# So you Want to be a Paramedic???



## Craig Alan Evans (Mar 8, 2012)

The first step you need to take in order to be a good paramedic is to simply get in the game. I am a firm believer that a paramedic card does not make you a paramedic; it just gives you permission to learn how to be a paramedic.  So just get the card and start your journey. I have worked with medics with graduate degrees and medics with GEDs. I have worked with medics who have graduated from a two year program that was touted as the best school in the area, as well as, the 6 week condensed course that jammed packed everything in so fast the students barely remembered a thing. Each and every one of these people was issued the same card. They each were given the same opportunity to begin their journey as a paramedic. I have seen medics from each extreme and all in between both succeed beyond my expectations and also fail miserably. So forget how you got the card. It doesn’t matter anymore. Don’t think you are the bees knees just because your schooling cost a fortune. On the other side of the coin don't be insecure because you received your training from the Fischer Price Paramedic School. It's all what you make of it. If you want to be a good paramedic start by being a good person first, then make a commitment to learn each and every day because if you aren't moving forward you and moving backward. Medicine is not a stagnant profession. It is always evolving and changing in practice.  If you aren't learning something everyday then you are probably behind the times. Learn from each and every person you come in contact with. You can learn just as much from a bad paramedic as you can from a good one. You just learn what not to do rather than what to do. You can learn just as much from your patients, family members, and bystanders. Don't be afraid to ask questions. By all means don't be one of those paramedics that is silently ignorant. Just because you are a paramedic does not mean that you have suddenly become an all knowing savant. Just be honest, genuine, caring, and inquisitive and you will blossom into an excellent paramedic.  Any thoughts on this topic?


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## Amberlamps916 (Mar 8, 2012)

This makes me feel good and motivated to succeed in medic school!


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## terrible one (Mar 9, 2012)

Needs paragraphs.


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## NomadicMedic (Mar 9, 2012)

None of this is news.


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## Craig Alan Evans (Mar 9, 2012)

Yes, it could used some paragraphs, Thank you, and no it is not news but surprisingly enough not common knowledge among aspiring paramedics. The process can be daunting and overwhelming to many firefighters and EMTs. If it seems to be a waste of space to you then you have either forgotten the process or did not have any issues with the trasformation.  I applaud you! With the implementation of EMT-B in the 90s I feel we created a huge knowledge gap from BLS to ALS. We went from the EMT-A curriculum here in VA which was a diagnostic based program  to EMT-B which is an assessment based program.  Since that time the knowledge gap has been closed mostly after students received their certifications. ALS training can be mystifying to some and cause great angst during the transition from BLS to ALS.  The purpose of my writing was to empower up coming paramedics.


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## Sasha (Mar 9, 2012)

Yeah. The card does matter. It means you possess the knowledge needed to be a paramedic. 

Yes, you should be learning how to be a paramedic before you are a paramedic. That's what ride times are for. 

And it does matter where you went to school. It's a multiple choice test. Some pass out of luck...


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## usalsfyre (Mar 9, 2012)

I've actually had the pleasure of working with Lt. Evans at a previous employer. I assure you he knows of what he speaks.


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## Craig Alan Evans (Mar 9, 2012)

Sasha said:


> Yeah. The card does matter. It means you possess the knowledge needed to be a paramedic.
> 
> 
> 
> ...



Yes, the card matters, otherwise you would not be allowed to learn how to be a paramedic.  I would submit that it means you have the foundational knowledge needed to be a paramedic, certainly not all the knowledge. 

Ride times during paramedic school introduce you to the field.

I haven't met anyone who was able to pass the national registry test out of luck.  If you have encountered people who have passed the test and you feel do not measure up to the standards of your peers then that would be an argument in favor of my premise that the card only gives you permission to learn how to be a paramedic.  As I stated I have seen great paramedics come from horrible schools and vice versa.  

Just an opinion...not a fact


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## Sasha (Mar 9, 2012)

Craig Alan Evans said:


> Yes, the card matters, otherwise you would not be allowed to learn how to be a paramedic.  I would submit that it means you have the foundational knowledge needed to be a paramedic, certainly not all the knowledge.
> 
> Ride times during paramedic school introduce you to the field.
> 
> ...



