ALS+Some, would you go to school?

[MMiz]

So much is taught in Paramedic class, and locally it's a year-long course (both taken at private and community colleges.

How would you feel about a two-year long Paramedic program, how about a four-year BA/BS degree?

My perspective:

Many people in EMS aren't the "school" type, and I think it would drastically cut down on the amount of people able to staff these new units, ones with higher level of care.

I do believe that a certain amount of medics would take the course, and I can see how that would benefit the community and patients we serve in a profound way.

If a medic is able to provide services that were previously only obtained at the hopsital, and didn't require monitoring or in-hospital stay, I can see this cutting down on the stress on our already stressed hospital systems.

Any feedback? What are some services that we could provide in the field that are traditionally only done in hospitals?

 

[ffemt8978]

All of the programs around here are a two year program, with you having the option to continue on with a four year degree.

 

[Jon]

Matt (yeah - REALLY his name)

I belive you are talking about some form of Advanced Practice Paramedic

Would be nice to show up, run a 12-lead, send it to the doc, run a set (even 2) of the cardiac marker enzymes, then clear up, telling Pt. to follow up with his PCP on Monday. Everything is in place to do that.

-P school for me is about a 16 month class you get get it thru the college, pay a LOAD and get an associates degree.


Anywhoo...


Jon

 

[CodeSurfer]

It's almost like going back to the old days when doc's ran house calls. Hrmm...

 

[DFDEMS]

I don’t think it would work with the level of care that paramedics across the US can provide. Each one is different from the next. I don’t think Ambulance companies are going to pay any more for a degree either. As sad as it sounds I think that until EMS gets its act together its going to be a bumpy road.

The really sad thing is a longer course should be better than the shorter ones down the road I think.

 

[rescuecpt]

There are currently critical care medics in our area who attend more school after -P school.

(PS - I've never met one, only heard of them...)

 

[emtal233]

Originally posted by rescuecpt@Apr 18 2005, 08:38 AM
There are currently critical care medics in our area who attend more school after -P school.

(PS - I've never met one, only heard of them...)

I actually work with a CCEMT-P every saturday. Do alot of interesting transports mainly ER to Cath lab, perinatal, and picu & nicu, but sometimes we get IABP, LVAD jobs too.....

 

[Jon]

Originally posted by emtal233+Apr 20 2005, 07:33 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (emtal233 @ Apr 20 2005, 07:33 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-rescuecpt@Apr 18 2005, 08:38 AM
There are currently critical care medics in our area who attend more school after -P school.

(PS - I've never met one, only heard of them...)

I actually work with a CCEMT-P every saturday. Do alot of interesting transports mainly ER to Cath lab, perinatal, and picu & nicu, but sometimes we get IABP, LVAD jobs too..... [/b][/quote]
PaRescueEMT used to drive the Critical Care SCTU around....

One of my instructors worked for said hospital, and I used to work for another large hospita's tranport team on the BLS side of things.

It is a VERY intresting line of work, and most places dons say you need to be CCEMT-P cert'ed, but it is an added bonus to you.


Jon

 

[rescuejew]

Here the medic class is 11 months didactic with however long clinicals take to finish up, and there is a local 2.5 year AS program. I know there are some *awesome* associates-bachelors programs that are online only designed for the busy medic.

Here, if you dont have a degree, you arent eligible for a "white-shirt" position. And while you dont get paid more, (cause Durham sucks...) you can move up the ranks quicker. I work with a couple of CCEMT-Ps and NREMT-P who are the bees knees!

 

[ECC]

I have an Associate's Degree (working toward my Bachelor's) and have been a paramaniac since 1991. This is my take on this whole advanced practice paramedic thing.

