I can do that !. & you thought some of us were crazy !

[Nate]

I would take it further, combine your CNA/MA/EMT into one course. Thus you have three general levels:

[*]Doctor

[*]Nurse/Paramedic

[*]MA/EMT/CNA

I know some might find it degrading that I put CNA with EMT, but if you were to take the EMT or "tech" out of the ER they would be doing the same job as a CNA. Combination jobs would make it easier for those who wanted a change in pace to be able to jump from the ER to the ambulance with out taking a pay cut.

There are a few flight nurse/paramedics that I know of who enjoy being able to dabble in the ER, ambulance, and bird. It is also good for when you get close to retiring because if you weren't able to perform in an ambulance or helicopter, you could take a teaching/administrative position either in the hospital, ambulance service, or school.

You would gain the benefits of the various nursing associations, and you would see a huge increase in respect, pay, and demand for quality workers.

[retired_medic61]

I remember at the college I took my paramedic course we used the five volume series from Brady along with many other texts. The problem that my college faced was that a "private school" was offering the EMT-Basic in six weeks, the EMT-I in nine weeks, and the EMT-P class in three to six months. It is hard to attract new students when:

[*]your limited by the state at five semesters from EMT-B to EMT-P

[*]they strike really "cheap" deals with city services to send their personal there

[*]there is no one to answer too other then the DSHS

The college was limited in both hours, semesters, and budget. There are 5 major universities in the city of Houston (population 4,000,000); four very large community college chains (with 4 to 10 schools each); and countless small one campus community colleges. By far the best one has to be San Jacinto College, yet they have the lowest enrollment rate compared to the others. Why? Because HFD pays Houston Community College to teach it's paramedics because they just rent space, and HCC coordinates the whole thing. They also happen to have the lowest passing rate of them all. North Harris Montgomery Community College (NHMCD) has several campuses, and they have deals with most of the volunteer departments to provide "reduced" tuition to their programs. Their students do okay, but the minute they leave the safe haven of North Houston and walk into the low income South East Houston they are lost.

Paramedic education is a major problem, it is the reason why we are short staffed at my service. Simply put, we can't find any decent paramedics that can pass the test, make it through FTO, and not get weeded out once on the streets. You would think a paramedic would know better then to fake vitals, yet on his first day of FTO a new hire flat out lied. Why? We don't know.

I've given report to countless crews only to get that ghost look on the face of the crew after I just gave them a simple report. Have you ever noticed that EMS is the one field of medicine that doesn't really use all that much medical terminology? People like to say things like "we can't afford that," or "this is all we can afford out here," and my favorite one is "we just don't have the time to go back to school."

It is funny how almost every rural hospital seems to have RN's there, why can't they get educated paramedics? If so many people are still gung ho about volunteering, then why do they have such a problem conforming. Wouldn't they want to see these changes take place? You know education is an issue when you see a job discription that states the following: "ACLS, BTLS, PALS, preferred..."

I know which "private school" you are talking about and their pass rate is terrible. I know one quality Paramedic from that school.

I went to San Jacinto central campus and the education there was excellent and I know several quality Paramedics from there and several have gone on to nursing school and are now RNs as well. One in particular is a Flight Nurse and others are Critical Care Nurses.

[Nate]

Then you know Jay Could their paramedic instructor. I look back at the material we covered and you can align that with the DOT requirements and you see that he covered them all and went above and beyond and taught you more.

Between him, the clinical settings, and the intense labs; I feel like I really got a good education as an entry level paramedic. That is key, because that is all they say they can produce is an entry level paramedic. Unlike many other schools, San Jacinto understood that you can not teach experience.

That is the thing we have to get people, services, and college to understand.

[TechMedic05]

Every time I hear a medic (or EMT or PCP or CCEMTP or anybody else, for that matter) mouthing off about how their school was "too long" or even "long enough," or how they don't need or don't have time for more education, or bragging about how many "skills" or drugs they have, or whining about how they ought to have more, I just want to bitch slap them out of the profession.

Dust - I agree with you completely. And that's a great way to put things. But do we expect people wanting to get into this field to choose a two year [if not longer] degree program versus a certificate program for less money, less time, and lower expectations...For the same pay? You expect people to become educated beforehand? Or, even, I know many who don't even care the quality paramedic they are, because 'All Paramedics are the same, we are all NR, insert state here', etc. etc.

Jeeze, I'm going back to school :-P

[Dustdevil]

I agree. The temptation is great to the newbie. Especially the younger ones who still think life is a race and are all about instant gratification. And since the system basically tells us that it only takes 6 months to be a good paramedic, I certainly understand how those with no real knowledge or exposure can conclude that it is adequate for them. Unfortunately, when somebody gives you a patch and a licence, it only reinforces the belief that you are "there." And since the market is flooded with 1 month EMT's and 6 month paramedics with low intelligence and even less motivation, newbies are given no significant motivation to advance beyond all the other slugs.

It's our job to educate the new generation and expose the realities of the profession to them, showing them what they do NOT know, showing them how much more they could and should know, how important it is to them and their patients, encouraging them to continuously progress and improve themselves, and improve the profession as a whole. But more importantly, it is our job to lead by example. As long as only one out of several hundred medics they meet has bothered to earn a degree or otherwise improve themselves, we can't expect them to believe they need to do so themselves.

