Paramilitary style paramedic courses

[NREMT-Basic]

I didn't say anything about 100%. Pretty damn rare you'll catch me doing that on any subject. I thought we were talking only about educational theory here. In the realm of educational theory, yes, we should be emulating the medical professions a lot more closely than the technical and labour trades. Would you disagee?

We ought to be emulating other public safety professions, in particular law enforcement. If I could find a paramedic program in my area with the kind of regimentation we are talking about here, I would do it in a heart beat. The reason we have sloppy, unprofessional and haphazard providers is because that is the way they are trained. EMS is already built on a paramilitary model. Modern EMS is a direct descendant of military field medicine. And yes, I press my uniform shirt and pants, shine my boots and keep my hair cropped short. I also dont wear facial hair in the field. My uniform now is khaki BDUs and while is may not look that way at the end of a tour, it is always squared away when I start. I call everyone I come into contact with whether a paramedic, an EMT-B who is older/has more experience, a patient, doctor or nurse sir or ma'am. If I am put in charge of a team, I dont allow them to be seen smoking in uniform and if they have dropped food or something on their uniform, I tell them to change it. We want professionalism and the respect that goes with it and belly ache when anyone tries to achieve it. In that regard, we are are own worst enemy.

[JPINFV]

How would you explain the lack of such problems (to the extent that it occurs in EMS at least) in other health care fields that don't resort to such a regimented educational style?

[NREMT-Basic]

How would you explain the lack of such problems (to the extent that it occurs in EMS at least) in other health care fields that don't resort to such a regimented educational style?

I wouldnt try to explain it because Im not in those fields and they dont concern me.

[Richard B the EMT]

Re uniforms, either military or paramilitary:

There's an old line, "The right way, the wrong way, and the Army way." Everyone is supposed to be training to do the same job, and wear the same uniform while doing the same job. The uniform is indicative that an individual is supposed to be a part of the group, not so much as inclusion in the group, but the exclusion of everyone else.

There is argument pro and con about public school students wearing uniforms, one being losing individuality (con), another is not being identified erroneously by inadvertently wearing "gang-banger" clothing while in a different gang's area (pro).

Look at it this way. A uniform is a form of camaraderie, and accomplishment. I see NYPD officers wearing Grey, I know they are in the NYPD Academy. They graduate, they wear the Navy Blues. FDNY EMS trainees wear the Navy Blue Pants, and white shirts with no patches. They graduate, they earn the right to wear the Navy Blue shirt with the patches, and hopefully the respect due for the job they do from the public.

[DwayneEMTP]

I can't really explain how it works in the other medical fields. I know in my college the nursing students have a "professional" dress code, which they seem to enforce, as the nurses tend to look sharp and professional.

I'm not even sure that the paramilitary style teaching is the best way. I do believe it is a good way. Assuming that we're often reminded that it's 'para'military, and not military. Whoever said it before me...they have different central goals, though many of the behaviors are in common.

Professionalism is a partially a habit. Have you ever noticed that you can tell the kid that just got a new office job? You can spot him at the market, the post office, on the street. Even if his suit is well taylored and he's clean shaven. He the one that still looks like he's running around naked despite his great clothes. He hasn't had a chance to grow into them yet and feel comfortable. Dressing in a suit every day, pressed and clean, is a habit. It needs to be learned and practiced before one becomes comfortable with it.

That is my point with many of these kids. Pressing your clothes, shaving daily, being prompt, being respectful. Some are things you can pull out of your butt when you need them, but mostly they are habitual.

The students I've been exposed to, males more so than females, don't seem to have had a chance to model this behavior effectively, or if they have, have not become comfortable with it. Doing these things once or twice isn't enough. It must be reinforced (which it certainly will be in a professional environment) before it is something that they desire and seek to continue on their own.

Giving them an environment where they are faced daily with that positive reinforcement seem like a good thing.

If we were training young men, as was the case not so long ago, that were coming straight from military service, then perhaps these are wasted steps. The are proud of their appearance, their work ethic, and their committment to 'team'. (My experience again)

When we have a generation of kids that didn't have that vehicle to help define their self respect/esteem and the behaviors that accompany that attitude, why would we choose not to supply it if we're able to?

Dwayne

[triemal04]

I wouldnt try to explain it because Im not in those fields and they dont concern me.

