EMS v Fire v Higher education (No hate here!)

[DwayneEMTP]

Hey all,

One of the guys I work with is a fire medic and we got into an argument this morning concerning Fire and EMS. My argument was that most of the times that EMS has attempted to make a run at creating an entry level AAS for paramedic medicine that Fire has consistently opposed it. He claims that this is nonsense, that the fire unions are pro education and responsible for many increases in EMS education.

I'm looking for articles, as I know I've seen a lot of them, to support my argument that Fire consistently stands in the way of increased education in EMS.

I have no doubt that both arguments can be supported, but I am looking for support for mine only. Though I would be interested in seeing another thread to support the opposite if possible.

It is not my intention to start a flame war here. I have many, many friends that also happen to be infected by the Firebug. This is a good natured argument between a medic I respect and myself and I simply want to smite him in a good natured way. I simply don't have the time, or the mad Google skills to do so on my own in short order.

I'm asking as a favor that we avoid having this thread locked by keeping it in that spirit.

Thanks for any help you can provide.

Dwayne

[CBEMT]

Ask him if the IAFF supported the ORIGINAL National Scope of Practice document.

Argument over.

[P_Instructor]

Ask him if the IAFF supported the ORIGINAL National Scope of Practice document.

Argument over.

Perfect response!

Hey all,

One of the guys I work with is a fire medic and we got into an argument this morning concerning Fire and EMS. My argument was that most of the times that EMS has attempted to make a run at creating an entry level AAS for paramedic medicine that Fire has consistently opposed it. He claims that this is nonsense, that the fire unions are pro education and responsible for many increases in EMS education.

I'm looking for articles, as I know I've seen a lot of them, to support my argument that Fire consistently stands in the way of increased education in EMS.

I have no doubt that both arguments can be supported, but I am looking for support for mine only. Though I would be interested in seeing another thread to support the opposite if possible.

It is not my intention to start a flame war here. I have many, many friends that also happen to be infected by the Firebug. This is a good natured argument between a medic I respect and myself and I simply want to smite him in a good natured way. I simply don't have the time, or the mad Google skills to do so on my own in short order.

I'm asking as a favor that we avoid having this thread locked by keeping it in that spirit.

Thanks for any help you can provide.

Dwayne

I think it just may be your area. I currently instruct a Paramedic class that can be offered either diploma (just the Paramedic class) or also the AAS (Paramedic class with specific college course requirements). The kicker is that the current class has 4 fire fighters (1 basic and 3 intermediates), all looking to improve their own knowledge and skill base. The aspect of starting Paramedic Engine Companies is a National trend, but could have problems (i.e. the Naples, Florida debacle) unless everything (and I mean everything) is completely spelled out in what needs to be done and what is expected. My opinion is that many Fire Departments are looking into EMS because we handle more call volume (even though we are reimbursed less). This sounds like job security. It will also be determinate upon if Fire Departments are transporting patients or just providing first response (non-transport).

I believe the majority that the fire unions are pro education and responsible for many increases in EMS education is FALSE.

Personal note - Love the area around there, vacationed at Royal Gorge and made it into Canon City numerous times.

[HERBIE1]

Hey all,

One of the guys I work with is a fire medic and we got into an argument this morning concerning Fire and EMS. My argument was that most of the times that EMS has attempted to make a run at creating an entry level AAS for paramedic medicine that Fire has consistently opposed it. He claims that this is nonsense, that the fire unions are pro education and responsible for many increases in EMS education.

I'm looking for articles, as I know I've seen a lot of them, to support my argument that Fire consistently stands in the way of increased education in EMS.

I have no doubt that both arguments can be supported, but I am looking for support for mine only. Though I would be interested in seeing another thread to support the opposite if possible.

It is not my intention to start a flame war here. I have many, many friends that also happen to be infected by the Firebug. This is a good natured argument between a medic I respect and myself and I simply want to smite him in a good natured way. I simply don't have the time, or the mad Google skills to do so on my own in short order.

I'm asking as a favor that we avoid having this thread locked by keeping it in that spirit.

