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Hello all,

In a month I will be finishing my EMT-B and applying to different services. I'm

located in Central Texas (Waco to be more specific). The main service that

covers the Waco area isn't too keen on letting their Basics do much more than

drive and start O2 (little to no patient care, even on the BLS calls). I know

this isn't too uncommon, but I love patient care and would like to be able to

utilize the skills I have learned in school (assessment, splinting, assisting

with nitro, aspirin, etc.) to grow as an EMT.

Can anyone recommend a service which allows their EMTs to be more proactive in

care/utilize a greater scope? Moving isn't really an issue.

Thanks,

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At times it is not a systems issue it is a Partners issue. I've worked in

BLS services all my life (27 years as a Basic) in tiered systems where

certified Paramedics thought that by virtue of their certification level they

were the be all end all. we called them ParaGod's. These guys even when

employed as a B and working under a B's limitations (in systems where you could

not be a P unless you were working as a P on that shift or were employed by

that ALS provider who felt that they and only they should lay hands upon a

Patient. Most were very good at their jobs clinically but many were

complete horses a**es as a Partner.

Find a System that allows you to work to your scope then find a Partner to

let you do it when it's right to do so for the Patient. they tend to be the

ones you learn from in the long run both clinically and operationally as

well as how to be a good Partner!

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

In a message dated 3/24/2010 3:59:47 P.M. Central Daylight Time,

js0095001@... writes:

Hello all,

In a month I will be finishing my EMT-B and applying to different

services. I'm located in Central Texas (Waco to be more specific). The main

service

that covers the Waco area isn't too keen on letting their Basics do much

more than drive and start O2 (little to no patient care, even on the BLS

calls). I know this isn't too uncommon, but I love patient care and would like

to be able to utilize the skills I have learned in school (assessment,

splinting, assisting with nitro, aspirin, etc.) to grow as an EMT.

Can anyone recommend a service which allows their EMTs to be more

proactive in care/utilize a greater scope? Moving isn't really an issue.

Thanks,

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Why, Rob?

Is there a reason a paramedic can't stand back and let his/her basic

partner handle a basic run while providing tutelage to the basic?

That's what I thought Lou was suggesting.

ck

In a message dated 3/24/2010 19:31:46 Central Daylight Time,

rob.davis@... writes:

On Wednesday, March 24, 2010 16:05, _lnmolino@..._

(mailto:lnmolino@...) said:

> Find a System that allows you to work to your scope then find a Partner

to

> let you do it when it's right to do so for the Patient. they tend to be

the

> ones you learn from in the long run both clinically and operationally as

> well as how to be a good Partner!

And when you find that system, be sure to let us all know where it is. A

lot of us would want to avoid living in or visiting that area.

Rob

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Chuck you are a very bright guy!

I've learned a crap load of stuff BLS and ALS from my Medic counterparts

and even an RN and MD now and again but only the ones that gave a damn about

the long term Patient care issues.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

In a message dated 3/24/2010 7:40:14 P.M. Central Daylight Time,

krin135@... writes:

Why, Rob?

Is there a reason a paramedic can't stand back and let his/her basic

partner handle a basic run while providing tutelage to the basic?

That's what I thought Lou was suggesting.

ck

In a message dated 3/24/2010 19:31:46 Central Daylight Time,

_rob.davis@..._ (mailto:rob.davis@...)

writes:

On Wednesday, March 24, 2010 16:05, __lnmolino (AT) aol (DOT) _ln_

(mailto:_lnmolino@...) _

(mailto:_lnmolino@..._ (mailto:lnmolino@...) ) said:

> Find a System that allows you to work to your scope then find a Partner

to

> let you do it when it's right to do so for the Patient. they tend to be

the

> ones you learn from in the long run both clinically and operationally as

> well as how to be a good Partner!

And when you find that system, be sure to let us all know where it is. A

lot of us would want to avoid living in or visiting that area.

Rob

[Non-text portions of this message have been removed]

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Ya work as an FRO for the fire service or get your

Paramedic

Romy son

> Hello all,

>

> In a month I will be finishing my EMT-B and applying to different

> services. I'm located in Central Texas (Waco to be more specific).

> The main service that covers the Waco area isn't too keen on letting

> their Basics do much more than drive and start O2 (little to no

> patient care, even on the BLS calls). I know this isn't too

> uncommon, but I love patient care and would like to be able to

> utilize the skills I have learned in school (assessment, splinting,

> assisting with nitro, aspirin, etc.) to grow as an EMT.

>

> Can anyone recommend a service which allows their EMTs to be more

> proactive in care/utilize a greater scope? Moving isn't really an

> issue.

