Profession or Occupation

[medic366]

When I think of professional groups, I envision governing boards who help identify educational needs, entry requirements, standards of conduct (professional ethics), and ability to issue or revoke (or recommend) licenses/certifications. Rules, regulations and standards of practice are also part of the mix which a governing board would guide its members.

We are moving towards national accreditation through CAAHEP, at least at the paramedic level, which will help drive the transformation of an occupation to a profession.

The ability to increase educational requirements for all members, national recognition by other health professions, and mobility within will strengthen the movement to become a profession.

After over 40 years of teaching and working as an EMS provider, I have observed many changes in abilities, attitudes of providers as well as acceptance by other health care professions. I believe we are on the cusp of being a professional organization, thanks to many leaders who are taking strives to make it so.

[Ridryder 911]

Unfortunately, EMS will be considered an occupation because of our own demise. Professionals, usually require the minimum of a college degree or not being able to proceed any higher within their occupation (i.e physicians, attorneys, engineers, etc) You may not like the nursing profession, but over the past 40+ years they have rallied to see that most stand alone (i.e hospital based) programs have almost eleminated. You will find almost everyone is associated with some form of academic educational site.

Now, with NREMT bashing. True it is a testing agency... BUT .. without their push and drive of many of their ideas and encouragement, there would be no accrediating EMS education sites, local yoal Paramedic exams would be the norm. If you think paying more than a $150.00 for a professional test is high, obvioulsy one has not taken many professional level test, don't believe me .. just Google any CEN, CCRN, or even RN NCLEX exam. The chances are, your local territory i.e State/City etc. has attached fees causing the costs.

Alike NCLEX for nursing, NREMT is more than a test generator. they also conduct many formal and national surveys to see where EMS os heading; the highs and lows as well. This is scientic data not just someone sending out radomn questionares. If one really wants this to become a true profession, then yes; we should look at the agency the performs the most used test that validates those that work in this field. Testing (developing, formatting, etc) for a professional level; has many componets that the majority of EMS providers are not qualified (most do not have a PhD in academics, statistics, testing, etc) that ensures professional standards.

I do not work for the NREMT; and yes, I agree there are definitely some problems within the organization (as they will tell you too) but: I have been on many test writing committees and sessions and have seen and met the professional staff. I have discussed and heard some of their ideas on what they would wish to see EMS go forward. They could only profit more if those in EMS could become more professional.

So to the original post; yes we are a given profession/occupation. We need to become more professional within this. We have a long way to go before it will really become one. Beginning at minimal entry points for Paramedics (degree level) , educators have a minimal graduate degree (alike healthcare provider programs); administrators are educated within the health care business. Our standard of care is based upon clinical evidence and standard of proof; not tradition or just protocols. We start enforcing professional standards and professional ethics within each chapter, courses, clinical sites that educate.

It can all be started first by looking at self first and be sure that we are leading the example.

R/r 911

[Caduceus]

This is an interesting question I have been trying to answer for my parents. They're less than keen to let me get into pre-hospital EMS because they view it as an occupation, and as others have stated here, its quite obvious that in some views it is.

What I'm wondering is if I obtain a Bachelor's degree in paramedicine, can my personal career be considered a profession? I have personally noticed EMTs and paramedics are oft looked down on by the public (some of whom have not directly required their services, some of whom have) because its considered a job you work on your way to other jobs. But as IslandEmt said, it really depends on the individuals future plans, education, and attitude toward the job.

[island emt]

WOW Talk about a blast from the PAST:

Welcome back Rid.

We have come a long way in the past half a Century as far as Emergency care for folks needing it.

When I started working on an ambulance , requirement were not much more than advanced first aid & a strong back.

Emergency care back them was pretty much bag & drag. Some services had oxylators and basic bandaging & splinting materials.

It came about as a result of the 1966 "White Paper" Accidental death & disability:

It is good reading for all the youngsters in our profession as to how we came to be where we are today.

