paccookie

Grady is a great hospital. It's old, it's kinda dirty and yes, the vast majority of the patients are indigent care. But where else can you find the variety of illnesses and injuries that you see at Grady? If you work at Grady, you're going to learn and your subsequent employers are going to know that you know how to do your job under pressure and with a minimum of comforts. Time at Grady is measured like dog years when compared to other places. It's really great experience.

I live in Warner Robins, work full time in Warner Robins and part time in Atlanta. Given the choice of working in Macon or Atlanta, I chose Atlanta. If you are looking for a good place to move in middle GA, take a look at Houston County. The school system is great, housing prices are reasonable, people are fairly diverse thanks to the air force base. There aren't a million things to do in WR, but there are several museums in Macon and Atlanta is only a short drive away. If you are looking for a place to live in GA in general, there are a few good places that I would recommend. After WR, Atlanta would be my next recommendation. If you can't afford to live in one of the awesome neighborhoods like Virginia-Highlands and send your kids to private school, you might want to live in the suburbs and commute. There are tons of hospitals to choose from, as well as nursing homes and assisted living homes and home health agencies. I work part time at Grady EMS and we see all kinds of neighborhoods all over the city. There is good and bad everywhere. Don't think that you have to move to Buckhead or Gwinnett Co to be safe. Crime is everywhere and a lot of how it effects you depends on your attitude towards people. If you expect crime to happen to you, it will. If you walk into a situation with a chip on your shoulder, someone is going to mess with you. But that's anywhere, not just Atlanta. There are several neighborhoods that are up and coming that I would recommend. Castleberry Hill, parts of West End, parts of Old Fourth Ward. And there are several that are desirable and have been for a while Candler Park, Little Five Points, Druid Hills, Inman Park, Ansley Park, etc. It all depends on your budget. Henry Co is nice as is Fayette Co. Both are just south of the city but close enough for a reasonably short commute. Augusta is a good sized city that seems to have good schools and a reasonable cost of living. Savannah is gorgeous but is extremely humid year round and I don't know much about schools or cost of living. I wouldn't recommend Albany, but neighboring Lee Co is nice.

Tylenol PM. Usually people don't realize how dangerous all that Tylenol is and they end up destroying their livers when they say they "just wanted to sleep..." I picked up one girl who took a bottle of 50 Tylenol PM. On scene she was responsive but slightly drowsy. By the time we got her to the hospital (maybe 15-20 minutes later), she was unresponsive and nearly ready for intubation.

This is the way Grady in Atlanta does it and it works really well. Every patient that isn't critical goes through triage. Some are sent to the medical side, some to the trauma side and many to the waiting room. It's simple and effective. We call for orders or to notify the ED of a CPR in progress, a very critical medical pt or a major trauma. That's it.

Please remember that medics are governed by medical control. To by pass a hospital, we must ask permission from med control...even if we think that it's a given that the level I trauma center is needed. Sometimes docs say "bring them here" when they don't need to go to that facility. I do agree that sometimes the medics don't think and will just transport to the closest facility...then you must look at other factors. Is there an unstable airway? Is it an arrest situation? Is it a mortal wound that would not survive transport to the LI (such as a GSW to the head)? Medics have rules to follow just likes nurses.

EMS report is considered a courtesy, not a requirement. That said, I've only brought one patient in without a report and that was because the ED's EMS radio was on the wrong channel. Believe me when I say that EMS crews do not enjoy bringing their patients in to the ER without calling ahead with report. It creates unnecessary hassles with getting a room together and causes a delay in patient care. If the patient is critical enough that calling ahead is impossible for the medic, he or she will ask the EMT driving to call ahead with a very brief "hey, we're enroute with a cardiac arrest, asystole on the monitor, pt is intubated, ACLS protocols in effect, see you in 5" type of report. Gives the ER time to throw a room together and allows the medic to work without worrying about giving a report.