>

> Thanks,

>

>

>

>

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I hope there are places in Texas where that's not true.

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

On Mar 24, 2010, at 16:31, Romy son r.stevenson7013@...>

wrote:

> Ya work as an FRO for the fire service or get your

> Paramedic

>

> Romy son

>

> On Mar 24, 2010, at 12:05 PM, " my_rt_life " js0095001@...>

> wrote:

>

> > Hello all,

> >

> > In a month I will be finishing my EMT-B and applying to different

> > services. I'm located in Central Texas (Waco to be more specific).

> > The main service that covers the Waco area isn't too keen on letting

> > their Basics do much more than drive and start O2 (little to no

> > patient care, even on the BLS calls). I know this isn't too

> > uncommon, but I love patient care and would like to be able to

> > utilize the skills I have learned in school (assessment, splinting,

> > assisting with nitro, aspirin, etc.) to grow as an EMT.

> >

> > Can anyone recommend a service which allows their EMTs to be more

> > proactive in care/utilize a greater scope? Moving isn't really an

> > issue.

> >

> > Thanks,

> >

> >

> >

> >

>

>

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On Wednesday, March 24, 2010 16:05, lnmolino@... said:

> Find a System that allows you to work to your scope then find a Partner to

> let you do it when it's right to do so for the Patient. they tend to be the

> ones you learn from in the long run both clinically and operationally as

> well as how to be a good Partner!

And when you find that system, be sure to let us all know where it is. A lot of

us would want to avoid living in or visiting that area.

Rob

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Rob aren't army medics EMT basics................ Do they not measure

up either??

-Chris

Sorry for the spelling and punctuation this was typed on tge tiny

keyboard on my iPhone

On Mar 24, 2010, at 19:31, " rob.davis@... "

rob.davis@...

> wrote:

> On Wednesday, March 24, 2010 16:05, lnmolino@... said:

>

>> Find a System that allows you to work to your scope then find a

>> Partner to

>> let you do it when it's right to do so for the Patient. they tend

>> to be the

>> ones you learn from in the long run both clinically and

>> operationally as

>> well as how to be a good Partner!

>

> And when you find that system, be sure to let us all know where it

> is. A lot of us would want to avoid living in or visiting that area.

>

> Rob

>

>

>

> ------------------------------------

>

>

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I'd prefer to avoid systems overloaded with too many I'll practicied

ALS Providers and be hur in one where the keel of skills were better

matched to reality.

The bulk of the lives saved in the streets are saved by good BLS.

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

On Mar 24, 2010, at 19:31, " rob.davis@... "

rob.davis@...

> wrote:

> On Wednesday, March 24, 2010 16:05, lnmolino@... said:

>

> > Find a System that allows you to work to your scope then find a

> Partner to

> > let you do it when it's right to do so for the Patient. they tend

> to be the

> > ones you learn from in the long run both clinically and

> operationally as

> > well as how to be a good Partner!

>

> And when you find that system, be sure to let us all know where it

> is. A lot of us would want to avoid living in or visiting that area.

>

> Rob

>

>

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On Wednesday, March 24, 2010 19:40, krin135@... said:

> Is there a reason a paramedic can't stand back and let his/her basic

> partner handle a basic run while providing tutelage to the basic?

In reality, it's rarely " tutelage " . It's the " paragod " syndrome that Lou

referred to, where the medic simply dumps those patients he deems unworthy of

his presence onto the lesser provider. Without an EMT to dump on, there are no

" paragods " .

But more importantly, if the EMT is doing any of those things the OP listed,

besides splinting, then it's not a " basic run " , so it's a moot point. And if

that is the case, I as a medic don't want a helper. I want a full partner.

, don't rush things. You've still got two years of college ahead of you to

become a paramedic. Take things deliberately as they come. It is my experience

that those EMTs with the least experience make the best paramedic students.

They don't come in with all the bad habits and mistaken notions picked up from

Lou's " paragods " , and are therefore much more receptive of education. Be that

guy.

Good luck,

Rob

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On Wednesday, March 24, 2010 20:04, " " aggiesrwe03@...> said:

> Rob aren't army medics EMT basics................ Do they not measure

> up either??

Not as civilian ALS providers, they don't.

And let's not get into a word game here. It's not about titles. It's about

education.

Rob

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if moving is not an issue there are several very good depts to

work for in the Houston area and like Romy said fire depts are always

a good option to get experience good luck!!

