Citizen calls 911 for a possible man with a gun. No further details.
Police arrive on scene to investigate, and see a man run away, into a business, and up into the attic.
The attic is large.
Many more police arrive.
Police use fire department’s ladders to send K9 officer into attic.
Noise ensues, and K9 returns uninjured but unhappy.
Much thought is put into the safest way to approach the situation.
Long wait.
The roof is checked, thermal imaging is attempted without success.
Ladders are stuck into every attic access, and officers enter the attic with the K9.
“Come out now or we will release the police dog on you! Come out now or the dog will bite you!”
Wait.
K9 suddenly gets very excited, much noise ensues.
Sounds of person screaming can be heard, and officers are yelling commands to dog and subject.
More yelling, yelling, commands…
Bloody parolee descends ladder, in his underwear.
Parolee is assisted to the ground by officers while yelling “I didn’t do anything”.
Sunday, February 21, 2010
Friday, February 19, 2010
Smile and Do What You're Told
I’m not sure where I stand regarding ambulance companies, and I mean “companies” in the terms of business entities. There are so many factors to weigh. On one hand, I know for sure that any and every time that money unnecessarily becomes a motivator and decision maker before the best possible care we can offer our patients, it vexes me at least a little. This happens all the time in ambulance companies big and small, and that’s why the whole idea of an ambulance company being publicly traded or owned by a publicly traded company is anything but ethical in my eyes. It does, however give EMS providers a good opportunity to make a good living as a caregiver, and sometimes even makes them better equipped.
In a large, for-profit ambulance company, the loyalty of the company is certainly most often to the company itself, and not to the patients. In any EMS organization, large, small, private, or public, decisions have to be made that affect the provider’s ability to provide excellent care. Budgets have to be balanced with technology, ethics, and desires. Some EMS organizations have the money for things like portable ultrasound and video lanyngoscopes, and this undoubtedly benefits their patients in the long run. Some companies can’t even afford simple tools though like updated cardiac monitors. Sometimes these decisions are truly difficult to make, because there just isn't enough money to do everything, and sometimes these decisions aren’t made on the basis of what can be afforded by the company, but by determining the bare minimum to keep the company in the same amount of business, and sending the rest to the executives, the management, and the stockholders. It’s a shame that as a country we’ve let our EMS system come to this, but it is what it is and it’s too well developed to change overnight.
On the extreme other hand in ambulance companies, what do you do when a small, private ambulance company serving a rural community can’t afford the equipment they need to provide excellent care? If as the local protocols change they can’t afford the equipment upgrades then what? Should they simply bow out and let another company come in? I think if it’s better for the citizens of that community, then yes. Maybe there can be other ways found to obtain these funds, but sometimes especially in this present economy, a small business just can't afford to be what they need to be. It’s a shame because small businesses are the foundation of this country, and have played a huge role in the development of our EMS system, but realistically their role in emergency care may be facing an abrupt change.
Ultimately when it comes down to business ethics, an organization has the potential to do an injustice to their patients unless they are strictly policed by the agencies that govern them. If there is somebody that stands to benefit from cutting a corner, it eventually will happen. This is the nature of private business and of the human condition and simply won't change. It will be a long time until we get to the point in the USA where our EMS system has structure, uniformity, and keeps the public as its number one priority at every level. I don’t have an ultimate solution. I know that EMS is a public safety profession just like law enforcement and fire protection, but we don’t make it a public service or a public responsibility; not universally, anyhow. If we did, and if every ambulance was an ambulance, equally staffed and equipped, funded according to local needs of operation, deployed according to local needs of coverage, and accountable to the public, what would the difference be? If there were no middle-men that the overflow of money went to; if there were no stockholders, no profit-sharing, no bonuses, just paid personnel, and residual funds reinvested into the operation, what would the difference be? Maybe we should look internationally for the answer. For now, the best we can hope for is that our EMS agencies continue to govern providers well enough to ensure acceptable minimum requirements, and that organizations do all they reasonably can to provide excellent service.
Honestly, we’ll be hard-pressed to right the injustices of our EMS system in the USA in our lifetimes. It’s true that you can find systems run elsewhere without these same problems, but mostly in older societies. Our country is very young compared other societies which are older than their written history.
The problems of United States EMS are similar to the problems that our medical system faces as a nation. There are people making money due to the different levels of healthcare that people receive. Managed care means a lack of care. This, I suppose, is the basis of our capitalist society, which saddens me.
