New Standards/Levels

[Kiwiology]

Here's what I propose for the new levels...

Paramedic - Certified (PM-C)

Paramedic - Advanced Practice (PM-A)

Critical Care Paramedic (CC-P)

Eliminate "technician" from the job title, make PM-C equivalent to EMT-Basic in terms of skills, maybe give them a few extra tools, and make it a one year certification program. PM-A would be equivalent to the current EMT-Paramedic and would be a two year associate in applied science. CC-P would be a four-year bachelor's.

This is my perfect world. As long as we have "technician" in our name, we will continue to be treated like technicians and continue to earn a technician salary. Look what happened when RTs became Respiratory Therapy and upped their educational standards. Besides, everybody calls us paramedics already anyway.

That's not a bad idea.

Canada has pretty much had the same problem and they changed to ...

- Primary Care Paramedic (BLS),

- Advanced Care Paramedic (ALS),

- Critical Care Paramedic (HEMS/CCT)

Here in New Zealand since the mid-seventies we have indentified EMS as "Ambulance Officers" and that is still the generic term used for a crewmember regardless of practice level. The term AO was originally what you would graduate as when you obtained what was called (up until 1994) the Proficency Ambulance Aid Certificate and became a proficent, qualified "Ambulance Officer" just like somebody who graduated Police College is called a Police Officer. Also at that time there was only ONE level so hence the singular term of "Ambulance Officer" this however was expanded upon to include an IV/Cardiac level called "Intermediate Care Officer" and finally, advanced life support known as "Paramedic" however everybody was still generically said to be an "ambulance officer" which ended up being used as the term for basic life support.

We moved away from that terminology throughout the last 10 years and have realised it's inadequacices and are now moving back to unified terms.

- Ambulance Technician (BLS)

- Paramedic (ILS)

- Intensive Care Paramedic (ALS)

I hate the term "Ambulance Technician" but because we generically identify everybody here as an AO; it had to be changed to avoid confusion with the "Ambulance Officer" (BLS) level of practice. Calling everybody here a "Paramedic" is inappropriate as "Paramedic" in New Zealand implies you can at least start an IV, give fluid and manually defibrillate (in 90% of the country). There is one service here who calls everybody "Paramedic" and it was more borne out of people seeing Officers with "ICO"/"IV/Cardiac" etc on thier patches and saying "I want a Paramedic!".

I am in favour of all EMS falling under a single identity as do fire, police, nursing etc however I believe it is inappropriate to call the BLS level "Paramedic" because they are unable to offer at least some invasive care.

This is really hard for me because I can see the immense benefit it would provide but I just don't like the idea of a lesser qualified basic life support provider being called a "Paramedic" and potentailly being placed into a situation when they are unable to offer an appropriate standard of care - e.g. IV fluid in hypovolemia. On the other hand a firefighter is a firefighter be they paid, volunteer, retained, hazmat, Captain, training officer etc etc and a nurse is a nurse is a nurse.

Of course the other way to get around that problem is to upskill to level of practice where it is possible for your base level to start IVs, use a monitor/defibrillator and administer various medications. That is the situation in Australia (they only have two levels, ILS and ALS) and the situation here where ILS will become the minimum standard with BLS preserved for the volunteers as a reasonable alternative. Canada has also gotten round this problem by calling the volunteers "Emergency Medical Responder" or EMR.

I hate to use the terms like "basic", "primary", "fundamental", "limited" etc but I really do feel very strongly about providing an appropriate image to the public as to the level of care being provided unless we have sufficent education and training to enable an entry level provider to be able to perform some invasive skills, e.g. IVs/defib/ECG/fluids. I just don't see that ever coming about in the American system becasue it's so fragmented and standards are so low.

If you don't get out of that situation I would recommend

- Emergency Medical Technician (BLS)

- Paramedic (ILS)

- Advanced / Intensive Care Paramedic (ALS)

If you do ever move to such a system perhaps something like this

- Paramedic (BLS)

- Intermediate Care Paramedic (ILS)

- Advanced Care Paramedic (ACP)

The other two things we need to look at are the critical care people and the burgeoning role of enhanced scope paramedics who do the very low priority jobs. "Critical Care Paramedic" (CCP) and "Extended Care Paramedic" (ECP) should work for them.

