Random thoughts on education and mudslingin

July 16, 2004

> > wes True but I firmly think that EMS students should get their

hands

> > dirty getting in on surgies and a mourge rotiaon I would even

like to

> > see a cadver lab at some point and why well looking at a book

and

> > reading it are not the same as seeing it here we can do ride

time and

> > clincial after we have finnshed the class room segemt I think

we

> > should do clincial and class time at the same time if you are

studying

> > cardiac you should do time on a Icu or a TLemtrey unit you

> learn

> > that way

>

> And yet here is a perfect post illustrating Wes' point. No

punctuation, no

> sense of grammar or spelling, no sign of higher education at all:

it's not

> pretty. Can you imagine the run reports written in this style?

Or, trying

> to communicate with a nurse in a run-on sentence?

>

> I'm sorry, folks, Wes is dead-on here - higher education shows

itself.

> My only disagreement is that one does not have to be formally

educated to

> have a higher education. Many people have self-taught themselves

all types

> of subjects... but, formal education is the only way we have to

> *track* that learning.

>

> Mike

>

Ok guys lets circle them there wagons tighter so we can do more

damage to them there non educated Indians…I can't believe that so

called educated folks would write this dribble. I would rather have

a poor speller and English lit challenged medic work with and have

them work on my family than to have egomaniacs. Why did ya'll attack

this guy in an open forum, you could have at least removed his name

and you still would have made your point. This was a post not an

article in NY Times. But nooooo you had to show everybody how smart

you are. This is the prime example of why education doesn't mean

better, it just means bigger words and pretty writing. C'mon folks

for those that have a college education instead of finding things to

elevate your status why not elevate those around you? Has anyone

here not seen a rookie LP try to take over a call from a veteran

medic. Now we're supposed to mind or P's n Q's and god forbid us if

we leave our participle dangling in order to post thoughts and

concerns about EMS in an open forum or is this only for degreed

EMS? For all the studies there has been can you show me where LP or

college EMS programs have produced a medic with higher level of care

than the others. I'm beginning to see that a lack of oversight is

the problem not the education. If you are in a supervisory or Med

Control position and the staff under you are writing poor patient

reports and you've done nothing but scream from the mountain tops

that if they were educated they would know better then you have done

diddly squat about the problem. All the years I've been doing this I

have only sat through one class on report writing provided by my

service. Is that an education or a oversight issue. I can't count

the number of times that management has bitched about reports and

then went off to play golf. Weren't all of Enron's executives

college boys?

Now before you get the rope ready for the neck stretchin'. I'll

freely admit a college education is very important and needed in

today's world. But education is only the base to build off of. I

wonder if the Eiffel tower needed a larger base? Pushing for college

medics is and should be a good thing but doing so at the cost of

making others look bad is poor leadership. I read this post and sat

there shaking my head wondering if it was a put on. Because how

could anyone critique a post in that fashion without realizing they

were attacking that writer? Do they teach you in college that

because of your superior mind power that you have a duty to show us

just how superior you are? Forcing your views only makes the

resistance stronger. Lack of leadership and oversight is the biggest

problem we face. Complacency seems to be the motto for EMS

management. " Let's not fix the problem it's much easier to blame it

on the medics. " Here are a few examples from this group.

Subject: RE: Re: New EMS Provider Levels- A Mossback

Medic's thoughts

1. Which EMS interventions are beneficial and which are not? The

OPALS study is providing some light on this.

Me: This would be a Medical Control issue. Not every Dr. would

agree. That's why we have different protocols. Example MAST pants

were going to save the world, where are they now?

2. The more skills/drugs you place in a paramedics armamentarium, the

greater the potential for skills decay and the greater the need for

ongoing training.

Me: The more experience along with continued education you have with

these additional tools the more proficient you become. Example; 12

lead ekg in EMS has steadily become standard care. What's wrong with

continuing training?

3. Which treatments, although possibly beneficial, are cost-

effective? For example, should we buy this $13,500.00 Revivant CPR

vest when it will only possibly benefit 1-2 patients a year, per

ambulance (a very overstated estimate.

