# Away with the national registry



## KillTank (Jan 23, 2008)

I have heard rumors that they might abolish the national registry. Do any of you know that this could be true?


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## bstone (Jan 23, 2008)

KillTank said:


> I have heard rumors that they might abolish the national registry. Do any of you know that this could be true?



Very doubtful. The NREMT keeps growing and adding more. You might want to post this in the NREMT forum, tho. It's a few above this one.


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## Asclepius (Jan 23, 2008)

Not that it is stellar, but right now NREMT is the closest thing this nation has to a uniformed approach to EMT education and certification. I doubt highly that it is going anywhere. I'm curious though, where did you hear that from? Perhaps you have a better source than the rest of us?


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## Arkymedic (Jan 23, 2008)

KillTank said:


> I have heard rumors that they might abolish the national registry. Do any of you know that this could be true?


 
I highly doubt it.


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## VentMedic (Jan 23, 2008)

I can see where a few Paramedic schools that are not up to par for achieving accreditation might be upset with the NREMT.  Even if they didn't start the rumors they might be very happy to support the rumors.


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## bstone (Jan 23, 2008)

Not only medic schools. Some basic schools. Even Intermediate schools. all of them, infact.


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## seanm028 (Jan 23, 2008)

bstone said:


> Not only medic schools. Some basic schools. Even Intermediate schools. all of them, infact.



Are you saying that all EMT schools are not up to par with NREMT standards?


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## VentMedic (Jan 23, 2008)

*NREMT Sets Deadline for Paramedic Education Programs*
*Will certify only graduates of accredited programs after 2012*

http://www.jems.com/news_and_articles/articles/NREMT_Sets_Deadline_for_Education_Programs.html


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## Ridryder911 (Jan 23, 2008)

KillTank said:


> I have heard rumors that they might abolish the national registry. Do any of you know that this could be true?



I am sure it is from those that do not want to adhere to the new requirements of accreditation for NREMT/P testing (please note, it is ONLY for the Paramedic level). As others described, this event has shaken many and actually made them more credible. This will help abolish the "**** & Jane" Paramedic schools and courses. 

The accreditation process usually only certifies advance level courses.

Again, it is  *NOT* the NREMT that has these standards. It rather is the accrediting agency (CAAHEP) as the article describes. 

There are very few accredited programs out there. In reality there are very few good EMS programs at all. 

Most EMT's will inform you two things. Either they attended the best or worse... Why? Most do not attend more than one in comparison. 

I get amused that most describes how "great" their course was, only to later find out they were taught very little, had poor instruction/teachers, and the whole process.... well.. basically sucked. 

That is why it is so essential that students investigate their education facility, and why it is important that those institutions be held accountable and be accredited. Just because the state approves it and one can take the NREMT doe NOT automatically ensure it meets any true standards and distributes the needed education.

R/r 911


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## bstone (Jan 23, 2008)

Ridryder911 said:


> I am sure it is from those that do not want to adhere to the new requirements of accreditation for NREMT/P testing (please note, it is ONLY for the Paramedic level). As others described, this event has shaken many and actually made them more credible. This will help abolish the "**** & Jane" Paramedic schools and courses.
> 
> The accreditation process usually only certifies advance level courses.
> 
> ...



Why do you use a / and not a - like everyone else, including the NREMT?


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## bstone (Jan 23, 2008)

seanm028 said:


> Are you saying that all EMT schools are not up to par with NREMT standards?



I think that every program should be licensed by their state and accredited by a national accreditation board and the students required to pass a national certification exam.


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## Ridryder911 (Jan 23, 2008)

Because that was the original approved DOT abbreviation and title for the Paramedic. Alike many other approved EMT titles (EMT-A = EMT Ambulance NOT advanced, EMT/A = Advanced, etc.). Many used to use RP (registered Paramedic) and totally removed the EMT wording altogether.


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## bstone (Jan 23, 2008)

Ridryder911 said:


> Because that was the original approved DOT abbreviation and title for the Paramedic. Alike many other approved EMT titles (EMT-A = EMT Ambulance NOT advanced, EMT/A = Advanced, etc.). Many used to use RP (registered Paramedic) and totally removed the EMT wording altogether.



Ok, but you wrote NREMT/P, when everyone else, including the NREMT, write it -P.

Sometimes I see just REMT-P. What's up with that?


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## JPINFV (Jan 23, 2008)

We could always do away with basics and have just one (paramedic) standard level of care across the country. That'll solve the nomenclature problem pretty quickly.


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## Emt /b/ (Jan 23, 2008)

JPINFV said:


> We could always do away with basics and have just one (paramedic) standard level of care across the country. That'll solve the nomenclature problem pretty quickly.



Yeah, just as soon as there is more incentive for someone to become a medic.


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## JPINFV (Jan 23, 2008)

As long as a 120 hour advanced first aid course is considered enough "training" to be in charge of patient care, then it wouldn't be. Of course, as long as that's the case, EMS will maintain its red headed step child status in the medical community.


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## Asclepius (Jan 23, 2008)

Ridryder911 said:


> Most EMT's will inform you two things. Either they attended the best or worse... Why? Most do not attend more than one in comparison.


I took my first paramedic class at a "training center" - that is to say, it was not a fully accredited university based class. It was good, but it wasn't great. I then chose to repeat the paramedic training at a major university in Ohio. I received much better classroom instruction through the university, but had a better internship experience at the training center. 

