What I Hate the most about EMS

[Meursault]

Well, forum's done. Rid wins. Everyone go home.

I'm not in EMS as a career, and he pretty much outlined why.
I'm young, have attempted and still occasionally attempt to actually change things, and have almost no experience to speak of, but even I'm not quite as upbeat and gung-ho as some of the posters in here. What are you people on and where can I get some?

It doesn't look like EMS reform is going to be an internal effort. Like most things (our healthcare payment system, for example), it has to get seriously and visibly broken before people start talking about fixing it. So far, I don't see any evidence that people outside of healthcare (the people who for some reason make all the decisions) have noticed that the entire American model of prehospital care is deficient.

 

[mycrofft]

Start now...email your elected representatives;.

Mentor a newbie. Teach a class.
How about a thread about "What you can do personally, in the next year, to positively affect EMS where you stand"?.

 

[marineman]

Mentor a newbie. Teach a class.
How about a thread about "What you can do personally, in the next year, to positively affect EMS where you stand"?.

Go for it, that's what I was getting at earlier but bossy cow gut upset that she couldn't complain so I gave up.

 

[BossyCow]

Go for it, that's what I was getting at earlier but bossy cow gut upset that she couldn't complain so I gave up.

This wasn't my thread.. and the point of the thread was to vent and complain.. just trying to maintain the integrity of the thread..

 

[suziquzi99]

[Benefits? yeah right. that must be it, or it could be the cool uniform. I may not have a lot to say about it yet but I will. do you honestly think that everyone goes into this profession just for those reasons? Well if you do you just met someone who is not enering this profession for that reason. I am going into ems because that is where I want and need to to be.

I could be a stay at home mom if I wantd to to, But I need and want to be out there making a diffrence in the world.Even if it is just a small diffrence that no one even really notices. I realize That I will be called every name in the book, me kicked at, spit on, vomited on and even worse. I get that I am ok with that.

I have done research, I do know the basic components of ems. I also realize that the emt-b class is just a step above first aid. Do I think that makes me 100% prepared? Not a chance, there is no book, or story that an instructor can tell or a video that I can watch that will prepare me for what is out there. All I can do is study hard and go out there and do what I was taught, learn from the mistakes that I know I will make. As long as I learn from them and continue my education I will do great. I am not going to become an experienced emt overnight, I would be an *** to think that.

agreed

Rider, I didn't read this before I posted my other thread, guess you're one of those. lol. Every job has newbie gung ho people who are ready to do what needs to be done. Not all but many and that is where change happens and the profession continues. There are many medics who have over 15 years where I am at and still going strong. I don't know if I will be one of the ones still going in 15 but I'm guessing right now, yes. If you're going to include politics, what could and should be done, there would be not many professions to go in.
And benefits?? Really! You'd do better to get a degree in education and have holidays and summers off!

 

[Bosco578]

Fire Rocks!

The system sucks, too many wankers and losers. Rid is right. It's just a job. At the end of the day the hose monkey's are the heros in the public's eye,they can do no wrong. A.s.s. Holes. We get in this field for whatever reason,yet it attracts some of this biggest jerk off's. The clowns that have more flashing lights on their POV's,that carry trauma bags and whatever else "just in case". Life sucks! This job is going down hill. Nurses treat us like s.h.i.t.,hospital waits,those dill holes that call us for stupid crap. People suck. This job sucks! F**k it.

And look at some of the posts. People asking or afraid of getting AID's or Hep, or whatever by having their clothes touched by someone infected. Are you really a retard? Yes you are. Some of the stupid questions posted. No matter what site you go on, these kind of lame stupid posts exist.
But hey, the Mods will come in and say, oh it's inflammitory, or whatever. No it's the cold hard truth, posting stupid questions = you are a retard. Simple educational questions you should have learned or could look up or ask. But WTF, just lock a post or ban someone, ya that helps.

 

[Shishkabob]

Ok, who stole Bosco's blankey?

 

[FFMedic1911]

After reading the posts I think I will chime in.Our biggest problem is right here in the posts.We all know there is a problem.We just can't agree what it is.That is where I fell we are getting into trouble.How can we lobby for change when we can't agree among ourselves what needs to be changed.We could have a union with 3/4 the population of the U.S. as card carrying members and we still couldn't get anything done in ems.Until we can pick our battles as a group and fight for that we are a lost cause.I would also like to add that I am a career FF/Medic.I do take my job serious.I challenge anyone from private,third service or hospital base to prove that I do not.With that being said I will not sit here and say that fire based is worse or best than any other way to provide ems.So to start for change lets figure out what we are as a profession.Than we can go from there.Rid I would also like to add that your first post was wonderful and really sheads light to many problems in ems.

