Mark did a nice job outlining this topic, his personal opinions nicely
coinciding with "the penn state way" regarding training
trainees/volunteers/thirds/probies.... by the way we prefer to say
"non-compensated employees!"  I know when I came into the program here, I
was raring to go, and being someone who had my hands into EMS for awhile
before I came to the University, I probably would have been VERY frustrated
if I was restrained from patient care or doing anything besides watching
everyone.  In fact, I might have not stuck with the program.  I am reading
a lot about 12 step checkoffs, and crew chief interviews, and practical
skill tests.... which sounds a bit elitist and non-productive to me.
	 Don't get me wrong, we have a strong training program with evaluations
after each call and shift reviews and a constant in-service training
program, but it allows for the fact that some people need a lot of guidance
and reassurance, but MANY of the good people you recruit will be ready to
jump right in and show you what they can do.  If you are talking about
retention problems, perhaps this is an area you should look into.
	 A program for new members should be well-structured, but even more
importantly it must be flexible and allow your new recruits to show how
good they are right away. What good are you doing by making someone sit
there and watch you work for the first few months?  And the other key is to
have a good path for advancement after that.  Consider this.... when I work
here with my crew member partner, regardless of if he/she is an officer or
has been here for 6 years, or 3 months, we are all equal when it comes to
working on the truck.  It makes for a nice nicer atmosphere for the working
crew, and the volunteer watching from the airway seat trying to learn what
the job is all about.... good teamwork. The other thing it does is allows
for peer pressure not to #@%^$ up.  No one has any reason to be hesitant
about questioning someone else if they make a bad decision for fear of
doubting the crew chief, and their almighty EMS power.  Even the volunteer
is encouraged to critique the crew members after a shift if they'd like to.
  In EMS we all for some reason feel a need to have such a heirarchy.  But
when you think about it, how necessary are 2 chiefs 5 liuetenants, 2
sergeants, 9 crew chiefs with a staff of 20 or 25 college students?!?
**********************
Darren Robertson
The Pennsylvania State University
Office of Emergency Medical Services
University Ambulance Service
dxr169@...

O.K., here are my theories on this and the other related discussions.

Maureen O'Neill wrote:

> How do you as organizations train new members?  Do you allow them to ride on
> the Ambulance right away or do you hold them for some amount of period?
> What do you do as orientation for new members?  One last question, what do
> you do for Lt. training, CC training?

Don't delay new people from riding along any longer than it takes to get them
to sign all of the necessary paperwork (confidentiality forms, workers comp
liability, blood borne pathogen "don't touch blood with your bare hands"
briefing sheet, and all the other safety related B.S.).

Don't delay them from touching a patient either....in the context of providing
care to the level to which they are certified.  98% of the calls you would
really have to go out of your way to hurt a patient.  I mean, how (with minimal
supervision) can you screw up a twisted ankle call?

As I am always the seniorest (a term which people should remember doesn't
always necessarily translate into "best") EMT when on with our campus squad, as
a crew chief, supervisor, incident commander, EMT-Instructor,
Lord-and-Master-of-the-EMS-Universe, etc., my elitist attitude is to do
absolutely as little as possible.  I don't drive - checking out the "scenery"
is better accomplished from the pax seat; I don't touch patients - I might
accidentally touch some spooge*; I don't glove up on scene - someone might
inadvertently think I might be willing to touch a patient; I don't lug
equipment - I might accidentally drop something expensive and have to pay for
it; I don't lift stretchers with patients on them - um, bad back, yeah, that's
it; and I especially don't fool with the paramedic's stuff when they intercept
us (i.e. spiking bags, glucometers, etc.) - because they get paid to do that
stuff, and being even more elitist than I, if I let them get away with it they
would do even less on scene than me.

*blood, vomit, urine, feces, other icky bodily fluids.

Seriously though, what the senior EMS crew members should be doing on calls is
teaching the new members/trainees/less experienced staff by helping them and
letting them do as much patient care as possible.  People retain about zip of
what you lecture at them, a little of what you show them, and a lot of what you
do with them and let them do.  Stand back and let them go.  Only intervene when
necessary; and remember there is more than one way to do most things so guide
but don't interfere as long as no one is getting hurt.  Sometimes you might
even learn something.  I you want to show a "trick of the trade" or more
efficient way of doing something, try not to take over - show them and then let
them do it when possible.  If it's one of those 2% of the time life
threatening, in a big damn hurry calls, at least take the time after the call
to talk about what went on and what you did.

When I was the service supervisor here, I wanted to move up the trainees to
full crew status as soon as possible because people become responsible when
they are given responsibility.  Our training officer at the time thought that
no one was ever ready to be moved up.  I guess we balanced each other out.

As for training your officers, we just recently developed a supervisors' manual
and have been conducting supervisor training that emphasizes our local
idiosyncrasies.  I will hopefully be posting our supervisors' manual to the SOP
page soon and will post a note when that happens.  There are EMS related
courses appropriate for officers (i.e. Mass Casualty Incident Management), but
also look for general leadership training opportunities at your school.  Does
your student government or your Student Affairs office offer or sponsor student
leadership seminars or courses?  Getting involved with those is also a great
way to network with other student leaders (such as those on the student
government budget committee, etc.) and with school administrators.

--
Mark Milliron, M.P.A., M.S.
----------------------------------------------------------------
The Pennsylvania State University
Office of Emergency Medical Services
21 Ritenour Bldg.
University Park PA 16802
http://www.psu.edu/dept/ems/                          mem9@...

Treasurer, National Collegiate EMS Foundation Board of Directors
http://www.ncemsf.org/                         treasurer@...
----------------------------------------------------------------

Hi Jessica!

	 I got you e-mail on how to an EMT class on campus.  Can you send me more
information on how you succeeded in doing this at Wake Forest.

