What are we attracting to enter EMS?

[MSDeltaFlt]

After reading multiple posts on EMS forums, from the "Not wanting to be touched", "Paramedic steals body parts" to " I don't want to have to attempt to resuscitate anyone" . It has made me wonder, who and what we are attracting to enter the EMS profession?

Unfortunately, we (instructors) know that when the NREMT made a statement that "many are now attempting to enter EMS, when they fail the fries section" ... they were not joking. From either the formal NASA rocket scientist that retired or the one that has ran out of options.

1. Are people entering for the right reasons?

2. Should there be a screening process to help eliminate those that expectations are not that of the career?

3. Should we allow anyone to enter?

4. Was emphasis placed during the educational process, that majority of our job is NOT technical, rather humanistic?

5. Are we producing EMT"s and Paramedics with unrealistic expectations?

What they expect and what it really consists of is much different?

Discussion? I will hold my comments for a while?

1. Some yes. Some aren't. The others aren't sure.

2. If you start doing that, then the shortage will exacerbate.

3. Not those who get queezy at the site of blood.

4. Not technical enough would be more appropriate.

5. Yes. Hence the term "Paragod".

 

[pumper12fireman]

I believe a lot of people are entering this profession for the totally wrong reasons. Mainly, "to get a fire job". I have heard this SOOO many times it makes me wanna puke. I come from a fire background. Did I use my paramedic education to go somewhere that doesn't even transport?? NO. These guys coming through fire academies are having it drilled into their heads that you "gotta go medic to get a job". Most of these firefighters don't want anything to do with patient care. They want to ride the fire rig, fight fire, and get that extra little stipend.

There was a relatively tough screening process to get into my medic program. However, compare that process to a nursing school or med school process and it was pie. And we're in charge of patient care decisions much more than nurses and work in shi**ier conditions than docs. More education is needed. Period. This would benefit many angles of the profession, including keeping out those that just want to drive an ambulance, or wanna be a "hero".

 

[Sasha]

I think a lot of shows like Rescue Me are glamorizing EMS. It looks like a bunch of sex with nurses, hanging around the station kicking back, and heroic acts. They show the life and death decisions, dramatic CPR and carrying helpless women out of burning buildings.

It doesnt show the little old ladies who call EMS out simply because they want someone to remember they are still there, and they want to talk about old times, nor does it show the vomit, blood, guts, and general ickness of patient contact, the drunk guy groping on you while youre trying to take a BP or the narc OD patient who just got a dose of narcan and comes up swinging.

I have met a lot of people who are in EMS simply because its a cool job and dont care for the patient at all. They want the discounts at fast food places from stopping by in uniform, or to be able to get a little high off that god complex.

I think there should be some kind of screening about who they let into EMT school, also people should be fully informed what to expect pay wise so they dont gripe about it later, and should learn what is REALLY expected of them out of patient care and get a good grasp over the fact its not simply popping in an IV and pushing drugs, its smiling and laughing with them to put them at ease and holding their hands while they drive off to the hospital.

And its physically demanding. I see a ton of EMTs and medics who cant lift worth crap because they are jello arms!

 

[Hastings]

And its physically demanding. I see a ton of EMTs and medics who cant lift worth crap because they are jello arms!

Since I apparently provoked a Paramedic vs Firefighter discussion, I find it fair to note that this is one area where Firefighters rock. I don't have to lift anything. That's what the firefighters are for.

Firefighters shouldn't be providing patient care, but if they want to help me load up a patient, I'm all for it.

 

[mycrofft]

Great question!!

It takes all sorts, but some sorts a lot less than others.

Firefighters should never be required to be formal EMS...yet, the majority of fire dept calls involve EMS without fire. How about splitting EMS off the FD's...no, wait then they lose all that staff and money and admin positions. My ducats, my daughters...

Training can be part of the screening, but the probie period tells much more, and also is the point where you start really learning. I've seen screwy ba$t$&ds give excellent care under high duress, and very good techs/paramedics who can only operate in a parlor. Both are needed, both need good partners (not coworkers) to complement and supplement their talents and quirks.

 

[Flight-LP]

Since I apparently provoked a Paramedic vs Firefighter discussion, I find it fair to note that this is one area where Firefighters rock. I don't have to lift anything. That's what the firefighters are for.

