controversial- what leads you to believe we are in a "legitimate profession"?

[VentMedic]

I totally agree. Being that the 'profession' is so young, this will obviously take time. So who/what entity that currently exists has the potential to get the ball rolling. What types of things can be done at the bottom end?

EMS is well into being middle-aged with it being over 40 years old. It is one of the older allied health professsions but the only one that has not established itself with even a mere 2 year degree for entry level. The other professions are now moving past the 2 year degree and on to 4 year and Masters' degrees for entry level.

The one way is through at least a strong state and/or national organization to unify the EMS providers. Unfortunately since FF/medics hate private Paramedics and this one doesn't like that one, there is little chance for much unity to come to a decision. Also, since FDs require their FFs to become Paramedics on hire or within the first year, the likehood of support for increased educational standards from the FF union will be slim to nil. This I do know since I have be fighting that battle in FL for many years. At least 30 years ago, some FDs did recognize education for the Paramedic and supported the 2 year degree. But unfortunately those old timers who promoted education in the FDs for EMS have retired.

 

[mycrofft]

Second Vent. Add a trouble-brewer:

Here's a novel idea: embrace fire EMS. Firefighters have a union, they have numbers. The missing part would be the aspect of a medical professional association, but a toothless one is in some ways worse than none at all.
The majority of FD calls are EMS. The addition of non-fire EMS to their union could tip the scales.

Let the shoe throwing commence.

 

[silver]

EMS needs to embrace the academia. When the educators become professors and hold advanced degrees and are not called "instructors" then we can be like other medical professions. Simple as that. With education and the display of the education through medical skill, EMS will become respected...

The battle with between fire, private, and third service will need to be left behind, otherwise EMS will stay in this area of not being a profession.

 

[WarDance]

I think there are medics and EMS services out there that do an amazing job at making this a legitimate job. I have worked with some paramedics that embrace the academic side of the job and do a great job with patient care. It sounds like medics like them are rare but they are out there and I think there will soon be a new generation that mirror this.

 

[White Fang]

i think there are medics and ems services out there that do an amazing job at making this a legitimate job. I have worked with some paramedics that embrace the academic side of the job and do a great job with patient care. It sounds like medics like them are rare but they are out there and i think there will soon be a new generation that mirror this.

amen to that!!!

 

[Lifeguards For Life]

I think there are medics and EMS services out there that do an amazing job at making this a legitimate job. I have worked with some paramedics that embrace the academic side of the job and do a great job with patient care. It sounds like medics like them are rare but they are out there and I think there will soon be a new generation that mirror this.

I have worked with a few GREAT medics. intelligent, compassionate, able to think on their feet, and able to remain calm in any situation. Though the majority,feel they are great medics because "no one can start an Iv faster than me" or "i'm the best intubator in this town." I dont think its the skills that make a medic good. (while yes it's important to be able to do skills in the appropriate amount of time).I think the best medics have an understanding of the anatomy and patho physiology and are able to anticipate what will most likely occur within their patient in the next few minutes. I've seen too much "it doesnt matter because we're taking them
to the hospital"
what do you feel makes the diference between a bad medic, a good medic and a great medic. or emt or first responder?

 

[Seaglass]

what do you feel makes the diference between a bad medic, a good medic and a great medic. or emt or first responder?

Bad medic: incompetent, a jerk, or some combination of the above. If you're the nicest guy in town but can't perform, you're bad. Same if you're great at determining what to do and how to do it, but treat the patient badly.

Good medic: Treats patient well, recognizes and treats patients' problems accordingly, remains calm and in control of situations. Has enough education and experience to know what various symptoms can imply.

Great medic: Same as a good medic, but is particularly good at it. Often has a good intuitive sense of what the problem and treatment should be, picks up on important details that even good medics overlook, and connects with patients really well.

 

[White Fang]

I think there are medics and EMS services out there that do an amazing job at making this a legitimate job. I have worked with some paramedics that embrace the academic side of the job and do a great job with patient care. It sounds like medics like them are rare but they are out there and I think there will soon be a new generation that mirror this.

