# Does Anyone Else Hate "Too Smart to be a Paramedic"?



## RocketMedic (Sep 20, 2012)

Title says it all- I really don't like it when people go and say that someone's too smart to be a paramedic (especially if it's fellow EMS workers). How can we even begin to lay claim to true professional status if we tell our brightest to leave the field and become nurses or whatnot (yes, I know, the money is better), but it's retarded for us as a profession to welcome our new members by warning them to leave.

We in EMS do some incredibly invasive, complex, risky things with inadequate training and no supervision. We should probably try and keep our smartest people and change that "inadequate training" thing along the way. To me, it's "are you smart enough to be a paramedic?" Perhaps that is the question we should ask.


----------



## JPINFV (Sep 20, 2012)

If there's one thing paramedicine is good at, it's the anti-intellectualism aspect.


----------



## NYMedic828 (Sep 20, 2012)

Rocketmedic40 said:


> To me, it's "are you smart enough to be a paramedic?"



9/10 of my coworkers, aren't. Or maybe they are capable and don't strive to be.

That is what drives people like myself away from wanting to remain in EMS. The patient base is bad enough but when your colleagues are just as intolerable and stupid, you have no desire to stay and it just makes sense to move on to more respected professions.

It is never going to change. Don't get your hopes up. As I said countless times, the only cure for EMS is to destroy it and rebuild from the bottom up. EMS has to die before it can be fixed.


----------



## STXmedic (Sep 20, 2012)

NYMedic828 said:


> 9/10 of my coworkers, aren't [smart enough]. Or maybe they are capable and don't strive to be.
> 
> That is what drives people like myself away from wanting to remain in EMS. The patient base is bad enough but when your colleagues are just as intolerable and stupid, you have no desire to stay and it just makes sense to move on to more respected professions.


Exactly how I feel. My coworkers stress me out far more than the patients. There's something wrong when you're shunned by your colleagues for trying to further your own knowledge. :glare:


----------



## Christopher (Sep 20, 2012)

PoeticInjustice said:


> Exactly how I feel. My coworkers stress me out far more than the patients. There's something wrong when you're shunned by your colleagues for trying to further your own knowledge. :glare:



If you'd just treat the patient and not the monitor you wouldn't be shunned......or something silly like that ;-)


----------



## Jambi (Sep 20, 2012)

NYMedic828 said:


> That is what drives people like myself away from wanting to remain in EMS. The patient base is bad enough but when your colleagues are just as intolerable and stupid, you have no desire to stay and it just makes sense to move on to more respected professions.



QFT :glare:


----------



## shfd739 (Sep 20, 2012)

This^^. 

From what I see I can further my education and still be a medic. I'll still make the same money and not really be able to move forward until the old guard moves on. 

Or move to nursing and double-triple the money and education is valued.


----------



## WolfmanHarris (Sep 20, 2012)

Maybe it's a difference in education up here versus the states, the competition to get into Paramedic programs (the majority in my program had Bachelor's or another two year college program) or just the culture of the service I work in, but we really don't see any of this as you describe it. 

It is a regular occurrence for medics here to be working on degrees on the side, being involved in research, attending PA school or a few heading off to medical school. Certainly that's not the majority or even a large minority, but it's not a rarity. More importantly there is not a culture to push these people out, discourage them or even consider it as odd. 

I'm extremely lucky to work somewhere that still aggressively pays for medics to go to ACP school, paying their wages for the year while they attend school. In the more distant future as part of the Community Paramedicine project the current plan is to send experienced ACP's to PA school and utilizing PA's on the road. 

On a related note I was quite surprised when I was teaching an EMR course recently to a group of enlisted soldiers at the wide variety of educations. I had an ACP with 18yrs experience prior to going reg force, a guy with a MSc in chemistry and a few others all with honours Bachelor's degrees all were also combat vets. I suppose I was guilty of a similar attitude going into this course as described by the OP.


----------



## NYMedic828 (Sep 20, 2012)

99.999% of the people I work with, would look at me like I had 10 heads if I suggested giving a peds patient IN fentanyl for a fractured limb. They actually would probably tell me I am crazy and going to kill the kid. Best to just let him suffer on all the bumps we hit on the way to the hospital.

Actually, they look at me like I have 10 heads already if I suggest getting discretionary orders for opiates or benzos. If it doesn't fall into the protocol, it must not be worth our time right? Just ambulance drivers after all.


----------



## silver (Sep 20, 2012)

when you have an education system using "instructors" and a practice based off of protocols it comes with the territory...


----------



## Jambi (Sep 20, 2012)

WolfmanHarris said:


> Maybe it's a difference in education up here versus the states, the competition to get into Paramedic programs (the majority in my program had Bachelor's or another two year college program) or just the culture of the service I work in, but we really don't see any of this as you describe it.
> 
> It is a regular occurrence for medics here to be working on degrees on the side, being involved in research, attending PA school or a few heading off to medical school. Certainly that's not the majority or even a large minority, but it's not a rarity. More importantly there is not a culture to push these people out, discourage them or even consider it as odd.
> 
> ...



The Canadian system is how it's should be in my opinion.  There is no EMS education here in the states.  It's vocational training, nothing more.


----------



## bigbaldguy (Sep 20, 2012)

Wow negative thread spiral, quick everyone think about puppies chasing butterflies.

Part of the reason that medics get the whole "not very smart" label is that it's part of the act many medics have to put on to fit in. I think it comes from the all male beginnings of the profession. Real men don't do a lot of thinking, real men don't need a bunch of book learning, real men just need a strong back and strong stomach ect. Eventually they get tired of the act and move on to something else and the ones who don't have to act remain behind. Although the demographics of EMS have changed the mindset hasn't caught up. The fact that people are here on EMTLIFE is proof positive that there are those in EMS who seek to improve the profession and themselves. It's slow going admittedly but the only way it will get done is by changing attitudes one at a time from within. I think as providers we in EMS need to become better at raising ourselves up to the level of our "smart" peers and less dragging them down to our level.

I get the "you're too smart to be a flight attendant" from pilots all the time. I just tell em nah maybe you're just too dumb to be a pilot, but you know I laugh and smile....


----------



## Veneficus (Sep 20, 2012)

Rocketmedic40 said:


> Title says it all- I really don't like it when people go and say that someone's too smart to be a paramedic (especially if it's fellow EMS workers).



Welcome to my world.

For years it has gone from "you're too smart to be a medic" to "quit wasting time with those people."

Some things never change.


----------



## rescue1 (Sep 20, 2012)

I'd like to think that times are slowly changing. The fire service used to think college educated applicants were useless academics who couldn't hack it in a fire 50 or so years ago, and now every fire officer and half of all fire candidates have a bachelor's degree or higher in something.

EMS is slowly getting on that bandwagon. I work in the suburbs of Philly, and there are several medics at my service with higher education, sometimes in fields unrelated to EMS. No one has yet told them they are too smart to be a medic. No-one looks at me funny for mentioning medical studies either.

I think that some of those quotes come from the assumption that a very intelligent person tends to be only book smart--like a paramedic who can explain anything you want to know about intubation, but is unable to actually intubate when the time comes.
It's a completely false assumption, but stereotypes being what they are, I'm sure at some point in everyone's life they've met someone like that, just probably not on the ambulance.

The other reason I could think of would be confusion as to why someone who dropped $120,000 on a 4-year degree would then decide to work at a job that pays $20/hour.


----------



## RocketMedic (Sep 20, 2012)

Well, I'm not going to fall into that retard trap. I need to become more knowledgeable to do this job better.


----------



## shfd739 (Sep 20, 2012)

As long as EMS attracts "life savers" that can finish a year of VoEd and think they are awesome it wont change.


----------



## shfd739 (Sep 20, 2012)

Rocketmedic40 said:


> Well, I'm not going to fall into that retard trap. I need to become more knowledgeable to do this job better.



Too bad more dont think this way.


----------



## Jambi (Sep 20, 2012)

rescue1 said:


> to why someone who dropped $120,000 on a 4-year degree would then decide to work at a job that pays $20/hour.



