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Cake day: June 1st, 2023

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  • Both.

    The US never had a comprehensive EMS system as it was never seen as an essential service, both because EMS is expensive to run (especially in the healthcare/insurance/taxation environment the US has) and because there was significant lobbying against it (there is money in EMS on a large scale if you operate it in a very cut-throat way).

    But the recent downturn in healthcare availability and county-tax-income in rural regions and the dwindling volunteer numbers and enshitification of medicine have all done their part in making the whole situation so much worse.

    There is actually a good study showing “ambulance deserts”. (Just as a reminder: That does not mean that no Advanced life support provider comes…it means that no Ambulance is available at all. So not even one staffed by an EMT-B and an emergency medical responder. And we’re not talking about "what happens if we need two ambulances at the same time)


  • A EMT is in no way qualified to handle emergencies on their own (and yes,I know their curriculum very well). And no, the majority of ambulances are not paramedic-staffed in the US - Actually only 25% of all licenced providers are Paramedics and there are large areas which have only BLS available in a reasonable timeframe. Or no EMS at all, as ambulance services are NOT an essential service in most states. (Only 11 States see it differently).

    So no, not even remotely “most ambulances” are paramedic staffed. Mathematically impossible.

    Besides: The shortest current timeframe in the US for paramedic training is 6 months.

    That is incredibly short in international comparisons, especially when one does compare it to the skills allowed with it.

    Comparison: Australia: 3 year bachelor degree to even make it on a Emergency ambulance (not counting very rural WA&NT), a master degree for the more serious skills.

    Germany: 3 Year apprenticeship to be in command in the ALS ambulance, but emergency physicians are tasked to more serious cases

    Switzerland: 3 year degree, emergency physicians being somewhat common, though, often additional nursing and critcare degree required for more serious cases.

    Hungary: 2 Year EMT course for EMT, 4 year Bachelor for Paramedic

    Poland: 3year Bachelor as minimum.

    South Africa: 1year minimum for the entry, 2 year’s for most jobs, 4 years for paramedic.





  • You forgot the “basement dwelling gatekeepers”, there are the ones whose minds never left their parents basement and whose social skills aka lack thereof is evident in their gatekeeping.

    Their way is the only correct way and Linus has actually no idea how to run Linux, hardware manufacturers don’t know anything about their products, anyone using not their service of choice is automatically an idiot and if you don’t know how to compile xyz yourself by using a self taught technique you really should get off the internet right now.

    Often their advice is inefficient, sometimes it’s outdated and some even blatantly lie (had one boast in a discord that he has a myriad of secret user accounts where he intentionally gives bad advice to a FOSS product he hates).

    Some also intentionally make whatever the goal is appear much harder in an effort to look smarter (that behaviour is often found in the professional world as well*)

    They are the cancerous sore of FOSS and social media,imho.

    PS: Anecdote: I work in healthcare,not IT originally. Everything I know is self taught, therefore. Started a new consulting gig and one of these guys, very much a “IT gatekeeper” always made the company he worked for think it takes a massive effort to install a certain product. Which made everyone’s life much harder because yes,he did install it, but he manually compiled it which took him weeks at a time, while his other work piled up. So they tried not to use this essential product whenever possible and worked their way around it.

    I came there, saw that I needed said product and had it installed within 20min. The CEO sat right next to me and was stunned. “You prepared that, right?” “Uhm,no? You can just download and install it like this?”

    IT-Gatekeeper was asked to join the meeting asap and told to explain why they need so long. His only excuse was “I need to review all the code” - which he did diligently, but he always reviewed ALL the code not only changes, according to his notes.

    I made the mistake of saying to myself a bit to loud “but if you compile that stuff yourself then you are liable if it breaks,if you use the advised packages from the manufacturer they are”(medical device law can be interesting). IT-Gatekeeper exploded and screamed at me how I have no idea how IT works,etc.

    He was let go shortly after that.











  • It depends on the type of “nursing home” - in a facility catering for more mobile clients, yes, there are some benefits from it and there are actually some good studies on it. The major obstacle is the reduced joint mobility (Arthritis of the fingers) and reduced reaction times. Therefore it would be paramount to use adapted control methods and adapted games.

    In a nursing home that has a clientbase focused on the nursing aspect it’s far more difficult - most clients will be “too far gone” for most aspects of gaming with a regular PC,but there are some studies using adapted devices and therapists to activate patients ressources.



  • Same with healthcare. I am a paramedic by trade, was the youngest in my class, youngest commander, went to work around the world, from the European Alps to the African jungle to Australian outback.

    It was quite a journey.

    But sadly I had to recognise that I am not cut out of the wood that is required to survive in today’s healthcare systems in industrial nations. It made me profoundly hate humans and even more sick humans. I dread every single day I still have to work with patients. Especially awake patients. I can’t handle them anymore. Don’t get me wrong. I am still giving 100%, sometimes more - and I don’t judge,like some other colleagues do over the years. I don’t care if you are a frequent flyer, a drunk or a murderer - I will give everything and be very nice to you. But inside me? I burn out.

    It’s not that I can’t work with the misery,with things I’ve seen. It’s just that I can’t work with people and the system they are part of anymore.I am now lucky enough to mostly be “off the road” in a cushy,self employed, desk job. But still, I can’t fully leave healthcare,as I invested to much. And so I will torture myself again.

    In less than 5 hours my alarm clock is going off for another shift. And I am dreading the moment it will.

    Fuck.