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SAAS / Re: Interesting problems with private providers.
« on: May 05, 2010, 08:30:26 PM »
In reply,
>>>>AmboMan...... patients don't pay for anything on intra hospital transfers form public hospital that is, the hospital do. Hospitals want people who have solutions not problems. So if they are willing to go up to wards and get patients, the hospitals will love them.
I know that this is the way interhospital transfers work - even amongst the private hospitals, but what about those hundreds who get a SAAS ambulance INTO hospital, how do they get home? - in a private?, and if so - who pays? You also forget that SAAS personnel cannot go past the reception area of a public hospital without causing a demarkation dispute with the orderlies (see todays medical directive that spells out the few times when we can take a patient to/from a public ward). Many PTS crews would rather go up to the ward, meet the patient and get a proper handover
>>>>As a Paramedic of some years I have to disagree with your last comment. Most of PTS/ATS current woes and potential downfall is their own staff not willing to do certain jobs even though they are trained to do it, i.e an emergency crew, sprint car or EOC clinican downgrades the job from Emergency to ATS or ESS, then the ATS/ESS crew gets there are refuses to take a basic patient.
As an ATS/ESS officer of some years, I have to disagree with your last comment. We are more than happy to jobs we are trained to do, but for so long we have been limited by restrictive policies and stifling initiative. Remember when we wore a different uniform?, how about not letting us have glucometers because they were too complicated?, how about having to consult with an ICP or Hugh to administer penthrane. how about not being able to carry a patient who has had morphine within the last hour or so (obviously we are too stupid to recognise respiratory depression).
A PTS crew has every right to refuse to carry a patient they are not happy with or does not fit within their extremely limited protocols - maybe the initial emerg crew did not do any handover paperwork, maybe 4 or more hours had passed between being seen by SPRINT and the patient has deteriorated since then, maybe the ECP has been given a "bum steer" by hospital staff anxious to clear a bed - and yes, maybe the PTS could see the hospital from the front of the re-triaged patient's house and thought "stuff it - lazy p***s". All of these things have happened to me. Maybe they simply don't feel comfortable because they haven't had any meaningful training or development for the last year or two, no audits, no nothing. Oh yes, I forgot the jobs where the EOC has downgraded the really sick patient (and not told us the patient's true condition) because all of the emerg cars are tied up.
Quite frankly, I don't care how many privates come in as competition, I just want the opportunity to compete on equal terms, and as 360 Joules says, work at the level we are trained for. And quite right, - limit the number of casuals so we don't spend all our time training uni students into future paramedics; if you want to transfer patients after midnight, don't put the only crews doing it at Port Adelaide; give us more dedicated PTS radio operators (not emerg fill-ins) who understand that good coordination is more than clearing the screen, and yes, get the guts to move on the deadwood who think that PTS/ESS is a quiet place to reside until retirement comes.
Maybe the ones that should really be worried are the Emerg crews. "The Road Ahead" mentions that that up to 20% of emerg jobs are "low acuity"(??non emerg), how often are eight university trained para/ICPs needed at a four car bingle; are death rates so dramatically different in the country where Cert IV is the usual qualification; with SPRINT, ECP's etc as rapid backup, do we REALLY need to send fully qualified crews to "call direct" non responses, "lift onlys" or a hundred other basic jobs, - all at professional rates. It would not be too hard to argue that greater efficiencies in SAAS could be had by increasing the non-emerg section.
Not that it will ever happen of course - just like there would never be competition for PTS.!!!
>>>>AmboMan...... patients don't pay for anything on intra hospital transfers form public hospital that is, the hospital do. Hospitals want people who have solutions not problems. So if they are willing to go up to wards and get patients, the hospitals will love them.
I know that this is the way interhospital transfers work - even amongst the private hospitals, but what about those hundreds who get a SAAS ambulance INTO hospital, how do they get home? - in a private?, and if so - who pays? You also forget that SAAS personnel cannot go past the reception area of a public hospital without causing a demarkation dispute with the orderlies (see todays medical directive that spells out the few times when we can take a patient to/from a public ward). Many PTS crews would rather go up to the ward, meet the patient and get a proper handover
>>>>As a Paramedic of some years I have to disagree with your last comment. Most of PTS/ATS current woes and potential downfall is their own staff not willing to do certain jobs even though they are trained to do it, i.e an emergency crew, sprint car or EOC clinican downgrades the job from Emergency to ATS or ESS, then the ATS/ESS crew gets there are refuses to take a basic patient.
As an ATS/ESS officer of some years, I have to disagree with your last comment. We are more than happy to jobs we are trained to do, but for so long we have been limited by restrictive policies and stifling initiative. Remember when we wore a different uniform?, how about not letting us have glucometers because they were too complicated?, how about having to consult with an ICP or Hugh to administer penthrane. how about not being able to carry a patient who has had morphine within the last hour or so (obviously we are too stupid to recognise respiratory depression).
A PTS crew has every right to refuse to carry a patient they are not happy with or does not fit within their extremely limited protocols - maybe the initial emerg crew did not do any handover paperwork, maybe 4 or more hours had passed between being seen by SPRINT and the patient has deteriorated since then, maybe the ECP has been given a "bum steer" by hospital staff anxious to clear a bed - and yes, maybe the PTS could see the hospital from the front of the re-triaged patient's house and thought "stuff it - lazy p***s". All of these things have happened to me. Maybe they simply don't feel comfortable because they haven't had any meaningful training or development for the last year or two, no audits, no nothing. Oh yes, I forgot the jobs where the EOC has downgraded the really sick patient (and not told us the patient's true condition) because all of the emerg cars are tied up.
Quite frankly, I don't care how many privates come in as competition, I just want the opportunity to compete on equal terms, and as 360 Joules says, work at the level we are trained for. And quite right, - limit the number of casuals so we don't spend all our time training uni students into future paramedics; if you want to transfer patients after midnight, don't put the only crews doing it at Port Adelaide; give us more dedicated PTS radio operators (not emerg fill-ins) who understand that good coordination is more than clearing the screen, and yes, get the guts to move on the deadwood who think that PTS/ESS is a quiet place to reside until retirement comes.
Maybe the ones that should really be worried are the Emerg crews. "The Road Ahead" mentions that that up to 20% of emerg jobs are "low acuity"(??non emerg), how often are eight university trained para/ICPs needed at a four car bingle; are death rates so dramatically different in the country where Cert IV is the usual qualification; with SPRINT, ECP's etc as rapid backup, do we REALLY need to send fully qualified crews to "call direct" non responses, "lift onlys" or a hundred other basic jobs, - all at professional rates. It would not be too hard to argue that greater efficiencies in SAAS could be had by increasing the non-emerg section.
Not that it will ever happen of course - just like there would never be competition for PTS.!!!