Tuesday, July 5, 2011
Really?
I am at work tonight and I overheard another EMT saying to another group of EMTs, "what other job in the world allows for a non-college educated person to make a steady salary and have multiple days off?" He was saying this to explain why this job is so great. Tell me something, how many people say this about their jobs seriously? More importantly, how sad is it that this is what makes this job great?
Teamwork Part II
My last post on Teamwork was designed to give an idea of how two people working towards a common goal can come together to help an individual in need. That is what being an EMT is all about. Good physicians and nurses confer with their fellow healthcare professionals in order to complete the puzzle of a patient's illness and provide the proper care.
Recently I ran a call that I feel is fit to be used as an example in teamwork. I was working with a fairly new employee at my company out of a base that I am not very familiar with. This is a recipe for a bad shift as I have had a recent streak of partners who are new to the job and are therefore in the stage of feeling invincible and/or full of themselves; simply put, they do not like to listen, take criticism, or work as a team. This was a lucky situation for me, I ended up with a partner with some past experience with another company taking 911 calls. We immediately hit it off and by the time of our first call, we were already working well together. He knew the northern half of our response area, I knew the southern. Our first call went off without a hitch; we communicated well and got the patient packaged, transported, and safe at home without any problems, besides a malfunctioning radio. Our second call was for a cold response to a facility in the southern part of our response area and proved to be an interesting case.
Like I have said before, communication is key, if you can look at your partner and know his/her next move, you can function well as a team. If you can talk to your partner and confer on decisions, the patient is going to get the best care. Two heads are always better than one.
We get a cold response for a male with lower abdominal pain. On arrival, the nurse hands us a packet of information on the patient. We ask the nurse what is going on with the patient, the nurse seems to know very little about the situation other than he has had pain for 5 days and now it is getting worse. The patient is ambulatory in his room; we convince him to sit on his bed while I grab vitals and my partner starts an assessment. We find the upper right quadrant of his abdomen is distended with rigidity.
On the way over to the facility, my partner and I were discussing how we would go about handling the scene (who would do what, what we would be looking for, and what we might expect). This is another aspect of teamwork; bouncing ideas off your partner is NOT a bad thing!
After we find the patient's abdomen is distended and rigid we decide without more than a glance that we are going HOT to the ER, especially with the patient presenting with a fever. Long story short, we got to the hospital and found that the patient, among other issues, had an SPO2 stat of 91% (despite not reporting shortness of breath or difficulty breathing). The next day, I checked on the patient, he had been admitted, that is all they would/could tell me. I hope he did alright, but I know that if he is doing better, it is in large part due to the teamwork that my partner and I had and our quick decision making and assessment abilities.
Recently I ran a call that I feel is fit to be used as an example in teamwork. I was working with a fairly new employee at my company out of a base that I am not very familiar with. This is a recipe for a bad shift as I have had a recent streak of partners who are new to the job and are therefore in the stage of feeling invincible and/or full of themselves; simply put, they do not like to listen, take criticism, or work as a team. This was a lucky situation for me, I ended up with a partner with some past experience with another company taking 911 calls. We immediately hit it off and by the time of our first call, we were already working well together. He knew the northern half of our response area, I knew the southern. Our first call went off without a hitch; we communicated well and got the patient packaged, transported, and safe at home without any problems, besides a malfunctioning radio. Our second call was for a cold response to a facility in the southern part of our response area and proved to be an interesting case.
Like I have said before, communication is key, if you can look at your partner and know his/her next move, you can function well as a team. If you can talk to your partner and confer on decisions, the patient is going to get the best care. Two heads are always better than one.
We get a cold response for a male with lower abdominal pain. On arrival, the nurse hands us a packet of information on the patient. We ask the nurse what is going on with the patient, the nurse seems to know very little about the situation other than he has had pain for 5 days and now it is getting worse. The patient is ambulatory in his room; we convince him to sit on his bed while I grab vitals and my partner starts an assessment. We find the upper right quadrant of his abdomen is distended with rigidity.
