Bledsoe article: The Vanity of EMS

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http://www.ems1.com/columnists/bryan-bledsoe/articles/421845-The-Vanity-of-EMS

The Vanity of EMS

Here, in the Republic of Texas, there are five levels of EMS providers: Emergency Care Attendant (ECA), Emergency Medical Technician (EMT), Emergency Medical Technician-Intermediate (EMT-I), Emergency Medical Technician-Paramedic (EMT-P), and Licensed Paramedic (LP). The ECA is the same as a first responder in most states. The LP is something unique to Texas. Let me digress.
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http://www.ems1.com/columnists/bryan-bledsoe/articles/421845-The-Vanity-of-EMS

From a functional and legal standpoint, there is absolutely no difference between an LP and an EMT-P. Some systems will pay a little more for LPs as an incentive — some don’t. While the LP level does recognize those with a degree — and I don’t mean to downplay education — it does not really benefit the profession. LPs are not truly licensed and are not allowed to perform any additional skills or have any responsibilities above an EMT-P, despite their increased education. That is wrong. Instead of having a higher level that providers would actually want to strive to reach, an LP is simply an empty moniker that serves to bolster our vanity.
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But, as has been the history of EMS, the slogan, “Give them a patch and they will shut up,” seems to have worked again.
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Another vanity favorite in EMS is the self-assigned title of CCEMT-P, which is the acronym for Critical Care EMT-Paramedic. Most people self-assign this title after completing a CCEMT-P course or a similar course. And while some states have started to recognize this level (i.e. Tennessee, Louisiana, West Virginia), most have not.
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http://www.ems1.com/columnists/bryan-bledsoe/articles/421845-The-Vanity-of-EMS

In many countries, critical care certification is available for EMS. Generally, you need four to six years of field experience and a year of critical care education — similar to nursing. Then you take an amazingly difficult certification exam. That is quite different than in the United States, where people take a 120-hour EMT class, go immediately to an 800-hour EMT-P class, then take the 80-hour CCEMT-P class – after which they feel really competent to take care of complicated ICU cases. We are only fooling ourselves here.
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I challenge those who push for Paramedic/ EMT Licenses to ask themselves are they only wanting more letters behind their name, or another card in their pocket. All of us here are licensed already. It may not be called a "license" by the state but it is very much so a license. Check the definition of license:

"a legal document giving official permission to do something" -source; Princeton university library.

"Regardless of what descriptive title is used by a state agency, if an occupation has a statutorily or regulatorily defined scope of practice and only individuals authorized by the state can perform those functions and activities, the authorized individuals are licensed" -NREMT's website

A whole article written about this can be found here: http://www.nremt.org/about/Legal_Opinion.asp"

We are licensed as EMS professionals already. We are permitted by the state to preform actions restricted by law. Thats the definition of a license.
 
we are certified. Not licensed.
 
But can we say that we are at a level of training and expertise to take up that responsibility of being independent under a licensure? We as medical professionals still do not have the training and educational background or the recognition within the medical community as professionals to be able to use the extensiveness of a license. And those states that do use a license system, what is different form a certified emt and a licensed emt?

Like it was stated in the article, it was a title not anything different in the skills used by this individual. I would like to know if this is different in any state that does offer a license system.
 
Guardian said:
He was making an intellectual argument. You wrote a couple of incomplete sentences. And you're wrong, because in some states ems providers are licensed.
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I am right. I am certified. I am not licensed. Those sentances are complete.
 
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Well, I'm both certified AND licensed.
 
Technically, I am certified in a couple and Licensed in some. It all goes by how the state words it.
 
I posted this article on three different forums. It is interesting to see how different groups have or have not discussed the article.
 
VentMedic said:
I posted this article on three different forums. It is interesting to see how different groups have or have not discussed the article.
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Which proves my posts on one of the other forums and my question still goes unanswered.
 
Yes, I enjoyed your posts on the other forum.

Mike Hester, RRT/NREMT-P/CCEMT-P/FP-C

I'm happy to see that you still know where the RRT belongs in that alphabet soup behind your name. :D
 
Brian Marks ABCDEFGHIJKLMNOPQRSTUVWXYZ
 
zacdav89 said:
But can we say that we are at a level of training and expertise to take up that responsibility of being independent under a licensure? We as medical professionals still do not have the training and educational background or the recognition within the medical community as professionals to be able to use the extensiveness of a license. And those states that do use a license system, what is different form a certified emt and a licensed emt?

Like it was stated in the article, it was a title not anything different in the skills used by this individual. I would like to know if this is different in any state that does offer a license system.
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There we go. You hit it in the heart. Are we educated enough to take responsibility for independent practice? Like ventmedic echoed, we cannot make a band aid by changing our title from uncertified to licensed. at least until we change everything else.
 
VentMedic said:
I posted this article on three different forums. It is interesting to see how different groups have or have not discussed the article.
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We are a social experiment than? :P

Actually I am quite a fan of Bryan Bledsoe. I almost always find his articles to be eye opening, and I usually agree with what he is saying. This one is no different. I work a lot of CCT right now and his comments about an 80 hour course tackling complicated ICU cases made me laugh, as I just transported a man with AMI and arrested seven times in the ICU. He was being brought to the regional Catch Lab, and was on three pumps with close to eight drips of I had no idea what. He was intubated with blood pouring out of his mouth because of all the heparin in his system, and the trauma from intubation. I was glad we had a seasoned RN who was also an RT with my partner and I.
 
VentMedic said:
Yes, I enjoyed your posts on the other forum.

Mike Hester, RRT/NREMT-P/CCEMT-P/FP-C

I'm happy to see that you still know where the RRT belongs in that alphabet soup behind your name. :D
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Grandmama always told me, "Remember who you are and where you came from."
 
i think that if you have to go to school as long as an LPN, then you should be licensed the same. Then again an English major isn't licensed.
 
Too many slices of the old salami.

Cutting to the chase (pun intended after I saw I'd typed it), and in accordance with the Pareto Principle, eighty percent of EMS responses do not truly require the full capabilities of a paramedic, and except for superduper specialized transports to the Mayo clinic or whatever, virtually nothing requires more than the full capabilities of a paramedic. In those cases, they otherwise would hire, train, retain and pay a nurse or physician or physician extender (PA or NP), except now they can use a certified tech and save all that money...or, looking at it another way, they are paying you less than they ought to for the same work.

My wife says I'm becoming a Bolshevik.;)
 
Although I usually agree with Dr. Bledsoe, this is one of the few times I have to somewhat disagree with him. He is only partially right.

Yes, I am licensed. Yes, I work as a licensed medical person the same as a Physician has a medical license.. no difference; of course the level etc... It is NOT the same as a certification and if you think so, then you never have had a medical license.

Certification means you have met the obligation of the education or learning requirements, not that you are held responsible to any party or state, etc.. That is why one has a drivers license not a drivers certification.

Yes, there should be standardization. I agree, and yet as well do not in some aspects. In his regards of multiple titles and certifications, physicians as well obtain numerous post- titles. Don't believe me, read his bio...

R/r 911
 
VentMedic said:
I posted this article on three different forums. It is interesting to see how different groups have or have not discussed the article.
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I didn't see anything worth commenting on. Maybe you could enlighten us to the important take home message. Bledsoe seems to be pointing out the obvious. Yes, there isn't much standardization. That has its good points and bad points. If there is some specific new insight, I'd love for you to point it out.
 
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