Basic questions about EMS field

[Floridastudent]

Hi all! I hope I'm posting this in the right forum. I'm in my mid-40s and, after 20 years in a completely non-health-related field, I am back at school in the Orlando area and enrolled in an EMT course that starts next semester. After that, I can enroll in a one year paramedic program (or I could enroll in an LPN program that starts next August, and then do the LPN to RN online thing once I get my LPN, and be an RN instead. Still debating.)

I know I want to be in the emergency medical field. However, I have some questions. I am in Orlando - most LOCAL paramedic jobs are being taken over by the fire department right now. I can relocate once I become a paramedic.

I don't have a really good feel for what the paramedic field is like outside of central Florida. I'd love to hear from people in other parts of Florida and other parts of the country - especially if you live somewhere where job demand is decent and where there are opportunities for paramedics who aren't firefighters.

I know there's this myth that if you are a nurse you can ALWAYS find a job - but if you go on allnurses.com, you will see new grad nurses in every state saying they've been unemployed for months, even a year, and sending out hundreds of resumes and networking like mad. So this recession has, at least for the next few years most likely, taken away THAT safety net.

I do want to be a paramedic but I also want to be able to get a job when I graduate, so I'd love to know what the paramedic job market is like out there. Like I said - I can relocate anywhere - especially for a few years to get experience.

[Kiwiology]

You should realise that (and I know its a bit rich coming from somebody down here) but whodathunkit the IAFF and Fire Departments in places like FL/CA/TX/DC are not known for thier stellar standard of Paramedics (ALS) and I would bet dollars to defibrillators many of them are terrible patch factory graduates.

That said be careful where you choose to go to school; many on here like AK and Vent can offer you advice on where to avoid.

As far as nursing I'd recommend you get your RN and eventually your BSN; Vent should be able to give you more detail about how that works in Florida but I think she runs a decent bunch of NICU/ICU/CC IFTs which will get you out of the hospital anyway; not sure about HEMS but may be an option.

Nursing offers far-in-advance the opportunities of Paramedicine, not just in the US but most places in the world. Now this is more true in the US from what I have seen than say here or in Canada, but EMS is the bastard child of medicine that has for the last four decades managed to be a profession built upon skill without a decent foundation of medical knowledge and research.

While you are waiting for your EMT class to start see if you can take college A&P, patho and pharm (might have to seek out somewhere specifically with a nursing or allied health faculty). It will give you a good foundation of knowledge far beyond the ten pages of A&P in your EMT textbook.

Personally if it were you (and I've kinda found out the hard way) that it's easier to get your nursing qual's FIRST then if you want to work in the street for a bit maybe see if you can challenge your Paramedic test; Florida lets you challenge as an RN or BSN and I am sure a bunch of other states have a bridge program.

As for the job market I can't specifically say in the US what its like but I know a few people who have graduated here (we only have a BN (BSN) program per the nursing council) and have found work in Canada, the US and Australia. I know some places in the US have a severe skill shortage while others generally only hire Bachelors Degree qualified nurses ... might have to go work out in Tumbleweed, Arizona but heck a jos's a job right?

[Niftymedi911]

Ben, I surprised you didn't say anything about my neck of the woods..... Or is it because you secretly want to work here too?

[Floridastudent]

I appreciate your info!

This semester, I am taking basic algebra (how sad is THAT! Forgot all my math) and medical terminology at my local community college. Getting A's so far. The EMT course is next semester. I still need to take all of my nursing pre-req's; I have a B.A. from a million years ago so all of my humanities are covered, but I need biology, A&P I and II, chemistry, nutrition, possibly statistics depending on the school, possibly organic chemistry, etc.

I want to take the EMT course next semester at my local community college no matter what. The big question is - should I take the paramedic course after that? Or go to LPN school? I really like the idea of doing medicine in the field, outside of the hospital, if possible, but again - I also like the idea of being employed. I used to be in journalism. We all know how well THAT's doing these days.

(If you're wondering why I wouldn't go straight to an RN school - it's a year of pre-req's AT LEAST, and then two years of full time school. If I do the paramedic program - one year. If I do the LPN program - one year. In Florida at least, with both of them, I could then work a couple of shifts a week while taking pre-req's, and then do either paramedic to RN online or LPN to RN online. So the goal here is to get some kind of degree that would have me working, as soon as possible.)