					 Thank You,
					 Maureen K. O'Neill  RIEMT-A
					 URI EMS
					 Special Activities Chairperson


-----Original Message-----
From: ncemsf-l@... [mailto:ncemsf-l@...] On
Behalf Of Jessica C. Murray
Sent: Wednesday, April 29, 1998 12:04 AM
To: Multiple recipients of list
Subject: Re:  EMT class on campus, getting new members

At Wake Forest (we are a very new group), they way we went about securing an
EMT course on campus was this:

         A local community college teaches the course here in Winston-Salem.
I got together with the head of the department, and asked him if we could
host a community college course on campus (it was the same as it was at the
cc, but the location was more convienent).  All I had to do was find
interest and secure a room to have it in.  Make sure you get an
administrator or two to back you (VP).  Then, midway through the semester, I
took it to our Health and Exercise Department (I am sure you could do this
with a number of departments) and with a pilot class under our belt and a
vice president to back us, we suceeded in getting the class implemented into
the course schedual for two credits for the next semester- and taught by the
community college instructors!  Make sure you go to the top first.  Upper
administrators have the power- just make sure you present yourself with hard
data and a plan of action.  You are more than welcome to use Wake Forest as
a comparison to your program to make your case stronger.(feel free to write
for more information on exactly how I did this).
         Once you have a class on campus, you will most likely have a good
handful who are interested in the squad.  What we did was have them be
observer status while in the class.  This is a probationary period where
they learn the ropes and observe on calls.  This gives some extra hands, and
when they are out of the class, they will be ready to jump right in.
Training in groups with individual attention is the way to go- it builds
cohesiveness and trust.

thanks
jessica c. murray
captain
wake forest emergency response team



At 11:00 PM 4/28/98 -0400, you wrote:
>I would like to thank every one that has written me back with ideas to
>increase our numbers here at University of Rhode Island Emergency Medical
>Services.
>
>We do have dedicated people but these same people also want to do well in
>school.  It also seems that the same people are doing a lot of work with no
>one to relieve them of it.  We currently have six Lt.'s, one Captain, and
>three drivers that are not an EMT or Lt.  We also have three commander's
>that end up filling a lot hours when they should be doing administrative
>"stuff". I guess what I am trying to get at is how can we effectively train
>incoming members and encourage them to take an EMT course.  Currently the
>EMT course is not on the URI campus it is at the Community College in RI.
>How can we work to bring it on campus?
>Also, is it better to train people in a group, for example all the
>probationary members come down all at once, or to train them here and there
>one on one.  What are some ways for both the probationary members to be
>involved with training along with people that are already members?  How can
>we everyone enthused about training?
>
> 		 Maureen K. O'Neill RIEMT-A
> 		 URIEMS
> 		 Special Activities Chairperson
> 		 MONE6418@...
>
>-----Original Message-----
>From: ncemsf-l@... [mailto:ncemsf-l@...] On
>Behalf Of Marc Unangst
>Sent: Tuesday, April 28, 1998 2:02 PM
>To: Multiple recipients of list
>Subject: Re: none
>
>Maureen O'Neill <mone6418@...> writes:
>> on campus (URIEMS).  I have been a member here for about a year and we
>seem
>> to have a problem getting members and keeping them.
>
>This is a problem that almost every service has, but frequently for
>different reasons.  You need to look at your membership, and maybe
>interview members who are resigning, and find out why they are
>leaving.  Some possibilities:
>
>* No time to do EMS.  Many people who join as freshmen or sophomores
>end up having to cut out some activities when their class load
>increases in their junior year.
>
>* Loss of interest in EMS.  Some people just decide that EMS isn't for
>them and drop out.
>
>* Personality conflicts with officers, other members, etc.  Is there
>someone in the organization that doesn't get along with a lot of the
>members?  Especially if this person is an officer, they may drive away
>people who find that it's more trouble than it's worth to stay a
>member.
>
>* Boredom.  What is your call volume like?  Especially if you have a
>low call volume and frequently get shifts with no calls, members may
>get tired of putting their time into what they perceive as a "useless"
>service.  Consider ways of increasing the amount of activity that the
>crew gets on a shift (such as making the shift longer, so it's rare to
>go an entire shift without a call).  Or, make being on shift a less
>onerous task: get a computer or video game machine for the station;
>have the service buy food for the crew while they're on duty; allow
>the crew to leave the station (with the ambulance) while on duty, as
>long as they stay in the service area; let the crew separate, and have
>one member respond in the ambulance and the other member respond on
>foot or on bike, etc.  Naturally, some of these will depend on the
>logistics of your service area -- CMU's campus is small enough that
>you can bike from one end to the other in 3-4 minutes, so not having
>both crew members in the ambulance would be fine.
>
>> We also need more Rhode Island EMT's.
>
>Again, look at the causes of your problem.  Why are members unwilling
>to take the EMT course?  Do they have trouble making time for it
>during the school year?  Is it prohibitively expensive?  Is it only
>available in a location that's relatively inaccessible from your
>campus, especially if the member doesn't have a car?  Once you figure
>out why you don't have enough EMTs, you can address the causes of the
>problem -- offer an EMT class on campus, structure the hours to make
>it easier for college students to take the class, or have the service
>pay for all or part of the class.
>
>-Marc Unangst, EMT-B
> Operations Manager, Carnegie Mellon EMS
> mju@...
>
>
>

How do you as organizations train new members?  Do you allow them to ride on
the Ambulance right away or do you hold them for some amount of period?
What do you do as orientation for new members?  One last question, what do
you do for Lt. training, CC training?

				 Maureen K. O'Neill NREMT-B
				 URI EMS
				 Special Activities Chairperson
				 MONE@...

I would just like to put my couple of thoughts in on the topic of riding
at other organizations and new members.

Even though we are not operational yet, riding with other organizations is
something I have suggested to our many new, inexperienced members. From my
experiences of working for the local squads, I have found that most campus
calls fall into about three categories: alcohol, psych, and sick/anxiety.
But, I have also had a few serious calls: cardiac arrest, respiratory
distress, etc.

Therefore, most students who first experience EMS through our squad will
most likely not experience many "serious" calls. So, I recommend riding
with the local squad or at least a home squad to gain extra experience.
Two other advantages of this are: increased relations with the local squad
and many volly squads will assist in financing training.

Now on the topic of new members. Again, this is just from my local volly
squad experiences. EMS is an educational field. An EMT who refuses to
learn is not doing any good for him/herself or the patient. This education
also extends to teaching the public about EMS.

When it comes to new members, the only way someone can learn is through
hand on experiences. The best program I have seen is at my home town
squad. A new member of the squad rides with two experienced EMTs. This new
member goes through an internal training program comprising of different
levels of patient care. The new member (Proby) advances at his/her own
pace. This continues until the proby is ready to handle a call on their
own, with the two experienced EMTs there to make sure things go well.
Once, the proby successfully runs a few calls and feels comfortable
themself, a line officer conducts a final evaluation and clears the proby
as a crew chief.

