Advice Needed

[Guest guest]

In a message dated 3/15/2007 11:03:14 A.M. Central Daylight Time,

paramedicmegan@... writes:

Well thank you for your time and listening to me, and if you have any advice

for a new, stupid, just out of school, green paramedic it would be

appreciated.

Not stupid, just frustrated with the " system " . My advice is learn the

system, work the system and you will be fine unless of course your system is the

real problem then the only advice one can offer is to change systems and that

means a move and the like.

Frustration when new is common, it's even more common among some of us

having done this for the better part of a quarter century.

I got my first card in 1981, I was gonna change the system and the ways of

the world. Now I know better but I can sleep well knowing I've done some good

here and there for both a patient and even in terms of changing some things on

a system level but these things they do take time. That's a fact of life

period.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

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

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

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

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[Guest guest]

I went on a call this morning and I tell you I have never felt

so...IDK...how to even put it in words. I felt like I knew nothing,

couldn't get my IV and get this I am not allowed to give narcotics.

The only other paramedic which hasnt had any sleep because she just

got off work had to take this pt. to town because of the sheer fact i

can't give drugs only unless she says I can or the " Director " says I

can. Isn't that why I have Paramedic behind my last name. I mean I

went to school, I passed the registry don't that mean something?? I

feel like I don't belong in this profession. Well thank you for your

time and listening to me, and if you have any advice for a new,

stupid, just out of school, green paramedic it would be appreciated.

[Guest guest]

unfortunately thats the quirks of being new....I went through the same thing

when I first started....give it time and be patient. SOME people,

unfortunately, look at " green " medics as someone who doesn't know anything....we

know better but you have to prove them wrong. Dont beat yourself up over it and

it will all work out...If you need anything just let me know.

wrote:

I went on a call this morning and I tell you I have never felt

so...IDK...how to even put it in words. I felt like I knew nothing,

couldn't get my IV and get this I am not allowed to give narcotics.

The only other paramedic which hasnt had any sleep because she just

got off work had to take this pt. to town because of the sheer fact i

can't give drugs only unless she says I can or the " Director " says I

can. Isn't that why I have Paramedic behind my last name. I mean I

went to school, I passed the registry don't that mean something?? I

feel like I don't belong in this profession. Well thank you for your

time and listening to me, and if you have any advice for a new,

stupid, just out of school, green paramedic it would be appreciated.

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

Get your own web address.

Have a HUGE year through Yahoo! Small Business.

[Guest guest]

Well said

________________________________

From: texasems-l [mailto:texasems-l ] On

Behalf Of Hatfield

Sent: Thursday, March 15, 2007 14:38

To: texasems-l

Subject: RE: Advice Needed

Lets try that with a little more clarity

>> <paramedicmegan@ <mailto:paramedicmegan%40yahoo.com> yahoo.com>

wrote:

>>I went on a call this morning and I tell you I have never felt

>>so...IDK...how to even put it in words. I felt like I knew nothing,

>>couldn't get my IV and get this I am not allowed to give narcotics.

>>The only other paramedic which hasnt had any sleep because she just

>>got off work had to take this pt. to town because of the sheer fact i

>>can't give drugs only unless she says I can or the " Director " says I

>>can. Isn't that why I have Paramedic behind my last name.

Nope, you have that behind you last name because you completed a course.

>>I mean I went to school, I passed the registry don't that mean

something??

Yep, it means you passed a written test

>>I feel like I don't belong in this profession. Well thank you for your

>>time and listening to me, and if you have any advice for a new,

>>stupid, just out of school, green paramedic it would be appreciated.

Now, a few things you need to understand, and all theses things are

said

without knowing you, your boss, your Medical Director or your system.

If your frustration is because you were not allowed to do anything to

your patient because you are a new paramedic, then be patient

Grasshopper, there are services that have orientation periods of 6

months before you are allowed to function on your own. What do your

SOP's say? How long, and who clears you to fly solo (so to speak)? Is

there certain criteria that must be met? We have a new medic that is 2

months in, and still being precepted, not unusual at all.

If your frustration is in not being perfect, hitting every IV, and never

missing a tube....OK, you gotta get used to it. I been doing this for a

few months now, and I still miss a tube here and there, and I still miss

IV's every now and then. High expectations of yourself are awesome, so

long as they remain realistic. Perfection is not realistic. Give

yourself some slack.

My best advice? Don't try to save the world. Be a sponge when it comes

to learning, never assume that you learned it all in school. Quit being

hard on yourself. When you got your drivers license the first time, were

you ready to cruise the Autobahn? I think not, look at this the same

way. Eventually, you will be happy content and terrorizing the newbies

yourself, and hopefully..HOPEFULLY, you will remember how you feel right

now and sympathize with them.

[Guest guest]

Meagan,

Take a deep breath, try to calm down a little, and relax, if at all possible.

What you are feeling is what most paramedics have felt when they first get their

certification, be it EMT, Intermediate, or Paramedic. A " newby " generally feels

that he/she can concur the world with their newly acquired knowledge.

