- 7,875
- 2,830
- 113
By follow ups do you mean "the doctor said to come back if anything changes, and it did," or "the doctor told me to come back so he could check me out on this date and time?"
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"the doctor told me to come back so he could check me out on this date and time?"
this
The consensus that I am developing from this thread, is that more or less it's time for American Paramedics, and American EMS in general to either step up, or step off.
I am hopeful that it is only a matter of time before we "step up."
Isn't it commonly agreed upon that less than 10% of 911 call volume truly requires ALS-level skills (ignoring simple cannulation/fluid administration), or at least can honestly be billed for as ALS-2?
That doesn't address the issue of RN having both AS and BS level degrees. Seems a little bizarre of someone could be an RN with an AS but only an EMT B with an AS.
The power does not lie in the piece of paper, but rather in what was required to obtain it. A degree has a set of requirements that must be fulfilled by all that wish to get it, military service or prior experience guarantee nothing to employers.
My point is that a degree guarantees a depth of knowledge, something that our current system can't do. Some Paramedics need to learn A+P before they graduate, some don't, but both end up with the same patch even though one paramedic might have a greater appreciation and understanding of what is taking place with their patient.
You might laugh at anyone demanding appropriate pay for their level of education, but it is simple economics. If every paramedic had to get a degree to keep their cert, I promise there will be a lot less paramedics, and those paramedics that can get a BS will get to tell employers what their pay rate will be. Simple supply and demand.
"We" is people who are actually in this profession and vested in it. Unfortunately, getting "we" to speak with one voice and come up with, and then implement a coherent plan is likely next to impossible.EMT's, and that DOES include paramedics as defined by NHTSA who fathered them, were intended to be a low-price, widely disseminated technical group. Interfacility transfer was not even planned on, injury by car crash was their primary objective of preparation.
But medicine changes; that's just the nature of the beast. Just because something was initially designed as one thing does not mean that it shouldn't change to fit the current needs. Look at nursing now compared to what it used to be (don't anyone take that as an endorsement of what's happening in nursing please).
Do we strip rural and frontier areas of their EMS because vollies and certified (versus degreed) techs are downgraded and degree-prepared techs mandatory but not a realistic option out there (unless paid for by federal grants)?,
In a fashion, yes. A true rural area is different than what many people consider rural. And while I think a system should be put into place to allow all areas to have access to professional EMS services, even then a longer responce time would still be a reality. So...if volunteers were used to augment the system...that's acceptable. As long as they maintain the same standards and educational requirements as a professional service. If they can't do that or are unwilling...then tough. If you choose to live in a rural area there are things that you need to consider, and a lack of immediate medical care, police responce or fire responce are only some of those things.
Do we artificially limit the supply? Many (mostly young) people want to be heroes, and this is one avenue, so the supply of cheap young labor is very large. Also, with low entry thresholds to certification and employment, PEMS offers a means to get a decently paying job, sort-of.
Not artificially. If educational standards were raised the number of providers would initially decrease I think; not as many people would be willing to put the time in for the compensation. This is NOT a bad thing. I do think that as time went on, more people would start to move into the field again as the situation improved.
Sort of is a good way to put it as far as a decent paying job goes.
Do we prune off all the superfluous varieties of tech which various states and etc. have created since the inception?
Absolutely. One way to increase the amount of funding available is to increase the medicare reimbursement. This would be much easier to do if there were only 1 or 2, 3 at the absolute most, levels of providers. Of course it would also be easier to increase medicare reimbursement if the standards were raised, and different levels were only used when they were actually needed.
And who is "We"? Who will bell this cat?
Why not just make paramedicine a real profession through education, which will lead to empowerment of paramedics?
Do we strip rural and frontier areas of their EMS because vollies and certified (versus degreed) techs are downgraded and degree-prepared techs mandatory but not a realistic option out there (unless paid for by federal grants)?
Do we artificially limit the supply? Many (mostly young) people want to be heroes, and this is one avenue, so the supply of cheap young labor is very large. Also, with low entry thresholds to certification and employment, PEMS offers a means to get a decently paying job, sort-of.
Do we prune off all the superfluous varieties of tech which various states and etc. have created since the inception?
And who is "We"? Who will bell this cat?
As an aside, in my experience its best to have the BSN or BS in something relevant (cell biology, chemistry, etc) if you want serious recommendation for hire these days as a nurse, especially in the critical care arena. I will say though that frankly, a BSN program's contents do not in any way better prepare a nurse to handle critical patients.
I don't know. How did the RNs do this? Or the RTs (they're definitely moving in this direction too). Even a lot of the lab tech / diagnostic imaging is moving this way.
Unfortunately, that says it all right there. Not fire departments being involved in EMS, but people using their time and involvement in EMS just so they can move on to something else.Another concern is how will this affect fire EMS? Many of us are firefighters or looking at becoming firefighters, and their priorities may differ.