As for the EMT certificate - I can and likely will go volunteer for a volunteer ambulance company with that, but my understanding is that hardly anyone is hiring EMTs alone - they want paramedics. Also, of course, EMT pay is the pits.

Funny thing - my mother was an EMT a long time ago - she had 80 hours of training! Yikes!

Oh - as to standards - to get the EMT license I have to take the national test, according to the EMT program director. And I think community colleges are probably better than the diploma mill/patch factories. I hope, anyway.

Edited September 27, 2009 by Floridastudent

[Niftymedi911]

Well, sometimes one can only speak from experience and I will try to help you out as much as possible.

Right now you need to focus on schooling. Find a community college with an aggressive program. Sometimes it might be looking at their pass/fail rate. If you've got a 97% pass rate its more then likely a medic mill. In all honesty it might be a lil easier for you if you go through the EMT/RN/Paramedic route. They incorporate all the fields of practice and study you will need for EMT/Paramedic field work, but it will also incorporate a higher education that most college EMS programs cannot offer. You'll learn better patient care tactics, a much more in depth pathopysiology study with diseases, medications, interactions, and medical/legal. Most standard EMS programs offer the basics, touch on the most important things you'll need to know and then move on. Something that almost everyone in EMS currently wishes would stop. You'll find the general consensus around here is to try and get higher educational levels for Paramedic/EMT certs.

Some people I've also been told find it a little harder for paramedics going through RN school. They develop habits, tactics, and the like while in the field, and when its time to convert that into an RN lifestyle its completely different. Most RN's cannot act on their own authority, they have to follow doctor's orders. Paramedics also do have to follow protocols, but can operate within those established protocols without the doctor standing directly over them. Some find it hard, that once they've been given that freedom that paramedics have over RN's, to go back to being, "mother may I?"

After obtaining your EMT/RN you can then challenge the Paramedic boards for FL. If you pass, now you will have the street knowledge to work in the field and rely on yor basics, the higher knowledge to understand the different situations to encouter, and now the freedom to practice those knowledges. Not to mention that fact that you will have an RN license on a resume or job application will make you stand out above the rest. Something that this day in age you will desperately need. The job opportunities will aslo allow to you to cover almost every aspect of EMS. HEMS, Special Events, Special Appointments (Oil rig, Factory etc), GEMS (Ground), or the potential to work for Homeland Security.

After you complete EMT school, you'll need to find a good RN school.... Edison State College down here has one of the best RN programs in the nation.

Here are some services in FL that do not require fire certs that do hire EMT's

AMR (Palm Beach, Broward, Miami-Dade, Monroe)

Sunstar (St. Petersburg/Clearwater)

Lake-Sumter EMS

Polk County EMS

Lee County EMS

Collier County EMS

Hendry County EMS

Medics Ambulance Service (Palm Beach / Broward)

Good Luck and Happy Hunting!!

[Floridastudent]

I really appreciate the tips on which counties will hire in FLorida! That's exactly what I was looking for. Do they hire just EMTs or do they prefer paramedics? For LPN to RN or paramedic to RN - I'm currently in Orlando and there are several schools within driving distance - Valencia, Seminole - that offer bridge programs.

Would you say that community colleges generally have good programs?

Also - Nifty - I sent you a yahoo message, hope that's okay, but since you are local I wanted to see if I could ask you a few more Florida-related questions.

[Kiwiology]

Ben, I surprised you didn't say anything about my neck of the woods..... Or is it because you secretly want to work here too?

But of course mate, I'm just about ready to launch my floating door!

I really like the idea of doing medicine in the field, outside of the hospital,

If I may for a moment shit in my own nest; EMS does not "practice medicine"; from talking with people in the US it seems that in the thirty five years since Johnny and Roy hit the street ltitle has changed. A lot of places still require "base hospital" contact (even that term is just nasty) for things outside say 10mg of morphine, rapid sequence intubation or the admininstration of some pharmacologics or procedures like cardioversion.

This is not "medicine" in my allbeit lowly opinon; it is technical psychomotoring by remote control or medical director signature on a piece of paper. You are unable to decide to leave a patient at home, you are unable to give dosages of drugs in advance of certian limits or perform certian procedures without seeking permission and dare I say the DOT standard for education is inadequate and out-dated.

