Jump to content


Photo

Proposed New Law: Only Medics For Cct's


  • Please log in to reply
112 replies to this topic

#41 BackcountryMedic

BackcountryMedic

    Advanced Member

  • Members
  • PipPipPip
  • 441 posts

Posted 27 March 2009 - 08:53 PM

I mean, RN's as a whole are a pretty cautious and self-conscious bunch....paramedics, not so much.


Interestingly, you've hit on the real difference between "typical" RN's and "typical" paramedics. While much of their training is very similar it is temperament that makes one excel in one environment as opposed to the the other. But, we digress...

Then why the push for this do you think? Your first post on this thread gave me the impression that you supported it; perhaps I misinterpreted.


We do agree on much. Unfortunately, the way the original post was phrased set me off as someone trying to save nursing jobs at the detriment to paramedic growth. That may not be the case, but that is my perception.

"True" paramedics, by temperament, education and experience, should perform patent transports. It is what they are designed to do.

Unfortunately, as long as OC continues to use nurses as a "crutch" for CCT then you will not get the growth needed in training and experience. I really hope that if this law comes to pass then there will be a giant oh shit moment when They (paramedics, managers, and medical directors) realize it is time to grow up. Until that type of push occurs everything will be status quo. It's time to shake things up.
  • 0
"If everybody is thinking alike, then somebody isn't thinking" - Patton

#42 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 28 March 2009 - 01:17 PM

[quote]We do agree on much. Unfortunately, the way the original post was phrased set me off as someone trying to save nursing jobs at the detriment to paramedic growth. That may not be the case, but that is my perception.[/quote]

Paramedics are overly sensitive to this. As a group, they seem to think that everyone is "out to get them" or "hold them down".

In school, paramedics are overtly instructed that their is nothing they can't do; many new medics truly think that they are the be-all / end-all of the health care system, and that anyone who doesn't believe that they (the new paramedic) can do anything is an idiot. I know I thought this way to before I had worked as an RN and realized how much I didn't know as a paramedic.

The reality is that the vast majority of paramedics simply don't have the education or the background to manage an ICU patient solo. That's why doing CCT without someone who DOES have a strong background in ICU management (usually an RN) is a bad idea. But many paramedics don't even realize this. They don't know what they don't know.


[quote]"True" paramedics, by temperament, education and experience, should perform patent transports. It is what they are designed to d[/quote].

I would disagree with this. I think paramedics are "designed" to provide prehospital assessment and management of acutely ill and injured patients. That is very different that managing an ICU patient, even if that ICU patient happens to be temporarily in an ambulance. Again, there is nothing in most paramedics' background to prepare them for that.

[quote]Unfortunately, as long as OC continues to use nurses as a "crutch" for CCT then you will not get the growth needed in training and experience.[/quote]

I am dismayed that you would refer to an RN on a CCT transport as a "crutch". Is having a paramedic on a flight crew a "crutch" for the flight nurse?

Do you really think it is a good idea to do true critical care transports with only a paramedic?

I realize that my statements may sound like I dislike paramedics. Nothing could be further from the truth. I was a paramedic long before I became an RN and I still maintain my NREMT and state paramedic credentials. I am, in fact, a strong advocate of paramedicine but before we try to advance the profession we need to have an honest and realistic understanding of where we are now....what our capabilities are and what our limitations are.
  • 0
bring it in for the real thing

#43 BackcountryMedic

BackcountryMedic

    Advanced Member

  • Members
  • PipPipPip
  • 441 posts

Posted 28 March 2009 - 01:47 PM

I am dismayed that you would refer to an RN on a CCT transport as a "crutch". Is having a paramedic on a flight crew a "crutch" for the flight nurse?

Do you really think it is a good idea to do true critical care transports with only a paramedic?


I don't think you dislike medics. I don't dislike nurses. I do believe in the CCT team of a PM/RN for the truly high acuity calls. None of my displeasure has been directed at nurse, only paramedics and a system that allows mediocrity. Until a place is created for paramedics to grow they will not move forward.

