As EMS/PHC Providers; Are We That Lazy?

[mobey]

Whay are we discussing pt's in respiratory distress? or kids with suspected menengitis? Are these really our target patients for treat and release?

Once again, Crotchity takes it too an extreme untill everyone agrees with him.

Too bad he can't comprehend anyone elses viewpoint.

[NYCEMS9115]

Paramedics can't have Bachelor's Degree in Paramedics but you can get a Bachelor's in "STOP, DROP, & ROLL; put the wet stuff on the red stuff"...

http://www.columbiasouthern.edu/Degree/Bachelor/Safety/Fire-Science

[NYCEMS9115]

A Master's in Fire Science too....

http://www.newhaven.edu/5922/?

[HERBIE1]

A Master's in Fire Science too....

http://www.newhaven.edu/5922/?

Here's my take on the education issue. First- education is never a bad thing, but does a bachelor's in paramedicine make you a better or more effective provider? If that's what interests you, by all means, go for it with gusto.

An undergrad or graduate level degree is a great idea, but I see limited value in a degree only related to paramedicine. If we are trying to move forward in this profession, we need to think more broadly than just EMS. We do not operate in a vacuum, meaning we interact daily with police and fire, as well as other public safety agencies. Learning how our jobs are linked to these other professions- beyond the obvious day to day work- is vital. Management, leadership, budget, interoperability issues- all need to be understood in order to move past our second class citizen status.

[NYCEMS9115]

Let me give you an example of Nursing Degrees. Almost all RN Certificate Programs have been eliminated in the US. They're still some but majority of Nursing Students are enrolled in a Nursing Degree Program. The Associates in Nursing (ASN) is a RN but the pre-core studies are basic requisites. The various Nursing Courses that are taken at the ASN level is all you need to be a RN (assuming the NCLEX exam has been passed). The Bachelors in Nursing (BSN) is still just a RN but the center of focus of the studies is on Theories of Nursing Concepts. The Masters in Nursing (MSN) is a RN but the focus is more in depth. The Doctorate in Nursing (PhDN) is a RN but the theories are more complex and the Doctor has proven abilities in analytical research and conceptualizes it in a Dissertation. They are all still Registered Nurses...

The Paramedic AAS (ASP) is a combination of pre-core course: prerequisites and the Paramedic Concepts. The Paramedic Theories will be in the BS in Paramedics (BSP) Curriculum; focusing on EMS Fundamentals & History, EMS Management, Emergency Disaster Management & Preparedness, Medical Coding and Billing, Communications, Introduction to HAZMAT/WMD, and Ambulance Maintenance. The MS in Paramedicine (MSP) will add more Paramedic Theories with in depth studies in all the Paramedic Core Concepts; along with analytical research and theory reasoning.

The AAS/ASP is all that will be required but the other more Advanced Degrees will be preferred...

[Just Plain Ruff]

But seriously with a masters degree costing upwards of 40K depending on what school you go to, how will you recoup that cost when most ems agencies are run on the seniority promoting scale. What positions are there in small ambulance services that will use the masters level education?

Even the big services would be hard pressed to pay the employee enough for them to recoup that out of pocket cost.

I'm envisioning only the biggest ems agencies to take advantage of that education and those medics will definately not be working the streets.

Maybe a governmental agency could use them. Certainly not the mom and pop systems. Maybe AMR corporate or Rural Metro and I am betting that the person with that education will be used differently than we might envision.

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[NYCEMS9115]

But seriously with a masters degree costing upwards of 40K depending on what school you go to, how will you recoup that cost when most ems agencies are run on the seniority promoting scale. What positions are there in small ambulance services that will use the masters level education?

Even the big services would be hard pressed to pay the employee enough for them to recoup that out of pocket cost.

I'm envisioning only the biggest ems agencies to take advantage of that education and those medics will definitely not be working the streets.

Maybe a governmental agency could use them. Certainly not the mom and pop systems. Maybe AMR corporate or Rural Metro and I am betting that the person with that education will be used differently than we might envision.