Out here on the left coast in socal, it's more like $17 top step for AMR.

Also, why anyone would drop 120k on a degree (MD/DO/DDS aside) is beyond me.  If someone is dumb enough to do such a thing...


----------



## Jambi (Sep 20, 2012)

I'm also reminded of this article:

http://chronicle.com/article/From-Graduate-School-to/131795/


----------



## WestMetroMedic (Sep 20, 2012)

I took the Maryland critical care course earlier this year and am taking classes to get my community paramedic certification now and i got the "why don't you just go to PA school" from my wife.  I told her it is because i can't do algebra,  but secretly, it is because i like being the smart kid at work in spite of the fact that 95% of what spews from my mouth is a loosely fact based glob of BS.


----------



## NomadicMedic (Sep 20, 2012)

WestMetro... Best post of the day!


----------



## RocketMedic (Sep 21, 2012)

Jambi said:


> Out here on the left coast in socal, it's more like $17 top step for AMR.
> 
> Also, why anyone would drop 120k on a degree (MD/DO/DDS aside) is beyond me.  If someone is dumb enough to do such a thing...



A friend of mine from high school dropped $150k on a bachelor's in music theory. He's a ride operator at Knotts and an assistant band teacher.


----------



## rescue1 (Sep 21, 2012)

Assuming no scholarship, even a degree from a state college will set you back 70-80 grand. That's the wonderful price of higher education.


----------



## JPINFV (Sep 21, 2012)

Rocketmedic40 said:


> A friend of mine from high school dropped $150k on a bachelor's in music theory. He's a *ride operator at Knotts *and an assistant band teacher.



Well, that explains a lot.


----------



## firecoins (Sep 21, 2012)

I am taking per reqs right now. Want to increase the education.


----------



## Jambi (Sep 21, 2012)

rescue1 said:


> Assuming no scholarship, even a degree from a state college will set you back 70-80 grand. That's the wonderful price of higher education.



BS...the common term that is, not bachelors of science.

You're looking at around 13k at a state school and up to 30k at a private school.

http://nces.ed.gov/fastfacts/display.asp?id=76

Anyone paying more than that (within reason not withstanding) is paying too much.  

Corollary: The more a school spends on advertisement, the less a person should go there.  The Kaplan and UoP commercials look fancy and are inspiring...


----------



## JPINFV (Sep 21, 2012)

Don't forget cost of living in addition to tuition.


----------



## Medic Tim (Sep 21, 2012)

JPINFV said:


> Don't forget cost of living in addition to tuition.



tuition is one of the cheapest parts of going to school.


----------



## Sandog (Sep 21, 2012)

Jambi said:


> BS...the common term that is, not bachelors of science.
> 
> You're looking at around 13k at a state school and up to 30k at a private school.
> 
> ...



California State Uni's have a much lower tuition than some other states. Although with the current state of affairs not sure how much longer that will be true. The local CC's like Miramar or Mesa went from $26. per unit to $57.


----------



## JPINFV (Sep 21, 2012)

Sandog said:


> California State Uni's have a much lower tuition than some other states. Although with the current state of affairs not sure how much longer that will be true. The local CC's like Miramar or Mesa went from $26. per unit to $57.




Bright side, CSUs are cheaper, even compared to UCs.  

Down side... it's a CSU.

/Go Anteaters!
//ZotZotZotZot.


----------



## rescue1 (Sep 21, 2012)

Jambi said:


> BS...the common term that is, not bachelors of science.
> 
> You're looking at around 13k at a state school and up to 30k at a private school.
> 
> ...



Ummm...you realize those are yearly costs, right? I just graduated from an average priced four year college and paid 40 grand a year.


----------



## silver (Sep 21, 2012)

Jambi said:


> Out here on the left coast in socal, it's more like $17 top step for AMR.
> 
> Also, why anyone would drop 120k on a degree (MD/DO/DDS aside) is beyond me.  If someone is dumb enough to do such a thing...



you got to spend money to make money.


----------



## Veneficus (Sep 21, 2012)

rescue1 said:


> Ummm...you realize those are yearly costs, right? I just graduated from an average priced four year college and paid 40 grand a year.



You paid way too much...


----------



## rescue1 (Sep 21, 2012)

I paid $36,000/year WITH room/board, tuition was about $25,000 with my scholarship. I don't think it gets THAT much cheaper in the Philly/Baltimore area for private college though.

I'm not sure how much U Maryland was, but I think it would have been around $25,000--$30,000 a year-ish with room and board, as a cheaper state school (as an out of state applicant).


----------



## AngelMedic360 (Sep 21, 2012)

LOL, dont be a retard spending all that money for a career. You have to be smart and spend 2K at a JC for 4 months worth training so you can become a medic and get payed the same as burger flipper's supervisors :blink:

*Sarcasm is my weakness :wub: *


----------



## Veneficus (Sep 21, 2012)

AngelMedic360 said:


> LOL, dont be a retard spending all that money for a career. You have to be smart and spend 2K at a JC for 4 months worth training so you can become a medic and get payed the same as burger flipper's supervisors :blink:
> 
> *Sarcasm is my weakness :wub: *



ummm, I paid $18k a year at a state school for tuition for undergrad.

That was almost 8 years ago, but generally even with out of state tuitions, certain sections of the country are better for cost, even if you end up with cost of living, you can still get a better deal than some of the population centers I have seen like Boston, NYC, LA, etc.

What I see here is people paid 10s of K extra to stay near home.


----------



## NYMedic828 (Sep 21, 2012)

Veneficus said:


> ummm, I paid $18k a year at a state school for tuition for undergrad.
> 
> That was almost 8 years ago, but generally even with out of state tuitions, certain sections of the country are better for cost, even if you end up with cost of living, you can still get a better deal than some of the population centers I have seen like Boston, NYC, LA, etc.
> 
> What I see here is people paid 10s of K extra to stay near home.



Yea but... its not like you learned anything in all your schooling :blush:

My girlfriend pays $15,000 a year to go to nursing school on Long Isand. Thats with scholarship. Normal tuition is $30,000. Living at home.

I have it all planned out. They passed a bill last year that volunteer firefighters/EMS go to our community college for free. So I am going to do 2 free years of prerequisites that match a local nursing school. Then I just have to transfer my credits and pay for nursing classes. Hell if I am going to spend $20,000 a year to take math and science classes for two years.


----------



## Veneficus (Sep 21, 2012)

NYMedic828 said:


> Yea but... its not like you learned anything in all your schooling :blush:
> 
> My girlfriend pays $15,000 a year to go to nursing school on Long Isand. Thats with scholarship. Normal tuition is $30,000. Living at home.
> 
> I have it all planned out. They passed a bill last year that volunteer firefighters/EMS go to our community college for free. So I am going to do 2 free years of prerequisites that match a local nursing school. Then I just have to transfer my credits and pay for nursing classes. Hell if I am going to spend $20,000 a year to take math and science classes for two years.



make sure that the school doesn't require x credit from their institution.


----------



## Tigger (Sep 21, 2012)

Veneficus said:


> You paid way too much...



Indeed I'm not sure how I feel about paying about 50k a year all told to go get a BA in a field I am interested in but with little practical viability. I'm at a top-tier small liberal arts institution and getting a great education, but I'm not blind and know that I could have gotten something that is 90% of what I am getting now for 50% of the cost. 

You want an experience, you pay for it. Whether or not it is worth it is a question that can only be answered several years from now.


----------



## NYMedic828 (Sep 21, 2012)

Veneficus said:


> make sure that the school doesn't require x credit from their institution.



The nursing school actually has a little class finder that links you to what they accept from other schools as equal to theirs. 

My only hurdle is I probably won't be a full time student so it will take me 5 or so years to get a BSN from the ground up.


----------



## Veneficus (Sep 21, 2012)

NYMedic828 said:


> The nursing school actually has a little class finder that links you to what they accept from other schools as equal to theirs.
> 
> My only hurdle is I probably won't be a full time student so it will take me 5 or so years to get a BSN from the ground up.



there is a difference between what classes they accept and how much credit they accept.

