EMS/Nursing vs. Firefighting

[frdude1000]

I do not agree with making medics take hard science courses. To perform the current role of Paramedic, most of the information presented is not relevant. Its not like we're going to have all sorts of specimen (urine and blood) testing equipment on a rig anytime soon. We practice under protocols; for the most part, we treat what we see. How does the ecology topic in a Biology class have to do with working a code in the middle of the street. If we changed the role of a paramedic, I can maybe see a use for some of these classes. I am all for more education for EMS personnel, but I believe it should be in something useful; we really don't use genetics and mollecular biology too much in the field. How about more education on the illnesses, injuries, and diseases we see in the field and the skills we use to treat them.

 

[brentoli]

Do you think a paramedic should be on par with a nurse? They have a year of chem, micro biology, a year of a&p, along with other math, science, and english classes.

 

[Akulahawk]

A college degree is considerably different than a certificate issued by a tech school. A tech school also has lower entrance requirements so that almost anyone can enter into a trade.
...
That is true only if you have completed all the prerequisites for entry which includes college level A&P, microbiology, math, chemistry and pharmacology. Very few Paramedic programs require these since trade schools lead the market. All the prerequisites will take you well over 1 year to complete and probably more like one and a half years. These prerequisites are the same for almost any allied health program. If you wanted to be a Radiology Technologist, you would probably need another 2 years of college in addition to the prerequisites. About all the Paramedic cert will get you is the equivalent of 1 semester off a nursing program.

Let's see: College level A&P, Micro, Math, Chem... got'em all. I got all but one of those classes during the first Allied Health program I went through. Pharmacology may or may NOT be required prior to entry, depending upon the program. It would certainly be part of the program though.

Not all programs are identical, nor require the same number of hours to complete. The program I took required about 68 units in core coursework, of that, about 6 were directly listed in the core work. The rest of my prereqs for a nursing program came from prereqs for those required core classes. After reviewing the core work and prereqs for them for my local ADN and RN programs, it appears that they're done after about 40-44 units. But an ATC program is NOT an RN program and the reverse is also true. An RN does not possess the educational foundation to be able to become an ATC or to safely function in that environment without a LOT more education.

 

[Symbolic]

Do you think a paramedic should be on par with a nurse? They have a year of chem, micro biology, a year of a&p, along with other math, science, and english classes.

It would be nice, but in the grand scheme of things it seems unrealistic. looking at it from a fire-medic perspective, It would require potential candidates to complete at least two years of college level classes while also working full time with the fire-department. I don't necessarily think this is a bad thing, but promotions would be long and dragged out. IF you plan on working as a fire-medic, most departments require that you be on as a firefighter for at least 3 years before eligibility. The 3 years of work experience in conjunction with at least 2 years of college education seems a bit excessive, at least to me. Also, its really not necessary to take a micro biology or chemistry class, or even anatomy and physiology in order to become a competent Medic. Education can never be a bad thing and I think Para-medicine would be more respected if it was held to higher standards, I just don't know how realistic that would be. If anything, it would narrow the competition.

 

[TransportJockey]

It would be nice, but in the grand scheme of things it seems unrealistic. looking at it from a fire-medic perspective, It would require potential candidates to complete at least two years of college level classes while also working full time with the fire-department. I don't necessarily think this is a bad thing, but promotions would be long and dragged out. IF you plan on working as a fire-medic, most departments require that you be on as a firefighter for at least 3 years before eligibility. The 3 years of work experience in conjunction with at least 2 years of college education seems a bit excessive, at least to me. Also, its really not necessary to take a micro biology or chemistry class, or even anatomy and physiology in order to become a competent Medic. Education can never be a bad thing and I think Para-medicine would be more respected if it was held to higher standards, I just don't know how realistic that would be. If anything, it would narrow the competition.

I'm trying to understand why this would be a bad thing?

 

[Akulahawk]

I do not agree with making medics take hard science courses. To perform the current role of Paramedic, most of the information presented is not relevant. Its not like we're going to have all sorts of specimen (urine and blood) testing equipment on a rig anytime soon. We practice under protocols; for the most part, we treat what we see. How does the ecology topic in a Biology class have to do with working a code in the middle of the street. If we changed the role of a paramedic, I can maybe see a use for some of these classes. I am all for more education for EMS personnel, but I believe it should be in something useful; we really don't use genetics and mollecular biology too much in the field. How about more education on the illnesses, injuries, and diseases we see in the field and the skills we use to treat them.

Do you think a paramedic should be on par with a nurse? They have a year of chem, micro biology, a year of a&p, along with other math, science, and english classes.