[JakeEMTP]

Perhaps CCEMT-P's could muscle in on the RN home visit sector. Another income stream for the agency.

You realise of course that there isn't a level of provider called CCEMT-P. CCEMTP is another alphabet course, albeit an excellent one. I plan on attending one in the very near future. Anyone who claims to be a CCEMT-Paramedic is just doing so to make themselves sound more important. In reality, they took the initiative to upgrade their education. Kudos for that!

http://ehs.umbc.edu/CE/CCEMT-P/

Edited October 18, 2009 by JakeEMTP

[cosgrojo]

I've asked several times on this forum and others as to how this positive change will come about. I only get vague answers claiming that education will force change, education plus organization will force change, but no concrete plan of action. I've suggested that EMS learn from the IAFF's success and employ a similar strategy. Or form unions to better their deal at their particular agency.

Just think, the union will demand higher wages, better retirement, working conditions, medical, so on and so forth. Management will scoff, of course. The union can come back with a suggestion that management meet them in the middle if they all up their education to a degree level in an agreed upon time frame, as a condition of continued employment. A higher quality provider deserving of this generous deal. Having successfully bargained for a better deal, other EMS professionals will seek employment there. They'll also need degrees to apply. Other agencies will lose their best employees to this one. Other employers will be forced to increase their salary, benefits, education requirements, etc. etc. to match. Just one possible scenario.

At the present, I don't see many in EMS going the degree route solely for a career in EMS. Not without a federal mandate or a livable wage and decent retirement to attract the more highly educated. EMS missed the boat on increasing education. Many use the field for a quick way to make some cash without spending years in school. Since most that enter the field are doing so to earn a living without having to go to school for several years or so in the first place, then it's quite a stretch to believe that individuals in the future that enter EMS for the same reasons would voluntarily go the degree route without an immediate lucrative payoff for their efforts. RN's, RT's and others went the education route first, citing pt benefit, then increased insurance reimbursement, then salary/benefit increase, but the EMS workforce is of a different mentality.

Excellent Post. A couple of years ago we got into a similar education debate on this forum, and after we went on for ages exclaiming the need further education, and stop volunteering our time, I asked how do we fix it? The Thread petered out rather quickly s/p that question. I agree with all of what you say, and have long held the belief that through organization, cooperation, and negotiation, we can reach the goals of independent profession. Obviously it would be difficult to completely flesh out the template in which to proceed because things never work the way in which we foresee... but I like the skeleton format that you have presented in your second paragraph.

I also agree with your assessment of the general workforce in EMS (the same that Ventmedic has been correctly espousing). These are real challenges to change, especially if we continue to be a fractured and fragmented industry. The major difference, in my view, between EMS of today, and Allied Health professionals of old, is the presence (or lack thereof) of a progressive guiding force. I feel pretty certain that not all RN's and RT's were on board with increased standards and responsibilities without immediate recompense. They were required to make those changes because both the medical world and their professional leaders were mandating these changes. EMS does not have this coordinated leadership to enact change. At this point in the game, it would be difficult to accomplish these changes in the same manner because of past practice.

Do you think PAs and NPs work completely independent or are subject to a "supervising" or "collaborating" physician? To say that EMS doesn't and won't ever practice completely independent in the US misses the point that there are only an extremely limited number of health care professionals outside of MD and DOs that practice independently.

JPINFV- Far be it from me to speak for someone else... but as I read Herbie's post, I interpreted it to mean exactly what you said. Independent practice in the US system is not an appropriate goal for EMS because it isn't allowed in almost all of US health care. We are a Nation of Check and Balances... at least that's what we are supposed to be.

[VentMedic]

That's not a bad idea, just that you'd need to convince employers to get onboard with that. Tell them that they could stop using RN's to do CC txp's, and instead bill for the CC medic at a higher rate. Perhaps CCEMT-P's could muscle in on the RN home visit sector. Another income stream for the agency.