Me: Again a Medical Control and management issue. How is this

associated with a paramedic degree? Example: Do you buy a type I, II

or III ambulance. HP monitor or Physiocontrol is not a medics

decision and rarely do they have any input.

4. The problem with unsupervised field experience is that errors that

develop are never corrected. That is the reason EM (and all medical

specialities) went to a residency program--4 years of supervised

" experience " . As they say, it's not the exam, it's the training. I

have seen several great paramedics who developed poor skiils and

passed them on through preceptorship.

Me: Unsupervised, really then why are they required to ride along

with experience crews? If there is a problem with a particular

school or system then correct it through mediation involving Medical

Control and the services involved. The same goes for the great

paramedic with poor skills. Why is there no oversight system? And I

work under the umbrella of a medical control DR. isn't that

continued supervision? If you witnessed poor skills being passed on

and did nothing about it then you helped pass them too. If you fixed

the problem then why mention it? Example: I was fortunate to do 240

hours of internship with Dallas Fire & Rescue. To DF & R Station #38

thanks for the eye opening adventure. And that was followed up by

riding with FTO's. I have precepted college program paramedics that

went through the entire school without even seeing a CPR.

5. As Gene mentioned, health care in Canada and Australia is seen as

a

right--thus they put money into the ambulance system as it is a part

of the health care system. Paramedics are respected and paid a

liveable wage. (See my story at

http://www.bryanbledsoe.com/Pay.pdf). In this country, healthcare is

not a right. If it were made a right, Americans wouldn't like some

of the decisions that will then be made such as: " No, you can't have

a bypass untill you have stopped smoking for 6 months " or " I'm sorry

you are not eligible for a kidney transplant because you are over 65

years of age and your predicted longevity is so short that we can

not spare a valuable commodity (such as a kidney) for you " or " We'll

remove your gall bladder February 10, 2005. Come in at 6:00 AM and

don't eat or drink anything—and take these pills in the mean time. "

Liberals say that that we deserve health care as a right--but they

will complain about the way it has to work.

Me: The sad state of healthcare in the USA is probably the real

issue in this post. How can we all make a living when the lawyers,

insurance co. and HMO's have more say so than anyone else. But this

has what to do with degreed paramedics and not grandfathering? $$$$

is the issue.

Example: Austin/ County EMS has made the investment to provide

an aggressive and professional service. They seem to have succeeded

and I'm sure it cost a pretty penny. Those of us that haven't gone

through the necessary steps to provide a long term EMS are the ones

with continuing problems.

So to me it seems that most of the problems could be fixed by

having a higher oversight education. Management and Med Control that

is ready and willing to give whatever is needed to educate the

medics that are already doing the job. Not hiding from their

responsibility but instead finding ways that they can help elevate

their medics. How many systems ever have a confidence vote on their

supervisors? Just to see if the folks they lead have enough respect

in them to listen or follow. We have way too many leaders that

constantly are stepping on others to climb the ladder. In the

services I have been a part of there were always folks in a

leadership role that were clueless and were not respected. There for

useless leaders. Have you ever worked somewhere that didn't have one

of these? Ok Ok I'll get off my soap box….for now…

If you disagree that's ok just do it with a little class… ok let

the mudslingin' begin

Larry Feagin

Waxahachie TX

These are my opinions and are meant to only represent my thoughts.

July 19, 2004

That is what the National Registry of EMTs has been doing for the past few

years. http://www.nremt.org/about/lead_survey.asp

E. Bledsoe, DO, FACEP

Midlothian, TX

RE: Re: New EMS Provider Levels- A Mossback

>Medic's thoughts

>

>1. Which EMS interventions are beneficial and which are not? The

>OPALS study is providing some light on this.

>

>Me: This would be a Medical Control issue. Not every Dr. would

>agree. That's why we have different protocols. Example MAST pants

>were going to save the world, where are they now?

>

>2. The more skills/drugs you place in a paramedics armamentarium, the

>greater the potential for skills decay and the greater the need for

>ongoing training.