You must realize that your new employer, your new training officer, and you

yourself all have a responsibility to verify the new employees have the

training,

knowledge, and ability to function at their level of certification. The amount

of

training that a company requires of the new hire once they are hired varies from

company to company. I know of two EMS providers with very extensive training

programs, Austin/ County EMS and DFW Airport Dept. of Public Safety. I am

talking about training programs lasting up to 6 months. I am sure there are

other

services with training programs lasting as long or longer periods of time.

This training is not because they, the service, does not trust you or does not

have

confidence in you. If they didn't have confidence in you, they wouldn't hire

you.

What they are doing is simply verifying your abilities through training,

observation, you actually performing in a controlled environment, and

documenting

this training and performance.

You have come to the right place for information. There are literally hundreds

of

very experienced EMS provders on this list server who are ready, willing, and

very

capable of answering your questions and giving you all the support they can.

Anytime that you have a question, you can come to this list server and ask your

question. You will generally receive quite a few responses, some that you will

not

agree with and some that you will agree with. Remember that people want to help

you.

Once you complete your required field training you will be released to function

at

the level of paramedic with your employer. Some day you may be in the position

of

a field training officer, preceptor, or mentor. You too will want to veryify

the

capabilities and training of those whom you are training/overseeing.

Do not get discouraged. Keep your chin up. Ask questions. You will make it

and

you will be good at what you do.

Sorry I have been so " long winded. " I, like many, many people on this

listserver,

have been involved in EMS for a long time. I want everyone to do well in EMS,

BUT,

I want everyone to be professional, competent, and an asset to the EMS

profession.

Education Manager

Champion EMS

Longview, Texas

> I went on a call this morning and I tell you I have never felt

>

>so...IDK...how to even put it in words. I felt like I knew nothing,

>

>couldn't get my IV and get this I am not allowed to give narcotics.

>

>The only other paramedic which hasnt had any sleep because she just

>

>got off work had to take this pt. to town because of the sheer fact i

>

>can't give drugs only unless she says I can or the " Director " says I

>

>can. Isn't that why I have Paramedic behind my last name. I mean I

>

>went to school, I passed the registry don't that mean something?? I

>

>feel like I don't belong in this profession. Well thank you for your

>

>time and listening to me, and if you have any advice for a new,

>

>stupid, just out of school, green paramedic it would be appreciated.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

[Guest guest]

Comments inline

From: texasems-l [mailto:texasems-l ] On

Behalf Of

Subject: Advice Needed

I went on a call this morning and I tell you I have never felt

so...IDK...how to even put it in words. I felt like I knew nothing,

couldn't get my IV and get this I am not allowed to give narcotics.

The only other paramedic which hasnt had any sleep because she just

got off work had to take this pt. to town because of the sheer fact i

can't give drugs only unless she says I can or the " Director " says I

can. Isn't that why I have Paramedic behind my last name.

Nope, you have that behind you last name because you completed a course.

I mean I

went to school, I passed the registry don't that mean something??

Yep, it means you passed a written test

I

feel like I don't belong in this profession. Well thank you for your

time and listening to me, and if you have any advice for a new,

stupid, just out of school, green paramedic it would be appreciated.

Now, a few things you need to understand, and all theses things are said

without knowing you, your boss, your Medical Director or your system.

If your frustration is because you were not allowed to do anything to

your patient because you are a new paramedic, then be patient

Grasshopper, there are services that have orientation periods of 6

months before you are allowed to function on your own. What do your

SOP's say? How long, and who clears you to fly solo (so to speak)? Is

there certain criteria that must be met? We have a new medic that is 2

months in, and still being precepted, not unusual at all.

If your frustration is in not being perfect, hitting every IV, and never

missing a tube....OK, you gotta get used to it. I been doing this for a

few months now, and I still miss a tube here and there, and I still miss

IV's every now and then. High expectations of yourself are awesome, so

long as they remain realistic. Perfection is not realistic. Give

yourself some slack.

My best advice? Don't try to save the world. Be a sponge when it comes

to learning, never assume that you learned it all in school. Quit being

hard on yourself. When you got your drivers license the first time, were

you ready to cruise the Autobahn? I think not, look at this the same

way. Eventually, you will be happy content and terrorizing the newbies

yourself, and hopefully..HOPEFULLY, you will remember how you feel right

now and sympathize with them.

Mike

[Guest guest]

Lets try that with a little more clarity

>> <paramedicmegan@ <mailto:paramedicmegan%40yahoo.com> yahoo.com>

wrote:

>>I went on a call this morning and I tell you I have never felt

>>so...IDK...how to even put it in words. I felt like I knew nothing,

>>couldn't get my IV and get this I am not allowed to give narcotics.

>>The only other paramedic which hasnt had any sleep because she just

>>got off work had to take this pt. to town because of the sheer fact i

>>can't give drugs only unless she says I can or the " Director " says I

>>can. Isn't that why I have Paramedic behind my last name.

Nope, you have that behind you last name because you completed a course.

>>I mean I went to school, I passed the registry don't that mean

something??

