We announced the Project yesterday to rave reviews, it seems. Many of our followers are understandably congratulatory, they are like friends. I think the real admiration for the project, if there is any, will be in the real time sharing and interaction with the experience. I envision (hope) to update the blog and twitter constantly, so folks feel as if they're riding along side.
In other Project news:
Spoke with the BBC rep this morning (his afternoon) to discuss different topics he wanted clarification on. A lot of trying to explain how EMS is delivered in the US, without making it sound like a bunch of thrown together ideas, which it really is. the problem with "State's Rights" is that everyone invents a wheel of a different size and shape so that it barely works, if at all, somewhere else. I'm interested to see how a generalized program can work as I believe the NHS model does.
For now, we're just waiting on the BBC schedule, and then it's off to the races to get everything lined up and ready to go.
Tuesday, June 16, 2009
Friday, June 5, 2009
The veneer begins to peel
I had been frustrated by a series of calls, all in a row, with people who not only didn't need an ambulance, but didn't need a doctor, they just wanted access to a doctor for another reason. And since I am unable to redirect them, I was forced to take them in, all the while listening to other units screaming for an ambulance for medical emergencies.
The kind of day I wish there was an ejector seat button in the back of the rig. For them or me, I'm not that picky.
The original post
"What are we doing anymore?
Not an entirely rhetorical question, but looking back over the last few dispatches I've been on, it's a fair question.
What is the role of Emergency Medical Services in the 21st Century?
We were born of the traumatic injuries of the 50s and 60s, adapted from the battlefield surgeons of old. We were given basic skills, then basic tools.
Then the emergence of advanced cardiac care. We became the first link in the Chain of Survival and evolved from ventilators and thumpers to vasopressors and antiarrythmics. We can create artificial, clinical life and, in some cases, perfuse tissue until advanced care can take over.
We started as funeral home drivers, then ambulance attendants, then technicians and are now on the verge of being recognized as a legitimate profession, not just a trade school certificate.
We have evolved by setting training standards, publishing journals and lobbying politically for this new profession, the one we chose to advance by doing it to the best of our ability.
And then something happened. Something slowly, so as not to alarm us or give us a chance to object.
EMS became the catch all for everything lacking in the Health Care system. We're the hospice nurse after hours, the 2 AM taxi driver. We're the solution when the question defies reason. It used to be "I don't know what to do, call 911" now it's "I want to goto the hospital, call an ambulance."
Ambulances and by extension, those resources that respond with them, are being called to extend aid to the homeless, the elderly, the disadvantaged, not the sick or injured. When I took this job I knew that people of all races, creeds and economic status would need our services and I treat each one with the respect I would want to receive.
The car accident, the allergic reaction, the choking, these are our patients.
The hungry, the tired, the alone, they are our fellow citizens, but not our patients.
But what about those who don't need us? Those who simply have no other recourse or way to receive assistance, whatever their issue may be? The woman who can't stand up when she sits down too far from her walker? The man out of breath at the top of the flight of stairs not because of his asthma, but because of his obesity and poor exercise habits?
They call us knowing full well it is against the law for us to deny them care. I have been told to my face by persons who requested our services (not patients by definition) that my job is simply to drive them to a doctor. I take a deep breath smile and do it, knowing they'll never listen to reason or wait in line like everyone else to get an appointment.
Many may wish to blame immigrants. People not paying into the system who are perceived in the news as clogging the system. I happen to work in a municipality that is very lenient when it comes to enforcing immigration and I see few of them.
It is those who believe they are entitled to a level of care they do not need that are clogging the system and it is, I fear, too late to change the mindset they have adopted.
I see their children watching, learning that no matter how you mismanage your affairs or ignore your health, no one will tell you otherwise.
I'm really happy to be where I am. I worked very hard to get this job and chose it specifically because it is still a Fire based transporting agency. I love my carreer and am proud to work with other professionals on a daily basis, bad apples aside.
At the rate our responses are growing and the impending retirement of the baby boomers, when will Emergency Medical Services be reclassified as such? If there was a Routine Medical Technician position, I would not put in for it.
If we don't get a handle on what the public expects from their emergency responders, I fear in 10 years time we will be giving psych evals and family counciling in the back of the ambulance instead on focusing on the reason we exist in the first place.
We are the insurance policy. We are the only ones who can do what we do and are asked more each day to pick up the slack of other agencies while seeing our own budget cut.
I don't have the answer. We may never have an answer, but when will we begin to speak up against the blanket policies that require us to act when our action is not needed or being blatantly abused?
Call this a rant, a complaint, call it the random ramblings of a misguided almost burnt out medic, but I'll still be at work next shift, an hour early with a smile on my face because I know as bad as it gets, it can always get worse.
I could be back making tortillas for $4.35 an hour.
Your still Happy Medic"
A comment on the original post mentions referring people directly to a taxi service. Hmmm...
The kind of day I wish there was an ejector seat button in the back of the rig. For them or me, I'm not that picky.
The original post
"What are we doing anymore?
Not an entirely rhetorical question, but looking back over the last few dispatches I've been on, it's a fair question.
What is the role of Emergency Medical Services in the 21st Century?
We were born of the traumatic injuries of the 50s and 60s, adapted from the battlefield surgeons of old. We were given basic skills, then basic tools.
Then the emergence of advanced cardiac care. We became the first link in the Chain of Survival and evolved from ventilators and thumpers to vasopressors and antiarrythmics. We can create artificial, clinical life and, in some cases, perfuse tissue until advanced care can take over.
We started as funeral home drivers, then ambulance attendants, then technicians and are now on the verge of being recognized as a legitimate profession, not just a trade school certificate.
