No NR test??

[Ridryder 911]

Again, most people are not aware what minimal competency means and represents. Basically, just enough knowledge not to kill anyone. So yes, NREMT, and every other state (no matter which one) is going to be the same.....why ? Because they all use the same national curriculum, and until that changes, we will continue to have uneducated, poorly skilled personnel.

So while the states foolishly spends their money on designing and organizing new test, to be in a pissing contest with NREMT, nothing new is accomplished. Okay, maybe a higher pass rate because their students could not read a 6'th grade level EMT test.

If you are going to criticize NREMT, then you should be criticizing the system. They are only a testing agency.. that is is it. Nothing more....They don't develop the criteria to test, only test in what has been presented to them. This would be like comparing the Bar examination for attorneys, describing since the exam is crappy, it the examination's fault of knowledge of attorney's.. no, you would place it on the education and curriculum agencies.

As well, as the old saying "you pay, for what you get" could be true. Most EMT's are very ignorant on the costs of most medical license, board examinations. In comparison <$100 to those of nursing of usually ranging from $200 to 500 per examination.. and you don't even get a patch !...lol

For those that criticize, have you ever attempted to change things? Are you actively involved in legislation and curriculum review and even have a knowledge who develops the curriculum?... I have learned over the years that is very easy to criticize, but harder to change things.

Be safe,

R/r 911

[JakeEMTP]

The NCLEX is set up a little differently that the NREMT exams. Like the NREMT the goal of the NCLEX is to test someone to a minimum competency level. As you take the exam the questions get more complex and head toward the set minimum competency. If you start answering incorrectly, the questions become less complex. This game of getting more complex as you answer correctly and less complex as you answer incorrectly goes on until it is determined that you can consistently answer questions correctly in the minimum competency level or you cannot answer questions in the minimum competency level. One that is determined the computer will stop spitting out questions and you are done. This can be as little as 75 questions or over 200 questions. You are not graded on a percent correct, but solely on you ability to achieve the minimum standard for competency. It is a little complicated, but I hope that helps.

Take care,

chbare.

Thx for explaining this chbare. I appreciate it and now have a better understanding. 8)

[chbare]

JakeEMT, no problem.

Take care,

chbare.

[paramedicmike]

So what do people think of this as a potential solution? Not that I think it'll get very far but just for S&G...

Maryland requires NR for both their I and P level providers. Once you've successfully completed the test at your respective level, you take a state test on the statewide protocols. Pass that and you're good to practice anywhere in the state. To continue working you maintain your registry cert and complete protocol updates as they are made.

I realize that not all states operate on a statewide protocol system. (I think they should but that's another issue altogether.) Would a program like this keep the states happy in that they still have their politically corrupt hands in the pot while maintaining some level national standards?

Just thinking out loud...well...sort of.

-be safe.

[Ridryder 911]

Although state protocols have some definite merit, I also see a potential restriction or may even the opposite of allowing ones to perform care not up to standards or control.

I agree Mike, there should be some continuity in at least general scope of care (gulp) a national scope of practice .. It is a shame, that it became such a political battle and lost it's goal and mission. Now, whenever you hear such .. snickers or waves of nausea approaches some. This could had lead to easier reciprocity for most and have the state(s) develop their own scope of practice (similar to nursing). With this diversity in career, career ladder, and educational opportunities could had been developed. Another possibility of the EMS being a profession shot down by political and focus groups agendas.

Many in EMS do not know how licensing boards operate or even having a authority board over them (not to be confused with EMS divisions). A professional board composing of actual members of EMS, could be placed knowing the needs of the community and local profession.

This again if properly had been performed could had opened the door for many EMT opportunities.

So what do we do now?

Become very involved in local, State, & even National EMT associations. Over-all, I could probably predict that most EMT associations are being managed and ran by the same "old" group that has been doing for years. Their agenda and your may not be the same. Change it...Do you know your local and state EMS division personal by name? .. Do you know when the state EMS meetings and policy, rule committees meet?..

Are you still certified instead of licensed ?.. How is your state educational standards?.. Look at how many EMT's in comparison to EMS agencies, is there a flood of EMT's, but no jobs ..?

