28 February 2010

I am what I am...

I’m back! Hope I haven’t been excommunicated or anything yet since I haven’t been out “visiting” much. I just have not had a lot of spare time to devote to reading blogs and writing as I usually do, and boy do I miss it.

We’re coming down to crunch time around here as my trek towards the NREMT-P glitter enters its final stages and May 12, 2010 is circled on my calendar. This has been a long two years and there have been a lot of ups and downs along the way. A lot of learning has gotten underway and a new mindset has emerged. I will hate to see it all end soon, but at the same time I am so ready for it to be over. Luckily there is going to be a few months off for me before I trace off to the University of Georgia to take the Critical Care portion that will set me at the pinnacle of training in EMS.

With the clinical rotations at the hospital almost done, there’s nothing left really but a bunch of field time under the watchful eyes of a preceptor; who I think just appreciates the opportunity to just sit back and ride third-man. It does get mundane having to do this in a clinical/student atmosphere since this is what I do for a living as well. It just ends up being the same ‘ol stuff over and over, almost like a recurring nightmare or something. Add in amongst all this the remaining course work, studying and finals approaching; it’s almost more than I can stand. Oh, and of course let’s not forget that I fancy myself to be a family man, and all this “free” time on a truck takes some pretty valuable time from the wife and kids. But alas…it’s almost over!

A little housekeeping is necessary as I continue on. I got a message on FB the other day from an individual who was curious as to how I can call myself a “medic” when I’m just an Intermediate, but a NREMT-I mind you.

It’s a legitimate question I guess.

In all fairness I admire the person for taking the time to educate themselves. Then the other night at work another discussion came up about who calls themselves a nurse. Seems that an LPN, or a LVN in some areas, should not be allowed to call themselves nurses because they do not go through as much schooling and training as an RN…really? Apparently, a CNA is as an EMT…a LPN is as an Intermediate and of course an RN is as a Paramedic.

This to me is a wierd analogy because I as an Intermediate (we as medics) can do more outside the hospital than most of them can ever immagine doing inside the ER. I guess they will just be happy with the respect the have garnered.

Now I’m not really sure how this washes out in the hierarchical ladder of certs and licensures, nor do I really care. I came to the conclusion a looooong time ago that it doesn’t matter what my title or position is in life, just as long as I do my job to the best of my ability. John Q. Public is gonna call me a lot of other things, like an Ammalance Driver, or an EMT, and to some, everybody who shows up on the ammalance is a Paramedic. John Q. Public also doesn’t realize what I, you or anybody else on that ammalance can do as far as procedures are concerned or what drugs can be administered. They just want a ride to the ERrah , gimme sompin’ for pain and nausea or there is of course the legitimate 911 caller who will expect you perform heroically and save the day due to a life threatening illness/injury. So it really doesn’t matter what you are to me as long as you do your job as trained and certified, and do it in a professional manner.

Let me see if I can make this short and simple.

I’m not gonna get into a pissing match about who calls themselves what. What does matter is that it comes down to the discipline and the skill set. I’ve never represented myself as a Paramedic, however, the great Commonwealth of Virginia has seen fit to align the skill sets (protocols) of the I-99 level and those of the Paramedic in almost a mirrored fashion, with the exception of a drug and/or procedure two that calls for on-line orders… that are usually given depending on the provider. Do I like it? No. I know some Intermediates who will NEVER rise to the knowledge required for the Paramedic level because in truth they are incompetent in a lot of areas that matter most. But still yet, when they are on a truck, it is a medic truck none the less. On the same hand I can count the reasons some Paramedics I know should not wear the title either because the are as unprofessional as they come. But there it is folks, call it what you may, but when I show up you will get the all that I have been taught, trained for, certified by my state to practice and all that my OMD will allow me to do. I guess the beautiful thing is that when someone does get their Paramedic in Virginia, they come out into the field with a leg up in the game already having had some experience in the field.

So yes, as much as some may not like it (me included sometimes), I am a medic for all practical purposes. Just as the basic trained soldier on the battlefield who wore a red cross on his helmet was a medic, so am I. I do however, reserve and revere the title of Paramedic as someone who has been trained to the minimum levels required by a sanctioning body to practice at a certain level and has the professionalism to operate as a skilled physician outside of a skilled physician’s direct control.

Now in the words of the great Forest Gump of the renowned Bubba-Gump Shrimp Co. ……That’s all I have to say ‘bout that.


  1. Gatekeeper -

    Best of luck with the rest of your training, which - as I'm sure you know - will never really be over.

    I admire much of what you say & I've been through a ton of the emotion & exhaustion (I graduated 32 years ago, when most all training was via medical schools)

    12,200 calls since 1978.

    But I happen to believe "what we are called" is not only important, but critical. I believe the profession of Paramedics has taken a huge hit, and much of it began when medics allowed themselves to be referred to as EMTs.

    The dumbing-down of the profession - and the fact that we allowed it to happen by not structuring a serious national union 30 years ago - is part of why medics are so often now treated (and paid) as they are.

    Adding to the demise of Paramedic with a Capital P respect, was the advent of AMR & system status management. Parking ambulances on street corners was why I walked away from the EMS model, incorporated myself; got my own malpractice insurance and started working on movie sets. I simply gagged on the changes I was seeing. And it's only getting worse.

    And these days, on the rare occasions when I tune in the EMS units nationwide, I gag yet again, at what medics are being "ordered" to do.

    On the other hand, when the typical medic I see sits in his unit with a burrito, studying to be a firefighter - then it isn't a profession. It's a transient job.

    I honestly hope you are working in an area that appreciates you and the poop you'll get on your palms sometimes. I know full well there are terrific niches out there.

    I wish you only the best. Let me know if you're interested, and I'll forward my 13 Immutable Laws of EMS. Trust me - you're gonna need 'em.

  2. I feel you have every right to call yourself a medic but are also correct in not calling yourself a Paramedic. Compared to an EMT-Basic, you have so many more skills available to you as a NREMT-I. I wish I had half the skills you have right now, let alone the knowledge span you are getting as a Paramedic.

    Someone once tried to explain the difference between B, I and P to me, and while I do not quiet agree with how it was phrased, it does "fit" what we are taught. B's treat the minor symptoms, I's treat the more major symptoms, and P's think first before deciding to treat an underlying problem, not just a symptom.

  3. Thank you for your kind words and admonitions.

    You are spot on with your assessment of the modern day Paramedic, and yes it is quite sad how the ethics and morals of many are dictated by what is "reimbursable".

    The area that I work in is not at all conducive to professional standards, actually it's not anywhere in the ballpark of any standards. The montra here is "Get the call covered...no matter what". For that reason alone I take the stands that I do on the side of service and job integrity.

    I am indeed interested in any advice that you might offer and thank you in advance for it. I'm smart enough to know that there are people who have far more experience than I may ever have...and I need all the help I can get.

    My sincerest thanks!!