a female perspective, please

[yogakat]

But what I am saying is, don't choose EMS simply because it seems like an exciting way to "help" people. I don't even accept students if they can't come up with a better reason than that. That motivation wears thin pretty quickly, especially when you come to realize that you are truly "helping" very few people with anything more than a taxi ride. If you do EMS, do it because you think that the practice of medicine is simply the coolest, most intellectually stimulating thing you can think of to do with your life.



i've been interested in the medical field for some time. i've looked at the many options that are available to me and the ones that would best fit my interests and character. I want to be hands-on and have direct patient contact. i've always thought that you never know who could be in the ambulance going by...it could be your spouse, child, parent. and that person needs someone who is caring, focused and committed to doing all that they can for them to ensure the best outcome.

one of the best things about this area is that it is constantly changing...new ideas, new procedures, new protocol...there is always more that you can learn. i want a job that is both physically AND mentally challenging

I am thinking of doing a year or so as an emt and then going back for paramedic (a little experience is always nice). or, would you recommend to just go straight from one to the other?

 

[yogakat]

ummm...i was replying to aj hidell...who i thought that i had excerpted in the first paragraph...sorry...my thoughts are from the second paragraph on...

 

[sir.shocksalot]

I am thinking of doing a year or so as an emt and then going back for paramedic (a little experience is always nice). or, would you recommend to just go straight from one to the other?

Get some experience first, as an EMT you need to be at the point where you aren't scared of sick patients, you can absolutely nail your phone and hand off reports every time without thinking, you have a strong knowledge of ALS procedures and medications, their indications and roughly how to administer them. And most importantly, you can obtain a good and thorough patient history, critically think through patient conditions, and focus you history taking to obtain rule out and differential diagnosis. The best EMT's make the best Medics. To get to that point might take you 3 months or it might take 3 years.

 

[AJ Hidell]

I am thinking of doing a year or so as an emt and then going back for paramedic (a little experience is always nice). or, would you recommend to just go straight from one to the other?

Yes and no. I do recommend that you immediately continue your education before the ink is even dry on your EMT card. However, it will take you at least a year of college to complete the prerequisite support courses necessary to enter paramedic school with a clue. Consequently, no, you would not go directly to paramedic courses, per se, but on to take anatomy & physiology 1 & 2, microbiology, algebra, chemistry, psychology, and sociology to establish a solid scientific foundation for paramedical education. While your medic school may well require other support courses for graduation, those are non-science courses that you can take concurrently with the medic courses without overloading yourself.

I disagree wholly with sir shocksalot about EMT experience. In my experience as an educator, a preceptor, a supervisor, a manager, and as a medic, you don't have to be a good EMT first to be a good medic. In fact, I find that the best EMTs make the worst paramedic students. Being a good EMT is completely different from being a good paramedic. In fact, the two jobs are so different as to bear very little resemblance to each other. The attitude required for success is very different for each. The more time you spend as an EMT, the more it works against you as a paramedic student. An ungodly number of hours are wasted in every paramedic class, arguing with "experienced" EMTs who are convinced that their measly field experience is greater than anything that we can teach them. Consequently, much time is wasted listening to their pointless and counterproductive war stories and trying to break mistaken notions and bad habits that they picked up in the field. There is nothing you will pick up in most EMT experience that is not just as easily picked up during paramedic ride time. If you can avoid it, don't do it. The very best medics I have ever work with all had two things in common:

1. They were college graduates
2. They went directly to paramedic school with no EMT experience

Look at it this way. Would you rather raise your own kids from birth, the way you want to raise them, or would you rather adopt someone else's thirteen year old and try to raise them from there? It's a no brainer. A clean slate is always the best way to start off. And the slate of someone with a few years of bad EMT experience is very hard to erase.

On the other hand, you have to do something during that year that you are taking the college courses, right? Some part time experience to test the water is not totally inadvisable. It can help you assure that this is really what you want to do with your life, by exposing you to the mechanics of the job, such as dealing with screwy shifts, spending 12 to 24 hours a day cooped up with someone you may not like too well, being abused by people who don't appreciate you (patients and management both), and getting paid peanuts for hard work. That, however, is really the only positive thing that I -- with over three decades of experience as a medic and educator -- can say about an EMT getting "experience" before attending medic school.