I am telling you this because I can vouch for the importance of accreditation. If you have a choice, elect to take it through an academic institution. It may cost you a little more, but you'll walk away with college credit which can be used towards a degree. Additionally, I think you will find that they adhere to a more uniformed approach to learning and you're educational experience will be far greater.


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## bstone (Jan 23, 2008)

JPINFV said:


> We could always do away with basics and have just one (paramedic) standard level of care across the country. That'll solve the nomenclature problem pretty quickly.



Yes. At the same time we can do away with Licensed Practical Nurses, Licensed Vocational Nurse, Registered Nurse, Certified Critical Registered Nurse, Certified Emergency Registered Nurse, Certified Registered Nurse Anesthetist, Nurse Practitioner, Advanced Registered Nurse Practitioner, Certified Nurse Specialist....shall I go on? Find one to standardize on? Certainly not. I think the nursing unions would put a stop to any attempt real quick.

Also, standardizing on paramedic is an idea of folly. It would get rid of about 80% of the volunteers out there (more?) and eliminating their positions would leave the door wide open to no licensing, regulation, training, etc. Do you really advocate for that?


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## KEVD18 (Jan 23, 2008)

JPINFV said:


> We could always do away with basics and have just one (paramedic) standard level of care across the country. That'll solve the nomenclature problem pretty quickly.



would never work, purely from a financial standpoint. here in mass, basics make anywhere from 11-13 or better. medics start at 14 and go from there. now the jump from 13 to 14 isnt much, but imagine if you run an entirely bls transport service( no 911, just dialysis and dr appts) and pay your guys say 11.50. so a law is passed that there is now one level(paramedic). well here, you'll have to pay them at least 14(and that really really low end). so you entire payroll just went up $3/hr/person+. i know of services that would just throw in the towel right there. just call it a day.

aside from that, we cant even get a national standard curriculum. everybody gets taught something different. its insanity.


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## VentMedic (Jan 23, 2008)

bstone said:


> Yes. At the same time we can do away with Licensed Practical Nurses, Licensed Vocational Nurse, Registered Nurse, Certified Critical Registered Nurse, Certified Emergency Registered Nurse, Certified Registered Nurse Anesthetist, Nurse Practitioner, Advanced Registered Nurse Practitioner, Certified Nurse Specialist....shall I go on? Fine one to standardize on? Certainly not. I think the nursing unions would put a stop to any attempt real quick.



I think you are confusing entry level requirements for the nursing profession which is the equivalent of 2 years with the additional opportunities available after that minimum is met.  BTW, the LVN/LPN has been limited in what areas they are now allowed to work in since RNs established their 2 year minimum or almost 30 years.  LVN/LPNs are also represented by SEIU (Service Employees Internaional Union) and not a nursing union in many unionized area. They are now in the "tech" category.



bstone said:


> Also, standardizing on paramedic is an idea of folly. It would get rid of about 80% of the volunteers out there (more?) and eliminating their positions would leave the door wide open to no licensing, regulation, training, etc. Do you really advocate for that?



I do believe there will continue to be a place for the EMT-B. However, the paramedic should have a minimum of a two year degree for their entry level. After that, they can get their critical care or flight certs with much more additoinal training and not just the bare minimum overview classes offered now.


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## JPINFV (Jan 23, 2008)

bstone said:


> Yes. At the same time we can do away with Licensed Practical Nurses, Licensed Vocational Nurse, Registered Nurse, Certified Critical Registered Nurse, Certified Emergency Registered Nurse, Certified Registered Nurse Anesthetist, Nurse Practitioner, Advanced Registered Nurse Practitioner, Certified Nurse Specialist....shall I go on? Find one to standardize on? Certainly not. I think the nursing unions would put a stop to any attempt real quick.


Yep, EMS and nursing (including advanced practice nurses) are the same thing. :sad::unsure: 

Of course those levels mentioned also have more than 2 weeks of full time school to be able to work towards that level. Nice red herring though. 



> Also, standardizing on paramedic is an idea of folly. It would get rid of about 80% of the volunteers out there (more?)


Whoa, wait a minute. I thought EMS was supposed to be about the patient. If the volunteers don't want to become educated to the point where they can do more than "O2, call medics, transport" then good riddens. If volunteers aren't willing to improve the care that they provide then they are in a medical field as a hobby. People's lives should not depend on a hobbyist.  



> eliminating their positions would leave the door wide open to no licensing, regulation, training, etc. Do you really advocate for that?


It's a false dilemma since there are plenty of other services that rural areas offer whom they either pay, or expect competency out of.


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## JPINFV (Jan 23, 2008)

KEVD18 said:


> would never work, purely from a financial standpoint. here in mass, basics make anywhere from 11-13 or better. medics start at 14 and go from there. now the jump from 13 to 14 isnt much, but imagine if you run an entirely bls transport service( no 911, just dialysis and dr appts) and pay your guys say 11.50. so a law is passed that there is now one level(paramedic). well here, you'll have to pay them at least 14(and that really really low end). so you entire payroll just went up $3/hr/person+. i know of services that would just throw in the towel right there. just call it a day.