Welfare checks, maybe but...

There is also nothing in the Paramedic curriculum that would prepare a Paramedic to do what RNs do in home care. When was the last time you staged a wound and applied treatment? What do you know about insulin and diabetes teaching? Nutrition? Tube feedings? Various vacuscular access devices for the long term? Chemo? Stoma care? Various ostomies? Evaluated BP medication effectiveness? Administered all the typical medications many, many times to be familiar with them? Did family education for all of the above procedures? To be effective, one should have enough knowledge and experience where all issues involving long term patient care should come easily for the practitioner.

For the CCEMT-P, some ambulance services hand out those letters after a two hour inservice. They may even call them that so the truck can be a CCT but due to protocol restrictions they may not have any more skills or knowledge than a regular 911 ALS truck. Some Paramedics, such as in FL, can have an expanded scope to do IABP and ventilators. However, again, the training/education will vary from 2 hours to 2 weeks. And yes, some doctors have refused to let some Paramedics take the patient unless a nurse went with them when they appeared clueless or overwhelmed by a critical patient. We have also had some very back adverse outcomes from Paramedics transporting patients that were way out of their expertise. Unfortunately the Paramedics didn't understand enough to ask questions or what even what questions to ask.

The UMBC CCEMTP is a very basic overview of a few critical care concepts. In two weeks it is very difficult to teach one to be a competent critical care clinician. Several RNs and RRTs have taken the program only to be disappointed in the material but most already had critical care experience and found it to be very basic knowledge. For the Paramedic, it is a decent program but should NOT be taken as an end all or even a good beginning for all there is to know about critical care medicine. Too many have come away from the UMBC class thinking they know everything there is to know and that leads to very bad things for the patient they are assigned the responsibility of.

There are only about 5 states that do recognize the CC-P/CICP/CCEMT-P credential in their list of levels. I believe Ohio has a decent setup for their CICP but less than 100 hours of training is required. That pales in comparison to the training other practitioners get for critical care even without the experience. If you look at the degree of the RT, it is essentially an introduction to critcal care medicine and even at that it barely scratches the surface for all one can experience working an ICU.

The Canadian Flight/Critical Care Parmedic program is very impressive. Their training is adequate enough to where nurses do not need to accompany them. But, it is built off of an already impressive education foundation.

U.S. Flight Paramedics can also have an expanded scope and often do get a decent amount of education and additional skills from their employer. However, the ideal candidate should have at the very least college level A&P. Pathophysiololgy and Pharmacology would also be a big plus. As it is now, an RN is usually paired with the Paramedic if they do CC IFT. It is even difficult for CCT and Flight RNs to keep up with all the advances in Critical Care medicine unless they are hospital based or continue to work in an ICU on their off days. Paramedics do not have that opportunity nor to they have the base education required to fully grasp all the critical care concepts if they graduated from a Paramedic program that just did the minimum "hours of training". Just learning a few "tech skills" to be a knobologist for the IV pumps and the ventilators are not sufficient to manage an intensive care patient. Unfortunately, those that have gotten a CCEMT-P patch from their employers with little training rely on speed to get from point A to point B if taking a nurse is not an option or they bluff enough to make people think they are well qualified.

There are of course exceptions. Rid has explained his program for CCT and it appears to be quality.

[VentMedic]

The major difference, in my view, between EMS of today, and Allied Health professionals of old, is the presence (or lack thereof) of a progressive guiding force. I feel pretty certain that not all RN's and RT's were on board with increased standards and responsibilities without immediate recompense. They were required to make those changes because both the medical world and their professional leaders were mandating these changes. EMS does not have this coordinated leadership to enact change. At this point in the game, it would be difficult to accomplish these changes in the same manner because of past practice.

The major difference between EMS and other allied health professionals is EMS believes it is so different and forgets it is part of medicine.

