should we do away with EMT certification

[Kaisu]

Just one man's opinion, and knowing it will get me flamed, here I go...

Maybe not flamed, but your arguments are subject to scrutiny. (this is true of anyone that posts anything on this site.)

I think that the EMT level is important for one reason if no other, it takes the beginner in and exposes them to EMS and gives them a chance to gain some experience before becoming a Paramedic.

Having worked with several of what we call "fast track" paramedics, who went from street to Paramedic without any previous training or experience, I feel qualified to offer this opinion.

You are qualified to offer any opinion you want, but anecdotal evidence provides no validity. Everyone and their brother has an opinion, but that does not mean it is backed up by facts. I know a guy who knows a guy that says onions will cure cancer and this qualifies me to have an opinion that onions will cure cancer. An ill informed opinion backed by nothing but an opinion nevertheless.

The ones I worked with were without any previous experience, except what they gained on clinicals, and when they were on scene with a traumatic or stressful scene, did not preform well. And for the record, they were some very intellegent people, just didn't have any experience.

I personally am one of those people that went straight to paramedic without being an EMT. According to my preceptors, I perform better under stress. In cases of pediatric death, I actually out performed experienced providers. It is personal qualities I bring to the job and has nothing to do with whether I was an EMT or not.

On the other hand, I've worked with many paramedics who had two or three years as a EMT before going to paramedic school, and they are some damn great paramedics.

I’ve worked with paramedics that were EMTs for years. They were idiot EMTs and they are idiot paramedics.

That alone made me decide to get a couple of years experience under my belt before I started school, and I am glad I did. The first couple of codes I worked with my paramedic, I knew what I had to do, but hadn't a clue really what they were doing, but after I got used to my part, then I could do my job and observe them at the same time, and learn. When I started paramedic school, I had a much better understanding of why we did this or why we pushed this drug, believe me, it helped.

I would hope it did more than help. EMTs are taught nothing about the physiology or anatomy or the disease process that they are contending with.

Am I saying that every "fast track" paramedic is sub standard, NO, nor am I saying every paramedic who has EMT experience is great, but the figures speak for themselves.

What figures? You haven’t provided any.

Anyway, it is a useless argument, because as long as the private services can hire EMTB's to work at minimum wage, there will be Basics.

As long as there are vested interests out there that perpetrate the nonsense that an EMT is an adequate pre-hospital care provider, there will be EMTs. As long as the public remains ignorant of the issues there will be EMTs. As long as pre-hospital care is used as an excuse to justify huge budgets and fancy toys, there will be EMTs.

Georgia only recently decided to acknowledge the Basic certification, and the reason was due to lobbying efforts by the big city private services.

It’s enough to make me weep.

None of the county or hospital based services I know of will hire Basics.

For good reason.

I appreciate your willingness to put your opinions out here. I sincerely hope that you will read what I wrote in the spirit in which it is intended - to illuminate and illustrate. A lot of people are afraid to engage in these arguments because they are afraid that they will have to change their minds. Believe me, there is no shame in that. The shame is persisting in wrongheadedness and ignorance.

[Mateo_1387]

I wonder if there is a little bit of confusion Kaisu. From reading Sir Duke's post, it appears to me that he is talking about a "medic mill" "zero to hero" medic. I think he is talking about that medic with/without prior experience. I am not 100% sure though. Kaisu, I am getting the idea that you are talking about a Paramedic with a 2 year degree, becoming a medic without the other certifications.

If that is the case, then I can see the validity of both arguments. The medic mill zero to hero medic without experience would have a difficult time gaining experience to be a competent provider, they start off way behind the 8-ball. A 2 year degree paramedic may not have the experience, but they have the education, and the experience will be super easy to get. The 2 year paramedic will excell very rapidly.

[AnthonyM83]

And for the record, they were some very intellegent people, just didn't have any experience.

The first couple of codes I worked with my paramedic, I knew what I had to do, but hadn't a clue really what they were doing, but after I got used to my part, then I could do my job and observe them at the same time, and learn. When I started paramedic school, I had a much better understanding of why we did this or why we pushed this drug, believe me, it helped.

Actually, this is one of the reasons I'd support maybe six months as a basic before paramedic school (not in perfect world, just realistically). Your learning curve is initially stunted by trying to figure out WTF's going on on-scene, getting used to scene presence, scene awareness, patient interaction, dynamic environment, flow of calls, nature of job. That has given me SO much more context for all the EMS related classes I've taken since being in the field.

BUT I'm sidetracking the argument. If we got rid of basics as primary responders, then medic schools would account for their students not having experience and either extend clinicals and/or have them do clinicals from the beginning of the class to get them settled in.

[sirduke]

I was indeed talking about the "Zero to Hero" types. Hadn't heard it put that way before, but it sure fits the bill.