Bad medic: incompetent, a jerk, or some combination of the above. If you're the nicest guy in town but can't perform, you're bad. Same if you're great at determining what to do and how to do it, but treat the patient badly.

Good medic: Treats patient well, recognizes and treats patients' problems accordingly, remains calm and in control of situations. Has enough education and experience to know what various symptoms can imply.

Great medic: Same as a good medic, but is particularly good at it. Often has a good intuitive sense of what the problem and treatment should be, picks up on important details that even good medics overlook, and connects with patients really well.

Very nice and well described..... that is why we are the patient advocate and also we need to be hungry to learn more so we could be great best excellent in what we do

 

[Melclin]

I read all the replies and we have to agree to disagree, i also still in emt school and i have gone through several careers in my life and to answer your question lifeguard for life is yes EMT is a career and my personal opinion is because you get trained, and you can advance in life to develop and or refine your skills. know as other pots they mention quick money??? I dont know about that you want to make fast easy money they are easy jobs other than drugs and prostitution, be a broker (mortgage, stock, insurance ETC) thats not a profession thats a easy way to make money not even going to college i was a mortgage broker/loan officer and let me tell you i made 100K a yr with out a sweat on the books plus more on the side plus bonus and incentives i did nothing what so ever seating in my arse all day. know the reason i went this path is because i realize that i lost track of why i became in the first place a loan officer and notary public to help the one who was in trouble, and that is why i choose to go back to school and become something better in life to provide help to those one in need do the things that a few would do. Dont get me wrong they are some out there that they are RATS and dont need or should be there in the first place, but thats life and you will find them every where in every profession. My EMT class is awesome here in NJ the instructors (not teachers) are knowledgeable and they been around since the 70's and they are hard on us and they dont brag about there accomplishments nor stories they go and do what they like to do best and the only thing that you can do is to be good at what you like to do. Every chance you have to make a person feel better or secure and you do all whats in your power and in reach to make that person secure trust me you are a professional!

I think there are medics and EMS services out there that do an amazing job at making this a legitimate job. I have worked with some paramedics that embrace the academic side of the job and do a great job with patient care. It sounds like medics like them are rare but they are out there and I think there will soon be a new generation that mirror this.

I think you're missing the point a little about what a debate about a profession involves. Defining paramedicine as a profession has very little to with the personality traits of medics, although they may serve to influence the eventual outcome. The "legitimacy" of the "job" is not in question, at least not here, defining it as a profession is; the two are quite different. Stacking shelves at a supermarket is a legitimate job, however, the Royal Australasian College of Grocery Assistants and Professorial appointments in can stacking at major universities are probably not in our future.

"Instructors" that have been around since the seventies are half of the problem. Blind pedagogy in paramedicine is one of its major educational downfalls: "My instructor said, 'Son, oxygen is a good thing right? So the more you give, the betterer it is for the patient', so its true, I don't question it and I especially haven't investigated any of the literature on it, so I wouldn't know if it wasn't". While experience is very important, it does not, in and off itself, trump evidence based practice. Without an extensive evidence based education, experience is simply a long string of anecdotes and as one of my favourite sayings goes, "The pleural of anecdote is not data".

I went to a conference earlier in the year on paramedic professionalism. Here were some of the key ideas put forward:

- The definition of a profession must necessarily involve: a unique body of knowledge; autonomy to collect; develop and apply that knowledge; and the authority to apply that knowledge, given legislatively and communally.

- There must be an agreed upon set of professional values (this is not an employee code of conduct) that is heavily enshrined within the profession. For EMS it would be things like the pay off principle as well as the usual collection of technical competence, compassionate practice and ethical conduct as decided by general societal values.

You might notice that, particularly American EMS, does not really fulfill any of the criteria in that first point.