Well, if you have hung in this long thank you. I'm open to all comments.

Paul White
Lions' EMS
lionsems@... or
whitepa@...

At 3:00 PM -0400 4/30/98, Scott C. Savett wrote:
>Don't box yourself into a "number of calls" requirement.  I think that number
>of duty shifts or number of hours on shift per month would be a better
>requirement to keep people active.  Add to that a required number of hands-on
>training sessions, and your members should be able to keep up their skills
>even if there isn't a large call volume.

I agree wholeheartedly.  There are simply not enough calls to allow
anything based on "number of calls" as a strict rule.

What we're trying to do is port our current "must do 4 (or is it 6?) calls
with RPIA" to a more reasonable one, based upon our comparatively low call
volume.  We're trying to make, say, 4 calls at one agency equal one of ours
with the stipulation that a certian number still have to be done on home
turf.  I think that anyone who promotes or bases membership status solely
on the number of calls done is silly.  By doing more calls elsewhere, it
gives the trainee more opportunity to demonstrate their competence before
they're released.

Just my thoughts (okay, so I don't have 7 years in college EMS, but I do
have 5, and I'm still an undergrad on my second college EMS system *grin*),
--CAH

____________________________________
Christian Holt, NYS EMT
Captain, RPI Ambulance
Class of 1999 - B. S. Biology and Psychology
Rensselaer Polytechnic Institute, Troy, NY
____________________________________
holt@...
http://www.rpi.edu/~holtc2
"Every jumbled pile of person has a thinking part that wonders what the
part that isn't thinking isn't thinking of..."  --They Might Be Giants
____________________________________

Christian,

Don't box yourself into a "number of calls" requirement.  I think that number
of duty shifts or number of hours on shift per month would be a better
requirement to keep people active.  Add to that a required number of hands-on
training sessions, and your members should be able to keep up their skills
even if there isn't a large call volume.

The reason I am opposed to active status being determined by the number of
calls is that one of your members might choose a weekly shift, such as
Tuesdays, when the call volume is low.  They might go weeks without having a
call, while the people on Friday and Saturday nights, who are putting in just
as much time as the Tuesday person, are getting calls left and right.

I guess what most people are trying to express in this thread is that there's
a balance between riding time, call volume, experience level, and time
available that must be weighed.  We should not be forcing people to be crew
chiefs if they are not ready for it -- and I would venture to say that most
EMTs have a feeling for when they are ready.  But on the other hand, if
someone has the experience and knowledge to be a good field EMT, we
shouldn't hold them back for fear of losing them.

These are my thoughts as a 7-year veteran serving with three different
campus EMS groups.

Regards,

Scott
ssavett@...

On 30 Apr 98 at 12:26, Christian Holt wrote:
> One of the ways that we're thinking of doing this is saying that to become
> a Crew Chief, or remain active as same, you need a certain number of calls
> per semester.  We're thinking of making it so you _do_ need a certain
> number with us, on campus. However, others can be made up elsewhere through
> vollying elsewhere, doing ride-a-longs, etc.

Scott Savett
ssavett@... -or- webmaster@...
http://www.ncemsf.org/
ICQ: 746028

In most states CME is mandatory. Setup a mandatory CME program that
requires X number of credits a semester. Have things like classes,
conferences, ER time, and ride alongs count as CME. That way you can get
your members to brush up on their skills, but you give them several options,
so they can fit it into the schedule.
	 We used to have a setup with the local hospital, so we could
practice IV's, blood draws and intubations in the ER and operating rooms.
Now that isn't the same experience as running calls, it can give people the
confidence in the basic skills, so they can focus on over all patient care
and not sweat over can they start that line, or get the blood pressure, etc.

-----Original Message-----
From: Christian Holt [mailto:holt@...]
Sent: Thursday, April 30, 1998 12:26 PM
To: Multiple recipients of list
Subject: Re: Riding at other organizations


One of the ways that we're thinking of doing this is saying that to become
a Crew Chief, or remain active as same, you need a certain number of calls
per semester.  We're thinking of making it so you _do_ need a certain
number with us, on campus.  However, others can be made up elsewhere
through vollying elsewhere, doing ride-a-longs, etc.  (ex: you need 10
calls, a certain number of which need to be on campus; on-campus EMS calls
count as 3 calls, non-emergency calls and calls while riding for other
agencies count as 1... just a thought)

Instead of making it mandatory, make it an "available option" that people
can take.  It can improve relations with neighboring squads, etc., too.

[snip]

By not making it "mandatory" you eliminate the liability hassle, too... a
member riding for RPI who decides to try to get calls in at North Greenbush
Ambulance (neighboring ALS squad) would be an individual who just happens
to ride for RPI Ambulance as well, not through any formalized, legally
binding agreement.

Just my rambling,
--CAH

____________________________________
Christian Holt, NYS EMT
Captain, RPI Ambulance
Class of 1999 - B. S. Biology and Psychology
Rensselaer Polytechnic Institute, Troy, NY
____________________________________
holt@...
http://www.rpi.edu/~holtc2
"Every jumbled pile of person has a thinking part that wonders what the
part that isn't thinking isn't thinking of..."  --They Might Be Giants
____________________________________

One of the ways that we're thinking of doing this is saying that to become
a Crew Chief, or remain active as same, you need a certain number of calls
per semester.  We're thinking of making it so you _do_ need a certain
number with us, on campus.  However, others can be made up elsewhere
through vollying elsewhere, doing ride-a-longs, etc.  (ex: you need 10
calls, a certain number of which need to be on campus; on-campus EMS calls
count as 3 calls, non-emergency calls and calls while riding for other
agencies count as 1... just a thought)

Instead of making it mandatory, make it an "available option" that people
can take.  It can improve relations with neighboring squads, etc., too.

Generally, everyone whom I've talked to about this is favorable to the idea
that they would get to do a bunch of calls in a short amount of time just
by riding along.  It makes them more seasoned, too.