The assumption is that most non-emergent transports require an ambulance, and therefore EMTs (B, P, other alphabet soup level). Most of those patients can get from A to B just as easy in a van with a gurney and an oxygen tank. Of course this would also require making Medicare reimburse wheelchair/gurney van transports. This brings me to your next point.


> aside from that, we cant even get a national standard curriculum. everybody gets taught something different. its insanity.


It's gotta start someplace. If someone is really concerned that everyone is being taught different things, then they should be either working towards a degree/cert that would make them eligible for system management positions, working with EMS courses, and/or working with state and federal legislators and other government offices/agencies for change. Nothing good was ever accomplished by people sitting on their hands.


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## bstone (Jan 23, 2008)

JPINFV said:


> Yep, EMS and nursing (including advanced practice nurses) are the same thing. :sad::unsure:
> 
> Of course those levels mentioned also have more than 2 weeks of full time school to be able to work towards that level. Nice red herring though.
> 
> ...



Um, no. 

When you're a farmer working from the crack of dawn until late at night, I admire you for getting your Basic and volunteering. I don't fault them one bit for not taking a year out of their life for getting their medic. Not at all.


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## Ridryder911 (Jan 23, 2008)

bstone said:


> Ok, but you wrote NREMT/P, when everyone else, including the NREMT, write it -P.
> 
> Sometimes I see just REMT-P. What's up with that?



Not trying to hijack but a little history lesson. 

In the late 70's to early 80's there were becoming so many abbreviations that the DOT decided to determine to clarify it for paperwork and legal purposes. Hence the three major divisions were made. EMT, EMT/Advanced, EMT/Paramedic. The Registry did not test or have the level of Paramedic until early 80's and the Intermediate level was not developed until mid 80's. 

The Registry used to divide the Basic level into Ambulance and non-ambulance rating with rockers on the patch and certificate, etc. Before one could describe you were ambulance rating, one had to verify they had 6 months experience. (As well before receiving any accreditation off provisional rating i.e Intermediate, Paramedic). 

Patch design went from just Registered EMT (REMT) to a rocker bar on top stating "National"... hence the new abbreviation NREMT. This was their promotion of being "national" and as well being "registered". 

My first EMT patch from the registry actually stated "Charted Emergency Medical Technician-Ambulance" in one round 5" patch. Very few, obtained this because it was limited to the first 10,000 EMT's.  Then I switched to the to the older EMT with the ambulance rocker and then onto National rocker, etc.. 

Now the patch design is going to a total round with the rockers being dissolved. 


Now back to the topic: 

Students are very vulnerable and especially those that are at the beginning phase or Basic level. Just talk to any experience instructor and they can verify that Basic level is nice to teach, because they do not know if you have made a mistake or not. They know no difference. 

The problem is just that. 

Some students are taken advantage of in many ways. Poor teaching with low expectations lead to poor outcome. Just read the numerous of posts even here on this site and others EMS forums. There should never be very many questions in regards of EMT testing and their certification level or even basic medical care. 

Blatant poor interpretation of legal descriptions of what is safe practice and not, as well as no continuity of being taught the "essentials". One should compare institutions endorsement of skills or lab time. Does the course have enough practice time? There should be at least one hour "lab" time per lecture time? Is there an open lab that will allow the students to practice between classes or off time? 

Does the institution require thesis or scientific research papers and scientific clinical presentations for those that are enrolled in advance level courses? Does the institution have a complimentary library offering such texts, scientific journals, so these requirements can be fulfilled? 

Does the educational facility have experienced licensed clinical instructors from the school on the clinical premises? Thus allowing the instructors to intervene with preceptors and observe the students performance first hand and is able to evaluate a true honest opinion, with suggestions of improvement or positive compliments.

Again, it is easy to become an EMT and definitely to simple to become a Paramedic. With additional requirements we will see our profession be more of that... a profession. 

R/r 911


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## JPINFV (Jan 23, 2008)

bstone said:


> When you're a farmer working from the crack of dawn until late at night, I admire you for getting your Basic and volunteering. I don't fault them one bit for not taking a year out of their life for getting their medic. Not at all.


Who ever talked about blaming anyone for volunteering. After all, shouldn't volunteers be happy if their system goes to full time paramedic staffing?


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## bstone (Jan 23, 2008)

JPINFV said:


> Who ever talked about blaming anyone for volunteering. After all, shouldn't volunteers be happy if their system goes to full time paramedic staffing?



Of course, but frustratingly that is not the reality for a huge number of counties in this country. Volunteer BLS is all they have to go by. So licensing of EMT-Bs with regular training, standards and coned is the way to go. Do you disagree?


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## Ridryder911 (Jan 24, 2008)

bstone said:


> Um, no.
> 
> When you're a farmer working from the crack of dawn until late at night, I admire you for getting your Basic and volunteering. I don't fault them one bit for not taking a year out of their life for getting their medic. Not at all.



Why are they not volunteering getting a professional EMS into their area?  Remarkably, we do not have volunteer nurses for nursing homes or clinics then why is it we have to have it in EMS? Do you see volunteer city water and sewer personal, jailers, postal employees or road workers? Why not? 

Why is it that we think that EMS should have to be volunteer? Again the role of the EMT should be strictly first responder only.

Yes, there are some areas that are *very* remote and that is a whole different situation. 

Let's now clarify some things:

There are very few areas in the nation that have and utilize Nursing Unions. 