On the way over to the facility, my partner and I were discussing how we would go about handling the scene (who would do what, what we would be looking for, and what we might expect). This is another aspect of teamwork; bouncing ideas off your partner is NOT a bad thing!
After we find the patient's abdomen is distended and rigid we decide without more than a glance that we are going HOT to the ER, especially with the patient presenting with a fever. Long story short, we got to the hospital and found that the patient, among other issues, had an SPO2 stat of 91% (despite not reporting shortness of breath or difficulty breathing). The next day, I checked on the patient, he had been admitted, that is all they would/could tell me. I hope he did alright, but I know that if he is doing better, it is in large part due to the teamwork that my partner and I had and our quick decision making and assessment abilities.
Friday, June 17, 2011
Teamwork
This is a word that is seldom used in EMS, yet it is also an expectation. The AHA, in it's recent changes to CPR, made mention of utilization of teamwork in it's curriculum. This is mentioned as if this never existed in CPR, let alone pre-hospital care and this is not particularly surprising. In EMT school we are taught to work individually, whether it be in class or testing. Each of us must pass without the assistance of a "partner" on exams and in class. Unfortunately, this is not conducive to real-world EMS.
Here are some reasons why I disagree with the individualistic mentality placed on EMS providers:
1. Individualism breeds competition and while competition in theory is not a bad thing, it does not help EMT's function better. Remember, our common goals are to make sure our patients get the proper care they need either during a routine transport or during an emergency.
2. Communications lacks! A large part of our job is communication, whether it be through radios, to our patients, or to our partners, this is an area of our job that is fundamental.
3. Patient Care is another area affected. Four hands are better than two, just as two heads are better than one. The more information you can get, the more life saving procedures can be performed, and the least amount of time sitting around without a clue...the BETTER!
There are other areas that are affected by our individualized education; however, these three categories are extremely important to our job. So how can we fix this?
1. More education. By changing the way we approach educating new and old EMT's, we can begin creating an environment of community and teamwork within the industry. This means learning as a team, practicing as a team, and testing as a team. This does not eliminate individual testing, but puts less emphasis on that individual mind set.
2. Emphasis on communicating on all levels. I recently had a partner who was near silent in the ambulance and while this is not necessarily a bad thing, it is when he/she could talk without issue with patients in a compassionate tone while responding to me in a harsh and dismissive tone. I do not take kindly to this. You or your partner may be having a tough day, but leave it at the door. You are a team. Without one of you, the team would cease to function.
3. Patient care can be looked at from a variety of angles; however, I like to look at how EMT's handle the patients once they are placed in the back of an ambulance. In my company, what generally happens is the Tech goes in back with the patient while the Driver goes to the front seat immediately to start the truck and get going. I want to propose another strategy. I would like to propose to EMT's, not only in my company, but elsewhere, to hop in the back with your partner and grab a set of vitals or help with some of the treatment before you run to put the pedal to the metal.
All of these basic tactics, while relatively small in the grand scheme of things, contribute to improving the way we function in an ambulance.
Here are some reasons why I disagree with the individualistic mentality placed on EMS providers:
1. Individualism breeds competition and while competition in theory is not a bad thing, it does not help EMT's function better. Remember, our common goals are to make sure our patients get the proper care they need either during a routine transport or during an emergency.
2. Communications lacks! A large part of our job is communication, whether it be through radios, to our patients, or to our partners, this is an area of our job that is fundamental.
3. Patient Care is another area affected. Four hands are better than two, just as two heads are better than one. The more information you can get, the more life saving procedures can be performed, and the least amount of time sitting around without a clue...the BETTER!
There are other areas that are affected by our individualized education; however, these three categories are extremely important to our job. So how can we fix this?
1. More education. By changing the way we approach educating new and old EMT's, we can begin creating an environment of community and teamwork within the industry. This means learning as a team, practicing as a team, and testing as a team. This does not eliminate individual testing, but puts less emphasis on that individual mind set.
