Saskatchewan "Old School" practitioners forced to upgrade or DIE!

[Arctickat]

The College of Paramedics in Saskatchewan just released this survey which indicates that the old designation of EMT will be phased out by designating such practitioners as EMRs unless they choose to participate in a bridging program to match the NOCPs. I have mixed feelings...if only because I am one of the "Old Guard" EMT-Ps. My current training level has been frozen. Although I have 30+ years of experience and have been involved in educating and training for almost as long, I am not permitted to provide new treatments or administer newly approved meds because I do not have the "training foundation" that the Advanced Care Paramedic training provides.

I'd link you to the actual survey page, but I fear that you all might be tempted to respond. lol

Here are the questions:

PCP Scope of Practice Survey

As members of a health profession privileged to be granted self-regulation, paramedics have accepted legal and ethical responsibility for their individual work and behaviour and hold the interest of the public and society as paramount.

Scope of practice for paramedics in Saskatchewan is set by the Minister of Health and SCoP, through The Paramedics Act, the Regulatory Bylaws pursuant to The Paramedics Act, related policies, as well as the Saskatchewan Emergency Treatment Protocols that have been approved by the College of Physicians and Surgeons. The revised National Occupational Competency Profile (NOCP) has recently been endorsed by the Canadian Organization of Paramedic Regulators (COPR). The NOCP have been used as the national benchmark for paramedic standards and Canadian Medical Association (CMA) approved programs.

In keeping with the NOCP standards, SCoP sees values in aligning with the following licensing levels: Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP), and Critical Care Paramedic (CCP ). The Intermediate Care Paramedic (ICP) is a vital link in the health care chain and SCoP will continue to license qualified ICP practitioners in Saskatchewan.

In addition, SCoP hopes to increase the scope of practice for the PCP. There are two main subject areas that are anticipated to be included in the new PCP upgrade training. This would include Pharmacology and Intravenous (I.V) Therapy. The Pharmacology Course may include administration of symptom relief medications. The actual list of medications is yet to be finalized. The I.V Therapy Course would include initiation of I.V fluid therapy as required in various medical and traumatic patient conditions. There would be other subject areas of review such as patient assessment, medical emergencies, traumatic emergencies, cardiac and respiratory emergencies, etc.

In following with the Strategic Objectives of SCoP, we are seeking input from the various stakeholders and members by requesting that you complete the following survey.

1) If you are EMT trained and have not yet taken the current PCP upgrade training (NOCP 2001), would you be interested in completing the current PCP upgrade training or would you prefer to be licensed at the EMR level?

2) If you are PCP trained, will you be upgrading to the new 2011 NOCP standards or would you prefer to be licensed at the EMR level?

3) What support mechanisms do you have to assist you with taking the PCP upgrade training? (ie paid time off, flexible work schedule, etc.)

4) SCoP is reviewing the use of a combination of delivery methods indicated below for the new PCP upgrade training. What do you think of EACH of the following components to this proposed delivery format? a. a take home study package to be completed prior to class; b. approximately 80 hours of scenario/skill review/evaluations; c. competencies to be completed in a clinical setting. 5) Intravenous initiation is one of the new skill sets proposed for the PCP practitioner. Presently, a set number of I.V. starts need to be successfully completed under supervision prior to the trainee initiating I.V. therapy. How many I.V. starts do you think should be completed under supervision?

6) Considering that there are potentially 1300 PCP’s that could be enrolling in the new PCP upgrade training, clinical space will be challenging to schedule. Do you have a proposal on how to complete the clinical requirement of I.V therapy?

7) SCoP is considering adding some pain relief medications to the PCP scope of practice. The final medication list is yet to be determined. What medications do you think would be relevant to the PCP?

8) In keeping with the NOCP standards, SCoP plans to move towards the following licensing levels: EMR, PCP, ACP, and CCP. In preparation for this change, SCoP recognizes that there are approximately 200 practitioners who have remained at the EMT trained level. What time frame for completion of the PCP upgrade training (NOCP 2001) would you consider appropriate? Why?

9) In keeping with the NOCP standards, SCoP plans to move towards the following licensing levels: EMR, PCP, ACP, and CCP. In preparation for this change, SCoP recognizes that there are approximately 1300 practitioners who are at the current PCP trained level. What time frame for completion of the PCP upgrade training (NOCP 2011) would you consider appropriate? Why?

10) Any other comments?

[Arctickat]

Oh, and these are the NOCPs. http://paramedic.ca/nocp/

[emtdennis]

What do you mean your current level has been frozen? Will you get a chance tu train into the new protocols?

[Arctickat]

Not at my current level. When the ACP concept was introduced 10 years ago the scope of practice was identical to that for the EMT-P, but a bridging program was provided for EMT-Ps who wanted to upgrade their certificate to a diploma. Since it had no effect on me and did not provide an improvement in patient care at the time, I saw little purpose in spending the money on a course lasting 2 weekends that would have the sole benefit of changing three letters in my certification status.

When the new NOCPs were introduced in 2011 it was decided to freeze the EMT-P level and prohibit us from utilising any new protocols. There are currently 35 of us left in the province, we can continue with our current scope but can not add to it.

As far as the PCPs go, as stated in the document, the current 200 of 1500 BLS providers who are still EMTs will revert to EMR status unless they take two upgrade classes, the duration of which have not yet been determined...possibly in the 2 - 4 week range in total.

