What has happened to good BLS?

[Jybehofd 85]

Lately it seem to me that good BLS has  fallen by the way side and the lack of skills on the EMT part and some ALS providers have been lacking in BLS skills, I have been on calls where the BLS crew waited 10 plus minutes for the medic to get there before they take a blood pressure or start taking a history on the patient???? the EMT just walking in with the clipboard on someone with difficult breathing still doesn't help the patient. I have seen other bring every single bag out of the ambulance inside when the medic is already there and treating the patient and the bags just get in the way because they drop them and go get the stretcher... does anyone have an idea on how to change this?

[x635 4,066]

As some ex-Empress EMS EMT's would say, including two members of this forum, "ALS is just a luxury, BLS is a neccesity".

I am a Paramedic, and know ALS interventions can save lives. BUT, as I was taught, BLS before ALS always. If you don't have strong BLS, then your ALS isn't going to matter.

I think the problem is, and has been for a while, is that some providers become "Flycar Dependent", and Paramedics don't help the situation by delegating tasks to let EMT's learn.

I think there are a lot of EMT's with good intentions, but have become too dependent on Paramedics for everything.

[PFDRes47cue 653]

Does anyone think that it may also be a result of EMT-B instructors pushing kids through the classes?

(NOTE: THIS IS NOT A DIG ON EMT-B INSTRUCTORS!)

[Bnechis 3,961]

Lately it seem to me that good BLS has  fallen by the way side and the lack of skills on the EMT part and some ALS providers have been lacking in BLS skills, ... does anyone have an idea on how to change this?

I just wrote about how to solve this in another thread (do line officers need medical training). The main problem is lack of supervison in the field. FD supervises its people, PD does also, EMS..you have a valid card...man the ambulance.

Does anyone think that it may also be a result of EMT-B instructors pushing kids through the classes? (NOTE: THIS IS NOT A DIG ON EMT-B INSTRUCTORS!)

Everyone cry's about adding more training time and who else is taking the classes?

[davidemt 9]

I recently finished my EMT-B class, and, once I got out into the field and started dealing with real-life situations, I was very surprised about how unprepared I felt. My instructor for the classroom/lecture portion of the class was very knowledgeable and prepared us well to pass the state written exam. (As with anything else, I'm sure the quality varies quite a bit between instructors.) On the other hand, the quality of some of the lab instruction—as well as the amount of time alloted for lab instruction—left a lot to be desired. And it seems like those practical skills learned and practiced in lab—built upon a foundation of knowledge about anatomy and physiology from the classroom portion of the class—are the mark of good BLS.

From my very limited experience in the field, it seems like adding a greater emphasis on practical skills training might help produce EMT's that provide the higher-quality BLS that the original poster asked about. This poses the problem, though, of creating EMT-B classes that are prohibitively long; I wonder if adding additional hours to the class to accommodate expanded practical skills training might dissuade a lot of people from taking the class altogether. If the length of the EMT-B class was kept the same but time was shifted toward practical skills and away from classroom instruction, I wonder if that might create EMT's who are good with BLS skills but are not sufficiently knowledgeable about the anatomy and physiology behind what they're doing. I guess it's a problem of finding the right balance between lab and classroom instruction.

Although adding more emphasis on practical skills training might help with improving the quality of EMTs' BLS skills, I was surprised about how little effort a few people in my EMT-B class put forth. You could tell they weren't reading the textbook or practicing the skills on their own. I'm not sure if those people passed the state written and practical exams or not. Although those exams might do a little to help keep people with poor BLS skills from becoming EMT's, I'm sure quite a few people eek by and get their EMT-B certification (they weren't that difficult). I agree with what PFDRes47cue said about "instructors pushing kids through the classes." It might help the quality of BLS that is provided by EMT's if the bar was set a bit higher.

(This is my first post... please be nice!)

[Goose 188]

Interesting discussion - and some great points have been posted. It's nice to hear from some newer EMS providers.

