should we do away with EMT certification

[Dustdevil]

Sorry to interrupt the "debate," however I am curious. I am not one for getting rid of the Basic cert, under CURRENT CONDITIONS. Why couldn't we take (I'm not just throwing this out, but seriously suggesting this) the whole Basic/Advanced/Paramedic thing, and make it a standard 4 year degree (could even equate this to "Med School"), where the first 2 years are nothing but classroom stuffs, and the last 2 class/clinical combo. Then...we could do away with the different levels, actually GAIN professionalism via education, and MAYBE, just maybe really expand our scope of practice. Seriously, why don't we try to do something like this?

I'm all for it. Best of all possible solutions.

There would have to be an incentive for people to spend four years training. A bridge over program to nursing or PA etc would have to built in. I wouldn't want to go to college for four years to get undergrad, then four years to train in EMS, then after 8 years in the field realize I don't want to retire out loading gurneys into the ambulance, still paying back my student loans . . .

Worst of all possible plans. No profession can progress, or even become a profession at all, so long as it is established as nothing more than a stepping stone to something else. Why should we be planning the exodus of our own people? That's insane.

And why do we have to move to something else? What do cops move to? What do firemonkeys move to? What is their incentive to stay in their profession (using the term loosely)? When EMS actually becomes a profession -- which is the immediate outgrowth of advanced mininum educational standards -- there will be plenty of reason to stay. If you still choose to leave, that's your choice, and not the responsibility of the profession to facilitate that. Take your BS degree and go to PA school if you want. Nobody's stopping you. Go be a government bureaucrat, or the aforementioned second lieutenant. A BS degree will get you either one of those. Those leaving the fire or police services sure don't have those options.

[AnthonyM83]

Good points. Though, I see more room for advancement and variety at a PD...detectives and narcotics get you doing something totally different...K9, motors, DT Instructor, SWAT get different equipment and lots to learn about. Then sergeant, LT, etc... I don't know...it's just that 8 years of school to do EMS seems a bit much.

[VentMedic]

...it's just that 8 years of school to do EMS seems a bit much.

8 years?

Arizonaffcep wrote:

Sorry to interrupt the "debate," however I am curious. I am not one for getting rid of the Basic cert, under CURRENT CONDITIONS. Why couldn't we take (I'm not just throwing this out, but seriously suggesting this) the whole Basic/Advanced/Paramedic thing, and make it a standard 4 year degree (could even equate this to "Med School"), where the first 2 years are nothing but classroom stuffs, and the last 2 class/clinical combo.

A 4 year degree would just bring it to where other healthcare professions are at for their entry level or recommended degree. Several already have Masters as entry level or recommended.

[AnthonyM83]

But it's a specialized 4 year degree specifically for EMS, like med school. You add that on to four years of regular college and it's 8. (Keeping in mind not everyone's going to go right into it after high school....and even those who are interested in EMS might not want to give up a traditional BA in case they want to work outside of EMS at some point)

[mitchb]

I have a 3 year undergraduate degree in Paramedicine. This gets me to a level below what you in America would call Paramedic. As of next Jan our equivilent to Paramedic will require a post grad diploma (another year of study and mentoring). Then the fun stuff begins. We hope to see Paramedic practitioners within 5 years or so. This will hopefully be at Masters level through a med school although this is still to be worked out.

Although the degree is not yet mandatory it will happen, and as it's looking good for registration and a scope of practice under the same legislation as Doctors, Nurses etc within the next year or so it is looking good for our profession here in New Zealand. Hopefully with education and registartion will come higher wages and more opportunities outside of working for ambulnace companies.

Having said that, the largest provider is against degrees for everyone due to - and wait for it - their relience on volunteers.

[CBEMT]

If you all stopped showing up tomorrow, what do think would happen?

The town would call the private service that has a base in town, like they did the last time there was an organized walkout.