Technically CCRN does NOT stand for Certified Critical Care Nurse.. look at the AACN site  

Any *board* certifications above the standard RN (which already possess a degree) means they have demonstrated that they have already performed several hours of clinical experience and have successfully passed the board examination in that *speciality*. Similar in comparison to professional standing of a Board Certified ER physician. (No, not all ER Doc's are board certified). 

When comparing the levels of CNA, LPN let's remember the rules! Those levels that are lower than the RN is considered to be assistants to the RN. They work under the direct supervision of a RN... period. Albeit per direct or standing orders, they are considered to be supervised. Hence they can have multiple levels due to always being supervised and again in the discretion of  the RN to assist in the care of their level. 

If the hospital is JCAHO, then LPN's, CNA or patient care representative or any other title cannot utilize them as nurses in critical care or emergency services as Vent described. Again, they are there to assist and are supervised.

Is the EMT always under direct supervision of a Paramedic? ...... 

Even PA's are technically under the orders and supervision of a physician. 

In regards to non-emergency transport (i.e wheelchair), why do they want and use EMT's?  Really, the curriculum has nothing to do with transferring of patients, lifting and assisting patients into and out of medical specialty devices.

I believe most use EMT's is because they are a dime a dozen. It looks good for their advertising, and some states require them to transport patients on oxygen. I do wonder why some outside agency has not designed a transfer technician course that includes movement of patients, precautions of different type illnesses, etc. It would be much cheaper and pertinent to the business. Then again, EMT courses are not too costly in comparison to other medical courses. 

This does not usually lead many into emergency services or provide any educational or clinical experience for emergency care. In fact many educators and administrators are now suggesting a "clean slate" so bad habits have not been obtained.


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## KillTank (Jan 24, 2008)

I was not asking about how it works, I know how it works, I thought maybe their contract was gunna end and someone else was gunna take over the testing. I myself dont agree on the national registry. call me stupid or ignorant but I do not agree with the test. it tests you on how good you are at taking tests, not how to be a great emt. go politics.


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## TNEMT06 (Jan 24, 2008)

I know Tennessee is considering getting rid of National Registry and use some other agency for curriculum and certification standards.


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## bstone (Jan 24, 2008)

TNEMT06 said:


> I know Tennessee is considering getting rid of National Registry and use some other agency for curriculum and certification standards.



What's your source?

I was considering going to a music festival over the summer and TN said they'd give me an EMT-IV license due to being an NREMT-I.


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## Ridryder911 (Jan 24, 2008)

KillTank said:


> I was not asking about how it works, I know how it works, I thought maybe their contract was gunna end and someone else was gunna take over the testing. I myself dont agree on the national registry. call me stupid or ignorant but I do not agree with the test. it tests you on how good you are at taking tests, not how to be a great emt. go politics.



I don't really think you truly understand .."_how it works"..._ I see that you are from Texas. Do you know why they use NREMT?  Texas used to have their own state EMT tests... Guess what ? They had a higher fail rate than that of the NREMT test. I can assure from one that was Texas Paramedic at one time, it was a horrible test (had to apply a Thomas half ring splint). 

Politically motivated... maybe. It is much cheaper to have a nationally recognized tests designed by professional test writers and accredited than to attempt to fund one yourself. IT costs hundreds of thousands of dollars to develop an accredited tests. Remember, it cannot be just a test.. it has to be a scientfic based tests to tests the minimal knowledge allowed for safety. 

Do medical test suck? Yes, but remember, we have to have some form of validating one's knowledge. How are we to obtain that than other than a written test? 

So you much rather have each state have a separate test? If your discussing test format, I can assure that the NREMT is much easier than most medical board testing. At the least you have one in four chance on each answer... Goodness, one can still retest after failing without going back to class. 

If you were not used to the NREMT testing style, then your school or program is to blame. Your instructor should understand the basic methods they use and should had been using those methods and formats during the testing phase of class. Unfortunately, most students are used the simplistic "matching, label the following, identify out of the following" etc. that they may see in workbooks; that are verily rarely utilized on medical board examinations. As well most classes never use computer testing while in the course, and students wonder why they fail? 

Do I believe the NREMT has problems? Oh my YES! It is much too simplistic and has a too high percentage of passing per applicants. The tests questions need to be more straight forward and a mixture of science and patient scenarios need to be added. Follow up of what portions candidates are weak in so they can improve, as well as feed back to educators so they can emphasize and focus upon to teach. 

I will agree with most, I have yet found a perfect test. That is why it is so essential for intense studying and being fully prepared

R/r 911


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## Ridryder911 (Jan 24, 2008)

TNEMT06 said:


> I know Tennessee is considering getting rid of National Registry and use some other agency for curriculum and certification standards.



I have heard rumors and actually seen some states do this only to return in a few years. Thus the reason so many states are NREMT. The main reason again, it is * very, very costly* to maintain a professional test. As well, most states realize getting other states to recognize their tests will be difficult, so limiting the profession. 

I do not think most understand the process of developing a recognized accredited test. It is a lengthy process of professional, educated test writers that have to validate tests questions in comparison to the professional standards, etc... again, it is not an easy, cheap process. 

I do realize TN has been very pro-active in some of their educational standards, but again one will have to see if they will want to fund such an endeavor.