I believe that Paramedics should remain in the emergency care setting. I do not think there is enough to gain for US by going advanced. There would be little to no money, less career advancement (Why am I going to promote my most valued asset to a non-patient contact role...who am I going to get to replace you?) not to mention the Nurses movement, and I do not suppose you read any of their trade journals, but there is no love there...why do you think we still have to recert every 3 years? <_<

Unless and until there are nationally recognized standards for APP, and there is a MEASURABLE difference in the pocket of US paramedics...I say they can stick it in their ear. :angry:

 

[Jon]

Originally posted by ECC@May 18 2005, 09:48 AM
I have an Associate's Degree (working toward my Bachelor's) and have been a paramaniac since 1991. This is my take on this whole advanced practice paramedic thing.

I believe that Paramedics should remain in the emergency care setting. I do not think there is enough to gain for US by going advanced. There would be little to no money, less career advancement (Why am I going to promote my most valued asset to a non-patient contact role...who am I going to get to replace you?) not to mention the Nurses movement, and I do not suppose you read any of their trade journals, but there is no love there...why do you think we still have to recert every 3 years? <_<

Unless and until there are nationally recognized standards for APP, and there is a MEASURABLE difference in the pocket of US paramedics...I say they can stick it in their ear. :angry:

Very well put. I must ask, though.... what about the "Physician Extenders" Acadian has working on offshore oil rigs? What about the CCEMT-P course? What about having a position for "Critical Care Transport"?? Do you really NEED a nurse to hang pre-matched blood? What can a flight nurse do, in terms of skills and procedues, that a well trained and compatent flight medic can't do or be trainied to do safely and effectivly?


Jon

 

[ECC]

Do not get me wrong, I am not against going further ie PE PA or CCEMTP...but there is a line where it must come out of the pockets of our employers. How many Paramedics are making the same as a nurse with the same experience?

The time has come! Proper compensation for our CURRENT skills prior to the addition of new ones!

 

[Ridryder911]

I have to totally disagree with you guys. I just recently went back into the field full time. Yes, I left ER nursing to go back as a Paramedic. I wanted to & now more happier. Actually, making more money now. I can work my 10/24 hr shifts & work flex as RN.

I was lucky, the EMS is paying me my RN salary. I have 27 yrs field Paramedic experience & 15 yrs as ER, RN experience. Yeah, I have been through the gammit of research, administration & flight nurse over the years. It is nice to be be able to enjoy your work again. ER had become a baby-sitters club & primary clinic with a few train wreck type patients.

If you limit the education of the Paramedic, the salary will never increase nor will the professional level. Who wants to pay a tech.. $ 40-60K a year, that has 1 year of training ? Beuticians has more clock hours of training, learning how to cut dead cells (hair) off your body than most Paramedics. The average text book is written at a 6-10'th grade reading level, and we are still having a high percentage of failure on board exams!

How do you think nursing demanded & recieved higher salaries ? When is the last time you seen a diploma nurse ? You won't see any more.. because they require at least some form of degree & nurses manage themselves. They are now considerd educated not trained . Yes, there is a difference. We could learn a lot & not re-invent the wheel. EMS needs to become a profession & start recognizing the needs of the patient & people who deliver care.

If we demanded more to begin with & increased our medical knowledge, maybe we would get better reimbursements from insurance & medicare. Opinion of most insurance companies, we are just a glory taxi ride. We have to disprove this opinion. Lets start at documentation & charting, medical procedures & yes the medical education of the Paramedic.

EMS should not be a short term career, we need seasoned EMS personal, to provide good quality care.

Be safe,
Ridryder 911

 

[ECC]

Many paramedics are degree holders...has the pay/benefits increased yet?

No.

I see this entire Advanced Care Paramedic thing as another way to squeeze more blood from the proverbial rock. I think also, that this is another way to bring the clinic to the home (house calls). I did not take this career path to babysit anyone...either in the rig, the ER or their home. If i had...paramedic would NOT have been the way to go.

My perspective is different than yours. I do not believe that EMS should be getting reimbursed from insurance or Medicare. Our revenue should be from the tax base. You should not (even though some municipalities do) pay extra for services rendered by the Fire Department...you do not pay extra if the police come to your home, investigate a burglary and make an arrest. EMS should be held in the same regard, as an emergency function of the government.