We have evolved by setting training standards, publishing journals and lobbying politically for this new profession, the one we chose to advance by doing it to the best of our ability.
And then something happened. Something slowly, so as not to alarm us or give us a chance to object.
EMS became the catch all for everything lacking in the Health Care system. We're the hospice nurse after hours, the 2 AM taxi driver. We're the solution when the question defies reason. It used to be "I don't know what to do, call 911" now it's "I want to goto the hospital, call an ambulance."
Ambulances and by extension, those resources that respond with them, are being called to extend aid to the homeless, the elderly, the disadvantaged, not the sick or injured. When I took this job I knew that people of all races, creeds and economic status would need our services and I treat each one with the respect I would want to receive.
The car accident, the allergic reaction, the choking, these are our patients.
The hungry, the tired, the alone, they are our fellow citizens, but not our patients.
But what about those who don't need us? Those who simply have no other recourse or way to receive assistance, whatever their issue may be? The woman who can't stand up when she sits down too far from her walker? The man out of breath at the top of the flight of stairs not because of his asthma, but because of his obesity and poor exercise habits?
They call us knowing full well it is against the law for us to deny them care. I have been told to my face by persons who requested our services (not patients by definition) that my job is simply to drive them to a doctor. I take a deep breath smile and do it, knowing they'll never listen to reason or wait in line like everyone else to get an appointment.
Many may wish to blame immigrants. People not paying into the system who are perceived in the news as clogging the system. I happen to work in a municipality that is very lenient when it comes to enforcing immigration and I see few of them.
It is those who believe they are entitled to a level of care they do not need that are clogging the system and it is, I fear, too late to change the mindset they have adopted.
I see their children watching, learning that no matter how you mismanage your affairs or ignore your health, no one will tell you otherwise.
I'm really happy to be where I am. I worked very hard to get this job and chose it specifically because it is still a Fire based transporting agency. I love my carreer and am proud to work with other professionals on a daily basis, bad apples aside.
At the rate our responses are growing and the impending retirement of the baby boomers, when will Emergency Medical Services be reclassified as such? If there was a Routine Medical Technician position, I would not put in for it.
If we don't get a handle on what the public expects from their emergency responders, I fear in 10 years time we will be giving psych evals and family counciling in the back of the ambulance instead on focusing on the reason we exist in the first place.
We are the insurance policy. We are the only ones who can do what we do and are asked more each day to pick up the slack of other agencies while seeing our own budget cut.
I don't have the answer. We may never have an answer, but when will we begin to speak up against the blanket policies that require us to act when our action is not needed or being blatantly abused?
Call this a rant, a complaint, call it the random ramblings of a misguided almost burnt out medic, but I'll still be at work next shift, an hour early with a smile on my face because I know as bad as it gets, it can always get worse.
I could be back making tortillas for $4.35 an hour.
Your still Happy Medic"
A comment on the original post mentions referring people directly to a taxi service. Hmmm...
Mark mentions Happy
Here is Mark's first mention of Happy Medic on his home blog. This was around the same time I took interest in his. It's clear we admired each other's style and wanted to see how each handled some of the same patients.
The original post
"
The original post
"
I have just read a post on one of my new favourite sites: You called 911….for this.
The post describes a moment which every paramedic will understand and will have a lot of fun reading how it was managed !
I wont spoil it any more as “The happy medic” puts it far better than I could.
Pop along to “for the altered mental status“, and have a giggle"
Where this thing started
Back in January of 2009, the Happy Medic was followed by a man calling himself MedicBlog999. It was the first time I realized my rantingstherapy was visible in other countries.
It was in this post I challenged Medic999 to tell the truth about the pros and cons of the nationalized system he works in.
Luckily, as it turns out, he is an honest person and has kept up his end of the bargain.
The original post
"The Happy Medic has gone International. I love reading about other pre-hospital providers from all over the country but never really realized (realised) they have the internets machine in other countries until I started following Medicblog999. But I'm being followed as well.
Reading the posts is like looking in a mirror. They have the same BS over there. It makes me feel better that no matter whether the system is for profit or Nationalized (Nationalised), the crazies still call 911 (999) to get help to the toilet (loo) or just for a ride.
(trying to help my new UK friends follow along with translations in parenthesis)
So I call out to my EMS buddy across the pond to tell it like it is. Here in the states we hear a lot about NHS and the troubles they're having with dispatch errors, long response times, etc. I plan to take these stories to the folks who can tell us what is really happening, the Medics on the streets.
HM
EDIT - forgot to put them on the other side of the "road" up there."
And the rest, as they say, is...
It was in this post I challenged Medic999 to tell the truth about the pros and cons of the nationalized system he works in.
Luckily, as it turns out, he is an honest person and has kept up his end of the bargain.
The original post
"The Happy Medic has gone International. I love reading about other pre-hospital providers from all over the country but never really realized (realised) they have the internets machine in other countries until I started following Medicblog999. But I'm being followed as well.
Reading the posts is like looking in a mirror. They have the same BS over there. It makes me feel better that no matter whether the system is for profit or Nationalized (Nationalised), the crazies still call 911 (999) to get help to the toilet (loo) or just for a ride.
(trying to help my new UK friends follow along with translations in parenthesis)
So I call out to my EMS buddy across the pond to tell it like it is. Here in the states we hear a lot about NHS and the troubles they're having with dispatch errors, long response times, etc. I plan to take these stories to the folks who can tell us what is really happening, the Medics on the streets.
HM
EDIT - forgot to put them on the other side of the "road" up there."
And the rest, as they say, is...
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