedic authorizations. Regardless, for all intents and purposes, what the state authorities hand out are paramedic and EMT licenses.

NREMT's official take on licensing and certification can be found here:
https://www.nremt.org/nremt/about/Legal_Opinion.asp


My favorite example of the stupidity of debating the difference between a "license" and "certificate":

California Professions Code regarding the practice of medicine.

2040. The terms "license" and "certificate" as used in this chapter
are deemed to be synonomous.

http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=02001-03000&file=2030-2041

Once I realized that the people who write the laws couldn't figure out the difference, I stopped caring.

 

[NREMTroe]

The only entity that can issue a license is the government, so it all depends on what the state wants to call it's EMT/paramedic authorizations. Regardless, for all intents and purposes, what the state authorities hand out are paramedic and EMT licenses.

NREMT's official take on licensing and certification can be found here:
https://www.nremt.org/nremt/about/Legal_Opinion.asp


My favorite example of the stupidity of debating the difference between a "license" and "certificate":

California Professions Code regarding the practice of medicine.


http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=02001-03000&file=2030-2041

Once I realized that the people who write the laws couldn't figure out the difference, I stopped caring.

Thanks JPINFV, I enjoyed reading that article. I think that should "settle" a lot of the discussion about it, even though it really doesn't matter B)

 

[usafmedic45]

USAFmedic.... My post about the license vs. certification isn't strictly talking about the fact that in a legal case THEY WILL come after the person with the license over the provider with a certification.

Does it really matter what they call your state credential? Either way, MIEMSS barely grant you folks the ability to wipe your own butts without asking Dr. Bass' explicit permission. Truth be told, I have so little faith in that state, that I would not be surprised if "dingleberries" would not be a qualifying criterion for a MSP mission. But back to the actual topic at hand....

As someone who works as a "PRN" expert witness for a malpractice attorney, we aren't going to go after the medic or the EMT anymore (assuming they both screwed up equally) unless the medic allowed the EMT to do something that violated a standard of care. This is not to mention that BLS screwups are very difficult to prove in court unless you have it on videotape or one of the providers on scene turns evidence for the plaintiff. The licensed person we are going to go after is the doc overseeing the service since they are the one with the nice fat wallet.

To be frank, if we want to punish an EMS provider for something they did, it's much easier just to have their credentials yanked. Not to mention, it's often much more productive, satisfying and less guilt-inducing.

As far the volunteers who are a RN, MD, RRT, horse doctor, whatever I guess to each their own. I have yet to meet someone who works in healthcare as something other then a EMT/EMT-P who is exceptional at field EMS in a volunteer capacity. Like I said previously I will put a GOOD MEDIC who does it day in and day out as a career up against a ER RN who volunteers and rides a unit any day....And I work with RN's who have ER and ICU background on a critical care transport team as well.

No offense, but that seems to just smack of hubris. In other words, you have have a confirmation bias that doesn't allow anyone to meet your standard. You're telling me that someone with several more years of education, probably more experience (since most EDs, even the slow ones, see more patients in a given time period than even busy ambulance services) and the ability to juggle multiple patients is less qualified than a full-time medic with a minimal education, limited scope of practice, etc? Maybe you guys just have some really crappy ED nurses out there in Maryland nowadays....

Let's use an example I know quite well: the medical director I worked under the longest and his assistants. All of them were EMS providers (the medical director had a state certification in EMS that put him among some of the first classes of ALS EMS providers; most of his assistants were EMT-Bs but a couple were EMT-Is or EMT-Ps) and all were required by policy to ride shifts with us if they wanted to remain able to give medical control orders. That usually amounted to one or two shifts per month for most of them. Are you really going to tell me that, as a general rule, a NREMT-P who works a busy service is a better provider in the field than a MD/DO with a board certification in emergency medicine (or in the case of our medical director: boarded in EM, CCM and IM, not to mention SF combat medic experience in Nam) just because they are volunteers who aren't spending all their working time on the ambulance? I know the field is a different environment than the ED but then again it's not that different and to be honest, clinical judgment is what matters and in that case the guy or gal with more knowledge and more patients under his belt is probably going to be a better provider.

It's kind of like how I'm willing to bet that I could probably outperform you clinically given that I'm used to working in situations (in and out of hospital; civilian and military) where the scope of practice would make Maryland style ALS look like ARC style first aid. However, that said, I still meet EMS providers of all ilks (BLS, ALS, RN, EMT-P, EMT-B, first responder, etc) who are sharper than I am. Included in this list are several members of this forum (Ridryder to name one).

Hands down the sharpest person I have ever seen clinically was a dairy farmer who never "advanced above" the level of first responder on a volunteer department which ran a whopping 100 or so calls a year. Even when I was his lieutenant, I looked to him for advice because he had been doing it far longer than I had been alive and likely longer than you have been alive. Literally, his state certification number had two digits in it that were not precedent place holding zeros; when he finally "retired" he was the longest active EMS provider in the state with something like 40 years of service, just counting the years after EMS was formally organized at the state level. I'd take his word clinically over most EMS providers I know and would even seriously reconsider my take on a case if he said "Hey...something's not right here, LT".

Even our medical director (the one I mentioned before) spoke to him with a respect that was freakishly abnormal for this doc. I found out when Dave (the first responder) retired, he had been one of the doc's EMS mentors after he came back from Viet Nam. It's an extreme example, but if you want to talk about how frequency of exposure to the back of ambulance being some form of penultimate determinent of prehospital clinical ability, I think a high school dropout who milked cows for a living and saw one hundred or fewer patients a year is a counterpoint to your argument.

 

[MrBrown]

Brown thinks of it this way .... on the behaviourist level the application of treatment modalities betweeen a barely homeostasasing Parathinktheyare Medicfighter who turned up on the big red "first responder non transporting ALS engine" vs one of our Intensive Care Paramedics or HEMS Doctors will look the same.

But can you really compare the two equally?

Brown would rather work with an ICU RN who has had one day of psychomotor skills training than some of these so called "Paramedics" with ten or twenty years on the job.

Lets face it, if all you have is the two bit Parathinktheyare training special then that is as good as you are ever going to be because that will be your most limiting factor it does not matter how much experience you have.