Sunday, June 13, 2010

The Para-God Complex: A Return to the Basics

I have been a nationally registered EMT-Basic for a year and a half now and a licensed and practicing EMT since January. Needless to say I am not the most experienced EMT in the world but I am learning a lot. Over the past six months I have worked with a number of ALS and ACLS providers, ranging from a fully endorsed basic to a paramedic. Each one has given me a different perspective. Also in my six months working for Eagle I have run into many other health care providers in the various hospitals I've seen. Now a lot of the providers are awesome, care about the patients enough to listen to a patient report and there are those that feel inconvenienced by patients. This ranges from EMS providers to doctors.

To be fair I have worked with my fair share of folk from both of these categories. I've seen good EMTs and medics who care more in making the patient the most comfortable they can be. I've also seen those EMTs who just want to get the patient dropped off and get back to the barn. I've run into Medics who are nothing but friendly and are willing to take the time to teach us basics various tricks of the trade and I've seen some that don't even give you the time of day. It's the latter I will be focusing on for the rest of this post. Here's an example:

One night my partner and I were coming in from a 911 to a nursing home. The patient was in no means critical but in distress nonetheless. We called a patient report in to a very annoyed nurse. Apparently calls at 0300hrs just do not make anyone's morning. We get to the hospital, get the patient moved over to the hospital bed and while my partner is giving his report as he was the one who did patient care, I went to remake the cot and clean up the rig. Well I got all the sheets together saw one of the hospital paramedics walking towards me. I asked him if he would help me lift the cot as it was lowered and he just ignored me and walked by. Now he may not have heard me but ask anyone that knows me, they will tell you I am not a quiet guy and he was two feet away from me when the question was asked. I asked my partner what his deal was as my partner also works as a medic for the hospital and he explained that this particular medic felt that cot making was beneath him. He finished by telling me that this medic was a prime example of the Para-god complex: a feeling of being above people because he knows how to push drugs, knows more advanced life saving techniques and can generally do a lot more than basics can. This would not be my first run-in with this complex. Other examples include being dumped with stable patients that the hospital medics don't want to transport.

Now I understand that with all this knowledge paramedics have a lot more responsibilities with trying to save a patient and that this can go to one's head. Especially if they were to have a streak of saves in the back of an ambulance. However as one of my fire instructors taught me, they can push all the drugs they want but if they don't start with the basics, the stuff an EMT-B is fluent in, no amount of drugs pushed will help a patient. The basics include opening the airway, checking and remedying patient breathing problems, and finally checking for adequate circulation. Without these there is no point in pushing drugs on a patient. The point is, that even with all the medical training in the world at your disposal not forgetting the basics is paramount for a patient's survival.

This does not mean that I won't be going for my paramedic certification. I plan on going for it as soon as I am done with fire school. What it does mean is that feeling that certain calls, or certain duties are beneath you causes not only a disservice to your patient base but also causes you to be complacent in patient care. This complacency will cause anyone to forget the basics needed to be done in every call. Maybe not all the time, but some of the time, which is many times too many in my opinion. Remembering that we all once started out as basics, unless someone skipped that step and went straight to medic school, and remembering we were all at the bottom of the totem pole will create more humble health care providers who don't mind teaching those below us the tricks of the trade. This in turn creates a chain reaction that will snowball lower and lower creating EMS providers who are focused on the most important part of patient care. The well-being and betterment of their patient.

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