Thanks for any help you can provide.

Dwayne

That;s going to be a tough one to prove, other than with anecdotal evidence or inferences. Example: Regarding the IAFF's nonsupport of the Scope of Practice issue. That's not condemning education, but clearly that's what the end result is if you oppose something like that.

I would be very surprised if you can find anything "on the record" where a fire department organization would ever say something that decries education for EMS or fire. That would be an enormously bone headed move.

Personally, I think this issue varies greatly depending on where you live and work. Some areas are very progressive, while others are traditional(old school). It also depends on the age of the respondents to such a question, as well as the stance/attitude/actions taken by the leadership of the person's organization.

[FireMedic65]

Only thing I can reference is personal experience. It is to my knowledge that everyplace you go, it will be basically the same, but different. In the state of PA, you need NO TRAINING to be a firefighter. What I mean is, you can join a fire company, or even get hired on as a firefighter, and immediately start fighting fires. That is, putting on the gear, the SCBA, grabbing a hose line and run into the house. Now, it is the policy of hopefully every department/station that you must meet the minimal training required by THEM before you can "fight fires".

As for EMS, no matter what you do, you need training and education. Even if you are a wheel chair van driver or volunteer ambulance driver who just drives. You need EVOC training and a minimal of CPR/First Aid.

As far as fire pushing for more education, sure but for fire education. There are numerous classes and weekend "schools" all year round offering training for fire courses. I could post links if you wish.

EMS should be the same way if you ask me. Continuing education for EMS is paramount. No matter if you have been doing this for years, or just starting. Everyone should always be learning, training, practicing skills, etc etc. Yes, I know we have to maintain CEU's to keep certs up, but that's very minimal. Most of the time, you can do these credits online, or sit in a class room with a bunch of your buddies and get the credit just for being there.

One of the problems I have noticed though, that a lot of these EMS courses/certs are often the same way. Especially the CRP/ACLS/PALS etc re-certs. I sat through an ACLS course during medic school at the hospital, prior to my course at medic school. It was a joke. I won't get into details. Re-certs are the same way from what I have seen. Things become too easy in my opinion.

Also, the cost of retaking these classes. Hopefully your employer foots the cost, because they are very expensive. I have noticed also, that if the service does not require you to have the cert, ie AMLS they won't pay for it.

Fire companies from my experience are always all about going to training, they get excited. Heck, I did too. I loved it. As far as EMS, not so much. It's all class room stuff usually, instructors/lectures are dry and boring. But it is very important to the patients we do these classes.

[46Young]

I can see why certain FD's would seeks to keep educational standards low. It may be difficult to hire enough medics to fill available positions, so they take FFEMT's off the road to complete medic school. This takes time and money, so it's in the best financial interests of the dept to push them through as quickly as possible. these mills also provide a supply of "qualified" applicants. If I had my way, FD's would require a two year degree and give hiring preference of at least a year (if not more) of single role EMS experience to be hired. Maybe even mandate prior experience in EMS. If you want the bennies, conditions, pension, $$$'s, show us that you're a legitimate ALS provider, not some joke from some fly by night mill who is only using the P-card as a quick "in", only to drop the cert at the earliest opportunity..

The problem with EMS as a stand alone industry, IMO, is that there are so few quality places to work, with a livable wage, bennies, working conditions, pension, so on and so forth. As such, a significant amount of the EMS workforce is transient, either completing degrees or waiting on a call from a civil service list from a FD, PD, DOC, sanitation, USPS, or whatever. This makes political organization, which is needed to effect any real change, extremely difficult. Only political pressure can raise the bar. Organization will be easier to achieve with individuals who have already made that educational investment. But how many will actually do that when there are easier options available, with employers unwilling to raise hiring standards to at least a two year degree? Too many individuals just use EMS for a short period to suit their purposes and then leave, not really caring about what happens to the industry as a whole.

It sucks, but it appears that there's a catch 22 situation here. Many look to EMS as a quick way to make money without having to do two or more years of college. I think that Ventmedic said that 70% of FL firemedics hold no degree of any kind whatsoever. I suspect the same for the EMS industry as a whole.

