Nurses vs EMT/Paramedics in EMS

[xgpt]

Have you seen how criminally inadequate Paramedic training in the US is?

You can be a "Paramedic" in a little as 12 weeks + 200 or so hours of "internship" that requires no college.

Forty years ago in this part of the world it took two years to become Qualified Ambulance Officer who could do little more than give oxygen, yet, in the US you cannot mandate such a requirement for your highest level almost a half century later.

Meanwhile .... in the rest of the world you are looking at four to seven years to become an Intensive Care Paramedic (ALS).

12 weeks? :wacko:


I know you can get your EMT-BASIC in <6 months.

EMT-I takes longer than that...

but full-on paramedic w/ all of the associated certs take around two years from what I've heard.

Am I just wrong here?

 

[JPINFV]

As with everything in EMS, it depends on where you go. I know places where you can become an EMT in 2 weeks.

 

[xgpt]

Have you seen how criminally inadequate Paramedic training in the US is?

You can be a "Paramedic" in a little as 12 weeks + 200 or so hours of "internship" that requires no college.

Forty years ago in this part of the world it took two years to become Qualified Ambulance Officer who could do little more than give oxygen, yet, in the US you cannot mandate such a requirement for your highest level almost a half century later.

Meanwhile .... in the rest of the world you are looking at four to seven years to become an Intensive Care Paramedic (ALS).

But no...I haven't seen any criminal inadequacy...I've only been doing this since February...and I've never run with a paramedic unit...

 

[dudemanguy]

Have you seen how criminally inadequate Paramedic training in the US is?

You can be a "Paramedic" in a little as 12 weeks + 200 or so hours of "internship" that requires no college.

Forty years ago in this part of the world it took two years to become Qualified Ambulance Officer who could do little more than give oxygen, yet, in the US you cannot mandate such a requirement for your highest level almost a half century later.

Meanwhile .... in the rest of the world you are looking at four to seven years to become an Intensive Care Paramedic (ALS).

Out of curiousity I was looking up EMS training in Australia and found that it only takes 4 weeks to become an "ambulance transport officer"...In the US a first responder course usually takes longer, and they arent even allowed to crew an ambulance. So should I begin an online crusade to improve Australian EMS based on one school I found online?.

I agree that EMS in the US should have better education standards. But do you have any statistics to prove that Australian or New Zealand EMS has far superior patient outcomes than in the US? I mean if not then what is the point really, bragging rights? If you have a paramedic with a 3 year degree making decisions that a doctor (with 11 plus years of training) makes here in the US, is that having higher education standards?

 

[VentMedic]

In the US a first responder course usually takes longer, and they arent even allowed to crew an ambulance.

Check again. In some states you only need to be an "ambulance driver" here in the U.S. and complete EVOC to be on an ambulance.

Do you agree that one should be pushing potentially harmful medications and doing advanced procedures without as much as a decent A&P or Pharmacology course?

3 years is not even that much just as an Associates is pitiful as the last couple of health care professions with that degree in the U.S. now have come to that realization and are doing something about it.

 

[JPINFV]

Out of curiousity I was looking up EMS training in Australia and found that it only takes 4 weeks to become an "ambulance transport officer"...In the US a first responder course usually takes longer, and they arent even allowed to crew an ambulance. So should I begin an online crusade to improve Australian EMS based on one school I found online?.

You might be comparing apples to oranges here. Clock hours (total length of time in hours) is different than calendar days. I know of EMT programs that are completed in 2 weeks.

 

[MrBrown]

Out of curiousity I was looking up EMS training in Australia and found that it only takes 4 weeks to become an "ambulance transport officer"...In the US a first responder course usually takes longer, and they arent even allowed to crew an ambulance.

ATO/PTOs do non emergent transport, they are really nothing more than a driver and have very strict critera about who they can and cannot transport.

So should I begin an online crusade to improve Australian EMS based on one school I found online?.

Absolutely!. For the record I use the Houston Fire Department 12 week + internship program because it is not the "best" that any system, concept or idea is judged by but rather the worst.

Oh and just one? .... Lets have a look:

Nebraska 12 week program with no health science requirement - thier "Associates Degree" requires only an "introduction" to A&P!
http://programs.mpcc.edu/Accelerated_EMT-Paramedic.html

Dallas Fire Rescue - 24 week program with no health science requirement
http://www8.utsouthwestern.edu/utsw/cda/dept29240/files/90946.html

Green Bay, WI - 36 week program with no health science requirement
http://www.nwtc.edu/academics/degrees/publicsafety/emergency-responders/Pages/Paramedic.aspx#tabs-4

Four month Colorado program who proudly boast a graduate serving as an instructor!
http://www.aims.edu/academics/ems/emsDept/

Some of our guys have taken the "authentic" NREMT Paramedic practice tests for a bit of fun and they score above 90% with little difficulty; I score around 80-85% because the questions are so basic it is not funny. I am not an Intensive Care Paramedic.