Of course, I have no idea where you are. You may or may not even have any options for employment as an EMT where you are. That is actually quite common in many parts of the US, where EMS is either run completely by the fire departments or volunteers, or else a system that does not utilize EMTs at all. And so many schools are cranking out so many EMTs across this country that there is a glut of them in most cities, meaning that the few EMS jobs for them out there are usually taken and heavily competed for. A better option would be hospital work, if you can find it. EMTs working as ER technicians tend to get a better educational exposure, acquiring quality patient contact, surrounded by a lot of doctors and nurses who are in teaching mode, and without picking up the bad habits you get in the field.

Unfortunately, there are a great many paramedic schools in this country that suck. Many are run by undereducated tech-school nimrods who don't know the first thing about the concepts of adult education. All they know is what they got from their medic school however many years before, and they tend to simply "do it the way everyone else does it". Consequently, many will have an entry requirement specifying a certain amount of field EMT experience before admission. If that is the case where you are, you may have to start working on that so-called "experience" right away in order to position yourself for enrolment as soon as possible. Just beware that the school that does that is to be suspected of suckage.

 

[LucidResq]

I am thinking of doing a year or so as an emt and then going back for paramedic (a little experience is always nice). or, would you recommend to just go straight from one to the other?

I think working as a basic for a while is a good idea. Just make sure you don't get side-tracked and lose sight of getting your medic.

I think it would be a bad idea to spend thousands of dollars and 6-24 months getting your medic without knowing this is a field you're sure you want to get in to. Many of the paramedic programs around here require a year of paid experience as an EMT-B as a prereq.

 

[medic417]

I am thinking of doing a year or so as an emt and then going back for paramedic (a little experience is always nice). or, would you recommend to just go straight from one to the other?

It is best to enter straight into Paramedic so you do not pick up bad habits. You can get some experience as a basic while you are in the Paramedic program. Honestly it is better to get your experience once you actually have some education. Think about other Medical professions, they do not stop and go they get their education then go do internships (clinicals) then go to work. Do yourself a favor and do not settle with doing first aid work as a basic, go straight to getting some medical education then hit the field as a Paramedic.

 

[Sasha]

I think working as a basic for a while is a good idea. Just make sure you don't get side-tracked and lose sight of getting your medic.

I think it would be a bad idea to spend thousands of dollars and 6-24 months getting your medic without knowing this is a field you're sure you want to get in to. Many of the paramedic programs around here require a year of paid experience as an EMT-B as a prereq.

ACtually, a lot of paramedic programs Don't require field experience as a basic, and I would recommend straight into paramedic school. You should find out "What you're getting into" while doing your preceptorship for emt. Other than that, there is really nothing to be gained from working as an emt. Experience? Doing what? Learning bad habits and providing basic first aide? Everyone preaches "Well if you work as an EMT you'll remember BLS first, ALS second." Well, if you're any kind of good medic you'll remember how to treat a patient correctly.

With proper education you shouldn't be afraid of sick people because you'll learn how to protect yourself from getting sick and what you can and can't catch, etc. Your assesment? You'll learn how to do an even BETTER assesment in Paramedic school, so why be satisfied with just knowing how to do a basic assesment for a year? Ask any Medic student. From even the first semester I was always thinking of things that should be done for the patient at a Medic level, thinking of things to asses to better understand the patient's problem, but could only provide BLS treatment.

 

[BossyCow]

As you can see the EMT first or straight to EMT-P is a well worn debate on here. Check out the requirements of your state. Some require a period of time as a basic before you can apply to Paramedic. It also depends on your financial situation and your individual learning style. Some workplaces will sponsor and even kick in on tuition for an EMT upgrading to basic. Some will guarantee your job when you are done.

I had to laugh about you being vegan. You will catch a lot more abuse over that than you ever will about being female!

 

[lightsandsirens5]

Well, yogakat, you sound alot like one of my favorite partners. About the only difference is she is not married. (Plus a few minor details.) She is even a vegan! (I enjoy her cooking anyway!^_^) I never really paid attention to this thread yet b/c of the title, but I have no problem working with a female partner as long as they can pull their own weight and half of the patients weight.