2. Emphasis on communicating on all levels. I recently had a partner who was near silent in the ambulance and while this is not necessarily a bad thing, it is when he/she could talk without issue with patients in a compassionate tone while responding to me in a harsh and dismissive tone. I do not take kindly to this. You or your partner may be having a tough day, but leave it at the door. You are a team. Without one of you, the team would cease to function.
3. Patient care can be looked at from a variety of angles; however, I like to look at how EMT's handle the patients once they are placed in the back of an ambulance. In my company, what generally happens is the Tech goes in back with the patient while the Driver goes to the front seat immediately to start the truck and get going. I want to propose another strategy. I would like to propose to EMT's, not only in my company, but elsewhere, to hop in the back with your partner and grab a set of vitals or help with some of the treatment before you run to put the pedal to the metal.
All of these basic tactics, while relatively small in the grand scheme of things, contribute to improving the way we function in an ambulance.
Sunday, June 12, 2011
Creating an EMS Bachelor Degree
The EMS Bachelor Degree, it is something I have been pondering for a while now. The value of a college education is boundless. I have heard people say why bother, a bachelor degree is just a piece of paper, it doesn't do anything for us. WRONG! I can't say that my entire college career was fun, exciting, or important to me; however, what I can say is this, my college degree gave me the intellectual capacity and experience to think critically, analyze decisions, and understand how to effectively research. What it didn't teach me was how to be a good EMT. There is a lot that goes into being an EMT, far more than we think and it couldn't hurt to fit it all into a four year degree program, or even a two year accelerated program. Here are just a sample of subjects that could be covered by an EMT bachelors program:
Physics, Biology, History, English, Psychology, Chemistry, Mathematics, and Foreign Language.
Physics, while helping to provide EMTs with a better understanding of driving techniques (which should be taught in a specialized driving school) would be helpful for an education in MVA related injuries and other blunt or penetrating trauma related injuries.
Biology would be taught similar to current pre-med programs with studies in programs such as anatomy and basic cell biology.
Chemistry and Mathematics would provide EMTs with the knowledge needed to understand medication dosages and reactions in the human body.
History would give the EMT a background in the field of Emergency Medicine to provide a link to our storied past.
English could be a helpful tool in learning how to effectively write run reports.
Finally, each student would have to choose a foreign language.
All of these programs would provide an EMT with a well rounded education in Emergency medicine including a choice in foreign language which would undoubtedly be of much use in communities across America.
These are just suggestions, but put to good use, these programs of study could be of great benefit to the creation of an Emergency Medicine Bachelors Degree. If anyone has further suggestions or ideas, feel free to comment!
Physics, Biology, History, English, Psychology, Chemistry, Mathematics, and Foreign Language.
Physics, while helping to provide EMTs with a better understanding of driving techniques (which should be taught in a specialized driving school) would be helpful for an education in MVA related injuries and other blunt or penetrating trauma related injuries.
Biology would be taught similar to current pre-med programs with studies in programs such as anatomy and basic cell biology.
Chemistry and Mathematics would provide EMTs with the knowledge needed to understand medication dosages and reactions in the human body.
History would give the EMT a background in the field of Emergency Medicine to provide a link to our storied past.
English could be a helpful tool in learning how to effectively write run reports.
Finally, each student would have to choose a foreign language.
All of these programs would provide an EMT with a well rounded education in Emergency medicine including a choice in foreign language which would undoubtedly be of much use in communities across America.
These are just suggestions, but put to good use, these programs of study could be of great benefit to the creation of an Emergency Medicine Bachelors Degree. If anyone has further suggestions or ideas, feel free to comment!
Thursday, April 14, 2011
CPR...why do we care?
