Can Fire Paramedics be good Paramedics?

[cosgrojo]

Of course Fire Paramedics can be "good paramedics." Can they be as good as they "could" be if they didn't have to split their time learning multiple roles? Of course not. But so what? I could be a better EMT if I spent more time than I already do bettering myself with extra education (instead of incessantly creating new and exotic chessecake ideas), but I don't. We all have other things we do in our lives. Just because we don't completely focus on one thing and one thing only, does not mean that we can not become proficient in it.

For instance... Splenac (I'm not picking on you, just using you 'cause you started the thread)... is their anything else that you do with your life? Any hobby or talent that takes you away from your EMS study? Do you think that your devout fanship of your beloved Cowboys (who are going to be upset by Seneca Wallace this week btw) is taking away from your ability to be a better Medic? I think that there is room for both in your life... so why not allow that a person can be good at fire fighting and at paramedicine?

I may not ever become the "best EMT", and I will never become the "best cheesecake maker." But I am pretty darn good at both... and that is enough.

46Young- good posts... but I think that you might have a sticky mouse button or something...

In no way am I endorsing that fire should dominate EMS, and not allow our wings to flap free... just answering the question at hand.

[46Young]

And here, 46Young, is the root of my gripe with Fire-Based EMS. My chosen profession is NOT a fire specialty. It is a unique and distinct area of HEALTHCARE. Then again, you and I have been round and round on this issue more times than I care to count, so you should know this already.

I see your point. It's just how the fire service sees it. I worked single role for over five years before going over to the "dark side". I believe that 911 paramedicine alone is quite simple to maintain provided you've been educated well prior. IFT medicine, CCEMT-P and flight are a whole other side to the paramedic profession. The medic who can do it all with the requisite knowledge base is truly bada$$, a professionally complete individual. I'm going to get myself to that level at some point. Too many 911 medics fail to understand the lasting effect of their treatment and interventions have on their pt's hospital course and time to discharge. The professional medic should have a solid knowledge base to that end. Many don't nor are they really required to. As such, 911 EMS has been reduced to a "specialty" of the fire service in general, rather than it's own profession. It's up to each dept, and more so each individual to strive to be better than that.

I wouldn't even know of dual role systems if I wasn't driven by greater job security and a lucrative defined benefit retirement than was available otherwise. My choice was due in large part for the desire to provide well for my family. When I took the job, there was a dedicated EMS only track (starting with the first promotion above FF) up to BC. If I felt that fire wasn't truly for me, I planned to branch off to EMS only. Same job, way better benefits and all. The thing is, the promotional track is now "all hazards". Good thing I like fire.

[Kiwiology]

I would not expect a physician to also be a plumber, a baker to also be a software designer or a pilot to also be a chef.

To that end, why should we expect firefighters to be paramedics or paramedics to be firefighters?

You send a bunch of firefighters to school for three years to obtain our Bachelor of Health Science (Paramedic) with the requirement they also meet the con-ed req's to be a Firefighter and I bet you none of them graduate.

[JPINFV]

If you're using EMS to justify maintaining the current fire staffing, then you won't be able to justify providing enough staff to keep proper staffing for both the EMS and fire calls. So if you have all these fire medics responding to the structure fire, who's going to respond to EMS calls?

Edited October 4, 2009 by JPINFV

[cosgrojo]

I would not expect a physician to also be a plumber, a baker to also be a software designer or a pilot to also be a chef.

To that end, why should we expect firefighters to be paramedics or paramedics to be firefighters?

You send a bunch of firefighters to school for three years to obtain our Bachelor of Health Science (Paramedic) with the requirement they also meet the con-ed req's to be a Firefighter and I bet you none of them graduate.

While I agree that it is not appropriate to "expect" that an MD could also be a plumber, there is nothing wrong with an MD that is a plumber, and no reason to think that he/she couldn't be good at both. I may be wrong, but I have interpreted this question to be about the ability to do both fire and EMS proficiently, and not about what we would think is the best EMS/Fire "system." There is an opportunity cost to everything that we do... is it better to be superlative in one thing, or be well rounded in many arena's? That is a personal decision people must make for themselves, and there is nothing wrong with either decision... provided you do it well.