R/r 911


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## bstone (Jan 24, 2008)

Plus I think that most EMTs hate it when a state stops using NREMT. It means we are less portable. And we hate that. A lot.


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## futureemt (Jan 25, 2008)

KillTank said:


> I was not asking about how it works, I know how it works, I thought maybe their contract was gunna end and someone else was gunna take over the testing. I myself dont agree on the national registry. call me stupid or ignorant but I do not agree with the test. it tests you on how good you are at taking tests, not how to be a great emt. go politics.



You know what....I soooooooooooo agree with you!!!!  We don't take it here anymore!!!


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## John E (Jan 25, 2008)

*I'm curious...*

you claim that you agree with the previous poster yet you're haven't taken the NREMT yet. What are you basing your dislike on? What other people have told you?

Contrary to the previous poster, the NREMT does not test the student's test taking ability, it is a critical thinking test, you can't just memorise a bunch of facts and go in and pass it. Given that you're entering the medical field, which if nothing else, DEMANDS critical thinking, you might think about working on passing it rather than on making what sound like unfounded complaints about it.

I've found that the majority of people who dislike it have either failed it or they've been told how bad it is by others who have failed it.

No one I've spoken with who's passed it seems to have any major problems with it, with the exception of a couple of people who post here.

John E.


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## Ridryder911 (Jan 25, 2008)

John makes some valid points. 

If you have never taken the NREMT how do you know? Also if you have never taken any other medical tests or National Boards in what comparison do you have? 

As well you stated you are a Basic Student, therefore you have definitely not taken any other NREMT tests as of yet. 

Finally, N.J. ... enough said. With the documented controversies within the state that still runs First-Aid units and fragmented ALS units. Ever consider really why they do not use NREMT? ... I suggest to check out the ease or shall I say the complexity of repricosity. 

R/r 911


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## disassociative (Jan 25, 2008)

TNEMT06 said:


> I know Tennessee is considering getting rid of National Registry and use some other agency for curriculum and certification standards.



TN is not thinking about getting rid of the Registry. We are requiring it for initial licensure. NR is not going anywhere.

EMT-IV(NREMT-B )
EMT-P(NREMT-P)


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## Vanatta67 (Jan 26, 2008)

I know that the practical portion of the National Registry is now not needed after you pass your course, when you take your final before you finish your basic or medic that will count torwards your nr now.


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## Ridryder911 (Jan 26, 2008)

Vanatta67 said:


> I know that the practical portion of the National Registry is now not needed after you pass your course, when you take your final before you finish your basic or medic that will count torwards your nr now.




???? WT???

Okay, once again... The NREMT has *never, ever* required practical portions for the Basic EMT! They will however; accept a state, the schools final examination. However; I believe you will find that one will be required to take a separate NREMT Advanced Practical Examination. It *cannot* be associated with educational systems, etc. It may be performed at one, but NOT associated with one. 

R/R 911


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## piranah (Jan 26, 2008)

well, i just took my basic NREMT exam and passed it and frankly i didnt mind it....but you have to study...i cant help but say if you cant manage the NREMT and cant recall basic knowledge for the exam.....what gives you the right to touch a patient. a smart medic once told me if you cant manage the airway you don't deserve to treat a patient...and i bring that to everything.....working EMS is a privledge(spell) not a right... you have to earn it....im in a NREMT accredited paramedic program and i had the choice between a MASS. non-NREMT course or the one im in and i think that the NREMT is the only way to go.....its a privledge...not a right....



-jim-   NREMT-B  / NREMT-P in training


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## futureemt (Jan 27, 2008)

John E said:


> you claim that you agree with the previous poster yet you're haven't taken the NREMT yet. What are you basing your dislike on? What other people have told you?
> 
> Contrary to the previous poster, the NREMT does not test the student's test taking ability, it is a critical thinking test, you can't just memorise a bunch of facts and go in and pass it. Given that you're entering the medical field, which if nothing else, DEMANDS critical thinking, you might think about working on passing it rather than on making what sound like unfounded complaints about it.
> 
> ...



I was told by many emt around here that it a pain to keep it up.


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## futureemt (Jan 27, 2008)

Ridryder911 said:


> John makes some valid points.
> 
> If you have never taken the NREMT how do you know? Also if you have never taken any other medical tests or National Boards in what comparison do you have?
> 
> ...



I wasn't trying to start a problem....I do apologize I was out of line.  I check it out....thanks!


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## Katie (Jan 27, 2008)

I'm not trying to start a fight here, but I don't think that she was out of line in expressing her opinion.  Founded or unfounded in other people's opinion, she has a right to express hers.  Has she taken the test?  No she hasn't, and maybe the post could have been worded better.  But the post that she quoted deals more with the theory of testing.  Like it or not, people will share opinions and there's no rule that says you can't say what you think.  This is a place to come and share ideas and all she was doing was agreeing with what someone else said which happened to be a differing opinion, not an error.  Sorry if I'm offending some people but I just think it's a bit harsh to jump on someone for entering into a discussion.


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## John E (Jan 27, 2008)

*Well I wasn't ....*

trying to start a fight either, I was simply curious as to how someone who hasn't taken a particular test can give an opinion about it.

As for my disagreement with the notion that the NREMT is just a test to test people's test taking ability, well that may be someone's opinion but it is simply not factual.

I can have and hold an opinion about most anything, that doesn't mean that I can use my own facts. 