 

[Bosco578]

Ok, who stole Bosco's blankey?

Really bad day.

 

[Medic]

This post makes me look at becoming an EMT twice, the reason I want to get into this system/profession/career is to help people in there darkest hour. I’m willing to earn peanuts to help and have little to no sleep. Never have time to be with family or friends.
In SA emt-b earn half of what you guys do. Plus all the added dangers of working in a 3rd world country. Where medics have to wear bullet proof vests and helmets and have armoured ambulances and armed guards from the police and army with them when they set foot into a township.(not saying we are worse of than you, I don’t know EMS system in US)

When you signed up to a program/degree/course. You should be aware of the factors of this system and the problems you might face. So if you knew this why did you look for a job in this system?

If there is an issue address it. Don’t sit here in a forum and moan. Vote or file complaints about the lack of education in the system. Express your views.
Do it for the love of helping, because after all EMS is a calling, not a profession

 

[Shishkabob]

One possible reason why EMS doesn't get the recognition of being a profession from other medical professions;



Medical Control.


In some of the on-line services, it can be a babysitter making sure everything is done right. How many other medical professions have to ask for permission before administering a drug in an emergency? While the idea is good, albeit sometimes great, it makes the service viewed as not being able to make our own decision.


Granted, civilians don't know about medical control, so that doesn't taint their view.



(Now here's a legit question... do nurses practice using a doctors license like we do?)

 

[Ridryder911]

One possible reason why EMS doesn't get the recognition of being a profession from other medical professions;



Medical Control.


In some of the on-line services, it can be a babysitter making sure everything is done right. How many other medical professions have to ask for permission before administering a drug in an emergency? While the idea is good, albeit sometimes great, it makes the service viewed as not being able to make our own decision.


Granted, civilians don't know about medical control, so that doesn't taint their view.



(Now here's a legit question... do nurses practice using a doctors license like we do?)

Most systems use standing orders and do NOT have to call medical control. Actually, I am surprised Medical Control will allow so many Paramedics to perform as many procedures as they do.

Let's look at it this way. Beauticians usually have double the number of hours of training than a Paramedic and thy cut dead cells. Now would trust most Paramedics or EMT's?

Now, I agree they could support us by being more concerned and stricter. Publicize and endorse better medical education.

But again.. the real culprit is ourselves.

R/r 911

 

[VentMedic]

(Now here's a legit question... do nurses practice using a doctors license like we do?)

A lot will depend on their work environment, job description, state board and medical director for their unit. Nursing is a very broad field with many different opportunities to grow or coast through one's career.

Nurses, RRTs, Radiology and a lot of other medical professionals practice under quidelines and protocols written by the medical directors of their unit or department as well as the nationally accepted clinical practice guidelines. There are also many nurse initiated protocols established by national standardizing organization the filter down to state and local regions as well as each hospital's RN initiated protocols. RNs who work in the ED, ICU or on code and rapid response teams may have a very elaborate set of protocols to follow. RNs that work med-surg also have various standing orders and protocols for emergencies or daily care.

The various member of the medical board (physicians) and medical directors of each unit will also dictate what the scope of practice will be for RNs (or RRTs) in each unit provided it is allowed by the state. That can include A-line or central line insertions, PICCs, intubations and conscious sedation procedures or various meds that once required a physician to give. One would be surprised by the equipment and procedures they do besides just the ones that are commonly used by Paramedics. Many are not aware of them because it is just part of a day in some ICUs. Healthcare professionals in the hospitals don't constantly count the number of procedures they do. Some could care less if they are the ones intubating because there is so many other things to do and patients they also are responsible for at the same time.

As an RRT, my medical directors, of both my direct overall practice and for whatever specialty unit I am working in, have also written many protocols and guidelines for RTs to follow for many different situations. I do work directly under the license of my medical director(s). The same on CCT, Flight and Specialty transprort. RNs are also included under the medical director of those teams.

Here is the part that many Paramedics don't get a chance to see about medicine in a hospital or critical care setting. There is so much going on for the long term that a physician must act as a team leader to cordinate the patient care. It is not that he/she much write or direct every order some one does. Emergencies are sometimes the easiest if they are just with the ACLS guidelines or for a very short term stabilization. HEMS or Flight from a prehospital scene can sometimes be easier than picking up a disaster in the making at a hospital for interfacility.

