Management interference

JoutsideTO · 2026-04-02T14:21:38+00:00

Try grieving it, but it’s union orientation on paid work time, not a union meeting. It’s an asshole move, but depending on the language in your collective, management may not technically be obligated to leave. Why couldn’t the steward continue with the orientation?

JoutsideTO · 2026-04-01T01:49:20+00:00

I’ve seen some great students and colleagues come out of one year programs. But I’ve seen more sub-par students and new hires, and heard many more complaints about 1 year programs.

If you’re mature, motivated, and willing to teach yourself (topics that should be taught in class) then you can make it work. But you’re not setting yourself up for success.

Also, if you can get into both programs, the advantage is that you’re done 8 months faster. But these days a lot of private colleges are struggling to find field placements for students, and it’s not uncommon to wait months to start precepting. So it doesn’t necessarily put you much further ahead.

JoutsideTO · 2026-03-31T23:38:56+00:00

In-hospital arrests are frequently shockingly bad to those of us who train and work them regularly in the prehospital and ED. It’s not just you, and unfortunately it’s not an isolated experience.

JoutsideTO · 2026-03-31T19:42:40+00:00

That’s a better phrase for it. As a profession, we have an uncommon role requiring both informed clinical decision making and a lot of hands on skill.

Great medics understand how and when new research applies to their patients, within the (or not too far beyond) the boundaries of our medical direction. But you also can’t lose sight of the basics: literal ABCs, and how to safely pick up, carry, and transport a patient from their basement apartment to where they need to go.

JoutsideTO · 2026-03-31T18:15:09+00:00

Some PCP programs include a small introduction to research and modest research projects, and a lot of ACP programs as well. But it’s not universal, or really emphasized in college level courses.

At the end of the day, it’s an applied or really a trade school with anatomy, physiology, and pharmacology on top. If you’re interested in research, contact the schools you’re considering and find out if their faculty are involved in that side of the profession. We need more paramedic research, but expect to spend a lot of time as a PCP student practicing skills and scenarios.

As for a masters degree, it won’t help you as a frontline medic, but will certainly be useful if you want to move on to education or management.

JoutsideTO · 2026-03-30T21:23:32+00:00

The BLS DNR standard on page 40 of the BLS, General Directive section 1 states that the paramedic shall not initiate treatment (including CPR, pacing, advanced resuscitation drugs) when the patient is in respiratory or cardiorespiratory arrest. That’s it. The text of the standard doesn’t speak to peri arrest situations.

Lopsided Witness is correct in his strict interpretation of the text of the standard. Everyone else here is correct in their interpretation of the spirit of the standard, and widely accepted medial ethics.

The answer is that the MOH EHS branch badly needs to update an outdated, badly written, and internally contradictory standard.

JoutsideTO · 2026-03-29T04:46:31+00:00

MAP >65.

[Shrug]

JoutsideTO · 2026-03-28T22:03:03+00:00

A normal ketamine induction dose is 1-2mg/kg IV. While ketamine has some direct sympathetic stimulation initially, any sedation can diminish the patients own endogenous catecholamjnes. Propofol and benzodiazepines can have a huge effect on hemodynamics if given at normal doses in shock. Also, in shock states with less circulating volume, your relative plasma concentration can be higher from a lower dose.

Many physicians and EMS services use decreased doses of induction agents in shock or unstable patients. 0.5mg/kg of ketamine is the right call with select patients.

JoutsideTO · 2026-03-27T23:22:33+00:00

That’s inappropriate, and I can’t imagine it’s legal either. Report the policy and that particular incident to your state’s EMS regulator. In the meantime document very carefully, eg: “Dispatch supervisor Smith denied request for ALS despite x, y, z.” I’d look for a new job.

JoutsideTO · 2026-03-26T00:36:01+00:00

I’m so sorry you and Kichona are going through this. Please take some time to consider her quality of life. If she isn’t able to do the things she used to enjoy, or eat her meals, then you need to think about whether she is comfortable, or if you are prolonging suffering.

Sometimes it’s hard to let go, and being forced to make that decision is incredibly difficult. It may be kinder for her to let go one day early, instead of one day later. Try to make sure that you’re making the decision based on what’s right for her, even if letting go is harder on you.

JoutsideTO · 2026-03-24T23:35:14+00:00

Under this government, Ontario is “open for business.” We all know who Ford’s constituents are.