Firefighters shouldn't be providing patient care, but if they want to help me load up a patient, I'm all for it.

Touche!!!!

 

[Flight-LP]

I think a lot of shows like Rescue Me are glamorizing EMS. It looks like a bunch of sex with nurses, hanging around the station kicking back, and heroic acts.

Hold on a sec.......So your saying we can't have a bunch of sex with the nurses?????? DAMN! There goes my idea.................

Keep it on the down low and break it to Rid gently.........I know he was hoping that nursing degree gets him somewhere in life!

 

[Hastings]

Hold on a sec.......So your saying we can't have a bunch of sex with the nurses?????? DAMN! There goes my idea.................

Keep it on the down low and break it to Rid gently.........I know he was hoping that nursing degree gets him somewhere in life!

Totally off-topic, and I apologize greatly, but I wanted to note that that's my greatest disappointment about EMS. It's not that most calls are dirty, repetitive, or unpleasant. It's that every single attractive female in a hospital is married or engaged. Seriously.

 

[mycrofft]

Heck, nearby we had a couple fire stations cut out the middle(wo)man

Caught having orgies. Got a new fire chief out of that one.

Seriously, I saw many excllent firefighters who were chopped off when EMS came onto the scene and then became mandatory. Been on both sides.

(Did my first sentence make this all sound sorta doubly entendred? Sorry, puns NOT intended).:blush:

 

[pumper12fireman]

Totally off-topic, and I apologize greatly, but I wanted to note that that's my greatest disappointment about EMS. It's not that most calls are dirty, repetitive, or unpleasant. It's that every single attractive female in a hospital is married or engaged. Seriously.

Mine too!!!! And there's a damn good reason for that, I think. I guess you gotta catch them while in nursing school...

 

[Hastings]

Mine too!!!! And there's a damn good reason for that, I think. I guess you gotta catch them while in nursing school...

Interesting theory. R/R? Well...?!

I'll try it out. Let ya know.



...I'm sorry, where were we? Oh, right, Firefighting and EMS should be very, very different.

 

[pumper12fireman]

Interesting theory. R/R? Well...?!

I'll try it out. Let ya know.



...I'm sorry, where were we? Oh, right, Firefighting and EMS should be very, very different.

I enjoy the system I work in a lot. We're EMTs/Medics first and foremost. Everyday we are assigned to the ambulance (captains included). When a fire call comes in, we hop in the engine and do the fire thing. It keeps me sharp on EMS, and yet I still get to fight fire.

 

[lalaneedstopass]

People need to get into not only this job but ANY job because they WANT to. Not to look "cool", not for the money, not for the name but because it's whatthey want to do. Otherwise you're going to get more and more people getting into this field that don't care and p/ts will see that. Not only that, but you normally don't take care really into things you don't want as opposed to things you do want. Like I said in the forum for the "soon to be student", don't get into this for the money. That's how burn out occurs. People get bored at doing something they never really wanted and it affects the way they work. Well that's fine when you're working at McDonald's. Oh no I don't care about working here so I'm going to treat people like they don't matter, I won't count all the change back, I'm not going to fill the soda machines up, I'm not doing a restroom check this hour. Who really cares? But in the medical field you're SAVING lives. You can't go into this job just for the looks because you're not going to do your best and you're going to work inadequately and people's lives are at risk when you aren't going to give it your all. Someone said it doesn't matter who enters the field as long as they're helping. Well, would you rather have somebody who cares about this job more than anything helping you? Or somebody who doesn't really care that much and is at the end of their shift and would rather race home because they have plans than spend a few more minutes on you? Remember, every single minute is vital. I would rather have somebody who values this job not for the money, the name, the clothes, the glamour, but values it in wanting to help people.

 

[Ridryder911]

Very interesting replies.

Okay, here is my ideas.

1. Are people entering for the right reasons?
As pointed out they maybe entering programs, but are they entering to be an EMT? Yes, most Fire Services require such to even be considered an applicant. This was to eliminate and decrease the number of applicants. This itself has harmed the profession of EMS. Over abundance of EMT's has made the demand and supply non-realistic. The problem again, many of those have no desire to be an EMT. Some will take a job until a F/F position opens. As well with the abundance of EMT's this has watered down the possibility of salaries for those really wanting to be a professional EMT.

