# Really getting discouraged...



## emsfire3924 (Oct 21, 2010)

I'm really getting bummed.  It's been almost 7 months since I became nationally registered and I still have not been able to find a job as a working EMT.  I have applied all over the place and still no one has called me back for an interview.  I've been volunteering at a fire department for experience and I love it.  I just want to do more!  I want a job more then anything and it's really bothering me.  :sad:  I want experience with my basic skills before I move on to the paramedic program but I feel like I'm just stuck here doing nothing...
Advice appreciated.


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## Veneficus (Oct 21, 2010)

Quit wasting time volunteering go to paramedic school.

Nobody needs experience as an EMT before becomming a paramedic.


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## emsfire3924 (Oct 21, 2010)

Veneficus said:


> Quit wasting time volunteering go to paramedic school.
> 
> Nobody needs experience as an EMT before becomming a paramedic.



Really?  That goes against everything I was taught in class.  Our instructors pretty much drilled it into our heads that we need to establish our basic skills before we go on to learn the advanced ones.  The next medic program at my local college starts fall of 2011.  I'm pretty sure I'm going!!


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## abckidsmom (Oct 21, 2010)

Sarah said:


> Really?  That goes against everything I was taught in class.  Our instructors pretty much drilled it into our heads that we need to establish our basic skills before we go on to learn the advanced ones.  The next medic program at my local college starts fall of 2011.  I'm pretty sure I'm going!!



You can totally do it.  Establish your basic skills now:  make sure you are extremely comfortable checking vital signs in a variety of settings, work on pre- or co-requisites for the paramedic program, practice documentation with the feedback from a more experienced provider.

I like volunteering, so I'd continue, but don't let the lack of EMT-B experience stop you from furthering your education.


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## emsfire3924 (Oct 21, 2010)

abckidsmom said:


> You can totally do it.  Establish your basic skills now:  make sure you are extremely comfortable checking vital signs in a variety of settings, work on pre- or co-requisites for the paramedic program, practice documentation with the feedback from a more experienced provider.
> 
> I like volunteering, so I'd continue, but don't let the lack of EMT-B experience stop you from furthering your education.



Thank you!  
Another question... The college I'm going to go to offers either the associate of applied science degree in paramedic technology or the paramedic certificate.  From what I see, the AAS just includes your generals but will take me longer to do.  I know its a degree but do you think when I go to apply for medic jobs that they will look down on me for not having a degree?  Afterall, I would have the same license as the person with a degree...


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## abckidsmom (Oct 21, 2010)

Sarah said:


> Thank you!
> Another question... The college I'm going to go to offers either the associate of applied science degree in paramedic technology or the paramedic certificate.  From what I see, the AAS just includes your generals but will take me longer to do.  I know its a degree but do you think when I go to apply for medic jobs that they will look down on me for not having a degree?  Afterall, I would have the same license as the person with a degree...



Start next semester and finish the degree properly.  When you graduate, immediately start a program to finish your bachelor's.  Don't get out of the habit of school, or pick up extra obligations before you've finished.  Your mid-career self will thank you, since you'll have the degree needed to remain competitive as you promote out of the straight field medic role and into education, management or whatever.

Personally, the flexibility of RN, BSN, EMT-P is overwhelmingly cool to me, but nursing school when you're starting a career in EMS is tough.  Really, finishing the degree in ANY related field will be useful:  a science, communication, or emergency management.  I've seen a couple of EMS BS degrees, but they seemed like a ripoff when I looked at them a couple of years ago.


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## Aidey (Oct 21, 2010)

Sarah said:


> Really?  That goes against everything I was taught in class.  Our instructors pretty much drilled it into our heads that we need to establish our basic skills before we go on to learn the advanced ones.  The next medic program at my local college starts fall of 2011.  I'm pretty sure I'm going!!



What basic skills do you need to establish that won't be gone over in paramedic school?


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## mgr22 (Oct 21, 2010)

I strongly agree with abckidsmom's suggestion that you get a degree instead of only a certificate. A degree gives you more options both inside and outside EMS. I know, I know -- lots of medics don't have degrees, and there aren't tons of management openings in EMS. But suppose you get hurt and can't do EMS anymore? Or suppose you do it for a few years and then want to try something else? That paramedic certificate won't help much.

In general, having a degree matters more than what you majored in, and a Bachelor's is better than an Associate's. But get whatever you can. It's an investment in your future.