Actually I think that a crew with one male and one female is a good idea 'cause that way it is easier to deal with some pts. (Like a guy that wants a male attendant and a gal that wants a female attendant.)(Of course if a guy wants a female attendant....................:wacko:that's a different story. Then I'm back there with him and my partner drives, unless it is her turn to do pt care and there is an LEO riding with us who can be back there with her. This don't happen often.)

Good luck!

Joe

 

[sir.shocksalot]

ACtually, a lot of paramedic programs Don't require field experience as a basic, and I would recommend straight into paramedic school. You should find out "What you're getting into" while doing your preceptorship for emt. Other than that, there is really nothing to be gained from working as an emt. Experience? Doing what? Learning bad habits and providing basic first aide? Everyone preaches "Well if you work as an EMT you'll remember BLS first, ALS second." Well, if you're any kind of good medic you'll remember how to treat a patient correctly.

With proper education you shouldn't be afraid of sick people because you'll learn how to protect yourself from getting sick and what you can and can't catch, etc. Your assesment? You'll learn how to do an even BETTER assesment in Paramedic school, so why be satisfied with just knowing how to do a basic assesment for a year? Ask any Medic student. From even the first semester I was always thinking of things that should be done for the patient at a Medic level, thinking of things to asses to better understand the patient's problem, but could only provide BLS treatment.

In my state if you want to go to a real paramedic program, you need a MINIMUM of one year of experience. If you pick up bad habits as an EMT you have no business going to medic school, and if you are the sort of person who is prone to picking up bad habits you will do them as a medic anyway. If you want to be a good medic, go work in the field for some time and watch what your medics do like a hawk. You will learn more watching a competent field medic than you ever will in school. School is way different from the streets. Learn how the streets work, learn how operate an ambulance, see some sick patients before you go to medic school, I have only ever seen one half decent zero to hero paramedic. The 1000 hours of ride time or whatever it is, isn't sufficient, if there was more ride time hours required I'd say go for it, or if you were in a BUSY system, go for it, but if you aren't running 15 or so calls in a 12 hour shift you aren't going to have the patient contact time to prepare you for life by yourself on the street.

 

[smvde]

. If you want to be a good medic, go work in the field for some time and watch what your medics do like a hawk. You will learn more watching a competent field medic than you ever will in school.

I agree in part, but the knowledge and theory you learn is school is tatamount to becoming a good medic.

School is way different from the streets.

So true as we all soon learn

Learn how the streets work, learn how operate an ambulance, see some sick patients before you go to medic school, I have only ever seen one half decent zero to hero paramedic.

Dead on the money. Having experienced/suffered through, several Zero to Hero medics, I agree.

 

[Ridryder911]

In my state if you want to go to a real paramedic program, you need a MINIMUM of one year of experience. If you pick up bad habits as an EMT you have no business going to medic school, and if you are the sort of person who is prone to picking up bad habits you will do them as a medic anyway. If you want to be a good medic, go work in the field for some time and watch what your medics do like a hawk. You will learn more watching a competent field medic than you ever will in school. School is way different from the streets. Learn how the streets work, learn how operate an ambulance, see some sick patients before you go to medic school, I have only ever seen one half decent zero to hero paramedic. The 1000 hours of ride time or whatever it is, isn't sufficient, if there was more ride time hours required I'd say go for it, or if you were in a BUSY system, go for it, but if you aren't running 15 or so calls in a 12 hour shift you aren't going to have the patient contact time to prepare you for life by yourself on the street.

Just think of how many poor medics that you see? Think of all those bad habits you see occur daily?

Anyone that think school is way different, never understands that one applies what they learn in school and place it in action. If one thinks school is way different, either had a piss poor program or does not know how to take comprehensive knowledge and place that into a clinical perspective.

I also throw the B.S. flag of "more calls is better". If you run more than > 10 calls in 12 hours then you are in a system that is a "load and go". Sure you will learn to rapidly assess and hurriedly transport but really how much treatment and assessment did you do? I have the same feeling as those “coffee clinical” that does not see anyone. Both are poor areas for a student to be in.

A normal call usually takes the minimum of 20 -30 minutes +. I much rather have a student perform clinicals participating in quality ride time than numbers. Numbers don't mean sh*t! As long as the student gains enough patient contacts and is able to be exposed and be able to perform their skills and meet their objectives is what matters. Yes, skills are easily obtained but the knowledge should be the main objective.