Should every firefighter be an EMT prior to entering a Fire Service? Why? Should it even be a requirement to be an EMT as a Firefighter? Seriously. Sure they should have first aid or MFR training being a firefighter, but does every truckie needs to be a medic? How much training is really kept up after receiving their accreditation? How often does each Firefighter put on a hare traction, KED, perform a thorough assessment before professional or more advance care arrives.

Would it not be more feasible and more prudent to teach a thorough MFR course within the Fire Academy? A percentage or at least one designated EMT on a truck or medics on a squad. Is requiring all firefighters to be an EMT an overkill? What was the main purpose of doing so? By doing this, has the objective been met?

I much rather have a well trained MFR with limited knowledge, than a so called EMT that has not kept up and presumes that they know it because they passed an EMT test, or will not participate in care at all.

2. Should there be a screening process to help eliminate those that expectations are not that of the career?
Do we allow everyone to enter medical school? Dental hygienist programs or even become a firefighter? Why should we allow everyone to enter EMS programs?

According to the NREMT less than 50% that enter EMT programs finish them. Worse many of those that do finish EMT programs never take the certification test to become EMT's and less than 50% of those that do pass their certification never enter the health field.

So apparently those that entered programs never really understood what an EMT or what EMS is, or never really planned to be an EMT. The expectation of the student was not what the course or occupation is in comparison.

We want our profession to be a profession? We want better salaries, more demand, to be respected? Then we will have to earn it.

Only the best and the select should be allowed to enter. Give validity and credibility to this profession.This means one will have to be able to read and write. (this job really does require it, if you do it the right way). Have basic mathematical and above average science knowledge. Go through a psychological test to detect if one is mentally healthy as much as physically healthy. The job demands as much mental stress as it does physical.

Place requirements alike other real professions do. Reference letters, display of intent and demonstration of interest. Demonstration of an understanding what the job and focus of what an EMT does and a full understanding the course is NOT and does NOT teach one to be a firefighter, nurse, physician, helicopter pilot, etc. This course is designed and solely to teach one to be an entry level into EMS to provide prehospital care in an ambulance. Nothing else. What one does with it, is up to them, but this is what they are going to be taught and it should NOT be considered a "stepping stone". If you want to go to that profession do so, don't waste time being an EMT. There are plenty of other temp jobs out there.

3. Should we allow anyone to enter?
Again, NO! EMS is not for everybody! Nor should it be. We have attempted to say it is by allowing volunteers, and opening the doors for every Tom , **** and Harry. See the results?

You can define success by evaluating if it is working or not. Obviously, it is not. Time for a change.

Life is not pretty. Not all us get to be what they want to be. Not all can be firefighters, astronauts, doctors or police officers. Not everyone can be in EMS. There are factors that may prevent individuals from being the "best" in that profession. This does not make them bad.. but, not the best suited for that profession.

We attempted to be so politically correct, it has now caused change within the medical profession. Even to the point, changing the outcomes of patient care.

Compare ACLS to that of even twenty years ago. Doubtful, that ten percent of Paramedics today could pass such examination of what knowledge was required. Oxyhemoglobin curve, acid base balance, nosocomial infections, cardiac assessments. True emergency and cardiac care. Again, it was presented and known that one had to have such knowledge to provide adequate care. Not everyone was going to be able to or even should. Where and when, did we decide it was okay to be mediocre?

4. Was emphasis placed during the educational process, that majority of our job is NOT technical, rather humanistic?

I recently started teaching a Basic EMT course. I have to admit, this is the first one in sometime. I usually teach advanced or critical care courses.

What I started out describing is that our main job is not just providing care. Really, that is NOT what most call 911 for. People call 911; because they do not know what to do!
If most citizens knew what to do during an emergency crisis, there would be very few responses made. We are there to take over their life during this crisis mode, to ensure them we have it under control and for them not to worry about it.

This maybe medical, psychological or what ever the case maybe.