The long term stabilization and diagnostics require much more effort. It is when you have a patient for the long haul and resuscitation may go on for hours or days. There can be an overwhelming amount of information that may need to be processed. It is sometimes nice to have a physician around to make that decision before giving a medication that you know will put the patient on dialysis for the rest of their life even if it may save their life at the moment. There could be alternatives but would they work or should you really mess with a study drug or break protocol and go with plan C or D?

Autonomy is good for some things, but when total patient care is expected to increase the patient's chance for survival and recovery to function somewhat normally, a multidisciplinary approach is the most successful. It also reduces medical errors if everyone is watching out for the patient's best interest.

 

[mycrofft]

Who needs a doctor's oversight?

Nurses, PA's. Sometimes FNP's. It can be as loose as them signing off on the protocols annually with some review, it can be as tight as every case has to be signed off, but somewhere a MD has medical control, not a "Master PAramedic" or "Great Cachina Nurse In The Sky" or whatever.
I used to see upwards of 150 patient visits a week and every one either involved use of a standardized procedure requiring countersignature (handed him/her a STACk at the end of each day), or review of a case which did not fall into my SP's, or a straight referral to see the MD at the next Dr sick call. There were a few where I could just say "no" (e.g. "Pt reassured, advised seek sick call as needed in future") but not very many. Now I see fewer but more serious pt's and I make sure the doc's and I are on the same page through daily interaction.

 

[Maya]

Wow, hmmmm.. this is all starting to make sense. I knew I didn't have all of the facts.

Okay this is obviously a big problem and I would like to give it the thought and the respect that it deserves, as people obviously feel very strongly about the subject. I hope you'll forgive me for bringing this thread up again, but I think that the subject is relevant now, even more-so than it was at the time it was written -- given the current state of our economy, the fact that we now have a new president who actually cares about and listens to the people, and that we are facing a massive re-structuring of a failing Healthcare System... Not to mention the fact that the Baby Boom generation is now aging, the health of Americans is rapidly declining, more than 1/3 of people born after the year 2000 will develop Diabetes, etc... EMS is *vital* to the Healthcare System, to the health of Americans, and to the Economy as a whole.

If you want to make a change, we need to Unionize. We need to write to Senators. We need to write to Congress. People have said this before, but I think that our leaders and the people are more willing to listen now than they were before. We've reached the Tipping-Point. We've seen the greatest Economic Collapse since the Great Depression.

Times have changed and it’s a BIG deal that Obama is president now. Obama is a Keynesian Economist – that means Demand-Side Economics.

In the Seventies, 1 out of 3 workers was a member of a Union. Now, after Bush, it is only 1 in 10. Standards of living have dropped dramatically. The distribution of wealth has changed drastically to favor the top 5% of the population, comparable only to the 1920’s when the top 10% of the population owned 72% of the nation’s wealth – Robber Baron’s, the top 1%, owning 26% of the nation’s wealth. The 1920’s was dominated by Republican presidents – Laissez-faire Capitalism – Supply-Side Economics.

Following the Great Depression, the ideas of John Maynard Keynes were put into practice by President Roosevelt and the economy began to stabilize. … skipping along… We then gradually moved back towards the ideas of Milton Friedman – laissez-faire Capitalism – this reached a peak in the Eighties with the Trickle-Down Economics of President Reagan. Fast-forward to modern-day and the likes of Alan Greenspan, Ben Bernanke, and Henry Paulson – Republicans – having absolutely no oversight and doing crazy-*** things like repealing the Uptick-Rule, causing the stock-market to crash, and all this other crap with mortgages and the housing-bust...

Anyway, I could go on about this forever and it’s very difficult to be clear and concise about a topic as complicated as this. Maybe someone with a stronger grasp of Economics than I have could explain it better.

The point is, Obama, more than any president since Carter (who got a bad rap, so let’s just say ROOSEVELT instead) will be willing to listen to the people. What he’s trying to do with the Green Initiative and with Healthcare Reform – these are HUGE undertakings that no-one has been willing to face before him.

To be quite honest, I can't even fully comprehend what the impact will be on EMS. However, I believe that whatever direction it takes, it is imperative that we work together to make sure that working conditions and wages are sufficient to meet living standards and for us to be able to support our families.

Take what you will from it. Maybe you agree with me, maybe you don’t. That’s just politics. But if you feel strongly enough about it, I think it’s worth discussing and I think it’s worth taking action to support a cause – the way they did in the Sixties and Seventies, when people actually cared about what happened in the world and about what happened to the common man – people in EMS should understand that more than anyone else. There are few professions that are more selfless than EMS.