There are some good programs out there;

Bellingham, WA
http://www.btc.ctc.edu/DegreesCertificates/programs/PRG-DegreesCertificates.asp?Program=26

Temple, TX
http://www.templejc.edu/dept/ems/Pdf/Handbooks/CertificateCurriculum.pdf

Eastern Kentucky University
http://www.justice.eku.edu/ssem/emc/

Now, by contrast check out international Programs

New Zealand 3 year BHSc(Paramedic) (non ALS)
http://www.aut.ac.nz/study-at-aut/s...-courses/bachelor-of-health-science-paramedic

UK FdSc Paramedic
http://www.gre.ac.uk/fd/subjects/hsc/b780

Australia (NSW) Paramedic (non ALS) 3 year BClinicalPrac(Paramedic)
http://www.csu.edu.au/courses/undergraduate/paramedic/

Australia (NSW) Intensive Care Paramedc (ALS) Post Graducate Certificate
http://www.csu.edu.au/courses/postgraduate/intensive_care_paramedic/index.html

Canadian Primary Care Paramedic (two years)
http://www.georgianc.on.ca/programs/PARA/outline/

Canadian Advanced Care Paramedic (one year)
http://www.georgianc.on.ca/programs/PARM/outline/

 

[dudemanguy]

Some of our guys have taken the "authentic" NREMT Paramedic practice tests for a bit of fun and they score above 90% with little difficulty; I score around 80-85% because the questions are so basic it is not funny. I am not an Intensive Care Paramedic.

I did take some NREMT-basic practice tests before taking the actual NREMT exam. I dont know if they were "authentic", or what that even means. I do know every practice test I took was far easier than the actual test.

The fact these people got 90% and found it easy is proof the tests werent very authentic. The NREMT exam is made to be difficult for everyone who takes it, since the difficulty of the questions asked is based on your answers to previous questions and the skill level you've demonstrated. Get a question right, and the next is harder, and so on. Get one wrong, and the next is easier. Hence someone taking the actual NREMT who finds the questions easy and thinks they got 90% right, probably failed. I'm sure there are lots of people who could pass some paramedic NREMT online simulation test that wouldnt make it through a paramedic course and internship.

Having said that I'm not claiming that the NREMT exam is some end all be all, only addressing the notion that doing good on some practice tests means someone is more than qualified to be a paramedic in the US.

I do get a little annoyed at some of the medics with paragod syndrome on this forum, and it IS nice to see them get put in their place by others with more education and experience. But the 911 EMT's and medics I've seen work were amazing to watch in action, total professionals. Then again I havent been to California, Texas or Florida, so my view might change .

 

[JPINFV]

The NREMT exam is made to be difficult for everyone who takes it, since the difficulty of the questions asked is based on your answers to previous questions and the skill level you've demonstrated. Get a question right, and the next is harder, and so on. Get one wrong, and the next is easier. Hence someone taking the actual NREMT who finds the questions easy and thinks they got 90% right, probably failed.

Well... last time I recerted I recerted by exam and took the NREMT progressive CBT for the first time... yea. Less than 30 minutes, 70 some-odd questions that were fairly easy, and a new card with 2 more years on it in the mail. What's easy for one person isn't necessarily easy for someone else. Similarly, just because a CBT is progressive doesn't mean it's going to be hard. "Harder" and "hard" are not the same thing.

 

[dudemanguy]

Well... last time I recerted I recerted by exam and took the NREMT progressive CBT for the first time... yea. Less than 30 minutes, 70 some-odd questions that were fairly easy, and a new card with 2 more years on it in the mail. What's easy for one person isn't necessarily easy for someone else. Similarly, just because a CBT is progressive doesn't mean it's going to be hard. "Harder" and "hard" are not the same thing.

I passed mine first time at 71 questions, but that was the Basic, not paramedic. Again I'm not saying the NREMT is some ultimate test of EMS knowledge. The main point I was making is that the actual test was harder than any of the practice exams I took.

Edit: I should also add that even if someone thought the NREMT wasnt very hard, I severely doubt they got 90% on it. So if someone says hey I got 90% on a practice test so I could get 90% on the NREMT...I doubt it. I got 89% on the last online test I took before the real one, and even though mine shut off at 71, I know I didnt get anywhere near that percentage right.

 

[MrBrown]

NREMT tests are designed to be adaptive so that if you answer a lot of questions correctly then the questions get harder.

 

[xgpt]

Check again. In some states you only need to be an "ambulance driver" here in the U.S. and complete EVOC to be on an ambulance.

Do you agree that one should be pushing potentially harmful medications and doing advanced procedures without as much as a decent A&P or Pharmacology course?

3 years is not even that much just as an Associates is pitiful as the last couple of health care professions with that degree in the U.S. now have come to that realization and are doing something about it.

I thought Pharmacology/A&P were required for paramedic...I know the paramedic degree program I've briefly looked into at the local community college requires it. And a bunch of other "hard" (as opposed to social) science courses for graduation.

and an Associates takes 2 years to get. Right?

 

[Melclin]

Out of curiousity I was looking up EMS training in Australia and found that it only takes 4 weeks to become an "ambulance transport officer"...In the US a first responder course usually takes longer, and they arent even allowed to crew an ambulance. So should I begin an online crusade to improve Australian EMS based on one school I found online?.

