I find myself shaking my head over a post over at Rogue Medic, he is talking about two separate but important situations, one being bad or poorly written protocols and the second is how one deals with those protocols. I will take what he has written in a different but related direction. Does forcing the paramedic/EMT student to slavishly follow skill sheets and failing them because they didn't say "Scene Safety and BSI" before doing anything to the patient really doing anything for patient care? Does anyone actually do that in the field? EMS training needs to be much more realistic and get away from rote memorization of NREMT Skill Sheets. I have nothing against the NREMT and understand that testing standards are needed but question the way the many of the courses I have seen or observed/taken seem to spend much more time on manual skills than on thought process. I have also trained a few new EMT's and found more than one of them wide eyed in fear because "It was never like this in class!"
I also have to say a few words about the program I am in at this point, it is taught by street paramedics and their instruction shows it. They emphasize that we need to learn the protocols but love to bring in real life situations that don't fit the nice carefully laid out skill sheets and or protocols and how they dealt with it when it happened to them. This post is not meant as any kind of complaint about the program I am currently enrolled in and should not be taken as such. I am very pleased with American Professional Education Services and would recommend them to anyone without hesitation. Forgive the commercial but I felt I needed to state that to be fair to them.
It would not be fair to anyone if I simply complained and didn't offer a solution but must be truthful the idea is not totally mine, both my instructors and many of the other bloggers such as Rogue Medic have said similar things. I find that teaching people to think is much more important than teaching them what to think, many of the best EMT's/Paramedics I know are good because they are always thinking and how why they do things rather than just that they should do them because that is what they were taught to do in that situation. I realize that some discussion of medical direction and how it effects education would be appropriate here but will also admit that my current level of exprience in providing Paramedic level care would render my thoughts both unimportant and ill informed and possibly misleading. In closing I would say that there needs to be much more teaching about why something is done instead just telling people to do it because protocol says to do it. EMS providers need to be trained to think and decide what is needed rather than what the rules are in a certain situation because the more rules that have to be followed are created the less thinking allowed and that can't really be better for the patient but I bet we should be focusing on the patient and what we think they need in addition to what protocol says is needed to treat the patient