For the private sector, of course, the situation is different and should be, but there are plenty of municipal EMS serivces that should operate as I have outlined.

Until the pay/benefits increase for your degreed profesionals, I see no need to take on extra certifications.

JMHO.

 

[usafmedic45]

If you limit the education of the Paramedic, the salary will never increase nor will the professional level. Who wants to pay a tech.. $ 40-60K a year, that has 1 year of training ? Beuticians has more clock hours of training, learning how to cut dead cells (hair) off your body than most Paramedics. The average text book is written at a 6-10'th grade reading level, and we are still having a high percentage of failure on board exams!

Basically it boils down to doing away with AAS and diploma EMT-P programs, either a BS or BA program or you're not a medic. Then of course we need to require prerequisites for admission- like you must already have three years of college under your belt before becoming a paramedic, like they do with physician's assistant programs (that being the only truly comparable program). Do a 3+1 program, where you have 3 years of classroom education followed by a year of clinical practicum. That or model it after medical school.....2 years of very intense classroom followed by 2 years of applied learning in clinical settings with mandatory rotations through:
-ER
-Ambulance
-OR/PACU
-ICU to learn vent management, etc
-Pathology (autopsies)
-Clinical management (an externship for those interested in managerial positions)
-Aeromedical (optional- only for those who believe in it's benefits to patients :lol: )
-Pediatric ICU
-Neonatal ICU
-Cardiology Diagnostics to learn EKG's
-Obstetrics
-Psychiatry

The problem isn't with the education in my experience- it's with the students. We don't attract the best and brightest as a general rule- we attract the adrenaline junkies, the nursing school washouts, the firefighters who are just taking it to pad their application to fill a Lazyboy at a paid FD for the next 20 years. You don't see people with competitively high academic marks in EMS programs very often. Those people go on to become doctors, lawyers, dentists, nurses, and other upper level professionals.

Tighten the requirements for admission to the paramedic program and I think you'll see the board scores rise. Personally I'd like to see the following prerequisites for the last clinical year if I was administrating a 4 year Paramedic program:
General Biology w/ lab- 8 hrs (2 semesters)
General Chemistry w/ lab- 8 hrs (2 semesters)
Organic Chemistry w/ lab- 8 hrs (2 semesters)
Biochemistry- 3 hrs (1 semester)
Human Anatomy w/ lab- 4 hrs (1 semester)
English composition- 3-6 hrs (1-2 semesters)
Human Physiology- 3-4 hrs (1 semester)
Physics w/ lab- 3-4 hrs (1 semester)
General Psychology- 3 hrs (1 semester)
Abnormal Psychology- 3 hrs (1 semester)
Microbiology w/ lab- 3 hrs (1 semester)
Statistics- 3 hrs (1 semester)
Epidemiology- 3 hrs (1 semester)
Public Speaking- 3 hrs (1 semester)
Foreign Language- 6 hrs (2 semesters)
Ethics- 3 hrs (1 semester)
Pathophysiology- 3 hrs (1 semester) **A 400 level (Senior) course

That would weed out most of the people who drag down our career field because of their lack of education or unwillingness to gain a requisite level of intelligence. B)

 

[usafmedic45]

Originally posted by ECC@May 24 2005, 11:21 AM
Many paramedics are degree holders...has the pay/benefits increased yet?

No.

I see this entire Advanced Care Paramedic thing as another way to squeeze more blood from the proverbial rock. I think also, that this is another way to bring the clinic to the home (house calls). I did not take this career path to babysit anyone...either in the rig, the ER or their home. If i had...paramedic would NOT have been the way to go.

My perspective is different than yours. I do not believe that EMS should be getting reimbursed from insurance or Medicare. Our revenue should be from the tax base. You should not (even though some municipalities do) pay extra for services rendered by the Fire Department...you do not pay extra if the police come to your home, investigate a burglary and make an arrest. EMS should be held in the same regard, as an emergency function of the government.