Actually, I think I've been harsher on Paramedics then you. The difference in our point of view may be that I feel they should step up to the plate and do the work needed to advance. Do you think it's too late, and they should just stick to pre-hospital care?
  • 0
"If everybody is thinking alike, then somebody isn't thinking" - Patton

#44 JLP

JLP

    Advanced Member

  • Members
  • PipPipPip
  • 493 posts

Posted 28 March 2009 - 02:41 PM

I don't think you dislike medics. I don't dislike nurses. I do believe in the CCT team of a PM/RN for the truly high acuity calls. None of my displeasure has been directed at nurse, only paramedics and a system that allows mediocrity. Until a place is created for paramedics to grow they will not move forward.

Actually, I think I've been harsher on Paramedics then you. The difference in our point of view may be that I feel they should step up to the plate and do the work needed to advance. Do you think it's too late, and they should just stick to pre-hospital care?


OK, I'm gonna give both of you half a "right on" and half a "what a load o'bollocks". As a medic in a system that does true critical care based on (heavily-educated) paramedics, I see both sides. Most paramedics are certainly not capable of managing ICU-level patients without a lot of extra education, and probably only 10-20% of paramedics have the aptitude to be any good at critical care even WITH the extra education. Notice, as well, I don't say "training" - I think the quickie "training" approach to creating medics is a big part of the problem. New medics are right out there with new med students as having vastly over-inflated senses of their importance and infallibility combined with far too little knowledge or experience to know how scary they actually are - and I say this having been a perfect example of that myself. True critical care paramedics require a long educational process, and many locales likely can't make them because the short initial training means they don't have the base knowledge to "get" what and WHY they are doing. However, a system that picks the top medics and pounds critical care into their skulls for a good long time can produce very high level people that can do the job out there as well as or better than all but a few "higher" level providers.

On the other hand: I can tell you from my own experience, the same is true of the majority of RN's to a large degree. Most RN's have a better base knowledge foundation, but probably 90% of the RN's I have seen in practice could not function well in the transport environment without just as long a lead-in period as a good ALS medic - and that includes quite a few ICU nurses. In the north we routinely fly RN's from small hospitals as escorts for our lower level flight crews (not all our a/c are critical care, because it simply isn't possible given the vast size of our province), and many of those escorts are, putting it mildly, unimpressive. I have also had the experience of running or assisting "letter courses" for a great many RN's, and a depressingly large number are staggeringly incapable of managing a critically ill patient without someone telling them what to do - no independent initiative or ability to critically think under pressure at all. Not a shot at you flight nurses, but if you look back at many of your general RN's you know what I'm talking about - you guys are all drawn from the 10-15% of RN's who are at all capable of doing independent critical care transport.

This is the real problem: whether you run PM, RN, RT, PA, MD or graduates of the tooth fairy school of fix'em up, the flight environment requires that we get the sharpest of the bunch b/c they're gonna work in a world that is NOT 911 response, NOT the ICU in a hospital where there are lots of helping hands, but a crazy hybrid of both. The closest equivalent is remote medicine, like working in the rigs, staffing a clinic in McMurdo base, or working in a battlefield hospital. I don't think ANYBODY should be allowed to work critical care transport without [a] a tough selection process to weed out the weak and the cocky, and [b] a six-month to a year or more CCT course (depending on your base knowledge and your experience). (this is also my answer to the whole "PA's on HEMS" thread currently going on). A 40 hour critical care paramedic program? Give a ******* break. That's the tinker-toy model of medicine, teach them a few tricks and they're masters of the universe! A quickie RN-to-PM crossover without real road experience? equally bogus. Hell, most MD's are not remotely capable of working in our world without a few months of lead-in, or back-up from good medics or flight nurses (I've taken a lot of hospital docs on flights too, and the results are pretty mixed). Now that I've pissed everybody off...
  • 0

#45 BackcountryMedic

BackcountryMedic

    Advanced Member

  • Members
  • PipPipPip
  • 441 posts

Posted 28 March 2009 - 03:19 PM

JLP -

You said it better then I've been able to. Thanks.
  • 0
"If everybody is thinking alike, then somebody isn't thinking" - Patton

#46 Macgyver

Macgyver

    Advanced Member

  • Members
  • PipPipPip
  • 868 posts

Posted 28 March 2009 - 08:52 PM

Do you really think it is a good idea to do true critical care transports with only a paramedic?


