Perceived or Real? America's Paramedic Shortage.

[UMSTUDENT]

While in class today, my professor made a comment about the "approaching paramedic shortage." It equated to light at the end of the tunnel for a dozen or so individuals looking at getting into the leadership echelons of EMS.

This guy is very well educated, is well credentialed, and works administratively for a nationally recognized flight service. He reads the literature and seemed realistic about many of the problems facing our profession. He's an adjunct instructor teaching a fairly specialized area of EMS. Cool guy!

Do you think there is, or will be a paramedic shortage? He compared it to the nursing shortage in the late 80’s and early 90’s. He seemed to believe that pay increase, professional recognition and a decent living will shortly follow. He did mention higher education standards (seeing as he’s teaching at a university), but definitely put stock in the supply and demand theory.

I’d like to hear everyone’s thoughts on the matter. What do you think? Is there a shortage in your area? Is it all smoke and mirrors?

[AZCEP]

It comes down to what you use to define "shortage".

The nursing situation came about from large numbers of nurses not wanting to deal with the day-to-day issues of patient care in many different facilities. Fewer nurses holding jobs that traditionally required a nurse leading to a perceived shortage. The nurses were still out there, they just didn't want to deal with workplace issues any longer.

I welcome any clarifications that the numerous nurses here can offer, but that's how I understand it to be.

The paramedic shortage could be along similar lines, and it is all of our own doing. We want better educated providers, but what do we do to accomplish this? We want better working environments, but what have we done to this end? EMS still does not have a cohesive relationship within it's own ranks, and we expect things to improve?

Smacks of the definition of insanity, does it not?

[PRPGfirerescuetech]

There was a recent article regarding this in JEMS actually, and yes, im too lazy to go find it.

Paramedic shortage? Nope.

Paramedic decreasing? Nope.

Well, i guess these two statements would be true if we began to utilize ALS providers at a systematic level appropriately, hmmm?

[Ridryder 911]

There is not a paramedic shortage, there all disguised as "greeters" at your local Wal-Mart. .. (not joking)

The difference between EMS and Nursing is the way of dealing with the potential shortage is multi faceted:

1) It is way too easy to be a Paramedic, within 9 months the shortage can be corrected. If it was hard and time consuming, there would be no volunteering. After a student loan of $40,000 .. I doubt anyone would be "donating" their services all the time.

2) Where as nursing has held their ground and refused to lower level of education... EMS has decreased and gone the opposite, lowered, made on line, expedited (weeks long) courses.

3) Like others described there are Paramedics out there, but where is the money ? As well communities that could afford paramedics, can get them for free as volunteers.

4) There are too many "pseudo" paramedics.. EMT/fill in the blank . Over 156 assorted titles and flavors .. that can always ...' perform similar, or almost like a Paramedic, but; much cheaper! ... and the company can get reimbursement the same as having the real thing.

So to answer your question, yes at one time it appeared to be there might be a shortage. But, thanks to those involved in EMS we have ruined any chances of taking advantage of the supply and demand. As usual, we ruin a good thing.....

R/r 911

[NREMT-Basic]

As I can testify from the difficult in finding gainful Basic work, there is no shortage of us running around out there since we are multiplying like rabbits and generally its the first guy in the door who gets the job. However, Ive done some research and I differ a little with the other posters. The median ages of people going into EMS is getting younger (in Illinois you have to be 18 and many people are going to EMT courses right after high school, as they would have CNA classes a few years ago) so there are lots of people out there with their EMT cards in their pockets, as Rid rightly said about medics, working at walmart and mcdonalds. However, in my home city of about 30,000 people and the next city of about 400,000, there are three hospitals offering Paramedic programs. I called them all three days ago and they either just finished a Medic school, or are finishing it up now. All three directors said the same thing...because of the educational level of many people coming out of high school (ie poor math and literacy skills, poor written and verbal communication, etc) alot of people do not look at going on to Medic school, or at least not right away. In the agency with which I did my clinicals, there were Basics who were my age (early 30s) and had been medics for 10 years. One of them has taken the NREMT-P twice and cannot pass it. If somehow this cross section of people do find their way into the paramedic arena, they will not be good and will not last long. Another factor to consider is the "greying of America": a significant part of our population is now living to be 90 or older...these folks tend to need a great deal more medical care. Finally, the Department of Labor anticipates that Paramedicine (and actually EMS in general) will be the fastest growing, non-physician medical careers through at least 2010. That being said, I have to reluctantly agree with other members of the City who say that the overall quality of EMS responders is going down. I was recently in a hospital after a volly run and heard one of the medics from a large midwestern service talking to his buddies...he had been a medic for about 18 months and as he said "got the chance" to do a needle crych. However, he couldnt manage it by the time he got to the ED. Now I will admit not being advanced enough yet to understand all of the ramifications, what he could do when this didnt work, etc...but its true that around the country, paramedics protocols are being limited because people simply are not willing to put in the thousands of hours of skill practice that is required. There may be no shortage of medics at the moment in the US, but there is a shortage of excellant medics. And honestly, in my area where there are enough services to make most transport times between 6-8 minutes, the medic often finds him/herself taking vitals, giving nitro/asa, starting a line and making his report to the receiving facility and thats about it. Wounds are bandaged on scene, usually by the Basic as is splinting and many people have figured out that they can often get a free check up by calling the ambulance and then signing the refusal form.

What we must do in order to create a demand for good EMS providers of all levels, is to raise the standards and start developing more progressive EMS services...check out services like Acadian, the largest single private provider in the country. They build their own rigs, have bike crews, marine crews, etc...they are on the cutting edge of what the field can be and they have their own Medic academy. If the profession is to flourish, we must expect more from our responders and start to see more services that are owned by someone other than some guy with the money to buy a few rigs. We need to see services started and owned by the practitioners of EMS themselves, meeting the needs of their own communities.

[emaxray]

It has become so hard to find work in OH that I am looking for reciprocity and moving to another state.

I think that answers the question, at least around here.

Edit: Rid, also come disguised as Subway employees, Burger King employees....

[Dustdevil]

An oft overlooked facet of the nursing shortage is the gender demographics of the profession. Especially in the 80's.

Think about it. What two professions in the US are in complete chaos? Yes... teaching and nursing. Now, what two professions in the US are overwhelmingly female? Yep, teaching and nursing. There ya go.

It is getting better in both fields as men begin to join in larger numbers. But in any profession that is dominated by a female workforce, you are going to have chronic staffing problems.

Conversely, more and more females are joining EMS. This will help us to create a shortage in the future, so yes... if we can just jack up the education to a minimum of two years entry level, we will have a wicked shortage for a few years. But it will not remain chronic as in nursing. In fact, it will stabilise within a decade and create an overabundance within a decade like in Canadia.

Problem with raising the education level is that it attracts more and better candidates. And you know how we see all these clueless n00bs now going to EMT school without spending a single minute checking out their career potential first? Well, that will continue to happen when an associates degree becomes the entry level. Possibly even more, because a lot of young idiots have listened to that tired old mantra about college being their key to success that many of them assume that a degree in any field guarantees them a wide open job market. Thus, instant glut.