Yep, it means you passed a written test

>>I feel like I don't belong in this profession. Well thank you for your

>>time and listening to me, and if you have any advice for a new,

>>stupid, just out of school, green paramedic it would be appreciated.

Now, a few things you need to understand, and all theses things are

said

without knowing you, your boss, your Medical Director or your system.

If your frustration is because you were not allowed to do anything to

your patient because you are a new paramedic, then be patient

Grasshopper, there are services that have orientation periods of 6

months before you are allowed to function on your own. What do your

SOP's say? How long, and who clears you to fly solo (so to speak)? Is

there certain criteria that must be met? We have a new medic that is 2

months in, and still being precepted, not unusual at all.

If your frustration is in not being perfect, hitting every IV, and never

missing a tube....OK, you gotta get used to it. I been doing this for a

few months now, and I still miss a tube here and there, and I still miss

IV's every now and then. High expectations of yourself are awesome, so

long as they remain realistic. Perfection is not realistic. Give

yourself some slack.

My best advice? Don't try to save the world. Be a sponge when it comes

to learning, never assume that you learned it all in school. Quit being

hard on yourself. When you got your drivers license the first time, were

you ready to cruise the Autobahn? I think not, look at this the same

way. Eventually, you will be happy content and terrorizing the newbies

yourself, and hopefully..HOPEFULLY, you will remember how you feel right

now and sympathize with them.

[Guest guest]

Meagan,

has given you some very good advice and I agree with his

observations. Good luck and welcome to Texas EMS paramedicine. I'm sure you

will have

a very rewarding career in our EMS profession, but remember this, education

does not end with a certification, it begins. You are lucky to have an

employer who cares.

Maxie Bishop, Paramedic

************************************** AOL now offers free email to everyone.

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[Guest guest]

Let me ask you a question. Why are you not allowed to give narcotics?

What is the process of being cleared to do that in your service? Have you been

through all the steps in the process?

As to the IV miss, we all miss them. What you should be worried about is if

you miss them consistently.

Now, as to having finished paramedic school and passed the NREMT exam. That

tells ME absolutely NOTHING about your abilities to function as a paramedic.

The NREMT-pass tells me you have enough knowledge to pick out the right

answer from four supplied, but not much else. It certainly tells me nothing

about your abilities to take a history, do a physical, know and understand the

mechanisms of actions of all the drugs in your arsenal, interpret 10-lead EKGS

and apply your findings to a patient's condition, rapidly develop a mental list

of differential diagnoses soon after you first see your patient, and choose

the correct intervention and apply it. The NR exam tests none of those things.

I have no idea what the quality or content of your paramedic course was.

Was it the " 90 day wonder " version or a two year Associate Degree Program?

I've been a Paramedic for 26 years, and today I spent over three hours

reading articles and studying my copy of Hearst's The Heart, 11th edition, which

I

am systematically going through from start to finish. It's a 2,472 page book,

and I am on page 725.

Why am I telling you this? Because you ask what a new, green, paramedic can

do to improve. You also mentioned the word " stupid " which I refuse to buy.

You're not stupid, or else you wouldn't have asked for help.

What I'm trying to say is that after over 30 years in this business, I still

consider myself " green " in some ways. There is so much to learn and know

that I will never achieve the level that I would like to attain because I won't

live long enough-----but I try every day to learn new things and improve.

So my advice to you is this: First, learn your protocols from start to

finish, top to bottom, back to front. Don't just memorize them, but actually

THINK about what they mean.

Second, make a list of the drugs in your ambulance and start with one, go to

the Internet, read everything you can find about it, look up the terms you

don't understand, ask for help if you need it, and then go on to the next one

until you know the classification, indications, contraindications, doses,

precautions, adverse reactions, drug interactions, and, if applicaple,

overdose

management for every drug in your box. That will keep you busy for a while!

After that, pick a medical condition that you see frequently, such as

congestive heart failure with pulmonary edema, and start reading everything you

can

find out about it. Go to eMedicine Online and read the articles.

Invest in Tintinalli's Emergency Medicine, and read what it says about it in

that book. Become familiar with the current discussions about treatments,

the relative merits of nitroglycerine vs. furosemide, the pros and cons of

morphine, and so forth.

In other words, do something EVERY DAY to increase your knowledge and improve

your understanding of the conditions you treat, the tools you use to treat

them, and what you can expect from the use of those tools.

If you do that, you will find yourself getting better and better at

everything. If you continue to have problems starting IVs, stop and try to

figure out

what it is that you're missing. Review the anatomy and get a solid

knowledge of the veins and where to find them; are you failing to hit them? Or

are

you getting a flash but then not being able to thread the catheter? Are your

IVs " blowing? "

Figure out what the problem is, and attack it. Talk to the " old medics " and

find out their tricks.

You will find that if you do these things, you will not only overcome your

feelings of inadequacy, you will develop a professional attitude, improve your

knowledge and performance constantly, and soon be headed to a successful

career.

Success is 99% perspiration and 1% inspiration.

Your paramedic course, no matter how good it was, is only the beginning of

what you need to know. Passing the NR means only that you have met the MINIMUM

requirements.

