# I can't decide!  EMT-I or Paramedic?



## CoffeeInThatNebula (Feb 18, 2011)

Ok, here's my deal.  I'm in an EMT-B class currently.  We have until May.  I've already been apply to volunteer rescue squads all over to try and get some experience in.  My issue is that I'd like to jump into ALS training as soon as humanly possible so I can be more useful and get more into the nitty-gritty part of EMS.

So I have three choices.  I live in Virginia so we have EMT-Enhanced which is the equivalent to a EMT-I/85 with a couple more allowances, EMT-Intermediate which is the same as EMT-I/99, or go through the local community college to get a 2 year paramedic degree.

Issues?  I cannot find ONE EMT-E class other than some crappy $2000 accelerated thing which I refuse to do.  We definitely HAVE EMT-I classes but there's such a big gap in between classes that I have no clue when the next ones with anyone will be offered.  The community college I attend also just recently scrapped their EMT-I program.  As far as the Paramedic program, they already have bunches of classes running so they won't even start enrolling until January.

I live in the Richmond area, EMT-Bs, from what I've been told, are basically ambulance drivers...but you have to be 21 to drive the ambulance.  I'm 20.  What the heck would I actually do?  I want experience treating patients not "Stand back and just watch" or "Oh lift this for me kthx."  

Does anyone live in this area?  If they do, do you know of any sort of ALS programs that begin in the summer or fall?  As you can likely tell, I'm very frustrated at this point and would be extremely disappointed to be stuck as a pack-mule for 6+ months after I get my certification for EMT-B.  At the same time, if I do find an EMT-I program or whatever that starts around that time, I don't want to find it to be a waste of time.  I like being able to plan things like schooling ahead of time so this very aggravating to me.

Any advice or encouragement that EMT-Bs actually do more than I've heard would be great. :sad:


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## usafmedic45 (Feb 18, 2011)

Just go for the paramedic credential.  One can never argue with going for more education and even if it delays your plans a little because you need experience, just remember that experience is a good thing before you are shouldered with more responsibility. 



> Any advice or encouragement that EMT-Bs actually do more than I've heard would be great.



If you don't want to be a "pack mule" or can only view your worth based upon "what you can do, then EMS is probably not the field for you.  Even paramedics in a lot of areas are glorified taxi drivers who get little respect and paltry pay.


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## medicRob (Feb 18, 2011)

CoffeeInThatNebula said:


> Ok, here's my deal.  I'm in an EMT-B class currently.  We have until May.  I've already been apply to volunteer rescue squads all over to try and get some experience in.  My issue is that I'd like to jump into ALS training as soon as humanly possible so I can be more useful and get more into the nitty-gritty part of EMS.
> 
> So I have three choices.  I live in Virginia so we have EMT-Enhanced which is the equivalent to a EMT-I/85 with a couple more allowances, EMT-Intermediate which is the same as EMT-I/99, or go through the local community college to get a 2 year paramedic degree.
> 
> ...



Paramedic. Why be an almost? Plus, EMT-I is about to go bye bye and be replaced with EMT-Advanced anyways.


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## dixie_flatline (Feb 18, 2011)

Do a little more research. A lot of the community college programs require a minimum of 1 year experience as an EMT-B with at least 100 patient interactions (signed/verified by your EMS captain or equivalent), even for an EMT-I program.  

There are certainly programs without those requirements, but I tend to think more highly of a program based on how stringent it's entrance requirements are.

Also, if you're 20 now you will certainly be 21+ by the time you get through any ALS program, even if you start as soon as you get your B card.  Don't be in such a hurry! Learn as much as you can now and you'll be a better provider later.

edit: also would recommend the paramedic option. I'm not going for my medic simply because I am a volunteer doing this 20-40 hours per month.  As stated in my other thread, that's not really enough time to be a competent medic. (sometimes I wonder if it's enough time to be a competent Basic ).


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## fast65 (Feb 18, 2011)

usafmedic45 said:


> *Just go for the paramedic credential.  One can never argue with going for more education and even if it delays your plans a little because you need experience*, just remember that experience is a good thing before you are shouldered with more responsibility.
> 
> 
> 
> If you don't want to be a "pack mule" or can only view your worth based upon "what you can do, then EMS is probably not the field for you.  Even paramedics in a lot of areas are glorified taxi drivers who get little respect and paltry pay.