There is a happy medium. Schools and educational instruction needs to seek those places, as well as good and competent clinical preceptors. If one has a good institution of education, I see no difference from student outcomes. I teach both. Where the experience field technician may have street sense, the non-experience medic usually is more attentive in the care and treatment of the patient.

R/r 911

 

[PapaBear434]

I agree in part, but the knowledge and theory you learn is school is tatamount to becoming a good medic.


So true as we all soon learn




Dead on the money. Having experienced/suffered through, several Zero to Hero medics, I agree.

I almost went that route. I got my BLS cert, applied to my current agency, and immediately started doing my ALS classes. I sat there, wondering what "vagal maneuvers" were and why I was the only BLS in the class that didn't know.

I took a few months off, got released to operate as BLS, and restarted medic school. Hopefully, I'll be better off for it.

 

[medic417]

I almost went that route. I got my BLS cert, applied to my current agency, and immediately started doing my ALS classes. I sat there, wondering what "vagal maneuvers" were and why I was the only BLS in the class that didn't know.

I took a few months off, got released to operate as BLS, and restarted medic school. Hopefully, I'll be better off for it.

Sounds like the school sucked if they did not teach vagal manuevers. As a basic you should not be doing vagal manuevers. So what is the point of your saying being a basic helps. I disagree. A quality paramedic program will educate you so that you are confident and well prepared for the field w/o having done any time as a basic.

 

[PapaBear434]

Sounds like the school sucked if they did not teach vagal manuevers. As a basic you should not be doing vagal manuevers. So what is the point of your saying being a basic helps. I disagree. A quality paramedic program will educate you so that you are confident and well prepared for the field w/o having done any time as a basic.

Basics DON'T do vagals, no. But you do see them in the field, so the other BLS people that have been doing this for at least a year knew what they were. I didn't know what SVT was either, for that matter. It's all stuff they just assumed was common sense, and I was clueless.

Going back after a year, everything makes a lot more sense and I am maintaining a 3.9 average, so it couldn't have hurt.

 

[medic417]

Basics DON'T do vagals, no. But you do see them in the field, so the other BLS people that have been doing this for at least a year knew what they were. I didn't know what SVT was either, for that matter. It's all stuff they just assumed was common sense, and I was clueless.

Going back after a year, everything makes a lot more sense and I am maintaining a 3.9 average, so it couldn't have hurt.

Well honestly the other basics had no real knowledge of what they were either. The school failed you by not educating you. I am glad you are doing better this time around though. Keep up the hard work.

 

[AJ Hidell]

Anyone that think school is way different, never understands that one applies what they learn in school and place it in action. If one thinks school is way different, either had a piss poor program or does not know how to take comprehensive knowledge and place that into a clinical perspective.

Spot on. The only difference between the classroom and the field is the environment. Medicine is medicine, no matter where you practice it. The principles do not change. I agree 100 percent with Rid (the only other educated paramedic educator on the forum that I am aware of, besides Vent), that if your medicine is different in the field than it was in classroom or clinicals, then either your school sucks, or you are on the road to FAIL. Do not let all the blowhards out there BS you with that worn out line. It will hurt your professional development.

I ... started doing my ALS classes. I sat there, wondering what "vagal maneuvers" were and why I was the only BLS in the class that didn't know.

I took a few months off, got released to operate as BLS, and restarted medic school. Hopefully, I'll be better off for it.

I'm not sure I am getting you, Papa. You thought you weren't ready for paramedic school because you did not already know the information they were trying to teach you? WTF? Teaching you what that information is about is what paramedic education is all about! You're not getting the point that Rid and I are putting forth here. It is better for you and your educational development if you do NOT know that stuff before beginning paramedic education! True, competent educators want a blank slate. We do not want to have to spend valuable educational time trying to overwrite the bad information that is already scribbled into your brain by working with lazy and undereducated medics who take shortcuts or believe that the field is different from the classroom. Those instructors and those medics -- no matter how good they are in the field -- know zero about the concepts of adult education, and what it takes to make you the best medic that you can be. And most of the people out there spouting this nonsense about getting street experience before medic school are doing so for one of two reasons:

1. They are ignorant, and all they know is what they have been told by others. It's the old "this is the way we've always done it" argument with absolutely no basis in sound educational theory.