Make sure you research both. 

At my undergrad state university, they would accept any local community college credit but a maximum of 30 credits.

They also had a seperate rule that said at least 3/4 of your degree requirements had to be completed in that institution unless you were enrolled full time in that institution and was given "visiting student" status at another school. 

Always read the fine print when it comes to transferring credit.


----------



## mycrofft (Sep 21, 2012)

As a male nursing student in 1981, I was repeatedly asked why I was not in medical school. ("Look the grades, Teach...and I don't want to!").


----------



## NYMedic828 (Sep 21, 2012)

mycrofft said:


> As a male nursing student in 1981, I was repeatedly asked why I was not in medical school. ("Look the grades, Teach...and I don't want to!").



I wasn't born until 9 years later... :blush:


----------



## mycrofft (Sep 21, 2012)

I mighta delivered you. (not)


----------



## SDog (Sep 22, 2012)

Maybe I'm just young an optimistic but I do ems cause I love it sure it's a pretty underpaid and unrecognized career path. If you want to go spend bunch money on degrees hopefully it's for somethig you love and not for the love of money you hope to make.... But I stress I'm young and optimistic I figure I got a few years before I lose that and start sounding old and cynical


----------



## VFlutter (Sep 22, 2012)

mycrofft said:


> As a male nursing student in 1981, I was repeatedly asked why I was not in medical school. ("Look the grades, Teach...and I don't want to!").



I get that a lot even today, most of the time by patients. Many older patients find it odd to have a male nurse and some even refuse to have one. Or just as much as the med school comment is the "Are you straight?" comment.  

I find it funny when the old demented patients refer to me as "that nice young doctor" no matter now many times I correct them. It's better than the patient who asked me if I was the janitor <_<


----------



## JPINFV (Sep 22, 2012)

...and this somehow became applicable. Note the title of the account to understand the joke.


----------



## NYMedic828 (Sep 22, 2012)

SDog said:


> Maybe I'm just young an optimistic but I do ems cause I love it sure it's a pretty underpaid and unrecognized career path. If you want to go spend bunch money on degrees hopefully it's for somethig you love and not for the love of money you hope to make.... But I stress I'm young and optimistic I figure I got a few years before I lose that and start sounding old and cynical



I used to be the same way. Probably what resulted in the Star of Life tattoo on my arm. (Which I don't regret, but its more of a life experience tat now)

Unfortunately as you begin to age, you realize that while you should do something you love you also need to do something that will provide for your future family/dependants. Money can't buy happiness but it is certainly a good start.

I am very glad I got into EMS because without it, I would not of recognized my general love of the medical field. I would love working in an ER or doc office just the same as an ambulance and it pays more. Two birds with one stone.

Also as stated, if you take the right path to get the right degree you won't waste all your money on loans. If you get a bachelors in political science or something then yes you dun' goofed.


----------



## VFlutter (Sep 22, 2012)

JPINFV said:


> ...and this somehow became applicable. Note the title of the account to understand the joke.



Haha I refuse to wear my white coat. Some of my classmates do


----------



## Aidey (Sep 22, 2012)

One of my previous partners had 3 BAs and a MA. Think of the 3 most useless BAs and the most useless MA and those were his degrees. He was as useless as an EMT as his degrees were for getting a job.

Edit - It wasn't possible for him to be too smart for EMS. That would require he be somewhat able to do the job in the first place.


----------



## AtlasFlyer (Sep 22, 2012)

NYMedic828 said:


> I used to be the same way. Probably what resulted in the Star of Life tattoo on my arm. (Which I don't regret, but its more of a life experience tat now)
> 
> *Unfortunately as you begin to age, you realize that while you should do something you love you also need to do something that will provide for your future family/dependants. Money can't buy happiness but it is certainly a good start.*
> 
> ...



+1 

Money doesn't buy happiness, and relying on money to make you "happy" will make you anything but...

but.

Without money the rent/mortgage doesn't get paid, the kids don't eat and the car doesn't get fixed.  When I was young, single, no kids... life was SO different. I lived in Chicago making crap wages as a flight attendant ($15k a year doesn't go very far, but when you're young & single with no kids it's possible).  Now at 37 with 2 high-needs kids to take care of, life and priorities are significantly different.


----------



## sir.shocksalot (Sep 22, 2012)

AtlasFlyer said:


> +1
> 
> Money doesn't buy happiness, and relying on money to make you "happy" will make you anything but...
> 
> ...


+2

Right now I make pretty good money. Last year I pulled in $47,000, this year it will probably be $40,000-$42,000 (I really haven't been motivated to work OT this year). That kind of money is great for someone who is single, lives alone, with a small car payment and a one bedroom apartment in a middle-class neighborhood. I can buy toys and go out and still be comfortable, I don't live paycheck to paycheck.

But I couldn't dream of supporting anyone on that kind of pay and the reality is that EMS doesn't live much, if any, room for advancement. For a pay raise I can either go management or FD, and eventually I will need a Bachelors degree. If I need a BS degree to move into a better paying position in this job I would rather get a BS degree in something I would enjoy doing and get out of EMS entirely.

And to answer the OP, I actually think there are some people too smart to be paramedics/EMTs. If you are a person that pushes themselves to learn more and keep up to date with the latest advances in medicine, often you will be shunned by your peers. I remember going on a call for a guy that was jaundiced and altered as heck, when I did an assessment I noticed he had asterixis. When I told my FI this, he simply looked at me and said "Why do you care? Check his sugar, put him on the monitor and drive him to the hospital, diagnosis is a doctor's job." This attitude bugs me to no end, so what if we can't do anything about it? This is the sort of thing that keeps us being called ambulance drivers. I have often wondered if I would be better at this job if I was a little dumber and didn't think too much into what is going on with patients. I also think some people just aren't challenged enough by EMS, some people need to have a constant brain challenge at work and at a certain point EMS stops being challenging, not to say that there isn't more to learn or there aren't difficult calls, just that the day-to-day stuff stops challenging some people.

I recommend anyone with the drive or ability to get out of EMS while they can. Other careers can be much more rewarding both paycheck wise and intellectually.


----------



## Veneficus (Sep 22, 2012)

sir.shocksalot said:


> +2
> 
> Right now I make pretty good money. Last year I pulled in $47,000, this year it will probably be $40,000-$42,000 (I really haven't been motivated to work OT this year). That kind of money is great for someone who is single, lives alone, with a small car payment and a one bedroom apartment in a middle-class neighborhood. I can buy toys and go out and still be comfortable, I don't live paycheck to paycheck.
> 
> ...



Exactly what he said.


----------



## RocketMedic (Sep 22, 2012)

I do think it's getting better, slowly and sporadically. I didn't get the "meh" vibe from EMSA that I've gotten at other agencies.


----------



## NYMedic828 (Sep 22, 2012)

Rocketmedic40 said:


> I do think it's getting better, slowly and sporadically. I didn't get the "meh" vibe from EMSA that I've gotten at other agencies.



I think it's getting worse.

We keep adding expensive toys without adding education.

That's one step forwards and two steps back in my book.


----------



## RocketMedic (Sep 22, 2012)

I think the "education" is rather dependent upon the agency for the time being, but schools are catching up slowly. For instance, my pathetic excuse for a course coordinator didn't even know what parts of the heart a 12-lead monitored, how to interpret it, or how it ties into EMS, and the NR is driving her course out of business due to her failure to accredit and progress. 

The deaths of the "medic mills" will probably change this somewhat.


----------



## Veneficus (Sep 22, 2012)

Rocketmedic40 said:


> The deaths of the "medic mills" will probably change this somewhat.



I think the opinion that NR or any accrediting process is going to kill off medic mills is overly optimistic. 

Medic mills have only one purpose, to make money. In order to protect their revenue streams I have seen them come up with all kinds of imaginitive ways to skirt the rules. 

By far my favorite is when they pay fees to out of state community colleges to list themselves as "remote campuses" of that institution. 

