Paramedic advocacy

[VentMedic]

I hear stories of RN's who are fired because of incompetency and stories of RRT's who aren't allowed to work the critical care areas of hospital's because of their competency level. Its simply not just EMS...

Key words are in bold. Those two professions have no problem getting rid of those that don't make the grade.

RT raised their education requirements and also gave those of lesser credentials a time frame to raise their status. Those that didn't take advantage of the generous time period will be shown no mercy.

EMS in may regions continue to praise medic mills for a job well done with keeping a large amount of applicants coming their way.

It would be great to have degreed Paramedics on all primary EMS units but they're are many logistical aspects that sometimes prevent this.

Why then can some states mandate this and others can't?

How can all of the other professions (nursing, RT, PT, OT, SLP, PA, etc) mandate a minimum of a 2 year degree with most of those professions requiring more than a 4 year degree?

When is enough, enough for pre-hospital education to be considered adequate?

Is a two year degree really that unreachable for someone in EMS? Honestly? And you said I was the one who was calling EMS a bunch of dumb providers. I at least believe higher education is obtainable.

What logical excuse do you have for not having a minimum of a 2 year degree for the Paramedic? Do you really think the 3 month medic mills or 1000 hours of "training" is adequate?

 

[46Young]

Some states don't have the resources to pay the extra $$$ that a degreed paramedic would command over the paltry medic mill background. Sadly, they're happy with just a pulse, a patch, and the willingness to work for welfare wages. A two year degree or more would be preferable. However, would the employer be willing(able) to increase benefits/salary/working conditions/retirement bennies to compensate the extra education? I say extra in comparison to the medics that got their card out of a cracker jack box. Many rural areas, or even more populated jurisdictions in this economy don't have the funds to pay more than 10-12 bucks an hour for medics as it is. Most degreed medics, with 2 or even up to 4 years as some advocate here, would balk at such a low salary. As it stands, the typical medic needs to work an extra PT job, or even another FT job to be comfortable. A common complaint from medics is that they feel they should be compansated in line with an Assosciate RN. NS-LIJ CEMS in NY where I used to work came close, with EMT-B's at $21/hr, medics making a little over $30/hr, and CC medics making about $33/hr, plus 10% night diff. Yes, I know, RN's are subject to much more training, and rigorous standards, and deserve to be compensated as such. If comparable requirements were mandated for medic certification, what type of increase in salary/benefits could we expect? Likely little to none, especially in cash strapped jurisdictions, particularly in today's economic state. For example, in Virginia, we have what's called "The Golden Crescent". This covers NOVA, P-Willy down through Stafford, Fredricksburgh, Richmond, Norfolk, and Va Beach. These are generally the "haves". The rest of the state generally relies on state aid for EMS and fire, among many other things. They're mostly volunteer, and lucky to have an I on staff, let alone a P. I don't see someone going to school for 2-4 years to work for peanuts, or volunteer only. Many volunteer only agencies have gone to paid on call, paid medic fly cars, or even paid day personnel as result of dwindiling participation.

 

[Ridryder911]

Some states don't have the resources to pay the extra $$$ that a degreed paramedic would command over the paltry medic mill background. Sadly, they're happy with just a pulse, a patch, and the willingness to work for welfare wages. A two year degree or more would be preferable. However, would the employer be willing(able) to increase benefits/salary/working conditions/retirement bennies to compensate the extra education? I say extra in comparison to the medics that got their card out of a cracker jack box. Many rural areas, or even more populated jurisdictions in this economy don't have the funds to pay more than 10-12 bucks an hour for medics as it is. Most degreed medics, with 2 or even up to 4 years as some advocate here, would balk at such a low salary. As it stands, the typical medic needs to work an extra PT job, or even another FT job to be comfortable. A common complaint from medics is that they feel they should be compansated in line with an Assosciate RN. NS-LIJ CEMS in NY where I used to work came close, with EMT-B's at $21/hr, medics making a little over $30/hr, and CC medics making about $33/hr, plus 10% night diff. Yes, I know, RN's are subject to much more training, and rigorous standards, and deserve to be compensated as such. If comparable requirements were mandated for medic certification, what type of increase in salary/benefits could we expect? Likely little to none, especially in cash strapped jurisdictions, particularly in today's economic state. For example, in Virginia, we have what's called "The Golden Crescent". This covers NOVA, P-Willy down through Stafford, Fredricksburgh, Richmond, Norfolk, and Va Beach. These are generally the "haves". The rest of the state generally relies on state aid for EMS and fire, among many other things. They're mostly volunteer, and lucky to have an I on staff, let alone a P. I don't see someone going to school for 2-4 years to work for peanuts, or volunteer only. Many volunteer only agencies have gone to paid on call, paid medic fly cars, or even paid day personnel as result of dwindiling participation.

Excuses!

Although I don't doubt what you state is not correct, the basis is wrong. Amazing EMS Administration (including city government) loves to give excuses of such but when in comparison to those that provide professional services there always seems to be monies.

The only reason pay is low is because it is allowed to happen. Period. There is no mandate of providing good quality emergency health care to the citizens; hence you get what you pay for. The only reason there is paid fire departments is because of ISO ratings, I can assure you if there was not, we would see very few paid fire departments.

If there was an incentive, rules, law alike in other areas then we would see professional, qualified educated Paramedics. If the administrators were properly educated along with this a higher reimbursement rate and higher collections would be aimed for as well. Why should Medicare and Insurance companies pay high bucks for nothing more than a taxi ride. Even worse, many communities do not even tap into that and offer "free" even though truthfully, someone pays for it.