EMS author Karen Hauffman, wrote many years ago she did not believe there was as much "burn out" as the expectation of the EMT was unrealistic and not that of what the job was really about. Many assume that they know what being an EMT is, and assume that what they learned in class is what they will be doing. In truth, it is very rare to see a sucking chest wound, delivering a child, placing a hare traction on.... in reality and per percentages of dealing with grandma with a terminal disease, transporting dialysis patients, hearing and seeing personal matters of poor financial problems, lack of money for medications causing exacerbation, or abuse of medicines in general poor personal health care. Yet, our curriculum does not even address what our true job is or sees on a daily basis.

How many would had continue if they were told it would be very doubtful that they would ever perform a 10th of the procedures they learned? Yet, in case they did see such occurrences they would have to be above proficient and perform it flawlessly.

I have emphasized that this is a CARING business. Providing physical care is just one of part of caring. One has to be able to deliver both.

5. Are we producing EMT"s and Paramedics with unrealistic expectations?
As I described; yes. Most exit the programs without a clue of what the real job is. That is why forums have became popular.

Unfortunately, many want to argue and vent of what they want in lieu of listening to what it the profession truly is. Again, attempting to make the job or situation to fit them instead of them fitting the profession. This has even slid over to medical care. I now see medics treating based solely based upon protocols. Making the patients fit their protocols instead of treating upon what the patient solely presents. Example, IV lifeline. Will this patient need fluid or medication enroute? If not, why the IV? This usually comes from shake & bake training, thus cook book protocols are developed to "CYA" as much as possible.

Would it not be better to really inform students of what the "real" job is and develop a curriculum based to teach from that? That in-depth A & P, psychology, even social services is as much of our job than treating a tension pnuemothorax. The likelihood of seeing a diabetic being non-compliant of diet and med's is higher than seeing an eviscerated bowel.

This does not mean, we should have to lessen our teaching of emergency care. That emergency care has to be taught well and in-depth. Also critical care should be taught to Paramedic level students, recognizing the distinction that it is NOT the same as emergency medicine.

We have to abolish the BLS vs. ALS distinction mentality. There is NO such thing in the world of medicine. Either you can perform the procedure or you cannot. Not wrong, just the way it is.

It is unfortunate that most in EMS want someone else to do things for them. One of the reason we have so many multiple levels. We are always full of excuses instead of taking actions. The same reasons there is 5,000 EMT's for one position and the pay is sometimes below minimum wage.

Who's fault is it, really? ....

R/r 911

 

[firecoins]

Very interesting replies.

Okay, here is my ideas.

1. Are people entering for the right reasons?
As pointed out they maybe entering programs, but are they entering to be an EMT? Yes, most Fire Services require such to even be considered an applicant. This was to eliminate and decrease the number of applicants. This itself has harmed the profession of EMS. Over abundance of EMT's has made the demand and supply non-realistic. The problem again, many of those have no desire to be an EMT. Some will take a job until a F/F position opens. As well with the abundance of EMT's this has watered down the possibility of salaries for those really wanting to be a professional EMT.

Since the EMT class is so easy, why shouldnt firefighters and cops have some level of training? They are often used as first responders even if they aren't meant to be EMS. The entry level EMS level should be higher than the EMT class.

Should every firefighter be an EMT prior to entering a Fire Service? Why?

They get call for extrication, rescues in dangerous area and other situations EMS does not go into.

Should it even be a requirement to be an EMT as a Firefighter? Seriously.

No

Sure they should have first aid or MFR training being a firefighter, but does every truckie needs to be a medic?

No

 

[Emtint08]

What are we attracting?

After reading multiple posts on EMS forums, from the "Not wanting to be touched", "Paramedic steals body parts" to " I don't want to have to attempt to resuscitate anyone" . It has made me wonder, who and what we are attracting to enter the EMS profession?

Unfortunately, we (instructors) know that when the NREMT made a statement that "many are now attempting to enter EMS, when they fail the fries section" ... they were not joking. From either the formal NASA rocket scientist that retired or the one that has ran out of options.

Are people entering for the right reasons? Should there be a screening process to help eliminate those that expectations are not that of the career? Should we allow anyone to enter? Was emphasis placed during the educational process, that majority of our job is NOT technical, rather humanistic? Are we producing EMT"s and Paramedics with unrealistic expectations? What they expect and what it really consists of is much different?