I'd like to see EMS grow into a more respected, sustainable, fufilling career, with working conditions improved to prevent burnout and promote retention. I wouldn't suggest EMS to my children as it stands for the moment (as a career), but I would if the profession gains a certain amount of parity with RN's, RT's, PA's and such. I read forums by Canadians, Australians, and New Zealanders, and it would seem that the same problems exist regarding working conditions, mandatory OT, and such. And they have a much more advanced educational bar to meet prior to employment.

[Kiwiology]

What was in the original Scope of Practice document that's not in there now? The current one is pretty lame

The New Zealand Fire Service and the Professional Firefighters Union have both forceably resisted any attempts to get involved in patient care here beyond rural first response as they know it's not what they do best. At the most they offer advanced first aid and an AED.

While our working conditions are not as we would like (are they ever?) if you can last 20 or 30 years here in the ambulance service (as some people do; we have guys here who have clocked up 30 or 40 years) then you can retire on your 30 or 40 years of pension contribution and Government kickbacks and enjoy a pretty good retirement.

As far as our educational standards being higher; well yes they are but they are still below what I would like them to be but this is limited only to the BLS qualification so it's acceptable. Paramedic (ILS) or Advanced Paramedic (ALS) requires a Bachelors Degree or higher from 2011 so I can't complain there.

[RavEMTGun]

Explain to him that the problem is NOT the FF-EMTs or FF-Medics, it is the Fire management and the bean counters. Management wants EMS call volume and income to subsidize and justify the fire side where calls are down thanks to building codes lobbied for by Fire. Part of that plan is to quickly and easily make and keep as many FFs as EMTs/Medics as quickly and easily as possible. Increasing the barriers for their FF's (who they want to wear many hats) to become and remain medics by increasing education standards is not in their plan.

The line Firefighters are usually plenty professional. I think most Fire EMS people who actually want to do EMS (and there are plenty who don't want to do EMS) are people with no problem with increased education as long as they get out of it what they put into it (in opportunity and pay for time). However, most Fire Management isn't that interested. They are FIRE Management, right? Remember, it is Fire-EMS, not EMS-Fire. Nevermind which side gets more volume.

Edited October 7, 2009 by RavEMTGun

[RavEMTGun]

A DIFFERENT PERSPECTIVE:

County commissioner: So there were 4 structure fires in your district last year and you didn't even save any of the foundations. You have 3 stations staffed 24 hour with 75 full time paid FFs on payroll. You have $10 million dollars of apparatus, three expensive buildings, and a Godzilla sized personnel budget. Why on earth is the district giving you this much money? You guys barely do any fire fighting and when you do, you fail!

Fire Chief: Over the last few years I made all of my Firefighters into EMTs and we respond to all medical calls! And car wrecks too! My people could save your life, commissioner!

County commissioner: So you are doing what the ambulance service already does? Except they take people to the hospital. And they only have two small stations and 20 full time paramedics and $1 million in apparatus and they are mostly self supporting because they can bill their patients. They are very busy.

Fire Chief: We usually beat ambulance to the scene by 30 seconds! I'm also starting to hire paramedics to offer better care for those 30 seconds we are there before the ambulance. We can make money too if you let us transport patients! You should buy us a couple of ambulances!

County commissioner: You want more money??? Besides, that would put the ambulance service out of business!

Fire Chief: You know, that's a great point. You don't really need them. You HAVE to have a fire department. The district has got to pay for us. Look, there is a solution here. Let us take over EMS! I'll just make all my firefighters into paramedics ASAP. That will help you sell this to the voters. When can I expect delivery of my new ambulances?

[RavEMTGun]

PART 2:

Commissioner: Not anytime soon.

Fire Chief: Fine. I'll buy some ambulances out of my current budget and staff them with fire medics.

Commissioner: You don't have a transport license.

Fire Chief: Yes, but eventually you'll have to give me one or the public will wonder why YOU are stopping the FD from saving lives.

(This is why Fire will always win)

Edited October 7, 2009 by RavEMTGun