+1

You will never regret going for a higher degree of education, not to mention that your future patients will be the ones that benefit the most from it.


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## CoffeeInThatNebula (Feb 18, 2011)

Yeah you're all making sense.  Guess I just wanted to vent my frustrations.  And actually the Paramedic program through my community college is actually from no certification at all straight to paramedic so there's no sort of pre-reqs for it.  I'm actually taking a health science course in addition to my EMT class right now.  As long as I take this other sort of "how to survive college" course I actually will have completed the course material for the first semester.  I guess my real frustration is the fact that no one has responded to my applications yet.  I just want to get into a squad soon since it's a goal of the program to have joined one by the time you get through EMT-B.  

I've applied to four or five squads so far over the span of a week.  I should be more patient but I'm excited...I'll just continue harassing them with phone calls asking if they got my application until then.


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## Shishkabob (Feb 18, 2011)

If you want your medic, get your medic.  Don't do the roundabout way, as life has a way of postponing things indefinitely.


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## TransportJockey (Feb 18, 2011)

Linuss said:


> If you want your medic, get your medic.  Don't do the roundabout way, as life has a way of postponing things indefinitely.



THis. Take it from an intermediate, there is not point in waiting or spending any length of time at the ILS or BLS levels.


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## abckidsmom (Feb 18, 2011)

MCV has a great paramedic program that will start up again in the fall.

UVA runs an EMT-E class every year in the fall, though I agree with the others that it would be a waste of time.

RAA just lost a bunch of people to Henrico Fire's hiring process, I've heard they intend to hire a few BLS providers.

Hop in with them, learn the job, and hit the first paramedic program that you get into.  JSRCC is a good program, and more flexible than most with sceduling.

Good luck!


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## alphatrauma (Feb 18, 2011)

medicRob said:


> EMT-I is about to go bye bye...



^ *this
*

Never understood why many aspired to attain (and not progress past) the Intermediate level. :sad:

That being said, EMT-_Enhanced_ [along with Shock/Trauma and Cardiac Tech] certifications will no longer be recognized (thank goodness) by the state of Virginia as of 2012... That's next year! 

my opinion: Intermediate courses still exist today, largely due to the demand of the fire services. 

If you plan on running (PAID) 911 in Richmond, it WILL NOT be as an Intermediate. The General Assembly has provisioned the Richmond Ambulance Authority as the sole 911 EMS provider for the greater Richmond area, and they don't hire Intermediates as ALS providers... you are either a Basic or a (Para)Medic. If you are looking to work for a fire service or private transport (IFT), EMT-I should do the trick for you in the short term, although I do not envy those providers caught in transition when Intermediate becomes obsolete.

You do not need an Associates Degree, but I would wholeheartedly recommend it... _if_ you have the time and resources that will allow it. At the age of 20, I would have a hard time believing that you do not have an overabundance of both.


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## abckidsmom (Feb 18, 2011)

alphatrauma said:


> If you plan on running (PAID) 911 in Richmond, it WILL NOT be as an Intermediate. The General Assembly has provisioned the Richmond Ambulance Authority as the sole 911 EMS provider for the greater Richmond area, and they don't hire Intermediates as ALS providers... you are either a Basic or a (Para)Medic. If you are looking to work for a fire service or private transport (IFT), EMT-I should do the trick for you in the short term, although I do not envy those providers caught in transition when Intermediate becomes obsolete.



Just to help you with your facts, the City of Richmond established the Richmond Ambulance Authority, which in 2004 transitioned to having a paramedic on every ambulance that operates in the City.  The volunteer squads operating within the city limits are also required to meet those minimums.

There are still plenty of BLS ambulances and ALS ambulances staffed by intermediates in the surrounding counties.


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## 46Young (Feb 19, 2011)

The importance of a college education can not be stressed enough. It opens up all kinds of doors. If you do the degree paramedic program, you can progress to a BA in EMS to qualify for an admin position. A lot of the gen ed classes are the same as those in an RN program. If you decide to work as a medic in the fire service, having a degree will give max out your education points for a promotional exam. Not having those points can mean the difference between #1 on the list, and # 40, where you'll never get made.

