Another day, another set of great sessions. Granted, I’m generally playing in the dry area of the Admin and Educator tracts, but hey, I’m kinda of weird that way. The Community Paramedicine 101 session had an interesting overview of both systems that currently utilize community paramedics to differing degrees, as well as they’re effects and ways to fund them (again, more than slightly important if EMS is more than a quick ride to the hospital). Granted, that position isn’t for everyone, if you could return 11,000 bed hours back to the local hospitals (…and I can’t remember which system that was for the life of me), the efficiency added to the system alone is going to be worth something, if only by reduced wait times and hospital diversions.
The other session that would be ground breaking if (when?) implemented was the discussion in Do Your Protocols Penalize Your Best Paramedics? Even the concept of being able to tailor, on an official level, protocol restrictions to the provider has a huge opportunity both to revolutionize patient care, as well as the profession itself. Imagine the consequences if the protocol was a floor instead of a ceiling crawl space? All of a sudden all of those courses that don’t matter because “we’re not physicians or nurses” matters a great deal. Continuing education all of a sudden becomes pertinent (Side note, what’s the point of continuing education if you can’t actually implicate what you learned? After all, you’re being compared to Tommy, who couldn’t form a proper treatment plan with both hands, a map, and a cookbook protocol book who hasn’t taken that CE) because you’re expected to be different. All of a sudden knowing all of that anatomy, physiology, pathophysiology, etc becomes pertinent because the minimum standard is no longer the maximum standard.
Probably the most important thing is a potential end to the EMS brain drain. How many paramedics and EMTs are lost every year to medical schools, nursing schools, PA schools, or other professions? Sure, pay is an issue, but so is how restrictive some systems are when it comes to treatments or required medical control contacts. It doesn’t matter what the pay is when certain aspects of your job makes you hate it, such as an inability to use independent judgement (not to be confused with independent practice). After all, imagine how different EMS would be if the paramedics who left were the paramedics running EMS, both in the government regulatory agencies, as clinical managers, and as training/QI? Imagine how much easier it would be to implement community paramedics if you have a whole gaggle more of paramedics ready and willing to take on that challenge. Instead, they’re now the RN/PA/MD because the system essentially pushed them out.
Finally, I’d like to put 2 pleas out there. Sure, it’s 12:45 am on the last day of the conference, but if by some feat of magic or witchcraft (besides turning me into a newt*), please participate. First, ask questions. If the presentation asks for comments from the peanut gallery, raise your hand. You never know who’s going to say what that’s going to effect the direction of the conversation or influence someone else. At worse, you’re wrong (which is great because misunderstandings or mistakes happen, but not catching and fixing them is inexcusable), at best you’ve provided a kernel that may fundamentally change the conversation or how someone else interprets what’s being said. Your comment might get someone else thinking along the same lines, which eventually produces a refined and usable concept. Evolution is not a closed system.
Second, go and talk to the equipment manufacturers in the exhibit hall. Go sit in the ambulances, push the buttons, AND PROVIDE FEEDBACK. The manufactures can’t fix what they don’t know is broken. Sure, they have their focus groups of both managers and field providers giving them feedback, but here’s a chance for you to interact personally. Share what works. Share what doesn’t (Dear Wheeled Coach, do us all a favor and just make the “Patient heat/cool” HVAC switch in the back a standard feature). Many of the ambulance manufactures are going to LCD panes to control everything. How does using a touch screen, in contrast to mechanical switches, affect the driver’s ability to concentrate on the road? Sure, most of us have absolutely nothing to do with buying equipment, but we have to live with their choices, be it the ambulance or the monitor or the backboards. However, who ever does equipment and vehicle acquisitions can’t buy a vehicle with a feature that hasn’t been implemented or a “feature” that hasn’t been removed yet. The ambulance is your office, and everything else is your tools. You have a chance to speak one on one with sales and executives from many of these companies. Don’t squander it.
*I got better.