Why not? Other than the workload issue - some patients require two providers - but why not both paramedics?

The key is the educational background for the providers - whatever their background. Many programs in the world do NOT use RN's on CCT's and do just fine. But they also don't pretend that a 600-800 hour course makes a "paramedic" either.
  • 0
Ken BHSc, RN, REMT-P

#47 medic4cqb

medic4cqb

    Advanced Member

  • Members
  • PipPipPip
  • 308 posts

Posted 29 March 2009 - 01:24 AM

The key is the educational background for the providers - whatever their background.

I agree with that completely. It's been mentioned many a times on here and other forums that the field of paramedicine would much better advance if they moved to a mandatory two year degree program across the nation. Making the minimum requirement for paramedic eduacation a two year degree would not necessarily make the medic a better one, but a better prepared one. Their level of respect from peers and other healthcare providers coming out of school would be better. Granted many of the gen ed courses don't really mean squat, but the fundamental science background would definitely give the medic a better understanding of the "big picture".

Medics are not "dumb" nor are the just task do-ers. Medics are the eyes and ears and hands for that matter of the physician in the streets. Some function well off of just protocols while some can't do anything without calling the doc. Whatever the case, medics deserve the chance to prove their place in the healthcare arena.

If they were afforded the opportunity to gain critical care experience in the hospital setting, they would definitely be able to function in the CCT environment. The whole thing is how many places really have paramedics working in the ICU and actually have them functioning as other than "techs". Sorry, that's not the role of the paramedic. You may see a lot, but you are not the one providing total patient care. There has to be an arena for medics to able to gain that critical care experience in order for them to say, aside from a CCEMPT course and FP-C cert, I am a critical care paramedic.

My $0.02

Many programs in the world do NOT use RN's on CCT's and do just fine. But they also don't pretend that a 600-800 hour course makes a "paramedic" either.


  • 0

Steve A., RN, CCRN, EMT-P

"The usefulness of a cup is in its emptiness..."
- Bruce Lee


#48 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 29 March 2009 - 02:12 AM

The key is the educational background for the providers - whatever their background. Many programs in the world do NOT use RN's on CCT's and do just fine. But they also don't pretend that a 600-800 hour course makes a "paramedic" either.


Well that is the whole issue....can a paramedic be educated to perform CCT? Of course they can....no question there at all.

Every single day laypersons come in off the street and, with enough education and clinical exposure, they become trauma surgeons or anesthesiologists. So clearly a paramedic can be trained to do whatever you want them to.

But the point is....that just isn't how it is (not in the US). Paramedics receive barely enough training to perform in the limited and narrow scope of the prehospital world. Then, they take a brief course of questionable content and value that includes no clinical experience at all, and suddenly they become a "critical care paramedic" who is qualified to independently manage highly acute ICU patients?

Thats pretty how it works right now, in most places in the US. If the paramedic happens to work for a good flight program or something, then they are trained more and mentored by a more experienced partner and eventually gain the experience to do the job well.

But it doesn't sound like that is what is happening in OC...
  • 0
bring it in for the real thing

#49 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 29 March 2009 - 02:24 AM

The difference in our point of view may be that I feel they should step up to the plate and do the work needed to advance. Do you think it's too late, and they should just stick to pre-hospital care?


This difference in point of view absolutely IS the primary difference in our approach to this discussion, Backcountry. Your comments seem to come from the perspective that paramedics should be able to do these transports, and mine are from the perspective that maybe this isn't even the true role of the paramedic. We both agree that it isn't appropriate as things currently stand.

