When are we going to wake up as a profession?

[rimdup]

When are we going to wake up as a profession? I am a NREMT-P and work for a Fire based EMS system in the midwest. We are second rate to the fire service unfortunately. We have EMT's and Medics leaving everyday to become firefighters because of pay and benefits. My question is "do you ever think we will be equal to police and fire in the future?" I understand EMS has only relatively been a profession since the late 60's early 70's where as Fire and Police can be traced back to the greek/roman times. But can it ever happen? Can equality ever be a reality instead of a fantasy.

[BEorP]

But can it ever happen? Can equality ever be a reality instead of a fantasy.

Not without adequate education for every person working on the ambulance.

[VentMedic]

I am a NREMT-P and work for a Fire based EMS system in the midwest. We are second rate to the fire service unfortunately. We have EMT's and Medics leaving everyday to become firefighters because of pay and benefits. My question is "do you ever think we will be equal to police and fire in the future?"

There will be a change when we raise the educational standards for those that want to be medical professionals.

As stated many times in many threads on many forums, some become paramedics to get on at fire department with the knowledge that they will only have to work the ambulance for a couple of years. Then, it is off to an ALS engine and later a nice fire only engine in the suburbs. These people have no interest in the medical field and have no business taking care of patients or claiming to be health care professionals. Once each state EMS agency stands up and says we will only license those with a two year degree in something, even if it is not EMS, it will be more difficult for the medic mills to exist. The FDs would have to recognize this as a state mandate and may have to rethink their standing on EMS professionalism.

[EMS49393]

What does membership to NAEMT or registering with NREMT have to do with the advancement of EMS? Education is the answer, not meaningless memberships and poorly written, incredibly easy exams.

Requiring a two year degree and establishing a reputable and appropriate licensing exam would be a fantastic start.

[Amhet1]

The NREMT provides a "standard" for each level of prehospital care. This at least provides for some reciprocity between states so that we can move from one state to another and they know that they meet a minimum set of standards.

There is a group putting together educational standards. THese standards need to be higher than the current standards. Personally, I dont have a problem with Basics having a 1 college semester program because the basic is going to be frequently a volunteer is a small communiy department. The key is a transferable college level program, not a free-standing vocational "cna" school. If you move from a volunteer service to a full-time, professional EMS, an additional, college-level program should be required. This should include A&P, some english, biology, some public health, etc. Intermediates need to have basic plus at least 1 year of college, preferably an associates degree program. P school, should then be a Bachelors level program. I know, "everything I needed to be a paramedic I learned in P school" attitude. By the time you enter P school, you should have all the required basics. But the difference is being able to be a better medic.

From the point that a paramedic is a bachelors level program, there can be a split in the career tract. To continue your education within the medical field, WE can develop an "advanced level Paramedic" which could be equivelent to an ER BSN, or Primary Care Paramedic where they can function semi-autonomously in rural areas (somewhat similar to the canadian model, if Im not mistaken). (The Air Force IDMT is similar to what I describe as the PCP as they care for patients without direct phycian oversight. Is there any reason that a doctorate level Paramedic isnt reasonable at some opoint in the future?

The other option would be an administrative tract, where education focuses on the administrative side. This program would involve leaders hip and management could be developed. Bachelors, Masters and Doctorates. THere are already Masters and PhD programs in the Public Health/Publich Administration arena. These can be adjusted to meet the needs of the EMS Administrator.

If this sounds familiar, it is. You see career ladders such as this within the FD and PD. The difference is that we have the ability to build the system WE want to build. WE can set the standards for basics, intermediates, Paramedics, Advanced practicioners, our leadership needs and requirements.

This is the same thing nurses do. The lower levels are CNAs and LPNs needing a certificate or 1-2 years of school. They have diploma RNs from (hospital) nursing schools, ASNs, BSNs, Advanced care nurses, Nurse Practitioners, CRNAs, MSNs, and now Doctorate degrees in Nursing.

I dont know the educational fire requirements, but a basic fireman needs a certificate an it grows from there to Chief-level education. There is a career ladder and lateral moves into specialties.

