# Austere EMS Jobs?



## RICollegeEMT (Oct 26, 2016)

I think I may have posted this in the past, however I figured its worth another posting.

I'm thinking about getting out of conventional EMS.  Quite frankly I'm looking for a change, with decent money to support a family, and most importantly a challenge.

Some of you may have read that and said "Did I read that wrong?"  But alas you haven't.  Quite frankly I am bored.  I'm watching my skills atrophy, I'm no longer "learning something everyday".  Etc.  And honestly it scares me. 

I don't claim to know everything.  In the broad scope I know very little.  I know how to patch you up and do enough so that you make it to the hospital. But where I work that often means very little.  I might do a dressing, start an IV, give you oxygen, maybe even drop an airway.  However to me that isn't being an EMT.  That's skills atrophying.  I rarely give drugs (and I'm not talking about albuterol and Zofran..  I'm referring to the rest of the meds in my scope), never had a need to intubate, and very rarely "challenge" myself.  That's "hospital is 5 minutes out, what can I do before then?"

Now some of you may say "he's looking for a rush".  And I don't dispute that I'm looking for some adrenaline---  I think most of us in EMS like the feeling of being challenged and making a save, seeing something new and working the problem-- that does give a rush like outsiders wouldn't imagine; but my reasoning is less egocentric.  Because through challenge we become better providers...  And to the outsider that may sound so very wrong.  But the way I look at it is this:  through challenge I become better, and the better I become the better I can help my patients, and ultimately they deserve the best damn EMT/Medic they can have.  And I wanna return being a damn good provider.

I'm an EMT-Cardiac.  We're Rhode Islands little ******* whose trained to use medic level procedures (minus a few procedures and a handful of interfacility meds) yet focus on the "fix what I can see".  And I know this is going to start a **** storm but I'd argue the "down and dirty" thinking often outweighs what can be read in a science book. Just my opinion, if you agree you do, if not then I can respect that. 

I'm looking for leads on where I can go to find a more austere environment.  And yes to be honest I'm open to jobs in war torn countries-- although I am not looking for military. I don't mind the ocean, or the air, honestly I've got little back here in the states so I don't mind going to remote places. 

I don't want this thread to become a debate.  I respect everyone's opinions and stances equally.  However I am asking, if anyone has any leads that may help me find what I am looking for that you'd help me out.

In summary: young adult looking for an austere EMS job.  Trained to provide Advanced Life Support; don't know everything but wants a new challenge.  Looking for something that pays well.  Willing to go into a hostile environment but doesn't want to sign up with Uncle Sam.  Looking to go international although I'd consider domestic in places that would give reciprocity.

Hope I didn't ramble too much. Just looking for a change of scenery, from a cargo ship in international waters, to somewhere like Burma, or even Greenland.  Hopefully one of you fine folks can help me.

Thanks,
B


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## dutemplar (Oct 26, 2016)

Without significantly more experience in the tactical/ military/ police (SWAT) environment, most of the austere/ war-torn environments won't touch you.  The large contract companies (think Blackwater, Triple Canopy, Olive Group, etc..) want more solid tactical experience before they unleash you to areas where you can be doing care under fire and all the fun and excitement that comes with it.

The cargo ships, and to an extent the cruise ships, looks for more primary care integration as well as emergent background and most of that is spent doing safety/ hygiene and passing out tylenol or pepto bismol and not acute emergency critical care.

Sadly, you're probably better going full paramedic (possibly with FPC, or CCP) and looking for a more challenging area.  Or enlisting under either Option 40 or 18X and trying your hand there...


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## akflightmedic (Oct 26, 2016)

Short and sweet...to the austere world...you are an EMT-Basic. All those skills, knowledge and experience you have are no good.

This is contractually stipulated by the client, therefore arguing you are above a basic is pointless. There are two titles for nearly every contract abroad and most of them lean towards the latter (Basic and Medic). As in Paramedic, card carrying NR-EMTP. While some gigs do not require the NR, they do require a PARAMEDIC Card. 

Good luck, however at your current accreditation level you will find all the luck in the world useless.


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## Summit (Oct 26, 2016)

Outside of RI, you are a basic EMT in the US, and internationally probably just a first responder. Nobody in Burma is going to let you push drugs and drop tubes based on a proprietary US EMT certification.

Without your Medic or RN, you are going to have trouble getting a volunteer position much less a paying medical job outside of the US, although there are some contract positions that will take EMTs although they usually have a different primary role (driver, security, fire, etc). The world is full of people who think they "don't need know book learnin"... well... employers outside of US EMS decided they don't need those type of employees in healthcare.