By not making it "mandatory" you eliminate the liability hassle, too... a
member riding for RPI who decides to try to get calls in at North Greenbush
Ambulance (neighboring ALS squad) would be an individual who just happens
to ride for RPI Ambulance as well, not through any formalized, legally
binding agreement.

Just my rambling,
--CAH

____________________________________
Christian Holt, NYS EMT
Captain, RPI Ambulance
Class of 1999 - B. S. Biology and Psychology
Rensselaer Polytechnic Institute, Troy, NY
____________________________________
holt@...
http://www.rpi.edu/~holtc2
"Every jumbled pile of person has a thinking part that wonders what the
part that isn't thinking isn't thinking of..."  --They Might Be Giants
____________________________________

I would suggest against it.  Having a requriment to ride on another service
would be very bad for member retention.  That is too time consuming for
members who don't want to do it.  Those who want to ride on a trans unit will
do so on their on volition. Another thing that has to be considered is the
"legality" of the issue.  Such a requriment may violate non-discrimination
clauses that usually have to be written into constition and by-laws.  This
would discriminate against members who do not/ cannot ride with organizations
not affiliated with the university.

Marc Lewbart
Startup Coordinator NCEMSF

Hamilton College EMS is initiating mandatory ride-time for 1998-99.
Members will be required to do 12 hours per semester.  Additionally, any
active member is allowed to ride in with a patient.



Tony Katsetos, EMT-D
Hamilton College EMS




--------------------------

Antonios D. Katsetos '99
Hamilton College
198 College Hill Rd.
Clinton, NY 13323
(315) 859-0720
<akatseto@...>

"There is not any Musicke of Insturments whatsoever, comparable to that
which is made of the voyces of Men."

         -William Byrd, dead English composer, commenting on the musical
genius of the Hamilton College Buffers.


"Shoot, did I forget to say "clear" again?!"
         -Homer Simpson, EMT-D


Wakawaka!

         -Fozzie

Actually as the person who has been doing crew chief training at SBVAC, I think
I might actually have something intelligent to say for a change.

When I first came to SBVAC CC training was basically a EMT class with 1 or 2
mock calls per session.  It also taught things never taught in EMT class that
were specific to campus.  i.e. Calling for a signal 10 (PD) and having to
specify PUBLIC SAFETY, and not Suffolk County PD.  And that we have PD and
Environmental Health and Safety responding to every call, and how to deal with
them etc.. etc...

I took It over completely about 1 year ago and turned it into nothing but MOCK
calls, because we have a very low call volume, and EMT class is not enough to
give you the confidence needed to run a call (at least in this county).  I have
seen many an EMT just outta class get scarred for life because of their first
solo call is a bad one.  I also teach how to make a hospital present and write
a PCR (prehospital care report).  I try to stress that Confidence is an
important part of being a CC.  That you have confidence in yourself, That you
can gain the confidence and respect of both your crew and patient, the call
will go much better.

I also don't force them to complete CC training if they don't need it.  I
usually consult with one or 2 other people and if the Trainee thinks they are
ready and I think they are ready and the others agree with me they get
blessed.  If after CC training they are not ready to run calls then they don't
graduate.
A perfect example is I just gave the last CC training class of the semester.
Only 5 people actually did CC training this semester and I didn't feel any of
them were ready.  The first thing I asked is are you ready to be CC's?  and
fortunately for me the answer was a unanimous NO!

The moral of the story is I believe in the CC system.  If people are not ready
to Be CC's they should not be forced into it.  At the same time those that are
should be allowed to be.  Additionally those that just need some more training
and Pseudo experience (mock calls ) should get it, so they have the confidence
necessary to be good CC's.

Just my $0.02 worth.


--

Jay Hellmann AKA The Lunatick
Deputy Chief (2 more weeks and counting WOHOO!)
SUNY @ Stony Brook Volunteer Amb. Corps.
Internet: lunatick@...
Web Page: http://www.li.net/~lunatick

"EMS is my hobby" ;-)
"I am Dr. Demento, I need tape for my IV pole, HEH HEH HEH"
"Carpe Corpus!"

I am going to assume that your organization is a volunteer one, if
not please ignore everything that I am about to say.   Although I am not

a member of a campus ems system, I am a member of a volunteer EMS system

on Long Island.  Keeping members IS a huge problem.  You go through all
the time (and money) to train them both in department policy &
procedure, and as EMT's to only have them quit six months latter.  It is

very frustrating, and makes it hard to get calls answered with out
enough personnel.  The single biggest thing that I see that drives away
new members (we call them probationary members or "probies" for short)
is lack of organization in training.  If a new member (especially one
who has never been in EMS before) joins and they can't follow the
training procedures or don't know who to contact if they have a
question, or if that contact person makes themselves unavailable, the
new member gets VERY frustrated, and quits.  What we have is a
"Probationary Member Packet" it is basically a book put together by
members of the training committee that describes exactly what probies
can and can't do, what training they need to get, what meetings they
need to attend, who to contact if they have a question, department
operating procedure, and BASIC EMT skills.  This way at any time the new

member has every piece of information they could ever need at their
fingertips.  Since we started doing this, the number of new members
staying for a year or more has increased dramatically.    Of course
there are other reasons that members quit, they don't have enough time,
they decided that EMS just isn't for them, etc.  However, by making sure

that your training policies and normal department policy is very clear
to the new member, they are much more likely to stay a member for a
longer period of time.
     Also, the department sponsors fun events like picnics, parties, and
trips, to help relive some of the stress brought upon by the very nature

of EMS.  It helps everyone unwind, and forget some of the horrible
things we have seen.  It also fosters friendship between members which
is very important when we have to work together to help another person.
It isn't much, but it is better than nothing.

Just my two cents worth (actually more like $20...), hope it helps.

-Robert Stadelman NY-EMT-D  NREMT-B
Western New England College, Biomedical Engineering Major
email: rstadelm@...
web page: http://www.ncemsf.org/~rstadelm

-----Original Message-----
From: John Cloudman <jcloudm@...>
To: Multiple recipients of list <ncemsf-l@...>
Date: Wednesday, April 29, 1998 1:26 PM
Subject: Riding at other organizations


:I have a question for everyone who is involved in a quick response
:(non-transporting) service: Do you require your members to spend any
amount
:of time riding at another agency in the area?  We are considering
this
:requirement, but there are a number of arguments for and against it,
the
:strongest two being:


>>>Well- I can tell you that Radford University EMS is considering
doing the SAME thing right now.  What we are doing is considering
making it mandatory for all NON-OIC's to run with the county hospital
transportation system, for a certain amount or hours (not sure how
many yet) per semester.

