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Memory lane time! When my brother and I were young

we both had the mumps at the same time, and our cat

also had a foot injury (from a trap). When the

doctor came to the house (yes, I'm that old) to

check on my brother and I, he also examined and

treated the cat's foot. We all recovered nicely,

thank you.

On the other side of that coin, about 40 years ago a

friend of my husband had a shoulder injury. He had

been to the doctor several times and tried several

remedies, but the shoulder just didn't get better.

He told the vet who cared for his horses about the

shoulder problem. The vet told him about a horse

linament. Problem solved - the horse linament did

the job.

Those were the days!

Maxine Pate

---- Original message ----

Date: Sat, 3 Jun 2006 12:07:09 EDT

From: krin135@...

>

>Dudley, I was teasing...however, I will point out

that most vets could

>probably do a better job of treating a human than

most MD/DOs could do treating a

>horse!

>

>ck

>

> S. Krin, DO FAAFP

>

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Bottom line is we all have room for improvement. We can learn from each other

and take the valuable information and apply it were it works best in our field

of interest. I have learned new ideals from RN's, Doc's and other medics and

also from educators. There are those that are strong and weak in every field

with no exceptions. I have never had the opportunity to shadow a ER Doc but

would love the opportunity to watch one work a shift and pick there brain.

THEDUDMAN@... wrote: Doc,

I also believe, by reading all these posts, that EMS has a generally

over-inflated sense of both our importance and our abilities. By

reading these posts I am lead to believe that every call we run is

" crash-burn-die, life-saving, death-cheatin', knife and gun club " type

activity. I must have led a sheltered life as a Paramedic...because I

would only classify about 8 to 12 percent of the patients I have

treated as these.

The remainder were in various stages of health, various socio-economic

status, in and around common areas we all live, work and deal with.

The biggest majority needed someone who would listen to them, PAY

ATTENTION to them, and take their complaints seriously...even though

they didn't weigh 350 lbs, down 3 flights of muddy stairs, in the dark,

surrounded by drunk, load billegerent people. They possibly needed

some small interventions to help them feel better, make them more

comfortable and then they needed a compassionate ride to the ER where

hopefully we could hand them off to an MD and an RN that would listen

and pay attention to them so that they could return better off to their

families and loved ones who were worried sick because this was the

first time they had had any exposure to the healthcare system outside

of possibly their primary care physician if they were fortunate enough

to have one.

I agree, EMS does have some challenges...and the calls that Gene

describes certainly can be difficult and trying on the patience...but

even more important are the calls that are not physical and emotional

challenges...because we rarely teach new recruits, rookies,

paramedic-wanna-bes or whatever name we call them...that EMS has those

situations but the majority of what we do is listening, holding hands,

and giving rides to the hospital. Until we can teach both sides of

the coin...we will continue to have folks with poor job satisfaction

and short-term experience before they look elsewhere to progress their

medical career.

So, Doc, I'd be happy to shadow you for a few shifts...matter of fact,

if you were around SA, I would like to get all my medics to do the

same...because you may not be upside down in a ditch with 2 feet of

water around you in the rain at night...but I bet I could learn

somethng none the less....that I could apply to the one or two calls we

run that aren't like these EMS scenarios we have been reading.

Dudley

Re: Re: Protocol Testing

Gene,

Ok, I'll bite.

First, I agree with much of what you say, but if I gave you point by

point

on my agreements with you I think it would go to your head, and then we

might have trouble extricating you. =)

The main point that struck me is the exaggerated and really demeaning

way

that you referenced nurses and others (eg reference that RNs could only

teach paramedics about bed baths). That sort of literary device is

great

for a beer where you know your audience but not much for esprit de

corps on

the world wide web of EMS interested folks. That is the attitude I was

referring to that I believe may hinder EMS efforts to move forward.

I think that some our divergent opinions on protocol testing is because

I

think that I understand your training perhaps better than you

understand

mine (I do not really mean YOURS, but that of EMS.) I think that you

may

underestimate the level of education and experience of a typical EM

boarded

physician. Perhaps I am overestimating as I can only attest to my

personal

experience. It is possible that you may not have a good dialogue with

enough of them to know. I know that many MDs to not have much dialogue

with

EMS, often attitude is an issue. You would be amazed what you can

learn if

you shadowed an ER MD and listen and ask lots of questions.