I don't know if I think paramedics should just "stick to prehospital care". I've worked with some medics who really did a great job on IFT's, and like I said before there is no question that paramedics are capable of learning to do ICU transports.

On the other hand, the profession doesn't seem to have any interest in doing what needs to be done, in terms of real education and clinical experience, to do this type of work independently. As an industry, we aren't even getting paramedics truly well prepared for the narrow scope of 911-only work, nevermind this.


In a perfect world, I would honestly love for every paramedic in the US to be able to function at the level of the critical care flight paramedics in parts of Canada. And I would love to see paramedics able to independently provide ALL care outside of the hospital, leaving the nurses inside the hospitals and clinics.

But in reality, we are a long, long way from that, and I don't see standards being raised anytime soon. On the contrary, they seem to be weakening.

The way things are now, and they way it looks like they'll remain for quite some time, it just isn't safe to try to do true critical care without an RN on the team.

I think a strong RN and a strong EMT-P make a pretty solid team, capable of managing just about anything.
  • 0
bring it in for the real thing

#50 Gila

Gila

    Advanced Member

  • Members
  • PipPipPip
  • 588 posts

Posted 29 March 2009 - 04:12 AM

Well that is the whole issue....can a paramedic be educated to perform CCT? Of course they can....no question there at all.

Every single day laypersons come in off the street and, with enough education and clinical exposure, they become trauma surgeons or anesthesiologists. So clearly a paramedic can be trained to do whatever you want them to.

But the point is....that just isn't how it is (not in the US). Paramedics receive barely enough training to perform in the limited and narrow scope of the prehospital world. Then, they take a brief course of questionable content and value that includes no clinical experience at all, and suddenly they become a "critical care paramedic" who is qualified to independently manage highly acute ICU patients?

Thats pretty how it works right now, in most places in the US. If the paramedic happens to work for a good flight program or something, then they are trained more and mentored by a more experienced partner and eventually gain the experience to do the job well.

But it doesn't sound like that is what is happening in OC...


True in many ways. Interesting, that many of the physicians that I have flown with prefer paramedics. In fact, at first many of the docs though I was educated as a paramedic. Nurses in the HEMS role is virtually nonexistent in countries such as South Africa. So, clearly, paramedics can be educated to provide advanced care in the transport environment and excel in such a role.

As an advocate for EMS, I would love to see paramedic education advance to the next level and begin to provide serious competition for the nurses. However, as a nurse I also advocate having nurses move into the pre-hospital environment. A curious conundrum; however, the day that I am forced to choose between my respect for EMS and support for my profession, will be the day EMS is finally educated and respected as true profession. That will be a good day.
  • 0
Christopher Bare
"Non fui, fui, non sum, non curo "

#51 BackcountryMedic

BackcountryMedic

    Advanced Member

  • Members
  • PipPipPip
  • 441 posts

Posted 29 March 2009 - 04:51 AM

I think we may have beaten this to death. Just a few more points then I think we can respectfully part ways.

[quote name='old school' post='16921' date='Mar 28 2009, 08:24 PM']Your comments seem to come from the perspective that paramedics should be able to do these transports, and mine are from the perspective that maybe this isn't even the true role of the paramedic. We both agree that it isn't appropriate as things currently stand.[/quote]

Yep, yep, and yep. We hear each other. We disagree about the current and future role of paramedics. The world is a marvelous place.

[quote name='old school' post='16921' date='Mar 28 2009, 08:24 PM']In a perfect world, I would honestly love for every paramedic in the US to be able to function at the level of the critical care flight paramedics in parts of Canada. And I would love to see paramedics able to independently provide ALL care outside of the hospital, leaving the nurses inside the hospitals and clinics.[/quote]

I actually don't want every paramedic to function at an advanced practice level. I'm fine with all the fire medics in Orange County keeping their EMT-I scope of practice. What I want is a place for the top 10% of real paramedics to rise to. A place that will encourage them to go on and get that extra education everyone agrees they need. I think training everyone to a CCT standard will dilute the skills base in the same way as putting a "paramedic" in every red truck has already proven to do.