For the private sector, of course, the situation is different and should be, but there are plenty of municipal EMS serivces that should operate as I have outlined.

Until the pay/benefits increase for your degreed profesionals, I see no need to take on extra certifications.

JMHO.

You're missing the big picture. The payscale won't increase unless there is a demand for it to. Basically cut off the supply of diploma and AAS degree paramedics, and they will be forced to pay for bachelor degree EMT-P's. Ohio, Washington, New York and a couple of other states already have degree regulations in regards to their RT's. Why should EMS be any different?

Oh and because a paramedic holds a bachelor's in something else doesn't mean they deserve anything more. Just like my EMT-I credential doesn't get me more money as an RT, an English degree won't get you more money as a paramedic.

 

[Ridryder911]

Sorry, ECC EMS is a business. A medical business. Squeeze more out of tax payers ? I(I guess you are for socialized medicine too ?)

I know a way too cut taxes for EMS, lets start by trimming FD expenses, since the number of fire(s) responses has went down. Make sure all those grants for WMD are specifically ear-marked for EMS & truley bio-terrisom training, not fire supression or increased FTE's for FD's for fire supression. People are tired of paying for civil servant extras.

As far as babysitting, EMS as it you used know it will be a thing of the past. Mobile Health Care, is the new trend. Insurance companies are tired of paying several hundred to thousand dollars for a taxi ride. As the baby-boomers get older & increased number of ER patients increase,(predicted a 40% increase in 10 yrs) there will not be enough services to provide in-patient care. If EMS or Mobile Health Care is to survive, we will have to have a paradigm shift. People who usually get shot & stabbed .. do not usually have BC/BS.

If you want to be an ambulance driver/attendant fine.. be an EVO. If you want to be payed & respected by other medical professionals.. go get a degree or advance your medical training , like every other medical profession had to. If you don't want to .. quit *****in about low pay, no respectablility among medical peers, and no career ladder, etc..



Also, Steve FYI.. most P.A.C. programs are now post-graduate level.

Be safe,
Ridryde 911

 

[rescuecpt]

If you want to be an ambulance driver/attendant fine.. be an EVO. If you want to be payed & respected by other medical professionals.. go get a degree or advance your medical training , like every other medical profession had to. If you don't want to .. quit *****in about low pay, no respectablility among medical peers, and no career ladder, etc..

So just because I'm satisfied being a critical care EMT and I don't want to become an RN or RT or MD I don't deserve your respect? LOL... so much for one big happy family caring for the patients.

PS - I'm not continuing my medical education at this time because my day job pays 2x as much as anything except an MD would, and even that - so I guess I don't deserve any respect as an EMT.

 

[ECC]

Originally posted by usafmedic45@May 24 2005, 11:27 AM



...the firefighters who are just taking it to pad their application to fill a Lazyboy at a paid FD for the next 20 years. .

That is for the next 23 years for your information, Missy!

Boy that smarted!

 

[usafmedic45]

Rid, yeah, I know most PA-C programs are MS programs now. I thought about going to PA-C school. You can apply with 90 hrs of undergrad credit. I was speaking of what the requirements to apply for admission are.

RescueCPT, don't put words in my mouth. I don't have a problem with someone who wants to stay an EMT, but if you want to be a EMT-P you should have to prove you deserve it. It's not a matter of voc-tech training anymore. As for your day job, that's fine. You're a volunteer EMS provider...so am I. I just believe that you should be better educated than most EMT-Ps are if you want to be one. There's nothing wrong with wanting to improve our stand in the medical field. But it becomes an evolutionary type scenario....what is called the "Red Queen Theory". Remember Alice in Wonderland? The Red Queen told Alice that she has to run as fast as she can just to stay where she is. That's true in evolutionary biology and it's true in modern medicine.

It's not a matter of becoming a doc, an RT, or RN....it's a matter of changing what it means and takes to be a paramedic.