Dustdevil

And I've never heard of snow tires either. They both must be a northern thing.

No argument there. That's why I specifically avoided mentioning that term. Hell, I remember thirty years ago people complaining about clergymen being called "doctor" in the hospital. Pharmacists too.

How? I have only seen the horizontal carrier pouch.

Wait... do they really have an "Upstate" in South Carolina? The whole state is the size of Houston.

Anyone that cares about this is stressing over nothing. You have to learn not to care about little things, or you'll burn out early. The unfortunate truth is that nobody but us knows what all those letters mean. And none of us likes to be called an ambulance driver, even if it is accurate. So "medic" is the logical default term for us all. Nurse is the default term for everyone from a CNA with a month of training (more than most EMTs) to a PhD Nurse Practitioner, and you don't often hear anyone except the freshest nursing school grads complain about it. In paramedic school clinicals, the school nametags said "Paramedic" on them, even though we had only completed the classroom portion. No big deal, unless intentionally misrepresenting one's licensure for practice. If so, that's a whole 'nother story.

Bernhard, I understand where your assumptions come from, but your conclusions are dead wrong. If you were correct, we wouldn't be arguing this 40 years later, and governments wouldn't be complaining about the costs and the quality, as they always are. You have to see it first hand to get it, because the theory alone simply never works. Are they sitting around doing nothing if there are no fires? Yes. But that's where the validity of your theory ends. Every valid study tells us that the ONLY thing we provide that consistently improves mortality and morbidity is TRANSPORTATION. PERIOD. So the problem is not that there enough hands on-deck, but that we don't have enough stretchers on the road. That is what people are bitching about. They're tired of waiting so long for an ambulance. Even the firemen are tired of it. So more first responders, incapable of transport, is wholly irrelevant to the equation, no matter how you add it up. Then the problem is multiplied by the extension of your logic to the ambulances. "Hey, they're not always on an emergency, so they should run a non-emergency taxi service in-between EMS runs!" So now, not only are you running too few ambulances for the need, but you are tying up half the fleet on BS. And the same thing happens with half the FD fleet, which is ow unavailable for fires because of EMS. Then, when the quarterly numbers reveal this (as they always do), the knee-jerk reaction is to always blame the underfunded and understaffed EMS, and give yet more money to the FD, who without ambulances, have zero potential to fix the problem, no matter how well they are trained. You have to look at the big picture, mein freund.

They still haven't. They're just great at talking BS to impress the easily impressed with.

Just when I was giving up on anyone in Kalifornia ever figuring this out! http://www.ems1.com/fire-ems/articles/1065703-Calif-county-issues-scathing-report-on-emergency-responses/ Not that anything will ever come of it. They're not that smart. But at least they can no longer plead ignorance.

Send them back to Africa.

The question that needs to be asked here is, what is the purpose of your EMT course? Is it college based? Is it primarily preparation for budding paramedics? Is it just an advanced first aid course for first responders? Do they have any chance of actually ever getting a paying job out of this, or is it just the local good ol' boys' hobby club? This is why I believe that EMT training and paramedic education should be entirely separated. If you wanna be a first aider, go train with the Red Cross. Let them run it, and take all comers, regardless of education, in Ingles or Espanol, and go for it. After alli, it ain't rocket surgery. If they pass, great. If not, oh well. It's their money. And, the more advanced first aiders society has, the better. This way, we don't even fret over nonsense like this. Unless this is the entry exam for a group of people who are all headed for the EMS profession, I could not care less how smart or educated they are, or how good their Ingles is. if they can pass the course, that is good enough for me.

Yep. That's what got Dan Quayle in trouble.

