Well kiddies if you think that I'm some precious little fragile thing you've obviously never met me. I jumped into an Airway discussion on Rouge Medic and some person, who wishes to remain nameless, had his 2 cents to throw in. For those who know me, I am not going to just let it go. Anyway if you want to read the initial topic go to Rouge Medic and look for Teaching Airway-Part I. There is also a link from Rouge on my comment and his take. So here's what I had to say to Anonymous:
Let’s respond to some of Anonymous’ comments”
"Yes, you do need more practice and it's your fault for not banging on the door of your higher ups demanding more training and why do you need an MD to confirm your tube. Your training should allow you to know that way before."
First let me say this before you go judging have your house in order and know your job. With that said, I do the initial confirmation of my tubes but in my system it is not considered a "successful" tube until verified by a MD at the ER. As for training, the places that are best suited for this according to my medical director and training officer do NOT want medics there so aside from going to the college on a regular basis and tubing a simulator, my hands are sort of tied.
“The person I want treating my family is the person trained appropriately, assesses and performs appropriate skills when necessary, recognizes change better or worse to take appropriate steps to correct, and deliver them to the appropriate next level of care. They may need you to do that skill, I hope you know how.”
If my patient needs me to do a skill then it gets done. I never withhold a treatment that I know how to do when that treatment is indicated. I however am not a cookbook medic. I was taught to think without needing a script for every patient. Sounds like maybe you should try it sometime.
“You've never worked in a teaching hospital have you. Hold on to that dream.”
I have. UNC Chapel Hill and Duke University and you worked where for your training?
“An IV can be placed by most medic's without thought but we all still miss occasionally. Is that a reason to stop the skill? Do we need more practice? Or was it because that patient was a little more difficult then others? In an arrest do we not give medications because we blew the IV or do we try an IO next or vice versa?”
Ok so now if you fail to successfully obtain a skill it’s the patient’s fault? I’ll remember that next time I am unable to get my IV. That is probably the single most moronic statement I’ve heard and why are you even bothering with an IV in an arrest situation? IO is quicker and the quicker you can get medications to the patient, along with continuous chest compression, the better outcome potential for the patient or did you miss that part at the last ACLS class?
Is it so hard for you to imagine that you may not be the best provider to do a skill for your patient or does your ego get in the way of treating your patients?
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Wow, Rachel. I think I am aroused! I was going to respond to Anonymous' comments, but you are doing just fine!
ReplyDeleteMissing the IV is the patient's fault? OK, then.
But I will say, you are right- the OR's around these parts do not want paramedics in them and THEY have the upper political hand. So that is not going to change. You have to do what I do- seek out every opportunity to practice with the manekin. I know it is not the same, but it will have to do.
And I try to plan how I am going to tube every patient I have. Kind of like a 'preplan' the fire service does. I try to assess their anatomy, and such.