Guest guest Posted December 26, 2008 Report Share Posted December 26, 2008 My two cents: I've attended several of he big EMS conferences nationally as well as here in my state (NC) and I have always been struck by the wide continuum of competence manifested under " EMT-P " banner. I meet extremely sharp medics who are worthy of any degree of responsibility that could be heaved upon them, and I meet buffoons who by their conversation and overall presentation appear barely literate. Then again, I have met more RN's and MD's of all nationalities who could similarly be placed on either end of said continuum. As for the US Paramedic education system prepping medics for remote work is concerned, it doesn't. It's not what the DOT standard is for. I regard the HSE side of medic work as an unfortunate, boring necessity. I have no boastworthy level of experience measuring handrails or distributing rolls of grip tape for marking off walking paths on a rig, but I know what to do when someone is threatening to die, regardless of the mechanism or etiology. Did my training prepare me for OM and gastroenteritis? No. Could I talk you through the steps of assuring that all safety precautions have been employed before raising a worker on a genie lift? No. But I can (and have) educated myself on OM and gastroenteritis to the point were I can confidently treat according to the standard of care and I can hold a checklist on a clipboard as well as anyone for that genie lift. Anyone who hires me can rest in the knowledge that I will hold my own with all of the HSE business, and when the shit hits the fan - I'm ny on the spot with the paramedickin' SHO NUFF, WEST SIDE!!!!!!! But that's just me . . . Cheerio! Guy From: Brault <c_brault@...> Subject: Re: Re: Rotational Work Date: Friday, December 26, 2008, 11:19 AM WOW Lot's of subjective information But merely speaking It has helped me understand better the US Paramedic Education quagmire Thanks And I would not and am not ungrateful to A A He also helps us understand the state of things Re: [Remotemedics. co.uk] Re: Rotational Work On Wednesday, December 24, 2008 13:41, " A Austin " <abaustin+group s@...> said: > > The generalization that American paramedics are inadequate is about as > valid as the one that all male nurses are gay. For every example of an > inadequately training U.S. Paramedic, I can show you one homosexual > male nurse. That's a fair analogy, albeit an irrelevant one. I can show you a hundred inadequately trained US paramedics for every gay nurse in the world. But homosexuality in the workplace is not relevant. Incompetence in the workplace is extremely relevant. Either you're being hypersensitive to the issue for matters of national pride, or else you are incapable of recognising incompetence when you see it. > There are obviously significant shortfalls in paramedic education in > the United States, and trying to argue otherwise is stupid. The > reasons for them are numerous and significant, but the number one > failing (in my opinion) is poor institutions and instructors. It's a Catch-22. Institutions and instructors typically provide what the community demands. And the overwhelming demand of paramedic schools in this country is that they be quick and easy, dumbed down to the 8th grade level, so that firemonkeys and volunteers don't have to devote too much time or effort to sewing on their patches. If you open up a school next door that requires a significant educational commitment, you will receive one application for every two hundred applicants that the 6 month patch factor receives. It's not the instructors as a group that are the problem (although many share in the incompetence individually) . It is the EMS management and administration that encourages inadequate education in order to keep their rosters full, and those who enter the field unwilling to commit to significant professional education. > compounded by the fact that the medical field is largely a " learn by > doing " area. Someone with a inadequate education and poor OJT (on the > job training) is going to be bad at their job. This is certainly not > exclusive to Paramedics or Americans. I maintain that the problem begins long before you ever get to the OJT portion of education. It begins when the tech schools FAIL to provide an adequate didactic foundation to their students, therefore sabotaging their field competence, no matter how much OJT they receive. Cardiology, pharmacology, physiology, and psychology are not learned OJT, no matter how long you try. Those are theoretical foundations that must be established in the classroom and laboratory before they can be applied in the field. The vast majority of paramedic schools in the US FAIL to even marginally accomplish that. If they did, few students would choose to go there. The problem is compounded by the attitude fostered by the US paramedic system that paramedic practice is nothing more than a collection of advanced " skills " to be memorised and applied with no more concern than first aid. And this attitude is only validated (albeit erroneously) by those who strut around spouting off that " we don't need all that book learnin' " and " I learn better by hands-on than in a classroom " . Those aren't the schools making that mistake. Those are the students and administrators in EMS making that mistake. > U.S. Paramedics, as a general rule, don't have the background to work > offshore/remote. Of course, as a general rule neither do U.S. Nurses. Ah, that's a wonderful argument! " We suck, but you suck too, so there! " Very mature and insightful, indeed. I was a medic for 21 years before I became a nurse. And I've been a nurse for fifteen years. Consequently, I know of what I speak from both perspectives. You