This even permits them to issue actual credit hours if requested by students from the "parent" organization. 

Where there is a will there is a way.


----------



## psyanotic (Sep 23, 2012)

I'm not sure what the national state of EMT-P competency is, but around here paramedics are highly regarded. King County WA paramedics have an incredible amount of training and are also VERY well paid. It's been said that having a medic one medic on scene is like having an ER doctor in the field.

But I understand that this probably isn't the case in most places. A lot of my friends are switching to ER tech positions because it's almost twice the hourly pay and the hospital environment mixed with the desire to learn as much as possible in order to provide great care seems to work out much better than my friends in the field. Most EMT's I know are either complacent or ignorant. Most could care less about learning things that are a "doctor's or nurse's job". Everyone else either has or is moving on to a PA, medic, RN, etc. program.

Again, I'm only talking about basics here. Like I said, the attitude around here is a pretty high regard for medics.


----------



## VFlutter (Sep 23, 2012)

psyanotic said:


> It's been said that having a medic one medic on scene is like having an ER doctor in the field.


----------



## NomadicMedic (Sep 23, 2012)

psyanotic said:


> It's been said that having a medic one medic on scene is like having an ER doctor in the field.




The only person who's ever said that was another Medic One medic. 

:rofl:


----------



## Aidey (Sep 23, 2012)

ChaseZ33 said:


>





n7lxi said:


> The only person who's ever said that was another Medic One medic.
> 
> :rofl:



+1 :lol:


----------



## Jambi (Sep 23, 2012)

psyanotic said:


> It's been said that having a medic one medic on scene is like having a highly proficient and well-practiced technician in the field.



I fixed your typo for you...


----------



## JPINFV (Sep 23, 2012)

psyanotic said:


> It's been said that having a medic one medic on scene is like having an ER doctor in the field.


----------



## RocketMedic (Sep 24, 2012)

That may be a slight exaggeration.


----------



## psyanotic (Sep 24, 2012)

"Medic One paramedics are trained to be an extension of the emergency room physician."

"Harborview Paramedic Training Program provides 3,000 hours (compared to the national standard of 1,100 hours) of instruction and hands-on training to its students."

"Medic One, Seattle and King County’s pre-hospital emergency care system, sets the standard for lifesaving excellence in the U.S. and worldwide."

"Seattle and King County setting standard in prehospital ETI" - JEMS

"Its cardiac arrest survival rate for bystander-witnessed VF/VT is 43%. Its intubation success rate is 99% with a first pass rate of 80%."

"The median gross earning was $116,788.70. 78% of these paramedics earned over $100,000. The least experienced medic who worked a full year (not as an intern) earned $79,876.98."


Although clearly an exaggeration, I think some of the incredibly kind, respectful and considerate senior members here may have missed my point. Thanks for the warm welcome!


----------



## JPINFV (Sep 24, 2012)

psyanotic said:


> "Harborview Paramedic Training Program provides 3,000 hours (compared to the national standard of 1,100 hours) of instruction and hands-on training to its students."



Medical school alone is over 4,000 hours. Actually, I don't know what the final hour count is for medical school, I just know that the statutory minimum for California is 4,000 hours, and I know that doesn't include time spent out of class studying. Then, for EM, there's 3-4 years of residency on top of that.

Now if any Medic 1 paramedics would like to take a look at some of the questions from the Step 1 question book I have sitting in my bookcase (I should burn it or sell it...), I'll be happy to type them up for them.


----------



## abckidsmom (Sep 24, 2012)

psyanotic said:


> "Medic One paramedics are trained to be an extension of the emergency room physician."
> 
> "Harborview Paramedic Training Program provides 3,000 hours (compared to the national standard of 1,100 hours) of instruction and hands-on training to its students."
> 
> ...



Stick around a bit. When you open with an exaggeration around here, especially deep in a real discussion, you might find some pushback. 

This was humorous pushback, and you rebutted nicely. Please know that you will get pushback again for taking a quote from JEMS (trade propaganda magazine) out of context and spinning it. 

"Extension of ED physician" =\= "like having a physician on scene"

I for one would love to hear more details about the system in Seattle, so please don't go running off already.


----------



## abckidsmom (Sep 24, 2012)

JPINFV said:


> Medical school alone is over 4,000 hours. Actually, I don't know what the final hour count is for medical school, I just know that the statutory minimum for California is 4,000 hours. Then, for EM, there's 3-4 years of residency on top of that.



3,000 hours is a year and a half of 40 hour weeks. 

This is real, and not an exaggeration too? I knew it was crazy, but that's just insane!


----------



## JPINFV (Sep 24, 2012)

abckidsmom said:


> 3,000 hours is a year and a half of 40 hour weeks.
> 
> This is real, and not an exaggeration too? I knew it was crazy, but that's just insane!



Yea, but 40 class hours a week of anything even mildly difficult is rather insane. Full time undergrad is normally, 12-20 hours/week of lecture. The bigger question is how much time outside of class is necessary for a student to become proficient in the material. There's a big difference, after all, in having 4 hours straight of an EMT-B and 4 hours straight of undergrad biochem. Actually, I think 4 hours straight of biochem is approaching torture criteria.


----------



## Jambi (Sep 24, 2012)

As far as providers are concerned, Medic 1 in Seattle are pretty on top of their stuff.  Tossing their salary around is likely to upset folks because they work for a well funded fire department.  

Regardless paramedic =/= doctor and they are still, despite what they would like to think, highly proficient and well-practiced technicians...

If you take the same money and political will else were, you will have the same results elsewhere.  It's not magic, just money and politics.


----------



## Jambi (Sep 24, 2012)

JPINFV said:


> Yea, but 40 class hours a week of anything even mildly difficult is rather insane. Full time undergrad is normally, 12-20 hours/week of lecture. The bigger question is how much time outside of class is necessary for a student to become proficient in the material. There's a big difference, after all, in having 4 hours straight of an EMT-B and 4 hours straight of undergrad biochem. Actually, I think 4 hours straight of biochem is approaching torture criteria.



I've heard the 12,000 number tossed around when including the standard 2 year residency.  Figure you're hitting that 80 hr/week mark during residency...


----------



## JPINFV (Sep 24, 2012)

Jambi said:


> I've heard the 12,000 number tossed around when including the standard 2 year residency.  Figure you're hitting that 80 hr/week mark during residency...




...but standard residency is 3 years, unless you want to include internship year (post graduate year 1) as different (which they can be).


----------



## Jambi (Sep 24, 2012)

JPINFV said:


> ...but standard residency is 3 years, unless you want to include internship year (post graduate year 1) as different (which they can be).



My bad, meant to say 3 year...EM, FM, IM, etc


----------



## psyanotic (Sep 24, 2012)

Of course, they're not doctors, and their certifications reflect that fact. But they are trained BY doctors to be as proficient AS doctors at a few things. And I can tell you, they definitely are. I think doctors are required to know a little about a lot (med school) and then a lot about a little (residency). I do think it's true though that medic one intentionally designed their system with exclusivity in mind in order to provide their medics with ample experience to keep them current and adept.

Given, I do see them make mistakes sometimes, and they tend to not be too humble about it.


----------



## Tigger (Sep 24, 2012)

JPINFV said:


> Yea, but 40 class hours a week of anything even mildly difficult is rather insane. Full time undergrad is normally, 12-20 hours/week of lecture. The bigger question is how much time outside of class is necessary for a student to become proficient in the material. There's a big difference, after all, in having 4 hours straight of an EMT-B and 4 hours straight of undergrad biochem. Actually, I think 4 hours straight of biochem is approaching torture criteria.



Here at my lovely college, every class is taught in 3 hour long blocks, usually 9-12 (ish). Class 5 days a week, and if you're in any sort of science class, expect lab in the afternoon at least three times a week if not five. Classes are three and a half weeks long with a break to get your mind back from Wednesday to the following Monday. 