A professional is a person who drives her own development and learning

processes from within. A professional does not need CE requirements or

external

rules to force him to do what is necessary to maintain knowledge, skills, and

performance. A professional is never satisfied with her own status, and spends

every day trying to improve.

If you determine to be a true professional and follow my suggestions, you

cannot lose.

Best of luck to you, and never stop learning.

Gene Gandy, JD, LP

>

> I went on a call this morning and I tell you I have never felt

> so...IDK...how to even put it in words. I felt like I knew nothing,

> couldn't get my IV and get this I am not allowed to give narcotics.

> The only other paramedic which hasnt had any sleep because she just

> got off work had to take this pt. to town because of the sheer fact i

> can't give drugs only unless she says I can or the " Director " says I

> can. Isn't that why I have Paramedic behind my last name. I mean I

> went to school, I passed the registry don't that mean something?? I

> feel like I don't belong in this profession. Well thank you for your

> time and listening to me, and if you have any advice for a new,

> stupid, just out of school, green paramedic it would be appreciated.

>

>

>

**************************************

AOL now offers free email to everyone.

Find out more about what's free from AOL at http://www.aol.com.

[Guest guest]

Dear ,

Being a new " green' paramedic is a challenge. We come out of school and get

certified or licensed and think we are going to change the world and save

everyone. I know I went through that. We think we are going to be able to do all

the things we learned in school and that we will fit right in. What we forget is

that our co-workers have been at this a lot longer than we have and we have to

" prove " ourselves. Many systems have a preceptor program where new employees are

" third ridden " with an experienced employee so they can get the hang of the

system, its policies, procedures,and protocols and be able to practice their

skills new or old under the preceptor's supervision. It is rare that a new

paramedic will be allowed to give drugs, especially narcotics without

supervision. Remember that we all work under a physician's license and if he or

she is not comfortable with our skills and knowledge we will not be able to

function as a paramedic. In the service I work for we have

to ride out with an experienced employee and then when they say we are good to

go we have to go through an interview with the medical director. He really

grills us on knowledge through direct answer questions and scenarios. The

bottom line is you are not the only new " green " paramedic who has felt this way,

we all go through it. Just be patient and do what your employer asks, learn as

much as you can from the more experienced employees of all levels not just

paramedics, and don't forget the basics, (ABC's). Before you know it you will be

the lead medic in charge of the scene and able to give the drugs as the patient

condition warrants. Good luck in this exciting career and congrats on your

certification.

Anita M.

NREMTP/LP

Take care and stay safe always.

" Commit to the Lord whatever you do, and your plans will succeed. "

(Proverbs: 16:3)

May God Smile on you today.

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

Food fight? Enjoy some healthy debate

in the Yahoo! Answers Food & Drink Q & A.

[Guest guest]

Gene,

As a fellow senior citizen I should caution you (It's a 2,472 page book, and I

am on page 725) that at your age you may not be able to accomplish this feat

with the amount of time you have left. It takes much less time to bait your hook

and cast. If I were you I would take up fishing so that you may accomplish more

than one task.

Henry

Re: Advice Needed

Let me ask you a question. Why are you not allowed to give narcotics?

What is the process of being cleared to do that in your service? Have you been

through all the steps in the process?

As to the IV miss, we all miss them. What you should be worried about is if

you miss them consistently.

Now, as to having finished paramedic school and passed the NREMT exam. That

tells ME absolutely NOTHING about your abilities to function as a paramedic.

The NREMT-pass tells me you have enough knowledge to pick out the right

answer from four supplied, but not much else. It certainly tells me nothing

about your abilities to take a history, do a physical, know and understand the

mechanisms of actions of all the drugs in your arsenal, interpret 10-lead EKGS

and apply your findings to a patient's condition, rapidly develop a mental

list

of differential diagnoses soon after you first see your patient, and choose

the correct intervention and apply it. The NR exam tests none of those things.

I have no idea what the quality or content of your paramedic course was.

Was it the " 90 day wonder " version or a two year Associate Degree Program?

I've been a Paramedic for 26 years, and today I spent over three hours

reading articles and studying my copy of Hearst's The Heart, 11th edition,

which I

am systematically going through from start to finish. It's a 2,472 page book,

and I am on page 725.

Why am I telling you this? Because you ask what a new, green, paramedic can

do to improve. You also mentioned the word " stupid " which I refuse to buy.

You're not stupid, or else you wouldn't have asked for help.

What I'm trying to say is that after over 30 years in this business, I still

consider myself " green " in some ways. There is so much to learn and know

that I will never achieve the level that I would like to attain because I

won't

live long enough-----but I try every day to learn new things and improve.

So my advice to you is this: First, learn your protocols from start to

finish, top to bottom, back to front. Don't just memorize them, but actually

THINK about what they mean.

Second, make a list of the drugs in your ambulance and start with one, go to

the Internet, read everything you can find about it, look up the terms you

don't understand, ask for help if you need it, and then go on to the next one

until you know the classification, indications, contraindications, doses,

precautions, adverse reactions, drug interactions, and, if applicaple,

overdose

management for every drug in your box. That will keep you busy for a while!