Accidental Death and Disability: The Neglected Disease of Modern Society, more commonly known as The White Paper, was an influential report published in 1966 by the National Academy of Sciences that is considered a landmark in the development of the emergency medical services system in the United States.^[1]

The National Academy of Sciences—National Research Council Committees on Trauma and Shock, a federally funded department of the government, published the report of their research which concluded, in part, that both the public and government were "insensitive to the magnitude of the problem of accidental death and injury" in the U.S.; that the standards to which ambulance services were held were diverse and "often low"; and that "most ambulances used in this country are unsuitable, have incomplete … equipment, carry inadequate supplies, and are manned by untrained attendants."^[2]

The report led to the design and implementation of the first federally qualified ambulance services and personnel. The reforms inaugurated by the publication of "The White Paper" led to higher quality care provided on-scene and in-transit by trained paramedics and EMTs.

Today we have gotten to where most services are providing Paramedic level advanced life support and many of them are now degreed Practitioners of Paramedicine.

Yes there are still a lot of technical schools folks practicing, but as time goes by the level of education is rising as are the standards of care we are providing based on true evidence based studies.

Are we there yet ???? No,

But as the saying goes ::: WE'VE COME A LONG WAY IN A SHORT TIME BABY.

ED

[paramedicmike]

Welcome back, Rid. Stick around for a bit, won't you?

[Ridryder 911]

Thanks for the welcome back, nice to see all of you here again,

I do hope all those that are newer in EMS will read the White Papers. You cannot go forward, without knowing the past. If you read the details, the emphasis was never to develop Paramedics rather place surgeons or physician to go with the rescue/ ambulances. Well, we know how far that went....

Ironically, it was the list of many things to do for the Johnson (LBJ) administration (I believe number 14 or 16) on highway safety. Ironically, this is the first we seen the term Emergency Medical Service (EMS) and why we were associated with Department of Transportation (DOT) now called NHTSA.

Part of our demise or blessing? ...

R/r 911

Edited February 1, 2014 by Ridryder 911

[chbare]

EMS is a rather non-coherent concept. As such, it's very difficult to debate the vocation/occupation/profession issue. Some areas are very different; however, it would be hard to argue that EMS is a well defined profession across the board in the United States. I agree on the Registry. The exam process is pretty robust and validated IMHO. Compared to what I had to do with the NBRC exam process for RRT licensing, the NREMT CBT was simple and much more cost effective.

I wish I had a robust appreciation for degrees, but I'm not entirely convinced a higher degree will always advance a profession. My experience in respiratory therapy in my area of the country has enabled me to rethink long held beliefs about degrees, professional licensing and what that can do for things like wages, respect and advancement. Forgive me for making parallel assessments, but my experience in the educational and political arena of respiratory therapy has made a profound impact. Without a robust political machine in place that has significant funding, advancing a profession is difficult and education is not a magic bullet IMHO. Not that I'm opposed to education, but the occupation/profession discussion is far more complex than I knew. If EMS advances in the ways many professions have, we will undoubtably have to navigate these issues. Additionally, the drastically changing healthcare landscape in the United States will likely impact all professions/vocations involved in the greater health care machine of this country.

[Just Plain Ruff]

Thanks for the welcome back, nice to see all of you here again,

I do hope all those that are newer in EMS will read the White Papers. You cannot go forward, without knowing the past. If you read the details, the emphasis was never to develop Paramedics rather place surgeons or physician to go with the rescue/ ambulances. Well, we know how far that went....

Ironically, it was the list of many things to do for the Johnson (LBJ) administration (I believe number 14 or 16) on highway safety. Ironically, this is the first we seen the term Emergency Medical Service (EMS) and why we were associated with Department of Transportation (DOT) now called NHTSA.

Part of our demise or blessing? ...

R/r 911

I clicked on the link to the white papers in your post Rid and I got a link to Amazon for Cigarette rolling papers. HooRah!!!!