It is not a good way to take any lab class, in my opinion. There is no escape, and it beats you down to a hollow shell of a person. Unfortunately the grades I have in the classes that matter (Chems/Psych/Stats/Calc) are not as good as they could be. I did not think I would end up pursuing medicine when I enrolled, and I loved and still love it here to much to leave, but damn I am not looking forward to Bio of Animals coming up next Monday.


----------



## psyanotic (Sep 24, 2012)

abckidsmom said:


> Stick around a bit. When you open with an exaggeration around here, especially deep in a real discussion, you might find some pushback.
> 
> This was humorous pushback, and you rebutted nicely. Please know that you will get pushback again for taking a quote from JEMS (trade propaganda magazine) out of context and spinning it.
> 
> ...



Glad to know it's all in good jest 

I just get defensive because I've always wanted to be a paramedic and threads like these that present personal realities that suggest that it's not fulfilling or actualizing of one's potential kinda make me sad :sad:


----------



## RocketMedic (Sep 24, 2012)

psyanotic said:


> "Medic One paramedics are trained to be an extension of the emergency room physician."
> 
> "Harborview Paramedic Training Program provides 3,000 hours (compared to the national standard of 1,100 hours) of instruction and hands-on training to its students."
> 
> ...




Medic 1 is also known for doing some things very right and other things less right than other systems.


----------



## psyanotic (Sep 24, 2012)

Rocketmedic40 said:


> Medic 1 is also known for doing some things very right and other things less right than other systems.



What kinds of things?


----------



## Handsome Robb (Sep 24, 2012)

psyanotic said:


> What kinds of things?



I've never been there or worked there or met anyone who has but from what I hear they've got themselves a reputation for turfing calls that should be ALS to BLS crews, for one.


----------



## NomadicMedic (Sep 24, 2012)

psyanotic said:


> What kinds of things?



The do a great job of resuscitating witnessed VF arrests and then writing press releases about it. . 

I'm really only half kidding. Their service is really no more progressive than many others, their culture is one of elitism  and exclusion and they provide some of the absolute worst customer service I've ever witnessed. Oh yeah, they turf a lot of stuff to BLS. I don't know if its because they're lazy, overworked or just know they can get away with it...

(And yes, I worked in King County as a BLS provider both before and after medic school. I worked with those medics every day. *My* opinions of KCM1 are based on what I witnessed.)

Other than that, they have nice trucks, the education they are provided is nice and the pay is outstanding.


----------



## NYMedic828 (Sep 24, 2012)

psyanotic said:


> Glad to know it's all in good jest
> 
> I just get defensive because I've always wanted to be a paramedic and threads like these that present personal realities that suggest that it's not fulfilling or actualizing of one's potential kinda make me sad :sad:



Really not helping your situation... You need to throw out the delusion of what EMS is to you and realize what it actually is...


----------



## VFlutter (Sep 24, 2012)

psyanotic said:


> But they are trained BY doctors to be as proficient AS doctors at a few things. And I can tell you, they definitely are.



So what skills are they definitely as proficient as doctors at? Also being able to perform physical skills just makes you a technician as stated earlier.


----------



## NomadicMedic (Sep 24, 2012)

ChaseZ33 said:


> So what skills are they definitely as proficient as doctors at? Also being able to perform physical skills just makes you a technician as stated earlier.



Just because I give breaking treatments and use a vent, that doesn't make me as proficient as an RT. 

I can intubate and decompress a chest. That certainly doesn't make me as proficient as an ER Trauma Doc. 

I may know some skills and be deemed competent to perform them. That doesn't mean I have the same education or skill set as a physician or any other specialist. I equate my skill set to that of a plumber or an electrician. I may fix the pipes or wire a doorbell, I'm not trained to draw the plans to build the house. An architect is. 

I, like the KCM1 medics, am only a paramedic. Trained to perform very specific skills in very specific situations in order to stabilize and manage patients while they are transported to an Emergency Department, or infrequently, treat and release patients that meet specific criteria. 

Paramedics that think they're "as good as doctors" are dangerous and do nothing to develop respect for paramedicine as a profession, rather than just a skilled trade.


----------



## medicsb (Sep 24, 2012)

n7lxi said:


> The do a great job of resuscitating witnessed VF arrests and then writing press releases about it. .
> 
> I'm really only half kidding. Their service is really no more progressive than many others, their culture is one of elitism  and exclusion and they provide some of the absolute worst customer service I've ever witnessed. Oh yeah, they turf a lot of stuff to BLS. I don't know if its because they're lazy, overworked or just know they can get away with it...
> 
> ...



I've always been curious about how they triage to BLS.  I've always found it interesting that they have never published any data about the patients that do not go by ALS who were triaged to BLS (either by medics or EMTs).  I think that is something that could help guide other systems - who can be safely transported without ALS.

Anyhow, in my opinion, there is plenty that people would make ALS that doesn't actually need to be ALS.  When I worked in NJ, ALS was dispatched on about half of all EMS calls (a lot of overtriage as dispatchers didn't have to follow the guide cards) and we generally got recalled anywhere from 40-70% of the time.  In my general experience, about 1/3 to half of what we regularly "rode in" didn't need us.  I would have gladly turfed those patients to BLS if I didn't have to worry about the medical director raising a stink for turfing a dyspneic patient with normal VS in no distress because she got sent to a tele floor with anemia.  I would have gladly turfed plenty of pneumonias, hyperglycemias, pleuritic CP, etc. but couldn't because of the chance that they would get admitted to non general medical floor, which would prompt the medical director send out a nasty-gram.    

Anyhow, there is a lot that KCM1 does well for which they deserve credit.  (For one, I can't think of one EMS system that does even half the research they do.)  Also that PR they generate likely keeps them funded.  More EMS systems should do similar.  Also, most (say, 98%) of EMS systems probably have too many medics, so KCM1 will always get credit for not diluting their system with unneeded medics.  That and research are the two things that all EMS systems should try to emulate.


----------



## Aidey (Sep 24, 2012)

When he says turf to BLS he isn't just talking about downgrading patients. KCM1 has a very nasty habit of treating things on scene, pulling the interventions and then sending the pt in with a BLS crew. Brilliant idea for allergic reactions and asthma attacks. I have a friend who used to work BLS in King County and she pretty much spits every time someone says their name.


----------



## NomadicMedic (Sep 24, 2012)

Aidey said:


> When he says turf to BLS he isn't just talking about downgrading patients. KCM1 has a very nasty habit of treating things on scene, pulling the interventions and then sending the pt in with a BLS crew. Brilliant idea for allergic reactions and asthma attacks. I have a friend who used to work BLS in King County and she pretty much spits every time someone says their name.



Don't forget opiate ODs, altered mental status, assaults with head injuries and chest pain. 

One of my last days working in King County, a medic tried to turf a fulminant CHF patient to me. Seriously. 

And yeah, I refused to take the patient. That's an ALS call, pal.


----------



## Veneficus (Sep 24, 2012)

*it is 'jack the thread week*



medicsb said:


> I've always been curious about how they triage to BLS.  I've always found it interesting that they have never published any data about the patients that do not go by ALS who were triaged to BLS (either by medics or EMTs).  I think that is something that could help guide other systems - who can be safely transported without ALS.
> 
> Anyhow, in my opinion, there is plenty that people would make ALS that doesn't actually need to be ALS.  When I worked in NJ, ALS was dispatched on about half of all EMS calls (a lot of overtriage as dispatchers didn't have to follow the guide cards) and we generally got recalled anywhere from 40-70% of the time.  In my general experience, about 1/3 to half of what we regularly "rode in" didn't need us.  I would have gladly turfed those patients to BLS if I didn't have to worry about the medical director raising a stink for turfing a dyspneic patient with normal VS in no distress because she got sent to a tele floor with anemia.  I would have gladly turfed plenty of pneumonias, hyperglycemias, pleuritic CP, etc. but couldn't because of the chance that they would get admitted to non general medical floor, which would prompt the medical director send out a nasty-gram.



I read a study years and years ago done by an anesthesiologist in Virginia who was a prior medic about EMS ability to determine which patients were likely to be admitted to the hospital.