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## 46Young (Oct 21, 2010)

abckidsmom said:


> Start next semester and finish the degree properly.  When you graduate, immediately start a program to finish your bachelor's.  Don't get out of the habit of school, or pick up extra obligations before you've finished.  Your mid-career self will thank you, since you'll have the degree needed to remain competitive as you promote out of the straight field medic role and into education, management or whatever.
> 
> Personally, the flexibility of RN, BSN, EMT-P is overwhelmingly cool to me, but nursing school when you're starting a career in EMS is tough.  Really, finishing the degree in ANY related field will be useful:  a science, communication, or emergency management.  I've seen a couple of EMS BS degrees, but they seemed like a ripoff when I looked at them a couple of years ago.



@ OP, listen to everything abc says. I also started a thread in this section for those such as yourself, "EMT's Can't Find Work."


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## Veneficus (Oct 21, 2010)

Sarah said:


> Really?  That goes against everything I was taught in class.  Our instructors pretty much drilled it into our heads that we need to establish our basic skills before we go on to learn the advanced ones.  The next medic program at my local college starts fall of 2011.  I'm pretty sure I'm going!!



Considering the meager skills taught in EMT class, I question the quality of instruction that promotes such nonsense.

The people I have seen struggle most in paramedic class are the EMTs with "experience" that think they already know, or know what is important. They confuse the bad habbits they have seen and learned and forget what is on the test is not what they have been doing. 

In my 7 years teaching medic class, experienced EMTs were the largest percentage of failing out, and consistantly were the lower end of the class academically. The 2 people that were asked not to come back to clinical sites because of their attitude/behavior were "experienced volunteers" who thought they had seen/done it all.


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## emtstudent04 (Oct 21, 2010)

Don't get discouraged that it's taking this long to get hired. It took me about 7 months to get on with a company. Just keep trying and be persistant with places your applying to. Call those companys every week to check up on that status of your application or call every other week. Make visits to the places you want to work at and show that you really want the job. Keep doing the volunteering it's good experience.

Best of luck!


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## JJR512 (Oct 21, 2010)

Veneficus said:


> Quit wasting time volunteering go to paramedic school.
> 
> Nobody needs experience as an EMT before becomming a paramedic.



Not entirely true...All the Paramedic programs in Maryland I've checked out (HCC, AACC, and BCC...I think UMBC as well) require a minimum number of patient contacts at the basic level before acceptance to their paramedic programs will be granted. That number is either 100 or 150, or may vary between schools.



Aidey said:


> What basic skills do you need to establish that won't be gone over in paramedic school?



How about the skill of dealing with people?

True, a degree program will probably include an introductory psychology class—but not everybody takes the degree program. And true, you will be dealing with patients in clinical situations. But it's news to me if a paramedic program teaches you how to deal with emergency situations and the people in them. There's nothing like field experience to teach you that. There's nothing like _trying_ it to see if you can even function in those situations in at all.


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## Lifeguards For Life (Oct 21, 2010)

The only people I have ever heard say "you need experience as an EMT before paramedic school" have all been EMT's. I have never heard a medic say this. 

It's almost like an excuse used by basics to justify why they are avoiding furthering their education and worth.

there is nothing taught in basic classes that requires working time as a basic to master.


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## Aidey (Oct 21, 2010)

JJR512 said:


> Not entirely true...All the Paramedic programs in Maryland I've checked out (HCC, AACC, and BCC...I think UMBC as well) require a minimum number of patient contacts at the basic level before acceptance to their paramedic programs will be granted. That number is either 100 or 150, or may vary between schools.
> 
> 
> 
> ...




You misunderstand Vene, experience as an EMT B may be a requirement for some Paramedic schools, but it is a useless requirement that schools came up with for some arbitrary reason. Schools can require underwater basket weaving as a pre-req but that doesn't mean it does the students any good. Same thing with the requirement that people have some number of years or hours of experience as an EMT before going to Paramedic School.

As for dealing with people I should hope that anyone attending Paramedic school has enough maturity that they can deal with people. If they don't they will learn during their clinicals and internship or fail out. 

Nursing schools don't require that people be a CNA first, why should Paramedic schools require that people be an EMT?


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## Veneficus (Oct 21, 2010)

JJR512 said:


> Not entirely true...All the Paramedic programs in Maryland I've checked out (HCC, AACC, and BCC...I think UMBC as well) require a minimum number of patient contacts at the basic level before acceptance to their paramedic programs will be granted. That number is either 100 or 150, or may vary between schools.



I would very much like to tell whoever came up with those requirements how absolutely foolish they are. It is blatent stupidity. 

Keep in mind at least more than 70% of all EMS instructors have no education other than paramedic class. Even amongst the higher end educators, few of them actually have some knowledge about educational processes. 