Nice. The "I'm going to ignore this because it's not exactly what I do so thus must be completely unrelated and not matter" mindset. I like it. Good on ya mate. Also known as the "I can't think of an accurate response" mindset.

Dwayne, I definitely agree with enforcing some standards while people are still learning how to be an EMT or medic, but going so far as to mandate that they be in uniform for a lecture is going a bit far. Enforce a "no tardiness" policy, and if it's violated, give them the boot. Same for missing classes. For a dress code...I don't know that it would be completely wrong to enforce some type of one, but in all honesty, how many people do you know that one their days off can look like crap, but when it comes time to go back to work look like an advertisement for their company/service? Professionalism should be taught to students from the beginning, but I'm not sure that making them wear uniforms is going to do it. May have the opposite effect, especially if you are dealing with a bunch of 18-20 year olds.

Different story entirely when students are doing their clinicals and internship; if they aren't in either scrubs, the schools uniform (if they have one) or whatever is required to be worn for their internship, they should be getting the boot. That may be a better time to start showing them how to act as a professional and why appearances can matter. Probably be easier to get the point across then as well.

Richard- I agree, when someone has been hired and is being put through their initial training with that company, or department or service, then definitely they should be in uniform, for all the reasons you gave and more. But when they're still in school? They aren't dealing with the public, most people probably won't end up working together, and when you're done with medic school, you don't come back afterwards, so there wouldn't be another type of uniform to wear. So what would be the point?

[Eydawn]

Talking about the videos of the two classes... one of the professionally dressed paramilitary class requiring uniforms and one of the "I'm a hippie college student so I look like crap hey nice sandals" class...

Were I to see both of those, only one thing would concern me and it would be the sole basis for my decision. Audio.

What are the folks in the hippie class saying? Are they actively discussing what's going on, or is it forced discussion, like pulling teeth? Are they discussing to the minimum to avoid getting slammed by their professor? I hate it when that happens in my classes... where I'm the only one who really wants to talk about what's going on and everyone else wants to bitch about their favorite latte disappearing from Starbucks.

What are the folks in the paramilitary class saying? Are they bitching about how uncomfortable the uniform is the whole time, or are they focusing on the topic at hand and again, really discussing it?

The content, depth, and length of discussions would be the factor that would make me decide who I was more comfortable with having work on me. Know-it-alls from either side? Go away. Obvious dummies asking questions and then asking more questions to figure it out? You have a chance. A slim one, but a chance. People actively taking time to explain things to their peers and ask for clarifications on the bits they aren't understanding? The ones who don't want lecture to resume because they weren't done wrangling that idea yet? Winner.

The bottom line is, yes, the way you're dressed has an impact on how I view you and you should always be clean and completely covered in clean clothes. No skanks need apply. But- the factor that will make me be comfortable with or uncomfortable with your abilities as a medical provider is whether or not you are truly invested in it and communicate that to me.

Case in point... off duty EMT up in the mountains, comes across a wreck. The local EMS there need a hand. He's dressed in hiking gear and unshaven... but the second he opens his mouth his assistance is welcomed. It's all in how you present yourself. How many of us have found ourselves dressed less than ideally in a situation and still been able to make it work despite our clothes? And I'm not just talking EMS here. I'm talking showing up at an interview and realizing that your idea of professional, which has worked for every interview before, is different from that of this company. THAT sort of thing.

The ultimate point I am making here is that while clothing does have an impact on people psychologically, it is not the deciding factor. It is the content of someone's brain and their ability to use it, while communicating their thought process or at least a portion of it to me as they work, that makes me confident in their abilities. Not how clean their uniform is or whether or not they decided to take out the nose stud today.

Side note- almost ALL of my superiors at my current job have visible piercings and tattoos. Kind of surprised me to be honest. Guess it's part of the field I'm in where folks are a lot more liberal in general. Yeah, it made me dubious at first but you know what? My top supervisor is much smarter than many of the college professors (well dressed, sans pierces/tattoos) I have encountered and I trust her judgment.

Wendy

CO EMT-B

[AnthonyM83]

I think it comes down to what kind of students you're admitting. If you have students who already have the drive to be professionals, as well as an educational background that has taught them how to present themselves properly, a paramilitary program is pointless and would DETRACT from academics. Maybe wearing a uniform would help keep the study mindset a little, but the negatives would outweigh that...might possibly lead to elitist attitude...and away from a medical professional mindset.