Get involved, get your crew involved, it really does not take much time.. a few minutes a day on the phone, e-mail your legislature, etc.. Expect confrontation, change (good or bad) will always get attention...

If you expect someone else to do it... it will never happen, tired of the same old B.S., then change it !

Be safe,

R/r 911

[Dustdevil]

Just like every other question, problem, dilemma and quandary facing EMS, the answer to this one is one simple word:

• The whole "scope of practice" debate was and is a complete joke. It was destined to fail from the very beginning for one reason: again, education. Debating scope of practise is putting the cart before the horse. Until there is a nationwide standard of education (as opposed to training) that reflects a professionally educated workforce, the debate is headed nowhere. I damn sure know I would not vote for an advanced scope for US EMT's or medics with most of them being so pitifully trained and uneducated. And neither would most of the movers and shakers in this industry. It is one of the biggest reasons why, in the end, even staunch supporters like Dr. Bledsoe (author of the most popular paramedic textbook and a former paramedic) backed out of the push for a national scope of practise. Nobody was willing to raise their educational standards to a point where anybody with half a brain would advocate advanced practise.

So that's the answer. Education. Improve it drastically and our profession will improve drastically in every conceivable way. Scope of practise. Pay. Respect. Recruiting. Conditions. You name it. This really isn't hard to fix at all. The problem is, as is clearly shown by this particular thread, more than half the people in EMS don't want no more of that book learnin'. They just want more drugs, more skills, more respect, and more money for the 120 hours of training they already have. :roll:

[cosgrojo]

Just like every other question, problem, dilemma and quandary facing EMS, the answer to this one is one simple word:

• The whole "scope of practice" debate was and is a complete joke. It was destined to fail from the very beginning for one reason: again, education. Debating scope of practise is putting the cart before the horse. Until there is a nationwide standard of education (as opposed to training) that reflects a professionally educated workforce, the debate is headed nowhere. I damn sure know I would not vote for an advanced scope for US EMT's or medics with most of them being so pitifully trained and uneducated. And neither would most of the movers and shakers in this industry. It is one of the biggest reasons why, in the end, even staunch supporters like Dr. Bledsoe (author of the most popular paramedic textbook and a former paramedic) backed out of the push for a national scope of practise. Nobody was willing to raise their educational standards to a point where anybody with half a brain would advocate advanced practise.

So that's the answer. Education. Improve it drastically and our profession will improve drastically in every conceivable way. Scope of practise. Pay. Respect. Recruiting. Conditions. You name it. This really isn't hard to fix at all. The problem is, as is clearly shown by this particular thread, more than half the people in EMS don't want no more of that book learnin'. They just want more drugs, more skills, more respect, and more money for the 120 hours of training they already have. :roll:

Dust-

I agree with your premise, and have agreed to this rant a number of times. But I don't see that this is feasible. It would be wonderful if the educational requirements were to a level where we could attain universal respect for our professionalism, but it is not such an easy road to hoe. It would take a concerted effort and dedication to the "vision" by all in EMS, plus the "movers and shakers" that you referred to.

What is required here is an entire industry to adopt a paradigm shift. This is not easy (I ask you to refer to any thread that discusses the nature of Fire Services controlling EMS). This revolution cannot be attained through minor improvements such as Rid has suggested. Getting together with your locals and improving the education of your particular area and people are commendable, but without the thrust from the industry, it will not catch on.

In order for us to improve ourselves on a global scale, we would need to make a few things happen first:

1. Unify as a collective, have everyone from the top down agree with and move toward increased educational requirements.

2. Stop working for free, nobody can take us seriously if we have 80% of our workforce agreeing to respond from our homes (and without pay).

3. Wrest our industry away from the fire services and stand on our own feet.

4. Recognition from the government that we are an essential service and offer to fund the enhancement of EMS through grants and financial aide (which would happen easily if we stopped working for free).

There are probably more things that need to be done in order to facilitate wide-spread change in EMS (and feel free to add), but I believe these to be most important.

Those are my thoughts on the subject...

Peace out.