Let me also respond that I think that I would be qualified to do

" protocol

testing " for a paramedic. No, I was never a paramedic. In fact,

because I

would be qualified to do some testing doesn't mean I would be qualified

to

do all of it or that I am qualified to be a paramedic. I am not an EMS

director and personally as of this moment would not be the best person

to do

the testing for a whole system. I have not done an EMS fellowship.

Could

I test RSI and field skills? You betcha... However, there is a lot

about

incident command, safety, driving emergency vehicles, extrication,

etc...

that I would not be qualified to perform.

I assume that my experience as an EM physician is close to average.

Perhaps

you are not aware that many of us, as part of our training, have hands

on

experience.

Assuming ER MDs had my training, then they would have:

-trained with 911 operators and observed calls and verbal lay person

protocols

-ridden the box and worked MANY shifts with paramedics, usually 12 or

more

hours at a time

-been able to give MCO orders in the field since they were present

-intubated in the field on a bouncing ambulance using a whistler nasally

-given multpile lectures to EMS students

-reviewed protocols with EMS directors for potential issues and

improvements

-reviewed EMS charts for QA

-perhaps done EMS research

-performed paramedic testing to insure adequate fund of knowledge

-ridden in EMS helicopters for transport

-given countless complicated medical direction to incoming fixed wing

and

helicopter crews, sometimes for patients transported for hours

-and of course be used to waking up on call and working many codes and

resusciatiions of complex medical ICU patients with very little time to

assimilate the data, and a lot of folks running around (not so unlike

being

at a nightclub as a paramedic!)

So, I appreciate that your job is difficult and that you must perform

it

under circumstances that are different than a hospital. However, I

think

that the paramedic model is operating under the license of an MD who

ultimately is reponsible, or should be, for their performance. As

such, I

believe it is up to them to dictate testing. I suspect many directors

involve senior level paramedics to do much of this testing. I don't

really

see how you compare an EMS MD doing paramedic testing to you as a

paramedic

evaluating an ER MDs work in the hospital. Not even close my friend,

cheers....

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

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In a message dated 03-Jun-06 19:14:17 Central Daylight Time,

durrahf@... writes:

To all at the texasems, I regret to inform you that my husband, durrah

Foshee passed away in Afghanistan on May 25th 2006. I will be closing his

account soon. Thank all of you whom he had conversation with and I know that

ya.ll made his term there easier. Thabk you again, Tawnya P. Foshee

I'm sorry to hear that, Mrs. Foshee...

To Absent Comrades!

ck

S. Krin, DO FAAFP

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To all at the texasems, I regret to inform you that my husband, durrah Foshee

passed away in Afghanistan on May 25th 2006. I will be closing his account

soon. Thank all of you whom he had conversation with and I know that ya.ll

made his term there easier. Thabk you again, Tawnya P. Foshee

tawya_pingree@...

Re: Protocol Testing

>

> I have yet to see a reason why nurses should test paramedics? You

> don't see paramedics testing nurses? Kind of seems like a step in the

> wrong direction to start having the hospital staff train/test people

> who work prehospital.

>

> IMHO, thats like asking a vet to test dental students.

>

> Nate

>

>

>

>

>

>

>

>

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Kirk,

First of all, just about everybody on here and around the state knows me

and how I write. They know not to take everything I say literally. As far as

anything going to my head, if it's not 80 proof, forgeddaboudit. I don't

expect bouquets, but I'm always watching for brickbats.

Second, I probably was shadowing ER physicians when you were in diapers.

I've worked with a family practice physician, set up systems, been on

committees with lots of physicians on them, had them on advisory boards, and I

count

many ED physicians and other physicians as friends.

I am well aware of what their training and education are and what mine is

not.

My sister is an RN, and I have plenty of knowledge about how hard her job is

and what she can do. I work in the SLAM program with nurse/paramedics who

are at the very top of their game.

There is and always has been a mostly friendly tension between nurses and

medics. My remark about bed baths was nothing out of the ordinary. That's

the

most benign thing that medics might say. The nurses have their own little

jabs aimed at medics, and we trade them all the time while remaining friends.