If an EMS program requires OTJ after the educational period which is not specifically in an academic setting, like a medical residency, clinical, or the like; that program is a diservice to the students and just ripping them off. There is no promise, no telling, and no direction to what those people may be learning in the academically unsupervised employment. There are no learning objectives that must be met, there is no criteria as to what constitutes "patient contact" and no ability to correlate the patient contact with specific experience or understanding. 

How exactly does that benefit anyone?

In my last full time employ I worked for a hospital and in the ED we could expect to have 150 patients in a 12 hour shift. Does that mean I saw all of them? certainly not. What if I just poked my head in, said "hi" and asked why they were there? I could have decided they all needed to see a physician and had 150 patient contacts in 12 hours. While you could learn a lot, how much do you think one 12 hour shift would benefit you? Especially when you had no idea what you were looking at as the Basic EMT curriculum is on a lesser level than WebMD.(which is not even for healthcare providers) 

At the same time you could work for Dewey, Cheatum, and Howe, IFT company running the dialysis derby and other than lifting a cot and learning how to get from the local nursing homes to the local dialysis center, see 150 patients in a bout a week. What would you do? Take some vitals? Not exactly a difficult skill to master. If it was so critical why wouldn't your EMT program require a week of clinicals? Every program has the authority to exceed the minimum standards. Clearly they don't think it is so important or they would.

What if you volunteer for a year and only see 149 patients? What if none of them are "sick" as often referred to by people who take care of critically ill people regularly? You could see 150 patients and never once perform CPR, attach an AED, control a life threateing bleed, or even put somebody on a backboard. (a skill which is given more time in lifeguarding class than EM class)

Would you be on par with a paramedic student who started clinicals thier second week of school? 

I know you didn't come up with this gem on your own, but I hope you can see just how fake it is.

Fear not, I know we all had the best EMS instructor ever. They are all number 1. As well as the only ones any of us ever had.     



JJR512 said:


> How about the skill of dealing with people?



What about it? I know doctors who have practiced for decades who can't deal with people. They are absolutely brilliant people and I would trust my life to them, but they are a bit short on people skills. 

But aside from that little anecdote, go back to the volunteering scenario. What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?

Because they actually lose financially, McDs takes customer service a lot more serious than most EMS or IFT agencies. They actually put you through customer service training. (So does Wendy's for that matter.) So now the McDs grill cook has more customer service training than many EMS providers.

If it was so important, why isn't it given more attention in EMT school?

See the pattern here? 

I like to say the purpose of education is so that students don't make the same mistakes I made. They should come up with new and amazing ones. It is the purpose of collective knowledge. It is how we advance as a species. 

In short, if a teacher tells you that you have to spend time outside of the educational environment to learn or master specific skills, if those skills are so damn important to the job they should be part of school. You don't get out of any other healthcare related school without all the skills you need to function in your role. even medical residency is an educational position. 

I have to see ~40 patients tomorrow morning, strangely enough, I have already mastered all the skills I will need to see them, and I am still a student with clear and predetermined objectives on what I need to accomplish.


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## emsfire3924 (Oct 21, 2010)

To answer some of your questions...

My instructor has been in EMS for 18 years.  I think what he means is that you want to have your basic skills mastered before adding the advanced skills and it will make medic school so much easier on you.  

We had a week of clinicals that were required of us in EMT class.  

To get into the medic program here you have to show 100 patient contacts... which is a medic signing off that yes, you had contact with that patient and probably their vitals, interventions you done, etc.


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## Aidey (Oct 21, 2010)

Sarah said:


> To answer some of your questions...
> 
> My instructor has been in EMS for 18 years.  *I think what he means is that you want to have your basic skills mastered before adding the advanced skills and it will make medic school so much easier on you.  *
> 
> ...




Again, what basic skills did you cover in EMT class that will not be covered in Paramedic school?


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## emsfire3924 (Oct 21, 2010)

Aidey said:


> Again, what basic skills did you cover in EMT class that will not be covered in Paramedic school?



None, but I think what he was meaning is that he wants it to be like second nature to us.  Sure they will go over it again in medic school but this is stuff he wants us to do over and over again so it's going to be easy for us.  I guess I can't really explain what he meant to you but I do understand it.


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## Veneficus (Oct 21, 2010)

Sarah said:


> To answer some of your questions...
> 
> My instructor has been in EMS for 18 years.  I think what he means is that you want to have your basic skills mastered before adding the advanced skills and it will make medic school so much easier on you. .



I have been in EMS longer. So what?

Modern day paramedicne is not about skills. It is about knowledge. Drug abusers teach themselves how to start IVs. An AED can defibrilate a patient just as easily as a medic reading a monitor.

