# Certified but not yet licensed



## EMTktr (Mar 24, 2008)

Hi all, Having recently passed my NR tests, I am currently getting set up to run with a local rescue squad. My question is...what is protocol for being certified but not yet licensed to practice in a state as relates to stopping at the scene of an accident and rendering care within my scope of practice, until EMS arrives? Has not happened yet but I would like to know what is "proper".
Thanks in advance.....


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## Sapphyre (Mar 24, 2008)

As a bystander/witness, in most states you can only do whatever you would have done before training.  Essentially, advanced first aid only.  Unfortunately, I don't know if it's different in Vermont, or as a WEMT.


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## BossyCow (Mar 24, 2008)

Most of the interventions you could do as an EMT will require equipment that you probably won't have with you as a private citizen. O2, Backboard, Extrication, etc.  So you most likely can't do more than a sort of modified first aid response. 

Check with your local licensing agency for any restrictions unique to your state.


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## Ridryder911 (Mar 24, 2008)

First, not to be rude are you confusing or misunderstanding the terms of licensed and certified? 

Just because one is licensed in a state does not give any more authority off duty. 

Although, there is a significant difference in the terms of license and certified, do not confuse the intent. 

R/r 911


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## EMTktr (Mar 24, 2008)

Thanks to everyone for your replies. Rid, I believe that I am misunderstanding the terms. I am under the impression that having taken the course, passed the NR test, that I am now a Certified EMT-B. Doesn't licensing come next when I actually start to practice in a particular state?


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## Jon (Mar 24, 2008)

Unless you have a full BLS bag with O2, airway adjuncts, glucose, and activated charcoal... You are pretty much limited to providing first aid... so you should be covered under the good Samaritan laws, and you can't really make anything that much worse.


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## Jon (Mar 24, 2008)

Depends on how your state's OEMS works... Many places will "Certify" you as a state EMT on top of the NR... and that is usually just paperwork to get reciprocity for the NREMT. Some states treat the NREMT the same as a state EMT... or require that every EMT be an NREMT and use that number.

_Most _states don't license EMT-B's or EMT-P's. At all.


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## EMTktr (Mar 24, 2008)

Jon said:


> Depends on how your state's OEMS works... Many places will "Certify" you as a state EMT on top of the NR... and that is usually just paperwork to get reciprocity for the NREMT. Some states treat the NREMT the same as a state EMT... or require that every EMT be an NREMT and use that number.
> 
> _Most _states don't license EMT-B's or EMT-P's. At all.



Jon...thanks for your clarification.


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## mtmb (Apr 2, 2008)

Just another thought to about you stopping at the scene.  I just to recieved my certificate, anyways in class they made it very clear to us that once we stop we cannot leave that person tell someone with the same rank or above steps in.  Remeber if no one is around to call for extra help do that first and than go back.  I don't know where you are but we have alot of country roads that you can be out there for days and nobody would know.


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## VentMedic (Apr 2, 2008)

EMTktr said:


> Thanks to everyone for your replies. Rid, I believe that I am misunderstanding the terms. I am under the impression that having taken the course, passed the NR test, that I am now a Certified EMT-B. Doesn't licensing come next when I actually start to practice in a particular state?



The National Registry is a national exam used to test and certify EMTs that they meet the minimum requirements.   

Application is then made to the State for permission to work and perform as an EMT in your State.  

Some states call it Certification and some License.  Usually at the EMT level it is known by the State as Certification but I believe your state also refers to Paramedics as Certified also.   

For some states that is semantics except for Texas which differentiates Certified and Licensed Paramedics by an Associates degree. 

The reasons each state insists on certifying or licensing individuals are:
 1) control over who is practicing in their State 
 2) funding by fees to maintain a State EMS agency as oversight.  

Schools do not do background checks and just about anyone can get an EMT certificate by passing a course and taking a test.  If you have been convicted of certain crimes such as being a child molestor or drug dealer, that State may not want you practicing as an EMT in their state regardless of your NR certificate.   Once you are in the State's system, any illegal activity or professional violations of care that you commit, your employer will be obligated to report to the State.  You can lose your State certification to practice in that state but your NR may not be affected.  You could then apply with your NR certificate to a State like California which does not have, as of yet, strict oversight for its EMTs nor do they require background checks in all California counties.

As for as stopping on scene:
You are going to perform as a first-aider.  You can use your knowledge/training for scene safety, to open an airway, stop bleeding and perform CPR.   In some States, bystanders are allowed to ASSIST a patient to take their medications.  Check with your local and State statutes for Good Samaritain laws.  This may apply when you are not on duty also after you are officially certified by the State.


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## ErinCooley (Apr 3, 2008)

"Schools do not do background checks and just about anyone can get an EMT certificate by passing a course and taking a test.  If you have been convicted of certain crimes such as being a child molestor or drug dealer, that State may not want you practicing as an EMT in their state regardless of your NR certificate.   Once you are in the State's system, any illegal activity or professional violations of care that you commit, your employer will be obligated to report to the State.  You can lose your State certification to practice in that state but your NR may not be affected.  You could then apply with your NR certificate to a State like California which does not have, as of yet, strict oversight for its EMTs nor do they require background checks in all California counties."

This is only partially true... I had to have a NCIC background check before I could even take the EMT-I/85 class.  Also, NREMT.ORG asks if you have been convicted of a felony.  If you have, they will not allow you to test.   A friend from my class is currently battling with NREMT over this.  He inadvertently checked that he had been convicted of a felony, they refuse to even speak with him over it.


