Out of options NREMT-P wise, need help

[TraprMike]

Hoops,,, not only for basketballs, but for jumping threw also

 

[TraprMike]

And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?

but the nurse is not a EMT-P,, right?,, she's a pre hospital nurse thingy...

 

[BandageBrigade]

I teach most of those cert classes and you could learn more from an episode of House than you can in all of them added up. I can sum up all 16 hours of ACLS in 342 words. (less than some of my posts on this forum)

Challenge.

 

[Ewok Jerky]

From the NREMT website

OP-did you check the requirements before starting this process?


Individuals applying for Paramedic certification must meet the following requirements:

18 years of age or older.
-Possess current National Certification at the EMT-Basic level or current state certification at the EMT-Basic level or higher.
-Successful completion of a state-approved Paramedic course that meets or exceeds the U.S. Department of Transportation (DOT) Paramedic National -Standard Curriculum. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT web site.

If your initial Paramedic educational program was completed more than two years ago and you have maintained state licensure at the Paramedic level, you must submit documentation verifying completion of a Paramedic refresher training program within the past two years. If your initial Paramedic education program was completed more than two years ago and you never gained state licensure at the Paramedic level, you must complete an entire state-approved Paramedic course prior to applying for certification.
-Verification from the Program Director that you hold a current CPR credential for health care providers and have demonstrated competence in Paramedic skills.

 

[citizensoldierny]

but the nurse is not a EMT-P,, right?,, she's a pre hospital nurse thingy...

Not all nurse's are she's

 

[medicRob]

You could always go to the 12 week Houston Fire Department Paramedic patch factory for the barely homeostasasing and those with low synaptic ACh transfer rates.

Ondansetron, quick.

I laughed so hard I think I peed a little.

 

[Veneficus]

And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?

In Ohio, a physician can test out of paramedic school as well.

I think the problem is rather simple. EMS providers have lobbied to hold on to "technician" and "certification" status. As such, other "educated" "licensed" providers can demonstrate quite clearly and effectively that they posess all the core education requirements. Some brief examples to illustrate my point.

for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."

In nursing, they require a seperate a&p class. Often with a lab. Nursing can demonstrate they exceed the EMT-P curriculum. When you exceed the curriculum in a apples to apples comparison, in academia and usually for the purpose of certifications, you can "overlay" your credentials.

In any medical discipline "special education" suffices for psycho motor skills. For example, a nurse can take special education classes to care for wounds, insert a PICC line, intubate, the list goes on.

Hospital nursing administrations take great advantage of this not only for themselves but also for the "certified" technical levels. For example, sending EMT-Bs to phlebotomy, having ED techs (aka medics) trained on how to insert foley catheters, etc.

In all of education, skills are considered secondary to knowledge. I am not saying it is right, simply stating what I observe. A Chemist can learn to weld with a couple of classes, a welder cannot learn to be a chemist without years of education.

Take it one step farther. I have spent 440 hours in Human gross anatomy class. 200 hours of Medical physiology. At 640 hours of graduate level education for my A&P (not even counting undergrad) I far exceed even the level nursing has.

Everything a paramedic does is already a part of nursing. A nurse can follow standing orders. A nurse can follow premade algorythms that require clinical decision making.

A nurse has more comparable education than a paramedic. A paramedic cannot equal even 1/2 of what a nurse has. (Don't forget they also have chemistry and biology prereqs) which increases the level of detail they can be educated at in their comparable classes.

Now I don't think it should be this way, I think that a paramedic should have at least the same prereqs as nursing. After all, it is much easier to understand and work with PH when you learn the many theories behind acid/bases.

a majority of EMS agencies and providers of all stripes have chosen to limit themselves. It is one of the reasons EMS has become a stepping stone. When EMS persons can demonstrate an apples to apples comparison of why thier education is equal to nursing, then they will be able to test out of nursing too. The same thing with nurses pretending to be physicians.

 

[Veneficus]

Challenge.