Signing up for the class gives you permission to learn to be a paramedic. 

I went to a mill. I know another poster who went to a mill. It can turn out great medics but that's because we had the drive to go above and beyond and bust our butts. 

We are the exception to the rule. 

Mills generally turn out crappy providers.


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## abckidsmom (Mar 9, 2012)

Sasha said:


> Signing up for the class gives you permission to learn to be a paramedic.
> 
> I went to a mill. I know another poster who went to a mill. It can turn out great medics but that's because we had the drive to go above and beyond and bust our butts.
> 
> ...



We have a medic who absolutely positively does not possess the people skills to be a medic, but he passed the registry.  Now they're trying to figure out who's gonna precept him. Passing the test doesn't mean you have what it takes to be a medic.


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## NomadicMedic (Mar 9, 2012)

Sasha said:


> Signing up for the class gives you permission to learn to be a paramedic.
> 
> I went to a mill. I know another poster who went to a mill. It can turn out great medics but that's because we had the drive to go above and beyond and bust our butts.
> 
> ...



Not to be snarky, but what makes you "a great medic"?


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## abckidsmom (Mar 9, 2012)

n7lxi said:


> Not to be snarky, but what makes you "a great medic"?



To avoid making it personal, let's change the question to "what makes a great medic?" and see if she meets those criteria. 

In my opinion, a great medic combines clinical competence with ability to compassionately manage people and situations while maintaining the attitude of a perpetual student.


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## Sasha (Mar 9, 2012)

n7lxi said:


> Not to be snarky, but what makes you "a great medic"?



Maybe I'm not great but I know I'm not crappy.


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## NomadicMedic (Mar 9, 2012)

Good change alphabet mom. I didn't mean it to be a personal attack. I see people say "he/she is a great medic" and I wonder what the criteria for that is.


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## abckidsmom (Mar 9, 2012)

Another criteria I have is if that medic was dispatched to my grandma how hard would I work to move heaven and earth to be available?  

I work in my hometown and know about 20% of my patients personally. It makes me very sensitive to he lack of QA in my department.


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## rwik123 (Mar 9, 2012)

Sasha said:


> Signing up for the class gives you permission to learn to be a paramedic.
> 
> I went to a mill. I know another poster who went to a mill. It can turn out great medics but that's because we had the drive to go above and beyond and bust our butts.
> 
> ...



Did you knowingly go to a mill?

There's no question that an involved medic program with academic groundings will produce a better medic. Why not attend a school that's not a mill and be pushed by your educators rather than attend a mill where you have to do extra to meet a standard that they aren't providing?


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## Sasha (Mar 9, 2012)

rwik123 said:


> Did you knowingly go to a mill?
> 
> There's no question that an involved medic program with academic groundings will produce a better medic. Why not attend a school that's not a mill and be pushed by your educators rather than attend a mill where you have to do extra to meet a standard that they aren't providing?



Because I didn't have EMTLife to tell me the difference and assumed all medic programs were the same.


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## CALIFORNIA (Mar 9, 2012)

Hi, first post! 

I always hear this debate about mills and "good" paramedic programs.  Doesn't everybody study/learn from the same Brady textbooks?  Isn't ACLS/PALS the same for everybody?  The weight of success for the paramedic does not rest on the quality of the school at all.

I agree whole heartedly with the original poster, it's up to the paramedic/student to exceed and get hungry to be a great paramedic both in the classroom and the field.

(my 2 cents)


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## medic417 (Mar 9, 2012)

Yup she was young and stupid like many others.  Thankfully she was smart enough to understand her class was lousy.  Many post here that they went to a "great program" but sadly many of those "great programs" are worse than the mill Sasha attended just the Paramedics from there are to ignorant to realize that.


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## medic417 (Mar 9, 2012)

CALIFORNIA said:


> Hi, first post!
> 
> I always hear this debate about mills and "good" paramedic programs.  Doesn't everybody study/learn from the same Brady textbooks?  Isn't ACLS/PALS the same for everybody?  The weight of success for the paramedic does not rest on the quality of the school at all.
> 
> ...



