Basic vs. Medic

[speedygodzilla]

[new post because I need to disable BBCode for this explination]

Proper quote format is

Also you can click the quote button on the posting you want to quote.

As for the whole EMT-B thing, even though it discuss way to much here I still find my self passionate about the topic. EMT-B education is not where it should be, neither are many paramedic programs (not requiring vital classes ahead or to earn a degree). However I value EMT-B as they have a place in EMS as do CNAs in Nursing. I do not like the whole idea of BLS ambulances. One paramedic and one EMT-B makes a great ALS ambulance in my opinion. On those bad calls more than one ambulance should respond or at least a supervising paramedic should respond.

I wish this could be resolve where the Basic level of care wasn't like a Boy Scout merit badge but I have yet to find a way to make a real impact accept for maybe enlightening others here and being enlightened by others.

Rather than Medic vs Basics I wish it could just be something like Medics+Basics=Team, partners, EMS, care, etc.

[Dustdevil]

Okay, it's nice to see everybody holding hands and singing Kum By Ya like this. Really, it warms my heart. Or not. Call me a sceptic, but I am not ready to buy this philosophical transformation that took place in ten posts. I mean, our new friend comes here and cuts loose with a stream of nonsense -- not a lick of it making the slightest sense -- and within a couple of hours, he is the new champion of EMS educational excellence. Sorry... but I'm not ready to embrace this one yet.

I was reading an earlier post about someone who was taking an EMT course in High school' date=' and he wanted to know if it was a good idea. He was able to pull from that discussion that yes it was.[/quote']

You're giving his "ability" too much credit. He pulled from it exactly what he wanted to pull from it, totally disregarding the majority of the wisdom he received.

It is nothing but a first aid course, originally intended for first responders to trauma, but now used as an entry level to transporting EMS providers, that has improved by only 30 hours in thirty years. You don't think that is inadequate and antiquated? What rock have you been under for the last eighteen years?

I think this is where you went off track. What we were saying was that working in the field as a basic was all but useless to your professional development as a paramedic in the future. I don't think anybody said anything about EMTs being completely useless, although you can certainly make that point.

Again, nobody said that. We said basic experience had nothing to offer to your professional development as a medic. But yes, I'll say it. EMTs nothing to offer me as a partner that a paramedic couldn't offer better. Consequently, I have no use for them, except as first responders, which is all they are good for.

Too bad. You wasted a lot of time before deciding to commit to being a professional medical provider. I sure wish I had my five years as an EMT back. I could have done a lot more, a lot sooner, for a lot more people, and a lot more pay, instead of just wanking over the Dyna Med catalogue and thinking I was really something special.

Valuable? Because they can be your helper for less money? Because they give you somebody of lesser education to assert authority over? Because having a basic partner allows you to cherry pick the patients you want to care for, and pawn the Gomers off on him? You wouldn't find somebody of equal education and abilities to be at least as helpful as somebody with a month long first aid course? I find that extremely hard to believe.

I commend you for calming down and entering into some productive dialogue now. But yeah, before you go tossing out verbal challenges to people in the future, it would be helpful if you first tried to more carefully read what they are saying, and make some attempt to understand where they are coming from before you condemn them.

Not true.

That makes not the slightest sense. If your system utilises EMT-Bs to take over patient care when your medics fail, then your system sucks, as do your medics, and probably their school too. There is absolutely no excuse for that. Do you honestly not think a better plan would be to have another paramedic there to pull your slack? In what other profession in the world do the higher educated levels punt down to lower levels when they are stumped? That is the most absurd thing I have ever heard here! Insanity! A reflection of a very, very, very poor grasp of EMS realities. I just don't see how you could remain this clueless after eighteen years in the field.

If that is so, then why don't we just do away with paramedic school altogether and just OJT everybody? Your assertion is only half right. As JPINFV so correctly stated, experience is not a stand-alone concept. It has to have an educational foundation to build upon. Differential diagnoses are not learned through experience if you don't have the education to know what signs and symptoms you are looking for in the first place. Consequently, you can't separate the two. And it is a mathematical fact that the more educational preparation you have, the more fruitful your experience will be. Experience is absolutely necessary, but after only 120 hours of night school first aid training is not the place to start thinking you are ready to perfect any diagnostic skillz.