This list is an open, free wheeling list. It needs a little humor and

piquant writing to keep everyone from nodding off.

If you notice, most of the outrageous things I say usually result in some

very good and thoughtful discussion.

So take a deep breath and relax. I don't hate nurses. I don't hate ER

docs. I do think they have their limitations in EMS matters.

Every situation depends upon its own unique facts. Sure, there are medical

directors who could work the street tomorrow and do a credible job. And

there are some nurses. But for the most part, each of them delivers their care

in a completely different environment from ours.

I just got back from a call involving an acute exacerbation of a chronic

medical condition in an obese, diabetic, medication non-compliant patient.

Everything about the call was difficult. The house was cramped and furniture

had

to be moved. There were two upset dogs in the room plus several other people

adding what they thought were helpful hints to the situation, but in reality

they were not helpful. I sent them to gather up the medications.

Without going further and disclosing PHI I will only say that there were at

least 5 complicating factors that might have been responsible for the patient's

current complaint, one in which we were required to choose among several

treatment modalities. The level of critical thinking that went on in that call

was just as high as would be happening in the ER. Just knowing the

implications of the medications prescribed and possible interactions was near

the top

of the list. Our decisions had to be made without lab reports, which would

have made it a great deal easier. But we did it right. Of course, we had to

endure a bunch of rude questions from the ER doc who didn't have a clue what

had gone on, and not a hint of thanks or appreciation for having gotten the

patient there in good shape. We're used to that. It's the norm.

You have an obvious interest in the prehospital aspects of medicine, or you

wouldn't be here. So let's talk about how we can bring physicians, nurses,

and medics closer together and help them learn to appreciate the others. Any

ideas?

Gene

> Gene,

>

> Ok, I'll bite.

>

> First, I agree with much of what you say, but if I gave you point by point

> on my agreements with you I think it would go to your head, and then we

> might have trouble extricating you.  =)

>

>

> The main point that struck me is the exaggerated and really demeaning way

> that you referenced nurses and others (eg reference that RNs could only

> teach paramedics about bed baths).  That sort of literary device is great

> for a beer where you know your audience but not much for esprit de corps on

> the world wide web of EMS interested folks.  That is the attitude I was

> referring to that I believe may hinder EMS efforts to move forward.

>

> I think that some our divergent opinions on protocol testing is because I

> think that I understand your training perhaps better than you understand

> mine (I do not really mean YOURS, but that of EMS.)  I think that you may

> underestimate the level of education and experience of a typical EM boarded

> physician.  Perhaps I am overestimating as I can only attest to my personal

> experience.  It is possible that you may not have a good dialogue with

> enough of them to know.  I know that many MDs to not have much dialogue with

> EMS, often attitude is an issue.  You would be amazed what you can learn if

> you shadowed an ER MD and listen and ask lots of questions.

>

> Let me also respond  that I think that I would be qualified to do " protocol

> testing " for a paramedic.  No, I was never a paramedic.  In fact, because I

> would be qualified to do some testing doesn't mean I would be qualified to

> do all of it or that I am qualified to be a paramedic.  I am not an EMS

> director and personally as of this moment would not be the best person to do

> the testing for a whole system.  I have not done an EMS fellowship.   Could

> I test RSI and field skills?  You betcha... However, there is a lot about

> incident command, safety, driving emergency vehicles, extrication, etc...

> that I would not be qualified to perform.

>

> I assume that my experience as an EM physician is close to average.  Perhaps

> you are not aware that  many of us, as part of our training, have hands on

> experience.

>

> Assuming ER MDs had my training, then they would have:

>

> -trained with 911 operators and observed calls and verbal lay person

> protocols

> -ridden the box and worked MANY shifts with paramedics, usually 12 or more

> hours at a time

> -been able to give MCO orders in the field since they were present

> -intubated in the field on a bouncing ambulance using a whistler nasally

> -given multpile lectures to EMS students

> -reviewed protocols with EMS directors for potential issues and improvements

> -reviewed EMS charts for QA

> -perhaps done EMS research

> -performed paramedic testing to insure adequate fund of knowledge

> -ridden in EMS helicopters for transport

> -given countless complicated medical direction to incoming fixed wing and

> helicopter crews, sometimes for patients transported for hours

> -and of course be used to waking up on call and working many codes and

> resusciatiions of complex medical ICU patients with very little time to

> assimilate the data, and a lot of folks running around (not so unlike being

> at a nightclub as a paramedic!)