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## Sapphyre (Apr 3, 2008)

VentMedic said:


> Schools do not do background checks and just about anyone can get an EMT certificate by passing a course and taking a test.  You could then apply with your NR certificate to a State like California which does not have, as of yet, strict oversight for its EMTs nor do they require background checks in all California counties.



Hmmm, really?  California doesn't do background checks, and neither do the schools?  (sarcasm, a little)  In that case, would someone please refund the $69.95 I had to pay to get a background clearance before I could start class, and explain to my classmates who didn't have a totally clear check, why they had to talk to EMSA to be sure they'd be cleared with them?


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## BossyCow (Apr 3, 2008)

Depends on the class. Our local community college will give preference to those EMT-B students who are sponsored by an agency (Fire, Nat. Park, Private Amb.) but by law, they are not allowed to refuse anyone entrance to any class. So, if there are openings, and someone off the street, regardless of criminal history, wants to take the EMT class, they may. 

This became an issue with the ER who does the clinical time for this program. They cannot allow anyone into the ER without a background check. But they don't want to pay for it. So, if the student is in the class, and the class requires clinical time in the ER, is the college then responsible for paying and performing the background check? 

Our agency does background checks on all applicants and no one goes to EMT class without passing a 6 month probation with the district first. But, there are those cracks through which the sneaky will slither.


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## JPINFV (Apr 3, 2008)

Sapphyre said:


> Hmmm, really?  California doesn't do background checks, and neither do the schools?  (sarcasm, a little)  In that case, would someone please refund the $69.95 I had to pay to get a background clearance before I could start class, and explain to my classmates who didn't have a totally clear check, why they had to talk to EMSA to be sure they'd be cleared with them?



There's no requirement for background checks at the state level for either starting class or getting a certification to work. THAT SAID, the vast majority of the counties (In California you are certified by county, not the state) do require a background check for certification. The problem though, is that there is no strict requirement that you are certified by the state you work in, just that you are certified by any county in California. Some counties, such as Orange County, have worked around this by requiring a cert and a license to work on an ambulance that requires that county's certification (EMT-B certification, Ambulance Attendant license).

There was a rather large controversy over this last year. After a handfull of ex-cons were caught working on ambulances, the state realized that there were providers going 2-3 counties away to a non-background check county to get a certification.


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## Sapphyre (Apr 3, 2008)

Thank you, JP, for explaining that further.  And, I apologize if my post came across as snippy.


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## VentMedic (Apr 3, 2008)

ErinCooley said:


> This is only partially true... I had to have a NCIC background check before I could even take the EMT-I/85 class.  Also, NREMT.ORG asks if you have been convicted of a felony.  If you have, they will not allow you to test.   A friend from my class is currently battling with NREMT over this.  He inadvertently checked that he had been convicted of a felony, they refuse to even speak with him over it.



For the NR and some States, anybody can "ask" if you are a convicted felon or have been declared mentally incompetent (5150 in CA, Baker Act in FL) but unless they do a background check, you can answer whatever you want an they would be not the wiser.

In California, prior to last year, less than 50% of the counties did backgroud checks for EMT.  It took some serious newspaper articles to get another 25% of the counties to do background checks.


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## Topher38 (Apr 3, 2008)

Don't forget even though you passed the test, your NOT officially certified till you get your number.


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## JPINFV (Apr 3, 2008)

Sapphyre said:


> Thank you, JP, for explaining that further.  And, I apologize if my post came across as snippy.



huh? I didn't think you were being snippy. I guess I have a high snippy tolerance level.


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## rayemtjax77 (Apr 3, 2008)

EMTktr said:


> Hi all, Having recently passed my NR tests, I am currently getting set up to run with a local rescue squad. My question is...what is protocol for being certified but not yet licensed to practice in a state as relates to stopping at the scene of an accident and rendering care within my scope of practice, until EMS arrives? Has not happened yet but I would like to know what is "proper".
> Thanks in advance.....



Keep in mind that if your agency states that you have to stop under THEIR guildlines, then you do so.. Other wise you are covered to practice basic first Aid and CPR.


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## CFRBryan347768 (Apr 3, 2008)

Jon said:


> Unless you have a full BLS bag with O2, airway adjuncts, glucose, and activated charcoal... You are pretty much limited to providing first aid... so you should be covered under the good Samaritan laws, and you can't really make anything that much worse.



MVA, With no c-spine, or an attempt, well that just made it worse...B):wacko:^_^:glare:


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## rmellish (Apr 3, 2008)

Jon said:


> Unless you have a full BLS bag with O2, airway adjuncts, glucose, and activated charcoal... You are pretty much limited to providing first aid...



Not that I would suggest buying any of the above...

no no no, I'm not opening that can of worms :wacko:


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## BossyCow (Apr 3, 2008)

So, I'm curious... if there is no background check required to gain certification, how do you get your clinicals done? Does the ER allow unchecked students access to patients? 

Okay.. this is a hijack on the orignal thread so I'll repost it elsewhere.


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## JPINFV (Apr 3, 2008)

Essentially, yes.


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## daedalus (Apr 9, 2008)

My class required backgrounds before you could even apply to do your clinical times at the ER and on the ambulances. Both the hospital and private company doing 911 in my area also required a complete orientation, background checks by the school, TB test (2-step), and Hep B before you stepped foot in patient care areas. My county EMSA requires a background on file before issuing a cert. I live in california.


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## Kimmy Schaub (Apr 19, 2008)

In NH, if you come across an emergency, act according to your training until further help arrives. I think most states function like this...check your states Good Samaritan Law


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