Re: The future of EMS - don't confuse me with facts:

[Guest guest]

This is one of the most elequently stated editorials I have read in a long

while. I hope one of the magazines will pick this up and publish it. Donn

has nailed his subject.

Gene

In a message dated 12/31/2002 9:52:28 AM US Mountain Standard Time,

donn@... writes:>

>

>

> Recalcitrance and apathy - twin edges of the executioner's sword.

>

> Unfortunately it surprises me not in the least to read that Gene Gandy was

> met with resistance and outrage while attempting to teach documentation in

> Dallas (or Ft. Worth, or the suburbs, or anywhere else for that matter). I

> meet medics like the one described almost daily in various areas of this

> state and in other states as well.

>

> It has recently been mentioned on this list by some crusty old fart that

> the

> kind of situation Gene describes couldn't have occurred 30 years ago - that

> the old-timers were more dedicated, more willing to learn, more accepting

> of

> progress, and more steeped in science. If this be true (and I am by no

> means

> convinced that it is), then someone please tell me what changed to bring us

> to the mess we find ourselves in today?

>

> As I see it, the root of the problem can be found twenty some odd years ago

> in the rush to secure more red patches. We were still racing ambulances in

> those days, but more so in the commissioner's courts and city council

> chambers than on the streets. The competition was on for more street-level

> providers of the advanced variety, and it was Katy bar the door.

> Prerequisites were lowered, standards were compromised, rules were bent,

> and

> soon we were gloriously awash in a sea of pretty red patches.

>

> In our 600-hour (if we were lucky) garage bay programs we pounded protocols

> into pointy little heads until they could recite every algorithm rote. When

> we finally let them sleep they dreamt drip rates, contraindications, and

> aberrant ECG tracings. We taught them all the how's, but few of the whys.

> Our students turned into the trained monkeys we have talked so much about

> on

> this list. Somehow, in those days, it just didn't seem important for a

> medic

> to understand why something worked or didn't work, did it? Besides, some of

> them, while potentially capable of Skinnerian action/reaction association,

> were likely incapable of understanding the method of action of any given

> pharmaceutical. So why bother? Right? Many of our trained monkeys are still

> with us today and fortunately a few of them were curious enough to go out

> on

> their own to search for the answers to why something worked or didn't. Most

> of our simians, however, continue to worship at the altar of EMS as we knew

> it back then, and now we find ourselves debating what is wrong with our

> profession when 20-year medics refuse to attend anything but mandatory

> rehashed CE classes and argue when the instructor tries to show them the

> new

> standard of care. We are enstein - we created our monster - the

> monster

> has turned on us. That is the way of robots.

>

> It is the unfortunate result of our shortsightedness that too many medics

> today are more capable of opening their mouths than their minds, and find

> it

> easier to crucify than to understand. In the time I have been involved with

> EMS I have seen us constantly trying to devour ourselves, and succeeding

> more often than not. I fear Gene's assessment of the medics in his class is

> frighteningly correct. Gene stated " a " professional " is one who learns on

> his

> own and stays up with changes in the profession without being forced to do

> so. " . How many medics meeting this criteria do you know? How many have you

> met that are closer to the antithesis of the described professional? What

> is

> the ratio? Unfortunately it appears very lopsided to me, and it is

> painfully

> obvious just how difficult a task we face if EMS is to have any future at

> all.

>

> With the majority of medics today, more often than not, once something is

> learned anything new or improved is resisted. Thinking outside the box is

> not an option. Woe to the person who tries point to science (or the lack

> thereof) as proof that a cherished procedure or belief, so painfully

> learned

> at the knees of wizened mentors and faithfully practiced in the back of

> countless ambulances, no longer meets standard of care. And if it is that

> very mentor is the blasphemer, well, we must have outgrown him, so we can

> just toss him out too! I guess we will have to leave it to the personal

> injury attorneys to teach that lesson.

>

> The most unfortunate part of all this is that I remember seeing this very

> same conversation thread about ten years ago on alt.med.ems.

>

> Regards,

>

>

>

>

>

>