We also considered (since we are a non-transport service) to discuss
with the local hopsital about leting one of the members of the crew
on duty for whatever call it may be, to ride to the hospital with the
patient, instead of just stopping treatment when the hospital
arrives.  This way they can experience what care is like inside the
ambulance and get familiar with it and the hospital.

Hope this helps you some, John.<<<

Jamey***
***************************************************************
Jamey Lynn Haden---Firefighter
Executive Board Member:  Radford University EMS
Roanoke County Fire & Rescue Department
Email:  <jhaden@...>
ICQ#:  3302904
***************************************************************

A few things that were tried successfully at RPI were :

1) Host a presentation during Student Orientation.  We combined ours
with
the mandatory Dept. of Public Safety, and it put the idea in their heads
early.  In fact, we used to get several that would come up and get more
information right afterward.

2) RPI had an Activities Fair usually the weekend following Labor day,
maybe two.  We found that if the ambulance is introduced early enough,
students will be more apt to try it because they aren't committed to
other clubs/groups/organizations just yet.  Once they get committments
elsewhere, its nearly impossible to get them on.

3) Find a creative way to go to each freshman dorm room on campus (the
idea used by the person that started it was the phones should all have
emergency stickers on them).  That was our way to get them to open the
door, and hand them a sticker and pamphlet about RPIA.

A good way to get more EMTs is to host the course on campus, making it
very easy for them.  Also, contact your state DOH EMS rep and request a
bunch of reciprocity packets sent to you.  Make it easy for existing
EMTs from outside your state to apply for reciprocity (doesn't mean
they'll get it, but they're more apt to do it if they don' have to do
any legwork and find the application themselves).

There's plenty more ideas out there, some based upon service type and
size of campus.  Make recruitment a group effort (not just yours), and
it will work a lot better.

Once you got them, then you worry about retention.  You have to juggle
training, service, and the social aspects.  This really takes a
collective effort.  And an email for another time!

Remember one thing : recruitment/retention may not seem to pay off right
away, as most people have no more training than applying a bandaid.  But
it will pay off in the near future, maybe after you leave the school.
Keeping a steady build-up of new members over the years IS better than a
flood of new people for one year and minimal effort the next three ("but
we have enough right now.....").  Ask anyone who was with me during my
freshman year, when we had 12 out of 15 CC's and drivers graduate.  It
took a few years to build back up and some creative changes, but RPIA
went from being totally out of service for a short while back to 24/7
coverage, and each new group of officers and members has worked really
hard to keep the momentum going through today.

- Brian Wilde, RPI '95, FF/EMT-P/N2OWD (Former Captain, RPIA)
- Far Hills - Bedminster Fire Dept., First Aid Squad (Captain), NJ
- EMS Educator, Somerset County Fire Academy, NJ
- Paramedic, Southern Columbia County Ambulance, NY
- Engineer, Bell Communications Research (Bellcore), NJ

John Cloudman <jcloudm@...> writes:
> I have a question for everyone who is involved in a quick response
> (non-transporting) service: Do you require your members to spend any amount
> of time riding at another agency in the area?  We are considering this
> requirement, but there are a number of arguments for and against it, the
> strongest two being:

In order to become a medical member, our precepting members need to do
a ridealong with Pittsburgh EMS or another "approved" ambulance
service in the area.  (The "approved" is to make sure that they go
someplace with a respectable call volume; it doesn't do any good to do
an 8-hour shift with a service that gets 200 calls/year.)

There's no continuing requirement to volunteer or work at another
service.  You're right that this would probably be an unreasonable
requirement for busy college students, and it also raises problems
with the members getting transportation to the other service's base
and signing up for shifts.

Whether or not you can maintain your skills with a limited call volume
is an open question, in my mind.  I think there is benefit to seeing
some more serious calls at least once (and thus our ridealong
requirement), both to get the experience and also aid you in putting
the non-serious calls in perspective.  However, I'm not sure that
there are really a lot of BLS skills that degrade when not exercised.
Maybe one-person BVM, but if you're anything like our service, you'll
probably have plenty of people that come out of the woodwork when the
shit hits the fan, so finding someone to hold the mask shouldn't be a
problem.  Most of the other skill-maintenance problems can be
addressed with inservice training.

> One solution we have thought of includes requiring only the
> in-charges to ride somewhere else.  Does anyone else have any
> thoughts?  Thanks.

That sounds like it has a better chance of working, with the caveat
that the in-charges probably have even less free time to spend at an
outside service.  At CMU, it turns out that most of our supervisors
voluntarily spend time at another service, so we haven't had to
require it.  Naturally, we encourage everyone to spend time at outside
services (either as a regular volunteer, or even the occasional
observer shift), but I think that your members are more likely to view
it positively if it's pitched as a membership perk rather than a
requirement.

-Marc Unangst, EMT-B
  Operations Manager, Carnegie Mellon EMS
  mju@...

ok here's our system.  (in the two years we have been operational we have
have two name changes, this is the second) [ we are a bls bike respnse
group]

1. EMT-the is the lowest position.  requirements for an emt: 1 week EMeRG
academy (32 hour bike course, SOPs, protocols, fun, etc).  we allow new
emt, in fact they are the majority of our new members, to be emts.

2. Lead EMT- After 50 hours as an EMT yu are able to apply for lead.
after an interview, field training insuses for a couple of shifts (4 hours
each).

These two positions combine to for a "crew".  the crew can respond to any
call, but they must be together.   they have one radio and complete
equipment between the two bikes.  the lead is in charge of patient care,
and is responsible for transport decisions, etc.  Thcrew decideds what
role each plays, but ulitmately the lead is the responsible party.

3. CC- A lead can apply to be a crew chief after 50 hours as a lead.
After the interview an EXTENSIVE field training program ensues. (in the
past we have had inconsistancey in training, so we created a form to cover
everything).  A CC is on duty at all times, and can work alone (if no
other crew is available).  When ther is a full crew the CC, has the option
of responding to the call, or not.  He/she has thier own radio and can
separtate from the crew.  A cc can be called to the scene if something
happens (the brown stuff hit the fan), or if there's a second call (when
it rains it pours).