So ultimately, as providers, what can we do about the situation? Well, the answer is to do both everything and nothing.
We can realistically do nothing immediately, and probably nothing in our lifetimes, about the state of the US healthcare system, or the conflicts between capitalism and ideal patient care, so dissenting and rallying and getting angry won’t right what we feel is wrong. We’d be better off channeling our energies elsewhere.
We can, though, continue to do everything in our power as providers to provide excellent care on a daily basis. We learn very quickly the ins-and-outs of our systems, and the agencies we work for. We understand the rules that govern us and exactly what is and is not allowed. We know exactly how much we can do for our patients with what we have, and we can take every opportunity to be excellent providers, counselors, social workers, community paramedics, advisors, teachers, and anything else our patients need us to be. We just have to want to.
We need to get over this idea that our role is all about emergency medicine, because after a short while in EMS it’s obvious that it is not. We need to want to educate ourselves constantly, to learn all we can about the non-life-threatening illnesses and even the non-illnesses that we treat so often. We need to be able to provide expert care and advice, based on true expertise and knowledge. Really we would be at a greater benefit if our continuing education concentrated more on common ailments and social services than cardiac arrests.
So what does it come down to? I don’t know. I do know that perhaps what our employers want of us really is the best thing. Employers love submissive extroverts, meaning that we do what we’re told, and love people. That’s really the basis of being a great provider; love people, and be an exemplary employee so that your organization keeps providing you an opportunity to provide excellent care. As a group of type-A personalities the extrovert part comes easily for EMS providers, but the submissive thing not so much sometimes. We want to have fun all of the time, and to control everything. We can't, and I think now that part of the maturation of a provider is coming to that realization. I love the opportunities that being a paramedic provides, and I'm glad to keep learning these things about medicine, life, the business, and myself all the time.
In a large, for-profit ambulance company, the loyalty of the company is certainly most often to the company itself, and not to the patients. In any EMS organization, large, small, private, or public, decisions have to be made that affect the provider’s ability to provide excellent care. Budgets have to be balanced with technology, ethics, and desires. Some EMS organizations have the money for things like portable ultrasound and video lanyngoscopes, and this undoubtedly benefits their patients in the long run. Some companies can’t even afford simple tools though like updated cardiac monitors. Sometimes these decisions are truly difficult to make, because there just isn't enough money to do everything, and sometimes these decisions aren’t made on the basis of what can be afforded by the company, but by determining the bare minimum to keep the company in the same amount of business, and sending the rest to the executives, the management, and the stockholders. It’s a shame that as a country we’ve let our EMS system come to this, but it is what it is and it’s too well developed to change overnight.
On the extreme other hand in ambulance companies, what do you do when a small, private ambulance company serving a rural community can’t afford the equipment they need to provide excellent care? If as the local protocols change they can’t afford the equipment upgrades then what? Should they simply bow out and let another company come in? I think if it’s better for the citizens of that community, then yes. Maybe there can be other ways found to obtain these funds, but sometimes especially in this present economy, a small business just can't afford to be what they need to be. It’s a shame because small businesses are the foundation of this country, and have played a huge role in the development of our EMS system, but realistically their role in emergency care may be facing an abrupt change.
Ultimately when it comes down to business ethics, an organization has the potential to do an injustice to their patients unless they are strictly policed by the agencies that govern them. If there is somebody that stands to benefit from cutting a corner, it eventually will happen. This is the nature of private business and of the human condition and simply won't change. It will be a long time until we get to the point in the USA where our EMS system has structure, uniformity, and keeps the public as its number one priority at every level. I don’t have an ultimate solution. I know that EMS is a public safety profession just like law enforcement and fire protection, but we don’t make it a public service or a public responsibility; not universally, anyhow. If we did, and if every ambulance was an ambulance, equally staffed and equipped, funded according to local needs of operation, deployed according to local needs of coverage, and accountable to the public, what would the difference be? If there were no middle-men that the overflow of money went to; if there were no stockholders, no profit-sharing, no bonuses, just paid personnel, and residual funds reinvested into the operation, what would the difference be? Maybe we should look internationally for the answer. For now, the best we can hope for is that our EMS agencies continue to govern providers well enough to ensure acceptable minimum requirements, and that organizations do all they reasonably can to provide excellent service.