That doesn't come a a surprise to me because at no point in my EMS education was I told who would be addmited or why.

I have seen a handful of studies over the years showing that while many patients transported to the ED by ambulance did not need acute care, they did need primary care and may have been admitted for such. 

I think it was a misunderstanding on the part of your medical director to give you grief on that.

I also think we need to perhaps redefine what the role of EMS is. 

If it is a service only dedicated to acute emergencies, then we will need something to handle everything else to preserve and best utilize this resource.

If it is going to be "an extension of the ED" which fulfils the role of not only acute care, but entrance into the health system for many, then education and procedures for that will need to be included.


----------



## Veneficus (Sep 24, 2012)

psyanotic said:


> Of course, they're not doctors, and their certifications reflect that fact. But they are trained BY doctors to be as proficient AS doctors at a few things. And I can tell you, they definitely are..



I can tell you they are definately not. 

There is a lot more to being a doctor than a handful of skills and field resuscitation.

Many years ago I believed this same thing of the EMS system I worked in. I simply didn't know what I didn't know.

In terms of enviable EMS systems, Wake county is about the only one in the US I would list. AU/NZ definately make the number 1 spot for EMS in the world in terms of non-physician based EMS, with some European countries rounding out the top 5.

Keep in mind, in the AU/NZ/EU systems, 3000 hours of training would not even be enough for you to legally provide care on an als truck in those places.

King county has identified and as close as possible perfected a very small part of what EMS of today is. They also have made great strides in demonstrating effective EMS in the US in terms of bystander involvement, a small number of ALS providers, and as mentioned research. There is much that they could teach other US EMS, but it is simply not the best or the future of EMS.   



psyanotic said:


> I think doctors are required to know a little about a lot (med school) and then a lot about a little (residency).



Not exactly. This is a popular misconception because it is often used comparing an MD/DO to a PhD.

What a doctor is educated in is the principles of basic and clinical science and how to apply that to all patients. (medical school)

Specialty training gives additional knowledge and skills in order to improve upon the base understanding of medical school. While many doctors chopose not to function outside of their given specialty, an unlimited license to practice medicine is just that. Unlimited.

Where I am at is is the dominant philosophy/practice that all doctors must be capable GPs. Only then can they move on to specialty training. They are still expected to maintain competency as a GP.    



psyanotic said:


> I just get defensive because I've always wanted to be a paramedic and threads like these that present personal realities that suggest that it's not fulfilling or actualizing of one's potential kinda make me sad :sad:



Reality sucks doesn't it?

As food for thought, how do you know you want to be a paramedic when you don't seem to know what the realities of it are?

That is not meant to be  discouraging, on paper I am still a paramedic, but when I started I had the same perception of it you describe. My perception has changed. But still I stay involved.


----------



## NYMedic828 (Sep 24, 2012)

psyanotic said:


> I just get defensive because I've always wanted to be a paramedic and threads like these that present personal realities that suggest that it's not fulfilling or actualizing of one's potential kinda make me sad :sad:



Not a day goes by I don't wish I cared more in high school/college. Could have been a year or two into med school by now had I only known what I really wanted. Instead I'm staring at a dashboard for the next 6 hours.

Psyanotic, I presume you are young, as am I. EMS is not a waste of your time but its obvious you have ambition. More than likely, too much to be satisfied by EMS till you grow old and grey. I urge you to make the right decisions now and reach higher than you planned. If your interest in medicine is genuine and your heart is in it then climb the ladder, don't stop half way.

I hope to return to school in the near future for some higher medical title but who knows maybe my name will eventually end in MD. EMS has allowed me to see and experience things that most doctors/people will never. It isn't a loss but don't take it as a definitive career goal. You are too young and enthusiastic.


----------



## VFlutter (Sep 24, 2012)

psyanotic said:


> Glad to know it's all in good jest
> 
> I just get defensive because I've always wanted to be a paramedic and threads like these that present personal realities that suggest that it's not fulfilling or actualizing of one's potential kinda make me sad :sad:



You should be happy you are finding this out now and not after spending time and money on paramedic school if it is not something you truly want. I thought I always wanted to be a paramedic until I actually got into the field. Personally I could not get over the fact of not having a degree, among other issues. 

Nothing is ever as fulfilling as it seems. I was excited to be a nurse and actually take care of patients (instead of just transporting them and dropping them in the ED) until I realized that 80% of nursing is trying to turf gomers to  SNFs and hope they don't bounce back anytime soon or watching your oncology patient slowly suffer until they eventually die (never soon enough). 

Some people may criticize my attitude but I am glad that I realized this now before I graduate. The ones with the save the world attitude are always the first to burn out. It's good to have a realistic view of how the world actually works.


----------



## psyanotic (Sep 24, 2012)

sure, they've given us a couple sick patients before,  but that changes from.crew to crew. the majority of them end up transporting patients without any clear ALS indicators (at least to me) simply because they're already there. 

also note I'm only talking about the south county medics. Seattle, shoreline, etc. m1 are AMR's cup of tea.


----------



## abckidsmom (Sep 24, 2012)

psyanotic said:


> sure, they've given us a couple sick patients before,  but that changes from.crew to crew. the majority of them end up transporting patients without any clear ALS indicators (at least to me) simply because they're already there.
> 
> also note I'm only talking about the south county medics. Seattle, shoreline, etc. m1 are AMR's cup of tea.



Let's shift our focus back to the topic at hand, what happens to the brightest medics.  Further discussion of behaviors of specific agencies in this thread is not acceptable.


----------



## MexDefender (Sep 24, 2012)

From what I've gathered it's something the elders have stumbled upon and people who join as first career get verbally assaulted by the older crew for even wanting to do for your entire life. You're too green - a over said burnout response reserved for burn outs and the unchangeable. The reason one would say this is because of the education needed for you to become one back in the day, it has become better in time but many still believe it to be a undereducated course (paramedic) only when you learn to think like the cynic/burnout/experienced narrow minded paramedic will you become a respectable ems provider in their eyes. Being green until you see THE LIGHT they see but we "greenhorns" will only be able to in time and experience. These people are what hurt the service and keep it in the unchanged broken system it is. 

Too smart, too green, too this or that, it's all annoying and sad to see. I smile and agree so I don't have to deal with the egos that rule this field.


----------



## Veneficus (Sep 24, 2012)

MexDefender said:


> From what I've gathered it's something the elders have stumbled upon and people who join as first career get verbally assaulted by the older crew for even wanting to do for your entire life. You're too green - a over said burnout response reserved for burn outs and the unchangeable. The reason one would say this is because of the education needed for you to become one back in the day, it has become better in time but many still believe it to be a undereducated course (paramedic) only when you learn to think like the cynic/burnout/experienced narrow minded paramedic will you become a respectable ems provider in their eyes. Being green until you see THE LIGHT they see but we "greenhorns" will only be able to in time and experience. These people are what hurt the service and keep it in the unchanged broken system it is.
> 
> Too smart, too green, too this or that, it's all annoying and sad to see. I smile and agree so I don't have to deal with the egos that rule this field.



I am not so sure this is always the case. I have had coworkers, even mentors tell me I needed to get out of EMS because I could make a bigger difference somewhere else. 

These were not burnout old coots, these guys were the best of the best of some extremely respectable agencies. 

One of the things that never changes in EMS is that when the older guys (gals, whatever) try to push people to move on, because they have not so much seen the light, but have seen the forest from the trees, there is always a pushback from the idealistic new persons.

These new people work very hard with tremendous dedication to fight the good fight before becomming one of those guys trying to get young guys not to make the same mistakes they did or have to settle for being less than what they are.

I will agree there are many burnt out people in EMS who are just disgruntled in all respects.

However, this topic is not news. EMS has been losing its best and brightest for all of my career. 

The reason hasn't changed either. 

There are organizations and advocates who benefit from EMS not progressing into a profession. Thier money, power, and very job depend on it.  

So I will echo the advice I was given...