Having said that, I see that you live in or around Richmond. If you're looking for quick employment as an ALS provider, I would suggest applying to the Alexandria FD. They have single role medics, and they're hiring in Oct, says a few of their medics I run into in Alexandria hosp. You can be an I or a P. You do have to pass a CPAT, though. You can get a gig at RAA if you can in the meantime. If and when Alex hires you, just drop to per diem. Alex works a 24/48/24/96. You only have to travel twice every eight days. NVCC has an EMS AAS program. EMS  classes run on a flip-flop schedule to accomodate those doing shift work. If the class runs twice a week, it may run Mon/Tues for the first, and Wed/Thu for the second. You'll never have to miss a class due to work! Also, and I would check on this, it's my understanding that if you're an EMT-I (I'm not sure if it's VA or NR, I think NR, I heard this from an Alex medic) all you have to do to upgrade to NR-P is pass the written. That sounds too easy, so I would look into it. NVCC also does the EMT-I to P upgrade, also resulting in the EMS AAS.

There you have it - choose whatever option works for you. For me, I did a 13 month medic program over three years for my RN (NY Methodist; yes, it's accredited), so that I could better support my family financially that much sooner. I'm currently working towards completing NVCC's EMS AAS myself. I chose to get the career I want, and then go back for the degree. You may decide to get the degree first. To me, neither way is right or wrong. It's a question of what best suits your personal situation and goals. Good luck either way.

Edit: The above may not be popular with the pro-education crowd, but I felt you should have all the facts. Also, I wouldn't plan on doing RAA full time as a permanent career. They use SSM. You'll get plenty of experience, but running a lot of calls and having to constantly relocate with what little downtime you have will eventually get old. I used the NYC 911 system in the same fashion - worked there for five years, got real good at my job, then moved on to greener pastures.


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## alphatrauma (Feb 20, 2011)

abckidsmom said:


> Just to help you with your facts, the City of Richmond established the Richmond Ambulance Authority...



Actually, it _was_ the Virginia General Assembly that established/created the Richmond Ambulance Authority... the city (Richmond) gave the Authority the franchise to provide service to the citizens. 

Sources:

1991 Richmond Ambulance Authority Act

RAA site



abckidsmom said:


> The volunteer squads operating within the city limits are also required to meet those minimums.



I was not aware that there were volunteer ambulances operating in Richmond city limits (other than passing through).  



abckidsmom said:


> There are still plenty of BLS ambulances and ALS ambulances staffed by intermediates in the surrounding counties.



You are absolutely right, there are plenty of ALS ambulances staffed with Intermediates, but when the music stops, many will be left without a chair... which was the point I was trying to make. If the OP (or anyone else) wants to be an Intermediate, to each his/her own. 





46Young said:


> Also, and I would check on this, it's my understanding that if you're an EMT-I (I'm not sure if it's VA or NR, I think NR, I heard this from an Alex medic) all you have to do to upgrade to NR-P is pass the written. That sounds too easy.



Last I read (currently searching for source), everyone from First Responder to Paramedic will have to complete a NR approved course and pass examination for the new levels -  EMR, EMT, AEMT, and Paramedic - there will be NO grandfathering or freebies. The wild card of course, is the ability of certain individual states to "do their own thing"... who needs a cohesive national standard anyways :glare:


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## Outbac1 (Feb 20, 2011)

Go to P school and get the A Degree. Don't bother being an almost. (EMT-I).
 Even if you have to wait till Jan to get into a P course, wait. Get a job and save your money for when you're in school. You will still have expenses when you're in school. The more money you have before you start the less you will worry about it once school is on. Worrying about money can be a big distraction when you should be studying.


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## usafmedic45 (Feb 21, 2011)

> EMT-I is about to go bye bye and be replaced with EMT-Advanced anyways.



Changing the terminology doesn't change anything LOL


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## medicRob (Feb 21, 2011)

usafmedic45 said:


> Changing the terminology doesn't change anything LOL



I was speaking more about the decrease in the scope of practice (which will mainly affect the i/99) rather than the title.


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## usafmedic45 (Feb 21, 2011)

Remember that the "scope of practice" more or less is still going to be locally decided....the same sort of "this is really going to change the field!" crap was pontificated back during the leadup to the I/99 standards.  When it comes to massive changes to the EMS standards, I'm very much of the "I'll believe it when it happens" sort.


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## medicRob (Feb 21, 2011)

usafmedic45 said:


> Remember that the "scope of practice" more or less is still going to be locally decided....the same sort of "this is really going to change the field!" crap was pontificated back during the leadup to the I/99 standards.  When it comes to massive changes to the EMS standards, I'm very much of the "I'll believe it when it happens" sort.