NurseKitten - I won't tell you how many times I've gotten in trouble for this sort of thing! LOL I agree about your clinical experience. It makes all the difference in the world. My EMT clinicals were a joke, but paramedic clinicals more than made up for it. Working a year between the two programs really helped too. As CrufflerJJ said, your plan is do able, but not advisable. Medic school is tough. I haven't been to nursing school yet, but so far medic school was the toughest year of school I've ever been through. I have many friends who have been through both and they say that paramedic was definitely harder. Maybe because that came first though. My program was one year long, but we went to school 3 days a week, all day long. Sometimes 4 days a week. Plus hospital clinicals and EMS clinicals. We spent 2 weeks in the OR each (one-on-one), which seems to be rare in medic programs. I can't imagine trying to learn everything in five months, especially in a night program. My school used to do a night program, but it was nearly double the normal length and it was 3 or 4 nights a week, from 5 pm to 11 pm. They didn't cut out any of the classroom or clinicals hours and those people became good medics just like the people in the regular class. But night school wasn't a short cut for them. Anyway, in the end you will do what you want. All we can do is offer advice and hope for the best. And we really do hope for the best, for you and for your patients. You have no idea how it feels to be on scene with a patient for the first time and to be expected to function properly when your mind is spinning in fifty different directions. It's not something you pick up over night. I'll never forget my first code when I was an EMT. I've never felt so helpless in my life. But it taught me that I didn't know everything and that EMS required constant learning. Since then, I haven't stopped studying and trying to learn something new, often to great amusement of my co-workers. (yes, I'm a nerd and proud of it! lol)

So in 8 months you can go from being Joe Blow off the street to being a paramedic??? Wow. That's amazing. And not a good idea. I'm not a big advocate of taking short cuts like this. Paramedic school is tough, even if you have a science background to hang it on. If you've never taken care of patients before, it's really tough to learn how to talk to patients and how to assess patients. We had four "fast trackers" in my class who went from street to medic in a year. Two didn't make it past the midpoint. The other two struggled through. They had difficulty talking to patients, performing assessments and basic skills like IVs and medications. It's not something I would recommend. While taking one short cut is bad enough, you're talking about taking two short cuts. If you're going to take a short cut, please do yourself a favor and take one full length program. I would recommend the full length one to be whatever you're doing first. Medicine is not an easy field to jump right into. You're not going to learn everything over night...or in 8 months. I do wish you the best, but wow, you're talking about a heck of a short cut there.

2.90 may not be "good enough" for the accelerated program, but you can work on the additional core classes you need to bring up your GPA. Most nursing programs have about 30 hours of core classes even for an ADN. If your GPA comes up, you may qualify for the program or at least for a regular BSN program. A traditional BSN program would likely only cost you two year, rather than a year for EMT school, at least a year for paramedic school (assuming you go straight from EMT school to paramedic school and don't work between the two or need to take time for additional core classes for paramedic school), another year for core classes towards a nursing bridge program while you gain the required minimum one year of experience as a medic, one year for a paramedic to RN bridge, 1-2 years for an RN-BSN program, 1-2 years working in an ICU to gain experience for a CRNA program (could do this while doing the RN-BSN), 2-3 years for CRNA. That's 2-3 years vs 5-8 years. Think about it and weigh your options. Consider the cost of all that education and the cost to your family. Believe me, it's not easy being away from your family constantly. I've been in school almost non-stop for the past four years. Paramedic school was by far the most difficult year we've experienced. My kids are already dreading school starting in the fall and I'm only doing online classes! LOL Anyway, good luck to you! Send me and IM if you need any help with EMT or paramedic or just to talk.