apparently know nothing of what you speak from either perspective. Cheers, Rob ------------ --------- --------- ------ Member Information: List owner: Ian Sharpe Editor: Ross Boardman Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2008 Report Share Posted December 27, 2008 Re: Re: Rotational Work Speaking as a " know nothing, " I wonder how grounded in reality your comments are, when you feel the need to pull comments out of context to make a (thinly veiled) attack on a poster. ********* I am not too shure to whom you are addressing the comment to But it's not important As the comments where directed at " initial Paramedic taining " Not at individual And that is the whole point Don " t make it and don't take it personal We should still be able to discusses education models American and otherwise American because it is the basis of ALL other trainings The initial training of paramedics, nurses, etc, is ill-suited for the work we do, and that there are better people for the job (who are unused due to your most prominent argument: economics.) ********************* This is so true That it was not even part of the discussion Your whole attack on American paramedics ********************* First it is not the " American Parmedics " It " s the American Paramedic training model (whatever that is) This is very important Fore if you say or think that " American Parmedics " Then this would give yo a license to counter attack = ... end of a discussion .....is that (you feel) our initial education is (apparently universally?) insufficient. If initial education is the " whole game " then why aren't you arguing to use the people with the proper background to begin with? ******************* People argue the points they want to If you have more points to bring I suggest and look forward to YOU making them If a discussion had to follow preset rules and topics Then It would not be a discussion Or never a very good discussion Your other arguments have some merit and it would be worthy of some discussion (though maybe on a more appropriate venue) *************************** W H Y ! ! ! Are we not all interested in " Paramedic Education " ! ? Why limit ourselves to " Remote Paramedic Education " discussion ? however it's not worth conversing with someone who isn't willing to have an honest discussion. ***************************** The problem with the discussion is that it may be TOO honest We have a lot of freedoms (of expression) But I am always surprise at how when these freedoms are used They can be pretty easily reduced/illiminated ! ???? .... and how sucessfully this can be done ! So : EMT-B (Basic Paramedic) How many hours should be the initial training ? How many hours of recert per year ? How many E.R.? Clinical preceptorship (initial) ? How many E.R.? Clinical preceptorship per year ? Hoe many call audits per year ? Recert every how many years ? EMT-P (Advanced Paramedic) How many hours should be the initial training ? How many hours of recert per year ? How many E.R.? Clinical preceptorship (initial) ? How many E.R.? Clinical preceptorship per year ? Hoewmany call audits sesions per year ? Recert every how many years ? (Or professionalisation is prefered ?) I am curious what the Medics from other countries think ^ Have a Happy New Year. On Dec 25, 2008, at 3:47 PM, rob.davis@... wrote: > > U.S. Paramedics, as a general rule, don't have the background to > work > > offshore/remote. Of course, as a general rule neither do U.S. > Nurses. > I've added the rest of my statement, for clarification: If you want people who have the proper training right out of the gate, you can try to scrounge up Independent Duty Corpsman, Special Forces 'Medics (or equiv.) or make the jump and hire Physician Assistants/ Nurse Practitioners. This is just addressing the American side of the pond, of course, but having met a few people in the world of various nationalities and levels of practice, it's all not really -that- different. > Ah, that's a wonderful argument! " We suck, but you suck too, so > there! " Very mature and insightful, indeed. I was a medic for 21 > years before I became a nurse. And I've been a nurse for fifteen > years. Consequently, I know of what I speak from both perspectives. > You apparently know nothing of what you speak from either perspective. > > Cheers, > > Rob > ------------------------------------ Member Information: List owner: Ian Sharpe Editor: Ross Boardman Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2008 Report Share Posted December 27, 2008 Following on from previous comments. I think that there are very, very few backgrounds that prepare medics to work in remote locations. However most training will suffice -anaphylaxis does not change just because, for example, the bee that stings in the city differs greatly from one in the wilderness. It is about the confidence of the individual, not where he/she got their training (as this is pretty standardised in the US as here in the UK). I would, personally, rather work with someone who had the confidence to say 'I don't know' than be arrogant and overconfident. Cheers Tony On Fri, 26 Dec 2008 10:54:24 -0800 (PST), " Guy " <guyser1975@...