40 Years of NREMT Certification

[DrParasite]

BUT, I do fail to understand why someone who is Career EMS, is unwilling to maintain NREMT certification

Again, just my opinion, and you are certainly intitled to yours

I was a career EMS provider for years... my employer never required NREMT, so I never bothered to get it. In fact, the only time I looked to get it was when I was looking to relocated, at which point I took the exam, passed it, and moved on with my life. The only reason I maintain my NR is my local recert requirements are the same as NR; otherwise, it doesn't help me one bit.

It's hilarious that after all these years, ability to intubate is still the very first thing brought up in almost any discussion comparing nurses and paramedics

The statement made was that nurse's scope of practice is the same nationwide... you might think it's funny, but it is an accurate statement when it comes to cope of practice. No, intubation doesn't make paramedics better than nurses... you can bring up cancer management, ICU specialties, flight stuff, whatever. Different specialties often have different scopes based on what they need or do.

In fact, there are 43 "compact states" where as long as you are licensed in one of them you can practice in any of these others with no need to obtain additional license or certification.

If i'm a nurse in Wisconsin, and I want to get a side job in Minnesota, am I able to use my Wi Nursing license? no paperwork, no license application, no fees?

If it worked the same way in EMS, you'd take the NREMT exam once, use that to apply for certification in your home state, and then be able to practice in any of 43 other states with no additional credentialing needed.

Because when I moved to NC to NJ, all I had to do was submit paperwork to NC, provide copies of my NJ and NR EMS cert (and my EMD, because why not), and they printed me a card. However, if I wanted to maintain both certs, I needed to complete the continuing education requirements for both states.

Yes, each state has their own BON and Nurse Practice Act which is the actual law under which nurses in that state practice. Scope of practice varies some but the differences state to state are mostly administrative and your actual scope (skills you are allowed to do) is primarily dictated by your employer.

So, you're saying scope of practice ISN'T nationwide, as it's "primarily dictated by your employer," which is kind of like how EMS is in some states....

 

[FiremanMike]

I didn’t have the energy to type such an eloquent response like Carlos, but he definitely covered the advantages of a national accrediting body and the shortcomings of the national registry. I do believe national registry and the same vision on inception but just never had the teeth to make it work.

The board of nursing set national scope of practice and educational curriculum to the extent that nurses can be immediately licensed in all compact states and can simply apply for licensure in non compact states. There’s none of this “compare your states paramedic curriculum to ours and then take the classes we require to meet our standards, then you can be a paramedic here” crap.

The fact that anyone here feels national registry is on par with the board of nursing demonstrates a fundamental lack of understanding of the two bodies.

I definitely don’t mean to detract from anyone who has maintained their certifications, but the OP kinda rubbed me wrong with the condescension towards the “NR haters”. They had/have the right vision, but they fall very short of what a national accrediting body should accomplish.

 

[FiremanMike]

I've heard similar, and many other things, for 40+ years

As I said, in the 80's and 90's it usually was from those that couldn't pass the test (not all, but most)

I knew some that did pass, but then were too lazy to get the few hours of Con-Ed to maintain

The best part, to me anyway, was when they'd go to move to another state and need to re-test, seems pretty silly to me

Now it just seems to be "the in thing" to hate on NREMT

I have, in my 46 years of EMS, found that many wish to maintain at the lowest level possible

I realize that perhaps NREMT hasn't become everything, to everybody, but perhaps if people would support NREMT, they could make it what they want

Tell me what EMS organization, that we have now, is in a better position to make things happen on the National level?

I just noticed a nugget buried in the middle of this regarding maintenance at the lowest level possible. I’m not going to turn this into a **** swinging contest but I can assure you that this is not the case for me. Conversely, maintaining NREMT is far from the highest level.

I’d also add that my states CE requirements are higher than NREMT, so that argument is invalid as well.

I do agree with your last statement completely, sadly NREMT does nearly nothing to accomplish things at the national level.

The funny thing here is that you condescendingly judge those who don’t maintain NREMT and vehemently defend their efficacy while completely ignoring their shortcomings.

 

[FiremanMike]

National scope of practice? how many nurses can intubate? I know MICNs can... but it's not universal. And before you say it I know that not every nurse needs to be able to intubate, but my point was, the scope of practice isn't the same for everyone. That being said, the entry level standards are pretty much the same for everyone (which is similar to EMS).

looking quickly on the internet, it appears that nursing licenses are still done at the state level, exactly like EMS. in fact, when I go to https://www.ncsbn.org/nursing-regulation/about-nursing-regulatory-bodies.page, it says "Nursing Regulatory Bodies (NRBs) are jurisdictional governmental agencies in the 50 states, the District of Columbia and four US territories that are responsible for the regulation of nursing practice. " and "
Each jurisdiction has a law called the Nurse Practice Act, which is enforced by each NRB. Nurses must comply with the law and related rules in order to maintain their licenses. The law describes:

• Qualifications for licensure
• Nursing titles that are allowed to be used
• Scope of practice (what the nurse is allowed to do)
• Actions that can or will happen if the nurse does not follow the nursing law"

even https://www.ncsbn.org/nursing-regulation/licensure.page says that the NCLEX-RN is only the test part, and you still need to apply for licensure with the appropriate jurisdictional agency.