Dust once reminded me that the kids in EMT class are usually young kids out of high school who aren't much interested in professionalism so a dress code (collar shirt & slacks...not uniforms) might be warranted. I imagine the schools want model paramedics who will represent the school as the best. So, it might need that because of the student type it's admitting.

I'm currently interviewing paramedic schools, including the one from the video. I can tell you it's a negative in my book FOR ME. I want time spent on education, not militiristic discipline.

[Dustdevil]

I think it comes down to what kind of students you're admitting. If you have students who already have the drive to be professionals, as well as an educational background that has taught them how to present themselves properly, a paramilitary program is pointless and would DETRACT from academics. Maybe wearing a uniform would help keep the study mindset a little, but the negatives would outweigh that...might possibly lead to elitist attitude...and away from a medical professional mindset.

That sums it up nicely. Quite obviously, this school is fedding the firemonkey monster. That's what most all of these guys want to be. Paramedic certification is simply a means to an end, not a career goal or professional aspiration. Consequently, what they run at RCC is appropriate for the target audience. And that, unfortunately, is what the whole Community College concept is all about. They are established to fullfil a need in the community. And the overwhelming need in that community is people pre-trained to be firemonkeys so the city government doesn't have to spend their time or money to do it. Of course, if the firemonkeys would just turn it over to the professionals like they should, then they wouldn't have to worry about it at all, but I digress.

Is it good to instill discipline and pride in your students? Sure. That's a positive thing, no matter what your field. But, is it the responsibility of a paramedic programme to do that? Is it even within the field of expertise of a paramedic programme to do that? Did they consult some expert resources on education to come up with this nonsense, or did they just draw upon their exposure to the various fire academies to throw something together? I think we all know the answer to that question. A student entering my paramedic programme should have at least twelve years of formal education behind him or her, as well as at least 18 years of life experience. If he or she has not gained the maturity to understand the concept of appropirate behaviour by then, then they aren't ready for my programme. Period. Our programmes should stick to what we know best, which is medicine, and leave the rest to the appropriate professionals to give the students. Any programme that is taking people who obviously lack the maturity and discipline to function professionaly, and trying to mold that person, is stepping WAY out of it's field of expertise, which in itself is a very bad sign.

Hell, just the fact that they are wasting so much valuable educational time on this kind of pointless nonsense would be enough reason for me to give them a thumbs down. We constantly complain about how ill-prepared our new medics are for field work. That's why so many people still claim that you should be an EMT for a couple years of experience before even going to paramedic school. Now, if you, as an instructor, had all that time they spend running laps, playing football, and shooting rubber bands, to use giving your students more medical and operational education and training, don't you think you could go a very long way towards closing that experience gap? If not, you suck as an instructor.

The answer to the OP is that no, this is certainly not an good way to educate medical professionals. In fact, it's not education at all. It's technical training and indoctrination, and you will never see any other medical profession doing it. That says it all. RCC is run just like a fire school, which is exactly how their target audience wants it. The firemonkeys stick with what they know best.

[Asysin2leads]

I don't necessarily agree with the paramilitary model being the correct one to teach paramedicine, but I would prefer it to no standards at all.

The correct approach to teaching paramedicine is the strict academic approach. What I mean is the discipline and respect most often seen in private academies and prep schools. I think most "pro-paramilitary" people see it as the only way to ensure the proper motivation and discipline in a student, and the only way to weed out the wrong people, but this isn't true. I once had a biology class taught by a former research scientist, and let me tell you, his standards for behavior, study, and methodology made every paramilitary run class I've been in look like kindergarten the day before Christmas break.

Secondly, particularly at the paramedic level, the ideals of subordination and group work that the paramilitary mindset fosters are not conducive to the role of the paramedic. The paramedic is supposed to be the leader. He's supposed to be resourceful, intuitive, and creative if necessary, and his guiding purpose should not be his unit, God, or country, but his patient, patient, and patient.

To sum up, you can still enforce a no tardiness, clean appearance, respectful class without resorting to everyone wearing the same color shirt. Besides, I'd rather have the student spend his time studying cardiology then polishing his boots.