Who's Training Who?

The one thing I take pride in is the amount of training that I have subjected myself to in order to get to where I am in my career. Granted, I'm not there yet and hope to never really get "there". I hope to be a lifelong learner and change with the times and advancements in the industry. More than the training is the amount of time my family has had to sacrifice, well, not being a family.

As of right now I'm on the last leg of becoming a National Registered Paramedic...four more months!! Luckily, I live in a state that has a level of certification that pretty much mirrors the Paramedic protocols as far as skill sets are concerned. It's nice to be taught at a Paramedic level and tested at that level and then given a year to work in the field learning and getting your street smarts in. I've been blessed to have been trained by a man who takes his job seriously and has a lot of pride in his program. He is a stickler for doing things right and having integrity and good moral character, and he tries his darndest to instill those values in his students. We are drilled hard on ACLS protocols, proper procedures and honesty is demanded when doing field and hospital clinicals. Over the past year and a half, these same values have been passed on to me and a few other in my class....some will remain true to their belief that a certification is all they need to make life good for them. I beg to differ.

What bothers me is that there are some agencies that will trump their professionalism just because they provide a career staff. They trump even louder because they require their employees to submit to mandatory bi-weekly "training"...well, some of the employees anyway. My eyes were opened the other day at a training session where we were supposed to do our quarterly skills check offs that are required to maintain an active certification. At this particular station was an EMT-Enhanced provider who was going to show us how to do an intraosious needle insertion. Now, let me explain this, an Enhanced in Virginia is much like an Intermediate in the rest of the country. They can do I.V's, D50, Albuterol, Epi during a code and not much else. In Virginia, an Intermediate can do just about anything a medic can do...some things we have to call for orders on, i.e. Dopamine ect. This guy in all his infinite wisdom proceeded to tell us that all we had to do was just locate the knee cap, come down a finger width under the knee cap...and drill. No Indications, contraindications and lets not overlook the fact that what was described was NOT the location to insert an I.O. needle. In this group was myself, another EMT-I and a Paramedic who CAN do this procedure being told wrong how to do something that he can NOT do in the field!! This insult to our combined years of training was further exacerbated when he began to instruct an EMT-B how to start an I.V.....inappropriatly again. Why was this individual assigned this task you might be asking. I can only assume it's because he has been in the "business" for about seven years and has garnered some favoritism as a reward for his loyalty; I really just don't know!

There has got to be a dividing line somewhere, and I'm just not sure where it is. If only all the talk of our company being the best were true. Sure, it all sounds good on paper and when giving a sales pitch, but when the rubber meets the road, it's all white-wash and fluff. The saddest part of it all is that there is no oversight of training and enforcement of state rules and regs are spotty at best. Most if not all or this validation is left up to the individual agency and leads to nothing more than the fox guarding the hen house. I do wonder though if this kind of stuff "happens everywhere"? Is it like this in a municipal service where there is supposed to be an established hierarchy that is qualified to teach, train and/or instruct?

If we are going to have anything, let's at least have some integrity. For all the profitability and good public relations that we would strive for, there is nothing more important than maintaining a level of professionalism that can not be questioned by anyone, whether it be internal or external. This leaves me in a state of frustration as I try to figure out how this situation can be fixed. I do realize that it didn't get this way overnight and it certainly will not be fixed by next week. What is even more frustrating, is that I am just a lowly field provider somewhere near the bottom of the totum pole. I have the ear of some, but their hands are politically tied and they are limited in their reactions.

But this I promise to those who will come after me and who are now working beside me...I will continue to stay abreast of the latest developments in pre-hospital and advanced medical care. I will honor those who have come before me by staying true to the skills they have developed and perfected through the years. I will with all that is in me protect the interest of the patient first, foremost and above all else. I will promote patient advocacy in any public forum in which I represent professional pre-hospital care. In all that I do I will...DO NO HARM.