> said: > My two cents: > > I've attended several of he big EMS conferences nationally as well as > here in my state (NC) and I have always been struck by the wide continuum > of competence manifested under > " EMT-P " banner. > I meet extremely sharp medics who are worthy of any degree of > responsibility that could be heaved upon them, and I meet buffoons who by > their conversation and overall presentation appear barely literate. > Then again, I have met more RN's and MD's of all nationalities who could > similarly be placed on either end of said continuum. > > As for the US Paramedic education system prepping medics for remote work > is concerned, it doesn't. It's not what the DOT standard is for. > > I regard the HSE side of medic work as an unfortunate, boring necessity. > I have no boastworthy level of experience measuring handrails or > distributing rolls of grip tape for marking off walking paths on a rig, > but I know what to do when someone is threatening to die, regardless of > the mechanism or etiology. > > Did my training prepare me for OM and gastroenteritis? No. Could I talk > you through the steps of assuring that all safety precautions have been > employed before raising a worker on a genie lift? No. > > But I can (and have) educated myself on OM and gastroenteritis to the > point were I can confidently treat according to the standard of care and > I can hold a checklist on a clipboard as well as anyone for that genie > lift. Anyone who hires me can rest in the knowledge that I will hold my > own with all of the HSE business, and when the shit hits the fan - I'm > ny on the spot with the paramedickin' SHO NUFF, WEST SIDE!!!!!!! > > But that's just me . . . > > Cheerio! > > Guy > > > > > > From: Brault <c_brault@...> > Subject: Re: Re: Rotational Work > > Date: Friday, December 26, 2008, 11:19 AM > > > > > > > WOW > > Lot's of subjective information > > But merely speaking > It has helped me understand better the US Paramedic Education quagmire > > Thanks > > > And I would not and am not ungrateful to A A > He also helps us understand the state of things > > Re: [Remotemedics. co.uk] Re: Rotational Work > > On Wednesday, December 24, 2008 13:41, " A Austin " <abaustin+group > s@...> said: > > > > > The generalization that American paramedics are inadequate is about as > > valid as the one that all male nurses are gay. For every example of an > > inadequately training U.S. Paramedic, I can show you one homosexual > > male nurse. > > That's a fair analogy, albeit an irrelevant one. I can show you a > hundred inadequately trained US paramedics for every gay nurse in the > world. But homosexuality in the workplace is not relevant. Incompetence > in the workplace is extremely relevant. Either you're being > hypersensitive to the issue for matters of national pride, or else you > are incapable of recognising incompetence when you see it. > > > There are obviously significant shortfalls in paramedic education in > > the United States, and trying to argue otherwise is stupid. The > > reasons for them are numerous and significant, but the number one > > failing (in my opinion) is poor institutions and instructors. > > It's a Catch-22. Institutions and instructors typically provide what the > community demands. And the overwhelming demand of paramedic schools in > this country is that they be quick and easy, dumbed down to the 8th grade > level, so that firemonkeys and volunteers don't have to devote too much > time or effort to sewing on their patches. If you open up a school next > door that requires a significant educational commitment, you will receive > one application for every two hundred applicants that the 6 month patch > factor receives. It's not the instructors as a group that are the > problem (although many share in the incompetence individually) . It is > the EMS management and administration that encourages inadequate > education in order to keep their rosters full, and those who enter the > field unwilling to commit to significant professional education. > > > compounded by the fact that the medical field is largely a " learn by > > doing " area. Someone with a inadequate education and poor OJT (on the > > job training) is going to be bad at their job. This is certainly not > > exclusive to Paramedics or Americans. > > I maintain that the problem begins long before you ever get to the OJT > portion of education. It begins when the tech schools FAIL to provide an > adequate didactic foundation to their students, therefore sabotaging > their field competence, no matter how much OJT they receive. Cardiology, > pharmacology, physiology, and psychology are not learned OJT, no matter > how long you try. Those are theoretical foundations that must be > established in the classroom and laboratory before they can be applied in > the field. The vast majority of paramedic schools in the US FAIL to even > marginally accomplish that. If they did, few students would choose to go > there. > > The problem is compounded by the attitude fostered by the US paramedic > system that paramedic practice is nothing more than a collection of > advanced " skills " to be memorised and applied with no more concern than > first aid. And this attitude is only validated (albeit erroneously) by > those who strut around spouting off that " we don't need all that book > learnin' " and " I learn better by hands-on than in a classroom " . Those > aren't the schools making that mistake. Those are the students and > administrators in EMS making that mistake. > > > U.S. Paramedics, as a general rule, don't have the background to work > > offshore/remote. Of course, as a general rule neither do U.S. Nurses. > > Ah, that's a wonderful argument! " We suck, but you suck too, so there! " > Very mature and insightful, indeed. I was a medic for 21 years before I > became a nurse. And I've been a nurse for fifteen years. Consequently, > I know of what I speak from both perspectives. You apparently know > nothing of what you speak from either perspective. > > Cheers, > > Rob > > ------------ --------- --------- ------ > > Member Information: > > List owner: Ian Sharpe > Editor: Ross Boardman > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 Wow, another one of these old and tired arguments of who is better at what. Jeez that gets old quick. So 2 year RN