What makes a "good" medic?
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Underoath87
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One who gives his patients the best possible care with the tools he has available, I would hope.
I've always heard that a medic is only as good as his/her partner helps him be. In other words if a medic has a good partner then he/she will be fine, but if the partner sucks then it has a tendency to reflect on the medic. That is just what I have been told by others in EMS.
"One who gives his patients the best possible care with the tools he has available, I would hope. "
What if the tools they have available are either limited or wrong? Not because of some systemic problem but because of a lack of training or CME? I have worked with plenty of other medics who really have no clue what they are doing but they still are doing what they think is best.
What if the tools they have available are either limited or wrong? Not because of some systemic problem but because of a lack of training or CME? I have worked with plenty of other medics who really have no clue what they are doing but they still are doing what they think is best.
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Melclin
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I would hope that they are. I don't know what it would mean otherwise.
If I say someone is a good medic, I mean they're are a good clinician.
Does that mean they do not have to have any bedside manor? Do they always follow the rules or do they know when they can bend them in the best interest of the pt?
Melclin
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Building a rapport with patients is part of being a good clinician. Its not just about "warm and fuzzy" VS "good at medicine". A good rapport is clinically important. Hx taking is more thorough and more accurate from a pt who likes you or feels comfortable and the physiological/psychological implications of a patient who feels safe and cared for are not to be discounted.
The same applies for people who memorise the textbook/guidelines/literature but cannot apply it well in real life. People say of them, "oh they're great at the medicine but they're not good with real pts". Well they're not good at the medicine are they?
The answer to the second part of that question is pretty clear. You cannot possibly create a rule book that encompasses every single situation and follow it completely. What rules you bend and how far you bend them should be part of the debate in any field, but to simply say no all together is ridiculous. I would include bending the rules (within reason) under the heading of not being an idiot in general. Not being an idiot, is then an important part of being a good clinician for a number of reasons.
I think what people may often mean when they say they're a good medic but not a good clinician is one of two things. 1, they like them personally. 2, They know a lot of "tricks", are good with patients, but know little about medicine". What they really should be saying for number 2 is they're a good medic by a half.
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sir.shocksalot
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I can't count how many times I have heard this myself. "Oh he/she is a good medic." With the only reasoning to this statement is that "He/She has been doing this for 15 years." While I concede that more time doing a job generally means better mastery of the work, in medicine if you haven't picked up a book since you started 15 years ago you cannot possibly be a good medic.
The best medics I have seen have had all of these traits:
1) Good communication skills.
2) Adaptability to situations both medically and when communicating with others.
3) A strong and broad interest in medicine.
4) A good sense of humor.
Medics should be able to get along with most people they meet, they should also be interested enough to pick up a book and learn more about medicine on their own. Without these things I think one can be okay at being a medic but can never really be great at it. They end up either 1) Smart about medicine but either unable to talk to patients -or- impossible to get along with. 2) Completely ignorant about medicine but easy to get along with (I think these people tend to be liked more, and thus less likely to get $h*t canned for poor medical skills). Or 3) A complete moron who is also a douche or a smelly toolbag.
Melclin
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Completely agree.
crazycajun
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I would also add that a great medic needs to have a strong passion to do what we do each and every day. Many calls have us doing nothing more than sitting and visiting on the trip to the hospital. Many are BS calls but we must always treat the PT with respect and dignity. This takes a passion that many do not have.
the_negro_puppy
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A good paramedic should:
Be competent in all their required skills
Be a good teacher
Be able to communicate with people from all walks of life
A good problem solver
Continue their education
Be competent in all their required skills
Be a good teacher
Be able to communicate with people from all walks of life
A good problem solver
Continue their education
firecoins
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And a good partner to work with.
Be a good communicator with the ED staff and nurses at ECF's and floors of hospitals.
I worked hard never to have an arguement with the floor and ECF staff. I don't know how many times our dispatchers would get calls asking if I was working, and if they said no; the caller would hang up.
There are alot of problems with ECF or floor staff, and yes sometimes even ED staff; not to mention coworkers and other EMS or FD/PD crews; but there is almost never a reason to get into yelling matches or fights with them.