I like it. Some people still seem to see this as an either/or situation. It isn't. Nobody is arguing that education replaces experience. It doesn't (although many seem to be arguing the reverse). Both are absolutely crucial to the development of a competent practitioner. The point that too many are missing here is that both education and experience need to be obtained in a logical order to maximise the result. I'm not sure how anyone here could have missed it, but I'll go back to the ultimate analogy: Building a home. You must lay the foundation first before constructing the house. Sure, you can just by a pre-fab home and roll it up on any old lot and you'll still have a home. You can even go back and pour a slab later, and maybe put brick veneer over the whole thing. But even then, it can never be as good as if you had done it right the first time. You're still just trailer trash.

I would just like to point out the obvious value of this thread in pointing out and validating the belief that EMT-B "experience" is detrimental to the educational development of the paramedic. The longer you spend cooking by the book, without the educational foundation to truly understand -- in an intelligent, informed, scientific manner -- what you are doing, the longer and harder it is for you to overcome all of those mistaken and misleading beliefs you pick up as a basic. This instructor is a poster boy. Can I say "longer and harder" here?

Fixed that for ya.

Definitely. A better system gives you a partner, not just a driver.

Excelsior is not a "bridge" programme. It's not even a correspondence course. There are no courses. There are no instructors. They don't teach you anything. It is merely an examining body, just like the NR, that attempts to validate through exam that you have -- on your own, through self-study, not through courses -- attained the very minimum level of understanding of the theory of nursing practice. That means that it is 100 percent on you. You can't count on the professors to help you learn complex pathophysiology, because again, there are no professors. If you don't have the maturity to make yourself get out of bed, take a shower, and go to class every morning for two years, then you don't have the maturity, self-control, or attention span necessary to teach yourself medicine, that's for sure. The graduation rate for Excelsior is frighteningly dismal. Only a micro-fraction of those who begin the programme ever complete it. It's not easier than nursing school. It's not faster than nursing school. It's not cheaper than nursing school. But most people who enrol into it do so thinking one or all of the above, only to slowly figure out how wrong they were four years and thousands of dollars ago. About the only people that Excelsior makes any decent sense for are: 1. Military medics with almost exclusively hospital-based (not field) experience -- and lots of it -- who because of deployment, simply cannot attend a traditional nursing school every day. 2. LVNs or LPNs who meet the above criteria. Being a medic will get you accepted into Excelsior, but the benefits stop there. Being an EMT or medic does not give you any other advantage or "leg up" on nursing education. Again, the similarities between the two jobs (and education) are almost non-existent. There is nothing you have already learned as a medic that takes the place of what you have to learn as a nurse, except for this: You already [should] know that you enjoy taking care of people. Period. That's it. There is no "bridge" to it, as no prior education is assumed. And, of course, you STILL have to take two years worth of college prerequisite courses to graduate, so again, how does anyone figure they are saving time with Excelsior?

Hey, I'm a certified firefighter III and NREMT-B. Just give me an 8 hour course and I can run MRIs for you. How hard can it be? There's a protocol book, right?

You seem to have misunderstood Mr. Lincoln. Four hours spent practising carrying the axe around isn't the same as sharpening it. Congratulations on all your meaningless merit badges, but it seems that a couple of key points have escaped you. First, before you started taking advanced skills courses on the weekends, did it ever cross your mind that it might be a good idea to go to college and learn the foundations of human anatomy, physiology, psychology, and microbiology first? Oh that's right, us firemen don't need all that book learnin'. Just give me a needle, an ET tube, and a cookbook and I can save the world. The most significant reason that EMS is still living in 1972 is the fire service, and their self-centred refusal (and often a mental inability) to accept advanced educational qualifications. Instead we get a constant stream of excuses, attempting to justify maintaining the forty-year old status-quo. Medicine has evolved greatly in that time, but EMS is still doing things the way they've always done them. Yet, we sit around and complain that we don't get enough respect. The scary thing is that so many of can't figure out why. Oh well, the IAFF will fix it for us! And how can YOU expect to perform a surgical airway when you have never seriously studied human anatomy? Another example of the firemen ignoring the obvious realities. I guess reality isn't in the protocol book. News flash (sort of, actually it's been covered for 4 pages now): The original poster can NOT get experience. It is not an option for her. In fact, in the real world, most basics cannot obtain EMS experience, because there are simply no jobs for them. In better systems, basics are not even employed at all. It's been twenty-five years since I worked in an EMS system that hired basics. So what you are recommending is not only stupid, it’s just plain un-doable. I fail to see how encouraging the OP to do something that cannot be done is constructive. I dunno, maybe I learned that in college or something. Logic 101 FTW.