>

> So, I appreciate that your job is difficult and that you must perform it

> under circumstances that are different than a hospital.  However, I think

> that the paramedic model is operating under the license of an MD who

> ultimately is reponsible, or should be, for their performance.  As such, I

> believe it is up to them to dictate testing.  I suspect many directors

> involve senior level paramedics to do much of this testing.  I don't really

> see how you compare an EMS MD doing paramedic testing to you as a paramedic

> evaluating an ER MDs work in the hospital.  Not even close my friend,

>

> cheers....

>

> Kirk D. Mahon, MD, ABEM

>

> 6106 Keller Springs Rd

> Dallas, TX 75248

>

>

>

>

>

>

>

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Right. Hell, I just ran another call (not a CPR thank God) that contained

about 85% of those elements and nobody got even the slightest bit excited. It

was handled with dispatch and competence.

GG

> Damm Gene,

> That sounds like the last CPR I ran. LOL......The hospital folks couldnt

> handle it.

>

> Tom

>

>

>

>

> Re: Protocol Testing

> >

> > I have yet to see a reason why nurses should test paramedics? You

> > don't see paramedics testing nurses? Kind of seems like a step in the

> > wrong direction to start having the hospital staff train/test people

> > who work prehospital.

> >

> > IMHO, thats like asking a vet to test dental students.

> >

> > Nate

> >

> >

> >

> >

> >

> >

> >

> >

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Tawnya,

I'm sorry for your loss!! Thank you for your families committment to our

Country.

I didn't know your husband, but I would like to acknowledge his and your

sacrifice for all of us!!

God Bless,

Wiseman

Re: Protocol Testing

> >

> > I have yet to see a reason why nurses should test paramedics? You

> > don't see paramedics testing nurses? Kind of seems like a step in the

> > wrong direction to start having the hospital staff train/test people

> > who work prehospital.

> >

> > IMHO, thats like asking a vet to test dental students.

> >

> > Nate

> >

> >

> >

> >

> >

> >

> >

> >

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Tawnya,

I am truely sorry for your loss. Your husband's service and

sacrifice as well as yours will not be forgotten. Please feel free to

contact me if there is anything that I can do for you or your family

during this difficult time.

Respectfully,

Vaughn EMT-P

>

> To all at the texasems, I regret to inform you that my husband,

durrah Foshee passed away in Afghanistan on May 25th 2006. I will

be closing his account soon. Thank all of you whom he had

conversation with and I know that ya.ll made his term there easier.

Thabk you again, Tawnya P. Foshee

> tawya_pingree@...

>

> Re: Protocol Testing

> >

> > I have yet to see a reason why nurses should test paramedics? You

> > don't see paramedics testing nurses? Kind of seems like a step

in the

> > wrong direction to start having the hospital staff train/test people

> > who work prehospital.

> >

> > IMHO, thats like asking a vet to test dental students.

> >

> > Nate

> >

> >

> >

> >

> >

> >

> >

> >

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You bet that most vets would be better in treating humans than ER docs would

be in treating horses.

Lots of doctors seem to think they are dealing with animals when they

encounter humans.

For the first time in my life, all my docs are D.O.s. I find that there is

a vast difference between their approach to my health and the MDs that I have

had previously.

The DOs take the time to talk to me, to delve into my medical history, and to

engage me in my treatments.

My experience with MDs has not been so good. I have found that MDs have an

attitude of superiority that gets in the way of their communications with

patients.

I will never again have an MD as my primary physician if I can possibly avoid

it.

Gene G.

>

> In a message dated 03-Jun-06 10:59:51 Central Daylight Time, 

> THEDUDMAN@... writes:

>

> Only one  small difference....EMS, RN, and MD/DO's and even DDS's ALL

> treat  humans...vets don't.  Comparing an RN testing/training an EMS

> person  to an animal vet teaching a human dentist might speak about how

> you feel  about your patients...but it is no true comparison...

>

>

>

> Dudley, I was teasing...however, I will point  out that most vets could

> probably do a better job of treating a human than most  MD/DOs could do

> treating a

> horse!