Hi Steve, First of all, why do you want to become a paramedic? Are you planning to work as a medic or use it as a stepping stone to CRNA? If you're not planning to work as a medic, I would highly recommend skipping the whole EMT and medic route and go straight to nursing school. You already have a BS, so you may be able to enter an accelerated BSN program for people who already have a bachelors degree. It would save you quite a bit of time and money. From there you can work in an ICU and get the required experience for anesthesia school. However, if you truly want to work EMS, go for it. I'm a paramedic and I plan to go the anesthesia route eventually. But I have other things I want to do first. I want to work as a medic for a couple of years while going to nursing school (will be ready for a bridge program next summer/fall). I also plan to work as a flight medic or nurse for a few years. Anesthesia school will be there when I'm ready. And I'll have gained some valuable experience along the way. If that's the sort of road you had in mind, go for it. But if you're looking at EMS as nothing more than a stepping stone from one thing to the next, I'd recommend skipping it. Don't work for the paramedic degree or cert if you're not going to use it. Good luck! Christina

Macon is not a bad place to live. Plenty to do, close to Atlanta. For apartments, I would highly recommend looking downtown. There are always lots of 1 bedrooms for rent in the historic district and the price is no higher than any other apartment in town. I lived in a building on College St called The Massee (believe it's 347 College), it was built in the 1920's and the apartments were gorgeous. I think rent was something like $350 for a studio and around $450-500 for a 1 bedroom. We paid $525 for an awesome 2 bedroom with two balconies in 1999, but prices have probably gone up a bit since then. Another plus to being downtown is that you're right near the two major hospitals - the Medical Center of Central GA and the Coliseum Hospital. MCCG is a level one trauma center and would provide a great experience for any nurse. I think they were recently certified as a stroke center as well. If Macon is not your ideal living area, check out the surrounding communities. I live in Warner Robins, about 15 minutes south of Macon. Housing costs are very similar and schools are great, if you happen to have kids. We also have two hospitals in our county. If I can help with anything else, let me know. I haven't been at Macon State in a while. I transferred to Darton College in Albany for paramedic school and plan to do the bridge program at ABAC in Tifton next year, then move on to the RN-BSN bridge either at Macon State or somewhere else. It's all a bunch of stepping stones, but it's been an enjoyable trip so far. Good luck to you. Oh, and beware of A&P at MSC. Many people fail the first time around.

The best ones are the ones you make yourself, because you will remember the info better. I carry a drug guide to clinicals. Seems to be the easiest options (plus it's required...LOL).

We just finished OB clinicals for paramedic school. There was a group of 9 of us... 2 girls and 7 guys. The instructor always paired the girls with a guy and just introduced us to the patients as paramedic students and asked if it was ok that we were there. Most of the patients were absolutely fine with all of us...guys included. If the instructors and the nurses don't make a big deal about "ooh, is it ok if there's a GUY in the room???" the patient doesn't seem to think much about it. If they DO make a big deal out of it, the poor guy in your class is going to get a very poor clinical experience and won't learn much. I hope your instructor is cool and doesn't do that.

I'm in the middle of paramedic school right now. I would ask why you're considering quitting and why you went to medic school in the first place. What are your goals and plans for the future? Are you already an EMT or are you in a fast track type program? I'm in my 2nd semester and will graduate in May with both a certificate in paramedic technology and an associate of applied science in EMS. I had already taken all of the core classes I needed for the degree prior to enrolling in this program, but most people finish the certificate first and then return to school for the degree. I love working in EMS, but I also have plans to return to school for a nursing degree in the future. First, I would like to work for a while and finish up the remaining few core classed I need towards a BSN and get the experience I need to start working in flight as a medic. I'm already working at a high-volume service, with plans to add a part time job at a level one trauma center's EMS service once I graduate. After a few years and a few more cerfications under my belt, I plan to start looking for a flight medic job. Nursing school will happen when it is meant to happen; I'm not in a huge rush for that at this point in my life, especially after being in school non-stop for the past three years. I drive 100 miles one way to school right now, because it's the best paramedic school in the state (and the only one that is actually at a college, not a tech school) and I think I'll be ready for a bit of a break from school once I graduate. LOL Anyway, the point is that you need to know what YOU want out of life and out of whatever degree you're pursuing. Do you want to be a medic or do you want to be a nurse? And most importantly...why? What are your ultimate goals? I think I'd like to go into anesthesia someday, but I can do that later in life, I can't really picture myself working in flight as an old lady. LOL I'm already 28 and I really want that experience, whether it's as a medic or a nurse. It doesn't matter to me which one it is.