Discussion? I will hold my comments for a while?

I got into this slightly by accident. Originally I was going to be a CNA but my brother inlaw, a battallion chief was singing the praises of emt. I am slightly late in life (Not very though) in this business. I went into the class really nervous and terrified. When I came out I WAS IN LOVE WITH it. I love the patients, the partners, the teamwork, the patients. I love to make a difference in someones life, even if it just helping them tie their shoe, or holding their hand, or getting them coffee, or providing them medical attention. I am FIERCELY loyal to my patients, and for the most part their families ( its not that easy many times). I than realized this is what I want to do. I have been a basic for two years and am currently going through Intermediate class. I was thinking the same thing you are today, as I watched many of our classmates come in very much hungover and not taking things seriously. it makes me cringe. Sad thing is, one of my classmates is no longer in the class after today as a result of the condition he came in. I believe there should be higher standards. I think we should all have fun. I am not against dark humor amongst ourselves, or practical jokes. And quite frankly, I don't get much offended by anything. But when I see people who arent doing this for the right reason ( or what I believe to be the right reason---THE PATIENTS), IT really gets me. I don't want to sound preachy. There are a lot of times I am so glad I do what I do. there are other times I consider switching careers. it happens. But there has to be some higher standard in which to achieve. I don't want substandard care given to my family.

 

[Emtint08]

Since the EMT class is so easy, why shouldnt firefighters and cops have some level of training? They are often used as first responders even if they aren't meant to be EMS. The entry level EMS level should be higher than the EMT class.



They get call for extrication, rescues in dangerous area and other situations EMS does not go into.

No

No

I am not a firefighter. I am strictly medical. But, although I don't think it should be a requirement for firefighters or police to have medical training, it may be a good idea, at least on a first responder level. Lord knows firefighters and police have plenty enough to do. Having said that, I think medics, basics and intermediates should be allowed to ride rescue without having to go through firefighting school. I would love to ride on fire and rescue, with an engine for fire and unit for rescue. But I would be required to go through the fire academy, even though I would not be fighting fires. heck, I personally think with the abuse of our ems and emergency room systems, ALL parents and potential parents should have first responder training. Along with a license to breed.

 

[John E]

Interesting...

numbers posted by Rid.

If I understand them, lets say we have a class of 100 potential EMT's.

Less than 50% will pass the course. That leaves us with lets say 45.

No specific number given for those who pass but who don't take the test but we know it's less than 100%, lets be generous and say 75% of those become certified, we're now down to about 33-34. Of those, less than 50% will go on to actually work, so now we're at 17-18 out of our original 100.

Seems like those who aren't serious about are already being screened out thru simple attrition.

I think the big question is what to do with those who pass, get certified, get a job and come here to ask really simple questions about stuff that they oughta already know...;^)

John E.

Seriously, I knew that the numbers were bad, didn't realise that they were quite that bad.

 

[daimere]

The more I go through my EMT class, the more I love EMS. I honestly wasn't prepared for it. I just knew it would be medical and I could be camp EMT at 4-H camp with this certification. I didn't know there were different levels from EMT to paramedic. The second day of class I called my mom (nurse) asking her to explain what an EMT really does compared to my ideas from media.

Of course, the more she realizes I really like this, the more she suggests me to keep EMS to the side and be a nurse or perfusionist.

 

[Ridryder911]

Yeah, it would sound like the numbers is working the problem is that there is so many classes at the same time. For example in my rural state alone during one semester is a three county area there are at least 8 EMT courses. So even if there is only 10-12 per class, that is 40 to 50 every 16 weeks. There is only about 15 to 20 jobs per year for the proportion of EMT's. Thus why in we have over 5,000 Basics in my state, only 180 EMS services and over half of those are advanced level.

Unlike other professions, when we have met the demand the courses stop, we continue to train. This is even on a national level. Hence a problem as well, that one has to be a basic prior to advanced (does not have to work as one). Since the Paramedic level has had a significant increase in pay, many of the old timer EMT's are now returning to complete their Paramedic.We have a higher demand for Paramedic than Basic level. Personally, rather see more formal programs than the so called classes. Which I believe is why there is so much fragmentation in EMS.