>

> ck

>

> S. Krin, DO  FAAFP

>

>

>

>

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Oh Gene, you that's not true. You're not predjudice, you just hate everybody.

wegandy1938@... wrote:

Kirk,

First of all, just about everybody on here and around the state knows me

and how I write. They know not to take everything I say literally. As far as

anything going to my head, if it's not 80 proof, forgeddaboudit. I don't

expect bouquets, but I'm always watching for brickbats.

Second, I probably was shadowing ER physicians when you were in diapers.

I've worked with a family practice physician, set up systems, been on

committees with lots of physicians on them, had them on advisory boards, and I

count

many ED physicians and other physicians as friends.

I am well aware of what their training and education are and what mine is

not.

My sister is an RN, and I have plenty of knowledge about how hard her job is

and what she can do. I work in the SLAM program with nurse/paramedics who

are at the very top of their game.

There is and always has been a mostly friendly tension between nurses and

medics. My remark about bed baths was nothing out of the ordinary. That's the

most benign thing that medics might say. The nurses have their own little

jabs aimed at medics, and we trade them all the time while remaining friends.

This list is an open, free wheeling list. It needs a little humor and

piquant writing to keep everyone from nodding off.

If you notice, most of the outrageous things I say usually result in some

very good and thoughtful discussion.

So take a deep breath and relax. I don't hate nurses. I don't hate ER

docs. I do think they have their limitations in EMS matters.

Every situation depends upon its own unique facts. Sure, there are medical

directors who could work the street tomorrow and do a credible job. And

there are some nurses. But for the most part, each of them delivers their care

in a completely different environment from ours.

I just got back from a call involving an acute exacerbation of a chronic

medical condition in an obese, diabetic, medication non-compliant patient.

Everything about the call was difficult. The house was cramped and furniture had

to be moved. There were two upset dogs in the room plus several other people

adding what they thought were helpful hints to the situation, but in reality

they were not helpful. I sent them to gather up the medications.

Without going further and disclosing PHI I will only say that there were at

least 5 complicating factors that might have been responsible for the patient's

current complaint, one in which we were required to choose among several

treatment modalities. The level of critical thinking that went on in that call

was just as high as would be happening in the ER. Just knowing the

implications of the medications prescribed and possible interactions was near

the top

of the list. Our decisions had to be made without lab reports, which would

have made it a great deal easier. But we did it right. Of course, we had to

endure a bunch of rude questions from the ER doc who didn't have a clue what

had gone on, and not a hint of thanks or appreciation for having gotten the

patient there in good shape. We're used to that. It's the norm.

You have an obvious interest in the prehospital aspects of medicine, or you

wouldn't be here. So let's talk about how we can bring physicians, nurses,

and medics closer together and help them learn to appreciate the others. Any

ideas?

Gene

> Gene,

>

> Ok, I'll bite.

>

> First, I agree with much of what you say, but if I gave you point by point

> on my agreements with you I think it would go to your head, and then we

> might have trouble extricating you. =)

>

>

> The main point that struck me is the exaggerated and really demeaning way

> that you referenced nurses and others (eg reference that RNs could only

> teach paramedics about bed baths). That sort of literary device is great

> for a beer where you know your audience but not much for esprit de corps on

> the world wide web of EMS interested folks. That is the attitude I was

> referring to that I believe may hinder EMS efforts to move forward.

>

> I think that some our divergent opinions on protocol testing is because I

> think that I understand your training perhaps better than you understand

> mine (I do not really mean YOURS, but that of EMS.) I think that you may

> underestimate the level of education and experience of a typical EM boarded

> physician. Perhaps I am overestimating as I can only attest to my personal

> experience. It is possible that you may not have a good dialogue with

> enough of them to know. I know that many MDs to not have much dialogue with

> EMS, often attitude is an issue. You would be amazed what you can learn if

> you shadowed an ER MD and listen and ask lots of questions.

>

> Let me also respond that I think that I would be qualified to do " protocol

> testing " for a paramedic. No, I was never a paramedic. In fact, because I

> would be qualified to do some testing doesn't mean I would be qualified to

> do all of it or that I am qualified to be a paramedic. I am not an EMS

> director and personally as of this moment would not be the best person to do

> the testing for a whole system. I have not done an EMS fellowship. Could

> I test RSI and field skills? You betcha... However, there is a lot about

> incident command, safety, driving emergency vehicles, extrication, etc...