Get your experience and get out.  Move on to where you can really make a difference.  

The younger you are, the easier it is. But it is never too late.

to steal a quote that wasn't on Youtube.

"We are both pawns in the same great game. But I escaped! So can you..."


----------



## VFlutter (Sep 24, 2012)

I remember we had a short answer question on the pediatric exam asking "What is the clinical signfiicance of grunting in infants." My response "The infant is breathing against a partially closed glottis to produce PEEP and promote gas exchange." It was origonally marked wrong until my instructor asked me to explain my answer to him and at the end told me to keep it simple and just put difficulty breathing next time.....


----------



## shfd739 (Sep 24, 2012)

Veneficus said:


> One of the things that never changes in EMS is that when the older guys (gals, whatever) try to push people to move on, because they have not so much seen the light, but have seen the forest from the trees, there is always a pushback from the idealistic new persons.
> 
> These new people work very hard with tremendous dedication to fight the good fight before becomming one of those guys trying to get young guys not to make the same mistakes they did or have to settle for being less than what they are.



We have a few young people that want to make a difference and have the dedication to hang around long enough to see it happen. Hopefully they make it as I see them being able to do it. These folks love EMS enough and dont want to be anything else. They also want to see their coworkers step it up. I hope the system doesnt burn them before they can make a difference.

Now Im pushing myself and some others to move on while we're still young enough to.

Its been 11 years of playing this game and I dont care to hang around long enough for it to change. I want more for myself.


----------



## sir.shocksalot (Sep 24, 2012)

shfd739 said:


> We have a few young people that want to make a difference and have the dedication to hang around long enough to see it happen. Hopefully they make it as I see them being able to do it. These folks love EMS enough and dont want to be anything else. They also want to see their coworkers step it up. I hope the system doesnt burn them before they can make a difference.
> 
> Now Im pushing myself and some others to move on while we're still young enough to.
> 
> Its been 11 years of playing this game and I dont care to hang around long enough for it to change. I want more for myself.


I can't count how many times I have seen this happen, heck it described me perfectly a year or two ago. A rookie EMS provider gets through a tough paramedic program and has this idealistic view that all EMS providers have the same desire for excellence and continuing clinical education that they do only to find that they are very alone. They push others to step up and better themselves for the sake of their patients and their profession, only to get pushed back and told nonsense like: "We aren't doctors", "I just did this to get a fire job", "You don't need to know THAT much A+P to be a good paramedic", and the excuses go on and on. Eventually said provider gets burned out trying to change things, or not being rewarded for their hard work as a clinician and moves on to a profession that will value their attitude and drive.

The fire department, private EMS, and volunteer agencies have lots of money invested in keeping EMS easy and simple. The efforts one individual are unlikely to change a system where money and time is put in to keep it as a non-profession. If you are smart enough to go back to school and get a degree that will get you somewhere, I doubt you will find much fulfillment out of an EMS career. It's not that you can't challenge yourself and become a phenomenal paramedic, it's just that you will never receive any professional recognition for excellence in clinical care. I have never heard of one person getting promoted because they were a "good paramedic", they get promoted for political reasons or "time in grade" reasons. We have created a career where we burn out and push out the best among us, and I don't see this changing.


----------



## shfd739 (Sep 24, 2012)

sir.shocksalot said:


> I can't count how many times I have seen this happen, heck it described me perfectly a year or two ago. A rookie EMS provider gets through a tough paramedic program and has this idealistic view that all EMS providers have the same desire for excellence and continuing clinical education that they do only to find that they are very alone. They push others to step up and better themselves for the sake of their patients and their profession, only to get pushed back and told nonsense like: "We aren't doctors", "I just did this to get a fire job", "You don't need to know THAT much A+P to be a good paramedic", and the excuses go on and on. Eventually said provider gets burned out trying to change things, or not being rewarded for their hard work as a clinician and moves on to a profession that will value their attitude and drive.
> 
> The fire department, private EMS, and volunteer agencies have lots of money invested in keeping EMS easy and simple. The efforts one individual are unlikely to change a system where money and time is put in to keep it as a non-profession. If you are smart enough to go back to school and get a degree that will get you somewhere, I doubt you will find much fulfillment out of an EMS career. It's not that you can't challenge yourself and become a phenomenal paramedic, it's just that you will never receive any professional recognition for excellence in clinical care. I have never heard of one person getting promoted because they were a "good paramedic", they get promoted for political reasons or "time in grade" reasons. We have created a career where we burn out and push out the best among us, and I don't see this changing.



You nailed it my friend. So many of my coworkers are using this as a stepping stone to fire or because it's easy compared to doing an RN program. The ones that will stay see no reason to improve themselves and follow protocols like a bible. 

As we try to push things forward it gets nowhere. Our newly promoted FTO has barely 2 years experience as a medic, no critical care transport experience, is still learning as a clinician and asking the more experienced ones what to do. Im supposed to have this person looking over my care? Not. So much for someone to push care forward when they arent even sure what to do.

It's like we took 2 steps back. The experienced/older ones of us that do care have been burned trying to make a difference so we are done. Time for the next group to try. I wish them luck. Sadly some are seeing how difficult it will be and are second guessing if it's possible.


----------



## JPINFV (Sep 24, 2012)

I wonder if the only real solution is to create little fiefdoms of meritocracy, high standards, and high pay. Then make it a "want to play with the big boys? Step it up."

Unfortunately, the only way I see system wide change is for a private organization to do it where they can start absorbing and taking on contracts. The problem with places like Wake County is that they're bound by political boundaries, thus limiting their impact on the industry as a whole.


----------



## shfd739 (Sep 24, 2012)

JPINFV said:


> I wonder if the only real solution is to create little fiefdoms of meritocracy, high standards, and high pay. Then make it a "want to play with the big boys? Step it up.".



For the most part I like this.

Makes me think of Australia where if you want to play you have to have the schooling. And are rewarded for it pay wise and system wise.

Whereas in the US you can go to school, get the knowledge, have the EMS degree but it wont pay you any better or get you any further ahead. 

There is no reward/incentive for making yourself a better medic and if you wanna spend the time on school might as well make it count for something- which means switching to another field.


----------



## Veneficus (Sep 25, 2012)

JPINFV said:


> I wonder if the only real solution is to create little fiefdoms of meritocracy, high standards, and high pay. Then make it a "want to play with the big boys? Step it up."
> 
> Unfortunately, the only way I see system wide change is for a private organization to do it where they can start absorbing and taking on contracts. The problem with places like Wake County is that they're bound by political boundaries, thus limiting their impact on the industry as a whole.



That sounds like a business plan.


----------



## psyanotic (Sep 25, 2012)

NYMedic828 said:


> Not a day goes by I don't wish I cared more in high school/college. Could have been a year or two into med school by now had I only known what I really wanted. Instead I'm staring at a dashboard for the next 6 hours.
> 
> Psyanotic, I presume you are young, as am I. EMS is not a waste of your time but its obvious you have ambition. More than likely, too much to be satisfied by EMS till you grow old and grey. I urge you to make the right decisions now and reach higher than you planned. If your interest in medicine is genuine and your heart is in it then climb the ladder, don't stop half way.
> 
> I hope to return to school in the near future for some higher medical title but who knows maybe my name will eventually end in MD. EMS has allowed me to see and experience things that most doctors/people will never. It isn't a loss but don't take it as a definitive career goal. You are too young and enthusiastic.



Thank you


----------



## psyanotic (Sep 25, 2012)

Veneficus said:


> Reality sucks doesn't it?
> 
> As food for thought, how do you know you want to be a paramedic when you don't seem to know what the realities of it are?
> 
> That is not meant to be  discouraging, on paper I am still a paramedic, but when I started I had the same perception of it you describe. My perception has changed. But still I stay involved.



I guess I don't really want to be a paramedic, I want to be a doctor. But it just doesn't seem realistic. Becoming a paramedic seems more realistic while still allowing me to upgrade the -B appended to my EMT title.


----------



## Aidey (Sep 25, 2012)

The NREMT took EMT out from in front of paramedic.