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I did post all different positions on this thread and the links. The bare minimum is an AAS if you want to be a Paramedic. The BS and MS is by choice. If you want to go further in EMS; you must have experience and education. Look and you'll see. Do you think the Director of NYS DOH EMS doesn't have a degree? He has a MPH. There's an Executive Director position opening in North Syracuse, NY but its asking for Ambulance and Managerial Experience; along with a minimum of a Bachelors but Masters preferred. This requirement is asked many times for a big Administration position.

We can argue that college doesn't make you a better Medic. Colleges doesn't make you a better Attorney, Nurse, Doctor, Journalist, Teacher, Astronaut, Executive Chef, Scientist, Commodities Broker, Advertiser, or Federal Agent but it requires College to be one...

[HERBIE1]

Let me give you an example of Nursing Degrees. Almost all RN Certificate Programs have been eliminated in the US. They're still some but majority of Nursing Students are enrolled in a Nursing Degree Program. The Associates in Nursing (ASN) is a RN but the pre-core studies are basic requisites. The various Nursing Courses that are taken at the ASN level is all you need to be a RN (assuming the NCLEX exam has been passed). The Bachelors in Nursing (BSN) is still just a RN but the center of focus of the studies is on Theories of Nursing Concepts. The Masters in Nursing (MSN) is a RN but the focus is more in depth. The Doctorate in Nursing (PhDN) is a RN but the theories are more complex and the Doctor has proven abilities in analytical research and conceptualizes it in a Dissertation. They are all still Registered Nurses...

The Paramedic AAS (ASP) is a combination of pre-core course: prerequisites and the Paramedic Concepts. The Paramedic Theories will be in the BS in Paramedics (BSP) Curriculum; focusing on EMS Fundamentals & History, EMS Management, Emergency Disaster Management & Preparedness, Medical Coding and Billing, Communications, Introduction to HAZMAT/WMD, and Ambulance Maintenance. The MS in Paramedicine (MSP) will add more Paramedic Theories with in depth studies in all the Paramedic Core Concepts; along with analytical research and theory reasoning.

The AAS/ASP is all that will be required but the other more Advanced Degrees will be preferred...

Again- a BSP sounds like a great idea, but it all depends on what your future plans happen to be. For those intent on moving up in the public safety realm- not just in EMS-I think they need to be well rounded in their education, for a multitude of reasons.

Realistically, I'd be happy if providers received ANY education beyond their EMS training. If we want to be treated as allied health professionals, we need to walk the walk, not just talk a big game.

[HERBIE1]

But seriously with a masters degree costing upwards of 40K depending on what school you go to, how will you recoup that cost when most ems agencies are run on the seniority promoting scale. What positions are there in small ambulance services that will use the masters level education?

Even the big services would be hard pressed to pay the employee enough for them to recoup that out of pocket cost.

I'm envisioning only the biggest ems agencies to take advantage of that education and those medics will definately not be working the streets.

Maybe a governmental agency could use them. Certainly not the mom and pop systems. Maybe AMR corporate or Rural Metro and I am betting that the person with that education will be used differently than we might envision.

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Looking at this strictly from a cost/benefit perspective, an advanced degree is not a quality bet. I agree that field promotions are often based on subjective factors, or straight seniority, which means that field providers who opt to get Bachelors or advanced degrees are rolling the dice. Their degree- and the time and money spent obtaining- may not pay off financially for them any time soon- if at all.

It has to start somewhere. There ARE folks out there with degrees, and this will be a long process. Yes, those with advanced degrees will generally want to move beyond the streets(if for no other reason than to recoup their investment), and that is exactly what we need. We NEED street providers with experience AND the education in management positions to move things beyond the status quo. They will be the policy makers, and set the agenda for the future. New ideas, new blood, new energy, and a new direction.

[zippyRN]

We are not talking aboout Patient Refusals, we are talking about Lazy EMS people refusing patient transport. Big difference. No one is going to argue that patients refuse AMA, although I will contend there was rarely a patient I could not talk into going if I tried for more than 2 minutes.

the problem is none of this is about REFUSALS it's in fact aobut APPROPRIATE CARE OUTCOMES.

one of the reasons Health insurance is expensive inthe USA (aside from the admin bloat) is the way in which it encourages the status quo and unnecessary consumption of resources to meet some fantasy 'standard of care' promoted by lawyers and fee for service providers ...