I agree that EMS in the US should have better education standards. But do you have any statistics to prove that Australian or New Zealand EMS has far superior patient outcomes than in the US? I mean if not then what is the point really, bragging rights? If you have a paramedic with a 3 year degree making decisions that a doctor (with 11 plus years of training) makes here in the US, is that having higher education standards?

I might add to what has been said that some of those courses you find online are private companies that run very expensive courses that have little to no actual career outcomes... they are rip off merchants basically. If you can get jobs, its usually in a first aid role.

There is a multitude of "EMS" companies/courses/jobs out there in the private sector playing on peoples fear of injury and public liability. They usually have fancy titles like "EMT" or "Medic" but are officially not any more than a first aider. They often drive around to events of to places of employment in ambulances, complete with lights and sirens, but it is a purely a PR thing. They are most certainly not allowed to transport pts.

Then there are slightly more reputable transport companies, but it is a very different landscape than in the states, where IFT and 911 have interchangeable personnel. These companies are nothing more than ambulance shaped taxis driven by first aiders. They are not considered to be "in EMS", there is no way for them to become part of "the ambulance service" "(state mandated emergency service) without a degree. 000 (911) response is purely by the ambulance service (except in certain mass casualty provisions) and hospitals requiring ambulances for IFT of sick people simply request the services of that which would otherwise be an emergency ambulance. Emergency IFT appears less common here than it appears to be in the states though, largely I imagine, because of our liberal ability to bypass hospitals and lack of insurance issues (woo socialised medicine ).

 

[MrBrown]

We have universal healthcare, the UK in comparison where doctors, nurses, ambos etc are directly employed by the NHS is socialised medicine.

I just had to clear that up coz its a peeve of mine.

Also likewise here in NZ, people who work for the one or two private operators are really just a lot of smoke and mirrors. They often have very little training and compete only in the "event" medical market. They aren't allowed to actually transport patients as that is purely the domain of the 111 (911) vehicles.

Heck in Oz its what, a year long course to become a Patient Taxi Operator, sorry, Patient Transfer Officer?

 

[Melclin]

We have universal healthcare, the UK in comparison where doctors, nurses, ambos etc are directly employed by the NHS is socialised medicine.

I just had to clear that up coz its a peeve of mine.

Also likewise here in NZ, people who work for the one or two private operators are really just a lot of smoke and mirrors. They often have very little training and compete only in the "event" medical market. They aren't allowed to actually transport patients as that is purely the domain of the 111 (911) vehicles.

Heck in Oz its what, a year long course to become a Patient Taxi Operator, sorry, Patient Transfer Officer?

Universal healthcare. You are quite correct. My bad.

The length of time varies with particular qualification. I've seen cert IIIs and cert IVs so between 6 months and a year of pretty casual technical college type education. This is for a scope that varies between AED+O2 only - through to what is known here as BLS (its what our ambulance officers had back when they were called ambulance officers), which is aspirin, nitro, neb salbutamol and methoxyflurane (pain relief).

 

[MrBrown]

Back in the day of the Lifepak 10 and really big orange and white plano drug boxes (which I note MICA still use)

 

[jjesusfreak01]

There have been several agencies that have attempted to do community paramedicine throughout the past 30 years but some of the programs were dropped because the Paramedic didn't like doing something that wasn't an "emergency". If you complain about doing routine calls, IFTs and responding to 911 calls that are medical and not trauma, then doing community paramedicine probably isn't for you. Unless the attitudes can be changed in EMS with a different patient care focus, those who don't like doing community paramedicine will give cause for complaints.

Wake County EMS in my area does this using something they call an Advanced Practice Paramedic. They ride in single responder vehicles (essentially cop cars with different markings) and do ALS backup on calls (they actually backup ALS trucks) as well as community paramedicine. The difference is that this is what they sign up for. They are trained above the level of standard paramedics, have a scope of practice that is significantly greater, but still get to respond to actual traumas on a regular basis.

 

[medichopeful]

and an Associates takes 2 years to get. Right?

Depends on how often you go to class, but in general yes

 

[EMSLaw]

Wake County EMS in my area does this using something they call an Advanced Practice Paramedic. They ride in single responder vehicles (essentially cop cars with different markings) and do ALS backup on calls (they actually backup ALS trucks) as well as community paramedicine. The difference is that this is what they sign up for. They are trained above the level of standard paramedics, have a scope of practice that is significantly greater, but still get to respond to actual traumas on a regular basis.

See, that sounds great, but then I realized that's exactly what Paramedics in my state already do. I'd be interested to know just how large their scope of practice actually is.

 

[JPINFV]

It's my understanding that the advanced practice paramedics do essentially two things. First, they do welfare checks and other preventative measures to help keep frequent flyers (especially legitimate freq. fliers such as patients who are having trouble controlling their BGL) out of the system by providing home checks.

The second thing they do is they respond to all of the critical calls so that there's a provider who's regularly performing the high risk/low utilization skills and to act as kinda of a director type person to make sure everything that needs to be done is being done.