New Standards/Levels

[Jwade]

Vent,

How do you qualify and quantify a satisfactory level of education in EMS? Who determines this?

At what point did I achieve a satisfactory level of EMS education?

EMT-Basic

EMT- I

EMT- P ( All university classes, with A&P, Pathophys, Micro, Organic / Inorganic Chem, Pharm I&II, Nutrition,)

Physiology Degree

Business Management Degree

MBA

MHA

17 years experience

> 1000 flights

CCEMTP, PNCCT, FP-C, ACLS / PALS instructor ..........and the blah blah blah goes on and on....Where is the end point? Am I a statistical Outlier?

Again, I fully agree education is the key, and the people who don't have it, literally dont know what they dont know, but would be interesting to see your response....

Respectfully,

JW

[VentMedic]

Vent,

How do you qualify and quantify a satisfactory level of education in EMS? Who determines this?

At what point did I achieve a satisfactory level of EMS education?

EMT-Basic

EMT- I

EMT- P ( All university classes, with A&P, Pathophys, Micro, Organic / Inorganic Chem, Pharm I&II, Nutrition,)Physiology Degree

Business Management Degree

MBA

MHA

17 years experience

> 1000 flights

CCEMTP, PNCCT, FP-C, ACLS / PALS instructor ..........and the blah blah blah goes on and on....Where is the end point? Am I a statistical Outlier?

JW, you have listed all the classes and then some for at the very least an Associates degree in EMS and that is without your Business classes.

I would just like to see half of those, which would be included in a quality Paramedic Associates degree.

As you know from being in a business school, many of the students know they are not qualified for most jobs with just a Bachelor's degree and continue to a Masters for even an entry level position. The same is now happening in many of the health care professions. Some are finding that they must not do just the minimum required to stay competitive for a good ICU job or work in a progressive SCI/TBI Rehab.

How many Flight Paramedics have you interviewed over the years who thought they were going to get the job by looking good in a flight suit? How many have showed up with just the bare minimum of certs that wouldn't impress even some of the worst ground trucks that only do basic ALS IFT?

There are those who just talk and make excuses for themselves and EMS. Then there are those who believe they can make a difference by becoming a role model for education and patient care through obtaining the degrees whether they are required or not. I think you already know which category you fit into.

[cosgrojo]

He did not get the Bachelor's degree in business to maitain a job as an EMT-B but rather to pursue other opportunities with the restaurant business.

This is not exactly true... and it is not your fault for not knowing the specifics and intricacies of my life. So no points deducted for coming to that reasonable conclusion. I got the Bachelor's to try and become the next major captain of industry. Since that has failed... miserably I might add, I discovered a talent and passion for creating a menagerie of different food stuffs. It just so happens that the education in Business has given me an understanding on how to go forward with my goals. While I appreciate your comments, and even your compliments to my well-written posts... I too, fail to see the irony involved in this. It would certainly be ironic if I had set out to be the best, most well-educated EMS provider possible and while pursuing this goal I stumbled into a bakery one day as the current baker quit in a fit of rage, and I was offered a quick tutorial and offered a job... thus changing my goals and passion for medicine.

While cosgrojo did see a value to education he was not always in agreement a degree is the way to go.

Not exactly my position. I actually agreed with you that I would prefer a degree requirement, you simply considered my agreement to be invalid because I do not have a degree in the medical world. If the standards changed, and they told me that I had to get a degree within a certain time-frame, or become unemployed and my certification obsolete... I wouldn't be that upset. In fact I would applaud the changes and either comply, or wish the industry good luck in the future as I mosey into the EMS sunset. To ensure change, the standards must change.

Vent, you correctly assess that EMS providers in general have an aversion to higher education (for various reasons, and many only get into the industry for a quick career, or to become a Fire Fighter), but then you say that the only way to improve is to all of these providers who will not pursue said education, to pursue that education. You are asking for the leopard to change its spots. My contention remains that in order to enact the type of progressive education you (and I) desire for EMS, it has to be REQUIRED. Make that education mandate, and people will be forced to comply, or seek other employment. As an example, see the Florida medical director who booted all those medic's for not complying with his regional requirements. If people at that level make the demands, then we will see change. If I do it, it benefits me and my patients, but not necessarily the industry as a whole (except incrementally).

*edited for misplaced comma*

Edited October 20, 2009 by cosgrojo

[VentMedic]

Vent, you correctly assess that EMS providers in general have an aversion to higher education (for various reasons, and many only get into the industry for a quick career, or to become a Fire Fighter), but then you say that the only way to improve is to all of these providers who will not pursue said education, to pursue that education. You are asking for the leopard to change its spots.