11,000 people would then be served by 250,000 mile ambulances that are just barely equipped to state minimums, which puts them WELL below what anyone here would consider acceptable for a 911 response ambulance. Most of the vehicles don't carry 12-lead monitors or pediatric ET tubes. None of them carry narcotics.

The personnel staffing them, while paid, are very much underpaid and mistreated by management, leading to zero company loyalty and rampant unprofessionalism in appearance, customer service, and patient care (due to the incredible turnover in this area's private ambulance industry caused by these factors, it's almost impossible to be fired strangely enough). Most of them have no 911 response experience, except for the occasional nursing home emergency call- which they were very likely not adequately equipped to deal with. They CAN sling a mean dialysis patient though.

Or my department can continue to volunteer our time (and, yes, accept our per-call stipend). We can use our newer ambulances, stocked to the gills with good equipment. There are things we still want, but we know that these are tough budget times. There's a lot of reasons why people work here, but I don't know of any that do it until they get their phone call from the fire department. I wish more of us wore the button-downs instead of department t-shirts, but we don't act like we've done more runs on this shift than we get paid per hour. The patient is our primary concern first last and always, not the fact that we haven't had a raise in 18 months but our health insurance went up twice and god just let me get through this week that call is coming any day now I hate this place so much.

THAT'S what would happen.

I'm sure everyone here will read a different version of what I said because obviously all volunteers and volunteer departments are exactly alike. Whatever. Not everything works the same way everywhere and you don't, in fact, know everything.

With such a profound personality, how is it that any of us choose to stop trying to be the highest licensure known to our profession?

I'm starting to think this argument is full of shit. Are BSN's not to be considered professional now too? It's possible to get a PhD in Nursing- the highest level of education in the nursing profession. Why aren't the BSN's interested in moving up instead of "just" staying at BSN? Why are PAs content to stay at Physician "Assistant"? Don't they want to be ACTUAL physicians? Any PA that doesn't is clearly not worthy of our respect. Right?

[JChernov1977]

Disclaimer::: This is only my opinion:::::

While consideration for doing away with the EMT Basic level shouldn't even be given thought in my opinion. There does need to be consideration to what actually happens in the field. I have asked the question for years in Phoenix, Arizona they staff the fire trucks with Paramedics, and they make you work on a rescue for so many shifts before you can ride the fire truck.

Now I'm not one who works in management or even always has a high opinion of fire fighters (no offense intended), however to me this doesn't make sense. You have highly trained medical personel on a fire truck that isn't used to transport the patients, but you have instead in the ambulance the rookies who are fresh out of the fire academy.

I think that there are some systems that do it correctly. Have a distinct seperation between EMS and Fire but at the same time have them working together and closely. Let the fire department do the more technical rescue and of course the firefighting while the people who want to work in the EMS and medical system are the ones riding in the ambulance, and treating patients.

When someone wants to work in medicine a lot of the time they are either not bitten by the fire bug or they have no desire to do firefighting. Myself for instance I am one of those people who loves medicine and would give anything to work in a system where I could make a decent living without having to have 2-3 jobs.

I have seen some of the statistics and I personally find it amuzing that a fire truck responds to a person down. I understand the logic that there are more of them throughout the city and that they might be able to get their faster if there are less ambulances, however what I don't understand is that the ambulance not only costs less, but costs less to operate. In a time of financial downfall in America you would think that the municipal systems would be looking at this fact very closely, yet they continue to buy more and more fire trucks. People that call 911 and ask for medical aren't thinking about getting a fire truck to respond to them, they are looking for a transport vehicle to take them to the Emergency room.

I know my wife is an epileptic and has had some pretty bad spells. I wasn't interested in getting a fire truck to her, I was looking for an ambulance to come so that she could be taken to her neurologist at Barrows. Instead they sent a fire truck for which the captain tried to tell me that she didn't need to go to the hospital and that the neurology center was to far away. Why would he care if they are billing by the mile, and not only that he wasn't the one that would be transporting her. There are people who just don't want to be involved in health care and this is why they are on the fire department, then there are people who want to be in health care that don't want to be fire fighters. I think that the real issue is that people should look at this type of thing and have a definate seperation of the two systems, while still having them under the same blanket. There are some systems here in Arizona that do that, but there are so many more that don't.