I might be wrong; you're an RN, with first hand experience, and I can only go with what I read on the internet.

I think NR is good as a testing agency, as it says each provider much pass the same basic and entry level exam, which results in every EMT, Paramedic, etc, having the same baseline knowledge. I haven't seen much benefit to maintaining your NR, unless you are planning to move, or live/work near a state border, as the CEs for NR don't always line up with your local state's CE requirements.

I don't hate the NR, but I do think it's a nationally recognized exam, which is more widely recognized than a state exam, and it's standardized across all 50 states, while some individual state exams might be easier or harder, or held to different standards.

State level nursing boards report to and are in compliance with the national board of nursing. NREMT has ZERO authority over state boards of EMS.

 

[Rubicon Bob]

I just noticed a nugget buried in the middle of this regarding maintenance at the lowest level possible. I’m not going to turn this into a **** swinging contest but I can assure you that this is not the case for me. Conversely, maintaining NREMT is far from the highest level.

I’d also add that my states CE requirements are higher than NREMT, so that argument is invalid as well.

I do agree with your last statement completely, sadly NREMT does nearly nothing to accomplish things at the national level.

The funny thing here is that you condescendingly judge those who don’t maintain NREMT and vehemently defend their efficacy while completely ignoring their shortcomings.

Sort of like how you "condescendingly judge" (your words, not mine) those that maintain NREMT?

I never said NREMT was a "higher level", but I certainly have known many Paramedics that couldn't pass the test

The reason I brought it up is because of the hatred shown for the NREMT, at this site, over the years

As I've said, this is my opinion, yours may be different

I know that I have certainly earned the right to my opinion

 

[FiremanMike]

Sort of like how you "condescendingly judge" (your words, not mine) those that maintain NREMT?

I never said NREMT was a "higher level", but I certainly have known many Paramedics that couldn't pass the test

The reason I brought it up is because of the hatred shown for the NREMT, at this site, over the years

As I've said, this is my opinion, yours may be different

I know that I have certainly earned the right to my opinion

Not once have I judged individuals who maintain their NREMT, in fact I said exactly that. But when someone tries to elevate themselves as superior over those who don’t maintain their nremt, or pass judgment and make false assumptions as to the reasons for their lack of motivation to do so, then I’m going to clearly articulate the elephant in the room.

 

[Rubicon Bob]

Not once have I judged individuals who maintain their NREMT, in fact I said exactly that. But when someone tries to elevate themselves as superior over those who don’t maintain their nremt, or pass judgment as to the reasons for their lack of motivation to do so, I’m going to clearly articulate the elephant in the room.

I'm going to clearly articulate the NREMT hatred shown by many at this site

Feel better now?

Would it make you feel better about yourself if I apologized for maintaining my NRP?

 

[FiremanMike]

I'm going to clearly articulate the NREMT hatred shown by many at this site

Feel better now?

Would it make you feel better about yourself if I apologized for maintaining my NRP?

You brought this on yourself.

You coulda posted your accomplishment by saying how excited you were at this milestone and left it at that, but you instead opened the door by mentioning you didn’t understand the hatred for NREMT. When you got responses to that statement (likely your intent for including it) you doubled down by essentially calling those of us who don’t maintain it as being either lazy or stupid.

 

[Rubicon Bob]

You brought this on yourself.

You coulda posted your accomplishment by saying how excited you were at this milestone and left it at that, but you instead opened the door by mentioning you didn’t understand the hatred for NREMT. When you got responses to that statement (likely your intent for including it) you doubled down by essentially calling those of us who don’t maintain it as being either lazy or stupid.

Again, the reason I brought it up is due the hatred of NREMT, from so many folks at this site

I never said anyone was stupid

But yes, I do find many are lazy

 

[VentMonkey]

Whoa, this got super deep, super quick.

Again, I don’t “hate” NR. It serves its purposes, but it does leave a lot to be desired.

@Rubicon Bob to your point, yes, there is no other better organization, or one really that we have, in a position to advocate for EMS in general. But that is a multifaceted approach and would have to come from not only the NR, but legislators and lobbyists, the large majority (if not all) of EMS whether fire-based, private or public models, and from frontline providers as well. It’s never too late, but over half of a century later seems like an awfully slow turning wheel.

Again, I’ve kept mine, initially out of the possibility of having to move out of state and not wanting to go through recertification if said state recognized NR, but now as others have mentioned it’s just easier to keep given all of my CE upkeep anyhow.

Side note, I’m currently inactive because i have been too lazy to email our education department who will then email my medical director. So yeah, there’s some laziness i suppose, but it hasn’t helped the way i initially thought or hoped which would be in advocating for higher standards, and ultimately standing firm like @FiremanMike mentioned.