-Chris

Sorry for the spelling and punctuation this was typed on tge tiny

keyboard on my iPhone

> At times it is not a systems issue it is a Partners issue. I've

> worked in

> BLS services all my life (27 years as a Basic) in tiered systems where

> certified Paramedics thought that by virtue of their certification

> level they

> were the be all end all. we called them ParaGod's. These guys even

> when

> employed as a B and working under a B's limitations (in systems

> where you could

> not be a P unless you were working as a P on that shift or were

> employed by

> that ALS provider who felt that they and only they should lay hands

> upon a

> Patient. Most were very good at their jobs clinically but many were

> complete horses a**es as a Partner.

>

> Find a System that allows you to work to your scope then find a

> Partner to

> let you do it when it's right to do so for the Patient. they tend to

> be the

> ones you learn from in the long run both clinically and

> operationally as

> well as how to be a good Partner!

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> Freelance Consultant/Trainer/Author/Journalist/Fire Protection

> Consultant

>

> LNMolino@...

>

> (Cell Phone)

>

> " A Texan with a Jersey Attitude "

>

> " Great minds discuss ideas; Average minds discuss events; Small minds

> discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 -

> 1962)

>

>

> In a message dated 3/24/2010 3:59:47 P.M. Central Daylight Time,

> js0095001@... writes:

>

>

>

>

> Hello all,

>

> In a month I will be finishing my EMT-B and applying to different

> services. I'm located in Central Texas (Waco to be more specific).

> The main service

> that covers the Waco area isn't too keen on letting their Basics do

> much

> more than drive and start O2 (little to no patient care, even on

> the BLS

> calls). I know this isn't too uncommon, but I love patient care and

> would like

> to be able to utilize the skills I have learned in school

> (assessment,

> splinting, assisting with nitro, aspirin, etc.) to grow as an EMT.

>

> Can anyone recommend a service which allows their EMTs to be more

> proactive in care/utilize a greater scope? Moving isn't really an

> issue.

>

> Thanks,

>

>

>

>

>

>

>

>

>

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I'm going to take the rare step of agreeing with Rob on this one.

Mark the date, folks.

While Lou's suggestion of finding a place to practice to the fullest

extent of your training and finding a paramedic mentor to shepherd you

through your first few years of EMT practice are good in theory...

.... in my experience, it rarely works that way in practice. There are

very few paramedics out there with twenty years of experience, and many

more with one year of experience repeated twenty times.

It's the first kind that every green EMT wants as a partner, but it's

the second type they usually get. And when they come to paramedic class,

I am usually faced with a supposedly " experienced " basic whose sum total

of field experience has only taught him to be rude, cynical, take

shortcuts, and memorize all the fast-food joints that give EMT discounts.

, the good news is, the medics you want to emulate are pretty easy

to spot, and even the idiots can teach you how *not* to act. Where you

wind up working isn't so important as who you wind up working *with.*

>

> On Wednesday, March 24, 2010 19:40, krin135@...

> said:

>

> > Is there a reason a paramedic can't stand back and let his/her basic

> > partner handle a basic run while providing tutelage to the basic?

>

> In reality, it's rarely " tutelage " . It's the " paragod " syndrome that

> Lou referred to, where the medic simply dumps those patients he deems

> unworthy of his presence onto the lesser provider. Without an EMT to

> dump on, there are no " paragods " .

>

> But more importantly, if the EMT is doing any of those things the OP

> listed, besides splinting, then it's not a " basic run " , so it's a moot

> point. And if that is the case, I as a medic don't want a helper. I

> want a full partner.

>

> , don't rush things. You've still got two years of college ahead

> of you to become a paramedic. Take things deliberately as they come.

> It is my experience that those EMTs with the least experience make the

> best paramedic students. They don't come in with all the bad habits

> and mistaken notions picked up from Lou's " paragods " , and are

> therefore much more receptive of education. Be that guy.

>

> Good luck,

>

> Rob

>

>

--

Grayson, CCEMT-P www.kellygrayson.com

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As the pundit once said, " Nobody is totally worthless; they can always be used

as a bad example. "

I always like 's " one year of experience repeated 20 times " reference. It

is so true.

GG

Re: Progressive services?

I'm going to take the rare step of agreeing with Rob on this one.

Mark the date, folks.

While Lou's suggestion of finding a place to practice to the fullest

extent of your training and finding a paramedic mentor to shepherd you

through your first few years of EMT practice are good in theory...

.... in my experience, it rarely works that way in practice. There are

very few paramedics out there with twenty years of experience, and many

more with one year of experience repeated twenty times.