>

>Me: The more experience along with continued education you have with

>these additional tools the more proficient you become. Example; 12

>lead ekg in EMS has steadily become standard care. What's wrong with

>continuing training?

>

>3. Which treatments, although possibly beneficial, are cost-

>effective? For example, should we buy this $13,500.00 Revivant CPR

>vest when it will only possibly benefit 1-2 patients a year, per

>ambulance (a very overstated estimate.

>

>Me: Again a Medical Control and management issue. How is this

>associated with a paramedic degree? Example: Do you buy a type I, II

>or III ambulance. HP monitor or Physiocontrol is not a medics

>decision and rarely do they have any input.

>

>4. The problem with unsupervised field experience is that errors that

>develop are never corrected. That is the reason EM (and all medical

>specialities) went to a residency program--4 years of supervised

> " experience " . As they say, it's not the exam, it's the training. I

>have seen several great paramedics who developed poor skiils and

>passed them on through preceptorship.

>

>Me: Unsupervised, really then why are they required to ride along

>with experience crews? If there is a problem with a particular

>school or system then correct it through mediation involving Medical

>Control and the services involved. The same goes for the great

>paramedic with poor skills. Why is there no oversight system? And I

>work under the umbrella of a medical control DR. isn't that

>continued supervision? If you witnessed poor skills being passed on

>and did nothing about it then you helped pass them too. If you fixed

>the problem then why mention it? Example: I was fortunate to do 240

>hours of internship with Dallas Fire & Rescue. To DF & R Station #38

>thanks for the eye opening adventure. And that was followed up by

>riding with FTO's. I have precepted college program paramedics that

>went through the entire school without even seeing a CPR.

>

>5. As Gene mentioned, health care in Canada and Australia is seen as

>a

>right--thus they put money into the ambulance system as it is a part

>of the health care system. Paramedics are respected and paid a

>liveable wage. (See my story at

>http://www.bryanbledsoe.com/Pay.pdf). In this country, healthcare is

>not a right. If it were made a right, Americans wouldn't like some

>of the decisions that will then be made such as: " No, you can't have

>a bypass untill you have stopped smoking for 6 months " or " I'm sorry

>you are not eligible for a kidney transplant because you are over 65

>years of age and your predicted longevity is so short that we can

>not spare a valuable commodity (such as a kidney) for you " or " We'll

>remove your gall bladder February 10, 2005. Come in at 6:00 AM and

>don't eat or drink anything-and take these pills in the mean time. "

>Liberals say that that we deserve health care as a right--but they

>will complain about the way it has to work.

>

>Me: The sad state of healthcare in the USA is probably the real

>issue in this post. How can we all make a living when the lawyers,

>insurance co. and HMO's have more say so than anyone else. But this

>has what to do with degreed paramedics and not grandfathering? $$$$

>is the issue.

>Example: Austin/ County EMS has made the investment to provide

>an aggressive and professional service. They seem to have succeeded

>and I'm sure it cost a pretty penny. Those of us that haven't gone

>through the necessary steps to provide a long term EMS are the ones

>with continuing problems.

>

> So to me it seems that most of the problems could be fixed by

>having a higher oversight education. Management and Med Control that

>is ready and willing to give whatever is needed to educate the

>medics that are already doing the job. Not hiding from their

>responsibility but instead finding ways that they can help elevate

>their medics. How many systems ever have a confidence vote on their

>supervisors? Just to see if the folks they lead have enough respect

>in them to listen or follow. We have way too many leaders that

>constantly are stepping on others to climb the ladder. In the

>services I have been a part of there were always folks in a

>leadership role that were clueless and were not respected. There for

>useless leaders. Have you ever worked somewhere that didn't have one

>of these? Ok Ok I'll get off my soap box..for now.

>

> If you disagree that's ok just do it with a little class. ok let

>the mudslingin' begin

>

>Larry Feagin

>Waxahachie TX

>These are my opinions and are meant to only represent my thoughts.

>

July 19, 2004