By no means is our system perfect but we are at least given a certian leeway to "practice" at a more autonomous level and decide to leave a patient at home or decide which drugs to give or whatever. I know I'm gonna chalk up to sounding like a bastard but if you would like to practice auctual medicine then I suggest working as an RN doing critical care transfers or HEMS.

I know, I suck right, and I hate to say it because I love the street; but the more of the street I see; the more I dislike it.

[VentMedic]

I really appreciate the tips on which counties will hire in FLorida! That's exactly what I was looking for. Do they hire just EMTs or do they prefer paramedics? For LPN to RN or paramedic to RN - I'm currently in Orlando and there are several schools within driving distance - Valencia, Seminole - that offer bridge programs.

Would you say that community colleges generally have good programs?

Also - Nifty - I sent you a yahoo message, hope that's okay, but since you are local I wanted to see if I could ask you a few more Florida-related questions.

The community colleges are your best bet. They are also about the only ones that have CoAEMSP accredited programs.

If you would like to fly or get into more challenging transport situations, Orlando Regional and Florida Hospital are great places to work while getting your RN. The community colleges will also use the credit earned from the RN prgram and apply toward the Paramedic. In the future, you get a flight RN position. Then all you have to do is just take the EMT-B and challenge the Paramedic test.

The LPN is a waste of time as few hospitals utilize them.

Of course any specialty team for RN be it Flight/NICU/PICU/Heart/Organ Procurement/ECMO will take much more education adn experiencee. The Paramedic programs in Florida can be done in less than 6 months.

Many of the EMS departments that do 911 are Fire Based. Polk County EMS has now merged with Fire and are in the process of cross-training.

Right now even Lee County which is the most stable for county EMS could go Fire in the next 5 years. Sunstar's future is very unstable. Unless you consider being a FF in Florida, the RN is the best route for job security. Florida also has an abundance of EMTs and Paramedics. Of course, most are waiting to get on with the FDs.

Edited September 27, 2009 by VentMedic

[Floridastudent]

My main motivation for getting an LPN is that it only takes a year, and I don't need pre-req's, so the hope would be that I'd get a job at a nursing home or LTC facility or hospice, while getting my pre-req's done, and then do the LPN to RN online bridge.

So you think I would be better off getting an RN degree BEFORE getting the paramedic?

Are most states doing the same thing - having the fire departments take over the ambulance services? That would make me think twice about paramedic because my goal is being in the medical field, not the firefighting field.

The community colleges are your best bet. They are also about the only ones that have CoAEMSP accredited programs.

If you would like to fly or get into more challenging transport situations, Orlando Regional and Florida Hospital are great places to work while getting your RN. The community colleges will also use the credit earned from the RN prgram and apply toward the Paramedic. In the future, you get a flight RN position. Then all you have to do is just take the EMT-B and challenge the Paramedic test.

The LPN is a waste of time as few hospitals utilize them.

Of course any specialty team for RN be it Flight/NICU/PICU/Heart/Organ Procurement/ECMO will take much more education adn experiencee. The Paramedic programs in Florida can be done in less than 6 months.

Many of the EMS departments that do 911 are Fire Based. Polk County EMS has now merged with Fire and are in the process of cross-training.

Right now even Lee County which is the most stable for county EMS could go Fire in the next 5 years. Sunstar's future is very unstable. Unless you consider being a FF in Florida, the RN is the best route for job security. Florida also has an abundance of EMTs and Paramedics. Of course, most are waiting to get on with the FDs.

[Niftymedi911]

Vent,

To be the best of my knowledge there is no "talk" of EMS/Fire Consolidation even within the next 5 yrs. There is only "talk" of fire consolidation. But I am watching the situation carefully.

Hey Flastudent.....if you send me a message please send it through forums PM. I don't have yahoo messenger anymore. Or email it to me.... thanks!!!!

Vent answered the rest of the questions better then I could..... she's got more info in that arena then I do.........

For the FD taking over EMS thing...... It's becoming the norm for the United States. Unless there is a strong EMS service with loads of public support, a private agency that can generate numerous profits, or a FD that cannot feasibly take over EMS..... those are the norm.