I can still respect the occasional family man who, not really understanding the profession, chooses the quickest route to entering the profession so he can get started feeding his family. You have to understand and respect that. But after that, it's time to improve yourself. I have no respect for the man who takes the quickest route to the profession, and then firmly plants his arse into the recliner chair at the station for the next twenty years without every going back to school. Matter of fact, I don't respect the one who plants his arse in the chair for only the next two years!

[Callthemedic]

Thank you very much Dust.

As you can see I've learned to edit even if I think a short post shouldn't have any need for it. :oops:

I had the opportunity to take a 6 month course at Southwest Medical. I could take in that information in 6 months pass the course, and the cert but I had the same kind of catharsis that dust was talking about. From infants to geriatrics, all the meds, the procedures, total responsibility for everything, your basic's actions................are they out of their f'ing minds?

I have since taken a step back and am going to take a 1 year cert, but only because I don't know of a longer one here. I'm going to ride out as many hours as my class schedule allows. I've got to apply the B material until I can lead someone else doing it at least.

I could lead an Army medic in daily tasks. just like Dust said, I look all the skill running sick-call and doing constant assessment and treatment in the field thinking that was pretty good. Now that I've seen descriptions and curriculum I'm thinking "Army medic is not much like a civilian one so this is largely new material"........damm, I thought it was hot stuff.

Why would anyone think they could go from no experience, or some experience to paramedic in 6 months?? Why would they want to wish that on themselves?

Not me. I'm not that selfish to my patients.

[kevkei]

I wholeheartedly agree with Bledsoe. These are the same reasons why many of us up north of you brag about our programs and why sometimes we come off as arrogant and eletist. More than that, it's because we are proud of our training. Personally, I used 18 textbooks for my program, I'm sitting at 4000 hours worth of training to become a Paramedic. Does this mean I know it all? Well, yes, but that's besides the point (kidding).

The moment we think we know it all, or stop making the effort to learn is the day we die as a good caregiver. On the subject of 'grandfathering' and 'I've been doing this for 10 years' our regulatory College requires all caregivers to upgrade their training because of a National Competency Profile as well as increasing our scope of practice ( seeAlberta GAP Training ). If you don't want to or refuse to do this, you lose your right to practice. Here is what is comprised in the upgrades, at each respective level.

EMR - Airway Module, Pharmacology Module, Trauma and MCI Module.

EMT - Airway Module, Cardiac Monitoring Module, IV Therapy Module, Pharmacology Module, Trauma and MCI Module,

EMT-P - Arterial Blood Gas Samples Module, Blood Products Module, Chest Tubes Module, Femoral Venipuncture Module, Intraosseous Module, Intrapartal Exam Module, Nasotracheal Intubation Module, Suturing and Hemostat Module

TCP Module, Urinary Catheterization Module.

The good thing with these areas is it will be a significant wakeup call for those that think they know it all or haven't picked up a textbook or journal or attended rounds in eons.

[Dustdevil]

I had the opportunity to take a 6 month course at Southwest Medical. I could take in that information in 6 months pass the course, and the cert but I had the same kind of catharsis that dust was talking about. From infants to geriatrics, all the meds, the procedures, total responsibility for everything, your basic's actions................are they out of their f'ing minds?

That's where I went to school. It was only 4 months back then. :shock:

You're absolutely correct. What most people fail to realise is that the accelerated shake-n-bake schools like that are almost all set up for one purpose: to put a patch on the shoulder of full-time urban firemen as fast as humanly possible so they can meet their numbers. Those guys are not being trained to work independently or with clinical sophistication. They are being taught how to perform at the minimal acceptable level for an urban environment where they will always be partnered with at least one other experienced paramedic and never face a transport time greater than ten minutes to a major medical centre. IV, airway, maybe a first round of prefilled cookbook drugs, then load and go. Hardly what any medic dreams of doing for his career. And hardly what the majority of medics end up doing with their careers. Definitely inadequate for suburban or rural practise, and arguably inadequate for even urban practise.

I would personally not hire a graduate of that program, or any other such program without significantly more post-graduate education and experience.

[Asysin2leads]

This was a great article and I agree with the good doctor. It reminds me of a time that an ER nurse friend of mine was telling me a story that happened in the ER with all the technical details, and I realized after the pont the patient had been cardioverted and intubated, I really had no clue what she was talking about. Seriously, drip this, rate that, lab values and such.she could have been talking Chinese. When she then asked my opinion on the subject, I had to admit I had no clue and I had spent most of the conversation letting the words go in one ear and out the other while I looking down her shirt. I didn't want to make it seem like it was a complete waste.

[TechMedic05]

Yeah. It's kind of funny, almost, up where I'm from. There are a couple Paramedic programs that are only certificate, where there's either a few month program, or a 16 month "Saturday and 2 night/ week" class, where expectations are quite different from the only degree program in the area, which has a 70 credit requirement. I know through all of the core classes, we never left a class early once. Actually, we rarely got out on time they had that much information on knowledge. And there still wasn't enough time. And "The more you know, the more you know you don't" is completely true. Even after several years of working, there's a huge difference between [most] of the degreed and non-degreed programs.

I'm still going back to school.