All that aside, you should really look at what austere medicine involves. It is NOT typically adrenaline pumping. It is a lot more like primary care or nursing with one or both hands tied behind your back combined with being uncomfortable and carrying heavy things. Austere medicine is where minor problems you'd scoff at in 911 EMS become deadly in a few days and deadly pathologies from 911 EMS might not be treatable at all.


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## VentMonkey (Oct 26, 2016)

All excellent posts by @akflightmedic, and @Summit. Both hit the nail on the head, and perhaps a bit of humility will do you some good.

That being said, perhaps something like this will be better fitted for your "needs":

http://emtlife.com/threads/mcpic-certification.44609/


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## SandpitMedic (Oct 26, 2016)

akflightmedic said:


> Short and sweet...to the austere world...you are an EMT-Basic. All those skills, knowledge and experience you have are no good.
> 
> This is contractually stipulated by the client, therefore arguing you are above a basic is pointless. There are two titles for nearly every contract abroad and most of them lean towards the latter (Basic and Medic). As in Paramedic, card carrying NR-EMTP. While some gigs do not require the NR, they do require a PARAMEDIC Card.
> 
> Good luck, however at your current accreditation level you will find all the luck in the world useless.


Bingo!


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## RICollegeEMT (Oct 26, 2016)

Slow down! 

I think you guys are taking what I said wrong.  I'm a fairly humble person.  And most of what I am looking for is a change of scenery.  So before you bash me lets get that straight! 

Vent Monkey, What exactly does MPIC entail?  Like what kind of training and so forth?   It seems intriguing and if you've got any more info I'd appreciate it.


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## VentMonkey (Oct 26, 2016)

RICollegeEMT said:


> Vent Monkey, What exactly does MPIC entail?  Like what kind of training and so forth?   It seems intriguing and if you've got any more info I'd appreciate it.


I do not, that isn't something I specialize in, but the op who posted that thread could probably help you. Also, read his article, it's quite insightful and detailed in terms of the job itself.

And, FWIW, at times it's hard to read through an op's post. No hard feelings.


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## RICollegeEMT (Oct 26, 2016)

I actually just stumbled onto that article and am reading it as we speak.

And by all means no hard feelings.  I know sometimes the "personality" doesn't convey through text. 

Thank you for your assistance!


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## NomadicMedic (Oct 26, 2016)

The MPIC is an interesting certification, teaches a lot of skills with very little training.

 In short, it's about a 70 hour course that teaches a crewmember or officer, usually already serving another duty on board ship, how to become the "medical person in charge", as determined by some coast guard rules, usually to obtain another coast board certification to get a pay raise. 

 Remote Medical in Seattle teaches it in conjunction with a wilderness EMT course.  Unless you're on board a ship, it's useless. It teaches a bunch of skills that you can't really ever use and providers aren't hired strictly as medical onboard most of the ships that would need an MPIC. Crews are small, medical problems are rare, it's a double duty that's tacked on.

http://safetyms.com/mcpic


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## RICollegeEMT (Oct 26, 2016)

DE, thanks for your information.  I'm definitely looking into it.   I've heard of wilderness EMT being thrown around.  What exactly is that?  I've never seen laid out on any "official" website, so is it actually recognized or is it "a lawsuit waiting to happen"?

I'm just trying to feel out what some options are that could be available.

Another thing I was tossing around and AKFlight you would probably be the best person whose responded so far to ask:  I'm about a stones throw from having my AEMT...  Is there any reciprocity for A in Alaska?  I know from where I am the whole "EMT 1-3" is confusing....


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## Summit (Oct 26, 2016)

WEMS is a focus on longer term care, improvised care, unique environments, and evacuation considerations for wilderness situations.

WEMS courses like WEMT are always fun, often informative, and sometimes useful. WEMT is curriculum that is recognized/desired to a limited extent in certain sectors of the outdoor industry (eg river and mountain guiding), but it is not a state recognized certification.


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## VentMonkey (Oct 26, 2016)

Summit said:


> WEMS is a focus on longer term care, improvised care, unique environments, and evacuation considerations for wilderness situations.
> 
> WEMS courses like WEMT are always fun, often informative, and sometimes useful. WEMT is curriculum that is recognized/desired to a limited extent in certain sectors of the outdoor industry (eg river and mountain guiding), but it is not a state recognized certification.


Think park rangers in some of the larger national parks, @RICollegeEMT.