4. Supervisor on duty- this is a pager carried around by on of the
supervisors 24/7, encase some one die/kills some one/has a question/etc.


This works for us, and the members seem to like it.  A person usually
becomes a lead after a semester and a lead becomes a cc after 2 semesters.


Terri L. Jadwin, NREMT-B
The George Washington University
Washington, DC
(H)(202)822-1210
(P)(202)206-4603

For Western EMS we have a candidate class.  They go through administrative
and organizational training.  Then they go through four ride-a-longs with
us and they go through a minor practical so their skills can be evaluated.
After this they go through a written scenario and have to write everything
they do down.  If it is not there they did not do it.  After a semester
they start running the calls themselves.


ron

If that's what you choose to call them...

What's the problem here?  How does anyone expect these *new people*
to get experience if you don't let them work on patients?  That's
probably where a lot of problems are starting with *relationships*
among the crew, keeping a membership, etc...

When I was new to EMS, which wasn't long ago, I was told to do
certain things on numerous amounts of calls, so that I could learn to
do the on my own and become confident.

EMS is a *hands-on* environment.  If you don't give a chance, they
never learn.  If someone hadn't given YOU a chance, where would you
be now?

Just something to consider...

Jamey***
***************************************************************
Jamey Lynn Haden---Firefighter
Executive Board Member:  Radford University EMS
Roanoke County Fire & Rescue Department
Email:  <jhaden@...>
ICQ#:  3302904
***************************************************************

What WPI*EMS did was get a bunch of the members to become instructors, then they
ran a Massachusetts First Responder class on campus.  The class was taught to
the highest level allowed by MA.  Since were were a quick response unit and
didn't have an ambulance, we only needed FR and not EMTs.

Just a few thoughts about these "titles", crew chiefs, attendants, etc.,

	 In my opinion the system absolutely works best when there are at least two
"equals" on each crew.  Your two minimun staff should be crew MEMBERS,
after all EMS in most of the rest of the real world is based on the partner
system.
	 It seems like many of your services get caught up in the Crew Chief
system.  I mean a twelve step check-off system before you can touch a
patient sounds a bit extensive. To hear the crew chief "is ultimly
responabile for every call from pt care to
hand off report to papework." points this fact out. Who is really learning
in that situation?

Our crews are supposed to encourage the for-lack-of-a-better-term
"trainee", who is the unpaid volunteer, to take ALL patient care, of course
with the assistance of one of the paid crew members as their second. This
is the best way to learn by hands-on, without getting thrown into it by
yourself.  It also helps defeat the elitist, "you're the probie and EMS is
so difficult that you can't handle this on your own" attitude.  This also
helps adjust to the fact that some of our new staff may know what they are
doing better than we do when they first come in!  It is very frustrating to
be the low man on the totem pole when you are very confident in your
competance.
	 What ends up happening is that, on a good shift with a confident
volunteer, each person may rotate through the role of crew chief on each
call.  We still maintain a training program for the volunteers, but it
encourages involvment from day 1... as a result I enjoyed the program when
I was in it, and I've been told most people do.... perhaps this is where
some of your recruitment and retention problems are rooted....  How do you
treat your new people?
That is all.
Darren Robertson
Penn State University Emergency Medical Services
21 Ritenour Building
University Park, PA 16802
dxr169@...

I have a question for everyone who is involved in a quick response
(non-transporting) service: Do you require your members to spend any amount
of time riding at another agency in the area?  We are considering this
requirement, but there are a number of arguments for and against it, the
strongest two being:

Pro: EMTs cannot maintain their skills in a quick response service with
limited call volume and limited call "seriousness."

Con: College students are busy enough already, and requiring them to work
somewhere else would turn them off from working with our service.

One solution we have thought of includes requiring only the in-charges to
ride somewhere else.  Does anyone else have any thoughts?  Thanks.


John Cloudman               jcloudm@...
Hanszen College             http://www.owlnet.rice.edu/~jcloudm
6350 Main Street
Houston, TX  77005-1888

I am relatively new to this list.  I am the executive offficer of Western
Illinois University EMS.  A way we keep members is that that WIU has an
EMT course and this is helpful due to the instructor allows are member to
take it.  It is also 7 hours of college ceredit attatched to it.  We also
provide the first reponder class that we teach ourselve.

We also have a system in which the officers and the EMT's get talant
grants from the university.


X/O Ron  Torkilse  EMT-B
Western EMS
316 Olson Hall
Macomb, Il 61455

>
>Does the CC actually direct care on all the calls, with the tech
>assisting them, or is the tech allowed to direct care (with
>supervision from the CC)?  Your system sounds reasonable, but I have
>trouble with any program that doesn't allow members to direct care
>until they become a CC

As I said the CC is ultimly resoncable for pt care and such. This does not
mean I as a CC can let me tech handle the call and I assits the tech in
what they need or just stand back and let the tech do it all. Jusy if any
thing goes wrong it is on my head since I am the CC. I complety agree with
you Marc how else is a tech suppose to move up in the ranks if they just
sit there and hold the clipboard.

Jamison Hughes
University of Hartford
Box 2750 200 Bloomfield Ave
W. Hartford CT 06117
phone: 860-768-7292
email: jphughes@...
web: http://uhavax.hartford.edu/~hughes

Greetings, NCEMSF-L readers.

I want to remind you and your colleagues who are not on the e-mail
list that #NC-EMSF chat will be held tonight at TalkCity at 9pm EDT.
Based on recent NCEMSF-L posts, my proposed initial topic of
discussion is: "New EMT's: when are they ready to be in control of
patient care?" Alternatively, we could discuss recruitment and
retention since that's also a common campus EMS problem.

If you have not used TalkCity before, you must enroll yourself, for
free, by going to http://enroll.talkcity.com

If you've been to TalkCity before and have your nickname and
password, you can login directly at http://www.ncemsf.org/chat.htm
The chat.htm page also has a link to TalkCity's enroll service.

The turnout in the chatroom has been steadily increasing.  Last week
we had a record of five people in the room at once.  I'd like to see
more like 10-15, but we'll see who shows up tonight.  I realize that
many people are finishing their academic semesters in the next two
weeks, so after this week we might put weekly chats on hold until the
fall, unless people tell me that they are still interested in
chatting over the summer.