Fall 2011 is when the standards take effect in TN. They will give EMT-IV 4 years to take the bridge to advanced (yes, gap analysis is complete). 

What I am wondering is how they are going to address the testing since the NREMT-Advanced level test will not be out til 2013.


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## medichopeful (Feb 21, 2011)

CoffeeInThatNebula said:


> Any advice or encouragement that EMT-Bs actually do more than I've heard would be great. :sad:



With around 120 hours of training there's not really much we CAN do :sad:


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## CANMAN (Feb 21, 2011)

Can't believe this thread made it to two pages. EMT-P or nothing /thread. That is like asking should I go for my CNA or RN....:glare:


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## medicRob (Feb 21, 2011)

CANMAN13 said:


> Can't believe this thread made it to two pages. EMT-P or nothing /thread. That is like asking should I go for my CNA or RN....:glare:



Deciding to go back to school is a big decision, to you and I it might seem pretty cut and dry, but this user is torn between paths and has asked for our help. Let us not be so quick to write this individual or all other individuals in this situation off instead of scoffing at a thread because you don't think it is befitting of two pages. No one made you read it. You are welcome to leave at any time.


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## Anjel (Feb 22, 2011)

3 pages  

My input is never stop learning. DO WHAT MAKES YOU HAPPY. 

But there are sooooo many more job opportunities as a medic than an intermediate. I'm pretty sure my county doesn't even recognize EMT-I's anymore.


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## CoffeeInThatNebula (Feb 23, 2011)

Where did all these pages come from?  Anyway, the only reason I was considering EMT-I was simply because I wanted to get into ALS sooner and be more familiar with it by the time I sit for the Paramedic exam.  I've heard that going from EMT-B to Paramedic is extremely difficult.  I guess that also depends on your definition of "difficult" however.  Even if I did go for EMT-I, the end goal would be Paramedic anyway.  I simply wanted to know, that if I'm willing to take that extra time to become an EMT-I in the process of becoming a Paramedic, do you think that I would become a better provider than if I simply charged straight through to Paramedic.  

I realize a lot of this is dependent on me, but I just like to hear people's opinions and advice is all.  EMT-E is what is getting with EMT-Advanced from what I understood.  I know that the I/99 SOP is probably going to be less but if it makes the transition from EMT-B to Paramedic easier, then I would be willing to take a shot at it.


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## Handsome Robb (Feb 23, 2011)

I went B -> I -> currently in the application process to medic school. I have also been told the jump from B straight to P is very difficult but I know a few people who have done it and are excellent medics. I can't know for sure but I believe having the I will make the learning curve in P school a bit easier. I'll let you know how that goes in about a year haha.


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## CoffeeInThatNebula (Feb 25, 2011)

NVRob said:


> I went B -> I -> currently in the application process to medic school. I have also been told the jump from B straight to P is very difficult but I know a few people who have done it and are excellent medics. I can't know for sure but I believe having the I will make the learning curve in P school a bit easier. I'll let you know how that goes in about a year haha.



*waits*

Unfortunately the Virginia Office of EMS hasn't posted any classes for EMT-I between May and December.  If something pops up around then and I'm eligible for it, I'll take a shot at it, but since I would start classes for the paramedic degree in January I would just go straight for it.  On the bright side it looks like there are a good deal of field and clinical hours required as credits in which I would be acting as ALS.  I heard somewhere that if I test for EMT-I, I can't test for Paramedic for a year or two...or something.  Not sure, gotta talk to my advisor again.

The good news is I've gotten little dips here and there of medical knowledge throughout high school and up until now which have helped tremendously with understanding everything I'm learning now.  Having a nurse as a mom helps too.  As for the people who suggested programs in Richmond, VA, I've been taking classes through J. Sargeant Reynolds Community College.


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## alphatrauma (Feb 25, 2011)

CoffeeInThatNebula said:


> *waits*
> 
> Unfortunately the Virginia Office of EMS hasn't posted any classes for EMT-I between May and December.


 

Not sure if you read it back on page 1, but...



alphatrauma said:


> *the Intermediate level...*
> 
> EMT-_Enhanced_ [along with Shock/Trauma and Cardiac Tech] certifications *will no longer be recognized (thank goodness) by the state of Virginia as of 2012... That's next year!*




Which is very likely _why_ you cannot find any Intermediate courses listed between May and December 2011. Why build a barn for a dying horse?