I have been teaching CPR classes for almost a year now and one thing never ceases to amaze me. I find that a large portion of the people I teach just do not seem to care. Why you ask? Because they do not get how important it is for community and personal health. The challenge I have comes in passing an individual who has taken the course, passed the written and has performed decently on the practical, but I wouldn't trust with my own life. How can I give them a card that says they can treat others when I would rather have someone without any training treat me over them? It is a difficult question and one that I ask myself every class. I think I am a pretty tough CPR instructor. I do not pass you if I think you are not going to perform well in the field and I certainly do not go over the answers with people during the test. If someone has a question or the class is stumped on a few questions, sure, I am more than happy to help and explain the answer if need be, but I am hard pressed to stand in front of the class and have everyone answer. I would rather see on an individual basis how people perform. I think I get the most exacerbated sighs when I say, "ok everyone, take a 10 minute break, then we are going to practice doing all the steps over again", but why is this different than any other class? I want my class to have as much hands-on training as possible and if that means pushing them to perform practicals over and over again, then yes, I am going to push you. I do not let the video do the instructing, it gives a good background to help answer questions on a test, but I do not want my class to just get 100% on the written, I want them getting 100% on the practical.
I have given my perspective on my classes, but I have not truly answered my question, why don't people care about CPR? Well, they do, it is just that they need to be motivated. There will always be a student who is taking the class because they feel they have to or are "forced" to and will take it out on you; However, there is also a large portion of people who want nothing more than to be a driving force for community health in society and if you make the course interesting, hands-on, and fast paced, they are going to enjoy every ounce of that class. My new resolution for the year is to not just teach CPR, but to TEACH CPR, that means pushing my students to bring 150% to each class in exchange for my putting in 200%. I will stay after for remediation, I will go over questions as long as you need to pass, but I will not pass you if you are not comfortable performing CPR. This is not just any skill, this is a life saving skill and we should treat it as such not only as instructors, but as students. My best to all those who work hard at this job, and to those who are feeing run down or unmotivated to teach, here is my advice...you bring 200% to each class and I assure you, the majority of your students are going to give the same or at least 150% back. Believe in your students and they will trust you as an instructor.
I have given my perspective on my classes, but I have not truly answered my question, why don't people care about CPR? Well, they do, it is just that they need to be motivated. There will always be a student who is taking the class because they feel they have to or are "forced" to and will take it out on you; However, there is also a large portion of people who want nothing more than to be a driving force for community health in society and if you make the course interesting, hands-on, and fast paced, they are going to enjoy every ounce of that class. My new resolution for the year is to not just teach CPR, but to TEACH CPR, that means pushing my students to bring 150% to each class in exchange for my putting in 200%. I will stay after for remediation, I will go over questions as long as you need to pass, but I will not pass you if you are not comfortable performing CPR. This is not just any skill, this is a life saving skill and we should treat it as such not only as instructors, but as students. My best to all those who work hard at this job, and to those who are feeing run down or unmotivated to teach, here is my advice...you bring 200% to each class and I assure you, the majority of your students are going to give the same or at least 150% back. Believe in your students and they will trust you as an instructor.
Monday, January 24, 2011
Finally Back...
It's been quite some time since I have written on this blog for good reason...my life has been crazy! Between keeping up with school and a new internship, moving to a different city, and trying to get my life in order so when I graduate in 3 months I am not running around like a chicken with its head cut off.
Needless to say, my last winter break, besides being by far one of the best I have had, was busy, but exciting. I have also finished my very short historiography/research paper on EMS. I have opted not to post it on the blog because of its length (18-19 pages). However, I believe I achieved an A of some sort on the paper, so I am happy with it. I also think it covered a great deal of topics in such a short document. It still needs to be worked on if it will ever be considered for publishing, but hopefully it will, at least for now, provide people with a brief idea as to what EMS is all about.
Needless to say, my last winter break, besides being by far one of the best I have had, was busy, but exciting. I have also finished my very short historiography/research paper on EMS. I have opted not to post it on the blog because of its length (18-19 pages). However, I believe I achieved an A of some sort on the paper, so I am happy with it. I also think it covered a great deal of topics in such a short document. It still needs to be worked on if it will ever be considered for publishing, but hopefully it will, at least for now, provide people with a brief idea as to what EMS is all about.
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