Hi there, I've been on Topamax since October and it has completely changed my world. Before, I was having migraines at least twice a week. I was exhausted all the time and spent a lot of time lying on the couch with a headache. I was also working nights and going to school during the day, which definitely didn't help things. I started on the Topamax on 10/8 and changed jobs on 10/21. I switched from night shift, 3 12s a week, to day shift, a mix of 12s and 24s (EMS - we can sleep at work). I had strange side effects from day one. I couldn't taste the carbonation in soda anymore, from the very first day I was on the Topamax. I had tingling in my hands and feets. I was tired a lot, especially about 30-60 minutes after taking the Topamax. I was forgetting words that I knew previously. However, those side effects gradually faded away (with the exception of the carbonation thing, I still can't stand soda). I've only had a handful of migraines since starting the Topamax. I also take Imitrex to get rid of a migraine if I do get one. I'm still on 50 mg a day at bedtime, although I was thinking of talking to my doctor about upping the dosage for the antidepressant benefits. It will likely take at least 2 weeks for the levels to stablize in your body, so be patient. The side effects will lessen or go away completely and you will be left without your headaches. I also lost about 20 lbs in the first 2 months of taking it. Nice little side benefit. A friend of mine said it made him feel crazy. Keep in close contact with your doctor if you exerience anything odd. good luck! Christina

the big brother set is not a home situation. there was a nurse on set with a medical room of some sort ready for emergencies. if they didn't have basic supplies such as iv supplies and simple meds like d50, that's poor planning on the part of the production staff and the medical advisor, especially with a participant with a known history of hypoglycemia. the other girl was given epinephrine, so obviously the nurse had access to iv supplies and epinephrine, meaning she probably had a code cart available. code carts contain d50... see where i'm going with this? if a patient's blood glucose level is so low that they're having seizures, you shouldn't be wasting time with oral or rectal glucose when you have access to an iv and d50. if you're at home without access to such things, sure. but this isn't a "home" setting since you have the nurse available when needed.

sure, you can do that, but you could also attempt to get an iv or give glucagon im. i started an iv on a very combative patient a few days ago without a problem. 1 attempt, got a 22 in the left wrist and managed to draw labs, flush the iv, secure it, and get saline connected and flowing well while she was actively fighting me. honestly, it wasn't that difficult. this girl was unresponsive and ended up having a stroke and was decorticate before we left the scene. it took about 15 seconds from looking at her wrist to find the vein, wiping the site with the alcohol prep, and sticking her with the needle to get the iv and probably a minute to get everything else done. you can't convince me that rectal drugs would be faster. even if you waited until the seizure was over, d50 would be absorbed way faster than rectal glucose.

Go for EMT. You can do far more with it. You can work in EMS or an ER or do nursing assistant work. And you will learn a LOT more.

Do a search and see what you find. I'm in Georgia and I don't know of any RN-to-Paramedic programs, although there are a couple of Paramedic-to-RN programs. Most paramedic programs culminate in a 2 year degree, so you would likely have some, if not most, of the core classes completed already. You may be able to finish in a year and I can't imagine a bridge program being much shorter than that. The clinical hours alone take a while to complete and the skills aren't learned overnight. I would highly recommend taking the time to do the full program or at least search out a good, reputable bridge program that doesn't grant your diploma/certificate/whatever in two weeks. You may be able to pass the test on knowledge alone, but once you're in the field, you will be in charge of the patient and your skills are going to be what you have to rely on. That you challenged the exam and passed isn't going to matter. You're already an EMT, so you must understand what I'm talking about if you've worked in the field at all. Don't put your license at stake and don't put yourself in that situation. I hope you find the right program for your needs.

What a paramedic can and cannot do depends largely on their service's protocols. If that service utilizes RSI, then the paramedics can do it. You may not like my answer, but the bottom line is if you want to be licensed as a paramedic, you need to go to paramedic school just like someone who wants to be an RN needs to go to RN school. It's as simple as that. How angry would an RN be if paramedics could suddenly challenge the RN boards and become RNs without all the stress and hard work of nursing school? It's the same concept. Paramedic school is not easy.