I think there are a number of issues at play when we talk about the quality of providers (EMTs and Paramedics) being graduated. For the sake of this discussion i will try to highly two of the larger (in my opinion) realities.

1) I think EMS education, nationwide, has become problematic. There are an awful lot of solid basic and advanced programs that exist out there, i think we are luckily to have a few locally. Unfortunately, some see the education EMS providers as more of money making opportunity than an opportunity to graduate thoughtful clinicians with the skills necessary to effectively care for acutely/chronically sick & injured of our society. I think this is why a very large part of me wants to see EMS education fall under the NY Dept. of Education.

2) As far as the strength of EMT basics more specifically, i think this ends up being a regional problem. The new york city 911 system (municipal & private) has some amazingly talented basic providers. I'm talking about incredibly seasoned professionals with a strong clinical ability. I was fortunate enough to come across a number while i was a paramedic student. I think there are a host of reasons for this - volume, retention and the design of the FDNY EMS system. The same exists in more rural sections of New YorK, in large part due to the design of the system and general lack of advanced providers in those regions. Westchester is fortunate enough to have an EMS system (if we can call it that ) that is heavily saturated with Paramedics. Many systems require a paramedic evaluation on every run. Combine this with low overall call volume and i think we have ourselves a recipe for "disaster," if you will. EMTs in some sections of the county may simply not be getting the experience or chance to practice their assessments and skills with the frequency that is required for mastery or that they personally desire.

We could probably talk until our fingers fall off about each of these individually, and maybe even more about what goes on within our own county. But these were the first two that came to mind while i was reading the other responses.

That's my limited and likely meaningless two cents on the issue. I do feel that ALS is/should be the standard of care but i also know every call requires solid BLS to be successful.

Edited March 20, 2011 by Goose

[Bnechis 3,961]

I recently finished my EMT-B class, and, once I got out into the field and started dealing with real-life situations, I was very surprised about how unprepared I felt..........I guess it's a problem of finding the right balance between lab and classroom instruction.

(This is my first post... please be nice!)

Excellent 1st post. Welcome

The right palance has always been an issue. Consider that 30 years ago the class was only 81 hours and the only major item that has been added is Defib. When I took my original EMT the instructor pushed us to 110 or 120 hours and I felt the same when I started in the field as you do. When I tought EMT classes I pushed it to 160-180 hours, & lucky for me I had a hosptial that was willing to pay for the extra time, even thought the state did not cover the additional time.

The key as I mentioned before is good field supervision, which saddly does not exist in much of the north east.

Good luck, find a good EMT or medic and learn from them.

Edited March 20, 2011 by Bnechis

[rob 249 0]

I feel that the new EMT are way too medic dependant Iam going on my fourth refresher and this is the first time I'm usinng the pilot program I sse new Emts refreshing this way right off the bat I feel that this is one reason things are the way they are new Emts should take a challenge class at least their first time so you at least remember what hands on feels like again. That is what is missing taking CME classes or lectures take that away

[foreman1923 22]

Does anyone think that it may also be a result of EMT-B instructors pushing kids through the classes?

(NOTE: THIS IS NOT A DIG ON EMT-B INSTRUCTORS!)

when I took my EMT course 6 years ago the instructors basically taught us how to rely on the medics for everything. lucily for me I had senior EMTs in my department that hated medics so I was able to get a happy medium of when to and when not to use ALS

[PFDRes47cue 653]

I recently finished my EMT-B class, and, once I got out into the field and started dealing with real-life situations, I was very surprised about how unprepared I felt. My instructor for the classroom/lecture portion of the class was very knowledgeable and prepared us well to pass the state written exam. (As with anything else, I'm sure the quality varies quite a bit between instructors.) On the other hand, the quality of some of the lab instruction—as well as the amount of time alloted for lab instruction—left a lot to be desired. And it seems like those practical skills learned and practiced in lab—built upon a foundation of knowledge about anatomy and physiology from the classroom portion of the class—are the mark of good BLS.