Anyone who thinks it is skills that make a medic had missed the boat by about 25 years. With each updated curriculum the focus is more on knowledge and less on skills. Infact I reviewed a recent educational manuscript that incorperated a basic biochemistry section in it. They removed pages from skills.  

Anyone planning on mastering biochemistry working as a basic EMT?



Sarah said:


> We had a week of clinicals that were required of us in EMT class.



Sorry. A week is nothing to boast about. 



Sarah said:


> To get into the medic program here you have to show 100 patient contacts... which is a medic signing off that yes, you had contact with that patient and probably their vitals, interventions you done, etc.



Then I urge you to seek a more respectable center of education.


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## JJR512 (Oct 21, 2010)

Veneficus said:


> But aside from that little anecdote, go back to the volunteering scenario. What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?



Well, does the person who works at McDonald's have to deal with a critically ill or injured person? Does the person who works at McDonald's have to deal with a wife who was in the passenger seat of a vehicle in which her husband was just decapitated? I worked at McDonald's from entry level into management for several years, and I can tell you that in my experience, the answer to all that is _NO_. I had _great_ customer service skills dealing with people in simple situations, sure. But nothing at McDonald's prepared me for EMS.

It'd be terrible for a person to take EMT-B then immediately go into Paramedic school only to find out two years later that he or she can't stand the sight of blood and guts. If that person had gotten some experience as an EMT-B first, he or she might not have wasted two years and several thousand dollars.

EMS isn't for everyone. It's better for someone to figure that out sooner, at the basic level.


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## TransportJockey (Oct 21, 2010)

JJR512 said:


> Well, does the person who works at McDonald's have to deal with a critically ill or injured person? Does the person who works at McDonald's have to deal with a wife who was in the passenger seat of a vehicle in which her husband was just decapitated? I worked at McDonald's from entry level into management for several years, and I can tell you that in my experience, the answer to all that is _NO_. I had _great_ customer service skills dealing with people in simple situations, sure. But nothing at McDonald's prepared me for EMS.
> 
> It'd be terrible for a person to take EMT-B then immediately go into Paramedic school only to find out two years later that he or she can't stand the sight of blood and guts. If that person had gotten some experience as an EMT-B first, he or she might not have wasted two years and several thousand dollars.
> 
> EMS isn't for everyone. It's better for someone to figure that out sooner, at the basic level.



If we would have proper educational programs like nursing, then they would find out in their first set of clinicals that EMS is not for them. I know RN students that found out in their second semester when they went out for clinicals their first time that nursing is not like they thought it would be.
Oh, and none of them were required to be CNAs first...


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## FrostbiteMedic (Oct 21, 2010)

I am probably going to come off a little different here, but many programs in my area do require at least a year's worth of EMS experience before allowing entry into the Paramedic program. Mind you, we do not have EMT-B in Tennessee, only EMT-IV and EMT-P (as well as CCEMT-P, but I digress). EMT-IV is pretty much an 85 standard intermediate, but we are going to the EMT-Advanced standard (they are adding new stuff....we'll see what happens there). I once had a good medic friend remind me that 95% of the stuff we do in EMS is at a Basic level, so I don't mind EMT's at least getting some real world field experience. In reply to the comment by Lifeguards, I do not use this as an excuse for not furthering my education. I start my medic in the fall, so we will see what happens from there.


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## emsfire3924 (Oct 21, 2010)

Veneficus said:


> I have been in EMS longer. So what?
> 
> Modern day paramedicne is not about skills. It is about knowledge. Drug abusers teach themselves how to start IVs. An AED can defibrilate a patient just as easily as a medic reading a monitor.
> 
> ...




You said before that you questioned his certifications- I'm telling you that he's been in it for 18 years and who am I to question his certs with that experience.  He isn't an idiot when it comes to knowing what's best for his students.


I'm pretty sure I didn't state anywhere above that it wasn't about knowledge.  OF COURSE it is! But skills are important, too.


EXACTLY.  A week is nothing to boast about.  Thats why he suggested working a couple of years before entering medic school.  

All I've heard about this medic program is good things and if you were to look around, its nothing unusual for schools to require their EMT's interested in the medic program to have patient contacts.  So, how can you judge the program based on the fact that they want you to have experience so medic school isn't like being hit with a ton of bricks when you start?


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## TransportJockey (Oct 21, 2010)

Sarah said:


> All I've heard about this medic program is good things and if you were to look around, its nothing unusual for schools to require their EMT's interested in the medic program to have patient contacts.  So, how can you judge the program based on the fact that they want you to have experience so medic school isn't like being hit with a ton of bricks when you start?



