It’s Time

Yesterday, I spent my day doing something I hadn’t done in a long time: Teaching.  I volunteered (was drafted?) a few weeks ago to produce an entire day of content for one of our paramedic refreshers, and the opportunity excited me.  As I started putting together my topics, I decided early on that I wanted to expose the class to things that they hadn’t been exposed to before.  The four presentations I put together were: EMS and the Non-Transport Call, The Well Being of the Paramedic, The Future of EMS, and EMS and the Internet.

The content seemed to be well received, and some of it sparked some decent conversation.  It got me thinking about our struggles here in Massachusetts over the last year.

As most of the EMS community knows, starting last summer, Massachusetts saw a number of indictments of instructors and course coordinators who were falsifying documentation to recertify EMTs and paramedics.  It was a pretty big deal, and punishment was not just served to the instructors but also to the recipients of the alleged training who signed the rosters.  Suspensions of certifications were as short as 90 days, and as long as in excess of a year.  Some even lost their cards and could face jail time.

In response to the problems experienced, the state’s Office of EMS has responded by increasing the oversight they have on classes throughout the state.  Evaluators will occasionally “drop in” on classes, sign in, sit to audit for content, and make sure everyone is there.  I’ve heard of it happening a few times, but unfortunately, I did not receive a visit on Thursday.

Let me preface this by saying I feel that the punishments handed down were just.  People got what they deserved for the mistakes that they made.  It saddens me though that thus far, the state seems to have missed the big picture.  Refreshers need to be revamped and restructured.  Priorities need to shift.

With all of the data that is being collected in the prehospital setting, we have a better look than we have ever had.  It’s time to put it to some use.  Tell me, and tell my colleagues in my system what our short comings are.  Tell us what we need to work on and what we excel at.  Tell us what our save rate is.  Tell us what our intubation rate is.  Immerse us in information.

Ask our medical director what we are doing well.  Find out from them what the other ER docs are saying and help us improve.  Lets get away from having an instructor stand in front of the class and retread information that we learn every two years.

Sure, there needs to be some core competencies that are reviewed like 12-Leads, protocol updates, and intubation, but the rest needs to be driven and steered by the data we are collecting, our medical directors, and where we see ourselves going in the next two years.

Right now, and I can say this from the experience I’ve had in the last 4 refreshers I’ve taken, the paramedic classes I’ve experienced have been nothing short of a grind.  You go, you listen, you sigh, and you wait for it to be done so you can come back the next day.  Don’t get me wrong, I’ve taken a lot from some of the classes I’ve done as part of them.  I’ve updated my PALS, retaken my PHTLS, learned about LVADs, and deal with some interesting topics, but for the most part, it’s a painful right of passion that unfortunately all paramedics must endure.

It is time for a change.  It is time for Massachusetts to restructure how they do their refreshers.  Give more freedom and control to the system . . . no. . . . REQUIRE systems to evaluate themselves.  Help us find out short comings, and help us improve the care that we deliver.  Do it for our patients.