See you in #NC-EMSF tonight!

Regards,

Scott
ssavett@...
webmaster@...
Scott Savett
ssavett@... -or- webmaster@...
http://www.ncemsf.org/
ICQ: 746028

Jamison Hughes <jphughes@...> writes:
> 1) The Crew Chief - This person is the lead for the given crew for that
> shift, this person is ultimly responabile for every call from pt care to
> hand off report to papework.

Does the CC actually direct care on all the calls, with the tech
assisting them, or is the tech allowed to direct care (with
supervision from the CC)?  Your system sounds reasonable, but I have
trouble with any program that doesn't allow members to direct care
until they become a CC.

At the outside service I volunteer with, we run ALS crews
(paramedic/EMT or paramedic/paramedic).  However, just because the
paramedic is nominally "in charge" doesn't mean that the EMT can't
direct care on the BLS calls; it just means that the EMT has to know
when it's time to have the medic turn it into an ALS call.  There is
also have a 3rd-person crew slot for OJTs (probationary members),
volunteer EMTs that can't drive yet, etc.  OJTs are allowed to direct
care, too, as long as one of the regular crew is supervising them;
when I was an OJT I was directing care, calling the hospital on the
radio, giving the hand-off report and writing the trip sheet.  How
else does the OJT learn how to do these things, and thus become a
regular crew member?  Obviously the crew has to be watching the OJT
and ready to step in if they're about to do something bad ("Oh, you
fell 30 feet onto concrete, and now you can't feel your legs?  Let's
have you turn your head left and right to make sure you didn't hurt
your neck..."), but the best way to learn how to do something is to do
it yourself.

-Marc Unangst, EMT-B
  Operations Manager, Carnegie Mellon EMS
  mju@...

Let me see if a can clarify Dave's statement and at the same time try toss
out my 2 cents on this topic of attendants, crew cheifs, etc....

Here at the University of Hartford Medical Team we have three riding
postitions. I will start from the bottom up.

3) The observer - this could be one of a couple of people. This can be the
possible new member that we are recruiting, a emt student gaining some on
the road experince, or a person intrested in what we do and wants to get a
closer look. To be an observer you must sign a legal wavier.

2) the tech - there are two possiblities here. first the stright forward
tech who is a MRT (CT first respondor) or a EMT that has rode at least two
shifts as an observor so they have a clue how we run things in the field.
second is the crew chief in training who is an experince tech who has shown
interest in becoming a CC. The person must go through a 12 step training
program pre say under the supervison of the Field Officers in all aspects
of being a crew cheif from on scene mangament of the pt and crew to
documenting, radios, etc. No CCIT will be made a CC until s/he has
completed the training program and all active CC concer that this person is
prepared to become a CC

1) The Crew Chief - This person is the lead for the given crew for that
shift, this person is ultimly responabile for every call from pt care to
hand off report to papework.

We here at UHA have been developing this sysytem of training and crew
organization for the past 15 years, we are not saying our way is the best
way or the only way but it works for us and we have have seen it work in
other places.

I hope this made some sense and may have clarified Mr Bacall's statement
and maybe I made a point or two in there as well.


Jamison P. Hughes, CT EMT-B
EMS Coordinator
University of Hartford Medical Team
phone: 860-768-7805   pager: 860-820-5293
email: jphughes@...
web: http://uhavax.hartford.edu/~hughes
UHMT webpage: http://uhavax.hartford.edu/~uhmt

At 12:03 AM -0400 4/29/98, Ramapo Col of NJ EMS wrote:
>NEVER compromise you atabdars we used to have CC ride 3 days in a row
>b/c we felt a new person was not ready I'd rather have less ppl do it
>right then more ppl do it half ass

What's an atabdar?

Seriously -- I'm not suggesting that we should put untrained people in the
field.  I'm just saying that to get there, there are better ways than the
ones we've been using.  Until this year, to be an Attendant here you had to
pass the attendant class (very close to DOT EMT curriculum), with quizzes
and a written and practical final, followed by the completion of a
checklist of skills and crews ridden, after which you went up for grilling
by a promotional board.

After that, you were allowed to ASSIST the Crew Chief by lifting, moving,
and taking vitals... now, doesn't that seem like a _little_ bit of
overkill??  Just imagine what our Crew Chief program is like!

I'm saying that we as college EMS administrators and trainers need to ask
why we make people jump through hoops (i.e. for the wrong reasons):

a.) I had to do it, so you do too.

b.) If we make it really hard, we'll be able to weed out "undesirables"
(regardless of ability of patient care)

c.) Elitism -- "We're BETTER than all the other squads in the area... our
Crew Chiefs have to know how to surgically repair a dissecting aortic
aneurysm before they can even THINK about getting a checklist..."

and so on...

I would much rather get someone into the field sooner so that they can gain
REAL experience than to keep them cooped up in a classroom memorizing Part
800 or Article 30 of the NYS Public Health Law... Yes, our members could
quote the exact number of each item required on an ambulance (24 4x4's, 2
10x30 trauma dressings, 2 burn sheets, one backboard...) or an "emergency
ambulance service vehicle" (and the specifications for both), but to what
end?

I think it also goes back to the old training vs. education dilemma/debate.

At the commercial service I work at, we take new EMT's, give them a week of
basic training, let them orient for 4-5 days as a third person on the crew,
and then it's baptism by fire.  Some don't survive... but the ones who are
cut out for it tend to flourish.

Just a reply...
--CAH

____________________________________
Christian Holt, NYS EMT
Captain, RPI Ambulance
Class of 1999 - B. S. Biology and Psychology
Rensselaer Polytechnic Institute, Troy, NY
____________________________________
holt@...
http://www.rpi.edu/~holtc2
"Every jumbled pile of person has a thinking part that wonders what the
part that isn't thinking isn't thinking of..."  --They Might Be Giants
____________________________________

Maureen O'Neill <mone6418@...> writes:
>  We currently have six Lt.'s, one Captain, and
> three drivers that are not an EMT or Lt.  We also have three commander's
> that end up filling a lot hours when they should be doing administrative
> "stuff". I guess what I am trying to get at is how can we effectively train
> incoming members and encourage them to take an EMT course.  Currently the
> EMT course is not on the URI campus it is at the Community College in RI.
> How can we work to bring it on campus?

