Volunteerism in Rural EMS

[rescue25]

... minimal level of an associate degree in EMS to perform...

I've heard a rumor that the local major teaching hospital & university (our nearby level 1 trauma center) is going to offer a four year baccalaureate degree in paramedicine soon. I'm still trying to confirm this, because it would wonderful and something I'd like to pursue. Currently the best you can get around here is an AAS and that's for paramedic. Are you suggesting an associate's degree for the EMT-B curriculum? And do you know of other universities offering bachelor's degrees in pre-hospital medicine (one that would allow you to write the NREMT-P exam at the end of the program)?

[Ridryder 911]

There are several B.S. programs that have been discussed (use search), most use the last 2 years for administration or education, etc...

I would think that all meet the standard curriculum and would allow sitting for the NREMT/P examination.

Albeit, a B.S. degree would be preferable, I do not see much employment opportunities for them over a AAS in the field setting.

Good luck,

R/r 911

[Rescue0ne]

The funny thing is, everywhere I have ever seen them eliminate volunteers in EMS and the fire service, I never saw all those people rush to find some other way to fill that need to serve their community. Not once. Never saw them organise a trash squad. Never saw them go drive school buses for free. Never saw them go feed prisoners for free. Never saw them cut the courthouse lawn for free. They just disappear. So much for that total BS about their need to serve the community.

A+ to DUST for the best rebuttal ever concerning that particular issue.

I have a simple way to find out true volunteerism. Require them to obtain the minimal level of an associate degree in EMS to perform, remove all identification labels, emergency lights, stethoscope around the mirror, multiple patches, etc. from their personal vehicles and persons. Require monthly in-services at the appropriate level, with failure requiring them to leave the service. As well as require clinical exposures for patient contact. After that, they would be able to maintain their certification level and volunteer as much as they want to.

R/r 911

I'd love for this to happen. It WOULD eliminate the bullshatters & useless elements.

What I'd also like to see is all volunteers manning stations &/or rigs while on duty. No more responding from home in POV's. If they care that much, they can sacrifice that much more, right? Personally, I don't think this is asking too much. I'm sure there are those that do. After all, sitting around the station is sooooo boring, right?

Alot of places do this with volunteers. Why can't it be the standard?

[akflightmedic]

I have to agree with the above post.

I started out as a volunteer and it was quite simple. Actually I thought it was the only way as the idea of responding from home in your POV was weird to me.

We provided coverage from 1800-0600 despite there being a strong county and city presence. My squad was just a hold out that refused to let go. I used to champion about vollie rights and why cant they leave us alone and do what we want to do. I never realized how ill equipped we were to project any semblance of professionalism. Those words meant nothing to me cause I didnt see a difference between professionalism and dedication. They are not synonomous.

I did see a lot of the stereotypical behaviors that have been listed repeatedly on this topic. I did not fit in that group cause I came to training nights ready to train and learn. I asked questions. I didnt mount a lightbar on my POV and I didnt wear a batman utility belt. Nor did I have 20 different tshirts stating " You have to be tuff to work a code in the buff". (I only had one of those..lol).

I was hired by the county relatively quick and soon realized while all the others were not, hence their reasoning for fighting for vollie rights. They just were unable to get hired for various reasons and the squad was a hobby. The city tried incorporating us several times, offered jobs and training if we would merge with them. But noooo, we are vollies and we fought for our rights. Oddly enough, we had public support as well to prevent the merger because the public was unaware of the true facts. All they remember was a time when we USED to be needed and we were volunteers so what was the harm. They care very little about education and training standards and quite frankly all they wanted was someone to show up when they called 911. The public for the most part did not realize there was a difference between us and the city. All they see are "medics" and ambulances.

Anyways, to make the long story longer, when you joined our squad, you had to ride a shift with every crew so all could get to know your personality and comfort level. After the introductory period, you were assigned to a crew depending on crew's medical needs and personalities. Once assigned to a team, you had a set schedule. You were on Team A,B, C or D. That was your night period. You came and rode from 1800-0600. You did not leave the station. This prevented people from jeopardizing themselves and others while responding to calls from home, it prevented people from picking and choosing which calls to respond to and it also prevented people overload on scenes.

