Doctors, nurses, medics all suck

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msmertka

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Hey all. As you can probably guess I have just found this forum though I have been reading some others I am interested in for a while now.

I just read a lengthy thread in another topic about how everyone has an opinion on everyone elses profession. So with my controversial topic I would like to ask a question here:

Why can't we focus energy on working together instead of all the bickering?

I am a paramedic, I hope to always be one as well. This year I also start med school because I want to do more for my patients. Without adding my resume lets say I have been in prehospital for a while moving up the chain from first responder back in my late teen years. (nobody is to call me grandpa ;) I have worked in many places in many capacities, currently I am working in the hospital. (as a paramedic not a med tech.)

All night long (proud night-shifter) I hear from nurses how stupid doctors and paramedics are. Doctors tell me how stupid nurses are. The ED medics (guilty myself) complain that the field medics are making us look bad. But here is the kicker: The EM docs gripe about how IM doesn't work and they pick up the slack. I spend 2/3 of my time with the trauma service (surgeons) who go on about how the EMs don't know crap and shouldn't even be involved with trauma care.

So first let me defend paramedics: The profession started because there was a need. It was originally offered to nurses but they declined for reasons unclear to me but the idea of not wanting to be responsible for decision making keeps coming up in my queries. That was in the 60's. So some Doc's got together and decided to create somebody who would fill the field role because there were not enough docs to go around. Looking to the military the Paramedic was born. Several years later there is a nursing shortage. (I will refrain from my opinions on the nursing profession here) So we moved into the Hospital, then clinics and we continue to be the plug that is constantly pushed in the ****. As a self-styled critic of paramedicine, I am quick to point out when things are inadequte. (like my spelling) But it is with the hope of making the profession better. There are EMS professionals trying desperately to raise the bar. But there are obstacles both internal and external that need to be overcome.

Now for DRs.:
I was raised with the value that doctors should always be respected. They are human and make mistakes, but they have spent many years at great sacrifice to help people. I have taught my share of residents and med students over the last few years. (merit badge courses like ACLS, etc.) They are in the process of taking this large step and we all should do our best to help them in a constructive manner. Back to the point. Nobody can compare to the broad base of knowledge a physician can bring to bear on a problem. (though BIOMED Ph.Ds disagree) but can anyone really say they have never "overthought" a problem? Can anyone claim they always look at every possibility based on this breadth of knowledge? Can all the doctors claim that they were never tired or taking care of too many patients and overlooked something basic? I think not. Wisdom also requires grace.

Nurses: Nurses play a vital role in healthcare, though not the role the ANA wishes them to. In an effort to be recognized as a profession they have heaped on eduation. (something paramedics also need to do) but quantity is not a quality all of its own. They take classes that relate to the art of dealing with people. Some take classes that emulate MD/DO but then have theory without practice. The older RNs I work with feel that nursing is losing site of what they are for. In their words: "caring for people." Nowhere in there is "pretending I am a doctor with less education and clinical training."


Doctors hating doctors:
Can you believe that the surgeons I work with can't stand EMs? (It's true.) Now which of these can we label as stupid? Clearly they are all doctors. But with different expertise. I think that is how we all fit in. Doctors, Nurses, Medics, PAs whatever it is you do. I could make an arguement that PAs are the stopgap for what paramedics were originally intended to be.

If you take any of us out of our element we are not going to perform at peak. That is why nurses can't anticipate what MDs are thinking. After being hounded in paramedic class that there is only one right way and everything else is wrong. (I call it breeding ignorance) What do we all expect? We are all convinced we are the best at what we do. I think we are right. The problem is we don't understand what it is each other does and just like a bunch of industrial age factory workers we just draw the conclusion because we don't understand the other the other must be stupid or wrong. (because I of course could never be wrong)

Now that we have identified that our broken healthcare system needs some tuning, I challenge everyone here to get together and bring everyone up a notch. I have been fighting to make paramedics better for a few years now. The problem is still the same. It is a misfit group that the requirements are stagnant or getting lower in areas because they are dual controlled by public safety managers and accountable to medical authorities. Doctors started the idea so doctors should take it back. Who but the ones who have spent countless years in school knows medicine and what is needed any better? Who else can train less educated any better? Who else can demand that medics have their own licence so not as to fall under somebody elses? I think the only answer is Docs. Nurses need to get back to the practice of caring for people, not making medical decisions and not trashing everyone else. Worrying less about their political and economic standing and worry more about what they do for patients. Here is a clue for the nurses: Doctors care about patients too, otherwise they would not do so much to be doctors. They are not just scientists with white lab coats. Medics need to advocate being part of healthcare not a safety force. Any idiot can start an IV, I know drug users that are better at it than I am. (I'd like to think I'm pretty good) Medics need to get away from the fire service and municipalities. In my ideal world all medics would work for hospitals. Medics also need to demand more formal education. Where I live our continuing ed is more than double that of nursing. We need that ed upfront not OTJ at the expence of patients.

There I have spoken my piece, who will help me in this endevor of mine?

Mike

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southerndoc said:
It seems that basis of medicine is to try to look like the brightest individual there is. Many people try to accomplish this by putting other professions or specialties down.
I think a big prob is that people in medicine expect perfection from others, that combined with the fact that failures are more mentally salient than sucesses means that it is easy to think of examples of when docs, nurses, emts etc. screw up. Harder to remember all the times that they did well. This leads to generalizations like "docs suck." We tend not to do the same for our own catagory becuase we say "oh, that guy is a bad paramedic" rather than saying that there is an inherent problem with paramedics or whatever one is, since one doesn't want to lump oneself in with others in a flawed catagory.

man, I hope this still makes sense when I read it in the morning. Yay head cold and late nights.
 
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