I worked hard never to have an arguement with the floor and ECF staff. I don't know how many times our dispatchers would get calls asking if I was working, and if they said no; the caller would hang up.
There are alot of problems with ECF or floor staff, and yes sometimes even ED staff; not to mention coworkers and other EMS or FD/PD crews; but there is almost never a reason to get into yelling matches or fights with them.
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That sounds ridiculous. I've had good partners, bad partners and horrible partners; my partner has no effect on how I provide patient care.
lightsandsirens5
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It's not ridiculous. No, you partner may not effect your pt care, but your partner does have significant impact on the call in general. If they didn't, ambulance would not be crewed by two people. So while you may not treat the pt any differently in the back, a bad partner will make the call much more rough, bring in much more potential for mistakes, etc. We all know about how you can only play the odds so long. The higher the potential for something "bad" the more likely it is to happen. Keep it up long enough, and that bad thing will happen. When it does, it reflects badly on you as the medic. It compromises overall care of the patient, resulting in possibly substandard care. Replace that Bad partner with a good one? Good to go for much longer in the game of odds.
My personal opinion is that a good (great) partner such as I am blessed with is worth their weight in gold, if not more.
Sent from a small, handheld electronic device that somehow manages to consume vast amounts of my time. Also know as a smart phone.
Shishkabob
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Pretty much only because I'm unable to treat my patient AND drive at the same time.
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I disagree. My partner plays no role in the care I provide, unless he is crappy driver. That is about the only way my partner can affect me and the implications will be felt by the patient. An annoying partner might make me crabby, but I am aware of that and take steps to ensure that I don't take it out on my patient. I imagine this is doubly true in P/B type system.
To add to some of the above posts...the importance of a quality and continuing education cannot be overstated. A "good medic" furthers his education in the professional sense but is also a able to listen to the suggestions of other providers. One doesn't have to implement any suggestions, but being a good listener is key. The opposite is true, a "good medic" is able to provide suggestions, lessons, and insight to his fellow providers in a constructive manner.
abckidsmom
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I disagree slightly. A completely idiotic partner can totally take my focus off of the patient (somewhat) and onto parenting him.
I had a guy dump out the drug box a couple of weeks ago, and spike the IV through the med port on the bag, and say some stupid things to the patient.
That particular partner doesn't get to do anything anymore except carry stuff, lift his end of the stretcher and drive. That makes me a slower medic overall, since I have to stop the interview to get vitals, hang my own IV bag, etc. And I think speed and efficiency matters.
I disagree with the thought that you're only as good as your partner lets you be, though. You just need to know how much you have to control your partner's actions too.
Also your partner affects patient care in that even if he/she is the most careful, considerate driver around; if they get lost alot and you can't get to the hospital in a prudent time it can and DOES effect patient care.
Case in point: we were taking patient from ECF to ED at night, dark out hard to see from the back. Pt was having an MI. ECF to Hospital was 25 miles. We got to the hospital, with a very smooth calm ride; went to unload the patient and I realized that we were are the wrong hospital, we went about 28 miles the WRONG direction. Hospital didn't have cardiac Cath capability even during the day, much less at night. Patient did survive, but that ED had to evaluate patient, make the decision to ship him.
Case in point: we were taking patient from ECF to ED at night, dark out hard to see from the back. Pt was having an MI. ECF to Hospital was 25 miles. We got to the hospital, with a very smooth calm ride; went to unload the patient and I realized that we were are the wrong hospital, we went about 28 miles the WRONG direction. Hospital didn't have cardiac Cath capability even during the day, much less at night. Patient did survive, but that ED had to evaluate patient, make the decision to ship him.
the_negro_puppy
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Wow, what was the outcome? Did you guys get in trouble? 28 miles in the wrong direction is a big boo-boo, particularly when time is myocardium. But we are human, its happens. I've accidentally left a stretcher at a hospital once (we had taken it out to do a full clean down) with the LP12 on it. We then responded lights and sirens to another call without a stretcher. Thank god the patient was not time or transport critical and it was appropriate to sit them up.