Entirely wrong on both counts. Let's not embrace them. That's just coddling them, blowing smoke up their arses to make them feel more important than they really are, making them comfortable at that low level of education, resulting in a serious delay in their professional development. Instead, how about we encourage them? What are you afraid of? And no, we don't owe that to our patients. What we owe to our patients is to provide them with competent, highly educated and experienced professionals, not month-long first aiders with an overinflated sense of self importance who have neither the education to diagnose their problems, nor the skills to treat them. I fail to see how holding our basics back from progressing serves the needs of them or their patients.

Ironically, it looks like YOU are the one who is holding basics down, not us. You're the one who wants them to sit around and pay dues for minimum wage for years on end -- just so you have a subordinate -- instead of moving on with a professional education to prepare them to better serve their patients. Remember, this is about the patients needs, not yours.

I get the distinct impression that you have spent your entire 18 years isolated in one little geographical area, not getting out and getting exposure to other providers and systems, resulting in a failure to see the big picture of EMS. That is the number one value of EMT City; you will learn that the way they do it in BF, Egypt isn't how it is in the real world.

And yes, I AM better than an EMT-B. A paramedic is better than an EMT-B. Two years better. Did you skip math in elementary school? That's not a slam on basics. That's simple math. If they have the professional commitment to get a real education and join the profession, they will be better than an EMT-B someday too. And, unlike you, I encourage them to do that at the earliest possible moment, not after they've screwed up their development with pointless years of ambulance driving, acquiring bad habits.

Welcome aboard bro. No hatred. I just want you to understand that the rest of us are just as passionate our views, and that we have real, concrete reasons for our views. We're not just talking out of our arses, so please give us a little credit. Thanks!

[DwayneEMTP]

I have been in EMS many years and am only now in Paramedic school and I would fully agree with a Paramedic saying they would rather have another Paramedic helping them...

Now that is a very intelligent response' date=' thank you for that... [/quote']

[JakeEMTP]

Okay, it's nice to see everybody holding hands and singing Kum By Ya like this. Really, it warms my heart. Or not. Call me a sceptic, but I am not ready to buy this philosophical transformation that took place in ten posts.

I was referring to the lack of " You're an idiot," Basics save Medics, You don't know what you farking talking about" etc. line of crap that was missing from this discussion.

Intelligent debate is what we strive for. Unfortunately, we rarely see that when this topic is brought up. That is all.

[firedoc5]

I didn't have time to read each and every post on this subject so I might be repeating someone else, but. Basics through Paramedic (or even higher) is all a team effort. One suppose to support the other. As far as advancing, I'm a firm believer in that you have to have "book learnin' "-classroom, clinicals, etc. AND "field learnin' "-actual hands-on experience. It always worried me when someone would advance without being proficient field skills. And that takes time. You can't rush it, no matter how much you want to.

[Just Plain Ruff]

Let me ask one question in regards to field skills.

Do you benefit from Field skills as an EMT when you get over 500 hours of field skills in your paramedic program.

What kind of field skills are we talking about here?

How to immobilize a fracture?

How to put oxygen on someone?

How to cover a wound?

I'd risk it to say that all those skills can be gained while in paramedic school.

Just why is it that our profession among the healthcare professions is the only profession that requires someone to get a basic class done before they go on the get the advanced.

RN's do not require that you get a lpn or cna training before you get your RN.

Physician training does not require that you get nursing or ems training before you get to be in the doctor classes.

What about veterinarians? are they required to be vet techs before Veterinarian education?

And finally how bout dentists? We don't require them to be dental tech's before they get their dentist training.

So why do we require everyone of us to be an emt first and then medic second?

Here's a thought or a solution

If you want to just be an emt and there are those out there who want just that - then let them take EMT classes and that's it.

If you want to be a medic then you should not have to get your emt first. Just go out and sign up for medic classes.

I think that this emt then medic mentality and requirements can directly be linked back to the education institutions that train them. there is money to be made in training both levels of provider and as long as you have to be a EMT first and then a medic the schools make money off it.

Take CEU's as another example. there are ceu's geared towards emts only and then there are advanced ceu's. There is money to be made in having two different levels of CEU's also.

I think that this is the one major problem we have.

The education system that we have for EMS is dismal. When you have small ambulance services putting on emt classes, hospitals putting on medic classes, community colleges putting on medic and emt classes and the fly by night 8 week emt class and 15 week paramedic courses with not a lick of conformity in their instruction styles the root cause is lack of consistency.

Maybe we need to re-evaluate who actually can teach classes. Someone who has been in the field for 9 days can teach a ceu class if they want. Does that make them a bad instructor, maybe or maybe not but does it make up for lack of experience? NO.