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## RICollegeEMT (Oct 26, 2016)

Ahh okay.  Thanks!  Appreciate it guys.


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## NysEms2117 (Oct 26, 2016)

Also some sheriffs departments have EMS units. which can be your "in" to swat medics ect. I work for a sheriffs dpt ems unit part time. I think it's great, it's mainly 911, and pretty severe calls at that. Just tossing it out.


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## NomadicMedic (Oct 26, 2016)

The wilderness EMT program will teach you how to use things like use sticks and rocks in place of a hare traction splint or a KED. They're fun, but unless you're planning on working as a person leading Boy Scout camp hikes or in the backcountry, it's pretty silly.

Also, beware of the oversell with these programs.


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## VentMonkey (Oct 26, 2016)

DEmedic said:


> The wilderness EMT...unless you're planning on working as a person leading Boy Scout camp hikes or in the backcountry, it's pretty silly.


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## NomadicMedic (Oct 26, 2016)

I know it makes me sound like a killjoy, but I hate to see people waste their money on a two week full immersion wilderness EMT course.

 when they get out of the class, they have zero experience but they know how to treat a head injury with a sharp stick, some twine and the foil pack from a dehydrated meal. :/

 Go get some real education. Like an A&P series.


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## Tigger (Oct 26, 2016)

DEmedic said:


> I know it makes me sound like a killjoy, but I hate to see people waste their money on a two week full immersion wilderness EMT course.
> 
> when they get out of the class, they have zero experience but they know how to treat a head injury with a sharp stick, some twine and the foil pack from a dehydrated meal. :/
> 
> Go get some real education. Like an A&P series.


Or a paramedic course...


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## RICollegeEMT (Oct 26, 2016)

NysEms2117 said:


> Also some sheriffs departments have EMS units. which can be your "in" to swat medics ect. I work for a sheriffs dpt ems unit part time. I think it's great, it's mainly 911, and pretty severe calls at that. Just tossing it out.



Silly question here, are you a police officer or an EMT?  I simply ask because again that sounds like an interesting job, just not sure how one goes about getting into such a position.

DEmedic, I just laughed my *** off.  You're right, I have no desire to be Mcguyver.. otherwise I'd be crushing the Nitrostat up for 4th of July.  haha.   And I agree full heartedly.  College really isn't my thing-- so before I go taking courses I'm trying to get a "take this course to get this job" sort of plan...

Thanks guys!


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## NomadicMedic (Oct 26, 2016)

Tigger said:


> Or a paramedic course...



Well, I'm assuming if somebody's taking one of these classes to advance their career, they want "all the skills without all that pesky education"


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## NysEms2117 (Oct 26, 2016)

RICollegeEMT said:


> Silly question here, are you a police officer or an EMT? I simply ask because again that sounds like an interesting job, just not sure how one goes about getting into such a position.


My "main" job is a Parole officer with NYS. However, my "side gig" is EMS, with the sheriffs dpt. Most of us that work here are Part time, because most of us do in fact work in law enforcement. HOWEVER, the 20-25% that are full time that work here, are non law enforcement, they just work for the sheriffs Dpt. Not all sheriffs departments will have EMS units, but most Urban ones will, for obvious reasons.


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## RICollegeEMT (Oct 26, 2016)

This picture comes to mind lol


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## RICollegeEMT (Oct 26, 2016)

Ill have to look into it. I assume you have to take NY Civil Service Exam?


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## Tigger (Oct 27, 2016)

NysEms2117 said:


> My "main" job is a Parole officer with NYS. However, my "side gig" is EMS, with the sheriffs dpt. Most of us that work here are Part time, because most of us do in fact work in law enforcement. HOWEVER, the 20-25% that are full time that work here, are non law enforcement, they just work for the sheriffs Dpt. Not all sheriffs departments will have EMS units, but most Urban ones will, for obvious reasons.


I don't think most law enforcement agencies have much to do with EMS at all. Upstate NY has some different stuff going on, but hardly the norm.


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## NysEms2117 (Oct 27, 2016)

RICollegeEMT said:


> This picture comes to mind lol



Your not a sheriff your a medic/ emt. So I would not think you'd have too.. But I could be wrong since I already took it. 


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## NysEms2117 (Oct 27, 2016)

Tigger said:


> I don't think most law enforcement agencies have much to do with EMS at all. Upstate NY has some different stuff going on, but hardly the norm.



I have no idea, I'm new to EMS in general, this is my first ems job so I was just speaking from my minimal experience 


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