 

[Ridryder911]

There are still areas of medicine you are naive on.

First, NO president is going to change any health care reform. Sorry, it can't be done. AMA, Pharmaceutical Corporations will ensure that their special interest will always come first. I don't care if they are Democrat or Republican, and as well the citizens acclaim that they want change..... as long as it does not affect them.

Start informing patients that frequent the ED for minor or chronic problems that they will have to start waiting and be seen in a scheduled clinic setting and see the outcry. As well as the difference in medical care of those that have the financial means and the ones that do not. CABG?.... take a number.

Your faith in Obama is much more than mine. I personally think he is the road of destruction but that is for another post and debate. Just remember, he was a former attorney for a major pharmaceutical chain.

Again, someone will have to pay for it. Yes, it will be those that are working as in per taxes (middle income).

The other thought is unions are not well liked among many health care professionals. Even speaking the word union in some of the hospitals I have worked in was a sure way to get fired for some other reason. Their effectiveness is only based upon how good that union is. I know the larger EMS in my area is union and they have not helped any. The major problem is it is a branch of the same union that represents firefighters, and they definitely would never interfere with their demands. So they only thing I see from that is medics paying dues and thus reducing their "normal competitive" salaries.

I lived during the sixties. Let's not dive into a heated debate about LBJ and the initial reasons how our economy started diving. Having assisted programs are fine as long as it is a hand up and not a hand out. Unfortunately, majority most liberals like developing programs but fail to recognize that there is no such thing as a money tree. Again, somewhere someone will have to pay for it.

I suggest you study the Carter administration and his inability to function. I met the man. His discussion and policies are the reason I went from a very active Democrat to a Republican.

R/r 911

 

[Maya]

Regardless of whether or not we agree on politics, I do think you made an excellent point on implementing and enforcing a higher degree of education. It makes absolute sense. Wouldn't it be worth lobbying for that?

You can't deny that people acting together for a common cause DOES have an impact.

 

[46Young]

There are still areas of medicine you are naive on.

First, NO president is going to change any health care reform. Sorry, it can't be done. AMA, Pharmaceutical Corporations will ensure that their special interest will always come first. I don't care if they are Democrat or Republican, and as well the citizens acclaim that they want change..... as long as it does not affect them.

Start informing patients that frequent the ED for minor or chronic problems that they will have to start waiting and be seen in a scheduled clinic setting and see the outcry. As well as the difference in medical care of those that have the financial means and the ones that do not. CABG?.... take a number.

Your faith in Obama is much more than mine. I personally think he is the road of destruction but that is for another post and debate. Just remember, he was a former attorney for a major pharmaceutical chain.

Again, someone will have to pay for it. Yes, it will be those that are working as in per taxes (middle income).

The other thought is unions are not well liked among many health care professionals. Even speaking the word union in some of the hospitals I have worked in was a sure way to get fired for some other reason. Their effectiveness is only based upon how good that union is. I know the larger EMS in my area is union and they have not helped any. The major problem is it is a branch of the same union that represents firefighters, and they definitely would never interfere with their demands. So they only thing I see from that is medics paying dues and thus reducing their "normal competitive" salaries.

I lived during the sixties. Let's not dive into a heated debate about LBJ and the initial reasons how our economy started diving. Having assisted programs are fine as long as it is a hand up and not a hand out. Unfortunately, majority most liberals like developing programs but fail to recognize that there is no such thing as a money tree. Again, somewhere someone will have to pay for it.

I suggest you study the Carter administration and his inability to function. I met the man. His discussion and policies are the reason I went from a very active Democrat to a Republican.

R/r 911

What are your thoughts on the 1199 organization?

 

[atropine]

Well, lets look and see where ems is a profesion, back east maybe I know where I work and live private emt's and paramedics are paid almost nothing, and firemedics make a ton of cash, so where in the nation is ems a profesion and how is it delivered.

The truth is ems will be delivered differently until the world ends. This is stepping stone job and as long as the privates and third servies can keep wages down things will not change.

 

[WolfmanHarris]

Well, lets look and see where ems is a profesion, back east maybe I know where I work and live private emt's and paramedics are paid almost nothing, and firemedics make a ton of cash, so where in the nation is ems a profesion and how is it delivered.

The truth is ems will be delivered differently until the world ends. This is stepping stone job and as long as the privates and third servies can keep wages down things will not change.

How many time does someone have to counter with the relative cost of living between CA and the rest of the US before we can call that horse? Unless it's in it's own thread can we just agree to disagree on your mantra?