From my very limited experience in the field, it seems like adding a greater emphasis on practical skills training might help produce EMT's that provide the higher-quality BLS that the original poster asked about. This poses the problem, though, of creating EMT-B classes that are prohibitively long; I wonder if adding additional hours to the class to accommodate expanded practical skills training might dissuade a lot of people from taking the class altogether. If the length of the EMT-B class was kept the same but time was shifted toward practical skills and away from classroom instruction, I wonder if that might create EMT's who are good with BLS skills but are not sufficiently knowledgeable about the anatomy and physiology behind what they're doing. I guess it's a problem of finding the right balance between lab and classroom instruction.

Although adding more emphasis on practical skills training might help with improving the quality of EMTs' BLS skills, I was surprised about how little effort a few people in my EMT-B class put forth. You could tell they weren't reading the textbook or practicing the skills on their own. I'm not sure if those people passed the state written and practical exams or not. Although those exams might do a little to help keep people with poor BLS skills from becoming EMT's, I'm sure quite a few people eek by and get their EMT-B certification (they weren't that difficult). I agree with what PFDRes47cue said about "instructors pushing kids through the classes." It might help the quality of BLS that is provided by EMT's if the bar was set a bit higher.

(This is my first post... please be nice!)

Welcome aboard! I also agree with you when you say that there should be more time spent on the hands on practical skills. The solution is not to spend less time on the other stuff but to add more time to the class for the practical skills. When I got my EMT 3 years ago, I also noticed quite a few people who were not taking the class as seriously as they should have. Sad part is that it is probably safe to say that most of, if not all of them are not EMT-B's.

I feel that the new EMT are way too medic dependant Iam going on my fourth refresher and this is the first time I'm usinng the pilot program I sse new Emts refreshing this way right off the bat I feel that this is one reason things are the way they are new Emts should take a challenge class at least their first time so you at least remember what hands on feels like again. That is what is missing taking CME classes or lectures take that away

I agree with you as well. I feel that it is very important for new EMT's and old to refresh. I personally am not a huge fan of EMT's only doing CME's to refresh. There are a lot of good CME credit courses/lectures out there and while being very good to attend, people need to do hands on and test their skills.

when I took my EMT course 6 years ago the instructors basically taught us how to rely on the medics for everything. lucily for me I had senior EMTs in my department that hated medics so I was able to get a happy medium of when to and when not to use ALS

A lot of people I have spoken with, feel that their instructors taught to rely on the medic. This is wrong! BLS before ALS. Luckily, my EMT instructor was very big on not relying on ALS unless needed. What made me respect him for this, was because he himself was a Paramedic and had been for much longer than I have been alive. It was also useful that I took my EMT class up at school in a place where ALS is no first on scene to every call and often times not intercepted with until the BLS crew is almost to the hospital.

I also have a lot of good senior EMT's in my VAC that have been great leaders for me. I realized very early on (even before my EMT class) that BLS comes before ALS. I have also been blessed to work with some very high quality Paramedics who also push for BLS before ALS.

[JJB531 652]

when I took my EMT course 6 years ago the instructors basically taught us how to rely on the medics for everything. lucily for me I had senior EMTs in my department that hated medics so I was able to get a happy medium of when to and when not to use ALS

The fact that you have "senior EMTs" in your department that "hated medics" is a concerning statement. Paramedics have their place in prehospital EMS, and are a necessity, not a luxury. Did these "senior EMTs" who "hated medics" withhold appropriate medical care from their patients by routinely not utilizing ALS services simply because they "hated medics"?

[Tapout 42]

Welcome, young new EMT! Please, please oh PLEASE always be a good EMT. Never forget good, solid BLS. In CPR, never stop compressing that chest... even if you hear pops and breaks of ribs. Never ever wait for ALS to bring you meds or a defibrillator. Do your thing. Chances are YOU will be the one, with good solid continuous CPR, who actually saves the life of the person who went down and out.