> that I would not be qualified to perform.

>

> I assume that my experience as an EM physician is close to average. Perhaps

> you are not aware that many of us, as part of our training, have hands on

> experience.

>

> Assuming ER MDs had my training, then they would have:

>

> -trained with 911 operators and observed calls and verbal lay person

> protocols

> -ridden the box and worked MANY shifts with paramedics, usually 12 or more

> hours at a time

> -been able to give MCO orders in the field since they were present

> -intubated in the field on a bouncing ambulance using a whistler nasally

> -given multpile lectures to EMS students

> -reviewed protocols with EMS directors for potential issues and improvements

> -reviewed EMS charts for QA

> -perhaps done EMS research

> -performed paramedic testing to insure adequate fund of knowledge

> -ridden in EMS helicopters for transport

> -given countless complicated medical direction to incoming fixed wing and

> helicopter crews, sometimes for patients transported for hours

> -and of course be used to waking up on call and working many codes and

> resusciatiions of complex medical ICU patients with very little time to

> assimilate the data, and a lot of folks running around (not so unlike being

> at a nightclub as a paramedic!)

>

> So, I appreciate that your job is difficult and that you must perform it

> under circumstances that are different than a hospital. However, I think

> that the paramedic model is operating under the license of an MD who

> ultimately is reponsible, or should be, for their performance. As such, I

> believe it is up to them to dictate testing. I suspect many directors

> involve senior level paramedics to do much of this testing. I don't really

> see how you compare an EMS MD doing paramedic testing to you as a paramedic

> evaluating an ER MDs work in the hospital. Not even close my friend,

>

> cheers....

>

> Kirk D. Mahon, MD, ABEM

>

> 6106 Keller Springs Rd

> Dallas, TX 75248

>

>

>

>

>

>

>

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ACLS, PALS, CPR, etc… those are not valid examples since those

certifications are very broad in whom they are targeted at. AHA even

states that some areas of the course aren't designed for every level

of provider that the course targets. So while an RN, a paramedic, or

an MD might teach the class; it still does not qualify them as

having the ability to test someone on their protocols that are used

on the ambulance.

I do not even feel that all doctors are qualified to test the medics

who follow their protocols, regardless of whether or not they wrote

them. We all know there are doctors who are active in EMS and their

medics, and those who are not as active. So how do you expect a

doctor who does not even care enough to get involved to test their

medic's? How can you expect someone who has never been in the role

of a paramedic (excluding doctors)to test another paramedic? How do

you expect them to look at the person testing and to be able to

watch and know that the person they are testing is probably going to

perform well on the street?

We have all seen paramedics out there who were great when sitting

around the station and armchair quarterbacking. However, the minute

you put them in the middle of a real live scene (be it simple or

complex) they freeze up? An experienced examiner can pick some of

these characteristics out; they have seen the faults that show up in

testing that are huge on the street. If you have never seen this,

how can you be expected to look for this warning signs?

I think the medical director should take an active role in their

medic's patient care, and I'm grateful that the ER's I visit have

doctors there that allow me to pick their brains and take time out

of their day to answer a question I might have. However, we all know

this is not the case across Texas or America.

My best solution to the problem would be for the medical director to

observe with an experienced paramedic, and then between the two of

them they can rate how the candidate did. I will leave everyone with

this to chew over. Paramedics and other EMS personal skills test our

EMS students in the colleges throughout Texas, so why would we not

expect them to do the same as providers outside of the school?

Nate

PS: I'm capable of telling you how I feel about my patients if you

ever wanted to know. Making uneducated guesses when you have no idea

who I am is not the best solution to the question.

>

> Only one small difference....EMS, RN, and MD/DO's and even DDS's

ALL

> treat humans...vets don't. Comparing an RN testing/training an

EMS

> person to an animal vet teaching a human dentist might speak about

how

> you feel about your patients...but it is no true comparison...