sucks compared to 4 year RN and the 4 year must really be lacking compared to the Nurse Practitioner, oh but wait they are all nurses. Obviously military nurse can¢t hold a candle to level 1 trauma civilian nurses. If you hate American standards or despise US paramedics so badly, you always have the option to leave. But judging from your e-mail address, I imagine you like getting paid American nurses wages, as opposed to some others country¢s wages for the job. I must say Australia does have a great system, 100%. Nurses stay in hospitals and paramedics do prehosipital. There everybody stays in their lane. Hey while we are at it let¢s get rid of the EMT- B¢s and I¢s, bunch of slackers. Just saying. Happy new year to all, no matter where your from. Never could stand a racist, now this board is going to start judging people by where they are from. That sure as hell wasn't something you learned in the ARMY I served in! From: rob.davis@... <rob.davis@...> Subject: Re: Re: Rotational Work Date: Monday, December 29, 2008, 6:26 AM On Sunday, December 28, 2008 01:28, " antony ewing " <tonytonefastmail (DOT) fm> said: > I think that there are very, very few backgrounds that prepare medics to > work in remote locations. However most training will suffice > -anaphylaxis does not change just because, for example, the bee that > stings in the city differs greatly from one in the wilderness. > > It is about the confidence of the individual, not where he/she got their > training (as this is pretty standardised in the US as here in the UK). Nonsense. Where a provider received his or her education is a significant factor contributing to his or her potential for competence in remote medicine. And that goes for " background " too. The simple fact is that -- all other factors being equal -- you give me a medic with a tech school paramedic training measured in hours, and a medic with a two year paramedic (or nursing) education, which included a solid didactic foundation in the sciences, and I can guarantee you which one is more likely to quickly adapt and succeed. It's a complete no brainer. I watched this theory prove itself over and over in Iraq. They'd send out these patch-factory fire-medics with over five years of experience, and very few of those guys ever achieved what I would call clinical competence. They were unable to think outside of their little street-medic cookbooks, and lacked the scientific foundation to understand clinical medicine. On the other hand, we'd get degreed medics (and nurses) -- even those with little to no experience -- and they typically adapted much quicker, finding it much easier to comprehend clinical medicine. That has EVERYTHING to do with their " background " and where they went to school. This goes right back to the root of the argument in progress, which is US paramedic inadequacy. The overwheliming focus of paramedic training in the US is on fast technical training, and not thorough medical education. The largest providers in the country typically send or encourage their members to attend the 13 week to 6 month patch factories. And damn few people coming into the field choose a 2 to 4 year option over the fast-track to firemonkey glory. We have two out of fifty states who actually require a two year degree for paramedic practice. And surprise surprise... neither of those states have many fire department EMS providers. Two out of fifty is a pretty dismal statistic. And it stands out as a neon sign to the world, illustrating the abysmal inadequacy of US EMS as a whole. If you are an exception to the rule, wonderful. Good on you. But the fact is indisputable that the country that once led the world into modern EMS has shamefully FAILED to progress beyond their 1970s beginnings. The rest of the world has passed us by. If I'm in a remote environment, give me a Canadian, Aussie, or UK medic ANY day over a US medic. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2009 Report Share Posted January 7, 2009 I really was going to let this go, but I can’t: The simple fact is that -- all other factors being equal -- you give me a medic with a tech school paramedic training measured in hours, and a medic with a two year paramedic (or nursing) education, which included a solid didactic foundation in the sciences, and I can guarantee you which one is more likely to quickly adapt and succeed. So are you telling me that the one weekend nursing evaluation at Excelsior is the “solid 2 year didactic” that you speak of. So a mail-in nursing school would not be considered a patch factory for RN’s? Funny the state of California seems to think so. Hence they won’t let Excelsior nurses in. Oh, that has to hurt for someone with your high standards and self regard. Wait back then I don’t believe the Excelsior program even mandated that you be a paramedic to enroll. I could be wrong. And damn few people coming into the field choose a 2 to 4 year option over the fast-track to firemonkey glory. The same could be said of the 2 year fast track nurses that don’t want to make the commitment to getting their BSN, so they go the reserve/national guard route and then go get a armynurse corps, email address. If I got this right it was ok for you to take the short cuts, but everybody else is substandard. Let me close by saying out of respect for your time served, I am cutting this short. As I said before could never stand a racist and sure as hell can’t stomach a hypocrite. From: rob.davis@... <rob.davis@...