Medical Services restructuring...

[Donut]

Elliot, I think I am, to a point, but I must confess I'm not that familiar with CFRG policies.  We're not just talking about a QL3 bypass, but an accelerated promotion for these members.  To the best of my knowledge this isn't being advertised or offered to Reserve types.  Sitting at my station I have three paramedics (one former mbr) around me who have asked all sorts of questions about joining, but probably won't think about it if they're coming in as Ptes.

Our recruiting NCO can't give them a definitive answer as to what their career progression will look like, so they're holding off on applications, and we're still hurting for qualified troops.

What they're waiting for is a clear-cut policy decision at the national level that states what they're going to be offered upon enrollment, and how fast they can proceed up the chain.

On a similar note, do any of the reserve types have any experience with the CFMSS PLA process?  I started putting it together, but have put it aside because it seems a ridiculous amount of paperwork for very limited return only to be told that I'm a Reg F QL3 (maybe).

Doug

 

[HCA]

You say they "probably won't think about it if they're coming in as Ptes." Why not? Pte is a good rank and everyone should have to do some time at this rank to appreciate it. Some of my best experiences were as a Pte. I would say there career progression would be as fast or slow as they work at it. In fact career progression just got a lot easier with the elimination of QL4 for Cpl's. If I remember correctly now if you have your BMQ, SQ and your QL3 as well as two years in your good to go.

We could also debate if this is to fast but for paramedics joining now I can't see why two years as a Pte would be so bad for them or how it would change there role if they were made Cpl's faster. Leadership will still be the stopping point for all pers with or without prior medical skills.

If you have a paramedic that joined up and was also able to get the courses required BMQ, SQ, QL3 bridge, QL4 and PLQ Mod 1-6 there is always accelerated promotions for the exceptional people that occasionally wander in our doors.

HCA

 

[vr]

This situation is already being addressed by some Reserve units.  It seems that QL-3 & most if not all of QL-4 are being written off for pers with civvy quals.  On a recent Reserve QL-6A which is the Sgt qual course there was a candidate who had civvy quals up the yin-yang but had never deployed with a medical sub-unit to the field.  I guess that the unit decided that the civvy quals overrode the need for the mbr to participate in the less glamorous aspects.

Is this the 2-tiered system that we are going to get?  One group of "inside" medics who stay in the tent/BMS/amb and only do clinical work and another group who do the "outside" work.  The ones who set up, run, and defend the facility.  Who, if they're lucky, get to be the "head-holder for a casualty.

The PRL is only required to do 14 trg days a year.  Will these pers be held to the same standard as everyone else when it comes time for promotions & appointments.  In the Reserves we have always used field training exercises to develop and assess our troops.  According to recent statements from senior personnel this may no longer be the case.  So when it comes time for promotions how do we compare the military trained versus the civilian trained member? :dontpanic:

 

[Donut]

HCA, I should have said â Å“they have stated they won't join as privatesâ ? vs â Å“probably won't think about joiningâ ?.  One person I am referring to is an ex-member, who knows exactly what it's like as a Pte, Cpl and an OCdt, others have looked at the pay scale and said no, others have thought about being clinically subordinate to a First Responder and said no.

The end result is that our organization is clearly not attracting enough health care professionals.  Telling them they'll spend a couple of years as pot-wallopers or sentries is not going to do it to bring them in.

So, new MP's are promoted Cpl as soon as they are trade qualified, the reasoning AFAIK is that they carry increased responsibility and are required to work independently immediately;  they, too, need a certain civilian skill set to be effective, the same can be said of the Paramedic qual'd Med A.

In terms of what we can offer them to enroll, I have to say not much, or else we'd be enrolling them now. 

Anyone know anything about spec pay?

 

[MedCorps]

Our Coy CSM gave a brief last week after talking with the Branch CWO .  The brief was centred around the Reg QL5A issue, but spec pay came out in the question from the class...

As it stands right now specialty pay for MOC 737 is not on the near radar. 

MC

 

[starlight_745]

My impression regarding the PRL is that there are no promotions or career courses within the PRL.  My info may be out of date though.

 

[Brad Sallows]

Well. If the difference between military command and clinical command can't be resolved and the reserve leadership isn't perceived to be capable of treating professionals at junior rank levels with sufficient respect, then the organization is indeed at an impasse.

Pay scale affects a lot of people, regardless whether their chosen MOSIDs draw on their civilian skills.  Stating that won't solve the perception problem, but reserve _service_ is a sacrifice.

 

[HCA]

I would have to agree with Brad on this one. Reserve service is a sacrifice. One that many of our society are not willing to make for a variety of reasons. (Which can debated elsewhere)
What we are looking for are those few people that are medically qualified and have the desire to serve their country. Now we can do a few things to make the joining more attractive but in the end it comes down to service. There can really be no other reason in the end that senior members like myself and others continue to serve.