[46Young]

Of course Fire Paramedics can be "good paramedics." Can they be as good as they "could" be if they didn't have to split their time learning multiple roles? Of course not. But so what? I could be a better EMT if I spent more time than I already do bettering myself with extra education (instead of incessantly creating new and exotic chessecake ideas), but I don't. We all have other things we do in our lives. Just because we don't completely focus on one thing and one thing only, does not mean that we can not become proficient in it.

For instance... Splenac (I'm not picking on you, just using you 'cause you started the thread)... is their anything else that you do with your life? Any hobby or talent that takes you away from your EMS study? Do you think that your devout fanship of your beloved Cowboys (who are going to be upset by Seneca Wallace this week btw) is taking away from your ability to be a better Medic? I think that there is room for both in your life... so why not allow that a person can be good at fire fighting and at paramedicine?

I may not ever become the "best EMT", and I will never become the "best cheesecake maker." But I am pretty darn good at both... and that is enough.

46Young- good posts... but I think that you might have a sticky mouse button or something...

In no way am I endorsing that fire should dominate EMS, and not allow our wings to flap free... just answering the question at hand.

I see your point. I think that those who have prior medic experience before entering the fire service will typically be the strongest, having concentrated solely on the EMS side alone for a period of time. That's what I did.

[cosgrojo]

Do you think that your devout fanship of your beloved Cowboys (who are going to be upset by Seneca Wallace this week btw)

Crap... messed that one up... I meant Kyle Orton... sorry. Seneca Wallace couldn't beat his red-headed step-child.

I see your point. I think that those who have prior medic experience before entering the fire service will typically be the strongest, having concentrated solely on the EMS side alone for a period of time. That's what I did.

I agree, but there are no absolutes. There will always be someone that breaks the mold and is able to thrive, and improve no matter what system they are in. Damn curve-busters... I hated them in college.

[46Young]

I would not expect a physician to also be a plumber, a baker to also be a software designer or a pilot to also be a chef.

To that end, why should we expect firefighters to be paramedics or paramedics to be firefighters?

You send a bunch of firefighters to school for three years to obtain our Bachelor of Health Science (Paramedic) with the requirement they also meet the con-ed req's to be a Firefighter and I bet you none of them graduate.

Firefighters that are put through medic class, be it a medic mill or legit degree program will typically be taken off the road the whole time they're in class. If anything, that actually makes it easier to graduate, not the other way around. Many of us have had to work FT jobs and then some while completing a medic program, myself included. There aren't any formal con-ed reqs per se for FF 1/2, only drills and company evolutions as mandated by each dept. Students would obviosly be waived.

Again, EMS and fire don't have many similarities, but giving FF's EMS responsibilities is efficient use of otherwise copious downtime in many cases. It happens to work well, at least from my personal experiences. As such, any lack of overlap between the two disciplines matters not. It seems to work better in suburban and rural areas as opposed to urban.

If you're using EMS to justify maintaining the current fire staffing, then you won't be able to justify providing enough staff to keep proper staffing for both the EMS and fire calls. So if you have all these fire medics responding to the structure fire, who's going to respond to EMS calls?

We have a dedicated EMS txp division, which basically functions like a third service, staffed by dual role personnel. We also have mutual aid agreements with all other neighboring jurisdictions. Having units tied up, be it on an EMS incident or suppression incident is something that good depts take into account and plan for accordingly. I haven't seen any issues here.

Crap... messed that one up... I meant Kyle Orton... sorry. Seneca Wallace couldn't beat his red-headed step-child.

I agree, but there are no absolutes. There will always be someone that breaks the mold and is able to thrive, and improve no matter what system they are in. Damn curve-busters... I hated them in college.

That's what it's all about, it's up to each individual to strive for excellence. There are good and bad providers no matter where you go. It's difficult to make blanket generalizations.