The reason the RN gets higher pay is because you have to have them. They also recognized that they had to be better educated not to be replaced and not alike EMS allow multiple levels to exist and work in lieu of their licensed level. They learned decades ago, to control the profession instead of others controlling it for them. In comparison, nursing has their own administration, their own education and their own Boards that regulate themselves. Ironically, you will not find any other profession else on these boards except for consultants. Now, compare these to EMS boards.

I realize there are areas that will always have to use volunteer systems, but in comparison those should be limited and very little. Very communities have ever attempted to really solve their EMS problems. Instead they always attempt to place a band-aid on arterial bleed and describe that they have something... which is better than nothing. How communities attempted consolidation and forming EMS Districts? How many have investigated their billing and reimbursement procedures, ranging from charting to collection methods? Again... it's just much more simpler to allow someone to do it for free... yes, services maybe only providing first aid; but hey, there is someone doing it!

R/r 911

 

[medic417]

How do you staff an all volunteer station that runs a few hundred calls a year with degreed, critical care Paramedics? That's a serious question that I would like to hear plans of how you would accomplish that with funding coming from bingo, the chicken BBQ, and maybe an annual carnival. And if you are a Paramedic, would you work at a station like this? How well would your skills be with only one or two calls every week?

This has been discussed to death and proof of how it could be funded and is being funded in some of the poorest areas of the nation. There is no excuse not to have paid Paramedic staffed ambulances 24/7. The basic information is towns/county's get priority's right and quit wasting money on holiday decorations, party's, new cars for the mayor, judge, etc.

As to how many calls is to few 1 service I am involved with pays great and runs fewer than 200 calls a year and has one of the highest poverty levels in the nation. How? They cut the fat out of the budget, they decided 1 life saved was worth have quality rapid response. As to maintaining skills most work also for other services and we also do additional rotations in ER, OR, etc. So actually probably better qualified to use our skills than many Paramedics in busy services that do not have such a strong educational program.

 

[cperschke]

Understand that the AAPA creates educational materials for the public, while we do not. It is time to stop fooling the public, and let them know that the ambulance responding to their kid may not even be able to give epi, and the EMTs probably do not know what a mast cell is.

I think there's a lot of truth to that. I had quite a few medic friends when I worked Law Enforcement, because of that I know many of the limitations of EMTs.

I only ever called for an ambulance for myself or a family member twice, once was after I got shot and the other time was when my wife lost consciousness and turned pink from CO poisoning. The only reason I had the ambulance come come to the house was because I couldn't get the car started after getting my wife out of the house and I couldn't get to a neighbor because I was still in my wheelchair (after getting shot).

Most BLS responders sadly don't have the authority to do important relatively easy tasks to render patient care (obviously very location specific). I truly believe if most people knew-understood the realities of EMS they would be lobbying for more education, more scope of practice, and more compensation for EMS.

It seems to me that most people just assume when the ambulance shows up they're going to be ok. If they knew that there was a decent chance that the equivalent of 2 CNAs were showing up to "treat" them they'd be upset.

After I got shot, all the EMTs were able to do for me was put a compression bandage on me and transport (25 minutes) to the County ER. No pain meds, no "treatment" just pack and ship. Basically because I was relatively stable they just let me lay there and kept an eye on my vitals. Even though I had suffered a very obvious fracture there was no attempt to immobilize, they just asked me not to try to move (throughout a bumpy 25 minute ride). Hell, They couldn't even run code 3 because they were a private ambulance company. I had already bandaged and elevated. I just needed someone to drive me.

I tell people I know about my story and they don't really believe it. Most people assume that the ambulance is like a rolling MD. I really think getting the public education would cause a lot of positive changes for EMS.

 

[daedalus]

I think there's a lot of truth to that. I had quite a few medic friends when I worked Law Enforcement, because of that I know many of the limitations of EMTs.

I only ever called for an ambulance for myself or a family member twice, once was after I got shot and the other time was when my wife lost consciousness and turned pink from CO poisoning. The only reason I had the ambulance come come to the house was because I couldn't get the car started after getting my wife out of the house and I couldn't get to a neighbor because I was still in my wheelchair (after getting shot).

Most BLS responders sadly don't have the authority to do important relatively easy tasks to render patient care (obviously very location specific). I truly believe if most people knew-understood the realities of EMS they would be lobbying for more education, more scope of practice, and more compensation for EMS.

It seems to me that most people just assume when the ambulance shows up they're going to be ok. If they knew that there was a decent chance that the equivalent of 2 CNAs were showing up to "treat" them they'd be upset.

After I got shot, all the EMTs were able to do for me was put a compression bandage on me and transport (25 minutes) to the County ER. No pain meds, no "treatment" just pack and ship. Basically because I was relatively stable they just let me lay there and kept an eye on my vitals. Even though I had suffered a very obvious fracture there was no attempt to immobilize, they just asked me not to try to move (throughout a bumpy 25 minute ride). Hell, They couldn't even run code 3 because they were a private ambulance company. I had already bandaged and elevated. I just needed someone to drive me.

I tell people I know about my story and they don't really believe it. Most people assume that the ambulance is like a rolling MD. I really think getting the public education would cause a lot of positive changes for EMS.

In the county I live in, our ambulance fleet is equipped with 12 lead EKG, EtCO2, CPAP, quality diagnostic equipment, and well trained medics who can divert to various specialty centers. They literally bring the ER to the patient. There is NO comparison between a quality ALS unit and a dual EMT bandage wagon.