The NREMT isn't used to test student's test taking ability, it's used to test their critical thinking ability and to determine if they've retained a minimal amount of specific knowledge on particular subjects. That's not my opinion, that's just what the test is. That's why it's used by so many states and counties to qualify potential EMT's and Paramedics. I've attended a fair share of classes, even helped to teach a few at the college level and I have never heard of nor seen a test that was used simply to test the student's ability to take tests. On the other hand, I've seen, read and heard many a student who failed a test use that as an excuse for failing. When pressed as to what they actually mean, I've never been given a single example that held up.

I would challenge anyone who thinks that the NREMT is an example of what the previous posted called it to give some specific examples of what they mean by calling it a "test to test a student's ability to take tests...". Frankly, I don't even know what that's supposed to mean. 

I'd go along with what "piranha" wrote, if the NREMT is too tough for someone, they shouldn't be treating patients. Or to put it into a familiar context, would you want someone who lacked the knowledge required to pass the NREMT to treat a member of your family? 

John E.


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## VentMedic (Jan 27, 2008)

Ridryder911 said:


> I have heard rumors and actually seen some states do this only to return in a few years. Thus the reason so many states are NREMT. The main reason again, it is * very, very costly* to maintain a professional test. As well, most states realize getting other states to recognize their tests will be difficult, so limiting the profession.
> 
> I do not think most understand the process of developing a recognized accredited test. It is a lengthy process of professional, educated test writers that have to validate tests questions in comparison to the professional standards, etc... again, it is not an easy, cheap process.
> 
> ...



Florida finally went to the NREMT a few years ago for EMT-B testing.  That was due to the unbelievable amount of EMT students testing in this state.  The expense of testing them with the state exam got very expensive. 

The paramedic test is still Florida's.  It has a minimum passing score of 80% as opposed to 70% on the NR.   Florida does accept the NR for retroprocity but reserves the right to retest someone if they graduated from a less than ideal school in another state.  That part I do find ironic since Florida is the capitol of medic mills.   Florida just negotiated for another testing vendor (Psychological Services, Inc.) to offer the state exam beginning Jan 08.  This has created much confusion in the application process again.


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## Katie (Jan 27, 2008)

John E said:


> On the other hand, I've seen, read and heard many a student who failed a test use that as an excuse for failing. When pressed as to what they actually mean, I've never been given a single example that held up.
> 
> I'd go along with what "piranha" wrote, if the NREMT is too tough for someone, they shouldn't be treating patients.
> John E.



I'll certainly agree with that


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## bstone (Jan 27, 2008)

Good or bad, NREMT is the best thing we got for a national certification. I suggest that the NAEMT and folks like us push our state boards to accept the NREMT. The folks in the offices don't often get on the ambulance so it's a little tough for them to know what's it's really like. Moreover, their paychecks are a lot larger then ours. 

At the same time, the NREMT exam needs to be thrown out and written anew. It needs to test clinical decision making and knowledge, not the "critical thinking" junk. The questions needs to be straight forward and much less confusing. I never had a problem with the NREMT written exams, but I acutely feel the pain of those who did.


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## futureemt (Jan 27, 2008)

John E said:


> trying to start a fight either, I was simply curious as to how someone who hasn't taken a particular test can give an opinion about it.
> 
> As for my disagreement with the notion that the NREMT is just a test to test people's test taking ability, well that may be someone's opinion but it is simply not factual.
> 
> ...





John

  I do agree with you, but I am  not "only" an emt b student...I'm human and make mistakes and maybe I was out of line.   I choose to go into the field for a reason. I guess what I was trying to say is what I have been told...I am looking into something and  why jersey isn't doing it anymore.  I would have no problem taking the test and believe it is worth it.  I may have not taken a practical for EMT, but I did have to sit to get my dental xray license. Maybe its not the same, but its not as easy as you may think.


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## Ridryder911 (Jan 27, 2008)

Katie said:


> I'm not trying to start a fight here, but I don't think that she was out of line in expressing her opinion.  Founded or unfounded in other people's opinion, she has a right to express hers.  Has she taken the test?  No she hasn't, and maybe the post could have been worded better.  But the post that she quoted deals more with the theory of testing.  Like it or not, people will share opinions and there's no rule that says you can't say what you think.  This is a place to come and share ideas and all she was doing was agreeing with what someone else said which happened to be a differing opinion, not an error.  Sorry if I'm offending some people but I just think it's a bit harsh to jump on someone for entering into a discussion.



You are right, people can voice any opinion, but should be able to defend their reasoning. The problem is on how that opinion is based and obtained. Should I condone people who's opinion is being of racist, ignorance, or judgemental without any found evidence? If you are going to state opinions then I would definitely would attempt to have the insight, knowledge, and if possibly experience about it; otherwise it would be just spouting off hot air. 

This is one of EMS problems, many love to give opinions, false innuendos and present them as factual things, only to find out later it was all myth, lies or just simply made up. Credibility is part of being a professional. Just like our treatment should be, everything we do and say should be justifiable. If you want to just to voice your opinion, that is what a blog is for.. placing thoughts into a diary. 