I love medics. I married one. But in the moment of BLS arriving first, IT IS THE EMT MOST TIMES WHO SAVES OR DOESN'T SAVE THE LIFE OF THE PATIENT.

Your job is soooo much more important than you realize. Thank you for choosing this path. Now own up to it and never underestimate your value when it hits the fan.

Gratefully,

An old ER RN

[conman 40]

Im my department we have fd owned rigs where we run BLS only. We rely on a commercial ALS agency especially during the day when we are understaffed. Ive been an EMT for just over 2 years now I have to say thanks to some of the other EMTs and Medics in my department. I was taught quite a bit in my EMT class but the people form my department helped me to learn how to do things in the real world. Im not saying that instructors don't do their job, its just that there is so much to be taught and such a little amount of time to do it in. I was lucky to have been surrounded with EMS prior to me obtaining my EMT. But I can also see why in a sense BLS seems to be lacking. It does seem to be that we are becoming more ALS dependent and at times I find myself depending on ALS to get me through calls. So I too believe that more focus should be put on practical skills. A scared unprepared EMT isn't any help to the patient.

[DDixie 12]

As I read through the comments, I couldn't help but realize that many people said the same thing. Education is key. Just the other night I went on a trouble breathing call, pt was quite elderly. She provided no medical history, stated that she had no medical history. And that is what the EMT wrote on his PCR. When we got to the hospital and he heard me give my ALS report to the RN, the EMT was obviously confused. He asked me how I knew the patient had CHF because she didn't say she had a history of such. EMT class use to focus on the pathophysiology of disease. It forced students to looks at SIGN and SYMPTOMS and put the puzzle together. Now, EMT has been dumb-downed so much that it is simply "You have trouble breathing? Here is oxygen." EMTs need to take an initiative to learn beyond their textbook and gather more information to supplement their career. Perhaps then the EMT on our call would have noticed her "CABG" scar, slightly swollen ankles, lasix and betablocker medications and been able to put some information together. Granted her lung sounds were clear and equal bilaterally, but not every call is textbook - - thinking is essential. Education is imperative.

[ny10570 745]

DDixie nailed it. Skills are nice, but I can teach a monkey to splint, immobilize, suction, control bleeding, intubate, and start IV's. None of these are hard skills especially in the lab setting. They only get tricky when you have to do them on live people. No matter how many hours you spend in class you're not going to learn about down jackets and people who won't let you move their broken arm until you get to that down jack wearing broken armed patient. I can intubate the mannequin blindfolded, upside down, backwards, digitally, and without a stylet. However there are still people that with all the help in the world and the ideal conditions myself and later the ER could not intubate without a camera. Lab time will never be enough for the real world.

Pathophysiology, anatomy, physics, and pharmacology are what separates the professionals from everyone else. If you understand spinal anatomy and the basics of newtonian physics given enough time you can figure out the KED. It all makes sense. Instruction just helps you put it together faster. Instruction teaches you about using the padding and the shoulder roll to fill the voids. Understanding anatomy and physics should be enough that you apply the collar, then gently work the ked behind the back, secure it to the torso, and then secure the head. Armed with this detailed knowledge we can properly apply our skills to the patients who don't fit the classroom scenario. Take the 250lb patient in xyz scenario. There isn't an EMT or Medic class out there that has a mannequin for this one, yet with the right education you can understand what the classroom skills are trying to accomplish and adjust them for this reality.

[JohnnyOV 2]

As I read through the comments, I couldn't help but realize that many people said the same thing. Education is key. Just the other night I went on a trouble breathing call, pt was quite elderly. She provided no medical history, stated that she had no medical history. And that is what the EMT wrote on his PCR. When we got to the hospital and he heard me give my ALS report to the RN, the EMT was obviously confused. He asked me how I knew the patient had CHF because she didn't say she had a history of such. EMT class use to focus on the pathophysiology of disease. It forced students to looks at SIGN and SYMPTOMS and put the puzzle together. Now, EMT has been dumb-downed so much that it is simply "You have trouble breathing? Here is oxygen." EMTs need to take an initiative to learn beyond their textbook and gather more information to supplement their career. Perhaps then the EMT on our call would have noticed her "CABG" scar, slightly swollen ankles, lasix and betablocker medications and been able to put some information together. Granted her lung sounds were clear and equal bilaterally, but not every call is textbook - - thinking is essential. Education is imperative.