----------



## VFlutter (Sep 25, 2012)

psyanotic said:


> I guess I don't really want to be a paramedic, I want to be a doctor. But it just doesn't seem realistic. Becoming a paramedic seems more realistic while still allowing me to upgrade the -B appended to my EMT title.



Everyone wants to be a doctor....there is nothing wrong with being a paramedic, you can have a great career and quality of life if you get hired at the right place. But just remember those good places to work are few and far between. Just have a realistic idea of what your getting into.


----------



## Veneficus (Sep 26, 2012)

psyanotic said:


> I guess I don't really want to be a paramedic, I want to be a doctor. But it just doesn't seem realistic. Becoming a paramedic seems more realistic while still allowing me to upgrade the -B appended to my EMT title.



If you want to become a doctor then become a doctor. 

The question becomes not "if?" but "how?"



ChaseZ33 said:


> Everyone wants to be a doctor....there is nothing wrong with being a paramedic, you can have a great career and quality of life if you get hired at the right place. But just remember those good places to work are few and far between. Just have a realistic idea of what your getting into.



This is just like EMS. Everyone thinks they want to be a doctor. Then the reality of the job hits. Especially in acute care.

I absolutely laugh at EMs, critical care surgeons, orthopods, etc who complain about having to deal with noncritical patients who are drunk, addicted to drugs, criminals, or otherwise undesirable to society...

That is what the job is. 

If you don't like it, there is always dermatology.


----------



## NYMedic828 (Sep 26, 2012)

Veneficus said:


> If you want to become a doctor then become a doctor.
> 
> The question becomes not "if?" but "how?"
> 
> ...



Is that so different from EMS? (The undesirables) If that's what you are going to be stuck with, at least strive for the top right?

Could always be an oncologist, if you can handle living in a world of depression with the hope of changing the world.


----------



## Veneficus (Sep 26, 2012)

NYMedic828 said:


> Is that so different from EMS? (The undesirables) If that's what you are going to be stuck with, at least strive for the top right?



Just like EMS, many people think they are going to be engaged in single combat with death in order to give somebody a desirable life back.

The reality is you will be trying to improve the lives of people you definately would not want to switch places with. 

Poor people get hurt more often than others.
Poor people have basic health concerns that are not for others.
They have to accept more risk both in life and at work.
They often cannot change their circumstances for various reasons.
They often have no positive coping mechanisms.
Their expectations and goals do not match others.
May wait to engage EMS and other healthcare only after something easily preventable has gone wrong.
Because of lack of knowledge and subsequent fear, will seek help both early and more often for minor illness.
Usually un/undereducated and rely on experts.

It is the primary acute care population.

On top of that, trauma is a recurrant disease. Just like heart disease. So you can expect to see the same people again and again and again. It is not simply one intervention and cured.

This is what leads many in both EMS and acute care to complain and ultimately burnout from perceived "system abuse."



NYMedic828 said:


> Could always be an oncologist, if you can handle living in a world of depression with the hope of changing the world.



If saving "innocent" productive lives with minimal intervention is what you want, pediatric oncology is the place. 

Emergency care, by  definition, takes place after something goes wrong. What goes wrong may not be medical in origin, but manifests with a medical condition.

I got involved in fire and subsequently EMS because of the show "Emergency." But again, perspective...

We saw Johnny and Roy have one maybe 2 life threatening "real emergencies a week. Their part in the story lasted on average 5-10 minutes. With the other 10-15 minutes being plot or character development.

In a 48-72 hour work week in a busy metropolitan system, during the realities of the 70s, that may seem about right. 

Some 40+ years later, in a developed nation, 1-2 a month is not even realistic. Simply, the game has changed, but the perception of what the game is by providers has not.

People in the US don't accidentally step on landmines.
They do not get stuck under ox carts. 
They have basic sanitation and vaccination.
Public and labor safety initiatives.
etc.

Look at how much time is spent in cardiology for medics. What do they actually do for it? Primarily Dx and transport to the proper place in a timely manner. 

Not exactly the instant gratification of life and death.


----------



## abckidsmom (Sep 26, 2012)

I have long said we don't save lives. Every once in a while, maybe, but how heroic is it if all you are doing is the same thing any other similar person would do?  

The most satisfying interaction I've had lately was an MCI with 8 to transport. In our system, with 3 staffed units, that's overwhelming. I got to organize patients and get them to appropriate facilities via appropriate vehicles. The other people on the scene couldn't do that as smoothly and quickly as I did. Even though those patients had relatively minor injuries, that's the kind of call that makes me feel glad I went to work that day. I really enjoy sorting out a mess, whether logistical or medical, that's what I find to be the most fun.


----------



## KingCountyMedic (Oct 4, 2012)

The majority of people on here that trash talk Seattle/King County Medic One have been trying to get hired with Medic One and have failed or they got fired while on probation with Medic One. I will not argue with people on the internet. Anyone is welcome to come to our program and go on ride a long anytime of the year. We are not perfect, we make mistakes just like any other agency on the planet. We are held accountable by our Medical Directors when we screw up. I am not "like a doctor" I am trained by doctors and held to a much higher standard than any place I have ever worked. I have been an EMT and a Paramedic in other agencies from out of state and Washington State. South King County will be hiring a lot of people over the next few years as we have A LOT of 25+ year Medics that will be retiring. If you have 3 years experience as an EMT or Paramedic please come and ride with us and consider applying. Have a good night everyone. :beerchug:


----------



## Veneficus (Oct 4, 2012)

KingCountyMedic said:


> The majority of people on here that trash talk Seattle/King County Medic One have been trying to get hired with Medic One and have failed or they got fired while on probation with Medic One. I will not argue with people on the internet. Anyone is welcome to come to our program and go on ride a long anytime of the year. We are not perfect, we make mistakes just like any other agency on the planet. We are held accountable by our Medical Directors when we screw up. I am not "like a doctor" I am trained by doctors and held to a much higher standard than any place I have ever worked. I have been an EMT and a Paramedic in other agencies from out of state and Washington State. South King County will be hiring a lot of people over the next few years as we have A LOT of 25+ year Medics that will be retiring. If you have 3 years experience as an EMT or Paramedic please come and ride with us and consider applying. Have a good night everyone. :beerchug:



I don't think it is a question of hating it just sounds like a pushback against self-promotion.

I cannot think of one agency that this does not happen to, inside or outside of EMS.


----------



## Undaedalus (Oct 4, 2012)

psyanotic said:


> I guess I don't really want to be a paramedic, I  want to be a doctor. But it just doesn't seem realistic.



Then I guess you don't really want to be a doctor.  To me, this attitude is the crux of the whole issue we're discussing here..  "I want to work in a field at a high level, and be reimbursed accordingly, but I'm not really interested in doing what's necessary to make that happen."  If you want to do something well, do it, and don't let other people stop you.  If you get there and realize it wasn't like you saw in the commercials, you have two options: do your best to fix it (often times against the currents), or find something else that might make you happy.  Well, I guess you can just b!tch about it too...



ChaseZ33 said:


> there is nothing wrong with being a paramedic, you can have a great career and quality of life if you get hired at the right place. But just remember those good places to work are few and far between. Just have a realistic idea of what your getting into.



I shouldn't be afforded the quality of life and great career where I live now, and in the community I've already been serving for years?  I am lucky to live in a small system, but the pay is just that.. small.  I'm gonna stick around and work hard, try and change a few of my pet peeves, keep educating myself, and see what happens.  All jobs can get old after a while..  Whatever, it's just life.  If you're not having fun, you're only ruining it for yourself.


----------



## JPINFV (Oct 4, 2012)

psyanotic said:


> I guess I don't really want to be a paramedic, I want to be a doctor. But it just doesn't seem realistic. Becoming a paramedic seems more realistic while still allowing me to upgrade the -B appended to my EMT title.




Why should ____ have to upgrade his first aid merit badge to a paramedic merit badge. A couple hour course seems much more realistic, so why not let them play with the cool toys too?


----------