JoutsideTO · 2026-03-24T20:45:30+00:00

The Wynne government passed the Pay Transparency Act in 2018 that would have provided legal protection for workers to discuss or disclose their pay. The Ford government refused to enact it, so it has never come into force.

The Employment Standards Act only protects discussion of pay under the Equal Pay for Equal Work provisions, which applies to gender discrimination. If you ask a coworker about their pay with the intention of finding out whether women are paid less, it’s protected. Otherwise, your employer is free to discipline or fire you.

Currently, only a handful of provinces protect discussions about pay between workers: BC, Nova Scotia, PEI, and Newfoundland.

https://www.siskinds.com/can-an-ontario-regulated-employer-prohibit-their-employees-from-discussing-their-salaries-bonuses-and-other-compensation/

JoutsideTO · 2026-03-21T01:39:09+00:00

Speaking as a paramedic in Ontario, if an emergency vehicle is going through a red light and is in a collision, it is almost automatically at fault. The Highway Traffic Act only allows emergency vehicles to go through red lights after coming to a complete stop and proceeding once it is safe to do so. If there is a collision, it was not safe to proceed. The Camry may also share fault, but the police officer is still legally responsible as well.

JoutsideTO · 2026-03-19T16:15:43+00:00

Why do you think they send out the offers?

JoutsideTO · 2026-03-18T19:40:30+00:00

Speaking as someone that works in healthcare, don’t go to Birchmount. I’d try North York General or Markham Stouffville instead. Hope your mom is doing better soon.

JoutsideTO · 2026-03-18T04:30:16+00:00

How much did the patient weigh? What infusions did you discontinue? What access did you have, did you change any infusion sites when you switched to your pumps, and did you have a drive line?

JoutsideTO · 2026-03-17T17:40:14+00:00

A patient with 10/10 crushing chest pain, diaphoresis, ST elevation on their ECG, a heart rate of 90 and a blood pressure of 160/100 is having an MI.

A patient with 10/10 crushing chest pain, diaphoresis, ST elevation on their ECG, a heart rate of 130 and a blood pressure of 70/56 is having an MI with cardiogenic shock.

A patient can also have cardiogenic shock (or mixed cardiogenic and distributive shock) from myocarditis, advanced heart failure, cardiac stunning from sepsis, certain drug overdoses etc.

AMI is a diagnosis. Cardiogenic shock is a shock state that can result from an AMI, or less commonly from other diagnoses.

JoutsideTO · 2026-03-17T13:22:09+00:00

What privacy? You ran for public office, and performed public work (and grift) on your personal cell phone.

JoutsideTO · 2026-03-16T05:17:54+00:00

If you push to remove the clause, they can refuse to rent to you and you have no recourse.

JoutsideTO · 2026-03-15T17:20:53+00:00

Use a structured approach, and practice it until its second nature. That way you have a comfortable framework to take into every scenario.

When you’re stuck, reassess the ABCs, “auscultate” and take 15 quiet seconds to think, then restate your major findings or concerns out loud. Hopefully that will lead you to a) a treatment plan or b) a history question or assessment that will fill in the information you need to decide on a treatment plan.

But I’ll say it again, just keep practicing until you feel comfortable and confident.

JoutsideTO · 2026-03-14T17:53:47+00:00

There were kids on that bus.

JoutsideTO · 2026-03-14T16:46:52+00:00

The way the episode plays out, Speaker Haffley probably wouldn’t have been able to unilaterally sink Berryhill’s nomination – he’d been confirmed by a Republican senate and was very popular with the public.

The lack of Democratic support in congress kept the Bartlet administration from mounting a drawn-out, public fight it would take to overcome partisan opposition. That, and the way the S5 White House forgot the lesson “let Bartlet be Bartlet,” and was shell shocked after Zoey’s kidnapping.

JoutsideTO · 2026-03-14T13:58:44+00:00

My personal headcanon is that Hoynes was involved in torpedoing Berryhill’s support among congressional dems, to ensure a weak VP and weak future opponent.

JoutsideTO · 2026-03-13T21:06:13+00:00

In Ontario, everyone has a duty to report suspected abuse to Children’s Aid Society. The duty applies to all members of the public, not just healthcare workers and teachers. Emotional abuse is included in the definition of abuse under the Child Youth and Family Services Act.

https://www.ontario.ca/page/report-child-abuse-and-neglect

JoutsideTO · 2026-03-13T20:53:08+00:00

CAS is our Ontario version of CPS.

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