zippyRN Posted July 24, 2005 Posted July 24, 2005 Tibby... I was speaking of land. 80% of the US is rural. Yes, the pop. is smaller and way more spread out....but that's the point. The system that has developed throughout the majority of the continental US to deal with emergencies relies on volunteers as its backbone. only because the white middle/ upper classes in the USA chose to take the USA down a complete or near enough complete free market system Only urban areas can afford to field full-time, paid paramedics and emergency responders. Getting volunteers that are trained and certified to respond to emergencies is hard enough without requiring a 2 or 4 degree training route. odd then that plenty of other counties manage to provide decent cover with full time paid staff subject to extensive training requirements and volunteers - just with a different model of service delivery Moving Intermediate and Paramedic to full health professional status won't effect First responders or legislative issues allow sub QAT/PCP level BLS ambulances (like most of the USA where EMT_B courses are less intense than UK volunteer ambulance attendant courses UK volunteer Ambulance crew / full scope ambulance service FRs {as opposed to those only sent to politically important calls such as Cardiac arrests and Chest pain} do approx 250 -300 classroom hours as well as clinical time) Let me sample our squad for a second: 8 full time employees. 4 medics, 4 EMT-I's. 6 more per diem medics that work for other services and come in to fill gaps. 25 volunteers, all EMT-B's and EMT-I's. Some are highly educated with degrees in engineering or law. Others have associates degrees in architecture. We've got a high school English teacher, a Concierge for one of the ski resorts, a butcher, an LNA, a fellow that works at the plastic's plant, and another that works at the local ironworks. We've got a softwear programmer, a mechanic, and an electrician. This is just a sample. Simply requiring a 2 or 4 year degree program removes all of these volunteers from our roster. or would it just downgrade the Is to Basics? Do they have the time or money to go through a program like that? No. Do we have the money to pay to replace them with degree'd medics? No. Hell, there isn't a single paramedic program, certification, associate, or bachelor's, in this entire freakin' state. until 1998 there was no accredited ab - initio degree program for paramedics in the UK, this September there's something like 10 - if the demand is there are education providers will provide the courses Am I happy about this? No. Am I endorsing the current status quo? No. I want highly trained EMTs. I want paramedics with B.S.'s in paramedicine...but recruiting for rural medicine is hard enough now without requiring a degree. Make the degree financially attractive and things will change. Right now, EMT's get paid $8 an hour in our service area. Medics are lucky to be pulling in $12 an hour. How do you entice the sort of highly educated individuals you want, when they can make three times as much money working in just about any other career field? because the job is a technician one even at paramedic level. issues here get distorted when attempting to compare with Nurses etc due to the crazy way the USA works requiring medical 'orders' for Nurses and AHPs to do their job - but while US Ems staff work to protocols , have to call in for permission to undertake key interventions and are locally certified rather than nationally qualified and registered
Ridryder 911 Posted July 24, 2005 Posted July 24, 2005 First of all Zippy RN.. you don't have all the facts. Please don't make broad statements or generalized statements. Not all RN's require individual orders, please I have worked with European nurses ..give me a break ! Talk about non-autonomous! Second, please don't start that free enterprise vs. socialized stuff .. Won't trade you taxes or socialized medicine.. no thanks! Second it is based upon state by state, some states are larger than your whole country.. & individualized by the local community. Yes, some are licensed & yes some are Registered. Yes, we have problems ...just like you do ! Be safe, Ridryder 911
hungrymonkey Posted July 24, 2005 Author Posted July 24, 2005 Since nursing was brought up, why do you think nurses get paid so much? Because they have to go through so much crap to get their nursing credential, that a lot of people are weeded out, there is a greater demand than supply and therefore they create a situation where they are needed and can demand what they want. Without the degree, nurses would be getting paid just like EMS is currently. And as for the "volunteer" problem, you know what? Perhaps rural communities should just remain as BLS operations- no one demands that there be volunteer paramedics (Need I remind you all that in many cases ALS has been proved to be little or no benefit?). My wife just finished her associates in nursing. She much more bang for her buck when it came to what she learned. Most of the classes she took were tailored towards the nursing career field. and out of curiousity, what more would you want to see added to the scope of practice?