For the RNs and RTs, there were a few hold outs but the majority of RNs and RTs already had their degrees long before the 2 year degree became mandatory or even before they had licensure in their State. FL and CA just got RT licensure in 1986. The RRT just established their 2 year degree mandate and many now have 4 year degrees. Exercise Physiologists have a Master's degree and have license in only one or two states. But, eventually that will change. Athletic Trainers with a 4 year degree do have licensure but have been around a little longer. Do you see how education plays a role in the career you have chosen? Why put the Paramedic at the far end of nowhere with just a tech cert when it deals with patients' lives?

Many RNs also now have 4 year degrees. The majority did not have to be told they needed more education. They sought it themselves. That is part of being a good clinician and professional. The one advantage of working in a hospital is you get to mingle with other degreed clinicians. You also get to see the differences of those with a tech menatlity and those who realize they need more education since medicine is ever changing. EMS has alienated itself to where it does not relate to the world of medicine. The "oh we are so different" crap has seriously played a role in warping attitudes against education.

Since you, who tries to say you are pro education but have not made any attempt to get a degree, you do not represent those who are pushing for higher standards. In fact, you are part of those holding it back. You spout off one way but state "make me" or offer every excuse not to get an education until you are forced. It is a mere 2 year degree. No one is saying you must even get a Bachelor's degree. What is so difficult about taking a couple of A&P classes and a few additional classes? Why don't you set an example instead just using "EMS" as an excuse not to get a degree? Maybe if you actually got the degree and saw what you are missing, you might be a better pro education spokesperson or at least have a little credibility when you do try to talk about it. 46young should do the same.

Since you and herbie are hung up on saying the RNs did not want to get educated, let me given you an example of how you are not correct.

In Dade (Miami) and Broward(Ft. Lauderdale) counties, there are 2 community colleges (2 year) that offer the nursing program.

Miami-Dade Community College

Broward Community College

There are at least five major 4 year colleges that offer the program and all have a waiting list.

University of Miami

FIU

FAU

Barry University

St. Thomas University

Nurses are already preparing themselves for the future. If nursing students thought a BSN was a waste of time, they would just wait for an opening in the community college. The other programs are very expensive but most are willing to do what it takes to get a good education and secure a future. But then, that is also what every parent wants for their child also.

Edited October 18, 2009 by VentMedic

[VentMedic]

Despite that your reputation meter keeps going up... I think my mind must be going wonky... You've made more spelling mistakes in your last two posts than I have in all of my posts combined, yet you are the highly educated "alphabet soup" provider, and I the undereducated fool. If you want the standards raised, start with the spell check.... besides I've never liked the number 14 anyway.

Now for personal attacks... You are the one who has stated you do not have a degree because it is not required. I have not used the words "undereducated fool" in any of my posts when speaking of you. Those are your words and if that is how you think of yourself, you might consider getting at least a 2 year degree. Having the letters of a degree behind your name is not a bad thing and should not be viewed so negatively.

Do you care to point out the spelling mistakes in post #94?

Those are abbreviations for the associations and not misspelled words.

In the other post I used Dustdevil's spelling for ass which is arse.

Could it be others agree that education is important and one shouldn't wait to be told or made to get it if they want a better understanding of medicine to provide quality care to their patients? Of course it would be nice to have the 2 year degree as a requirement for Paramedics.

Edited October 18, 2009 by VentMedic

[Kookaburra]

Here's a question - how far up must one be in the medical establishment to be a force for change? Are there doctors who would be allies in working to mandate increased educational standards? Or would Paramedics and EMTs who wish for prehospital care to become a respected profession need to leave the field behind and go to medical school in order to be in a position with sufficient leverage?

Are medical directors able to require that all Paramedics working under their license have an AAS?

And VentMedic's reputation meter keeps going up because people recognize that she is saying what needs to be said. We're dealing with people's lives here - no room for mollycoddling. I may be a rookie, but I can tell when someone is speaking from a place of experience. Like I said upthread, I came into my EMT/Paramedic program expecting the people in it to be the best of the best. While it's too early to tell in the Paramedic program, I was appalled at the lax attitude of many of my fellow students in the first year. I can also say with confidence that I would have learned more if those students had been washed out early in the program. Their presence was a constant drain on those of us who took the course seriously.