In your area maybe. But in the four states I've looked at medic schools, I've seen maybe one that required a specified amount of time in field. Never seen one that specified pt contacts though.


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## emsfire3924 (Oct 21, 2010)

frostbiteEMT said:


> I am probably going to come off a little different here, but many programs in my area do require at least a year's worth of EMS experience before allowing entry into the Paramedic program. Mind you, we do not have EMT-B in Tennessee, only EMT-IV and EMT-P (as well as CCEMT-P, but I digress). EMT-IV is pretty much an 85 standard intermediate, but we are going to the EMT-Advanced standard (they are adding new stuff....we'll see what happens there). *I once had a good medic friend remind me that 95% of the stuff we do in EMS is at a Basic level*, so I don't mind EMT's at least getting some real world field experience. In reply to the comment by Lifeguards, I do not use this as an excuse for not furthering my education. I start my medic in the fall, so we will see what happens from there.



That was one of his main concerns.  Working as an EMT, you develop that "sixth sense."  Being able to pick things out when you are doing a scene size up, looking at a patient and having an idea of what is wrong with them.... This is stuff they teach you but it really clicks when you see it and experience it first hand!


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## emsfire3924 (Oct 21, 2010)

jtpaintball70 said:


> In your area maybe. But in the four states I've looked at medic schools, I've seen maybe one that required a specified amount of time in field. Never seen one that specified pt contacts though.



You are pretty far from me.  I'm in Missouri.  
This is from the schools website. 

ENTRANCE REQUIREMENTS
1. Be a graduate of an approved high school or
the equivalentas determined by appropriate
accrediting agencies.
2. Applicants are required to have:
*a. EMT license for a period of one year or 100
documented patient contacts.*
b. Must be at least 18 years of age.
c. Current certification in BLS for Health Care
Providers.


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## TransportJockey (Oct 21, 2010)

Sarah said:


> You are pretty far from me.  I'm in Missouri.
> This is from the schools website.
> 
> ENTRANCE REQUIREMENTS
> ...



I know I'm pretty far, that's why I did say your area  The states I've looked at medic school in are CO, OK, TX (where I'll be attending in the spring), and NM (where I did attend medic school once already).


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## abckidsmom (Oct 21, 2010)

Sarah said:


> That was one of his main concerns.  Working as an EMT, you develop that "sixth sense."  Being able to pick things out when you are doing a scene size up, looking at a patient and having an idea of what is wrong with them.... This is stuff they teach you but it really clicks when you see it and experience it first hand!



I would argue that you really develop that sixth sense with more knowledge and by following the lead of a good preceptor through a lot of calls.  EMT-B sixth sense is a lot like "I have a feeling this is out of my league" without a real understanding of what's going on other than somebody else should be dealing with it.

Paramedic sixth sense is more like "Oh, this is going to get a little bit more complicated before we're done."

Rather than reinventing the wheel through trial and error or 100 patient contacts, if you were someone I cared about entering EMS I'd want to to enter a dedicated mentorship under someone who cares enough to put the effort out to challenge you while you waited to enter paramedic school as soon as possible.  This is one of those reasons I like to volunteer.  I have had all the best mentor/mentee relationships as a volunteer- but then again, all of those people were starting from 15-16 years old and had malleable enough brains that they listened to me.


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## emsfire3924 (Oct 21, 2010)

abckidsmom said:


> I would argue that you really develop that sixth sense with more knowledge and by following the lead of a good preceptor through a lot of calls.  EMT-B sixth sense is a lot like "I have a feeling this is out of my league" without a real understanding of what's going on other than somebody else should be dealing with it.
> 
> Paramedic sixth sense is more like "Oh, this is going to get a little bit more complicated before we're done."
> 
> Rather than reinventing the wheel through trial and error or 100 patient contacts, if you were someone I cared about entering EMS I'd want to to enter a dedicated mentorship under someone who cares enough to put the effort out to challenge you while you waited to enter paramedic school as soon as possible.  This is one of those reasons I like to volunteer.  I have had all the best mentor/mentee relationships as a volunteer- but then again, all of those people were starting from 15-16 years old and had malleable enough brains that they listened to me.



Yep, so if you're working at an ALS ambulance district, you would learn and experience a lot from watching your paramedic partner.


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## emsfire3924 (Oct 21, 2010)

jtpaintball70 said:


> I know I'm pretty far, that's why I did say your area  The states I've looked at medic school in are CO, OK, TX (where I'll be attending in the spring), and NM (where I did attend medic school once already).