rdenman26 Posted July 24, 2005 Posted July 24, 2005 We have a three year degree in paramedic studies avaliable here, but its not mandatory as yet. However its likely that it will be in time. I am led to believe that the european union expects paramedics to have a minimum of a diploma in higher education. Since we becames registered health care professionals along the same lines a nurses and other allied health professions, people are expecting us to be educated along the same lines as well. The degree incorperates the ambulance technician and paramedic training, and there are clinical placements on the road. Some people are a bit sceptical about these people being turned out of university as paramedics with very little real time experiance. Personaly I prefer to judge people as I find them and not on there background. Most of the people that do this degree are 18 year old just out of school. But for those of us that are already in the job, we can do these courses part time. I believe there has been a masters degree introduced. I cant help thinking how long it may be before we get the first PHd paramedic over here. I have also bee told of one medical school that is introducing an 18 month conversion course to become a doctor. Although I see the importance of education in EMS I have to ask my self how far do we need to go.
Ridryder 911 Posted July 24, 2005 Posted July 24, 2005 As one that has been through both RN & Paramedic (ADN/BSN) & AS in EMS.. I will tell you there is a great difference in programs. Actually my Paramedic was more difficult in medical care,& actually had more clinical hours (not clinical days) than both of my nursing programs. Nursing is very broad based & touches a large topic & various of diseases & disorders. Where as the Paramedic specializes & goes in great depth of narrow specific emergency disorder of emergency & critical care. What would I add to the EMT/Paramedic ..oh about 2 1/2 yrs of supplemental science, such cadaver anatomy, a 16 week pathophysiology course, microbiology, medical terminology, required reading level at least college sophomore level, technical writing & scientific studies. These would be co-requisites, for the program double the cardiology portion, hemodynamic, respiratory areas, as well psychology & high risks O.B. & Geriatric medicine to start with. There is no reason why a Paramedic should not be able to describe "shock pathophysiology" using terms i.e Fick principle, pre-& post capillary sphincters, Roleux effect , etc.. if you can't I highly you suggest you either refresh, or learn pathophysiology of shock. Can you really know how to fix something you don't is broken ? Even Mr. Goodwrench knows this much ! Getting tired of the pay in EMS , tired of no growth, benefits ? We HAVE to become more scientific, medical based. Without this, we will never receive adequate pay...or really should we ? You have to prove yourself in medicine.. & we have not yet ! Well I get off my Respectfully, Ridryder 911
vs-eh? Posted July 24, 2005 Posted July 24, 2005 I will quote from the first post in this thread... Although I did have one ems call that I used the stuff from A&P. My emphasis. Whelp, that basically sums it up right there doesn't it.
vs-eh? Posted July 24, 2005 Posted July 24, 2005 What would I add to the EMT/Paramedic ..oh about 2 1/2 yrs of supplemental science, such cadaver anatomy, a 16 week pathophysiology course, microbiology, medical terminology, required reading level at least college sophomore level, technical writing & scientific studies. These would be co-requisites, for the program double the cardiology portion, hemodynamic, respiratory areas, as well psychology & high risks O.B. & Geriatric medicine to start with. I had all that including cadaver labs as BLS. Believe it or not. Well maybe not solely along those time guideline, but.... I will admit that I don't know what the Roleux effect is though....
rdenman26 Posted July 24, 2005 Posted July 24, 2005 Ridryder 911, well done on your reply to zippyRN who seems to have opioions that dont help on these boards.
mediccjh Posted July 25, 2005 Posted July 25, 2005 When I went through medic class, I had a choice of a 2 yrs Associate's program, or just the certification. I didn't take the Associate's. Why? It's not gonna make a difference around here. Either way medics get paid sh-t here. So, because I didn't take the Associate's program, does that make me a bad medic? I don't think so. Will I go for my Associate's? I don't see why, unless someone's gonna pay for me to go to school and pay my bills while I'm in school.
vs-eh? Posted July 25, 2005 Posted July 25, 2005 Someone enlighten me on what an associate's degree entails. And what the difference is between that and a certification.
Recommended Posts