@Rubicon Bob would you agree our profession is better off focusing on increasing educational standards and requirements at all levels of prehospital providers? If so, who better suited to advocate and enforce said policies than the NR?…

Definitely solidarity in numbers, hence why i believe EMS is still largely a “solo sport”.

 

[Rubicon Bob]

Whoa, this got super deep, super quick.

Again, I don’t “hate” NR. It serves its purposes, but it does leave a lot to be desired.

@Rubicon Bob to your point, yes, there is no other better organization, or one really that we have, in a position to advocate for EMS in general. But that is a multifaceted approach and would have to come from not only the NR, but legislators and lobbyists, the large majority (if not all) of EMS whether fire-based, private or public models, and from frontline providers as well. It’s never too late, but over half of a century later seems like an awfully slow turning wheel.

Again, I’ve kept mine, initially out of the possibility of having to move out of state and not wanting to go through recertification if said state recognized NR, but now as others have mentioned it’s just easier to keep given all of my CE upkeep anyhow.

Side note, I’m currently inactive because i have been too lazy to email our education department who will then email my medical director. So yeah, there’s some laziness i suppose, but it hasn’t helped the way i initially thought or hoped which would be in advocating for higher standards, and ultimately standing firm like @FiremanMike mentioned.

@Rubicon Bob would you agree our profession is better off focusing on increasing educational standards and requirements at all levels of prehospital providers? If so, who better suited to advocate and enforce said policies than the NR?…

Definitely solidarity in numbers, hence why i believe EMS is still largely a “solo sport”.

I find all of your points fair, with merit, and very well said!

I do understand that NREMT cannot be everything, for everybody

As to your being "inactive", that is very easy to change, from what I understand, just maintain your Con-Ed until you're able to get your Med Dir to sign you off, and you'll be fine with NREMT

I also agree that NREMT is best suited to advocate for us (the individual EMS provider) and why I support them

I also agree that EMS is largely a "solo sport", and would add that many times EMS providers are/can be our own worst enemies

I guess what bothers me so much, is that instead of working against NREMT, which many EMS providers do, that if we worked with them, we could accomplish so much more

 

[ffemt8978]

Just think, in 40 years we've gone from your NR number being a single digit chisled into a stone tablet to being printed on paper.

 

[Rubicon Bob]

Just think, I'm 40 years we've gone from your NR number being a single digit chisled into a stone tablet to being printed on paper.

It often feels like that!

My knees and back keep telling me 50 years isn't looking good!

LOL!

 

[DesertMedic66]

Whoa, this got super deep, super quick.

Again, I don’t “hate” NR. It serves its purposes, but it does leave a lot to be desired.

@Rubicon Bob to your point, yes, there is no other better organization, or one really that we have, in a position to advocate for EMS in general. But that is a multifaceted approach and would have to come from not only the NR, but legislators and lobbyists, the large majority (if not all) of EMS whether fire-based, private or public models, and from frontline providers as well. It’s never too late, but over half of a century later seems like an awfully slow turning wheel.

Again, I’ve kept mine, initially out of the possibility of having to move out of state and not wanting to go through recertification if said state recognized NR, but now as others have mentioned it’s just easier to keep given all of my CE upkeep anyhow.

Side note, I’m currently inactive because i have been too lazy to email our education department who will then email my medical director. So yeah, there’s some laziness i suppose, but it hasn’t helped the way i initially thought or hoped which would be in advocating for higher standards, and ultimately standing firm like @FiremanMike mentioned.

@Rubicon Bob would you agree our profession is better off focusing on increasing educational standards and requirements at all levels of prehospital providers? If so, who better suited to advocate and enforce said policies than the NR?…

Definitely solidarity in numbers, hence why i believe EMS is still largely a “solo sport”.

You shouldn’t need to send anyone an email when needing a medical director sign off for NREMT. As long as Mercy Air/Air Methods is listed as one of your organizations when you reapply for your renewal they automatically get notified. I’ve been through 3 recert cycles and never once had to send an email…

 

[FiremanMike]

I find all of your points fair, with merit, and very well said!

I do understand that NREMT cannot be everything, for everybody

As to your being "inactive", that is very easy to change, from what I understand, just maintain your Con-Ed until you're able to get your Med Dir to sign you off, and you'll be fine with NREMT

I also agree that NREMT is best suited to advocate for us (the individual EMS provider) and why I support them

I also agree that EMS is largely a "solo sport", and would add that many times EMS providers are/can be our own worst enemies

I guess what bothers me so much, is that instead of working against NREMT, which many EMS providers do, that if we worked with them, we could accomplish so much more

From personal experience, all you have to do is take the test again, I don’t even think my med director had to sign off.

I think we all agree that NREMT is theoretically best suited for national advocacy and in a perfect world they’d be the accrediting body for all ems education and scope of practice. It’s never worked out that way and I think state ems boards are too deeply entrenched for it to ever be fixed..

Also - I don’t think anyone is working against the NREMT, can you provide some evidence of that?