Getting an AAS really is not that hard - most of my classmates have families, and there are several single mothers who also work full time in slave wage positions. They are some of the most organized and dedicated students. If they can do it, anyone can. The biggest obstacle people have is in their own mindset of "can't".

[cosgrojo]

Now for personal attacks... You are the one who has stated you do not have a degree because it is not required. I have not used the words "undereducated fool" in any of my posts when speaking of you. Those are your words and if that is how you think of yourself, you might consider getting at least a 2 year degree.

You can deny the inference if you like, but it has been a pervasive tone to your posts throughout the thread. You accuse me earlier of not reading your posts, and I apologized for misinterpreting your 2 vs. 4 year entry level concerns. Clearly you haven't been paying attention to my posts well if you haven't caught that I have indeed achieved your precious "higher education." I have a Bachelor's degree. I have a BS in BAD with a minor's in both Marketing and Economics, I graduated Summa Cum Laude, I am currently pursuing interests in education, teaching, and going through the process of opening my own restaurant in the next 2 years. I just also happen to be an EMT who loves to know as much as I can about the Industry and it's care modalities. I have decided, however to pursue other interests more passionately than I have EMS and Medicine.

So is your next stance that higher education is only important and valid if it is in the Health Care realm? So education is only important if it is in what YOU have and education in? Should I be penalized in your mind because I have chosen to pursue multiple interests in profession and education? Should I pigeon-hole myself into one area, despite the fact that I like other things as well? Apparently I should just engulf myself in just Health Care so that Ventmedic can appreciate and respect me. Your definition of successful education remain narrow and obtuse.

Do you care to point out the spelling mistakes in post #94?

Those are abbreviations for the associations and not misspelled words.

Nope, you were clean on #94... congratulations... copy and paste appears to be your specialty.

Could it be others agree that education is important and one shouldn't wait to be told or made to get it if they want a better understanding of medicine to provide quality care to their patients?

YES, YES, YES... a thousand times over, YES! It would be WONDERFUL, but it is not realistic under the current climate of EMS. We all agree that it is a horrible reality, but it is a reality nonetheless. If it was realistic, and the majority of people felt the same, it would have happened already. It is not going to happen the way you want it, so I say again, let's move on and start making realistic recommendations, and forgo the finger-wagging.

Here's a question - how far up must one be in the medical establishment to be a force for change? Are there doctors who would be allies in working to mandate increased educational standards? Or would Paramedics and EMTs who wish for prehospital care to become a respected profession need to leave the field behind and go to medical school in order to be in a position with sufficient leverage?

Are medical directors able to require that all Paramedics working under their license have an AAS?

And VentMedic's reputation meter keeps going up because people recognize that she is saying what needs to be said. We're dealing with people's lives here - no room for mollycoddling. I may be a rookie, but I can tell when someone is speaking from a place of experience. Like I said upthread, I came into my EMT/Paramedic program expecting the people in it to be the best of the best. While it's too early to tell in the Paramedic program, I was appalled at the lax attitude of many of my fellow students in the first year. I can also say with confidence that I would have learned more if those students had been washed out early in the program. Their presence was a constant drain on those of us who took the course seriously.

Getting an AAS really is not that hard - most of my classmates have families, and there are several single mothers who also work full time in slave wage positions. They are some of the most organized and dedicated students. If they can do it, anyone can. The biggest obstacle people have is in their own mindset of "can't".

I sincerely applaud you for your passion and your idealism. Both attributes will serve you well in any endeavor that you pursue. If I could mandate that only people with your attitude are allowed into the medical community, I would, but I can't. I have given Ventmedic credit for her correct assessment about the sad state of education for the past, current, and near future of EMS. These concepts are not new, they are not being disputed, and they add nothing to the potential bettering of the Industry. No one has doubted Vents experience and knowledge, and she is a benefit to wherever she works, and a benefit to this community... I just don't agree with her argument tactics and her refusal to admit certain realities. Other than that, I have learned a lot from her over the years I've been on this forum.

