Hello of an EMT from Paris, France !

[WelshMedic]

Hi Secouriste and Fab,

@SC: well , I think you'll find that a strong fire lobby is a common factor in a lot of countries, certainly in the US! Good to hear that although there are different services that you have training to the same standard. I wish you all the luck in getting into medical school this year!

@fab: it's in Belgium where the nurse occasionally replaces the doctor. However they are bound by very strict protocols and need to call for advice for all but the most simple calls. Here in Holland EMS is nurse-led. It's been that way for the last 30 years and so we have developed far reaching protocols which include almost all ALS interactions (with the notable exception of RSI). We do have physicians available, there are 4 on duty that cover the entire country by helicopter. They are strategically placed in Amsterdam, Rotterdam, Groningen and Nijmegen. Both Groningen and Nijmegen regularly have calls over the border in Germany. So you see, it's a small world!

Carl

[Kiwiology]

I want to work in France, only because SMUR translates roughly to Mobile Urgent Reanimation Service (Service de Urgence Mobile Renaimaitone or some near equivalent, my French not so good) and that sounds totally badass!

[fab]

Hi Carl,

you work in the Netherlands? How come (assuming you're Welsh)? Where do you work? I've heard good things about your system and thought about relocating either for EMS or Med School, Groningen actually has an English BA-program (medicine). But then again I'm not much of a nurse (especially considering 5 years of training required) and Holland is not really my favourite country. Maybe Switzerland, I'll have to see.

[Secouriste]

Hey Fab,

In France it's 3 years to become a nurse, after that, depending on where you did your internships and where you work (once u get the diploma) you can choose almost any medical field to work in

I have friends who are now official nurses, I'll be happy to answer your questions if you have any.

Welshmedic: thanks! It will be very very difficult, no doubt!

[WelshMedic]

Hello both,

I am indeed Welsh but I fell in love with a dutch girl and married her. That's how I ended up here. The road to ALS EMS here is indeed only accessible via the nursing route. It's basically nursing school to post graduate critical care qualification and then into EMS. The whole process takes about 6-7 years as we also like candidates to have experience in the critical care field.

I am currently doing a teaching degree (BEd.) in order to teach nursing and EMS at college. I also run the placement program for nursing and medical students so if you are looking to hear more then I'm your man! I can also arrange ride-alongs but you'd have travel a bit far....

Carl

[paramedicmike]

I'm impressed with the educational requirements being outlined here in recent posts. This is a bit of a nonsequitur, but do you find that a good percentage of the calls you run are not critical calls and could have been handled by means other than summoning an ambulance?

[WelshMedic]

I'm impressed with the educational requirements being outlined here in recent posts. This is a bit of a nonsequitur, but do you find that a good percentage of the calls you run are not critical calls and could have been handled by means other than summoning an ambulance?

Well Mike, I think it's an interesting point you make there. The way that healthcare works here is that everyone is insured and so everyone has equal acces to primary, secondary and tertiary care. We have nurses in dispatch that triage calls and give appropriate advice. If an ambulance is deemed not necessary then the caller will be referrred to another pathway (usually the family practitioner but there are other channels, e.g. mental health services). If we do get called to someone that, retrospectively, doesn't need an ambulance I will refer them myself to one of the alternative pathways.

Carl

[paramedicmike]

Thank you for the reply, Carl. I rather like the sounds of the system you have in place.

[WelshMedic]

Well, it's far from perfect (for what it's worth I think the Australians have a pretty neat system) but we are regarded as an integral part of the healthcare team and not just 'ambulance drivers' which does make it satisfying..

Carl

[Richard B the EMT]

If an ambulance is deemed not necessary then the caller will be referrred to another pathway (usually the family practitioner but there are other channels, e.g. mental health services).

Perhaps mentioned on a different string, but if a medical need is there, but not requiring an ambulance, I know some jurisdictions (definitely NOT New York City) can and do send a wheelchair coach, here known as an ambulette, to effect transportation. WelshMedic, are you in one of those jurisdictions?