The intellectual level of this argument reminds me of logging onto a new forum and seeing the extent of the theists vs atheists argument is:
"The catholic church has done many horrible things. SLAYER RULE! There 4, god does not exist VS God is real because everything has to start somewhere so the universe must have started with my interpretation of a christian god as per my sunday school." Seriously guys, get yourselves some book learnin on the topic, there are many interesting and important points of view on this matter from learned people. Don't sit there and say I know a good medic and I know this other bad medic and I reckon the first is better than the second, so bla bla bla.

 

[HuiNeng]

You might notice that, particularly American EMS, does not really fulfill any of the criteria in that first point.

I've got two questions to toss into the discussion:

1) Could Allied Health be the profession which covers EMS and the rest of the non-MD clinicians? EMS then would simply be a specialization.

2) Instead, might EMS be considered a Trade?

 

[Melclin]

I've got two questions to toss into the discussion:

1) Could Allied Health be the profession which covers EMS and the rest of the non-MD clinicians? EMS then would simply be a specialization.

2) Instead, might EMS be considered a Trade?

1) Yes, that's exactly what it is. The allied health professions all have academic bases and degree courses, why not EMS.

2) Depends on what you consider to be EMS. As I said, non-Emergency IFT here is predominantly the domain of smaller private companies that employ mainly variations of advanced first aiders (funnily enough, all with more education than the standard EMT-B). Nobody really considers them to be part of the Pre-hospital field. You could consider that to be a trade, in the same sense as you might consider div 2 nurses to be a trade (I think you call them LVNs) although it is different (EMTs have rather less training than LVNs, where as DIV 2 nurses are on par with non-Emergency transport officers; but you get the point).

The 000 (911) system is different. The base level employee is a bachelor degree qualified paramedic, who have the autonomy, authority and command of a unique body of knowledge to be considered professional. Post graduate qualified MICA paramedics, have been known to take on the role of physicians in small country hospitals over weekends and so on, and will soon have other career options open to them such as the "paramedic practitioner", who may act in a similar sense to your PAs or NPs. Paramedics like this are and should not be considered to be of the same profession as a first aider.

You don't get a fellowship to the Royal College of Anesthetists because you can make a relaxing cup of tea. The difference between a EMT and an Intensive care paramedic with post graduate degrees is similar.

 

[WarDance]

what do you feel makes the diference between a bad medic, a good medic and a great medic. or emt or first responder?

I think the great medics are knowledgable themselves but they are also concerned about the rest of the crew's ability and knowledge. The EMT can make or break a critical call for a medic.

 

[MrBrown]

I've got two questions to toss into the discussion:

1) Could Allied Health be the profession which covers EMS and the rest of the non-MD clinicians? EMS then would simply be a specialization.

No. "Allied health" makes it sound like a physician is at the centre of healthcare and all the other allies simply supoort them, or, that is the way I percieve that statement. A physician may have the most extensive education being that it is the longest and probably most intensive but who is they say that they are any better than a nurse, dentist, oral surgeon (there are a few non MD maxillofacial surgeons floating around here still), nutritionist, podiatrist, optometrist, audiologist, physical therapist etc?

Each of these specialties here in New Zealand is called a "health practitioner" under the Health Practitioners Competency Assurance Act; of note is that Ambulance Officers' are not included but watch this space.

The way I see it personally each is a building block in the house of healthcare; the physician, nurse, dietician, audiologist, dentist etc etc all have an equal part to play and is equally important.

An Ambulance Officer is a health practitioner (although not legally recognised as such here in law yet).

2) Instead, might EMS be considered a Trade?

EMS in New Zealand is working quite hard to upgrade itself out and away from the "trade" type qualifications toward a simmilar system to Canada and Australia.

A Bachelors Degree will become the minimum requirement for Paramedic and a Post-Grad Cert for Intensive Care Paramedic.

We will retain the "Ambulance Technician" basic life support level and require these Officers to hold a tertiary Diploma and have (AFAIK) differentatined the title from including the word "Paramedic" to recognise that while we are still relaint upon the volunteer contribution, they are not a working at a Paramedic level and therefore not capable of IV/IV meds etc.