Enjoy the day people, 3 minutes to FOOTBALL.

[VentMedic]

It is not going to happen the way you want it, so I say again, let's move on and start making realistic recommendations, and forgo the finger-wagging.

I don't know what points you are missing. I have given many examples of how nursing and other allied health professions encouraged those entering and already in their profession to get a degree long before it was required because they KNEW that was their ultimate goal. They didn't wait for some union to say it was okay or wait for someone to MAKE them get a degree. Most saw the need themselves. Once the educated become the norm or increase in numbers enough to show a difference between the grads from a medic mill and a degree program, those with legislative powers will get the message. Thus, it is up to those in EMS to start controlling their OWN destiny and that of their profession.

The other thing, as I have also mentioned many times in this thread, is to raise the educational standards for the instructors and make them true educators. That could within reach more realistically but at this time since there are few with even a 2 year degree, it will take a while to implement that. Once the instructors become educated, they can be role models for education rather than relying on "fish" tales to prove their value in the classroom.

Honestly this is not a difficult concept but if those who are providing the patient care fail to see the importance of an A&P class, what hope is there. Unfortunately too many are like you who just want to wait and be made to get a degree instead of taking the initiative yourself to set an example. If you already have a degree as you say, why do you think a mere 2 year degree is so unrealistic?

Once there are more educated people to speak for education, the IAFF and private ambulance complanies would be foolish to point out education is a waste if it puts them in a bad light with the tax payers. But, you can just sit back and continue to make excuses so you and the herbies of EMS can complain about the FDs.

But, I think this speaks volumes for your stance.

I graduated Summa Cum Laude, I am currently pursuing interests in education, teaching, and going through the process of opening my own restaurant in the next 2 years. I just also happen to be an EMT who loves to know as much as I can about the Industry and it's care modalities. I have decided, however to pursue other interests more passionately than I have EMS and Medicine

You are an EMT and not even a Paramedic but yet you are trying to tell us about a degree as a Paramedic. This would be like a CNA telling an RN that his/her BSN shouldn't be obtained until they are made to get that degree.

But, you are not even pursuing the Paramedic or even EMT as a career.

After 30 years I still have hope that the Paramedic will become a recognized professional health care provider but that is only if we stop catering to the weakest links and listening to the excuses or blaming someone (or the FD) for our failures in EMS.

I have been around to see first hand the many changes in medicine and that includes the many professions which are a lot younger than EMS. Medicine is not fantasy. It is a very much a reality which is based in the sciences. If a profession doesn't understand a few simple sciences, it becomes stagnated.

That being said, thank you for the compliments and good luck with the restaurant. I wouldn't mind having a wine bar and bistro for my retirement hobby. But, I am not oblivious to the fact it would take considerable education and dedication just as EMS should.

Edited October 18, 2009 by VentMedic

[46Young]

Welfare checks, maybe but...

There is also nothing in the Paramedic curriculum that would prepare a Paramedic to do what RNs do in home care. When was the last time you staged a wound and applied treatment? What do you know about insulin and diabetes teaching? Nutrition? Tube feedings? Various vacuscular access devices for the long term? Chemo? Stoma care? Various ostomies? Evaluated BP medication effectiveness? Administered all the typical medications many, many times to be familiar with them? Did family education for all of the above procedures? To be effective, one should have enough knowledge and experience where all issues involving long term patient care should come easily for the practitioner.

For the CCEMT-P, some ambulance services hand out those letters after a two hour inservice. They may even call them that so the truck can be a CCT but due to protocol restrictions they may not have any more skills or knowledge than a regular 911 ALS truck. Some Paramedics, such as in FL, can have an expanded scope to do IABP and ventilators. However, again, the training/education will vary from 2 hours to 2 weeks. And yes, some doctors have refused to let some Paramedics take the patient unless a nurse went with them when they appeared clueless or overwhelmed by a critical patient. We have also had some very back adverse outcomes from Paramedics transporting patients that were way out of their expertise. Unfortunately the Paramedics didn't understand enough to ask questions or what even what questions to ask.