If I had my way, there would be a requisite year of prior employment as a single role medic, preferably two or three, as a hiring condition.

I didn't mention that there are a good number of FDNY FF's that hold and use their medic cert or RN. They do well in maintaining/improving proficiency. Some did it prior to appointment, some did it while on the job. we're talking about graduates from Hunter College, Nassau CC, Hofstra, ect. Not some medic mill or online RN bridge.I have one friend that completed his PA while working FT at NSLIJ CEMS. He started working FT at Coney Island hosp. (I think) and had to resign to take the FDNY job. He can do PA PT now, and he has plenty of days off (26/72) to complete con-ed.

That reminds me...... how many medics do you know that are completing degrees while working FT, and how many of those are completing degrees that have little to no overlap with EMS? Examples include business admin, accounting, law, forensics, etc. Some also have families that take up a certain amount of time as well. Are they not spreading themselves too thin, like some like to say a FFM does? I didn't think so either. Remember, the FFM is getting con-ed and training through drills on the job for both disciplines, which leaves plenty of time off duty to do more self study if needed.

Edited October 4, 2009 by 46Young

[VentMedic]

While I agree that it is not appropriate to "expect" that an MD could also be a plumber, there is nothing wrong with an MD that is a plumber, and no reason to think that he/she couldn't be good at both. I may be wrong, but I have interpreted this question to be about the ability to do both fire and EMS proficiently, and not about what we would think is the best EMS/Fire "system." There is an opportunity cost to everything that we do... is it better to be superlative in one thing, or be well rounded in many arena's? That is a personal decision people must make for themselves, and there is nothing wrong with either decision... provided you do it well.

Unfortunately, if you have been following the headlines or the systems in CA and FL, the FD decides it wants to do EMS. The next thing you know they have contracted a medic mill to get ALL FFs a Paramedic cert as quickly as possible.

It was not always like this and some departments prefer it to never be like this. They want those that do have an interest in being a Paramedic doing the EMS part. The two year Paramedic degree was sort after and respected by the FFs (including myself) in FDs during the 70s and early 80s. Some of the departments that at one time had exceptional reputations for EMS have now had them thrashed with the more is better attitude by making a Paramedic cert preferred for hire and mandatory within one year of hire. Thus, most rush through a cert program and do not get a degree or take any classes that should be prerequisites because there is a time factor to get that job or keep it.

Do you think Collier and Miami-Dade would now be appearing in print with articles concerning their training if the Paramedic cert was considered "education" and not just another training cert. I believe 46young and I had a discussion about that at another place and time.

Edited October 4, 2009 by VentMedic

[46Young]

Unfortunately, if you have been following the headlines or the systems in CA and FL, the FD decides it wants to do EMS. The next thing you know they have contracted a medicl mill to get ALL FFs a Paramedic cert as quickly as possible.

It was not always like this and some departments prefer it to never be like this. They want those that do have an interest in being a Paramedic doing the EMS part. Some of the departments that at one time had exceptional reputations for EMS have now had them thrashed with the more is better attitude by making a Paramedic cert preferred for hire and mandatory within one year of hire. Thus, most rush through a cert program and do not get a degree or take any classes that should be prerequisites because there is a time factor to get that job or keep it.

Do you think Collier and Miami-Dade would now be appearing in print with articles concerning their training if the Paramedic cert was considered "education" and not just another training cert. I believe 46young and I had a discussion about that at another place and time.

How ya doin?

Yes, I agree with what you're saying. The majority of the fire service looks at EMS as a specialty rather than a full fledged discipline, or career, as it is for many sigle role EMS providers. I think you or someone else posted a link showing how one dept put students through their own mill, teaching them how to pass the registry and how to work with their protocols only. Sad.

Some depts value legitimate education, proficiency and accountability more than others *cough* DC, Collier Co. *cough*. Kudos to them. The only permanent solution is to advance the minimum education to a degree level, and have FD's hire only with that along with a prior single role work history. Medics that are serious about the EMS side. until then, each dept and each medic will need to be judged on a case by case basis.