2. They simply don't want to see anyone get there faster than they did or do. EMS people are an insecure lot, always measuring their progress against others. If they have screwed around driving a transfer ambulance for three years, then they want you to do that too. They can't stand the fact that someone actually had the time, funds, intelligence, and professional commitment to do it faster than they did.

Neither of those are valid reasons to establish policy. This is EMS, where our policies should be evidence based. And the evidence suggests -- and is validated by every other medical profession -- that straight through is the way to go. Think about it. We are not so special that some different rules of education apply to us than to every other medical profession, are we? Of course not.

Other than preconceptions from the above two reasons, the other reasons that people say they don't like "zero to hero" medics are because:

1. They simply don't want to like them, for reasons above, and lack the ability to objectively measure their competency. They will find or manufacture any reason to criticize them, regardless of validity.

2. They are measuring them by unreasonable standards. The medic can be the best diagnostician since Dr. House, but these people will call them losers because they didn't know some trick about spider straps that they knew from experience. Education trumps experience in medicine. Experience without the foundation of education is dangerous. But yes, everyone needs experience, and the more of it, the better. But you cannot judge a brand new, unexperienced medic based on the expectations you hold for someone with experience, even as an EMT. To judge them fairly, you have to compare apples to apples. That means that you can't have any more expectations for a fresh medic than you would for a fresh EMT. Both lack experience. A valid comparison would be a "zero to hero" medic with a year in the field post graduate, to a brand new paramedic graduate with a year as an EMT. Now think about it, which would YOU rather be? A new medic, with a year's experience as an EMT? Or a medic with a year's experience as a medic? That's a no-brainer there.

3. They simply do not see very many straight-through medics to judge, because either the culture or the school requirements in their area prevent such medics from being produced in their area.

Again, none of those standards are a valid means of judging the quality of a provider. This old, outdated, and invalidated belief that one should get field experience as an EMT to make him a better medic is just another of those ingrained fallacies that is holding EMS education back in the 1970s. It really has to change. And in the better educational systems, where truly professional educators (not just "instructors") like Rid run the show, it is changing. I just hope I live to see the day that everyone else gets a clue.

 

[Sasha]

In my state if you want to go to a real paramedic program, you need a MINIMUM of one year of experience. If you pick up bad habits as an EMT you have no business going to medic school, and if you are the sort of person who is prone to picking up bad habits you will do them as a medic anyway. If you want to be a good medic, go work in the field for some time and watch what your medics do like a hawk. You will learn more watching a competent field medic than you ever will in school. School is way different from the streets. Learn how the streets work, learn how operate an ambulance, see some sick patients before you go to medic school, I have only ever seen one half decent zero to hero paramedic. The 1000 hours of ride time or whatever it is, isn't sufficient, if there was more ride time hours required I'd say go for it, or if you were in a BUSY system, go for it, but if you aren't running 15 or so calls in a 12 hour shift you aren't going to have the patient contact time to prepare you for life by yourself on the street.

Some people feel Paramedics should be more than just ambulance drivers. How can you hope to get adequate skill practice doing 15 calls in 12 hours? How many of those were refusals, or talked into being refusals, and how many of those were treated by O2 and transport? Clinicals are not just about patient contact, but about patient treatment. It shouldn't be a numbers game, more of a quality game.

You should be exposed to sick people at clinicals. There's something called EVOC to teach you how to operate an ambulance.

You may pick up bad habits anyway, but it'll be easier for you to learn the RIGHT way than a medic teaching you the wrong way and going through school and learning it the right and trying to seperate the two. I can't tell you how many times I've heard "This is how the book says, but this is how you really do it".

 

[Sasha]

But you do see them in the field, so the other BLS people that have been doing this for at least a year knew what they were. I didn't know what SVT was either, for that matter. It's all stuff they just assumed was common sense, and I was clueless.

It's all stuff that needs to be gone over in the cardiac chapter, and if your instructor was just skimming through because he or she assumed you should know, then they were a horrible instructor.

 

[smvde]

As I have stated before, and told every student in paramedic school I know. The key to success in medic school is simple.

1. Save the war stories for smoke breaks or lunch.

2. Read all materials at least twice before class.

3. Listen at least 20 times more than you speak.

4. Remember it isn't about What you know, its about LEARNING what you DON"T KNOW.

Use the Sirduke Method and you will be miles ahead of the rest of the class.

What was the original thread?