Why are you having to go again?


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## Aidey (Oct 21, 2010)

Sarah said:


> Yep, so if you're working at an ALS ambulance district, you would learn and experience a lot from watching your paramedic partner.



That is assuming your paramedic partner isn't a complete moron, or hates teaching. IMO it is much better to get that education in a setting where the people supervising you know what they are doing, and you are in a learning environment. You also have the benefit of actually knowing what is wrong with your patients while doing clinicals. Watching your paramedic partner doesn't get you very far if they are wrong about their diagnosis and you never know it.


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## TransportJockey (Oct 21, 2010)

Sarah said:


> Why are you having to go again?



Lots of personal issues, including a failing engagement at the time, during my last internship cycle. Just couldn't get my head in the game. Took a break and since I'm moving to a different state I need to do the whole program again.


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## emsfire3924 (Oct 21, 2010)

Aidey said:


> That is assuming your paramedic partner isn't a complete moron, or hates teaching. IMO it is much better to get that education in a setting where the people supervising you know what they are doing, and you are in a learning environment. You also have the benefit of actually knowing what is wrong with your patients while doing clinicals. Watching your paramedic partner doesn't get you very far if they are wrong about their diagnosis and you never know it.



I am going to start next fall when its available if I am accepted.  I do agree that school is a better learning enviroment but I can also see how having that hands on contact working as an EMT will help ease you into medic school.

And yes, you may have an idiot for a partner but I am talking about learning things like reading an ecg.  Maybe you haven't been trained in class to do it yet but after seeing it so many times you will know what you're looking at.  Then when you do learn it in class its not so confusing because you've seen stuff like that before.


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## emsfire3924 (Oct 21, 2010)

jtpaintball70 said:


> Lots of personal issues, including a failing engagement at the time, during my last internship cycle. Just couldn't get my head in the game. Took a break and since I'm moving to a different state I need to do the whole program again.



Oh I see.  Well, hopefully we will be going through it at the same time!! Good luck to you.  ^_^


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## Aidey (Oct 21, 2010)

Sarah said:


> I am going to start next fall when its available if I am accepted.  I do agree that school is a better learning enviroment but I can also see how having that hands on contact working as an EMT will help ease you into medic school.
> 
> And yes, you may have an idiot for a partner but I am talking about learning things like reading an ecg.  Maybe you haven't been trained in class to do it yet but after seeing it so many times you will know what you're looking at.  Then when you do learn it in class its not so confusing because you've seen stuff like that before.



If your partner is an idiot, or isn't into teaching seeing EKGs isn't going to help you when it comes to medic school. If you want to get familiar with stuff like that get a good 3 lead work book, or a patient assessment text. Don't depend on your job to teach you anything.


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## DrParasite (Oct 21, 2010)

Veneficus said:


> even put somebody on a backboard. (a skill which is given more time in lifeguarding class than EM class)


considering lifeguards teach people to put a person on a backboard and CID without applying a collar (and that's per the american red cross training btw) you might not want to use them to support your cause.


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## Aidey (Oct 21, 2010)

DrParasite said:


> considering lifeguards teach people to put a person on a backboard and CID without applying a collar (and that's per the american red cross training btw) you might not want to use them to support your cause.



That may be because it doesn't change patient outcome at all.


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## JJR512 (Oct 28, 2010)

I've been a member here at EMTLife.com longer than anyone else who has posted in this thread so far. Almost five years, in fact.

Why am I bringing this up? Because way back in my early days (in March 2006, in fact—also before anyone in this thread joined up), I asked if I should go right from my EMT-B class into a Paramedic program, or if I should get some experience first as a BLS provider.

Interestingly, the responses back then were very much in favor of getting BLS experience first. How times have changed...

http://www.emtlife.com/showthread.php?t=2480


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## Aidey (Oct 28, 2010)

*gasp*

You mean maybe people have learned something and common opinion has changed? What a concept.

/shock
//horror


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## JJR512 (Oct 28, 2010)

Aidey said:


> *gasp*
> 
> You mean maybe people have learned something and common opinion has changed? What a concept.
> 
> ...



Yes, and if you stick your fingers into a bag of M&Ms and pull out three, and all three are brown, then obviously the bag is filled with nothing but brown M&Ms. 

Who learned anything? All those of you who have have sided against experience are a completely different group of people. You can't say _they_ learned anything (and frankly I think it's arrogant that you feel that just because their opinion isn't aligned to yours, they need to _learn_ something) unless you can get each and every one of them to post here and now that they've since realized that what they said back then was wrong. And you can't tell me that _you've_ learned anything because you've probably always felt the way you do, at least since you first formed an opinion about it.