[quote name='old school' post='16921' date='Mar 28 2009, 08:24 PM']I think a strong RN and a strong EMT-P make a pretty solid team, capable of managing just about anything.[/quote]

Absolutely. Especially for NEO's, IABP's, task saturated calls and other high demand calls. But, only a small percentage of IFT's are like that. We just need to build those strong paramedics. It won't happen without real autonomy and real training. That won't happen until a need is created. This regulation creates that need.

One last thing: The days of hospitals letting there nurses go for 1 or 2 hours is quickly coming to an end. Administrators are going to see that there is no money in it. In fact, as patient loads increase for nurses (again, money driven) there just won't be anyone available to break away. You can plan for it and solve the problem now, or wait until a crisis occurs.
  • 0
"If everybody is thinking alike, then somebody isn't thinking" - Patton

#52 USDalum97

USDalum97

    Advanced Member

  • Members
  • PipPipPip
  • 259 posts

Posted 29 March 2009 - 05:51 AM

That won't happen until a need is created. This regulation creates that need.


That's a scary thought. Creating a need for something with legislation in order to force a change WITHOUT giving the providers adequate training...how is that good for the patient?

In NH, the State changed the protocols to allow a medic to take any medication that was already hanging. This made SOME medics think they were qualified to transport these patients. It was scary. Medics would come into the ED and get their feelings hurt because I wouldn't let my patient's go without a nurse. Some really got their feelings hurt when I "challenged them" about what the medications were, indications for the meds, how to titrate them, etc. They had no idea, they just didn't get the training. They were good medics who were well respected. However, just because you CAN do something, doesn't mean you SHOULD.
  • 0

#53 Speed

Speed

    Advanced Member

  • Members
  • PipPipPip
  • 1100 posts

Posted 29 March 2009 - 02:38 PM

When I'm sizing up a "critical care paramedic" the most accurate "square peg in the square hole" test, or good indicator of competency (other than their education and CCT work history) that I have found is the whether or not they have accrued solid, in-hospital, full-time employment experience in the critical care setting (usually as a "very involved" RT or "upward-bound" tech which is sometimes just enough of a primer before EMT-P and subsequent bridge to CCT). To me that's the (I hate even saying this phrase) "gold standard". Anything else looks too much like smoke and mirrors, but not always; there are occasionally some exceptions.
  • 0
Mike Williams CCEMT-P/FP-C

#54 scottyb

scottyb

    Advanced Member

  • Members
  • PipPipPip
  • 248 posts

Posted 31 March 2009 - 12:36 AM

Yeah, I was being nice.
At this time, even with the ALS Paramedics that do CCT, their scope is as limited as I posted earlier. This discussion has been on other EMS forums and in the CA EDs. No one can come up with a really good example for a model CCT in California utilizing only Paramedics. There is usually an RN involved if the the patient requires more than what was mentioned earlier. Right now with the state EMS reform for their other many issues, it is unlikely there will be any change soon to advance their education or scope of practice. The state has just lost site of what the M stands for in EMS and what Paramedics could be capable of.

But, California is largely Fire Based EMS (nothing wrong with that for 911 in some states). Even the S.F. Bay area which is also FD EMS was ruled to allow private ambulances bid on the 911 contract for the city. At this time they are not ready for that project.

Yes, being nice seems to be quite a challenge for you there, FloridaMedic. Unfortunately your constant negativity is a reflection of all of us involved in EMS. Find another career endeavor. Thats why I myself finally got smart and am working on my BSN (and hopefully eventually anesthesia) as a second career. Do I love the fire dept? Absolutely. I will stay there until they pretty much kick me out. Do I still love running on the "10 percenters" that make this job exciting and fun? You bet. Do I still love being a paramedic? Yes. But I like many others are WAY burned out after 15 years of hearing "I'm sick and I don't have a ride to the hospital".

