A new type of Paramedic Internship (For AnthonyM83)

[captainstandup]

I wonder how much of this problem lies in the educational system and how much lies in the fact that there exists an incredible shortage of Paramedics in the US? Many administrators I know are just happy to have a "warm body with a patch, and a pulse" on the truck as opposed to seeking quality professionals.

A nearby county consistently operates with two or three units sitting unmanned due to staffing issues. The result of this has been to try fast tracking personnel from uncertified to paramedic in the fastest possible manner. One service has even taken the extraordinary step of advertising for persons interested in an EMS career, then teaching an EMT to Paramedic course in-house. The students are paid while in class provided they sign a contract to work for the agency for a period of time after becoming certified.

I believe this is simply a symptom of a much broader problem in the EMS world that is multidimensional. 1)Pay 2)Danger vs Pay 3)Lack of advancement opportunity 4)Lack of respect from the health care community and on and on and on.

Our industry has really only been an industry since roughly 1966 and we are neck deep in an identity crisis. Apart from airway, oxygen, epi in anaphylaxis, defibrillation and to an extent C-spine stabilization. there is really no SCIENTIFIC EVIDENCE proving that what we do is beneficial when compared to simply taking patients to the hospital. Before someone jumps on me about hemorrhage control, every civilian I know has enough sense to apply direct pressure.

I really don't have the answers, but I assure you rushing people from EMT to Paramedic is not the answer. Whoring out the profession for the sake of staffing with no chance for students to develop precious clinical judgment and a "feel" for emergency services cheats the student, and cheats the patients out of the care they deserve. This is another chip out of our very foundation. How long before we become irrelevant as other disciplines take over our role?

[DwayneEMTP]

Dwayne,

Don't get me wrong. We have to complete X number of skills and there is also a minimum number of hours. The point I was trying to make, albeit unsuccessfully, is that unless we as students are in the right place at the right time, then obtaining some of the required criteria could prove difficult.

Yeah, I got you Jake. That's one of the reasons I avoid the springs. Fire controls the patients until released for transport to the private company.(We ride with AMR)..I guess it often gets very uncomfortable trying to get the private students skills, as they want the fire students to get theirs first...

Yeah, only so many fish in the sea...I've heard horror stories about trying to complete clinicals...I'm keeping my fingers crossed.

[UMSTUDENT]

I can offer a fairly educated opinion about an alternative way of conducting field internships since our school takes a fairly different approach to the clinical process.

I'm currently engaged in about 33-40 hours a week of clinical time. Our system operates by requiring a minimum hour requirement, minimal level of documented competencies, and required evaluations by EVERY preceptor we come in contact with. Our total clinical time, if done properly, amounts to approximately 1,000 hours over the course of our education.

Clinical time occurs in a variety of settings with exposure to many types of patient demographics. Clinical time is split roughly 40/60 hospital-to-field. Time is spent on a variety of hospital services and with physicians. Field time is organized across multiple EMS delivery types and geographic areas. Urban, suburban, rural, and sky.

Our clinical evaluation is HEAVILY based on number of hours completed and is VERY patient assessment based. The idea is to expose students to types of patients rather than just skills and drills. For instance, NICU time is arranged specifically so that students may be exposed to a variety of neonatal problems.

I prefer this type of learning; however, I feel that EMS still suffers from skills obtainment issues. For instance, significant competition exist among classmates to obtain certain types of skills. I feel that FISDAP is actually a big cause of this. The idea of simple competency through a magic "number" is somehow silly to me, although I understand the need to measure statistical markers.

Problems:

Some clinical sites serve better as educational opportunities, rather than opportunities to practice. It can be frustrating spending 12 hours at a clinical site and having never done any type of skill. While often mentally exercising, there are certain skills that must be maintained.

[JakeEMTP]

For instance, NICU time is arranged specifically so that students may be exposed to a variety of neonatal problems.

I prefer this type of learning;

I agree UMSTUDENT. Part of our hospital clinical time involved Emergency, MICU, TICU, NICU, PICU, CICU, Cath lab and L & D, as well as time spent with a RT. The thinking is as I understand, to expose the student to things you don't see on a regular basis.

To see a catherization after the STEMI patient we leave in the ED and following them to the CICU was great exposure as to how the whole system works.

[DwayneEMTP]

UMSTUDENT, I think I'm missing the part that is different...

Except for doing 'air' clinicals it sounds about the same as ours...We'll log a minimum of 800 clinical hours, or more depending on getting skills accomplished during preceptorship...

Are other school's clinicals set up so much differently?

[UMSTUDENT]

UMSTUDENT, I think I'm missing the part that is different...

Except for doing 'air' clinicals it sounds about the same as ours...We'll log a minimum of 800 clinical hours, or more depending on getting skills accomplished during preceptorship...

Are other school's clinicals set up so much differently?

Read past the first paragraph...I wrote it for a reason. Thanks.

[DwayneEMTP]

Read past the first paragraph...I wrote it for a reason. Thanks.

Read the whole thing Hotshot...

I still don't see the difference. I had to get a preceptor review for every patient contact, as well as create a PCR for each...

I didn't say preceptorship was centered on skills, I was trying to say that not fulfilling the necessary skills could hold you in precptorship. Big difference. It seems to me...upon my SECOND reading..that you were saying the same thing..

My current preceptor is or seems to be the exception, though I've decided not to allow that track to continue so the point is moot.

Perhaps you could do this simple, feeble minded old fool the favor of highlighting the part that I misunderstood?

Have a good night sport...

Dwayne

NOTE: Yeppers, third time through. I usually respect your posts, yet can't find an inkling of what got your panties in a bunch...Point for point it sounds like my clinicals...You're going to have to help me out.

[Dustdevil]

I really don't have the answers, but I assure you rushing people from EMT to Paramedic is not the answer.

Excellent points all the way!

I just want to make sure we are on the same page on this one though. I too don't believe that rushing people from EMT to Paramedic is the answer. But I DO believe that rushing them from EMT to Paramedic school is an answer.

Were you referring to the rush to begin advanced education, or the rush through advanced education, as done by the short, tech school courses?

[captainstandup]

We are in fact on exactly the same page Dust, It nauseates me to see whats happening in the realm of "education" and thats certainly using that word loosely. I was referring to the rush to get them through school and on the truck with no consideration of knowledge or skill level and for damn sure no clinical judgment.

Capt.

[zzyzx]

Here in LA not too many years ago, LA City Fire was forcing their firefighters to go to paramedic school. That was their solution to a shortage of medics.