>

> Dudley

>

> PS: Paramedics teach and test nurses all the time in all types of

> courses (ACLS, PALS, CPR, BTLS, etc). Don't believe I have seen

TNA or

> BNE advocate only RN's can teach and train RN's....but then again

we

> can't learn anything from them anyway...

>

>

>

> Re: Re: Protocol Testing

>

>

>

> In a message dated 02-Jun-06 07:44:05 Central Daylight Time,

> medicnate2004@... writes:

>

> I have yet to see a reason why nurses should test paramedics? You

> don't see paramedics testing nurses? Kind of seems like a step in

the

> wrong direction to start having the hospital staff train/test

people

> who work prehospital.

>

> IMHO, thats like asking a vet to test dental students.

>

> Nate

>

>

> Considering that there are cases where Dentists have learned to

> rebuild

> teeth and jaws on animals....who do you think did the teaching?

>

> S. Krin, DO FAAFP

>

>

>

>

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Another good man make the ultimate sacrifice for his country. Sure makes

our bitchs and gripes sound petty. Mrs. Foshee, you should and I know

you are very proud of your husband. I am so sorry for your loss.

Henry Barber

krin135@... wrote:

>

> In a message dated 03-Jun-06 19:14:17 Central Daylight Time,

> durrahf@... writes:

>

> To all at the texasems, I regret to inform you that my husband,

> durrah

> Foshee passed away in Afghanistan on May 25th 2006. I will be

> closing his

> account soon. Thank all of you whom he had conversation with and I

> know that

> ya.ll made his term there easier. Thabk you again, Tawnya P.

> Foshee

>

>

>

> I'm sorry to hear that, Mrs. Foshee...

>

> To Absent Comrades!

>

> ck

>

> S. Krin, DO FAAFP

>

>

>

>

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Mrs. Foshee, your husband's sacrifice will never be forgotten. Please accept

our humblest thoughts and prayers for you and your family.

Jane Hill

-------------- Original message from Henry :

--------------

Another good man make the ultimate sacrifice for his country. Sure makes

our bitchs and gripes sound petty. Mrs. Foshee, you should and I know

you are very proud of your husband. I am so sorry for your loss.

Henry Barber

krin135@... wrote:

>

> In a message dated 03-Jun-06 19:14:17 Central Daylight Time,

> durrahf@... writes:

>

> To all at the texasems, I regret to inform you that my husband,

> durrah

> Foshee passed away in Afghanistan on May 25th 2006. I will be

> closing his

> account soon. Thank all of you whom he had conversation with and I

> know that

> ya.ll made his term there easier. Thabk you again, Tawnya P.

> Foshee

>

>

>

> I'm sorry to hear that, Mrs. Foshee...

>

> To Absent Comrades!

>

> ck

>

> S. Krin, DO FAAFP

>

>

>

>

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Mr. Gandy,

When you lectured at SLAM I really enjoyed what you had to say and I

learned quite a bit. Some of the comments you made, I passed on to

my Paramedic students. I have to say that I am a little confused as

to your " tone " in your reply. The MD is our Medical Director and

the nurse is also a Paramedic with field experience. Maybe it is

just a miscommunication, I hope. These are the folks who teach our

CE's and are very sharp individuals. I always try to emphasize to

my students about the old pseudo feud between nurses and paramedics

is a bunch of crap. That nurses think medics are stupid and vice

versa should be on the way out. In my opinion we are all part of a

team working together to treat our patients.

> > >

> > > Wayne,

> > >

> > > I agree with Gene, competency based evaluation is the only way

to

> > go.

> > >

> > > My question to your agency is why create 2 different leveles?

Why

> > not expect

> > > all your paramedics to be able to perform at an expected

level?

> > This sounds

> > > like you are moving back to the EMT/Paramedic team approach,

which

> > while it

> > > does have limited advantages, dual medics is much more

desired. It

> > seems

> > > like it would confuse staffing problems, with differenct

levels of

> > > paramedics instead of just 1 standard.

> > >

> > >

> > > Protocol Testing

> > >

> > >

> > > Here is a question for those of you that require testing of

> > personnel on

> > > service protocols. My company wants to establish this type of

> > testing, as

> > > they want to develop a level 1 & 2 for each level. Ex: Level

2

> > paramedics

> > > would be allowed to do more advanced procedures, such as RSI,

> > while the

> > > level 1 paramedics would not be able to do this unless tested

and

> > cleared by

> > > the MD.