Nope some use Mosby, some use AAOS.  Then you have the variables of how well the professors/instructors actually explain what is written.  Some focus only on the test others focus on teaching you medicine.  Big differences.


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## CALIFORNIA (Mar 9, 2012)

medic417 said:


> Nope some use Mosby, some use AAOS.  Then you have the variables of how well the professors/instructors actually explain what is written.  Some focus only on the test others focus on teaching you medicine.  Big differences.



I stand corrected.  I still feel the same though, I had a handful of instructors in my medic school that did not explain the material well at all some days.  On those days I would make it a point to go over the material more thoroughly on my own.  If I had questions I would usually seek answers from one of the instructors that could explain and relay what's written in the text.


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## triemal04 (Mar 9, 2012)

Sasha said:


> Yeah. The card does matter. It means you possess the absolute bare minimum knowledge needed to be a paramedic.
> 
> Yes, you should be learning how to be a paramedic before you are a paramedic. That's what ride times are for.
> 
> And it does matter where you went to school. It's a multiple choice test. Some pass out of luck...


Fixed that for you.

Yes...you should be *learning* how to be a paramedic during your field internship...unfortunately there aren't any that I have ever head of that last long enough for someone to truly come out of it a proficient provider who is completely competant as a paramedic.  200 hours (all that is required by NREMT and followed by many states) is maybe a monthes full time work.  Think that is long enough to acutally figure things out?  Learning how to do something and functioning at a mastery-level are two different things.

Wait...it does matter where you went to school, but it doesn't matter if you go to a crappy medic mill?  I'm confused.

I doubt that anyone passed/passes the NREMT test by luck.  When it was a paper test it was 150 questions; lousy odds if you are guessing each time.  With the adaptive test that's being used now, even worse odds.  While it doesn't show anything other than that someone possess a small amount of knowledge, to say that you can pass it out of luck and by guessing...no.


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## Sasha (Mar 9, 2012)

triemal04 said:


> Fixed that for you.
> 
> Yes...you should be *learning* how to be a paramedic during your field internship...unfortunately there aren't any that I have ever head of that last long enough for someone to truly come out of it a proficient provider who is completely competant as a paramedic.  200 hours (all that is required by NREMT and followed by many states) is maybe a monthes full time work.  Think that is long enough to acutally figure things out?  Learning how to do something and functioning at a mastery-level are two different things.
> 
> ...



Maybe not luck but you can pass it without knowledge. Plenty of those who pass don't know their head from a hole in the ground. 

It does matter where you went to school. Crappy schools will in general produce crappy medics. There is a reason they are crappy schools. There are always exceptions.


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## Veneficus (Mar 9, 2012)

abckidsmom said:


> We have a medic who absolutely positively does not possess the people skills to be a medic, but he passed the registry.  Now they're trying to figure out who's gonna precept him. Passing the test doesn't mean you have what it takes to be a medic.



Why do I get the sneaky suspicion that "who" is going to be you?


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## Chan (Mar 9, 2012)

I was considering going to medic school, not I'm at another fork. PA or BSN.


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## abckidsmom (Mar 9, 2012)

Veneficus said:


> Why do I get the sneaky suspicion that "who" is going to be you?



I do love a good project. It would feel like an achievement if I got him to any kind of competent.


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## medic417 (Mar 9, 2012)

CALIFORNIA said:


> I stand corrected.  I still feel the same though, I had a handful of instructors in my medic school that did not explain the material well at all some days.  On those days I would make it a point to go over the material more thoroughly on my own.  If I had questions I would usually seek answers from one of the instructors that could explain and relay what's written in the text.



But many students do not take any inititive.  So if they get crappy instruction it is all they get.


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## medic417 (Mar 9, 2012)

abckidsmom said:


> I do love a good project. It would feel like an achievement if I got him to any kind of competent.



You do not have to be a people person to be a competent medic.  You can perform every EMS skill and ask every required question w/o any human compassion.


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## Veneficus (Mar 9, 2012)

abckidsmom said:


> I do love a good project. It would feel like an achievement if I got him to any kind of competent.