Honestly, we’ll be hard-pressed to right the injustices of our EMS system in the USA in our lifetimes. It’s true that you can find systems run elsewhere without these same problems, but mostly in older societies. Our country is very young compared other societies which are older than their written history.
The problems of United States EMS are similar to the problems that our medical system faces as a nation. There are people making money due to the different levels of healthcare that people receive. Managed care means a lack of care. This, I suppose, is the basis of our capitalist society, which saddens me.
So ultimately, as providers, what can we do about the situation? Well, the answer is to do both everything and nothing.
We can realistically do nothing immediately, and probably nothing in our lifetimes, about the state of the US healthcare system, or the conflicts between capitalism and ideal patient care, so dissenting and rallying and getting angry won’t right what we feel is wrong. We’d be better off channeling our energies elsewhere.
We can, though, continue to do everything in our power as providers to provide excellent care on a daily basis. We learn very quickly the ins-and-outs of our systems, and the agencies we work for. We understand the rules that govern us and exactly what is and is not allowed. We know exactly how much we can do for our patients with what we have, and we can take every opportunity to be excellent providers, counselors, social workers, community paramedics, advisors, teachers, and anything else our patients need us to be. We just have to want to.
We need to get over this idea that our role is all about emergency medicine, because after a short while in EMS it’s obvious that it is not. We need to want to educate ourselves constantly, to learn all we can about the non-life-threatening illnesses and even the non-illnesses that we treat so often. We need to be able to provide expert care and advice, based on true expertise and knowledge. Really we would be at a greater benefit if our continuing education concentrated more on common ailments and social services than cardiac arrests.
So what does it come down to? I don’t know. I do know that perhaps what our employers want of us really is the best thing. Employers love submissive extroverts, meaning that we do what we’re told, and love people. That’s really the basis of being a great provider; love people, and be an exemplary employee so that your organization keeps providing you an opportunity to provide excellent care. As a group of type-A personalities the extrovert part comes easily for EMS providers, but the submissive thing not so much sometimes. We want to have fun all of the time, and to control everything. We can't, and I think now that part of the maturation of a provider is coming to that realization. I love the opportunities that being a paramedic provides, and I'm glad to keep learning these things about medicine, life, the business, and myself all the time.
Friday, February 5, 2010
Thanks to GenMed
Firstly, thanks to the GenMed Show for having me on their second episode, “I’ve Got You Under My Skin”, which was recently posted. Secondly, my sincere apologies to the GenMed Show for my contribution to the night’s technical difficulties. A new headset mic and a little tweaking of my Skype settings and all is well now.
On the topic of microphones, if you’re going to buy a lower-end (under $100) mic, go with Plantronics. Plantronics makes communication equipment, as a trade. Other companies like Logitech make other things like keyboards and such, and just don’t make the same quality when it comes to audio equipment. Plantronics has made every mic and headset I’ve used in all five emergency dispatch facilities I’ve worked in, and I’ve had nothing but good luck.
The GenMed Show episode was a talk about body modification, as it relates to a medical workplace, especially an EMS workplace. They brought up concerns including health and safety risks, professionalism and appearance, developing patient relationships, and conflicts with management. Some excellent points were made by the hosts, and by a couple very thoughtful people in the business who left voicemails that were played on the show.
Despite the technical problems I think the show did great. Those guys and gals are obviously working hard at getting the show going, and doing a great job. I can’t wait to hear future episodes on equally interesting and controversial topics.
Check out the episode and those to come at http://www.genmedshow.com/.
On the topic of microphones, if you’re going to buy a lower-end (under $100) mic, go with Plantronics. Plantronics makes communication equipment, as a trade. Other companies like Logitech make other things like keyboards and such, and just don’t make the same quality when it comes to audio equipment. Plantronics has made every mic and headset I’ve used in all five emergency dispatch facilities I’ve worked in, and I’ve had nothing but good luck.
The GenMed Show episode was a talk about body modification, as it relates to a medical workplace, especially an EMS workplace. They brought up concerns including health and safety risks, professionalism and appearance, developing patient relationships, and conflicts with management. Some excellent points were made by the hosts, and by a couple very thoughtful people in the business who left voicemails that were played on the show.
Despite the technical problems I think the show did great. Those guys and gals are obviously working hard at getting the show going, and doing a great job. I can’t wait to hear future episodes on equally interesting and controversial topics.
Check out the episode and those to come at http://www.genmedshow.com/.
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