I would say that a Paramedic would benefit greatly from a year of A&P and taking a Micro class. The prereqs to be able to take those would also mean that chem, math, and english writing would also be required along the way. Once those topics are out of the way, far more could be taught in a Paramedic Theory course than presently is found. More importantly, pathophys would be stressed far more because you'd already know what "normal" is. At the end of the program, you'd be able to come up with care plans easily for patients that do NOT fall into a pre-approved protocol.

A Nurse might not directly utilize the info from a Chem class or a Micro class... but when thinking about pathophys, it helps.

 

[Akulahawk]

A firefighter probably could do better with an understanding of chemistry and physics... It's cheaper & easier to hire and train a firefighter who is already a Paramedic than it is to take a FF and turn 'em into a Paramedic. So, you take the well educated Paramedic... and put them through a Fire Academy... Now you've got a well educated Fire Paramedic who now has a degree to go along with the FF stuff, and possibly additional pay for having a degree on top of being a Paramedic.

Furthermore, if call trends don't reverse any time soon, I could easily imagine a Fire Department that does EMS transitioning to an EMS Department that does Fire...

 

[Symbolic]

. So, you take the well educated Paramedic... and put them through a Fire Academy... Now you've got a well educated Fire Paramedic

Pretty much how most departments are hiring around these parts.

 

[Akulahawk]

Pretty much how most departments are hiring around these parts.

Yep. All because it's cheaper. Potentially MUCH cheaper...

 

[Journey]

Let's see: College level A&P, Micro, Math, Chem... got'em all. I got all but one of those classes during the first Allied Health program I went through. Pharmacology may or may NOT be required prior to entry, depending upon the program. It would certainly be part of the program though.

Not all programs are identical, nor require the same number of hours to complete. The program I took required about 68 units in core coursework, of that, about 6 were directly listed in the core work. The rest of my prereqs for a nursing program came from prereqs for those required core classes. After reviewing the core work and prereqs for them for my local ADN and RN programs, it appears that they're done after about 40-44 units. But an ATC program is NOT an RN program and the reverse is also true. An RN does not possess the educational foundation to be able to become an ATC or to safely function in that environment without a LOT more education.

Does every Paramedic program require those same classes in your state? I didn't think California required a degree from a college to be a Paramedic. Don't confuse the classes which tech or trade schools call A&P, Pharmacology or math. These abbreviated classes are not the same as a college class and will not transfer to a university or even a community college. You can get a few credits for your Paramedic cert but that is about all.

A Paramedic can get a degree but it is not required. Usually only a certificate is required. You can advance in some agencies if you have a degree but few EMS employers will state degree preferred. A nurse can get a BSN or MSN although just an ADN is required for entry. Employers can also state they prefer a BSN in their employment ads and it is not considered unual to require more education than the state or national minimun in that profession or most of the other health care professions. It is unual to require a degree to be a Paramedic unless you are in Oregon.

A BSN can be required for Public Health or School RN positions along with some specific requirements. A Paramedic can be called a community health Paramedic with the bare minimun certificate plus a few extra hours of training. A title can be misleading especially if there is not a minimal standard to back it up or some consistent regulations at the state level.

The other poster stated it would take less than a year to become a nurse with a Paramedic cert. If the student did not have any of those science classes, it will definitely take longer than a year and that is just to complete the science classes. I do not know any nursing program that will allow entry without the basic sciences like A&P from an acceptable source such as an accredited college. It also is not just about the number of credit hours or units. The units must be in the program.

You can not compare an ATC to an accountant either just as you can not assume that if someone has a two year degree with a few sciences they can be either a Radiology Technologist or a nurse. The core courses must be taken and the specialization for each is what sets them apart.

A Nurse might not directly utilize the info from a Chem class or a Micro class... but when thinking about pathophys, it helps.

Nurses do utilize these classes almost everyday. The chemistry gives them an understanding as to why lipids can not be ran in the same lines as other medications and why certain meds are light sensitive. They may not remember all the little details or equations but they will know enough to check the compatability chart when they see various meds that have a composition which might raise a red flag from the info stored somewhere in their memory. It can keep the nurses from making a dangerous mistake. If they are getting an inservice on a new medication, they will have a better understanding why it is more compatible or what makes it different from the others. As far as microbiology, it would have to be a very, very stupid nurse to not know what bacteria or viruses the patients have and how they are being treated. In microbiology you also learned which microorganisms were more resistant which should indicate some areas require special handling or cleaning. These classes are included in all the other health care profession programs for a reason.

 

[Journey]

Also, its really not necessary to take a micro biology or chemistry class, or even anatomy and physiology in order to become a competent Medic.

This statement would explain some of the topics on this forum where there is confusion about BSI, PPE and the body's response to pain. Anyone can be a competent technician and follow orders. But to know the whys behind the orders, you must extend beyond the tech mentality.

