EMT-B Seeking Wisdom from Medics

[CombatCasualtyCare21]

In my state a Basic is seen as little more than an advanced first aid cert. Not in high demand. Its been a struggle to even get my foot in the door. I have had plans of starting medic school in the fall, but I originally enrolled assuming I would have about a year of paid experience to build upon. Instead I have only the 36 hours of rotations from my cert. This question probably comes up a lot.

What would you all advise? volunteer while in school, postpone medic classes and keep hopelessly searching for EMT-B work, when they all only NEED medics and nurses? I guarantee I can handle the courses, I just worry that a "green" medic might possibly be looked at in a worse way than a "green" basic. What do you guys think? and thank you in advance.

I know the value of experience. I just need some wisdom.

 

[rescue99]

In my state a Basic is seen as little more than an advanced first aid cert. Not in high demand. Its been a struggle to even get my foot in the door. I have had plans of starting medic school in the fall, but I originally enrolled assuming I would have about a year of paid experience to build upon. Instead I have only the 36 hours of rotations from my cert. This question probably comes up a lot.

What would you all advise? volunteer while in school, postpone medic classes and keep hopelessly searching for EMT-B work, when they all only NEED medics and nurses? I guarantee I can handle the courses, I just worry that a "green" medic might possibly be looked at in a worse way than a "green" basic. What do you guys think? and thank you in advance.

I know the value of experience. I just need some wisdom.

Guess it's entirely up to what YOU feel most suits your own abilities. I, never worked as a Basic beyond a little volunteering while in Medic class. It's not the best way to start out but, if you're the jump in head first sort of personality and you accept your greeness...have a great time! I sure did
People don't care if you're green. They care if you're a jackars and green.

 

[wyoskibum]

Dont worry about it

What would you all advise? volunteer while in school, postpone medic classes and keep hopelessly searching for EMT-B work, when they all only NEED medics and nurses? I guarantee I can handle the courses, I just worry that a "green" medic might possibly be looked at in a worse way than a "green" basic. What do you guys think? and thank you in advance.

In my experience, Paramedic school ruined me as an EMT and I was a brand new Medic. You are going to have opportunities during your clinical rotations and field rides. If were me, I would concentrate on taking additional classes that will help me in Paramedic school. College level A&P, medical terminology, etc...

 

[Shishkabob]

Like rescue stated, it depends on how you feel.

I barely worked as an EMT before going to medic school.. like 5 shifts total. You get plenty of time in clinicals and internship in medic school to work on your basic skills. Don't let lack of experience hold you back if that's your only concern.

Out of the 9 of us left in my medic class, 4 of us worked as EMTs beforehand, the other 5 did not.

 

[medic417]

There is no need to waste time as a basic. You will learn better how to do the basic stuff while getting your education. You and your patients will be better for it.

 

[OHMEDIC]

There were several people in my Paramedic class that had less than one year experience as an EMT-B. In fact, there was one person who had never even been in the back of the ambulance..he finished the course, but definitley had a harder time than the rest of us. Experience is priceless in terms of starting a Paramedic class, but it can be done without it.

 

[medic417]

There were several people in my Paramedic class that had less than one year experience as an EMT-B. In fact, there was one person who had never even been in the back of the ambulance..he finished the course, but definitley had a harder time than the rest of us. Experience is priceless in terms of starting a Paramedic class, but it can be done without it.

Better to gain experience after you are educated. Yes a basic that has practiced may seem more comfortable but uneducated experience is of no benefit beyond just knowing what it is like in an ambulance. After proper education A Paramedic with no basic experience will quickly catch up to his so called "experienced" new Paramedics.

Again do not waste your time at the basic level.

 

[Jersey]

Better to gain experience after you are educated. Yes a basic that has practiced may seem more comfortable but uneducated experience is of no benefit beyond just knowing what it is like in an ambulance. After proper education A Paramedic with no basic experience will quickly catch up to his so called "experienced" new Paramedics.

Again do not waste your time at the basic level.

While I respect your opinion, I strongly disagree. I worked for two years as an EMT-B before going on to paramedicine, flight medicine, and now on the MD path.

Being a paramedic is 90% BLS. Some of the worst paramedics I've encountered have used their "skills" without developing proper assessment skills.

Many EMT's who work with an ALS partner get the "scraps" and never learn assessment and treatment. These EMT's dont get much exposure, and sometimes leads to the erroneous opinion that you have expressed.

Once again, I respect your opinion but believe it is tremendously off base. Also, I think that many hard working EMT's who are excellent clinicians (and can school a lot of paramedics) would also be taken aback by that statement.

 

[JPINFV]

So... even yourself admitting that EMT-B experience can be next to wortless (assessing left over "scraps"). You're looking at medical school. Would you go to a medical school that refused to teach you have to take a proper history and physical?

 

[Jersey]

You're comparing apples and oranges.

Many reputable, college based academic paramedic programs require EMT experience. Most leaders in the field of EMS education are adament about the fact that EMT experience is tremendously important for safe paramedics.

Since you brought it up, lets get into the medical school thing a little farther. First, I'm a little beyond looking at medical schools! (and have the negative bank account to prove it haha!). Secondly, medical schools assume no patient care experience. For this reason in the second half of the second year, third year, and fourth year your "clinical" time is almost exclusively focused on assessment. This is years of learning how to do an assessment.