It's the first kind that every green EMT wants as a partner, but it's

the second type they usually get. And when they come to paramedic class,

I am usually faced with a supposedly " experienced " basic whose sum total

of field experience has only taught him to be rude, cynical, take

shortcuts, and memorize all the fast-food joints that give EMT discounts.

, the good news is, the medics you want to emulate are pretty easy

to spot, and even the idiots can teach you how *not* to act. Where you

wind up working isn't so important as who you wind up working *with.*

>

> On Wednesday, March 24, 2010 19:40, krin135@...

> said:

>

> > Is there a reason a paramedic can't stand back and let his/her basic

> > partner handle a basic run while providing tutelage to the basic?

>

> In reality, it's rarely " tutelage " . It's the " paragod " syndrome that

> Lou referred to, where the medic simply dumps those patients he deems

> unworthy of his presence onto the lesser provider. Without an EMT to

> dump on, there are no " paragods " .

>

> But more importantly, if the EMT is doing any of those things the OP

> listed, besides splinting, then it's not a " basic run " , so it's a moot

> point. And if that is the case, I as a medic don't want a helper. I

> want a full partner.

>

> , don't rush things. You've still got two years of college ahead

> of you to become a paramedic. Take things deliberately as they come.

> It is my experience that those EMTs with the least experience make the

> best paramedic students. They don't come in with all the bad habits

> and mistaken notions picked up from Lou's " paragods " , and are

> therefore much more receptive of education. Be that guy.

>

> Good luck,

>

> Rob

>

>

--

Grayson, CCEMT-P www.kellygrayson.com

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Ah but you assume the world is populated with a majority of

Paramedic Providers and while it is in Texas there are other places

outside the Great Republic where the Systems I describe do in fact

exsit.

I'll grant you that point about 20 year Medics but isn't a 5 year

Medic who treats only ALS Patients likely to have more Patient Contact

Houra (for want of a measure). Therfore those Patient Contacts are

more meanigful ( for want of a better term) to that Medic and his

professional development?

We've discussed studies where having multiple Medics on a scene has a

possible harmful outcome to the ALS Patient and we've talked about

skills degredation in all or mostly Medic based systems hence those

things suggest that less is more, do they not?

I have nothing but respect for good Medics I know dozens from around

the world. I envy them as I was one of those 7 year olds that long on

a Saturday night wanted to be ny Gage. I never got there but it's

been a wild ride ever since.

The perfect system doesn't exsit maybe conversations such as this will

make it possible.

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

> I'm going to take the rare step of agreeing with Rob on this one.

>

> Mark the date, folks.

>

> While Lou's suggestion of finding a place to practice to the fullest

> extent of your training and finding a paramedic mentor to shepherd you

> through your first few years of EMT practice are good in theory...

>

> ... in my experience, it rarely works that way in practice. There are

> very few paramedics out there with twenty years of experience, and

> many

> more with one year of experience repeated twenty times.

>

> It's the first kind that every green EMT wants as a partner, but it's

> the second type they usually get. And when they come to paramedic

> class,

> I am usually faced with a supposedly " experienced " basic whose sum

> total

> of field experience has only taught him to be rude, cynical, take

> shortcuts, and memorize all the fast-food joints that give EMT

> discounts.

>

> , the good news is, the medics you want to emulate are pretty

> easy

> to spot, and even the idiots can teach you how *not* to act. Where you

> wind up working isn't so important as who you wind up working *with.*

>

>

> >

> > On Wednesday, March 24, 2010 19:40, krin135@...

> > said:

> >

> > > Is there a reason a paramedic can't stand back and let his/her

> basic

> > > partner handle a basic run while providing tutelage to the basic?

> >

> > In reality, it's rarely " tutelage " . It's the " paragod " syndrome that

> > Lou referred to, where the medic simply dumps those patients he

> deems

> > unworthy of his presence onto the lesser provider. Without an EMT to

> > dump on, there are no " paragods " .

> >

> > But more importantly, if the EMT is doing any of those things the OP

> > listed, besides splinting, then it's not a " basic run " , so it's a

> moot

> > point. And if that is the case, I as a medic don't want a helper. I

> > want a full partner.

> >

> > , don't rush things. You've still got two years of college

> ahead

> > of you to become a paramedic. Take things deliberately as they come.

> > It is my experience that those EMTs with the least experience make

> the

> > best paramedic students. They don't come in with all the bad habits

> > and mistaken notions picked up from Lou's " paragods " , and are

> > therefore much more receptive of education. Be that guy.

> >

> > Good luck,

> >

> > Rob

> >

> >

>

> --

> Grayson, CCEMT-P www.kellygrayson.com

>

>

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