After that, pick a medical condition that you see frequently, such as

congestive heart failure with pulmonary edema, and start reading everything

you can

find out about it. Go to eMedicine Online and read the articles.

Invest in Tintinalli's Emergency Medicine, and read what it says about it in

that book. Become familiar with the current discussions about treatments,

the relative merits of nitroglycerine vs. furosemide, the pros and cons of

morphine, and so forth.

In other words, do something EVERY DAY to increase your knowledge and improve

your understanding of the conditions you treat, the tools you use to treat

them, and what you can expect from the use of those tools.

If you do that, you will find yourself getting better and better at

everything. If you continue to have problems starting IVs, stop and try to

figure out

what it is that you're missing. Review the anatomy and get a solid

knowledge of the veins and where to find them; are you failing to hit them? Or

are

you getting a flash but then not being able to thread the catheter? Are your

IVs " blowing? "

Figure out what the problem is, and attack it. Talk to the " old medics " and

find out their tricks.

You will find that if you do these things, you will not only overcome your

feelings of inadequacy, you will develop a professional attitude, improve your

knowledge and performance constantly, and soon be headed to a successful

career.

Success is 99% perspiration and 1% inspiration.

Your paramedic course, no matter how good it was, is only the beginning of

what you need to know. Passing the NR means only that you have met the MINIMUM

requirements.

A professional is a person who drives her own development and learning

processes from within. A professional does not need CE requirements or

external

rules to force him to do what is necessary to maintain knowledge, skills, and

performance. A professional is never satisfied with her own status, and spends

every day trying to improve.

If you determine to be a true professional and follow my suggestions, you

cannot lose.

Best of luck to you, and never stop learning.

Gene Gandy, JD, LP

>

> I went on a call this morning and I tell you I have never felt

> so...IDK...how to even put it in words. I felt like I knew nothing,

> couldn't get my IV and get this I am not allowed to give narcotics.

> The only other paramedic which hasnt had any sleep because she just

> got off work had to take this pt. to town because of the sheer fact i

> can't give drugs only unless she says I can or the " Director " says I

> can. Isn't that why I have Paramedic behind my last name. I mean I

> went to school, I passed the registry don't that mean something?? I

> feel like I don't belong in this profession. Well thank you for your

> time and listening to me, and if you have any advice for a new,

> stupid, just out of school, green paramedic it would be appreciated.

>

>

>

**************************************

AOL now offers free email to everyone.

Find out more about what's free from AOL at http://www.aol.com.

[Guest guest]

Riiiiiight!

BTW, Jane and I never got back to you about May. Jane kept putting off

talking to me about it, because she was too busy. Now I finally got her pinned

down, and she says she just cannot do it at that time.

However, I can, if you still want me.

G

>

> Gene,

>

> As a fellow senior citizen I should caution you (It's a 2,472 page book, and

> I am on page 725) that at your age you may not be able to accomplish this

> feat with the amount of time you have left. It takes much less time to bait

> your hook and cast. If I were you I would take up fishing so that you may

> accomplish more than one task.

>

> Henry

> Re: Advice Needed

>

> Let me ask you a question. Why are you not allowed to give narcotics?

> What is the process of being cleared to do that in your service? Have you

> been

> through all the steps in the process?

>

> As to the IV miss, we all miss them. What you should be worried about is if

> you miss them consistently.

>

> Now, as to having finished paramedic school and passed the NREMT exam. That

> tells ME absolutely NOTHING about your abilities to function as a paramedic.

> The NREMT-pass tells me you have enough knowledge to pick out the right

> answer from four supplied, but not much else. It certainly tells me nothing

> about your abilities to take a history, do a physical, know and understand

> the

> mechanisms of actions of all the drugs in your arsenal, interpret 10-lead

> EKGS

> and apply your findings to a patient's condition, rapidly develop a mental

> list

> of differential diagnoses soon after you first see your patient, and choose

> the correct intervention and apply it. The NR exam tests none of those

> things.

>

> I have no idea what the quality or content of your paramedic course was.

> Was it the " 90 day wonder " version or a two year Associate Degree Program?

>

> I've been a Paramedic for 26 years, and today I spent over three hours

> reading articles and studying my copy of Hearst's The Heart, 11th edition,

> which I

> am systematically going through from start to finish. It's a 2,472 page

> book,

> and I am on page 725.

>

> Why am I telling you this? Because you ask what a new, green, paramedic can

> do to improve. You also mentioned the word " stupid " which I refuse to buy.

> You're not stupid, or else you wouldn't have asked for help.

>

> What I'm trying to say is that after over 30 years in this business, I still

> consider myself " green " in some ways. There is so much to learn and know

> that I will never achieve the level that I would like to attain because I

> won't

> live long enough-----but I try every day to learn new things and improve.

>

> So my advice to you is this: First, learn your protocols from start to

> finish, top to bottom, back to front. Don't just memorize them, but actually

> THINK about what they mean.