The UMBC CCEMTP is a very basic overview of a few critical care concepts. In two weeks it is very difficult to teach one to be a competent critical care clinician. Several RNs and RRTs have taken the program only to be disappointed in the material but most already had critical care experience and found it to be very basic knowledge. For the Paramedic, it is a decent program but should NOT be taken as an end all or even a good beginning for all there is to know about critical care medicine. Too many have come away from the UMBC class thinking they know everything there is to know and that leads to very bad things for the patient they are assigned the responsibility of.

There are only about 5 states that do recognize the CC-P/CICP/CCEMT-P credential in their list of levels. I believe Ohio has a decent setup for their CICP but less than 100 hours of training is required. That pales in comparison to the training other practitioners get for critical care even without the experience. If you look at the degree of the RT, it is essentially an introduction to critcal care medicine and even at that it barely scratches the surface for all one can experience working an ICU.

The Canadian Flight/Critical Care Parmedic program is very impressive. Their training is adequate enough to where nurses do not need to accompany them. But, it is built off of an already impressive education foundation.

U.S. Flight Paramedics can also have an expanded scope and often do get a decent amount of education and additional skills from their employer. However, the ideal candidate should have at the very least college level A&P. Pathophysiololgy and Pharmacology would also be a big plus. As it is now, an RN is usually paired with the Paramedic if they do CC IFT. It is even difficult for CCT and Flight RNs to keep up with all the advances in Critical Care medicine unless they are hospital based or continue to work in an ICU on their off days. Paramedics do not have that opportunity nor to they have the base education required to fully grasp all the critical care concepts if they graduated from a Paramedic program that just did the minimum "hours of training". Just learning a few "tech skills" to be a knobologist for the IV pumps and the ventilators are not sufficient to manage an intensive care patient. Unfortunately, those that have gotten a CCEMT-P patch from their employers with little training rely on speed to get from point A to point B if taking a nurse is not an option or they bluff enough to make people think they are well qualified.

There are of course exceptions. Rid has explained his program for CCT and it appears to be quality.

Regarding the first paragraph, a CCEMT-P with a bachelor's, such as EMTinEPA suggested earlier could have the sufficient knowledge base to do the home care thing. That's dependent on the course material, naturally. The CCEMT-P with a bachelor's ought to be able to perform well inn CC txp's, and perhaps NICU's and PICU's with specialty training. Ditto for flight.

As far as needing college to have any credibility as a pro education spokesperson, how about cutting me some slack. I already have A&P and pharm. After medic school I worked OT frequently as well as per diem jobs for two years, to get out of debt, and then to fund investments to provide my family with some measure of financial security. I then moved to Charleston for 6 months. Then it was a 9 month internship/recruit ordeal with Fairfax. The Fairfax career is proving way more lucrative than having an ASN or BSN. I now have the option of pursuing those goals, already being financially secure. Now I'm completing my rookie year. I spent those 9 months prior making only 53k without incentives, so I've spent my time post academy working OT and a side job, as before. We plan to buy a house soon. It's all about priorities, what's most important at the present. Did I not start the thread "RT vs RN" to ask for educational advice? Those wheels are in motion for the spring semester.

It just so happens, as I've come to find out during a conversation with a colleague at the ED today, that NOVA CC's paramedic program is an accredited assosciates. Why is this important? It's important because the Fairfax County FRD sends selected employees that submit a letter of interest to the FRD to NOVA to earn their paramedic cert. Fairfax sends their employees to college for a paramedic assosciates. No fast track medic mill here. The dept also seeks to upgrade all their I's to P's when economically feasable. Fairfax no longer hires I's to function as ALS providers, to my knowledge.

Score one for the fire service. I knew that I came to the right place.

I did a quick google search and found this:

http://education-por...n_virginia.html

Look to the Annandale campus, not Tidewater, which is down near the Va Beach/Norfolk area.

Edited October 18, 2009 by 46Young