The money is mediocre, the job stress high and the job satisfaction decreasing year by year as the workload increases logarithmically. The main reason I continue to serve is pride in the work I and the people I work with do.

We need others who are like minded and while I doubt we will find them in the numbers that the forces desires, we will find some. If they want to serve then it will not really matter to them what rank they join at. We as senior leaders will have to ensure the people we work with exercise their military command appropriately and employ their clinical experts to their maximum potential.

 

[Donut]

As Maj Sallows said, it is a matter of perceptions;   we are not perceived as capable of employing health care professionals appropriately.   While I am almost certain health care professionals have a desire to serve (very few are in health care for the money, and it's certainly open to debate if being a member of the CF is somehow less, or more, of a national service then being a RN, Paramedic, RT, what have you in the current health care crisis, but service it is)   it seems that our organization makes if more difficult and less rewarding then necessary for these people to serve two masters.

I'm not debating that service in the CF, much less the Reserves, is a sacrifice;   It does appear, however, that the CFHS are in a unique position in that we are a federally mandated health care provider, as much so as OHIP or BC MSP, and we are not doing all we can to attract the providers we need to meet our obligations to the other citizens who give up their time, family lives, and income to serve.   Relying on an already overworked segment of the workforce to feel some patriotic zeal and give up even more of their lives to face challenges that replicate or exceed their worst civi experiences seems destined to fail.   The game has to be worth the candle, no matter how dedicated you are to playing.

I think Starlight_745 may have hit it on the head in his July 8 post.   If we can't attract them, we need to find a better way to grow them ourselves.


Doug

 

[axeman]

hey para med tech this is the axeman .email me  way_to_evil @hotmail.com  then we can tell lies about the moolitia

 

[starlight_745]

I see grooming the the people we have as the most cost effective way to manage things.  Funding PCP spots, and running more courses and putting forth a good MCSP program in conert with some local civilian health care facilities would go a long ways towards retaining people then we wouldn't have to worry so much about recruiting all the time.  Most units are terribly bottom heavy adding to the burden for NCO's who have to manage all the training and supervision for all the BMQ qualified troops waiting for courses.  The equipment problems in my mind are the easiest to remedy but we need to think outside the box.  A lot of money could be saved if units got funding to make local purchases.  As I said in my earlier post, consumables are easy to get from CMED, it is the big ticket items where we break down. 

 

[Brad Sallows]

Another thought on recruiting professionals into the reserve:

My guess is that the number of medical professionals in the leadership - MCpl+ Lt+, but mostly Sgt and Capt - must reach a critical mass which provides a leavening of cultural maturity and interpersonal skills which in turn makes a unit attractive to other medical professionals (recruitment, retention).  I have no idea what this critical mass should be - maybe 1/3, maybe 1/2.  I do not suggest the rest of the leadership lacks maturity and interpersonal skills, but rather that it does not quite operate on the same wavelength.

If that hypothesis is true, then some potential approaches to a solution:

1) Recruit and train up (field and leadership training) the required mass.  This seems to be what we are trying to do.  Is it working?

2) Grow from within.  Train and maintain paramedical skills.  Expensive.

3) Curb non-professional growth by setting the bar high.  Force NCMs to acquire and maintain paramedical qualifications to advance beyond MCpl, and HCAs to acquire and maintain a trade-applicable professional certification (eg. diploma in a field of medical administration) to advance beyond Capt (or perhaps even Lt).  Not popular; likely to result in a contraction of units in the immediate future.

(1) and (2) are most discussed.  I believe (3) (and (3)-like) solutions should be considered.  The medical reserve might have to grow smaller before it can grow larger.

 

[Infanteer]

(1) and (2) are most discussed.  I believe (3) (and (3)-like) solutions should be considered.  The medical reserve might have to grow smaller before it can grow larger.

Mr Sallows, I think this practice (3) may be required CF-wide.

 

[Brad Sallows]

Are there combat professions in the civilian world we should be recruiting into the CF reserves, or do you just mean we need to slow the pace of rank advancement in the reserve?

 

[Infanteer]

Are there combat professions in the civilian world we should be recruiting into the CF reserves, or do you just mean we need to slow the pace of rank advancement in the reserve?

Haha, I realized I read into (3) a little incorrectly.  I'm still trying chuckling over the Infantry trying to get American 7/11 employees who've faced incoming rounds to join up an bring experience to the Army....

What I was trying to agree with is the fact that the bar should be set high and that the Army as a whole might have to get "smaller before it gets larger".  However, I realized this is not in the context of what you were proposing (ie: civilian requirements) and that I'm firing down the wrong lane.

I'll pull pin on this one ladies and gentlemen....

 

[Fraser.g]

With all the talk about the TCCC and Combat First Responder courses generated out of the states, why don't the medical reserve go about the same track as the US   Regular force as outlined by the 10th Mountain Division LI?