Systems across the country are what they are. EMS is what it is. You can try to re-invent the wheel all you want, but we all are glorified ambulance drivers with some special knowledge and skills. Piss and moan about other programs all you want. Politics is politics, life goes on. Don't let it consume you.

Here we go...you people see a window to bash fire dept. based paramedics, and you jump through it. All this fire dept bashing is bullshit. You cite examples about sub standard fire dept. based EMS care, and I will shoot 10 more private EMS examples right back at you. Moot point.

In my opinion, the ultimate critical transport team is an RN and a paramedic, ground or air.
  • 0
Scott Bild RN, FP-C

#55 FloridaMedic

FloridaMedic

    Advanced Member

  • Banned
  • PipPipPip
  • 790 posts

Posted 31 March 2009 - 01:32 AM

Yes, being nice seems to be quite a challenge for you there, FloridaMedic. Unfortunately your constant negativity is a reflection of all of us involved in EMS. Find another career endeavor. Thats why I myself finally got smart and am working on my BSN (and hopefully eventually anesthesia) as a second career. Do I love the fire dept? Absolutely. I will stay there until they pretty much kick me out. DoI still love running on the "10 percenters" that make this job exciting and fun? You bet. Do I still love being a paramedic? Yes. But I like many others are WAY burned out after 15 years of hearing "I'm sick and I don't have a ride to the hospital".

Systems across the country are what they are. EMS is what it is. You can try to re-invent the wheel all you want, but we all are glorified ambulance drivers with some special knowledge and skills. Piss and moan about other programs all you want. Politics is politics, life goes on. Don't let it consume you.

Here we go...you people see a window to bash fire dept. based paramedics, and you jump through it. All this fire dept bashing is bullshit. You cite examples about sub standard fire dept. based EMS care, and I will shoot 10 more private EMS examples right back at you. Moot point.

In my opinion, the ultimate critical transport team is an RN and a paramedic, ground or air.


Another thread starting about YOU and YOUR problems...

You have once again taken the opportunity to start something about the FDs for an area you know nothing about and to talk about yourself.

Let me summarize the whole thread since you have chosen to read only what was needed to start your own agenda.

In Orange County, CA, the FD has the exclusive rights to Paramedic services.

RNs/MICNs do CCT.

Paramedics from the FD provide EMS as a 911 service.

Not too FDs many want to take an ALS EMS truck out of service to do long hospital IFTs.

Private companies would also like to utilize more Paramedics appropriately if possible.

That means the rules must be changed to allow this to happen.

Private ambulances would then be allowed to use Paramedics or advanced EMTs for some CCTs instead of the RNs.

It is agreed that RN/EMT-P is a great combination but RNs don't always work for the Fire Department and that could present a problem for having an RN/EMT-P team in these counties. If the RN was with the FD, you would still be taking a Fire owned ambulance which may be providing 911 EMS out of service to do a long IFT.

As you said, politics is politics.


Get over your insecurities that everyone is out to get you and the FDs. Stating a few facts about areas that are Fire-based is not "bashing". It is just a fact that FDs are usually there for 911 EMS calls and not IFTs. You of all people should be proud that the FDs have hung on to the exclusive rights of Paramedic services for some counties. You seem to be the one who hates private ambulance services and they are the issue of this thread.

If you have gotten burned out as a Paramedic from doing 911 EMS because only 10% were exciting, imagine how quickly you would have gotten burned out doing IFTs and 911 calls.

Good luck with that nursing thing. You might find nurses aren't as likely to agree with everything you say either especially when you are afraid everyone is bashing you for some reason. And guess what? Those sick patients that didn't have a ride to the hospital will now be your patients for a whole 8 or 12 hours if you become an RN. You might want to rethink your plans since being an RN will still involve patient care.