The reason I get defensive about the NREMT and many other statements is most have nothing to compare it to. This is their first real "medical certification" test that they have ever taken. Is it confusing, controversial and ill written in many parts? You bet! The way all board examinations are and should be. I take over ten medical certification test and renew at least about three a year, I can assure you they are all written in the same manner or format, some better and some are not. Remember, they are there to test for minimal safety level. 

I may seem harsh at times, and personally I don't care. I am not here to give kudos, or paint the real world of medicine as a rainbow. I am here to discuss trends of EMS, new patient care, and if possible teach a little on the way.  I obviously enjoy and love the EMS profession, and have worked over three fourths of my life in it. Many new EMT's and those in school will find medicine is harsh. It has to be. We expect only the best to survive and those that will succeed will be able to defend themselves, their actions, and their line of thinking throughout their career. If you can not make it on a simple forum by defending yourself, doubtfully you will make it in the real EMS world. It is a tough world out there. Many have found these forums actually prepare them to before they enter the work field, and awaken them to "think outside the box". 

R/r 911


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## futureemt (Jan 27, 2008)

Ridryder911 said:


> You are right, people can voice any opinion, but should be able to defend their reasoning. The problem is on how that opinion is based and obtained. Should I condone people who's opinion is being of racist, ignorance, or judgemental without any found evidence? If you are going to state opinions then I would definitely would attempt to have the insight, knowledge, and if possibly experience about it; otherwise it would be just spouting off hot air.
> 
> This is one of EMS problems, many love to give opinions, false innuendos and present them as factual things, only to find out later it was all myth, lies or just simply made up. Credibility is part of being a professional. Just like our treatment should be, everything we do and say should be justifiable. If you want to just to voice your opinion, that is what a blog is for.. placing thoughts into a diary.
> 
> ...




You guys have gaven me a lot of confidence and I have learned a lot so far just by reading other posts.  I appreciate that!!  I do know its not easy....but I will to take it all the way because I'm determined to do so!!!

Donna


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## Ridryder911 (Jan 27, 2008)

futureemt said:


> I will to take it all the way because I'm determined to do so!!!
> 
> Donna



Good! That is a great start!

R/r 911


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## disassociative (Jan 27, 2008)

Ok, back to topic;

As far as TN and the National Registry, our state(which uses the NREMT-B for the EMT-IV state licensure) requires an additional practical examination to verify IV administation skills, advanced assessments, and certain other skills required of the EMT-IV that are not within the general scope of EMT-B care. This test is tended to by Joe Lynn, EMS Consultant(State of TN); I have tested under him personally. You are given stations and skills. 

Without passing this practical + your class final--the state will not allow you to proceed to the NR(Your EMS program director must login to the secret NREMT site and verify that you did in fact do both of these) before you can get your ATT(Authorization to Test) and schedule your test with the Pearson Vue.

You are also required by the state of Tn to have your 5 sticks on file as well as TBI/FBI Background Check. 
You must also pay your license fee with the state; They do 2 sweeps a month of the NREMT site(checking for who passed, who did not). Once, the state sees that you have passed, they will pass your license application on to Donna Tidwell; if your background check is clear, your license is authorized your license entry: Applicant in Process changes to EMT-IV and your license  # is assigned. You cannot work in the state of TN until you have THIS license number.


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## bstone (Jan 27, 2008)

Tedious! I tried to get a TN license this summer for Bonaroo as I wanted to volunteer. After a while I just gave up on it. I had all the skills but the paperwork was insane and the FBI backround check, cost and length of time was a bit much.


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## disassociative (Jan 27, 2008)

Yeah, bud- I agree. (P.S. I worked Bonaroo last yr; nothing like 19 yo's running up to you screaming, "I've Never tried acid before! Help.).

TN looks at the situation in the sense that, as EMS providers we are trusted to enter people's homes. When we arrive at the homes, they do not ask us, "Have you been convicted of a felony?, before you enter the back room with the jewelry on the table, nor do they ask if you are a sex offender when you enter the same room in which their 15 yo daughter sleeps. They simply know that you are EMS and that you are there to help, they put this trust in us. TN has simply taken the measures to ensure that personnel can appropriately perform their duties without such actions. Does this mean that TN EMS is exempt from "Bad Apples"? Absolutely Not. No one can ensure that. There will always be that one Paramedic or EMT that has no history, yet suddenly the morphine comes up missing on his/her count. However, the aforementioned measures do cull the herd significantly in my opinion. 

You shouldn't have much of a prob, since you are an EMT-I. The TBI/FBI background check costs $56; they will put all 10 of your fingerprints in the system, and file your results with the state with regard to criminal and misdemeanor charges.(I hated having to pay it as well!) Once the state does the bi-monthly check of the NR, they will issue your EMT-IV license. 

If you were NREMT-B from a Non-TN program, it could be a problem; as you would have to take the EMT-B to EMT-IV transition course in IV therapy, etc. 

Our emt-IV's hold NREMT-B with successful completion of EMT-IV training course in the state of TN. I'm sure, yourself being an EMT-I would not have a problem. 

Unfortunately, TN does not recognize EMT-B or EMT-I; so you are either an EMT-IV or a Paramedic.

Get your license and I'll secure you a spot on Bonaroo(My old EMT-IV instructor works with Tullahoma EMS as a Shift Supervisor/Paramedic, and they are the ones that work the event.) 

Metallica should be there this year; and rumor has it that the remaining members of Zeppelin will reunite. Woohoo!