ACLS does not make you an expert at resuscitative medicine, it gives you the guidelines to follow until an expert can be brought to bear or efforts terminated. (28)

All patients are to have oxygen, IV, and a cardiac monitor. (11)

Assess Airway, breathing, circulation, mental status. Obtain clinical data. (9)

All patients are either stable or unstable by mental status or blood pressure. (13)
There are 5 major heart rhythms. (6)

Normal, Brady, Tachy, vfib/no pulse vtach, Asystole/PEA (9)

Normal will not be covered. (5)

Unstable patients need help fast. Electricity is fast. (8)

Asystole/PEA receive no electricity (5)

Unstable brady is paced, unstable tachy is synchonized cardioverted, vfib/o pulse VT unsynchronized cardioverted. (13)

Stable patients are treated from least invasive treatment working towards most invasive. (12)

Brady: 0.5 atropine, consult expert, pace if become unstable. No atropine in high order blocks. (15)

Tachy subdivided into wide and narrow. (6)

Stable wide: 150mg amiodarone over 10 minutes. Consult expert (9)

Stable SVT: vagal, adenosine 6 mg, repeat at 12 mg, and 12 mg, elective cardiovert.(15)

Other narrow: supportive care consult expert. (6)

Vfib/0 pulse vt: begin CPR, defibrillate at 200J biphasic continue CPR for 2 minutes. Check pulse check rhythm. If same defib 200J, Continue 2 minutes CPR and administer vasoactive agent. After 2 minutes check pulse, check rhythm, if same defib 200J continue 2 minutes of CPR and consider administering Antiarrhythmic agent. (48)

Asystole/PEA: Start CPR, administer vasoactive agent. After 2 Minutes CPR check pulse, if rhythm the same and rate <60 administer atropine 1.0 mg (24)

The best chance for resuscitation is to identify and treat reversible causes. The specific treatments may be different from the basic guidelines listed here and are dependent on medical judgment, scope of practice, and available resources. (36)

Your agency will determine the criteria for termination of efforts. (10)

(288 total count) beat my own record.

 

[rhan101277]

Well over here in Mississippi you must have real college A&P I and II with labs, that is a whole 2 semester of nothing but anatomy. Then you have the built in anatomy in the medic class, which in no way compares to real college A&P.

I think nurses and paramedics are apples and oranges. With enough training/education nurses can be paramedics and vice verse.

Also here at RN, MD. etc. can't challenge the registry unless they have passed an approved paramedic program.

Also I have had others tell me that fresh new MD's without any internship or residency behind them, do not know how to treat patients. They learn all of this first hand.

 

[JPINFV]

for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."

Quick devils advocate. No medical school in the US requires A/P before matriculation. Furthermore, depending on how the curriculum is designed (e.g. PBL or organ systems based in contrast to traditional course work), there may or may not be a stand alone "physiology" course (among specific other courses). As such, how could a strict "course hour" count matter?

Now my reply to my own DA. While there is a legal hour minimum for medical school length (4000 hours with 80% attendance in California) and only a broad list of categories to cover with the only requirement that those subjects have "adequate instruction," unlike medical schools, paramedic courses have shown themselves to be unable to have the maturity to provide adequate instruction on their own to have the for the type of latitude that other health professions programs have over their curriculum.

 

[d3653je]

Thanks for the advice

Some of you made some really valid points and I thank you. I can say this much...in here at least I am among people who do the job for a living and not people who just push papers.

When you believe in something so strongly. sometimes stopping and smelling the roses can mean the world.

I still am doing to try and see my way through it.

The person or persons who said I would not pass the current NREMT-P, you may be very right or wrong... I'd like the chance to prove it and find out.

If I came across as a seen it all done it all kind of person, well then I did come across wrong. That is what is so hard about all this and posting in a forum. Anybody can say anything and there is no way to back it up. I am sure everyone is here has walked away from a course and thought...I can't believe that person passed, would not want them working on me. Is it fair or right to judge that person before they see any action? Most Agencies with good Medic Programs take on the new Medic and put them on probation. I think it is during that time you prove your worth. How one gets to that point...as un-orthodox it may seem, now it is time to prove you are a Medic.

There are some people in here who want to crack jokes and stuff, well we are what we are. Words are just words... face to face and not from behind a keyboard with some random name... guess that is just the way it is. I think face to face people have to be more civil to one another.

So all that being said, thanks to all for taking the time to respond to my post.

 

[medicRob]

Some of you made some really valid points and I thank you. I can say this much...in here at least I am among people who do the job for a living and not people who just push papers.

When you believe in something so strongly. sometimes stopping and smelling the roses can mean the world.

I still am doing to try and see my way through it.

The person or persons who said I would not pass the current NREMT-P, you may be very right or wrong... I'd like the chance to prove it and find out.

If I came across as a seen it all done it all kind of person, well then I did come across wrong. That is what is so hard about all this and posting in a forum. Anybody can say anything and there is no way to back it up. I am sure everyone is here has walked away from a course and thought...I can't believe that person passed, would not want them working on me. Is it fair or right to judge that person before they see any action? Most Agencies with good Medic Programs take on the new Medic and put them on probation. I think it is during that time you prove your worth. How one gets to that point...as un-orthodox it may seem, now it is time to prove you are a Medic.