There are over six billion people on this planet, and if you think that what works best for you is also what's best for everyone else, then again that word _arrogant_ is going to come into play.


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## reaper (Oct 28, 2010)

Problem there!

When that post was done you had 3 of 14 replies were from medics at the time. That is not a lot of consensus on the subject. 

It all depends on the person. Personally I don't think you even need EMT before Paramedic. But until the education catches up with the rest of the health field, we are stuck with it.


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## firetender (Oct 28, 2010)

Lifeguards For Life said:


> The only people I have ever heard say "you need experience as an EMT before paramedic school" have all been EMT's. I have never heard a medic say this. .


 
You've not been paying attention to me and a lotta other medics


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## firetender (Oct 28, 2010)

Sarah said:


> None, but I think what he was meaning is that he wants it to be like second nature to us... to do over and over again so it's going to be easy for us. I guess I can't really explain what he meant to you but I do understand it.


 
Two words; Scene Management, for starters AFTER you learn how to be with people in need

Too many people minimize the complexities of handling humans and scenes.

But that argument is puking all over this site. I say, if you can't find an EMT job go to the degreed school and then when you run into the real world we'll help teach you how to think like an EMT!


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## firetender (Oct 28, 2010)

Veneficus said:


> Modern day paramedicne is not about skills. It is about knowledge. .


 
EMT means supporting knowledge with skills; in effect, establishing a foundation from which knowledge is applied.

(the neverending debate!)


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## MonkeySquasher (Oct 31, 2010)

Veneficus said:


> But aside from that little anecdote, go back to the volunteering scenario. *What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?*
> 
> Because they actually lose financially, McDs takes customer service a lot more serious than most EMS or IFT agencies. They actually put you through customer service training. (So does Wendy's for that matter.) *So now the McDs grill cook has more customer service training than many EMS providers.*





JJR512 said:


> *Well, does the person who works at McDonald's have to deal with a critically ill or injured person?*
> 
> It'd be terrible for a person to take EMT-B then immediately go into Paramedic school only to find out two years later that he or she can't stand the sight of blood and guts. *If that person had gotten some experience as an EMT-B first, he or she might not have wasted two years and several thousand dollars.*



I believe you both raise very valid points, among other people.

It's true, while EMS is strongly customer service-driven, we are not properly trained to actually serve the patient's needs, only support them medically.  As firetender stated later, dealing with humans and keeping order during chaos are the two "basic" skills that a person must know before becoming a fulltime EMT, let alone a Paramedic.  The two key things that make a good Medic (or EMT) are being able to deal with things (see above) and solid assessment techniques with knowledge base to back it up.  All of the skills we perform could be taught to monkeys.  But ABCs, A+P, Pathophys, immunology, and formation of a good DDx are what separate Paramedics from everyone else.

I actually think Basic classes don't screen enough.  My fire company CICs the EMT-B class twice a year.  Starting in January, they're requiring proven competency of math/reading/english at a high school/GED level.  My Medic class requires a college-level math and english class, and some form of prior experience.  Though they've waive the "prior experience in EMS" a few times, I've seen what that can produce.  "prior experience" is a relative term, as Vene points out.  I can think of a few EMT-Bs at my fire company...  They've been EMT-Bs for atleast 2 years.  They go on a good number of calls.  There's almost always a higher level of care, they're NEVER in charge of patient care, and rarely do anything other than ask about allergies, ask for patient info, and maybe do a set of vitals.  They know nothing, but technically "have 2 years experience".  As JJR touched on, the turnover rate of EMT/Medics within 1 years is pretty high, and even higher within 5 years, due to people finding it wasn't what they thought it would be.

I have to side with Vene also, that outside of the experience dealing with people and chaos and keeping a level head, everything else can/should be taught in the class.  My Medic class teaches us everything from the ground up and assumes nothing...  We're re-taught CPR, Med/Trauma assessments, re-taught immobilization and KEDs and everything else possible.  Because the instructors want to be sure we're all being taught the correct way, and all on the same page.  And I gotta say, I enjoy it.


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## emsfire3924 (Oct 31, 2010)

Wow this has spun way off track from me posting I couldn't find a job lol.  
Just wanted to update this... A couple days after I posted this I got a job!


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## Veneficus (Oct 31, 2010)

"Experience is a fine teacher, but only a fool can learn from no other."
--(not really sure who said it)

I didn't go right to paramedic school, it took me a few years to decide I wanted to after becomming an EMT. What I discovered was that I would have been better served myself, and would have better served my patients, had I gone straight to paramedic school.