I can tell you of at least five or six places in the United States where you can go from 0 time to etomidate in less than three months. I can tell you many more where this time is under six months. Assessment and basics are absolutely necessary before you can move on as a safe (not good, but safe) ALS provider.

 

[wyoskibum]

Being a paramedic is 90% BLS. Some of the worst paramedics I've encountered have used their "skills" without developing proper assessment skills.

I disagree. Being a good paramedic is having an understanding of anatomy, physiology, and pathophysiology. Being able to assess their patients and come up with a plan to address their patients needs. The only way to get good at that is with experience. I would much rather have the Paramedic education and gain experience doing ALS assessments. There is no point in delaying medic school to get BLS experience.

Also, I think that many hard working EMT's who are excellent clinicians (and can school a lot of paramedics) would also be taken aback by that statement.

If you read the OP, the question was should he delay going to medic school to gain experience as an EMT. If the OP goal was to be an EMT, then yes he should work towards that goal. It has nothing to do with career BLS providers and their skill level. They have their niche and are happy providing that level of care.

 

[JPINFV]

Actually, plenty of medical schools have you learning how to conduct an assessment in first year and have opportunities to apply those skills starting second year or earlier (volunteer clinics overseen by an attending or resident). Similarly, I'd argue that clerkships and sub-internships are more than just learning how to do assessments. It's also learning how to practice medicine in addition to being able to try out several fields before the match.

As far as EMS education, it's my belief that one of the big cultural problems with EMS is how the educaiton is conducted. 6 months isn't enough time to properly educate a paramedic regardless the privous experience. Similarly, failing to teach how to go from assement to treatment plan to implementation at the paramedic level because they are relying on basic level experience to compensate for those program's shortfalls is what leads to the stupidity of "BLS before ALS." It shouldn't be "start with BLS than move to ALS." It should be a smooth continum where providers are will to use their tools and interventions as needed regardless of which box they're currently throwing the patient into. There's a reason why physicians aren't PAs first. I'd argue that any medical program that relied on prior experience to plug holes in the curriculum would be dangerous.

 

[Jersey]

Oh goodness. I'm associated with an ivy league medical school, and I promise it's not a dangerous place. 99% of medical schools also do NOT have meaningful block clinical time the first year.

Also the physician and PA are very different animals, lets not stir up that debate! haha

BLS to ALS is a very valid point, in my opinion. The basics must come first before the advanced stuff. We apply oxygen, ventilations, bleeding control, and other "basic" interventions before we crack the drug or airway box. Also, a good paramedic is knowledgeable about the fact that good BLS and good ALS saves lives, and they're not exclusive from eachother.

I think we can also reach some agreement. If a potential paramedic is going through a two year program that gives 600-700 hours of QUALITY clinical time on the ambulance and in the ER, I think that someone with very little EMT time can do it successfully and come out successfully.

Unfortunately, I've seen the trend of medic mill schools proliferate lately (with the advent of the FF/EMTP pre-req for hiring) and the only people who can come out of a 7 month program are those that have been EMT's for a WHILE on an ALS ambulance.

I compromised, it must be a friday!

Cheers to all

 

[JPINFV]

Did I claim block clinicals? Very few schools (any?) have block clinicals during 2nd year. Does your Ivy League school not have extracurricular programs for their students? Some schools have electives, however elective =/= clerkship.

Ah... BLS before ALS... So let's fast forward. You're an EM attending. Are you going to wait to see if oxygen has any affect before going to an albuterol neb for for asthmatic patient in distress? The problem with the BLS before ALS argument is that there are people who claim that going to an obviously indicated paramedic level treatment before trying a basic level treatment is wrong. For example, in my mind, failing to ventilate a patient to preoxygenate a patient before intubating isn't failing at "BLS." It's failing at intubation.

I do agree that there's no reason why someone coming out of a properly lenghthed paramedic program (2 years) shouldn't be adequately prepared to be a paramedic regardless of prior experience. On the same hand, I'd question the preparedness of just about any paramedic student fresh out of a 7 month wonder school regardless of prior experience.

Also, quick question. What do you mean by "associated with a med school?" Looking at your prior posts, are you in a post-bacc pre-med program?

 

[Shishkabob]

Where is albuterol a medic only intervention in asthma?


/me just nit-picking. ^_^

 

[JPINFV]

Location dependent, however most areas don't run nebs at the basic level, and some that do have stupid restrictions to go with it (looking at you, Massachusetts).

 

[Shishkabob]

Wow, I could not see not having Albuterol as an EMT... then again I can no longer see not having all the tools I have now either

 

[wyoskibum]

What do you mean by "associated with a med school?" Looking at your prior posts, are you in a post-bacc pre-med program?

It means he stayed at a Holiday Inn Express last night!

 

[TransportJockey]

Wow, I could not see not having Albuterol as an EMT...

I agree... but then again our two states have soem of the broadest scopes for EMT-Bs in the country...

 

[Jersey]

It means he stayed at a Holiday Inn Express last night!

haha I did! I'm second year.