If you could change one thing in EMS .......................

[ambodriver]

Things I wish would change in EMS

1) Minimal to have an associates degree to be a paramedic.

2) A national licensing program

3) All ambulances must have at least 1 paramedic

4) An increase in wages to come in line with RN pay (education would help that)

5) Not calling it Emergency Medical Services, but rather Emergency Medical Science

[sevenball]

Vent, I am aware that the DOT does not license us. That is why I said that the DOT governs us. On the same note, the national registry does not license us either. The National registry only certifies us. To be "licensed" you have to go through a state agency. Yes, a huge flaw in our system. Perhaps an argument for another post. My thought process on this was that the DOT sets the standards for the national registry. Those standards were origianlly set forth in the white papers, way back in the sixties. My opinion, and only MY opinion here, is that there has been little in the way of change set forth by the DOT to modify those standards. The government has allowed each state to stray from the National registry, create their own standards, and run wild.

Until the DOT can put their foot down, require all states to conform, and set forth new, advanced standards by wich the National registry must adhere to, then we are doomed to waddle in our own staleness. My thoughts were only to create a higher, no, highest power to which we must all march to.

[zzyzx]

So how can we get to a point where there is a national standard that requires paramedics to have the same level of education as an RN, RT, etc? Is there any organization lobbying for such a change? If there was, wouldn't firefighter advocates oppose this?

[CBEMT]

My one change is to eliminate my state's non-paramedic ALS level and require actual paramedics for ALS units, WITHOUT the "bridge" program that keeps getting suggested- all without the ability of the Fire Chief's Association to bully DOH into some half-ass version that looks nothing like the original plan.

[bbbrammer]

If I could change something about EMS, it would be to require nursing students (particularly RN students) to do several ambulance ride-outs as part of their clinicals. We often have to do several ER and hospital clinicals and that gives us an understanding of what their job entails, but they often don't know anything about what we do. Unless they are EMS trained too.

It would never solve the problems everyone runs into in the ER, but maybe if they had to go through some of the things we go through out there, they would at least understand why we are grouchy/wet/covered in blood/or just having a bad day. Maybe if they were on a multi-car pileup and had to do all the work themselves prior to other units getting there, without techs/docs/housekeeping/other nurses to help out, they would be just a little more with it on why we never quite got that laceration all cleaned up. Maybe at the least it would be better than nothing at all.

[akroeze]

If I could change something about EMS, it would be to require nursing students (particularly RN students) to do several ambulance ride-outs as part of their clinicals. We often have to do several ER and hospital clinicals and that gives us an understanding of what their job entails, but they often don't know anything about what we do. Unless they are EMS trained too.

It would never solve the problems everyone runs into in the ER, but maybe if they had to go through some of the things we go through out there, they would at least understand why we are grouchy/wet/covered in blood/or just having a bad day. Maybe if they were on a multi-car pileup and had to do all the work themselves prior to other units getting there, without techs/docs/housekeeping/other nurses to help out, they would be just a little more with it on why we never quite got that laceration all cleaned up. Maybe at the least it would be better than nothing at all.

How many nursing home shifts did you do so you understood why it is that you are greeted the way you are when you go to one?

[Mateo_1387]

We often have to do several ER and hospital clinicals and that gives us an understanding of what their job entails, but they often don't know anything about what we do. Unless they are EMS trained too.

I agree that we go to the hospital to see the voodoo that hospitals do so well.....but it is also to have extensive patient encounters, as well as see the course of care over several hours that patients receive, and to show you specialties such as Obstetrics that you may not see too often. Personally, I would not have minded working in a nursing home for a few rotations, There would be plenty for EMS folk to lean at nursing homes.

One hospital nearby makes the nurses ride on an ambulance for a few shift during their orientation. I have to admit that I was impressed with the few I met, they were educated, professional, and very willing to learn what they could about what they are not familiar with.

[HARDCORE CAP]

if i could change one thing i'd probably like to see more progressive, experimental thinking

[bbbrammer]

How many nursing home shifts did you do so you understood why it is that you are greeted the way you are when you go to one?

I did four nursing home rotations as a matter of fact. That was after working for two years in one. I am very understanding of what it is like to be an employee at one of those locations. I have also met several nurses who were understanding of what we do. It is just that 'understanding breeds empathy'. Perhaps if we all spent a little more time trying to get inside of what each profession entails, there would be a little less bickering about how long something takes, or maybe a little less of the 'us vs them' syndrome. I think it would help with providing a better continuity of care for the patient instead of the action/reaction of "I don't care what you think you did because it was before you got to the hospital". Same way I think my fellow EMT's could be a little less angry at the nurses who often times are overwhelmingly busy with multiple annoying patients while we just had to deal with one.

This is not an attempt to start arguments, merely an attempt to encourage better EMS/Nursing relations.

[ERDoc]

BBB, I think you miss the reason you are doing ER rotations. It is not to learn what nurses, doctors, RTs, janitors or anyone else does. It is to get a better understanding of the disease that your pt has. You get to see what is being done to work them up and what is being done to treat them so that you have a better understanding of the pathophysiology of the diseases you are seeing. Persoanlly, for someone in a medic class, I think your time would be better spent shadowing the doctor than the nurses (no offense towards the nurses).