Completely agree... however, no EMT class, original or refresher I've been a part of, has ever dove into the disease itself. I had to research on my own, and through working with medics the actual pathology of how and why signs and symptoms present themselves. Call me old fashioned, but I would much rather get to the root cause and understand why something is occurring, rather then just provide O2, throw them in the semi-fowlers position, and scoot them off to the hospital. Pt care upon transition from BLS to higher level could be much better served if EMT's actual understood what was causing the symptoms and why the signs were presenting themselves as such, and relay that information to the higher level. Now, instead of being just an "ambulance drive,r" you've become a valuable asset to helping this patient.

[conman 40]

And that is a sad thing. After our EMT class we are thrown into the real world. When we respond as a BLS agency and we are given very little for a patient history we lose out. We can delay urgent care in some aspects if we have to take the time to try to pin point the problem the patient is having. If we are unable to get a patient history we have to do the very basics until an ALS agency arrives and in some cases those minutes are critical.

[Guest alsfirefighter]

As an experienced ALS provider and one who saw first hand the decline in BLS skill while still a BLS provider I have several opinions on this. And for the one who said they had "senior EMT's who hated medics," my experience has been they are often the most dangerous and suffer from certification napoleon complexes and are some of the ones I have to keep the closest eye on. But either way...as I often tell people...I'm not here to function so EMT's like me...I'm here for my patients to like me and give good solid patient care. I take being called a "dick" or "intimidating" as a compliment. I'm one of the most demanding medics in my system..and for one purpose..solid patient care. Any instructor and I have heard stories of people teaching..."do this and that and WAIT FOR ALS TO ARRIVE"....WHat!!!???!! Are you kidding me? I have to tell bls crews by radio often to not wait for me if I did a job from far away. Clip boards should be banned from in houses. If you are thrown into the real world..something is wrong...and unfortunately too many agencies push new EMT's into spots they are not ready for. Have required ride time as curriculums do not have enough field rotations in them for EMT-B's. Someone said something about being called old fashioned for taking the time to understanding something instead of throwing on O2 and putting them in semi fowlers and going to the hospital. Yes you are right...but it should take no more then 60 seconds to realize they need oxygen..use the time to get the lifting device you may need or the time transporting to figure it out...on scene time is important and one of the singular most important treatments any EMS provider can perform is transporting your patient.

With that said...

1. The change in curriculum in the late 90's to me was a dumb down of the certification and reduced the background and A & P knowledge us old curriculum EMT's needed to know. The patient assessment in the curriculum is absolutely atrocious and too cookie cutter. I became the medic I am because of strong bls education and street experience...its not there anymore.

2. Lack of training within VAC's. Some things need to be learned on the street..other things need to be learned and practiced as you don't use them often. CME training is often lectures...get them out of their chairs and review equipment and bls skills done in courses and testing.

3. I've worked around and seen some medics who don't step back enough to allow BLS to do their thing when appropriate. I always give them slack...and then take back over if they are lost.

[helicopper 1,050]