You could swap nights with someone if you wished and if someone else signed up, you could also run a day crew. But if it was your night off, you took the night off. No need to allow it to consume your life and no need to carry a pager or radio on your hip everywhere you go. This allowed you to volunteer and have a life.

Remember, people will get hurt and die whether you are there or not. We have been doing it for eons and it is not up to you to save the world. The squad actually functions with or without you. It is a hard mentality to let go of, especially if you are die hard vollie but it is the truth.

[Michael]

Sorry, problem not solved: Some places make unpaid volunteering for anything impossible. Seems that if volunteering is outlawed, only outlaws will be volunteers.

[Rescue0ne]

I seriously doubt they'll actually illegalize volunteering in the near future. Even after every primary EMS agency is a career one (a decade or two from now), I'm thinking there will still be volunteer outfits around, as reserves for the career agencies. Volunteers needn't worry about continuity. There might not be as many incidents for them to respond to, but there will always be work to be done. Granted, take away the dash-strobes and lightbars from their POVs. Burn all those "trauma-junkie" type buffer shirts as well. I swear I saw a tshirt the other day that said "Dixie Tradition", and underneath it was "EMS" the background was a Confederate Flag. YEEEEEEEEHAWWWWWWW!!!! It makes me (insert profanity here) sick to my stomach.

These are my feelings concerning my area, and my state. These views are my own, and they do not represent the views of my agency, or employer.

PS: Is ILLEGALIZE a word? Spell check didn't say yea or nay, and I'm too tired to search it up @ the moment.

[Michael]

illegalize volunteering

My quip was semi-related to the news-item hyperlinked through the word anything in the post above.

[Chief1C]

PS: Is ILLEGALIZE a word?

Yes.

[pyroknight]

As an EMS administrator, this issue is one that I have to wrestle with constantly. In this vast state of the last frontier, we have small pockets of humanity separated from each other by mountains, glaciers, ocean waters, and, sometimes, miles and miles of nothing. Without local EMS volunteers, the "first responders" for many of these communities would be a turbo-prop air ambulance. Many times, the only "trained" medical professional in these villages is the Community Health Aide.

These small villages do not have the financial resources to have a physician (or even a mid-level) in their village. They have CHAs who, though definitely not lacking in commitment or desire to serve, have only a few weeks training, a very detailed manual, and a satellite phone to consult with a physician hundreds of miles away. In the other 49 states, can you imagine having to spend all day on planes to visit a physician? I live in one of the "big" towns in Alaska and I had to fly over a thousand miles (across Canada to another state) to have an angiocath!

We have areas of Alaska where the "local" government is the State Legislature. There is no tax base. There are no public services. No water department. No trash collection. If you need a cop, you have to wait for the trooper to fly in in a Cessna.

It's different up here.

The battle to "professionalize" EMS, however, is fought here as well. We DO have paramedics. The paramedics have in excess of 1,000 hours of training prior to licensure. There are NO paramedic EMS agencies outside of a handful of the "larger" (by AK standards) boroughs and cities. We have two intermediate levels of EMT above the basic level. Each level is an additional 50 hours of training. So by the time you are at the "EMT-3" level, you have had 220 hours of training. No internship. No clinicals. There are agencies in this state who do not want to pay the salary that is required to get paramedics to work here, so they write paramedic skills into their standing orders for their EMT-3s. Why pay a paramedic $50,000+ a year if you can pay an EMT half that and allow them to do the same skills?

Sometimes it is hard to hold the line between EMT and paramedic and not allow skills "creep". Communities argue that they cannot afford paramedics but that their citizens should have access to ACLS. Education, even on the last frontier, is still the key.

[AZCEP]

Your argument is not so much with the volunteer system as it is with the creation of add on levels of EMT's then. This is similar to what happened when the big cities decided they all wanted paramedics, and the smaller communities didn't think they could afford the same levels.

The intermediate, or enhanced EMT, was the result. This level of care is no longer worth having, as it, much like the volunteer, establishes a measure to provide a stop gap solution to a problem that does not get completely solved.

If a community wants to pay for add on skills, why not get all of them in one place? If a community, or region, wants full time EMS service, how does the volunteer system allow for this to happen? Allowing lower levels of care to present themselves as "almost paramedics" cheapens the entire profession.