So tell me why WE as EMS cant do the same thing?? We have flight medics, SWAT medics, We can develop NBC medics, knowledge in the public health aspect and have formal training to build our new managers, build advanced practice Paramedics. Obviously this is not an exhaustive list, but we need to look at things like medical care in Alaska, Indian health service, and still be able to provide basic medical care in rural BFE america. These are all things described in the Agenda for the Future. And it is up to us to find a way to blaze our own path!

lastly, I apologize for the typos...... dont mix drugs and alcohol.

[veryamusing]

I don't mean to offend anyone here, but to be honest with you, most of the people I went to EMT school with just didn't care. They were apathetic and put in as little effort as possible, and thankfully many of them didn't pass. Our community college imposed a requirement that students had to pass the class AND the final exam both with an 80 average, whereas many other schools require just a 70 like the NREMT exam. This made a lot of students mad, but perhaps it forced them to reevaluate their attitudes and get with the program of SAVING LIVES.

[Just Plain Ruff]

I don't mean to offend anyone here, but to be honest with you, most of the people I went to EMT school with just didn't care. They were apathetic and put in as little effort as possible, and thankfully many of them didn't pass. Our community college imposed a requirement that students had to pass the class AND the final exam both with an 80 average, whereas many other schools require just a 70 like the NREMT exam. This made a lot of students mad, but perhaps it forced them to reevaluate their attitudes and get with the program of SAVING LIVES.

VeryAmusing, I dont' think that what you said will offend anyone.

Everyone on this forum knows what the educational state of EMS is. We have debated this over and over and over and over and over and over on this forum almost to the point where those who have these opinions feel like we are banging their heads against the wall.

as for the group re-defining the educational requirements, I've been to their site, I've seen what they are wanting to do to EMS education and many areas they are dumbing down so even the dumbest guy off the street can pass. It really is so easy a caveman can do it.

The skills part of it is the least of our worries, Its the educational material and requirements that need the revamping and not dumbed down.

There are no easy answers, no quick down and dirty solutions and unfortunately a group of 20 or so EMT's and medics on this forum talking about this every day is not the solution either.

We have to have high visibility people like Paul Pepe, Dr. Scalia (shocktrauma), Bryan Bledsoe, Bob Page and many others take the reigns, until then the group of people on this forum who sorry to say are probably unknown to 97% of all the EMS personnel in the country. If we can get the above group on board then maybe, just maybe we have a real chance to make changes and make a difference but until then we are all just spouting off some hot air.

The suggestions on this forum are excellent for starters and it is not to say that we can't start a grass roots effort but I can't see much traction from just this group.

[VentMedic]

I don't mean to offend anyone here, but to be honest with you, most of the people I went to EMT school with just didn't care. They were apathetic and put in as little effort as possible, and thankfully many of them didn't pass. Our community college imposed a requirement that students had to pass the class AND the final exam both with an 80 average, whereas many other schools require just a 70 like the NREMT exam. This made a lot of students mad, but perhaps it forced them to reevaluate their attitudes and get with the program of SAVING LIVES.

This has been one argument for Florida still using its own Paramedic Exam with 80% for passing.

[mobey]

You know I have always thought that an EMS icon such as bledsoe should start a voluntary registry of his/our own.

There could be a handful of online courses, then a final. All done on-line so any provider can register. This is after basic or advanced school of course, and there could even be some A&P pre-requisite.

Over time with enough members and public awareness this national registry number could become the gold standard of EMS.

Maybe employers would put prospective employees with this number at the top of the pile!

OK Thinking too much....Time for some calls to roll in

[Sir Andrew]

As a person just thinking about getting into the field of EMT work I do like your ideas of making the educational requirements more along the lines of NR and true medical profession.

I still think that EMT-B should be keep to a much lower requirement then the others since this would alow people to "get their feet wet" and try out if being an EMT is right for them with out having to put their whole life into it. Unless you made a EMT internship for people to try it out, somewhat like when they have a ride time for being an EMT-B but keep it simple.

I do like the idea of more levels and other "fields" for EMT-Is and EMT-P. and the Idea of changing it all over to a college system where class credits are transferable. If a college can teach an RN why not make EMTs be a college degree?

I would think that one way to do a higher standard is by making it so states do not have the power to take away from the new National Standard Testing, but would have power to add to, and so would cities (such as if a city is in a high mountain area then they can add some skill as mountain survival, and such like that)

Now remember this is just a lay-person's thoughts on the matter