If you could change one thing about EMS what would it be?

[cdcmj]

PR and public programs are secondary. EMS needs to be responsible for EMS. We control our own destiny.

Dust, I disagree that we should have 2, 4, or even more levels of provider. All they are are more levels for ceilings of education. A profession does not have 5 levels of provider. Hence, reshaping of how we do things needs to be employed. We do on average 5% real emergencies. The other 95% of the call load needs to be addressed not only for the patient and community sakes, but for the future survival of our industry as well.

[RatPack]

CNA

LPN

RN

Nurse practitioner

Nurse anesthetist

[cdcmj]

Nursing at a professional level starts at RN, anyway you decide to look at it. And CRNA's and NP's are advanced level practitioner's. Hence a need for paramedic being the baseline (min. associates), and up and away we go.

[HERBIE1]

Fire NEEDS EMS to maintain their future.

I think as long as there are people crazy enough to run into a burning building...The fire service will always have a future

Yes, but without EMS, the future of FSR would be quite different. The only reason fire has reluctantly taken EMS into the fold is because it is a revenue generator and adds to their budget. In the minds of many of the fire big wigs, EMS is still only a necessary evil. Fire prevention, building codes, better construction materials all have reduced the number of fires. Firefighting will ALWAYS be necessary, but the industry is far different than it was even 15 years ago.

In a perfect world, EMS would be a separate entity, and enjoy the same attention, funding, pay, respect, and benefits that most professional firefighters enjoy. Do I think that will happen- not likely in my lifetime, if ever. The problem is, because of budget contraints, funding, oversight, and politics, it means that those responsible for public safety are looking to get more bang for their buck. Blended fire and EMS systems mean they pay someone who can perform 2 roles vs hiring and funding 2 separate entities. That said, just because someone is a FF and a paramedic, it does not mean the EMS portion of their toolkit has to suffer. It is up to the provider to maintain professionalism and standards, and if they do not, I blame the provider, NOT the system. Yes, without organizational support, it is difficult to accomplish this, but we are the ones who must look in the mirror everyday and have the integrity to do the best job possible- regardless of what your job is.

Hoping and wishing are fine, but you also need to realistically evaluate the climate we operate in. We have multiple levels of control- both medical and legal- and with this, often times what "we" want is almost irrelevant. We need to operate within our sphere of influence, push for change when possible, logical, and practical, and to also know when a battle should not be fought.

[Dustdevil]

Dust, I disagree that we should have 2, 4, or even more levels of provider.

You're not disagreeing with me. I never spoke in support of multiple levels. I said I favour one single level of EMS practitioner.

[EMS83]

What I tell everyone who bitches about fire/ems. Its not the service, its the attitude of the provider. If the medics attitude is not towards the well-being of the patient, patient care ultimately suffers. This can also be seen in private ambulance services as well.

I know in the state of Texas, Firefighters are only required 20 hrs CE per year to renew certification. It also is the firefighter's responsibility to maintain their EMS cert. (72 hrs EMTB, 104 hrs EMTI, 142 EMTP). I do agree that more focus should be on education per year vs every 4 years. I am also for 1 uniform certification for all EMS providers. I am also for designated drivers trained only to drive the ambulance to and from calls. I also think there should be legislation on the books that give certain criteria for lawsuits concerning health care providers. (not just EMS). I also think there should be a law making it a class B misdemeanor for abuse of the 911 system.

I have cast my 2 cents there.

take care, be safe.

Why can't both medics drive? To me it's a waste of a crew member if only one member is qualified and skilled enough to provide patient care..... a competent medic should have the ability to manipulate the ambulance in stress situations as well as attend to a patient or be able to assist their partner in providing pt care while knowing exactly what is happening and why certain protocols are being administered. Plus if someone is being paid to drive all the time, they are most likely being paid much less, and can result in jealousy issues and poor work ethic.

[Dustdevil]

Plus if someone is being paid to drive all the time, they are most likely being paid much less, and can result in jealousy issues and poor work ethic.

Ever see what a truck driver makes? Better than a paramedic. Truly professional drivers are worth good money. That takes a lot more training and experience than a stupid EVOC course though.

[spenac]

Why can't both medics drive? To me it's a waste of a crew member if only one member is qualified and skilled enough to provide patient care..... a competent medic should have the ability to manipulate the ambulance in stress situations as well as attend to a patient or be able to assist their partner in providing pt care while knowing exactly what is happening and why certain protocols are being administered. Plus if someone is being paid to drive all the time, they are most likely being paid much less, and can result in jealousy issues and poor work ethic.

I think she meant have 2 Paramedics plus a driver. Then both Paramedics stay in the back and take care of the patient while the Professional driver drives. In this scenario they would be paid well for this service.

[HERBIE1]

I think she meant have 2 Paramedics plus a driver. Then both Paramedics stay in the back and take care of the patient while the Professional driver drives. In this scenario they would be paid well for this service.

3 crew members-that's a luxury we don't have here. We can request an EMT come with to drive during transport if we have a critical patient, but it's not automatic.

[spenac]

3 crew members-that's a luxury we don't have here. We can request an EMT come with to drive during transport if we have a critical patient, but it's not automatic.

We don't have it either but I think that is a luxury she wishes could happen. I like the idea myself.