 

[JPINFV]

I do not agree with making medics take hard science courses. To perform the current role of Paramedic, most of the information presented is not relevant. Its not like we're going to have all sorts of specimen (urine and blood) testing equipment on a rig anytime soon. We practice under protocols; for the most part, we treat what we see. How does the ecology topic in a Biology class have to do with working a code in the middle of the street. If we changed the role of a paramedic, I can maybe see a use for some of these classes. I am all for more education for EMS personnel, but I believe it should be in something useful; we really don't use genetics and mollecular biology too much in the field. How about more education on the illnesses, injuries, and diseases we see in the field and the skills we use to treat them.

...then paramedics need to accept that they're just trained technicians and not professionals. They need to follow the protocol to a T with no variation or thought about it and check with medical control on every call, especially everything not textbook. My personal opinion is that working with a philosophy that strict is actually pretty dangerous as patients don't read the text book.

As far as genetics and molecular bio, paramedics should at least have a general understanding of it. Genetics can change things as simple as the proper dose of medication and having a understanding of the underlying mechanics prevents bouts of mass stupidity that is, unfortunately, all too common in EMS. There are way too many threads here which leaves people scratching their heads thinking, "Umm, the body/science doesn't work that way," and considering I think that the average forum participant is smarter than the average EMS provider, I can't imagine some of the misconceptions that the average provider has. After all, if you don't understand free radicals, and pulmonary equations, it's hard to imagine how supplemental oxygen isn't a cure all and how oxygen can hurt.

 

[Shishkabob]

By your reasoning, Respiratory Therapists, Radiology Technologists and Sonographers are also the equivalent of a nurse. The difference in these professionals and the Paramedic is that their minimum entry level is a two year degree. For your state of Texas, you only need 600 hours of traiing.

I actually tend to think of each one ABOVE the average new grad nurse in their respective field. 2 years specializing in what they do. Just as (in general terms) a Paramedic spends 2 years specializing in prehospital management. A nurse spends 2 years learning a little bit about all aspects of medicine, not one specific area. Where's the error in thinking?



(And don't you try and compare a BSN to another profession that only needs 2 years, as in most areas I know a BSN is a nice to have and not a requirement. Compare like things, which in it's current form is 2 years of education)

As a specialist trained specifically in Emergency Medicine, you do not have the same core education as a nurse and therefore you are not a nurse or like a nurse.

A nurse trained in OB/GYN cannot compare to my knowledge in pre-hospital emergency medicine, correct? So I, again, fail to see the error in thinking.



I have not once, in my two years on this forum, declared that education in ANY aspect of what we do as "more than enough". However, you need to realize that it is not our primary duty to be jacks of all trades, as a new grad nurse IS.




PS-- Not all accredited nursing schools require, nor teach, pre-reqs, and can require nothing more than a GED. Example in my short search, not too far from me. http://www.dni.edu/index.php?option=com_content&view=article&id=154&Itemid=32

 

[Akulahawk]

I don't think there is anything in your post that I didn't already know. I also didn't state that my undergrad program was in EMS. I am a Paramedic that happens to have a Bachelors in Sports Med. Paramedic school was easy.

The rest of my comments are bolded, in-line.

Does every Paramedic program require those same classes in your state? I didn't think California required a degree from a college to be a Paramedic. Don't confuse the classes which tech or trade schools call A&P, Pharmacology or math. These abbreviated classes are not the same as a college class and will not transfer to a university or even a community college. You can get a few credits for your Paramedic cert but that is about all.
California does not require a degree to be licensed as a Paramedic. I do understand the difference between the A&P stuff taught by a trade school and that taught at the collegiate level. Why is that? I actually attended a College that is well known for their Sports Med program.
A Paramedic can get a degree but it is not required. Usually only a certificate is required. You can advance in some agencies if you have a degree but few EMS employers will state degree preferred. A nurse can get a BSN or MSN although just an ADN is required for entry. Employers can also state they prefer a BSN in their employment ads and it is not considered unual to require more education than the state or national minimun in that profession or most of the other health care professions. It is unual to require a degree to be a Paramedic unless you are in Oregon.
I have seen that everywhere I go. Oregon has a better program that what I've seen elsewhere precisely because they require their Paramedics to have a higher level of education than what's required anywhere else.
A BSN can be required for Public Health or School RN positions along with some specific requirements. A Paramedic can be called a community health Paramedic with the bare minimun certificate plus a few extra hours of training. A title can be misleading especially if there is not a minimal standard to back it up or some consistent regulations at the state level.