>

> Second, make a list of the drugs in your ambulance and start with one, go to

> the Internet, read everything you can find about it, look up the terms you

> don't understand, ask for help if you need it, and then go on to the next

> one

> until you know the classification, indications, contraindications, doses,

> precautions, adverse reactions, drug interactions, and, if applicaple,

> overdose

> management for every drug in your box. That will keep you busy for a while!

>

> After that, pick a medical condition that you see frequently, such as

> congestive heart failure with pulmonary edema, and start reading everything

> you can

> find out about it. Go to eMedicine Online and read the articles.

>

> Invest in Tintinalli's Emergency Medicine, and read what it says about it in

> that book. Become familiar with the current discussions about treatments,

> the relative merits of nitroglycerine vs. furosemide, the pros and cons of

> morphine, and so forth.

>

> In other words, do something EVERY DAY to increase your knowledge and

> improve

> your understanding of the conditions you treat, the tools you use to treat

> them, and what you can expect from the use of those tools.

>

> If you do that, you will find yourself getting better and better at

> everything. If you continue to have problems starting IVs, stop and try to

> figure out

> what it is that you're missing. Review the anatomy and get a solid

> knowledge of the veins and where to find them; are you failing to hit them?

> Or are

> you getting a flash but then not being able to thread the catheter? Are your

> IVs " blowing? "

>

> Figure out what the problem is, and attack it. Talk to the " old medics " and

> find out their tricks.

>

> You will find that if you do these things, you will not only overcome your

> feelings of inadequacy, you will develop a professional attitude, improve

> your

> knowledge and performance constantly, and soon be headed to a successful

> career.

>

> Success is 99% perspiration and 1% inspiration.

>

> Your paramedic course, no matter how good it was, is only the beginning of

> what you need to know. Passing the NR means only that you have met the

> MINIMUM

> requirements.

>

> A professional is a person who drives her own development and learning

> processes from within. A professional does not need CE requirements or

> external

> rules to force him to do what is necessary to maintain knowledge, skills,

> and

> performance. A professional is never satisfied with her own status, and

> spends

> every day trying to improve.

>

> If you determine to be a true professional and follow my suggestions, you

> cannot lose.

>

> Best of luck to you, and never stop learning.

>

> Gene Gandy, JD, LP

>

> In a message dated 3/15/07 11:03:18 AM, paramedicmegan@paramedic writes:

>

> >

> > I went on a call this morning and I tell you I have never felt

> > so...IDK...how to even put it in words. I felt like I knew nothing,

> > couldn't get my IV and get this I am not allowed to give narcotics.

> > The only other paramedic which hasnt had any sleep because she just

> > got off work had to take this pt. to town because of the sheer fact i

> > can't give drugs only unless she says I can or the " Director " says I

> > can. Isn't that why I have Paramedic behind my last name. I mean I

> > went to school, I passed the registry don't that mean something?? I

> > feel like I don't belong in this profession. Well thank you for your

> > time and listening to me, and if you have any advice for a new,

> > stupid, just out of school, green paramedic it would be appreciated.

> >

> >

> >

>

> ************ ******** ******** *******

> AOL now offers free email to everyone.

> Find out more about what's free from AOL at http://www.aol.http

>

>

[Guest guest]

Please disregard private message to Henry that got sent to the group.

Gene

**************************************

AOL now offers free email to

everyone. Find out more about what's free from AOL at http://www.aol.com.

[Guest guest]

In a message dated 3/19/2007 5:03:41 P.M. Central Daylight Time,

wegandy1938@... writes:

Please disregard private message to Henry that got sent to the group.

Gene

AKA the jury is instructed to disregard the confession of the defendant.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

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

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" 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)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** AOL now offers free email to everyone.

Find out more about what's free from AOL at http://www.aol.com.

[Guest guest]

Da jury is heahby instructed to forgeddabowdit!

Gene

>

>

>

> In a message dated 3/19/2007 5:03:41 P.M. Central Daylight Time,

> wegandy1938@wegandy writes:

>

> Please disregard private message to Henry that got sent to the group.

>

> Gene

>

> AKA the jury is instructed to disregard the confession of the defendant.

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Freelance Consultant/Trainer/ Freelance Cons Freelance Consultant/Traine

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> " 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)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********<wbr>*********<wbr>

> **

> Find out more about what's free from AOL at http://www.aol.http

>

>

[Guest guest]

In a message dated 3/20/2007 8:07:23 A.M. Central Daylight Time,

hbarber@... writes:

I guess I have the same problem as Gene.

Don't sweat it many of us have that same problem and all the young ones will

sooner or later as long as they are lucky and don't die young.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

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

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" 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)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** AOL now offers free email to everyone.

Find out more about what's free from AOL at http://www.aol.com.

[Guest guest]

Do have enough material to keep us busy both days the 16th and 17th? If so, I am

still on for both days. It will be the same as last time you cover your expenses

and bill me for the whole thing. I would like to have a bill in hand by early

April so that I can have a check for you when you get here.

Henry

Re: Advice Needed

>

> Let me ask you a question. Why are you not allowed to give narcotics?

> What is the process of being cleared to do that in your service? Have you

> been

> through all the steps in the process?