[BillKaneEMT]

Not at my current level. When the ACP concept was introduced 10 years ago the scope of practice was identical to that for the EMT-P, but a bridging program was provided for EMT-Ps who wanted to upgrade their certificate to a diploma. Since it had no effect on me and did not provide an improvement in patient care at the time, I saw little purpose in spending the money on a course lasting 2 weekends that would have the sole benefit of changing three letters in my certification status.

When the new NOCPs were introduced in 2011 it was decided to freeze the EMT-P level and prohibit us from utilising any new protocols. There are currently 35 of us left in the province, we can continue with our current scope but can not add to it.

You're saying they froze you at emt-p and you cannot move to a higher level? That's insane. I assume I'm just not comprehending some aspect of this situation due to ... I dunno. Cultural differences I guess?

Ok. 10 years ago Advanced Care Paramedics appeared and they were identical to EMT-P's in scope of practice. They had diplomas as opposed to certs though, so existing emt-p's were offered the chance to get diplomas through a bridge program. I get that part. It didn't effect you or improve your pt care so you took a pass. I get that. They release the new National Occupation Competency Profile in 2011 and suddenly the Advanced Care Paramedics, who up until now have been identical to you in scope of practice, can continue adapting, accepting new protocols and improving their patient care abilities in myriad ways while YOU are stuck in your current place? You don't get, for example, some new meds when they're approved for use on the rigs by ACP's?

Assuming I misunderstood things, then I apologize and blame lack of coffee. Assuming I didn't misunderstand then that's just silly. Unless I'm missing some other aspect of the situation. Since my coffeemaker is taking it's sweet time today that's entirely possible. I require caffeine to function. I don't expect my car to run on no fuel~!

[Arctickat]

You're saying they froze you at emt-p and you cannot move to a higher level?

I can bridge to the ACP level with an online conversation with an instructor, a 4 hour skills lab and a $400.00 cheque.

You don't get, for example, some new meds when they're approved for use on the rigs by ACP's?

Correct. I will have no further enhancements to my scope of practice unless it is something added to the PCP level practitioner or I upgrade to the ACP.

I'm sorry, I am actually causing some confusion because I am discussing two seperate topics. The other topic in this is that the EMTs are also not just frozen...but reduced to EMR level. If they want to continue they will be required to take the PCP bridge and then another training session to reach the 2011 NOCPs.

[J306]

All I can say is that I sure am glad that I'm taking my ACP now. I honestly do not know how they will pull this off... I'm thinking it will most likely be offered as online modules and in-service training which will be added towards the providers annual con-ed points.

It also seems as though they will be expecting the health regions to provide practical training grounds to evaluate the newly added NOCPs. I think it's very unfair that they would demote or "freeze" any providers licence level because of ScoP's lack of foresight and lack of transparency.

[mobey]

I think it's very unfair that they would demote or "freeze" any providers licence level because of ScoP's lack of foresight and lack of transparency.

I disagree.

I think they are demoting those hillbillies who are still harming and refusing to treat patients based on their 1976 2 week EMT course, and 30 years of repeating the same "scoop and scoot" bullshit transport on every patient.

There are some very very poor practitioners in rural Sk (and Ab) and I think this is a great step towards a "S**t or get off the pot" motivation pushing them back into the classroom to increase competency, or off the ambulance.

Until you do a ALS intercept to a unconcious preggo with a C-collar upside down, and a NRB at 4lt, you may not understand

[J306]

I disagree.

I think they are demoting those hillbillies who are still harming and refusing to treat patients based on their 1976 2 week EMT course, and 30 years of repeating the same "scoop and scoot" bullshit transport on every patient.

There are some very very poor practitioners in rural Sk (and Ab) and I think this is a great step towards a "S**t or get off the pot" motivation pushing them back into the classroom to increase competency, or off the ambulance.

Until you do a ALS intercept to a unconcious preggo with a C-collar upside down, and a NRB at 4lt, you may not understand

I understand where you're coming from, and I have also worked with some terrible providers whos skills are no where near what they should be.. However, I have also worked with some excellent providers who have been working as EMTs for years and have kept up their knowledge base and skills and I don't think that we should throw the baby out with the bathwater.

Just because they took their training in 1976 doesn't mean that their designations should be demoted. That was all that was available at the time. If a more indepth and challenging course was available at that time, I'm sure a lot of them would have been willing to take it. Look at the RN program for example. It used to be a diploma program and they have now switched the course to a full degree. This doesn't mean we should demote the RNs who took the diploma to LPNs just because they took a 2 year program and not a 4 year one.

I agree that the oldschool "scoop and scoot" providers who have no interest in advancing their training or competency are holding us back as a profession, but that doesn't mean their title should be demoted to an EMR status "just because." We should have all providers do skill testing along with an annual knowledge exam to advance our profession and the problem will be corrected.

[BillKaneEMT]

I see what you're saying Arctic. They're eliminating the EMT-b designation altogether and locking you up unless you pay em and take a 4 hour course. Staying locked is a bad option so you'll probably have to pony up if you want them to keep you current on treatment options. For the emt's I guess they're just screwed unless they can come up with the tuition for PCP school. Are they totally eliminating BLS rigs or are they going to have the new EMR's still working them? Also, how tough is it to get loans for school up there? I'm probably going to have to get a family member to co sign a loan for me this spring, my bank pretty much spit in my face when I checked into student loans.