Mr Brown -- you say associate's for an ILS paramedic (Do you have associate's in NZ? I thought the associate's degree only existed in the US?), and bachelor's for the intensive care paramedic. I think you already have these programs, right? What works well / doesn't work? What sort of traditional university courses are included? Does the current system allow for lateral movement of RNs and medics? Will I ever stop asking questions?
We have two types of higher education - the "University" track which only awards Bachelors and higher Degrees as well as the "vocational/polytechnic" track which has Certificates (six months to one year of study) and two year Diplomas. These however are more towards the "technical" skill base and less towards the high level cognitive knowledge research based side of things that you find in University.
Our education system matriculates students into University after five years of high school so unlike the US, we do not have a "liberal arts" or "general education" component to our post-secondary education. A Bachelors Degree here is a three year course of highly specialised study in a particular field with no room for any coursework outside the sphere of "upper division" or "major" to use US terms. Even Certificates and Diplomas taken at polytech do not have any "general education". The notion of "pre-reqs" is also null and void here, for you take those classes as part of the core program.
The EMS system has three levels, an emergency medical technician (EMT) which requires a Diploma (one year), Paramedic (Bachelors Degree) and Intensive Care Paramedic (Post Graduate diploma). While it is possible secure employment as a paid Ambulance Officer at the EMT level there is a stated (and ever increasing) bias towards Degree graduates and Brown suspects it will soon be mandatory to have the Degree to become a paid Officer.
At the moment there is no movement between Paramedic and Nursing, the two are very seperate, completely distinct qualifications ie Bachelor of Nursing and Bachelor of Health Science (Paramedic). There is however a crosswalk program in development which will see an eighteen month program to convert Registered Nurses into Paramedics and vice versa. There is little movement of Paramedics into Nursing because here Ambulance is a well paid, well respected, seperate profession and not a "stepping stone". Now on the other hand there is some movement of Nurses into the Ambulance Service and with the new crosswalk program it will be considerably easier.
The Degree program works really well as it teaches student ambos a thorough grounding in the fundamental skills and knowledge required to be ambos, think critically, think clinically and prepears them for lifelong learning which is so critical to the profession. It gives them an excellent perspective of Ambulance and Paramedics as a part of the wider healthcare picture and educates to think on a level above "bus monkey" or scoop and run.
Where Brown thinks the Degree falls over a little is that it allows high school graduates with no prior work or life experience to become an ambo. Brown is of the belief that those who are a little older, nontraditional students with work and life experience make for better ambos.
Brown suggests a two and four Degree for your system because your Bachelors Degrees are four years long not three like ours and there needs to be a distinct, thorough qualification for ILS people as well as preserving BLS for volunteer only crews as a reasonable alternate.
Our BHSc(Paramedic) degree is as follows:
YEAR ONE
Psychology and Lifespan Development, Human Anatomy and Physiology I, Knowledge, Enquiry and Communication, Health and Environment, Introduction to Paramedic Practice, Human Anatomy and Physiology II, Risk Management
YEAR TWO
Methods of Research and Enquiry, Pharmacology for Professional Practice,
Professional Practice and Ethics, Intraveous Therapy, Paramedic Science, Clinical Practice I, Clinical Practice II, Cardiology
YEAR THREE
Health Law & Policy, Disaster Theory, Clinical Reasoning, Paramedic Theory and Management, Paramedic Theory and Management, Clinical Practice III, Emergency Planning
Our levels are as follows:
Emergency Medical Technician
Oxygen, OPA, NPA, LMA, entonox, methoxyflurane, aspirin, GTN, salbutamol, glucose, glucagon, paracetamol, ondansetron, 3 lead ECG monitoring, defibrillation, CAT.
Paramedic
12 lead ECG interpretation, manual defibrillation, cardioversion, IV cannulation, IV fluid administration, adrenaline, naloxone, morphine
Intensive Care Paramedic
Endotracheal intubation, cricothyrotomy, intraosseous needle access, chest decompression, atropine, amiodarone, midazolam, ketamine, frusemide, pacing, rapid sequence intubation, thrombolysis (select Officers only)