As an experienced ALS provider and one who saw first hand the decline in BLS skill while still a BLS provider I have several opinions on this. And for the one who said they had "senior EMT's who hated medics," my experience has been they are often the most dangerous and suffer from certification napoleon complexes and are some of the ones I have to keep the closest eye on. But either way...as I often tell people...I'm not here to function so EMT's like me...I'm here for my patients to like me and give good solid patient care. I take being called a "dick" or "intimidating" as a compliment. I'm one of the most demanding medics in my system..and for one purpose..solid patient care. Any instructor and I have heard stories of people teaching..."do this and that and WAIT FOR ALS TO ARRIVE"....WHat!!!???!! Are you kidding me? I have to tell bls crews by radio often to not wait for me if I did a job from far away. Clip boards should be banned from in houses. If you are thrown into the real world..something is wrong...and unfortunately too many agencies push new EMT's into spots they are not ready for. Have required ride time as curriculums do not have enough field rotations in them for EMT-B's. Someone said something about being called old fashioned for taking the time to understanding something instead of throwing on O2 and putting them in semi fowlers and going to the hospital. Yes you are right...but it should take no more then 60 seconds to realize they need oxygen..use the time to get the lifting device you may need or the time transporting to figure it out...on scene time is important and one of the singular most important treatments any EMS provider can perform is transporting your patient.

With that said...

1. The change in curriculum in the late 90's to me was a dumb down of the certification and reduced the background and A & P knowledge us old curriculum EMT's needed to know. The patient assessment in the curriculum is absolutely atrocious and too cookie cutter. I became the medic I am because of strong bls education and street experience...its not there anymore.

2. Lack of training within VAC's. Some things need to be learned on the street..other things need to be learned and practiced as you don't use them often. CME training is often lectures...get them out of their chairs and review equipment and bls skills done in courses and testing.

3. I've worked around and seen some medics who don't step back enough to allow BLS to do their thing when appropriate. I always give them slack...and then take back over if they are lost.

Good grief, do you have any idea who you sound like????

What he said! +1!!!

[Guest NickLFD]

I am from Larchmont and have worked/ volunteered in a few different areas and have found a lot of different changes between areas but I feel that they a lot of them share one thing in common. Medic dependency. In my short 3 years as an EMT basic I have seen that a lot of Basics will wait for the medic to make pt contact and are not able to complete the essential skills of a strong pt assessment that should go so much deeper than SAMPLE. I feel that because in a lot of places there is always a medic on the call, a lot of basics feel that they have to let the medic handle the pt assessment because they are the higher level of care. I have passed paramedic school at Springfield College in MA and in my clinical rotations and work at American Medical Response in Springfield, MA as an EMT-B. It's a very busy system and again, much like the comment about Empress ALS, it's a luxury. I will never wait for ALS on scene because most of the time, even if they are available, they are always at the furthest part of the city. By working without a medic, I have been able to build on my BLS skills and practice everything that I learned in EMT and Medic class without having to perform the skills of a paramedic. It has allowed me to apply the concepts from class to real life situations and think about them as I'm going with out having to think about them and worry about getting the IV in the pt's arm at the same time. The importance of BLS skills is essential to find the core problem with the pt. I don't think that good BLS is declining but that maybe the BLS providers are not getting the chance to practice the way that they should be.....

[GAW6 66]

This is a great topic and something I talk about all the time. As an EMT for 21 years, 9 of which as an EMT-I, I have seen such a decline in the quality of new EMTs. I am not sure if it is do to poor instruction, and people being "pushed through" the class, or it is Medic "dependency" (or a combination). I have always told my members that the best way to learn is by doing - the more calls you do, the better you will become. I have heard EMTs waiting on scene for the Medic to show-up - I always say, do what you have been taught and trained to do.

I admit, when the Medic system first came in to our Town, I had a difficult time with it. I went from running calls to driving the fly car. It was very frustrating to get up in the middle of the night, go to a call and either just stand there while the Medic "did his/her thing" and not say a word or give you any info, except for "can you find a garbage can for this stuff" and "who's driving my car". Things have improved greatly; I guess it just took time for them to realize the capabilities of the EMTs and for me to not be intimidated by them and be able to work with them.

Our Corps has abolished the CME program for recertification. We encourage people to take classes, attend lectures, get any further education you can. But when it comes to the basics, everyone should go through the skills and sit for the exam. If you can't do that, then you have no business being an EMT.