It would be helpful if more of those who think of EMS and the Paramedics as you do would leave the profession. EMS and the Paramedic might be allowed to move forward as a profession.
  • 0

#56 scottyb

scottyb

    Advanced Member

  • Members
  • PipPipPip
  • 248 posts

Posted 31 March 2009 - 03:04 AM

Another thread starting about YOU and YOUR problems...

You have once again taken the opportunity to start something about the FDs for an area you know nothing about and to talk about yourself.

Let me summarize the whole thread since you have chosen to read only what was needed to start your own agenda.

In Orange County, CA, the FD has the exclusive rights to Paramedic services.

RNs/MICNs do CCT.

Paramedics from the FD provide EMS as a 911 service.

Not too FDs many want to take an ALS EMS truck out of service to do long hospital IFTs.

Private companies would also like to utilize more Paramedics appropriately if possible.

That means the rules must be changed to allow this to happen.

Private ambulances would then be allowed to use Paramedics or advanced EMTs for some CCTs instead of the RNs.

It is agreed that RN/EMT-P is a great combination but RNs don't always work for the Fire Department and that could present a problem for having an RN/EMT-P team in these counties. If the RN was with the FD, you would still be taking a Fire owned ambulance which may be providing 911 EMS out of service to do a long IFT.

As you said, politics is politics.
Get over your insecurities that everyone is out to get you and the FDs. Stating a few facts about areas that are Fire-based is not "bashing". It is just a fact that FDs are usually there for 911 EMS calls and not IFTs. You of all people should be proud that the FDs have hung on to the exclusive rights of Paramedic services for some counties. You seem to be the one who hates private ambulance services and they are the issue of this thread.

If you have gotten burned out as a Paramedic from doing 911 EMS because only 10% were exciting, imagine how quickly you would have gotten burned out doing IFTs and 911 calls.

Good luck with that nursing thing. You might find nurses aren't as likely to agree with everything you say either especially when you are afraid everyone is bashing you for some reason. And guess what? Those sick patients that didn't have a ride to the hospital will now be your patients for a whole 8 or 12 hours if you become an RN. You might want to rethink your plans since being an RN will still involve patient care.
It would be helpful if more of those who think of EMS and the Paramedics as you do would leave the profession. EMS and the Paramedic might be allowed to move forward as a profession.

No issues, no insecurities here my dear....just replying to your constant whining about the current state of EMS as a whole...What I speak is the TRUTH, and I guarantee you have felt the same at one point or another in your illustrious Utopia of an EMS career. If you haven't then I humbly welcome you to ride along with me for 24 hours. We welcome ride alongs from all over the country. I just choose to be vocal about it. If there is another legitimate reason why the EMS profession in any given busy area has an average burnout rate of roughly 10 years, like police agencies in busy systems, or if you have evidence against, please DO tell. Again keep in mind I am not the one starting negative threads about agencies I do not even work for. EMS is what it is. Endo story. I am still committed to being the best EMS provider I can, knowing full well that I am BEYOND burned out, but still love and am thankful (especially during these hard times) for my job and I am proud of working on a 2nd career for when that time comes...

Try to wake up tomorrow happy...
  • 0
Scott Bild RN, FP-C

#57 FloridaMedic

FloridaMedic

    Advanced Member

  • Banned
  • PipPipPip
  • 790 posts

Posted 31 March 2009 - 03:20 AM

No issues, no insecurities here my dear....just replying to your constant whining about the current state of EMS as a whole...What I speak is the TRUTH, and I guarantee you have felt the same at one point or another in your illustrious Utopia of an EMS career. I just choose to be vocal about it. If there is another legitimate reason why the EMS profession in any given busy area has an average burnout rate of roughly 10 years, like police agencies in busy systems, or if you have evidence against, please DO tell. Again keep in mind I am not the one starting negative threads about agencies I do not even work for. EMS is what it is. Endo story. I am still committed to being the best EMS povider I can, knowing full well that I am BEYOND burned out, but still love my and am working on a 2nd career when the time comes...