Good Luck!


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## JPINFV (Jan 27, 2008)

At least you only had to pay for your background check once. California (well, *MOST* and soon to be all due to recent scandles regarding people going to other counties to get certified that didn't require a background check)  requires you to have a Live Scan (California DOJ and FBI) background check. To add to the fun times, California DMV also requires a Live Scan for the Ambulance Driver Certificate. It's fun because, due to "privacy" laws, county EMS can't/won't share your background check with the DMV (and vice versa). You MIGHT be able to save the rolling fee ($15-20, varies by location) by requesting both at the same time, but it's still going to be around $100 total. This is in addition to the NREMT test fee and county certification fee ($60 in Orange County including the Ambulance Attendent license).


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## futureemt (Jan 27, 2008)

okay so here's the answer I got:

You can still sit for the NREMT test once you graduate the class.  The only change is that when you complete the class the test they offer will be the State test, but you can always sit for the NREMT test as well if you would like.


Donna ( New Jersey)


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## John E (Jan 28, 2008)

*I'll raise you 1 Livescan...*

and a couple of administrative fees...

In order to work for a private ambulance company that operates in, as in picks up patients within the boundaries of, the city of Los Angeles, CA an EMT must pay/do/provide the following.

NREMT EMT-B test, obviously you have to pass this.

Practical skills tested on a pass/fail basis, done thru your certified by the county training program/school.

Livescan fingerprinting sent to the state Dept. of Justice, average cost, $50.00.

Current TB test, free at your local community college but only if you're a student there.

AHA/CPR for health care providers card, don't even think about laminating it, cost $5.00

Proof of graduation from aforementioned training program/school.

Los Angeles County EMT-1 certification, cost $30.00 plus Livescan mentioned above.

CA DMV Ambulance Drivers License, cost $25.00 plus yet another Livescan fingerprinting, also requires passing a written exam and generally wasting a fair amount of time in one of our lovely DMV offices.

Certified DOT physical exam, cost $60.00

A Los Angeles city Ambulance "permit", cost $142.00 which to their credit includes the cost of yet another Livescan,that makes a total of 3 for those keeping track, also required, a statement of employment from your company which surprise, has to be signed and filled out BEFORE you can apply, proof of all of the stuff you had to provide to the county must be in hand  when you go to the office cause just bringing your LA county cert. is too damned easy. And ironically enough,  the Dept. of Transportation, which in LA means the people who issue parking citations, does not have it's own parking structure. And whatever you do, don't photocopy the application unless you do it onto a 2 sided piece of paper, dividing it onto 2 separate sheets is strictly forbidden, too much paper to deal with apparently. And don't even try to contact the office by phone to find out what you need to bring cause it aint gonna happen. And best of luck with the spiffy website.

Along with the Livescan you have to sign an affidavit that states that you understand that not admitting to ANY criminal conviction of any kind at any time in your life, including juvenile convictions, expunged convictions, or those set aside for any reason, is grounds to deny you the permit.

All that to get a job that starts at around $8.00 per hour. But not to worry, you can make it up in overtime...;^)

John E.


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## JPINFV (Jan 28, 2008)

Damn, you're getting screwed, big time. Move down to OC. Same DMV BS and same DOT Card BS, but the cert is ~$60 (~$30 each for your EMT-B cert and attendant license) and you only need 1 livescan. Plus you can get it as a 2 year cert as well as before you're employed. Most of the companies down here also start at/above $10/hr (Care, Pacific, Lynch, at least. Doctor's has terrible pay though).

edit: Hell, CC students get free TB tests? Even UCI Student Health charged like $10 for that. (TB tests aren't required in OC though)


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## KillTank (Feb 7, 2008)

I find this rather funny, I was not questioning the test, It was a simple rumor and I thought maybe i would bring it to the forums for discussion.


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## John E (Feb 10, 2008)

*Forgot to mention...*

cost of tuition at community college $100.00, 5 credit hours @$20.00 per hr.

Books for above, about $100.00 depending on whether you can find em used.

Uniform and other stuff for above, another $100.00 or so depending on where you buy it all.

No TB tests required in Orange County, yikes...what about Hepatitis?

As far as the NREMT goes, rumours that it is going away seem to be wishful thinking on the part of folks who didn't or can't pass it. If only national testing/registration led to higher salaries as it tends to do in other health care fields.

John E.


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## JPINFV (Feb 10, 2008)

Nope, Orange County simply requires a copy of your course completion sheet, national registry card, drivers license, live scan, and a completed medical examiner's physical [green DOT card]. No immunizations or tests outside of that.


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## xBEEFx (Jun 13, 2008)

JPINFV said:


> Damn, you're getting screwed, big time. Move down to OC. Same DMV BS and same DOT Card BS, but the cert is ~$60 (~$30 each for your EMT-B cert and attendant license) and you only need 1 livescan. Plus you can get it as a 2 year cert as well as before you're employed. Most of the companies down here also start at/above $10/hr (Care, Pacific, Lynch, at least. Doctor's has terrible pay though).
> 
> edit: Hell, CC students get free TB tests? Even UCI Student Health charged like $10 for that. (TB tests aren't required in OC though)



I just got my OC certs, $80 for 2 year (40 for 1 year) for the EMT-B cert, $35 for ambulance, however they waive the $35 if you get them both done at the same time


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