How many members do you have, total?  At first glance, it sounds like
you have too many chiefs and not enough indians.  I'm not familiar
with your service, but one process we found helpful was to start over
from the beginning.  Throw out all the administrative labels you have
now and all the ranks, and then figure out what you need based on your
minimum staffing.  As an example, let's say that you are an BLS
service that transports patients, and in your state the minimum crew
for a BLS ambulance is one EMT and one First Responder.  That means
that in order to staff your ambulance you need to have on duty at all
times:

	 1 EMT
	 1 FR w/ driver qualification

Now, you probably don't want a brand-new EMT and a brand-new FR on the
truck by themselves, so you have some sort of qualification to show
that a member knows their skills and knows the local policies.  Let's
call that qualification "crew chief", so now we have

	 1 EMT (CC)
	 1 FR w/ driver qualification

Do you care if the FR is fresh out of class?  If so, then maybe you
need to have CC qualification for FRs.  Where does that leave new
people?  Well, they can ride as a third until they are CC-qualified.
Et cetera, et cetera, but you get the point.

As for bringing the class to campus, it's probably easier than you
think.  If the community college is willing to teach the class off
their main campus, you can probably talk to your administration and
reserve a classroom for it; especially if you're trying to get a room
on a weekend or at some other low-usage time, it should be pretty
easy.  (OTOH, if your campus is anything like CMU, don't be surprised
when you can't get a room for a 100-person class in the middle of a
weekday.)  Most schools are more than happy to let recognized student
organizations use classrooms on campus when they would otherwise be
vacant.  Naturally, your EMT students won't get any URI course credit
for the class, but that's probably not a big deal.  They will also
have to pay the community college tuition, but that's probably pretty
low, and if it's not your service might consider subsidizing all or
part of it.  (Two possibilities are to pay the EMT back for the class
after they become a full member of the service, or to pay for it up
front but require the EMT to pay the service back if they leave within
a year.)

> Also, is it better to train people in a group, for example all the
> probationary members come down all at once, or to train them here and there
> one on one.  What are some ways for both the probationary members to be
> involved with training along with people that are already members?  How can
> we everyone enthused about training?

We find that the FR and EMT training works best as a group activity,
for obvious reasons.  :-)  As far as local training goes, we do it on
an individual basis for the most part.  We generally have a group
orientation session for new members shortly after the FR class in the
fall ends, since that's when most of our new members join, but that's
just for convenience.  We have a Training Manual that has all of the
orientation information in it, so new members can peruse it at their
leisure and refer to it after the orientation session.  When it comes
down to it, the training is an individual thing anyway, since each
person makes it off probationary status as an individual.  You won't
hold someone back who's ready to be a full member just because the guy
next to him still can't spike a bag without hosing down the patient,
so why force everyone to take their training in lockstep?  Doing it
one-on-one lets you tailor the training to each individual and focus
on the skills that this particular member needs to improve.

We involve everone in training in a number of ways.  The first and
most obvious way is that, since precepting members go to calls with
medical members, all the medical members are involved in training the
precepting members to some extent.  We encourage all our medical
members to take a couple minutes for a "call review" with the crew
after each call.  This gives the medical member a chance to critique
the precepting members (though, of course, any serious criticism
should be done in private), and gives the precepting member a chance
to ask question about or discuss anything about the call that they
didn't understand or weren't familiar with.

In addition, a large portion of our precepting member training program
consists of scenarios (simulated calls).  Most of our medical members
are qualified as scenario evaluators, so they are involved in the
training.  We don't usually have many "scenario days" where everybody
gets together and runs a whole bunch of scenarios; usually what
happens is a precept grabs an evaluator and someone to act as the
patient (another medical member, or maybe another precepting member
who has already seen the scenario), and they run through the
scenario.  This gives the precepting members a chance to participate
in the training in small groups, but also keeps everyone involved.  We
think that it's important to be a patient for a few scenarios, in
addition to directing care, since you learn almost as much when you're
the patient as you do when you're the crew chief.  (Sometimes more;
most people don't realize how uncomfortable it is to be strapped to a
backboard until you've been there.)  Generally we keep the scenario
sessions informal; they tend to happen around shift change time, since
that's when you have a fair number of people in the same place at the
same time.

Finally, it sounds obvious, but it bears saying: never, ever look down
on new members because they don't know as much as you.  It's in
everybody's interests to make sure that they get the best training
possible, since today's new guy is your partner tomorrow and the
service chief next week.  (That's especially true in college EMS,
where the 10-year veteran is somebody who couldn't make it in the
real world rather than a mentor to look up to.  :-) )

-Marc Unangst, EMT-B
  Operations Manager, Carnegie Mellon EMS
  mju@...

Ramapo Col of NJ EMS <rcnjems@...> writes:
> NEVER compromise you atabdars we used to have CC ride 3 days in a row
> b/c we felt a new person was not ready I'd rather have less ppl do it
> right then more ppl do it half ass

I'm not really sure exactly what you mean by this; maybe if you wrote
in English, rather than some perverse abbreviated dialect, I'd have
better luck.  At any rate, my attempt to translate your message into a
language I understand yields results that go something like this:

	 Never compromise your standards.  We used to have a crew chief
	 ride 3 days in a row because we felt a new person was not
	 ready.  I'd rather have fewer people do it right than more
	 people do it half-assed.

If that was in fact what you wrote, Dave, then I'll reply to that: I'm
not advocating that anyone lower their standards, and I'm not
advocating allowing someone to treat patients on their own who isn't
ready to.  On the other hand, I think it's important to realize two
facts about EMS:

1) No matter how much practice someone gets, the real learning happens
on real calls with real patients; and

2) No matter how much experience you have, it's more important to have
sound principles and good judgement, because it's impossible to train
for everything you'll see out in the field.

Because of (1), I think it's important to get new members on the truck
and participating in calls as early as possible.  Obviously, don't
make them a part of your minimum crew until they can pull their own
weight, but there's a big difference between being able to take vitals
and being able to direct care for a complicated case.  If it's taking
you more than six months to turn new EMTs into competent crew members,
there's something wrong with your training program or your EMTs.

-Marc Unangst, EMT-B
  Operations Manager, Carnegie Mellon EMS
  mju@...