Straight to Paramedic

[Dustdevil]

[*]The bad habits with no training are, in my opinion, just as bad as they guy who graduates from the program with only the book knowledge and will argue with his FTO when a treatment is done just a little differently than he was taught.

So, you believe that it is preferable to go to the field BEFORE getting "only book knowledge"? At least those with the book knowledge have something to work with. And I've never seen a lack of "book knowledge" stop students and n00bs from arguing with me. In fact, because of all that so-called "experience," they tend to argue (and disrupt class for everyone) a lot more than those with no field time. This observation from teaching and preceptoring twenty times longer than you've been practising, so it's not a rash assumption.

[tniuqs]

Here are my thoughts:

<snip for brevity>

Toni

Sorry Toni I have to disagree with all of your points to rationalize this position, I will not go into anecdotal stories, of I saw this once and that guy ....

All gradate Paramedics DO HAVE field experience,called field praticums and hospital clinicals but guided and supervised by trained educators, so the students don't kill anyone, because they "didn't know" just like in a thing some call MEDICAL PRACTICE.(ps because that is what we do!)

Show me ONE only "book trained" not evaluated in the field, Paramedic, and I will show you a failed education program.

Besides the fact that "parroting" pneumonics is SOP in basic EMS .. this does not teach critical thinking, diffencial diagnosis, or evidence based medicine, this is how to teach monkeys.

IT IS THE BIGGEST SINGLE PROBLEM with this so called profession and if we DO NOT ABANDON this stepping stone education concept EMS is doomed to be first aiders and falsely glorified "life savers"

Edited June 13, 2011 by tniuqs

[fiznat]

We do argue this all the time. I'm sure if you search a little more you can find a heap of multi-page, passionately argued threads on this topic. I know me and Dust have butted heads on it on more than one occasion lol.

I am of the "you need EMT experience" camp. I think for you personally it might be worth considering moving forward with the EMT-P if it is getting paid for, but I do believe in general that experience as an EMT is essential to the development of an effective paramedic.

My basic reasoning:

-EMS isn't all about clinical medicine. Medicine accounts for maybe half (possibly even less) of what we actually do in practice. The rest is bedside manner, operations, managing a scene, adverse conditions, learning the system, giving reports to hospital personnel, working with a partner, interviewing family members and witnesses, lifting, etc, etc etc. Those are the things you learn how to do well as an EMT, and I strongly believe any good paramedic needs that foundation before he/she can expect to do medicine in the EMS environment. People like to blow this stuff off as "not important" or "easy to learn," but it really isn't. It can be very difficult to integrate all of those tasks smoothly together-- especially when scenes start to get chaotic. I would argue that those tasks account for probably more than half of what we do as EMS providers, require real skill and experience, and are as deserving of excellence as any other of our medical duties.

-We need to respect the role of our EMTs. I work with an EMT partner every day and I need to fully understand his/her role in prehospital care. EMTs are FAR more important than has been let on in this thread, and I personally believe you can't fully understand that until you work the job.

-Prospective paramedics need to know what they are getting into. EMS is not what outsiders think it is. The last thing we need is an influx of new paramedics who find out that this isn't what they bargained for. Pay your dues. Work as an EMT, and then go to medic school for the right reasons.

-Etc.

Edited June 13, 2011 by fiznat

[xselerate]

Has nothing to do with clinical knowledge or training, it has to do with having been by yourself with a critical patient and knowing what its like. You all want to jump on me and attack you can all you want but that guy is still going to be a crap medic. Experience in medic school riding as a third? Fail. Nay, epic fail.

Go ahead and whip yourselves into a frenzy now.

[tcripp]

So, you believe that it is preferable to go to the field BEFORE getting "only book knowledge"? At least those with the book knowledge have something to work with. Yes. I believe it is preferable for someone to work at their current level with the book knowledge they have before moving to the next level. Get comfortable where you are and then move on.

And I've never seen a lack of "book knowledge" stop students and n00bs from arguing with me. In fact, because of all that so-called "experience," they tend to argue (and disrupt class for everyone) a lot more than those with no field time. This observation from teaching and preceptoring twenty times longer than you've been practising, so it's not a rash assumption. Didn't think you would provide a rash assumption, so I accept your statement. However, let's agree that there will always be that personality type (with or without experience) who will be "that person".