> > >

> > > Where do most of you come up with your testing questions?

Is

> > there a good

> > > test bank that can be bought, or does each service develop

their

> > own

> > > questions and skills testing for protocols?

> > >

> > > Your input would be appreciated.

> > >

> > > Wayne

> > >

> > >

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

> > > Blab-away for as little as 1¢/min. Make PC-to-Phone Calls

using

> > Yahoo!

> > > Messenger with Voice.

> > >

> > >

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One last one on this thread and then I am out...

" How can you expect someone who has never been in the role of a paramedic

(excluding doctors) to test another paramedic? "

Here is an idea...the same method you use to know a paramedic can test ANOTHER

paramedic would probably work for other health care providers...does the mere

fact that they have run some calls in the field and are not branded as " great in

the station arm chair quarterbacking " make them qualified to tell who can do

what?

I know a lot of medics who have been in the field for many years (10+) that are

great in performing skills (they can tube a cinder block wall) but I sure

wouldn't want them evaluating the skills of any other paramedics...because they

sure have difficulty in recognizing the need to perform (or not perform) those

skills in a critical situation...and besides doing those skills...that is about

all they have exceled in...

So, we are all quick to say don't judge me doc and nurse...but exactly what

objective criteria do we use to evaluate which red patch can truly judge another

red patch?

Dudley

Re: Re: Protocol Testing

>

>

>

> In a message dated 02-Jun-06 07:44:05 Central Daylight Time,

> medicnate2004@... writes:

>

> I have yet to see a reason why nurses should test paramedics? You

> don't see paramedics testing nurses? Kind of seems like a step in

the

> wrong direction to start having the hospital staff train/test

people

> who work prehospital.

>

> IMHO, thats like asking a vet to test dental students.

>

> Nate

>

>

> Considering that there are cases where Dentists have learned to

> rebuild

> teeth and jaws on animals....who do you think did the teaching?

>

> S. Krin, DO FAAFP

>

>

>

>

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Guest guest

I am sure that the nursing industry finds itself in the same

position as we are in regards to " how do we know they are qualified

to test fellow persons of similar certification? " I feel that is

going to be something that is going to have to be evaluated by each

and every service (similar to picking those who make up your FTO,

education, and quality assurance departments).

I just feel that for to long we have made exceptions in the EMS

industry because of one thing or another. This is only one of the

many areas that EMS needs to take control over, and stop allowing

exceptions to the rule (but that is another topic for another time).

In reference to your other post, I must agree that we need to move

more towards educating in the academic world, and less in the

private sector. The medical schools and nursing institutions of this

nation do not educate in the motor pool as you put it, so why should

we. Sadly to say, but I feel that it is going to be a lot longer

before EMS unites as an industry and stops with the exceptions.

Nate

> >

> > Only one small difference....EMS, RN, and MD/DO's and even DDS's

> ALL

> > treat humans...vets don't. Comparing an RN testing/training an

> EMS

> > person to an animal vet teaching a human dentist might speak

about

> how

> > you feel about your patients...but it is no true comparison...

> >

> > Dudley

> >

> > PS: Paramedics teach and test nurses all the time in all types

of

> > courses (ACLS, PALS, CPR, BTLS, etc). Don't believe I have seen

> TNA or

> > BNE advocate only RN's can teach and train RN's....but then

again

> we

> > can't learn anything from them anyway...

> >

> >

> >

> > Re: Re: Protocol Testing

> >

> >

> >

> > In a message dated 02-Jun-06 07:44:05 Central Daylight Time,

> > medicnate2004@ writes:

> >

> > I have yet to see a reason why nurses should test paramedics?

You

> > don't see paramedics testing nurses? Kind of seems like a step

in

> the

> > wrong direction to start having the hospital staff train/test

> people

> > who work prehospital.

> >

> > IMHO, thats like asking a vet to test dental students.

> >

> > Nate

> >

> >

> > Considering that there are cases where Dentists have learned to

> > rebuild

> > teeth and jaws on animals....who do you think did the teaching?

> >

> > S. Krin, DO FAAFP

> >

> >

> >

> >

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