> Subject: Re: Re: Rotational Work Date: Monday, December 29, 2008, 6:26 AM On Sunday, December 28, 2008 01:28, " antony ewing " <tonytonefastmail (DOT) fm> said: > I think that there are very, very few backgrounds that prepare medics to > work in remote locations. However most training will suffice > -anaphylaxis does not change just because, for example, the bee that > stings in the city differs greatly from one in the wilderness. > > It is about the confidence of the individual, not where he/she got their > training (as this is pretty standardised in the US as here in the UK). Nonsense. Where a provider received his or her education is a significant factor contributing to his or her potential for competence in remote medicine. And that goes for " background " too. The simple fact is that -- all other factors being equal -- you give me a medic with a tech school paramedic training measured in hours, and a medic with a two year paramedic (or nursing) education, which included a solid didactic foundation in the sciences, and I can guarantee you which one is more likely to quickly adapt and succeed. It's a complete no brainer. I watched this theory prove itself over and over in Iraq. They'd send out these patch-factory fire-medics with over five years of experience, and very few of those guys ever achieved what I would call clinical competence. They were unable to think outside of their little street-medic cookbooks, and lacked the scientific foundation to understand clinical medicine. On the other hand, we'd get degreed medics (and nurses) -- even those with little to no experience -- and they typically adapted much quicker, finding it much easier to comprehend clinical medicine. That has EVERYTHING to do with their " background " and where they went to school. This goes right back to the root of the argument in progress, which is US paramedic inadequacy. The overwheliming focus of paramedic training in the US is on fast technical training, and not thorough medical education. The largest providers in the country typically send or encourage their members to attend the 13 week to 6 month patch factories. And damn few people coming into the field choose a 2 to 4 year option over the fast-track to firemonkey glory. We have two out of fifty states who actually require a two year degree for paramedic practice. And surprise surprise... neither of those states have many fire department EMS providers. Two out of fifty is a pretty dismal statistic. And it stands out as a neon sign to the world, illustrating the abysmal inadequacy of US EMS as a whole. If you are an exception to the rule, wonderful. Good on you. But the fact is indisputable that the country that once led the world into modern EMS has shamefully FAILED to progress beyond their 1970s beginnings. The rest of the world has passed us by. If I'm in a remote environment, give me a Canadian, Aussie, or UK medic ANY day over a US medic. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Hi All A Master of my vessel with many years at sea only just told me the other day. Rudeness, arrogance and incompetence has no nationality nor is it defined to any particular skill group of profession......it was well said. I have worked with great nurses, great docs and great paramedics. My 2 Aussie cents worth Darren ---- Dustan <madmedic25@...> wrote: > In reading this thread several of you are judging the book by the > cover. I think it shameful on your part to do so. I took the fast > track route for my medic, because that is what I could afford and what > would fit my work schedule while raising a family. When I took my > state and my NR (National Registry) I passed all exams on the first go > around, I know and worked with people that sit in class for two years > in a paramedic program that failed the NR 3 times and had to retake > the course before they passed. Questions is: Is it the Program? is it > the Person? or is it the instructors? all are factors when you really > look at it. While the programs may be limited or considered inadequate > in the US compared to the rest of the world, Slowly, I think some > states are changing there programs to meet what is needed to pass the > NR exam. Good or Bad? I really cant tell at this point but as I > understand it, it is putting the medic student in the class room more. > It is the person that makes the medic. I continue to learn on this > job. I look for programs to advance my knowledge and skill to be the > best medic I can be. I visit with the ER doctors when I get the chance > to ask questions. Just because I am a US medic, dont cut me short. I > have seen people make 100's on exams, pass the courses with flying > colors but put them in the field and apply the pressure of an > emergency, I would not give you 2 cents for them. They have no common > sense and they are in the damn way when minutes count. I have seen the > same with nurses and doctors. You can have all the degrees on the wall > that you want, but if you cant apply it in the field or when the > pressure is on then you are worthless to the pt and your partners. > Give me good instructors who want to teach what they know and person > who goes above and beyond to learn what was not given in the class > room and regardless of the nationality, you will get one hell of a > medical professional who should be able to adapt to any environment. > MY education did not stop when I got my patch, it continues everyday > as I am sure it does with everyone of you on this chosen path. And as > one that is looking to improve my knowledge and skill set I do look to > you, members of this group to help me or guide me in the direction > needed to reach that goal. I have gotten lots of pointers and useful > information from other post from this group and I thank you for those > that post the info. > > > Be safe out there, Happy New year and God bless. > > > Dustan Jesko, NREMT-P, LP > > > Quote Link to comment Share on other sites More sharing options...
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