CoffeeInThatNebula said:


> I've been taking classes through J. Sargeant Reynolds Community College.



Never attended SRCC, but have heard good things from those who have.


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## Bon-Tech (Feb 26, 2011)

I'm in a similar boat, although at a completely different stage of life. My long term goal is to get my Medic and then RN. I Got my Basic back in December but no one is hiring, so I'm actually driving two hours once a week to attend I/85 class. My hope is this will keep me "fresh" and in the habit of going to school.

As a plus, sounds like the hospital where I'll be doing clinicals is plenty busy, so I will try to max out clinic time to try and get lots of good (and bad) patient contacts.


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## HotelCo (Feb 26, 2011)

Just go for medic. No point in ****ing around... Just go for ur medic.


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## Pneumothorax (Feb 26, 2011)

HotelCo said:


> Just go for medic. No point in ****ing around... Just go for ur medic.



Quoted for truth!!!


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## rescue99 (Feb 26, 2011)

CoffeeInThatNebula said:


> Ok, here's my deal.  I'm in an EMT-B program, they already have bunches of classes running so they won't even start enrolling until January.
> 
> Any advice or encouragement that EMT-Bs actually do more than I've heard would be great. :sad:



Soooo, get busy taking a good A/P (and/or other science) course if you haven't already. If you have, there is nothing wrong with adding in 85 or 99 while you're on a waiting list for Medic. Honestly, Basic EMT's are such a important part of the EMS team. It's sad to see anyone dis the whole idea of experience (especially at a mere 20). Jumping from zero to hero without even a half stripe has it's down side. If I were 20, I'd take my time and prepare myself well for the job. You will be a better Medic for it, IMHO. People will do what they want so, do what you think is best. Good luck....


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## CoffeeInThatNebula (Mar 2, 2011)

Thanks everyone for the replies.  I think I'm just going to volunteer with a squad and run with them until I can apply for the paramedic program.  I'd like to get my RN afterwards, but I'm not sure if I should just get an associates or if employers are looking more at bachelors degree RNs now.  My mom is a fantastic nurse with 30+ years of experience and she's better than half the bachelor's degree RNs at her job.  That being said, when she began nursing I don't think that was as big a deal.

I've already been discouraged from LPN as apparently their pretty much limited to nursing homes now in this state.


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## usafmedic45 (Mar 2, 2011)

Just out of curiosity, for those of us who are EMT-Is and hold more advanced credentials (RN, RT, etc) is there any option for us to upgrade without having to go back to paramedic school?


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## fast65 (Mar 2, 2011)

usafmedic45 said:


> Just out of curiosity, for those of us who are EMT-Is and hold more advanced credentials (RN, RT, etc) is there any option for us to upgrade without having to go back to paramedic school?



If you have your RN I would think that you would be able to bridge to EMT-P, someone please correct me if I'm wrong.


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## usafmedic45 (Mar 2, 2011)

I know down in Florida, that is the case, but I know it's not the case up here so far as I am aware.  I'm an RT anyhow, not an RN.


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## Pneumothorax (Mar 26, 2011)

CoffeeInThatNebula said:


> Thanks everyone for the replies.  I think I'm just going to volunteer with a squad and run with them until I can apply for the paramedic program.  I'd like to get my RN afterwards, but I'm not sure if I should just get an associates or if employers are looking more at bachelors degree RNs now.  My mom is a fantastic nurse with 30+ years of experience and she's better than half the bachelor's degree RNs at her job.  That being said, when she began nursing I don't think that was as big a deal.
> 
> I've already been discouraged from LPN as apparently their pretty much limited to nursing homes now in this state.



Go for the BSN. It'll open more doors down the road. and ya the whole nursing home thing- yuck!


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## RuralMedik (Nov 25, 2011)

*Options*



usafmedic45 said:


> Just out of curiosity, for those of us who are EMT-Is and hold more advanced credentials (RN, RT, etc) is there any option for us to upgrade without having to go back to paramedic school?



If one is already an RN/RT etc, I don't feel like I'm shortchanging you, if I recommend an Intermediate to Paramedic Bridge class. Some colleges offer it, and the NR has recently officially endorsed such a thing, apparently, from what I read in "The Registry" newsletter.

I realize this thread is somewhat older, but I noticed no one mentioned the I/99-NRP Bridge.  Sorry to step on any toes.


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