Should Paramedic Programs be CoAEMSP or let the states approve?

[emt2359]

Looks like the NREMT is getting pressure to allow states to approve Paramedic courses in leu of CoAEMSP.   

https://nremt.org/News/An-open-letter-to-the-National-EMS-Community-from

Is the CoAEMSP requirement limiting the amount of new Medics?
Should the states have control over the programs vs a 3rd party?

[yakc130]

Interesting. I have registry, and I did not receive an email notifying me of any of this.

[Just Plain Ruff]

19 hours ago, yakc130 said:

Interesting. I have registry, and I did not receive an email notifying me of any of this.

You will not get an email notifying you of this - the unfortunate thing is that they don't notify any of us of anything like this, we have to be proactive and read up on this on our own.  

 

I'm against this - plain and simple.  The new emt's and medics that are coming out of school and getting licenced are a hodge podge of quality over quantity. 

 

I had a brand new EMT get hired at my agency.  She had no idea how to put a regulator on a oxygen bottle.  She didn't know really what the heck a Long spine board was or what it might or might not have been used for.  Traction splint - yeah that is a long metal splint that you use if you have time.  

These people are being taught to the test and the test only.  Ask em to think critically and they fall apart.  I'm not saying they all do this but the majority of those I've seen are ill prepared to face a critical situation until they are hired and have a strong preceptor to hold their hand and tell em what to do.  They rely on just enough to get by.  

If we allow this change to happen and it WILL happen if not enough of us step up and make our voices heard, people are going to suffer and they will die.  Not to be a doom sayer and negative nelly but remember back to when you were a brand new medic. Remember how much you didn't know, now take away the degree aspect of the learning and put the licensure in the hands of an already strapped overworked state bureau of EMS to oversee dozens if not hundreds of new fresh emt's and medics taking their classes and learning and just how can an already strapped and overworked and underfunded and understaffed agency like the bureau of EMS  (Yes I know you like to bash your state bureau of ems because i do to) and expect them to take on even more responsibility in overseeing all these education programs and ushering in these new undereducated students - soon to be new providers.  Do you see the problems here???  

 

This is an awful rule proposal and it's going to get your grandmother injured or killed.  maybe not yours but someones.  

[FireEMT2009]

So, I am a paramedic program director (have been for a couple years now) Some of you who remember me from few years back will know I started out in the fire service, got my paramedic, and did rural EMS before landing into EMS education. I just want to make it clear I didn't go directly into education without paying my dues in field time.

 

I think this is a bad move for NREMT. It adds a loss of trust to hold EMS certifications in a higher standing as well as a loss of trust that they are acting in good faith. Let me explain why.

If you look at most any other healthcare profession, whether that be nursing, PA, NP, respiratory therapy, radiology technician, etc. They are all accredited programs and you have to be accredited by their one or multiple accreditors before you are even thought about being allowed to test. Accreditation means that you get reviewed every so many years (CoAEMSP which is the EMS accreditor through CAAHEP, does their reviews every 5 years with annual reporting every year). This site visit and comprehensive review makes sure that you are holding to the minimum standard expected by CAAHEP and if you aren't, what you need to do to get yourself straightened out. CoAEMSP luckily is not a hard-ass committee on accreditation that wants to immediately punish you and revoke your stuff because you missed something, but they act in good faith that they will inform you of your missing areas and give you time to get it straightened out and assist you in doing so if you ask. The current NREMT requirement of CAAHEP accreditation makes sure that all paramedic programs are at least meeting those standards. One of the biggest standards is that the programs are held accountable to what they require of students as well as mandating that programs do continuous internal reviews of their programs to improve them every time. This is hugely beneficial for programs in general but also improves our education and end level competency for our paramedics who are entering the field to start filling holes set forth.

 

How can this be seen as acting in bad faith? I see it as an act of bad faith because it makes all the work and stress of programs who had to meet and maintain the CAAHEP accreditation requirements and the money and time spent to do it a waste. Accreditation is expensive, especially initially getting accredited, whether that is going through CAAHEP programmatic accreditation or starting with institutional accreditation and then getting programmatic. It is also a huge time investment for the programs. Especially when you look at program directors. We see about a quarter of program directors leave the position each year in paramedic programs, a lot of the time due to the stress and hell that the job can be from time to time. Also, I don't think we do a great job prepping our program directors to transition well from EMS providers to program directors, but that is a different Ted Talk. NREMT made this requirement with a hard deadline all programs must meet (again some just needing to get programmatic accreditation while some had to get institutional accreditation then programmatic accreditation as you cannot get programmatic accreditation without institutional). This was done with the expectation, belief, and faith that NREMT would not back down from this requirement and it would hold true to that mandate. They started this requirement to mandate full CAAHEP accreditation or letter of review (meaning in process of gaining programmatic accreditation) as of January 1, 2013. We are now less than 10 years or two site visit cycles away from that decision and suddenly they have decided to back away from that mandate.

It is hard to demand our profession be respected, paid better, and recognized as the profession we should be when our own certification agency is willing to drop standards and burn all the programs that have been working to obtain, meet, and maintain these standards. I hate the comparison of EMS to nursing as its apples and oranges, but EMS and NREMT need to pull their head out of their asses and keep the accreditation requirements they have adopted just as all other healthcare professions have before us. Once you go back to "state approved", its hard to say what standards those students are being held to cause there may not be a third-party double checking them.