There are some people in here who want to crack jokes and stuff, well we are what we are. Words are just words... face to face and not from behind a keyboard with some random name... guess that is just the way it is. I think face to face people have to be more civil to one another.

So all that being said, thanks to all for taking the time to respond to my post.

Good luck, either way.

 

[8jimi8]

And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?

Because the registered nurse has had enough education to test through EMT-P curriculum as a module. The research that I've done in this area has shown that to challenge the test, you have to hold EMT-B and take a Paramedic Refresher course prior to sitting for examination.

 

[Veneficus]

Obviously I attend a school that is measured in course hours. However, they are broken down into 4 subgroups.

lecture (where you listen to somebody talk at you)
lab (hands on simulators, microscopes, etc.)
seminar (small group interaction and problem solving, comparable to US PBL)
clinical (live people or functioning pathology labs)

So you have anatomy lecture, lab, seminar, and clinical, adding up to 440 hours. (not including "open" lab time of which there is a lot, but as it is not required I didn't include it.)

Quick devils advocate. No medical school in the US requires A/P before matriculation..

And they don't need to. Why require something that you will go over in more detail. Medic and nursing aren't required to take a&p prior to a gross anatomy course. It is their anatomy course. The other nice thing about medical school is between undergrad and the graduate portion, the classes are to use an educational term "scaffolded" you take gen chem an Ochem in undergrad but do not repeat them. You move into bochemistry. Just as you do not have to take genetics in undergrad or cell bio.

Also I would just like to point out, A&P is not "pure" or complete "anatomy" (forget who posted that) it is exacly what it says. Anatomy and physiology.

Furthermore, depending on how the curriculum is designed (e.g. PBL or organ systems based in contrast to traditional course work), there may or may not be a stand alone "physiology" course (among specific other courses). As such, how could a strict "course hour" count matter?

Strict course hour is just easier to compare quantitatively.

In PBL as I understand from my trip over to LECOM. PBL meets specific learning objectives. The same objectives that are outlines in "course hour" outlines.

I have no experience at all with organ system based learning, but I would imagine that it also uses similar course objectives.

Looking at it from a broad perspective, all have some sort of time to objective ratio.

Are you suggesting that paramedic school meets the same basic and clinical science objectives as Nursing school or Medical school? (I really don't think so as the DA )

At the same time though, would you compare the depth or breadth of learning objectives in a dedicated A&P to "included in 750 clock hours in this state?" Would you compare a 200 level(sophmore undergrad as we know it) A&P with your gross anatomy, system based learning, or PBL? Considering if it was comparable, you could finish medical school in 750 hours.

 

[CAOX3]

(4000 hours with 80% attendance in California)

Really only 80% attendance required?

Whats funny, I took a Western Civ survey class and 100% attendance was required, the prof didnt care if you were sleeping just that you made the effort to show up.

 

[JPINFV]

Really only 80% attendance required?

Whats funny, I took a Western Civ survey class and 100% attendance was required, the prof didnt care if you were sleeping just that you made the effort to show up.

Dirty secret of medical school. Most medical schools record their lectures and post them online for their students. As such, most students don't attend lectures. I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight. Now lab courses and clinicals are always required, but those are different situations than straight lectures.

 

[CAOX3]

I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight.

Understood, I also wasnt a big fan of standing up in the middle of lecture and stating can you repeat that or can you speak up. We didnt have the oppurtunity or access to recorded lectures, that seems like a great idea.

 

[MrBrown]

If I called a state or country medical board and asked them if I could test out of medical school because I am a paramedic, they would laugh at me.

Hmm so thats what I was doing wrong!

In Ohio, a physician can test out of paramedic school as well.

Here you can take the week long "operational ambulance induction" and do a couple short courses taught by the Ambulance Service and viola, you can get a bright garment with "DOCTOR" writtten on it and an Ambulance pager.

for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."

Our Paramedic (ILS) students have to take the standard two class (one per semester) anatomy and physiology class. Nursing has to only take a one semester class. I have read the Marieb A&P book back to front twice (it's a great book) and think the knowledge that our University educated Paramedics have is very good.

Having said that, I realise now how inadequate my education is given that a 200 hour combined A&P course is ...

Dirty secret of medical school. Most medical schools record their lectures and post them online for their students. As such, most students don't attend lectures. I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight. Now lab courses and clinicals are always required, but those are different situations than straight lectures.

I did most of my undergraduate degree in my PJ's and didn't make an appearance at a class for over a year ... it was great, I loved it!