>

> As to the IV miss, we all miss them. What you should be worried about is if

> you miss them consistently.

>

> Now, as to having finished paramedic school and passed the NREMT exam. That

> tells ME absolutely NOTHING about your abilities to function as a paramedic.

> The NREMT-pass tells me you have enough knowledge to pick out the right

> answer from four supplied, but not much else. It certainly tells me nothing

> about your abilities to take a history, do a physical, know and understand

> the

> mechanisms of actions of all the drugs in your arsenal, interpret 10-lead

> EKGS

> and apply your findings to a patient's condition, rapidly develop a mental

> list

> of differential diagnoses soon after you first see your patient, and choose

> the correct intervention and apply it. The NR exam tests none of those

> things.

>

> I have no idea what the quality or content of your paramedic course was.

> Was it the " 90 day wonder " version or a two year Associate Degree Program?

>

> I've been a Paramedic for 26 years, and today I spent over three hours

> reading articles and studying my copy of Hearst's The Heart, 11th edition,

> which I

> am systematically going through from start to finish. It's a 2,472 page

> book,

> and I am on page 725.

>

> Why am I telling you this? Because you ask what a new, green, paramedic can

> do to improve. You also mentioned the word " stupid " which I refuse to buy.

> You're not stupid, or else you wouldn't have asked for help.

>

> What I'm trying to say is that after over 30 years in this business, I still

> consider myself " green " in some ways. There is so much to learn and know

> that I will never achieve the level that I would like to attain because I

> won't

> live long enough-----but I try every day to learn new things and improve.

>

> So my advice to you is this: First, learn your protocols from start to

> finish, top to bottom, back to front. Don't just memorize them, but actually

> THINK about what they mean.

>

> Second, make a list of the drugs in your ambulance and start with one, go to

> the Internet, read everything you can find about it, look up the terms you

> don't understand, ask for help if you need it, and then go on to the next

> one

> until you know the classification, indications, contraindications, doses,

> precautions, adverse reactions, drug interactions, and, if applicaple,

> overdose

> management for every drug in your box. That will keep you busy for a while!

>

> After that, pick a medical condition that you see frequently, such as

> congestive heart failure with pulmonary edema, and start reading everything

> you can

> find out about it. Go to eMedicine Online and read the articles.

>

> Invest in Tintinalli's Emergency Medicine, and read what it says about it in

> that book. Become familiar with the current discussions about treatments,

> the relative merits of nitroglycerine vs. furosemide, the pros and cons of

> morphine, and so forth.

>

> In other words, do something EVERY DAY to increase your knowledge and

> improve

> your understanding of the conditions you treat, the tools you use to treat

> them, and what you can expect from the use of those tools.

>

> If you do that, you will find yourself getting better and better at

> everything. If you continue to have problems starting IVs, stop and try to

> figure out

> what it is that you're missing. Review the anatomy and get a solid

> knowledge of the veins and where to find them; are you failing to hit them?

> Or are

> you getting a flash but then not being able to thread the catheter? Are your

> IVs " blowing? "

>

> Figure out what the problem is, and attack it. Talk to the " old medics " and

> find out their tricks.

>

> You will find that if you do these things, you will not only overcome your

> feelings of inadequacy, you will develop a professional attitude, improve

> your

> knowledge and performance constantly, and soon be headed to a successful

> career.

>

> Success is 99% perspiration and 1% inspiration.

>

> Your paramedic course, no matter how good it was, is only the beginning of

> what you need to know. Passing the NR means only that you have met the

> MINIMUM

> requirements.

>

> A professional is a person who drives her own development and learning

> processes from within. A professional does not need CE requirements or

> external

> rules to force him to do what is necessary to maintain knowledge, skills,

> and

> performance. A professional is never satisfied with her own status, and

> spends

> every day trying to improve.

>

> If you determine to be a true professional and follow my suggestions, you

> cannot lose.

>

> Best of luck to you, and never stop learning.

>

> Gene Gandy, JD, LP

>

> In a message dated 3/15/07 11:03:18 AM, paramedicmegan@paramedic writes:

>

> >

> > I went on a call this morning and I tell you I have never felt

> > so...IDK...how to even put it in words. I felt like I knew nothing,

> > couldn't get my IV and get this I am not allowed to give narcotics.

> > The only other paramedic which hasnt had any sleep because she just

> > got off work had to take this pt. to town because of the sheer fact i

> > can't give drugs only unless she says I can or the " Director " says I

> > can. Isn't that why I have Paramedic behind my last name. I mean I

> > went to school, I passed the registry don't that mean something?? I

> > feel like I don't belong in this profession. Well thank you for your

> > time and listening to me, and if you have any advice for a new,

> > stupid, just out of school, green paramedic it would be appreciated.

> >

> >

> >

>

> ************ ******** ******** *******

> AOL now offers free email to everyone.

> Find out more about what's free from AOL at http://www.aol.http

>

>

[Guest guest]

I guess I have the same problem as Gene. Don't pay any attention to this post.

It was not ment for the list.