Let me tell you have the process will work as all the other health care professions have gone through this. Again, EMS should not alienate itself from the world of medicine and should learn a few things about the health care process. Just like in Business during the 70s when the job market was very competitive, people went to college to have a better chance of securing a decent job. The companies liked having well educated applicants to choose from and eventually higher education standards became the norm in many industries even without a State or Federal mandate that they must go to college. In healthcare, many saw the need for higher education longer before it became mandatory and got higher education. Before long the employers just started to expect educated professionals and not those from tech mills. That is how RT got rid of many of its tech mill in the 90s which was over 10 years before the degre became a requirement.

However, once a profession does change, there is a grandfathering period. For diploma RNs who held the title of RN, they were still allowed to maintain their positions. But, for the LVN or CRTT, which are low levels of nursing and RT, they had just a few years to upgrade or get booted from the ICUs in some places. A few hospitals kept them on but did not hire anymore lower level credentials for those professions. Thus, if the Paramedic is already credentialed with a cert from a medic mill, the profession will probably be stuck with that person and for a long time even with the standards raised, EMS will still be viewed by that weakest link. Of course, in the FD, that Paramedic could also lose his/her ALS privilege and become only a BLS provider. That is the medical director's option especially if they do not meet standards as we saw in Collier County, FL.

My contention remains that in order to enact the type of progressive education you (and I) desire for EMS, it has to be REQUIRED. Make that education mandate, and people will be forced to comply, or seek other employment. As an example, see the Florida medical director who booted all those medic's for not complying with his regional requirements. If people at that level make the demands, then we will see change. If I do it, it benefits me and my patients, but not necessarily the industry as a whole (except incrementally).

*edited for misplaced comma*

Of course it will have to eventually be required. but, that doesn't mean people can not take responsibility for their own education and their knowledge for patient care. To sit around and wait for something to happen even if you know it is the right thing just puts you in the same place as all the nay-sayers. Once there are more examples of well educated professionals in EMS, medical directors may be able to gain some confidence in their employees. Eventually change will happen even if just in the well educated and well trained agencies. Those who are weak links and refuse to gain momentum to keep up with progress will start to disappear from patient care. This has been witnessed in many professions and not just in health care.

You either become part of the change by doing what you believe in or you become part of the problem by just waiting around to be told what to do with your own professional development for providing patient care.

[cosgrojo]

Let me tell you have the process will work as all the other health care professions have gone through this. Again, EMS should not alienate itself from the world of medicine and should learn a few things about the health care process. Just like in Business during the 70s when the job market was very competitive, people went to college to have a better chance of securing a decent job. The companies liked having well educated applicants to choose from and eventually higher education standards became the norm in many industries even without a State or Federal mandate that they must go to college. In healthcare, many saw the need for higher education longer before it became mandatory and got higher education. Before long the employers just started to expect educated professionals and not those from tech mills. That is how RT got rid of many of its tech mill in the 90s which was over 10 years before the degre became a requirement.

Over the course of this thread I believe that I have been sufficiently educated on how all the other Allied Health Professionals attained professional status through education. I see that it worked for them, and concede that it was a template that met with success. I just think that the variables in EMS are different. The fractured nature of the industry, the variety of different service types, regional treatment differences and protocols, economic variables (i.e. Urban EMS vs. Volly Rural squads), and most pervasive, intention (lack thereof) of the current crop to make EMS a professional career. There are many other factors as well that make the template of individually taking the "bull by the horns" an incredibly long and fruitless road to hoe. I don't dispute it worked for others, I dispute that it will work for EMS.

To sit around and wait for something to happen even if you know it is the right thing just puts you in the same place as all the nay-sayers.

I own that criticism... but it is a personal decision based on what I truly want to do. I don't have a problem sleeping at night. I know that I put in more time learning my current craft than the majority of my co-workers... and that disturbs me, because they intend on staying in the industry. I spend a lot of time learning advanced interviewing techniques and researching areas of interest outside of my scope of practice... I just don't get a degree or certificate for it.

Once there are more examples of well educated professionals in EMS, medical directors may be able to gain some confidence in their employees. Eventually change will happen even if just in the well educated and well trained agencies. Those who are weak links and refuse to gain momentum to keep up with progress will start to disappear from patient care. This has been witnessed in many professions and not just in health care.