And what have you contributed to this thread except to update us on your own personal life? Did you even bother to read the thread? You have a selective dislike for me since I would like to see the Paramedic raised about the level of ambulance driver (your words - not mine). Your attitude about Paramedics being only ambulance drivers will not do EMS as a profession justice.

If you are burned out, please do move on. Your attitude will start to reflect in your patient care and it already has given you an attitude toward 90% of your patients. You will also drag down the Paramedics you work with who are dedicated to patient care. If you think becoming an RN will solve that you may be greatly mistaken since nursing still has to do with patient care.

BTW, you do know there are people involved in EMS for 20+ or even 30+ years? They however look at the profession from a medicine aspect and accept all patient care as part of their job, not just the L&S glamour and glory for 10% of the calls.

You have not read all the posts or seen who posted what. I posted the links to the protocols for the state of California and stated a few facts about CCT and EMS in that state. There was nothing in my post that you quoted to get your panties in such a twist.

Now, that we have had this warm and fuzzy moment catching up with what you have been doing, can the topic resume if anyone has anything else to comment on?
  • 0

#58 scottyb

scottyb

    Advanced Member

  • Members
  • PipPipPip
  • 248 posts

Posted 31 March 2009 - 03:26 AM

No issues, no insecurities here my dear....just replying to your constant whining about the current state of EMS as a whole...What I speak is the TRUTH, and I guarantee you have felt the same at one point or another in your illustrious Utopia of an EMS career. If you haven't then I humbly welcome you to ride along with me for 24 hours. We welcome ride alongs from all over the country. I just choose to be vocal about it. If there is another legitimate reason why the EMS profession in any given busy area has an average burnout rate of roughly 10 years, like police agencies in busy systems, or if you have evidence against, please DO tell. Again keep in mind I am not the one starting negative threads about agencies I do not even work for. EMS is what it is. Endo story. I am still committed to being the best EMS provider I can, knowing full well that I am BEYOND burned out, but still love and am thankful (especially during these hard times) for my job and I am proud of working on a 2nd career for when that time comes...

Try to wake up tomorrow happy...

Also, thank you for taking shots at my personal career goals.... I plan on working OR, therefore I look FORWARD to the patients I will be coming across. I would venture to guess the majority of those patients have legitimate medical problems that need addressing.

Also, I worked private EMS for many years before joining the fire department, so I am well aware of burnout from IFT's, thank you very much. I am also going to bed at 11 pm if that is ok with you, and I will be waking up at 0530 and having an english muffin...

How about you tell us about the system you used to work for? It is obvious that you are now a typical EMS "been there, done that, I am now a glorious instructor, and here is how the system should be" type person, but I would venture to guess you are on a 40 hour work week, working in the field on a limited basis, and probably get PLENTY of sleep...

My offer still stands...Come out and ride with E151 A shift for 24 hours...we average 10 to 15 calls per shift per engine company, and we are a dual company station...

Don't let this stuff comsume you, it is just a JOB. Regardless of what state is doing what.
  • 0
Scott Bild RN, FP-C

#59 FloridaMedic

FloridaMedic

    Advanced Member

  • Banned
  • PipPipPip
  • 790 posts

Posted 31 March 2009 - 03:31 AM

Also, thank you for taking shots at my personal career goals.... I plan on working OR, therefore I look FORWARD to the patients I will be coming across. I would venture to guess the majority of them have legitimate problems that need addressing.


You wanted us to know all about your problems by making the thread ABOUT YOU. If you didn't want us to know about your personal issues or to make them fair game for comment, don't discuss them on a public forum.
  • 0

#60 scottyb

scottyb

    Advanced Member

  • Members
  • PipPipPip
  • 248 posts

Posted 31 March 2009 - 03:38 AM

You wanted us to know all about your problems by making the thread ABOUT YOU. If you didn't want us to know about your personal issues or to make them fair game for comment, don't discuss them on a public forum.

What problems do you speak of? My system has it's faults, as any other...Do tell...
  • 0
Scott Bild RN, FP-C