You can have a paramedic who has been in the field for 30 years teaching classes but does that make them a good instructor? maybe or maybe not.

What about the medics who have been out of the field for 3 years or 10 years and they are still teaching? Do we take their experience at face value or does it provide some skepticism that they may not be teaching the newest techniques and processes that current medics would? Who knows.

all I'm saying is this, we get what we pay for. If you want a educational system that will be consistent, constant and up to date then you have to pay for it and as long as we have 10 different tracks for people to become paramedics or emt's then the ball really is not in our court.

[sevenball842]

Dust devil, although I appreciate your input into this topic, I fear that you completely mistook

my words, causing you to chase your tail around in circles until you are dizzy. My experience spans 18 years, yes. My experience spans 4 states, and many services. Fire based, private, hospital based, and now one of the largest "paramedic only", 911 providers in my state, for which I am a supervisor in. Not patting myself in the back too hard, but that makes me well qualified to offer my opinion.

Your argument, if I understand it correctly, only solidifies and validates what we were all saying. Education is lacking in the area of EMT-basics, thank you for proving me right. To quote myself as saying that if we could extend the hours that are required to become a medic, and extend the time needed to finish clinicals, I would completely support entry level medics.

My comment about relying on our basic skills was misconstrued by you again. I wasn't talking about triage to basic emt's, I was talking about relying on our own skills that we learned as basics to continue pt. care. Too many times I have seen these arrogant, ALS focused, microwave medics, become so focused on their "skills", that they forget how to properly bag a patient, do competent CPR, or god forbid, hold the hand of that little old lady who's scared. All skills you solidify while riding as a basic.

Should basics be allowed to ride a primary 911 truck alone? I agree that they should not. Should they ride with a medic? Absolutely! Being able to learn the difference between sick and not sick, hurt and not hurt, is not something that you can be taught in a classroom. On the same token, compassion is certainly something that cannot be taught. If we are so focused on our skills, we tend to overlook the more simple tasks. A good assessment, comfort measures (blankets, pillows, ect...), and most of all a kind soothing conversation. These are not things that I simply think, these are things that I witness on a day to day basis.

Moving on, Speedygodzilla, kudos to you. Medics+Basics=Team, partners, EMS, care, etc... Brilliant!!! How's that for Kumbaya for you?

ruffems, I couldn't agree with you more. Our education system is certainly sub-par. The need for better instructors, longer classes, and yes, more clinical hours, should put us right where we need to be.

As for physicians, nurses, vets, ect..., look at how long their classes are. Look at how long their clinicals are in comparison to ours. That is where the difference lies. You substitute BLS experience with longer courses and more clinicals, then you have something there. But until then, the experience you gain from being a basic is invaluable in this field, and replaces the need for course reform.

The final note on EMS vs. Physicians, vets, RN's is this. Because of the amount of schooling and amount of clinicals that are required, they are considered by society to be "professionals". As of right now, we are not considered to be in a profession, our field is still just a job.

[spenac]

I think that this emt then medic mentality and requirements can directly be linked back to the education institutions that train them. there is money to be made in training both levels of provider and as long as you have to be a EMT first and then a medic the schools make money off it.

Take CEU's as another example. there are ceu's geared towards emts only and then there are advanced ceu's. There is money to be made in having two different levels of CEU's also.

I think that this is the one major problem we have.

Ruff you hit it on the head. Love of money is the root of all evil ( 1 Timothy 6 ). The current EMS system in the USA is a disgrace and it goes back to the dollar. Education systems are trying to get as many dollars as they can as fast as they can. Companys want the cheapest workforce they can get thus encouraging volunteers and hiring basics. Who suffers? Everybody. Those of us trying to support our familys suffer with low pay. The public suffers because of bad care. In the current state of affairs of EMS why should anyone, other than for pride, spend any more money or time to get certification? Really no reason because you'll get the same crappy pay so again goes back to money.

We have been battling the basics, vollys, and education since I joined this forum. Now the truth has come out the real problem with EMS is money.

[Just Plain Ruff]

Spenac, it's about time that you realize that I'm right all the time. Actually just kidding

My wife keeps telling me that she's right and I need to get over it. But I digress.

[spenac]

Spenac, it's about time that you realize that I'm right all the time. Actually just kidding

My wife keeps telling me that she's right and I need to get over it. But I digress.

I thought I was right once but then my wife corrected me.