The other poster stated it would take less than a year to become a nurse with a Paramedic cert. If the student did not have any of those science classes, it will definitely take longer than a year and that is just to complete the science classes. I do not know any nursing program that will allow entry without the basic sciences like A&P from an acceptable source such as an accredited college. It also is not just about the number of credit hours or units. The units must be in the program.
Those units I stated were just the program requirements. General Ed for lower and upper division must be added on to that. While it's possible to get a Sports Med degree in about 128 units, it can often take >140 units to earn the degree.
You can not compare an ATC to an accountant either just as you can not assume that if someone has a two year degree with a few sciences they can be either a Radiology Technologist or a nurse. The core courses must be taken and the specialization for each is what sets them apart.

An accountant is not a medical provider. Their program will be very different. Their Gen Ed program should be fairly similar though... because the College requires it. Someone with an AA or an AS and that has the prerequisite coursework can become an RN or RT or Rad. Tech. if they do the program coursework.

Nurses do utilize these classes almost everyday. The chemistry gives them an understanding as to why lipids can not be ran in the same lines as other medications and why certain meds are light sensitive. They may not remember all the little details or equations but they will know enough to check the compatability chart when they see various meds that have a composition which might raise a red flag from the info stored somewhere in their memory. It can keep the nurses from making a dangerous mistake. If they are getting an inservice on a new medication, they will have a better understanding why it is more compatible or what makes it different from the others. As far as microbiology, it would have to be a very, very stupid nurse to not know what bacteria or viruses the patients have and how they are being treated. In microbiology you also learned which microorganisms were more resistant which should indicate some areas require special handling or cleaning. These classes are included in all the other health care profession programs for a reason.
Yes, the above chemistry and microbiology coursework provides the foundation for understanding the why, but the direct knowledge wouldn't normally be used. Microbiology teaches bug identification and how to kill them and that some bugs are resistant to meds. It's amazing what tea tree oil kills...

Please do understand that I possess a MUCH better education than most Paramedics do.

 

[brentoli]

(And don't you try and compare a BSN to another profession that only needs 2 years, as in most areas I know a BSN is a nice to have and not a requirement. Compare like things, which in it's current form is 2 years of education)

Obviously you haven't met a new grad ASN on their job search. The nursing shortage was hype by nursing schools. While a BSN isnt required it cuts down the job search 3-6 months because employers know they are getting more for their money. Some department directors at our local hospital require their RNs to do x amounts of research a year... something an ASN isn't prepared for.

A nurse trained in OB/GYN cannot compare to my knowledge in pre-hospital emergency medicine, correct? So I, again, fail to see the error in thinking.

But you won't compare to their education in chemistry / biology / pharmacology / mathematics straight out of a paramedic program

However, you need to realize that it is not our primary duty to be jacks of all trades, as a new grad nurse IS.

How does this help your case? You are saying a nurse has a much more broad education. By extrapolation it means the nurse is more adapatable to specialization.

 

[Shishkabob]

But you won't compare to their education in chemistry / biology / pharmacology / mathematics straight out of a paramedic program

Aside from math, which I publically admit I suck in and wish math would die a horrible death, you don't know WHAT my background is on those other ones, WHAT my school required, or anything of that nature. Assuming you do just shows you as foolish.

How does this help your case? You are saying a nurse has a much more broad education. By extrapolation it means the nurse is more adapatable to specialization.

I have ALWAYS said nurses are more generalized in their medical education. I have also always said that paramedics are more specialized in their education.



Is an orthodontist any less of a professional than a dentist just because the dentist is a generalist when it comes to medicine of the mouth? (Answer: No)

 

[brentoli]

Aside from math, which I publically admit I suck in and wish math would die a horrible death, you don't know WHAT my background is on those other ones, WHAT my school required, or anything of that nature. Assuming you do just shows you as foolish

No but I know what the standard paramedic program is. No one brought YOUR education into question. Quit being sensitive.

 

[Shishkabob]

No one brought YOUR education into question. Quit being sensitive.

Hmmm?

But you won't compare to their education in chemistry / biology / pharmacology / mathematics straight out of a paramedic program

Maybe YOU (you, as in brentoli) didn't mean "you" in a specific sense but in a more general sense, but that's not what you wrote, so that's the response you got in return. Don't be so sensitive to replies that your post warranted.

 

[brentoli]

Is an orthodontist any less of a professional than a dentist just because the dentist is a generalist when it comes to medicine of the mouth? (Answer: No)

This corollary doesn't make sense. An orthodontist is a dentist with a couple more years of education and training. I don't see how this relates to the nursing/paramedic topic.

 

[Shishkabob]

This corollary doesn't make sense. An orthodontist is a dentist with a couple more years of education and training. I don't see how this relates to the nursing/paramedic topic.

A Paramedic has more education in pre-hospital emergency management than a new grad nurse.


It's not to be taken at a 1:1 ratio..... Not my best comparison, but it gets the point across.