The EMT-Basic still needs to exist for the people who are the first responders, and those who want to get into the field but aren't sure about making the jump to medic. Emt-basics do have their place, when it comes to basic skills there are plenty of medics especially when they are new to the field or new out of class that want to jump right into the advanced steps when they haven't considered the basic ones yet.

For this reason I think that they should keep the EMT-Basic and cut out the middle like the Intermediate as they have for the most part done in Arizona.

[letmesleep]

I'm starting to think this argument is full of shit. Are BSN's not to be considered professional now too? It's possible to get a PhD in Nursing- the highest level of education in the nursing profession. Why aren't the BSN's interested in moving up instead of "just" staying at BSN? Why are PAs content to stay at Physician "Assistant"? Don't they want to be ACTUAL physicians? Any PA that doesn't is clearly not worthy of our respect. Right?

I wrote this so I will respond to this "full of shit" statement. YES, if they have a chance to advance in their particular field of choice (having a type A personality, which is the entire comment) then why stop? The difference here is that I was discussing OUR FIELD.

Considering the state of OUR profession, or lack there of, why are we content with staying at the lowest level of licensure? What is so fascinating about being the one who drives and cleans? Unless you work for a BLS system thats pretty much whats going to be expected out of you. I will restate that I'm NOT against having the EMT level, but WHY STOP THERE? What is the thought process to be a career EMT if EMS is the career that you choose for yourself? WHY?

[VentMedic]

I'm starting to think this argument is full of shit. Are BSN's not to be considered professional now too? It's possible to get a PhD in Nursing- the highest level of education in the nursing profession. Why aren't the BSN's interested in moving up instead of "just" staying at BSN? Why are PAs content to stay at Physician "Assistant"? Don't they want to be ACTUAL physicians? Any PA that doesn't is clearly not worthy of our respect. Right?

If they have a BSN, they are already at 2x what the minimum education for their licensing. PAs may also only need an Associates or BS degree in some states but may choose a Masters.

Where does that leave someone who chooses to remain with a 110 hour or 3 week course as the education for their profession?

[4kids]

The EMT-Basic still needs to exist for the people who are the first responders, and those who want to get into the field but aren't sure about making the jump to medic. Emt-basics do have their place, when it comes to basic skills there are plenty of medics especially when they are new to the field or new out of class that want to jump right into the advanced steps when they haven't considered the basic ones yet.

I can totally agree with that. Alot of the towns around us. Mostly the smaller low budget towns with very small pops. have the first responder services with the basics. They use them as nothing but first responders to stabilize while their contracted paramedic ambulance service is enroute to the scene. But the basics do not transport. Its cheaper for the towns to do it that way than to buy their own ambulance.

There's just not enough education given in the basic course. I was very fortunate when I took mine and recieved more than what DOT outlined as the standard when I took the class we had 12 White Cross exchange students in the class with us so we actually did alot of A&P, it was not the standard basic class. I think thats what's made me want more.

Now I'm not saying this about all basics, because now not all of them are as dumb as a rock. Some of them choose to continue to open books and learn. But because of the lack of A&P in the basic class most the basic don't understand that alot of injuries that may appear minor, may not be what they appear. You need to look at the big picture. And when you don't understand A&P because you weren't taught it and you respond to a 19 month old falling five and a half feet head first onto concrete, yep you beomce more concered about a little head lac and decide to make it a no transport. Probably should have been more concerned about what may have been going on inside that childs head instead.

Yes you have the NREMT standards, but then you can go from one state to the next and each state sets their own standards too. What I learn in my state may not be what you learn in yours. Part of it is the state, part of it is the difference in the instructor/instructors. There really is no set in stone national standard.