Four stages of treatment and care in a ratio of 100:50:25:2
100% Combat life saver
50% Trauma Focused Individual Training
25% Combat Medics
2% Advanced Trauma Management Providers

While in the reserve we are lucky if 10% of all troops have Standard First Aid, to train the reserve medics to the T-FIT(including TCCC and C(Ranger)LS) would be a major jump ahead in medical coverage for the reserves.

This would also give the reserves a bonified skill set for deployment to theater and by doing so reduce the stress of repeated deployments on the regular force. At least they could be employed as the Bison Amb Drivers and release the regular force medic in to the 25% and 2% of the above mentioned matrix.


T-FIT MTPs are:

Overview                                                                                    Introduction

Tactical Combat Casualty Care                                                    Triage  

Patient Assessment                                                                       Shock        

Airway Management                                                                   Head Trauma

Thoracoabdominal Trauma                                                          Burns

Extremity Trauma                                                                        High Altitude Sickness

CLS MTPs are:

Combat Lifesaver Course

Preventive Measures                                                                   Burns

Clearing an Object                                                                      Heat Injury    

Mouth to Mouth                                                                         Nerve Agent        

Field Dressing                                                                            Litter Transport

Dressing for Chest Wound                                                         One Man Carry

Dressing a Chest Wound                                                            CLS Task and Equipment

Abdominal Dressing                                                                    IV

Preventing Shock                                                                        Dressing a Head Wound    

Splinting a Fracture                                                                      Pulse

Spinal Injury                                                                                Respiration

J-Tube                                                                                        Sam Splint

Chemical Agents                                                                         Cold Weather Injuries

Meds                                                                                          Evaluate a Casualty

Trans in a Mil Veh                                                                       Battle Fatigue

First Responder MTPs are:    

First Responder                                                             Combat Casualty Care

Primary Survey                                                                          Airway Management

Thoracic Trauma                                                                        Hemorrhagic Shock

Extremity Trauma                                                                       CCP Casevac

Heat Injuries                                                                               Med Equipment

LPD Med

IMO the above outlined training is very doable and in a relatively short time frame. It would take 5-8 man days for the entire package.

GF

 

[starlight_745]

I think that we're stuck with AMFR2 from the sounds of it.   I have seen the medical reserve dying slowly more and more over the last 2 years.  Unless there are major infusions of kit, vehicles and some sort of defined scope of practice I know an awful lot of people that are planning on clearing out because they've reached their limit.  I think the medical reserve dearly needs a clear mission, scope of practice and the equipment to accomplish it.

 

[Fraser.g]

You are preaching to the quire here. I commissioned from the ranks and a "0" trade. It is almost as if CFMG was about to stand up on its own and then some clerk tapped the staff officer on the shoulder and said something along the lines of ....excuse me sir but what about the reserves?

I think that one of the major problems is that we keep on tyring to re-invent the wheel over and over again. We seem griped on having a "Canadian Solution" to every problem. This has caused such fiasco as the LSVW to name just one.

What is wrong with taking the lessons learned the hard way from other armies and embracing it as our own. There is some move to make the TCCC or Combat First Aid course available to the Combat Arms for tours but the Reserves are still stuck with a CIVI course, AMFR2, which does not address the problems of the modern battle field.

I am afraid that my frustration is beginning to show so I will sum this post up with the belief that the Medical Reserves have allot of committed personnel with a strong desire to learn and do the job the problem is that they are continuously being told that what they are to learn has changed and placed on a lower priority and skill level.

Take a look at the courses I have outlined above. If we can not take the whole course due to some archaic relationship between Saint John Ambulance and DND then we can take some of the valuable points and incorporate them into training such as TCCC.

GF

 

[Fraser.g]

It seems that we are changing from BTLS, the gold standard of pre hospital care in north America, to PHTLS. I have not seen the PHTLS course package or what the differences are as it is not offered in Western Canada as far as I know.
If any one out there can clarify or explain the change please wade in.
As a BTLS Advanced instructor I would like to know what the changes are and what the BTLS Instructors will have to do to cross over to PHTLS.
It would appear that we are bickering about the basics and not looking forward IMHO.

 

[old medic]

I know an awful lot of people that are planning on clearing out because they've reached their limit.  I think the medical reserve dearly needs a clear mission, scope of practice and the equipment to accomplish it.

I don't think any medical types are going to disagree with you. There is still a long way to go.  But it's come a long way already.
It wasn't so long ago the reserve medical units were stuck inside the local Svc Bn's.  The years under the Reserve Brigades were not
much better. (<- I'm sure that will draw a comment or raise an eyebrow).

Change is constant, especially in any medical field. Medics have to be willing to change.

I am curious about your "people that are planning on clearing out" comment. Any specific frustrations?

Cheers.