Better you than me. Good luck with it.


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## abckidsmom (Mar 9, 2012)

medic417 said:


> You do not have to be a people person to be a competent medic.  You can perform every EMS skill and ask every required question w/o any human compassion.



I disagree. There are entire subcultures in our country who will not communicate with people with whom they have no rapport. EMS is science, and also art. You need some of that to be able to deal with people and direct people to do what you want them to do.


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## triemal04 (Mar 9, 2012)

Sasha said:


> Maybe not luck but you can pass it without knowledge. Plenty of those who pass don't know their head from a hole in the ground.
> 
> It does matter where you went to school. Crappy schools will in general produce crappy medics. There is a reason they are crappy schools. There are always exceptions.


Well, no, by definition there is a certain amount of knowledge required to pass any test.  ^_^  It's just very low in this case.  And I think what you mean to say was that a paramedic who has the absolute bare minimum amount of knowledge required to become a paramedic doesn't know their head from a hole in the ground.  

Then by your reasoning and personal example, it shouldn't matter where you go to school; if you are an idiot who meets the minimums then you'll still be an idiot if you go to a good school.  If you aren't, then you'll figure things out on your own if you go to a lousy one.  Way over simplified, but kind of accurate.

Not to say that people shouldn't find a good paramedic school or that there aren't benefits to going to one.


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## triemal04 (Mar 9, 2012)

medic417 said:


> You do not have to be a people person to be a competent medic.  You can perform every EMS skill and ask every required question w/o any human compassion.


Yup.  You'll just be a :censored::censored::censored::censored:ty provider.


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## medic417 (Mar 9, 2012)

abckidsmom said:


> I disagree. There are entire subcultures in our country who will not communicate with people with whom they have no rapport. EMS is science, and also art. You need some of that to be able to deal with people and direct people to do what you want them to do.



If they choose not to answer that is their choice.  I agree some patients will not accept the bad attitude but honestly they are probably part of the 95% of patients that actually would be just fine not riding in the ambulance anyway.  I would bet the majority of the remaining 5% of patients that actually do need the ambulance either can't speak or if can will answer anything from anyone in order to get the help they need.  Thus while I would hate to meet them a medic with bad bedside manner can still do the job when it counts.


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## m0nster986 (Mar 9, 2012)

I will have to agree that a good paramedic demonstrate attributes of an adult learner. Someone who is compassionate and curious about medicine which fuels their fire to continue learning. 

Unfortunately, many individuals become paramedics only as a stepping stone to reach their dream job of pulling hoses and ride in that big red fire truck...

This is why I am a strong advocate of education. If we make it a little more difficult to become a paramedic, it will filter the weak and allow for a stronger profession with better incentives.


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## SoCal911 (Mar 9, 2012)

So I can pick on medics and send my annoying patients bls to an ER for no reason, duh


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## TatuICU (Mar 9, 2012)

Holy wall of text Batman!

Also, this just in, the Cosby show has been picked up for a second season.


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## TatuICU (Mar 9, 2012)

triemal04 said:


> Yup.  You'll just be a :censored::censored::censored::censored:ty provider.



Not true.  Best CV surgeon I've ever known was the coldest, most heartless :censored::censored::censored::censored::censored::censored::censored: I've ever met in my life this side of an honest to goodness sociopath.  There are other people who were much, much nicer and much more polite, but their clamp times, pump times, and technique were amateurish at best compared to him.


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## Craig Alan Evans (Mar 9, 2012)

Surgeons can get away with poor people skills. They introduce themselves, explain the procedure, and then walk away to return to an unconscious patient.  Good people skills are required of a prehospital provider. I have seen many loose their jobs for inadequate people skills.


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## EMTBHillbilly (Apr 6, 2012)

Is there any credence to looking at pass rates for schools as a way to judge their merit?


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## DrankTheKoolaid (Apr 6, 2012)

EMTBHillbilly said:


> Is there any credence to looking at pass rates for schools as a way to judge their merit?



In short yes.  BUT...................   Who is the school catering to? Fireman only looking to upgrade to paramedic for work and dont really care to actually learn medicine.  Or to people looking to become paramedics to become paramedics.