I have also taught medic school for 7  years before I became too busy with other pursuits. In my direct observation, when EMT education was downgraded to a skills based class and medic was upgraded with at least a rudementary basic science component, the things you could learn as an EMT were nullified. 

Even when dealing with people, the more knowledge you have, the better you can relate to them, or give them the assurance or information they need. Knowledge imparts some level of confidence.

Learning how to handle a scene is not something you should get by trial and error, it is a critical skill that needs to be imparted by effective an capable leadership. By capable mentors. Unfortunately even the best EMS systems because of the independant nature of EMS are not very capable at imparting this critical skill. If you really and truly are determined to learn it, the fire service, law enforcement, and the military are much better places.

Dealing with people requires empathy. There are several psychological theories detailing that certain people are predisposed personality types. But I don't think many are predetermined to fail, they just have to work harder than those predisposed to succeed. 

Like any social skill, you get better at it by interacting with people. If you are at any service with a low call volume, your interactions are limited. Worse still they are reinforced by a very small peer group. It is not conducive to gaining a braod understanding, acceptance, and ability with people. 

We present a great deal of proof positive experience, even I am part of it, but the perspective I offer on this topic is from the point of view of "if I could go back then and know what I know now."

In truth if I was asked this question 15 years ago if you should go right to medic school, I would have said "no, get experience as an EMT first." But I was lucky, my EMT experience was strongly positive and not by my planning. Never rely on luck.

I have seen EMS practiconers of all levels with more than a decade of experience in EMS park trucks in flammable spill puddles at MVAs. Box themselves in at mass casualty events, and even cut off all means of egress from potentially hazardous scenes. Not because they weren't smart or experienced, but because nobody ever taught them to recognize these things.  

"Poor is the student who does not exceed his master."
--Leonardo Da Vinci


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## MonkeySquasher (Oct 31, 2010)

Veneficus said:


> I have seen EMS practiconers of all levels with more than a decade of experience in EMS park trucks in flammable spill puddles at MVAs. Box themselves in at mass casualty events, and even cut off all means of egress from potentially hazardous scenes.



....you're not by any chance from my area, are you....   Haha


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## CAOX3 (Nov 1, 2010)

Fuuny, when I was thinking of going to paramedic school a few years back, I went for the interview.  I asked do you need my transcripts for my Anatomy and Physiology credits, they said oh you dont need that. 

Hmmm.... it was a pre-req for my EMT class


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## Veneficus (Nov 1, 2010)

CAOX3 said:


> Fuuny, when I was thinking of going to paramedic school a few years back, I went for the interview.  I asked do you need my transcripts for my Anatomy and Physiology credits, they said oh you dont need that.
> 
> Hmmm.... it was a pre-req for my EMT class



are you suggesting the DOT curriculum requires that or that requiring A&P is a majority of cases in EMT programs around the nation?


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## MrBrown (Nov 1, 2010)

One of the appendicies in the DOT Paramedic cirricula lists a whole bunch of A&P objectives which seem quite reasonable .... I bet dollars to donuts that no Paramedic program teaches them tho.


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## Veneficus (Nov 1, 2010)

MrBrown said:


> One of the appendicies in the DOT Paramedic cirricula lists a whole bunch of A&P objectives which seem quite reasonable .... I bet dollars to donuts that no Paramedic program teaches them tho.



I was referring to the EMT basic curriclum.

The objecties of most of the paramedic curriculum are not really taught, they are simply bullet points given for memorization. 

One of the largest problems is who is teaching US EMS, usually people with no more education than paramedic class offers + 5 years experience in many places.

I have met and worked with instructors who never spent a day in a basic science class.


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## MonkeySquasher (Nov 1, 2010)

Veneficus said:


> I was referring to the EMT basic curriclum.
> 
> The objecties of most of the paramedic curriculum are not really taught, they are simply bullet points given for memorization.
> 
> ...




Yeah, that's why I love my instructor.  Has a BS and was actually in Med school 2 years until he realized he would rather work in the streets and teach.  He's very knowledge-oriented and we actually have PAs and MD/DOs help in lab instruction.  And we actually follow the "expanded scope" portions of DOT curriculum, which I actually enjoy.  Almost makes me want a personal otoscope for my rig.  Haha


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## Medicnextdoor (Nov 6, 2010)

*Why?*

Before you go to all of the expense, try to find out "why" you aren't getting the job. If there is a bd job reference, bad credit reference, arrest record - you know what I mean. 

A good EMT with a good employment record (it doesn't have to be in EMS) should be able to get a bite....


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