I don't take offense to the arguments or hole shot in my theory, just putting my opinion out there.

Here in Georgia, most of the programs for paramedic are one year courses, there are very few paramedics that have a two year degree, though the push is on for that, at least where I am.

The majority of paramedics here are former EMT's, and have worked for at least a year or more before going to paramedic school.

And yes, there are many, many who were mediocre EMTs or worse, and they are piss poor paramedics now. The ability to pass the class, knowledge wise, does not mean they will make good medics. We unfortantly have one at our service, who knowledge wise is one of the smartest people I've ever met, but cannot for the love of God or money put from brain to hands. He was an EMT for 8 years before going to school, but the experience didn't seem to do any good.

On the other hand, I've noticed the ones who come in as EMT's and don't need to be in this line of work, are often weeded out by "natural" selection, and those left standing, go on to become medics.

As for the numbers, out of 5 zero to hero medics I know, only one ( 1 ) is still in the field, the other 4 were fired or allowed to resign.

The last class locally, there is only one doing the z to h, had 8 students graduate, and only 1 thus far has managed to pass National Registry. Could be the teacher perhaps? But her average before she started the fast track was extremely high pass rate.

Anyway, as I stated earlier, Just on man's opinion.

[Dustdevil]

Seeing it from an EMT perspective, and even from a Paramedic perspective, does very little to give you intelligent insight into what EMT experiences does or does not do for the prospective Paramedic. It is when you see it from an educator's perspective that you realise exactly what the consequences of EMT experience are to the Paramedic student.

If you saw how much time is wasted in Paramedic school arguing with thick-headed EMTs who are unwilling to accept what you are trying to teach them because of a mistaken and uneducated notion they picked up in the field, or from an idiot partner, you'd understand our point here. We spend hundreds of hours of valuable educational time trying to break bad habits and overwrite bad information in "experienced" EMTs, and it cheats them and the rest of the class of what they paid for, which is real education. Not to mention all the time listening to bullshyte war stories from whackers who are intent on proving to the rest of the class that they have more "experience" than everyone else.

The simple fact is that a blank slate is a much more ideal candidate for education -- any kind of education -- than someone who thinks the already know it all. Think of it this way; do you think it would be easier to raise your own child from birth, or to take over raising someone else's adolescent? That is how we see it as professional educators, who also have substantial time in the field.

If any paramedic school is graduating medics who are not fully functional, then that school sucks. It has nothing to do with how long their students spent as basic EMTs. That's a cop-out that completely ignores the concepts of professional education, and quite frankly, lets the schools off too easy. And that only assures that our professional educational standards remain shyte.

[sirduke]

As I said, one man's opinion.

But I still think experience does count. Think back on the Vietnam era Army, when you had Shake and Bake Sergeants, straight out of basic and into NCO school, did that make them great sergeants?

Perhaps one day we can all be as great as you.

[Dustdevil]

But I still think experience does count. Think back on the Vietnam era Army, when you had Shake and Bake Sergeants, straight out of basic and into NCO school, did that make them great sergeants?

You weren't even growing pubes when Vietnam ended, so don't even go there, Bro.

Regardless, it's apples and oranges. Leaders are not created from education. They are created from character and experience. That is a very different job from a scientific professional. The educational foundation must precede the experience, or else the experience has no informational foundation upon which to build on.

And really, dude, if you can't see the difference there, then I'm glad you're not my student. Or employee. Or partner.

[reaper]

Sirduke,

What county are you in?

[AnthonyM83]

Think of it this way; do you think it would be easier to raise your own child from birth, or to take over raising someone else's adolescent?

The problem is that paramedic programs aren't making the appropriate steps to accommodate those who haven't spent time in the field. They're thrown into internship with a limited number of shifts in which to be proficient at a multitude of objectives, not realizing they're not only teaching their "child" how to write cursive, but also teaching them how to craw, walk, speak, and write in print in the first place (following the child rearing metaphor).

This is information I've gotten from local paramedic instructors AND successful (and failed) students. If the paramedic schools accounted for teaching everything from the start, I'd much rather prefer that program...but I haven't really found those around here.

[defib_wizard]

Ok time to add a little fuel to the fire: :twisted:

To the people that support doing away with emt certs:

1. What do you do with the already certified emts?

Are they now unemployed? If not then what do you do with them?

2. If they are required to upgrade to paramedic can they work while going to school.

The cost of this would be paid for by whom? If the emts can't work they will have no money for school.

Will there be enough schools to handle this influx of students, or will we be creating medic mills?

That just teach what you need to pass national registry.

To the people that support keeping emt certification:

Should the education requirements be increased to teach advanced assessment skills.

Just some food for thought, we can complain all day long but unless we come up with answers to our questions. We sound like a bunch of whinebags on ritalin.