[ONEEYEDMIC 68]

This is a great topic and something I talk about all the time. As an EMT for 21 years, 9 of which as an EMT-I, I have seen such a decline in the quality of new EMTs. I am not sure if it is do to poor instruction, and people being "pushed through" the class, or it is Medic "dependency" (or a combination). I have always told my members that the best way to learn is by doing - the more calls you do, the better you will become. I have heard EMTs waiting on scene for the Medic to show-up - I always say, do what you have been taught and trained to do.

I admit, when the Medic system first came in to our Town, I had a difficult time with it. I went from running calls to driving the fly car. It was very frustrating to get up in the middle of the night, go to a call and either just stand there while the Medic "did his/her thing" and not say a word or give you any info, except for "can you find a garbage can for this stuff" and "who's driving my car". Things have improved greatly; I guess it just took time for them to realize the capabilities of the EMTs and for me to not be intimidated by them and be able to work with them.

Our Corps has abolished the CME program for recertification. We encourage people to take classes, attend lectures, get any further education you can. But when it comes to the basics, everyone should go through the skills and sit for the exam. If you can't do that, then you have no business being an EMT.

Except of course for Wed nights! That Medic guy was Awesome!

[GAW6 66]

Except of course for Wed nights! That Medic guy was Awesome!

ABSOLUTELY! Wish that Medic would come back - maybe someday?????

[ONEEYEDMIC 68]

ABSOLUTELY! Wish that Medic would come back - maybe someday?????

Not a chance!

[ONEEYEDMIC 68]

If I knew I wouldn't get in trouble I would stomp on those stupid clip boards! Any info you need you can obtain on the way to the ER or in the ER themselves. Unless it's gonna be a DOA or RMA, there is no need to get patient info inside a residence. Although I have been out of the EMS game for awhile, I have seen a big decline in ALS and BLS skills. One used to have to be a pretty seasoned Medic to work in a fly car system and now I guess it's who know in that system that gets you there. As for the BLS, I have no idea what is going on. I was always taught BLS before ALS!

[Guest alsfirefighter]

Good grief, do you have any idea who you sound like????

What he said! +1!!!

Hmmmm....I wonder. LMAO.

[velcroMedic1987 330]

If I knew I wouldn't get in trouble I would stomp on those stupid clip boards!

And the person holding the clipboard is always wearing gloves too!

[velcroMedic1987 330]

This is a great topic and something I talk about all the time. As an EMT for 21 years, 9 of which as an EMT-I, I have seen such a decline in the quality of new EMTs. I am not sure if it is do to poor instruction, and people being "pushed through" the class, or it is Medic "dependency" (or a combination). I have always told my members that the best way to learn is by doing - the more calls you do, the better you will become. I have heard EMTs waiting on scene for the Medic to show-up - I always say, do what you have been taught and trained to do.

I admit, when the Medic system first came in to our Town, I had a difficult time with it. I went from running calls to driving the fly car. It was very frustrating to get up in the middle of the night, go to a call and either just stand there while the Medic "did his/her thing" and not say a word or give you any info, except for "can you find a garbage can for this stuff" and "who's driving my car". Things have improved greatly; I guess it just took time for them to realize the capabilities of the EMTs and for me to not be intimidated by them and be able to work with them.

Our Corps has abolished the CME program for recertification. We encourage people to take classes, attend lectures, get any further education you can. But when it comes to the basics, everyone should go through the skills and sit for the exam. If you can't do that, then you have no business being an EMT.

I've been in the same boat and had many of the same problems. Because EMS is so poorly regulated and managed from the State right down to the agency this is not going to go away.

Glad you stuck it out and didn't go the way of so many EMT's and just quit.

[PFDRes47cue 653]

And the person holding the clipboard is always wearing gloves too!

They are often wearing the still CLEAN gloves while they write the PCR at the hospital.

[ONEEYEDMIC 68]

And the person holding the clipboard is always wearing gloves too!

Does that mean I have to put gloves on to knock it out of their hands? I got an idea, how about they put the clipboard down so I don't have to carry the Patient!