Sorry Toni I have to disagree with all of your points to rationalize this position, I will not go into anecdotal stories, of I saw this once and that guy .... It would be a sad thing if we all agreed all of the time.

All gradate Paramedics DO HAVE field experience,called field praticums and hospital clinicals but guided and supervised by trained educators, so the students don't kill anyone, because they "didn't know" just like in a thing some call MEDICAL PRACTICE.(ps because that is what we do!)

Show me ONE only "book trained" not evaluated in the field, Paramedic, and I will show you a failed education program.

Besides the fact that "parroting" pneumonics is SOP in basic EMS .. this does not teach critical thinking, diffencial diagnosis, or evidence based medicine, this is how to teach monkeys.

IT IS THE BIGGEST SINGLE PROBLEM with this so called profession and if we DO NOT ABANDON this stepping stone education concept EMS is doomed to be first aiders and falsely glorified "life savers"

I can't tell if you are really against me...or not. I apologize, but I'm having difficulties with your post. What "IS THE BIGGEST SINGLE PROBLEM"? Not providing field experience (which, by the way, is way not what I was saying)? Before I open my mouth (or let my fingers loose), please clarify your point.

I am of the "you need EMT experience" camp. I think for you personally it might be worth considering moving forward with the EMT-P if it is getting paid for, but I do believe in general that experience as an EMT is essential to the development of an effective paramedic.

-Prospective paramedics need to know what they are getting into. EMS is not what outsiders think it is. The last thing we need is an influx of new paramedics who find out that this isn't what they bargained for. Pay your dues. Work as an EMT, and then go to medic school for the right reasons.

-Etc.

Fiz - Love your post! Especially the point I copied above regarding prospective paramedics. Yes, it would suck to get through the full program to say, "Ummm. Maybe not."

Has nothing to do with clinical knowledge or training, it has to do with having been by yourself with a critical patient and knowing what its like. You all want to jump on me and attack you can all you want but that guy is still going to be a crap medic. Experience in medic school riding as a third? Fail. Nay, epic fail.

Go ahead and whip yourselves into a frenzy now.

Xselerate - be careful. We didn't ALL jump on you. I count at least two on your side here.

[zippyRN]

No one should go straight from emt to medic. You need time in the back of a bus (ambulance) by yourself with a patient in need to have the clinical experience to make you ready to be a decent medic.

If that is the case all it actually indicates is that the local programs are poorly designed and constructed courses, inadequately delivered. Here's a clue does anywhere else in the world actually mandate a period working at a lower level (in a substantive role - rather than as part of the training pathway having hired you as a Trainee Paramedic) before progressing to paramedic, or have they grown out of this ... ditto with other roles in healthcare ?

Edited June 13, 2011 by zippyRN

[tcripp]

Here's a clue does anywhere else in the world actually mandate a period working at a lower level (in a substantive role - rather than as part of the training pathway having hired you as a Trainee Paramedic) before progressing to paramedic, or have they grown out of this ... ditto with other roles in healthcare ?

If no one can agree, how could there ever be a mandate?

[usalsfyre]

Where are all these people getting "experience alone with critical patients" as a basic? The number of BLS ambulances in many parts of the US is very low, and usually >50% transfer services.

As to interview, operational integration, ect. That's all medicine in the EMS environment. Physicians don't learn just "medicine" during residency, they learn how to deliver it. Which is what any decent service should be teaching during internship.

Per my anecdotal experience as an FTO it is far easier to take someone new and train them to follow the expectations of your organization than it is to undo the bad habits of someone who has idolized their turd of a lame paramedic partner for q couple of years.

[zippyRN]

If no one can agree, how could there ever be a mandate?

note the phrase ' elsewhere in the world ' in my previous message , i.e. comparators from outside the USA.

[tcripp]

note the phrase ' elsewhere in the world ' in my previous message , i.e. comparators from outside the USA.

Sorry. Took your phrase as figurative and not literal.