I don't think you did anything wrong, but I would have felt the same way you did - that there was *something* you should have done while in that situation. I'm not sure what exactly, but your patient shouldn't have had to put up with such immaturity on the part of the EMT. You sound like you know your stuff. I'm not a paramedic (yet!), but we were taught to splint with all sorts of "unorthodox" things in EMT school and pillows are definitely not so out of the ordinary! You were doing things right, that EMT was not. Write a formal complaint, file an incident report, talk to whomever you need to talk to, but DO SOMETHING. That EMT should not be practicing if that's the way she's going to behave. Her attitude was unprofessional and her patient care sucks. There is no reason to make the patient suffer unnecessarily and she did exactly that because she wanted to be in charge of the situation. Keep going up the proverbial ladder and find someone who will listen to your complaints. Your DON obviously heard you when you told her about this situation, keep her apprised of it and keep talking to people until something is done. Who cares that this EMT is married to the fire chief? That shouldn't exempt her from doing her job correctly. I hope you don't have any more run-ins with her. Keep taking good care of your patients!

Your patient is diabetic and her body is compensating for the hyperglycemia via increased heart/respiratory/metabolic rate. Further workup needed to determine type of diabetes (you haven't given that info...). Patient needs insulin, oral meds, diet control depending on type of diabetes. Just write a good essay the same way you would in any other class based on the info you've been given. Do some research on diabetes. The body compensates by increasing the heart and respiratory rate to try to get rid of some of the excess glucose in the blood. The basal metabolic rate increases for the same reason. Patient probably has a fruity smell to her skin and breath. The clear thyroid test tells you this is diabetes and not some underlying thyroid issue.

When I worked on the floor as a secretary, it was common practice to call the ICU nurses if the floor couldn't get an IV after 2 sticks (yes, there were exceptions and there were a few nurses who were really good at IVs...one of whom posts here every now and then). Once I got my EMT cert, they even asked ME to start IVs a few times (I didn't - I wasn't practicing as an EMT at the time and thus not covered under the hospital's malpractice insurance). It was frustrating for the ICU nurses and irritating for me to observe. Learn how to start IVs - it's a necessary skill if you're a nurse, no matter what area you're working in.

It just takes lots and lots of practice. Start with the patients who have good, obvious veins. Get some good sticks on those patients and gain some confidence in yourself. Start off using 22s and 20s and move up to 18s when you find a patient with big veins. lol Don't do the 45 degree angle crap they teach you in school - it doesn't work and it makes you go right through the vein. Lay the needle next to the skin, almost parallel and slide it into the vein. This is the way my partner taught me to do it and it works nearly every time (I've never seen anyone who hits as many IVs as my partner). Be patient and realize that you're not going to get every one. Sometimes the only good vein is in the AC, even though most nurses hate using it. Don't be afraid to try a different vein though. And don't be afraid to straighten a squiggly vein if that's your only option. I got a good one in the left hand a few days ago that was very squiggly but straightened out easily with a little pulling on the skin. Anyway, good luck to you. IVs are one of those skills that is really more about practice and luck than anything else. You have to develop your own way of doing them and you also have to have a bit of luck on your side. Some days you will hit every vein that comes near you, and other days you won't be able to hit the broad side of a barn. LOL Just don't take it personally. Christina

My school only considers your GPA and how much of the core you have completed. It doesn't matter if you're a CNA, lab tech, EMT, ward clerk, etc. It just isn't a factor. I think it should be taken into consideration or at least given a spot for mention on the application, but it shouldn't be heavily weighted, just considered if there is a tie between two applicants. I have heard of schools requiring CNA certification for admission...that is something I wouldn't agree with since it would mean I'd have to go back to school to obtain a lower level of certification than I already hold. Bridge programs obviously take your experience into consideration and most have specific requirements as to the number of years of experience that you must have as a minimum for admission to the program.