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## rescue1 (Apr 6, 2012)

Eh...there are a decent amount of dubious schools that "teach to the test", where everything you learn is geared towards passing the NREMT and not towards actual medicine. That being said, that's not always the case, and looking at a school with a 60% NREMT pass rate may raise some questions as to its effectiveness.


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## sjlamb77 (Apr 6, 2012)

So this would probably be a good time to ask something I've been wondering. How can I find out which schools in my area are quality and which aren't?


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## EMTBHillbilly (Apr 6, 2012)

sjlamb77 said:


> So this would probably be a good time to ask something I've been wondering. How can I find out which schools in my area are quality and which aren't?



Talk to people at different EMS agencies.  You'll get a good idea after talking to a dozen or so.


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## Veneficus (Apr 6, 2012)

sjlamb77 said:


> So this would probably be a good time to ask something I've been wondering. How can I find out which schools in my area are quality and which aren't?



find out if any of the instructors actually have a degree in anything, that is a good place to start.

look at the booklist, that says a lot about a school. Especially if they have no recommended additional reading.

Ask if you can sit in a class. Find out if the instruction is just war stories, reading powerpoints, does the instructor know the material? Is the class fearful of the instructor?

Any worthwhile program should be willing to let you see. 

"You have nothing to fear, if you have nothing to hide."

Talk to the students. Get their likes/dislikes.


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## bigbaldguy (Apr 6, 2012)

sjlamb77 said:


> So this would probably be a good time to ask something I've been wondering. How can I find out which schools in my area are quality and which aren't?



Not sure how your state works but in Texas you can pull up the pass rates for each school. If you look at a school and they have a NREMT pass rate of less than 90 percent that's not so good. When they get down to pass rates under 70ish percent they stop being credible and anything under that try and go somewhere else.


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## Veneficus (Apr 6, 2012)

bigbaldguy said:


> Not sure how your state works but in Texas you can pull up the pass rates for each school. If you look at a school and they have a NREMT pass rate of less than 90 percent that's not so good. When they get down to pass rates under 70ish percent they stop being credible and anything under that try and go somewhere else.



I must respectfully disagree.

While that may seem intuitive, most medic mills have high pass rates because they teach to the test. 

Unfortunately there is more to being a paramedic than what is on the NR test.

Edit:

another trick less than reputable schools do is fail out everyone who doesn't have a high likelyhood of passing NR. So again the pass rates are inflated beyond truth.


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## EMTBHillbilly (Apr 6, 2012)

NR pass rate is 72%.


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## BigBad (Apr 7, 2012)

Nice read and I whole heartedly agree.   I went from zero to hero.  Only waiting a few months to jump into medic school.   But my GPA was 4.0 throughout school.   I knew deep down in my heart that this was going to be my life.   Despite all odds and people talking down to me about how I was no where near ready I passed.  I am now working as a paramedic on als bus.   The only reason I have gotten so far so fast is by being humble, constantly learning from peers and my mistakes and being a nice person.  Being a paramedic is so much more than practicing cowboy medicine.  I'm blessed to have found a job I love.   

My schooling didn't truly begin until I ran my first 911 without a preceptor and just an emt-b partner.


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## bigbaldguy (Apr 7, 2012)

medic417 said:


> You do not have to be a people person to be a competent medic.  You can perform every EMS skill and ask every required question w/o any human compassion.



And that's the difference between an artist and a craftsman. One does the job but the other brings passion to it.


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## bigbaldguy (Apr 7, 2012)

Veneficus said:


> I must respectfully disagree.
> 
> While that may seem intuitive, most medic mills have high pass rates because they teach to the test.
> 
> ...



When you're right you're right. I hadn't thought of it from that angle.  I would still check the pass rates for the school though. But as vent said take all things into consideration.


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## Veneficus (Apr 7, 2012)

bigbaldguy said:


> When you're right you're right. I hadn't thought of it from that angle.  I would still check the pass rates for the school though. But as vent said take all things into consideration.



No worries my friend,

I have seen every trick in the book (and a few that aren't) from less savory institutions.


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