Henry

Re: Advice Needed

>

> Let me ask you a question. Why are you not allowed to give narcotics?

> What is the process of being cleared to do that in your service? Have you

> been

> through all the steps in the process?

>

> As to the IV miss, we all miss them. What you should be worried about is if

> you miss them consistently.

>

> Now, as to having finished paramedic school and passed the NREMT exam. That

> tells ME absolutely NOTHING about your abilities to function as a paramedic.

> The NREMT-pass tells me you have enough knowledge to pick out the right

> answer from four supplied, but not much else. It certainly tells me nothing

> about your abilities to take a history, do a physical, know and understand

> the

> mechanisms of actions of all the drugs in your arsenal, interpret 10-lead

> EKGS

> and apply your findings to a patient's condition, rapidly develop a mental

> list

> of differential diagnoses soon after you first see your patient, and choose

> the correct intervention and apply it. The NR exam tests none of those

> things.

>

> I have no idea what the quality or content of your paramedic course was.

> Was it the " 90 day wonder " version or a two year Associate Degree Program?

>

> I've been a Paramedic for 26 years, and today I spent over three hours

> reading articles and studying my copy of Hearst's The Heart, 11th edition,

> which I

> am systematically going through from start to finish. It's a 2,472 page

> book,

> and I am on page 725.

>

> Why am I telling you this? Because you ask what a new, green, paramedic can

> do to improve. You also mentioned the word " stupid " which I refuse to buy.

> You're not stupid, or else you wouldn't have asked for help.

>

> What I'm trying to say is that after over 30 years in this business, I still

> consider myself " green " in some ways. There is so much to learn and know

> that I will never achieve the level that I would like to attain because I

> won't

> live long enough-----but I try every day to learn new things and improve.

>

> So my advice to you is this: First, learn your protocols from start to

> finish, top to bottom, back to front. Don't just memorize them, but actually

> THINK about what they mean.

>

> Second, make a list of the drugs in your ambulance and start with one, go to

> the Internet, read everything you can find about it, look up the terms you

> don't understand, ask for help if you need it, and then go on to the next

> one

> until you know the classification, indications, contraindications, doses,

> precautions, adverse reactions, drug interactions, and, if applicaple,

> overdose

> management for every drug in your box. That will keep you busy for a while!

>

> After that, pick a medical condition that you see frequently, such as

> congestive heart failure with pulmonary edema, and start reading everything

> you can

> find out about it. Go to eMedicine Online and read the articles.

>

> Invest in Tintinalli's Emergency Medicine, and read what it says about it in

> that book. Become familiar with the current discussions about treatments,

> the relative merits of nitroglycerine vs. furosemide, the pros and cons of

> morphine, and so forth.

>

> In other words, do something EVERY DAY to increase your knowledge and

> improve

> your understanding of the conditions you treat, the tools you use to treat

> them, and what you can expect from the use of those tools.

>

> If you do that, you will find yourself getting better and better at

> everything. If you continue to have problems starting IVs, stop and try to

> figure out

> what it is that you're missing. Review the anatomy and get a solid

> knowledge of the veins and where to find them; are you failing to hit them?

> Or are

> you getting a flash but then not being able to thread the catheter? Are your

> IVs " blowing? "

>

> Figure out what the problem is, and attack it. Talk to the " old medics " and

> find out their tricks.

>

> You will find that if you do these things, you will not only overcome your

> feelings of inadequacy, you will develop a professional attitude, improve

> your

> knowledge and performance constantly, and soon be headed to a successful

> career.

>

> Success is 99% perspiration and 1% inspiration.

>

> Your paramedic course, no matter how good it was, is only the beginning of

> what you need to know. Passing the NR means only that you have met the

> MINIMUM

> requirements.

>

> A professional is a person who drives her own development and learning

> processes from within. A professional does not need CE requirements or

> external

> rules to force him to do what is necessary to maintain knowledge, skills,

> and

> performance. A professional is never satisfied with her own status, and

> spends

> every day trying to improve.

>

> If you determine to be a true professional and follow my suggestions, you

> cannot lose.

>

> Best of luck to you, and never stop learning.

>

> Gene Gandy, JD, LP

>

> In a message dated 3/15/07 11:03:18 AM, paramedicmegan@paramedic writes:

>

> >

> > I went on a call this morning and I tell you I have never felt

> > so...IDK...how to even put it in words. I felt like I knew nothing,

> > couldn't get my IV and get this I am not allowed to give narcotics.

> > The only other paramedic which hasnt had any sleep because she just

> > got off work had to take this pt. to town because of the sheer fact i

> > can't give drugs only unless she says I can or the " Director " says I

> > can. Isn't that why I have Paramedic behind my last name. I mean I

> > went to school, I passed the registry don't that mean something?? I

> > feel like I don't belong in this profession. Well thank you for your

> > time and listening to me, and if you have any advice for a new,

> > stupid, just out of school, green paramedic it would be appreciated.

> >

> >

> >

>

> ************ ******** ******** *******

> AOL now offers free email to everyone.

> Find out more about what's free from AOL at http://www.aol.http

>

>