A LACK of "protocols" makes a system progressive to me. If you're still cooking by the book, you have no right to call yourself a chef. So, LOTS of education and very few protocols is the key to "progressive.' Unless you are up north, or some other kind of Weinercrat, then lots of protocols and federal grants make you progressive.

^ This. End of story. We all agree that it takes experience to become a competent provider. Nobody disagrees with that, so focus on the point here. What we are arguing -- for reasons beyond me -- is whether that experience should come before or after the student has obtained a didactic foundation from which to manage that experience. And I really can't believe that any intelligent professional would think that the vulnerable, sick and injured people who trust us with their lives, should serve as the Guinea Pigs for 3-week basics to experiment with to determine if they are really interested or not. That is absolutely criminal thinking. And, as already made abundantly clear, there is no chance of most basics getting a real EMS job to get that experience, even if they wanted to. That's why half the posts on any forum are n00bs complaining that they can't get a job. And NO, you guys running private transfers for three years before medic school are NOT getting EMS experience, so get over yourselves.

Yes, there is. But is a horrible choice for any medic who does not have significant in-hospital experience, and I don't mean as a simple ER tech. There is actually very little crossover education between the two jobs. So, except for already having your support courses out of the way, there is no significant benefit to being a medic before being a nurse. They are usually very separate career paths for a good reason. They really are not very similar at all. Any one who tells you different has not been both a medic and a nurse, and in that order. Most "bridge" programmes are community college based, not university based. Consequently you start off behind the 8-ball even if you manage to graduate. They get you through a little bit faster, but usually because they cram, not because they cut back much. And it still takes you at least two years to get all your support courses done, if you didn't do so in your paramedic programme. So, if you just get the cheap and quick paramedic certificate instead of the degree, then you don't save any time at all. Bridges are a desperate concession in a vain attempt to help make money for community colleges, not a genuine effort to educate competent nurses. If you're not concerned with competence, then go for it. But most all of the grads I have worked with had gaping holes in both their knowledge and competence, because years as a medic left them with the mistaken impression that we don't need all that book learnin', so they don't commit to it. If you think you may want to do both, then it is absolutely certain that going to nursing school BEFORE medic school results in a much better provider than the reverse. Not to mention the difference in job opportunities. Most EMT grads find they cant get an EMS job even if they do become a medic, as your schools are cranking out hundreds more grads than there are jobs in the area. Don't expect to hear that truth in the school catalogue. It's our dirty little secret. Do some serious job market research before you commit. Even if you can get an EMS job, chances are that it's neither stable nor well paying.

So, you believe that it is preferable to go to the field BEFORE getting "only book knowledge"? At least those with the book knowledge have something to work with. And I've never seen a lack of "book knowledge" stop students and n00bs from arguing with me. In fact, because of all that so-called "experience," they tend to argue (and disrupt class for everyone) a lot more than those with no field time. This observation from teaching and preceptoring twenty times longer than you've been practising, so it's not a rash assumption.

Or, another way for the firemonkeys to extort their share of the EMS economy, even after retirement. Aholes. Retired hose-draggers should be prohibited from teaching these classes.

Ya know, even if it were possible for most EMT-Bs to get serious clinical experience (which DAMN few can or do), your theory would still be absurd. Experience doing what? Looking at patients and not having the educational foundation to know what is wrong with them or what to do with them? Yeah... that's very productive, lol. Agreed that it only promotes very bad, very hard to break habits.

I've never been able to talk a bullet, knife, sideview mirror, cabinet edge, 02 cylinder, or any other flying object out of it's trajectory with my chest.