Unfortunately, EMS has never been judged by its best practitioners. EMS is always judged by our worst. Unless (in my opinion) the education and training is implemented across the board, forcing our weak links to either leave or attain respectability, we will continue to not gain the confidence of our Medical Directors. If the leaders of the Medical community want EMS to get better, they will have to lead the charge, because as you have pointed out, too many in EMS oppose it. While I agree that if everyone in EMS demanded higher education and increased standards, it would produce the changes that you suggest, I just don't see it happening... we should find another way.

I think that we are closer to agreement now than we were at the beginning, and I think that says something for both of us. It's been a good debate, a bit chippy at times, but I've enjoyed it.

I'd also like to add that I don't particularly enjoy being "lumped" into other people's ideas and words. I prefer to be evaluated on my words alone, and on several occasions I have been "lumped" in with Herbie. So I will suspend just this once my dislike for being lumped. I think that Herbie has had a number of salient observations and points that have gone unheralded. I think that he added a dimension to the argument that I was unable to, and was needed for the discussion. I don't know Herbie, never traded PM with him, so I not suckling at the teat of friendship here... just wanted to show some appreciation. Besides... I don't want Vent to think that I only give compliments to her.

[HERBIE1]

Over the course of this thread I believe that I have been sufficiently educated on how all the other Allied Health Professionals attained professional status through education. I see that it worked for them, and concede that it was a template that met with success. I just think that the variables in EMS are different. The fractured nature of the industry, the variety of different service types, regional treatment differences and protocols, economic variables (i.e. Urban EMS vs. Volly Rural squads), and most pervasive, intention (lack thereof) of the current crop to make EMS a professional career. There are many other factors as well that make the template of individually taking the "bull by the horns" an incredibly long and fruitless road to hoe. I don't dispute it worked for others, I dispute that it will work for EMS.

I own that criticism... but it is a personal decision based on what I truly want to do. I don't have a problem sleeping at night. I know that I put in more time learning my current craft than the majority of my co-workers... and that disturbs me, because they intend on staying in the industry. I spend a lot of time learning advanced interviewing techniques and researching areas of interest outside of my scope of practice... I just don't get a degree or certificate for it.

Unfortunately, EMS has never been judged by its best practitioners. EMS is always judged by our worst. Unless (in my opinion) the education and training is implemented across the board, forcing our weak links to either leave or attain respectability, we will continue to not gain the confidence of our Medical Directors. If the leaders of the Medical community want EMS to get better, they will have to lead the charge, because as you have pointed out, too many in EMS oppose it. While I agree that if everyone in EMS demanded higher education and increased standards, it would produce the changes that you suggest, I just don't see it happening... we should find another way.

I think that we are closer to agreement now than we were at the beginning, and I think that says something for both of us. It's been a good debate, a bit chippy at times, but I've enjoyed it.

I'd also like to add that I don't particularly enjoy being "lumped" into other people's ideas and words. I prefer to be evaluated on my words alone, and on several occasions I have been "lumped" in with Herbie. So I will suspend just this once my dislike for being lumped. I think that Herbie has had a number of salient observations and points that have gone unheralded. I think that he added a dimension to the argument that I was unable to, and was needed for the discussion. I don't know Herbie, never traded PM with him, so I not suckling at the teat of friendship here... just wanted to show some appreciation. Besides... I don't want Vent to think that I only give compliments to her.

You brought up an interesting- and very important- point. "Education" for the sake of education, is fine, and I'm all for it. I love to learn- about LOTS of things. My interests are varied and I have taken classes in many different disciplines- some related to work, some not. I take my hat off to someone like you that takes all the various certifications available to them- that is education for a very specific purpose. It may or may not make you a better provider, but knowledge of any kind is a good thing.

I took many of those classes but I will admit I no longer am as ambitious in that regard.

I went in another direction- I went to grad school to learn about the management aspect of public safety. It may or may not pay off for me professionally, but personally I have learned a lot. I have a greater understanding of the behind the scenes mechanics of how and why things happen as they do. It helped me in my management stint, and I hope to return to it soon. Being a provider is still fun, I love what I do, I am very good at it, BUT I want more. I want to be able to change things for future providers, and an advanced EMS degree is not the route I have chosen. My reasons are many, and I may or may not be able to effect those changes, but I continue to try, even now.

One thing I have learned is that education alone - especially in a large organization- is not enough to get policies changed or to push an initiative. Often times logic, facts, and reason are ignored when establishing new policies. Sadly, politics and $$$ are generally the most important motivators, which is why I say that in order to change the system, often times you need to be a part of it.