PHRN transfer to EMT-P in other states?

[Summit]

I agree with vene. Robb I felt just as you did. I didn't know what the solution would be, but I knew it wasn't coming soon. So, I went to nursing school.

I probably should have tried to emigrate. But, I enjoy what I'm doing now. It is different than EMS in many ways, but the same in many ways... more complex. I still enjoy EMS on the side. As vene said, volley can be a hold back for those who do it primarily, but it can also be an outlet for professionals.

 

[Veneficus]

Which is why Linuss and I are going to start lobbying for increased education standards in EMS, he just doesn't know it yet.

You wouldn't be the first. Nor the last. But unless you have the one thing that is holding it back, you will never have any better results than many great people who have tried and spent their careers and sometimes lives trying to get the same.

Buy-in from the rank and file.

"What's in it for me?" A common question in the US. A far cry from the generations of people, most of the greatest of which are now gone, who asked "How do we make it better for future generations?"

EMTlife is a microcommunity of EMS providers. We surround ourselves with like minded people and since people like that are who we spend the most time with, both here and in our non-online life, we can easily be fooled into believing we are representative of "everybody."

The fact remains, most US EMS professionals, from people who get an EMS cert to get a FD job, To IFT providers just earning a paycheque instead of driving a taxi or working in a factory, to providers who are so in love with their feeble skills thinking they alone hold the key to saving lives, that they tell new people "the book learnin stuff isn't what happens in the field and you are good at the former, you probably can't do the later."

Now medical directors could hold the key to fixing this by flexing their muscle, but the fact is they don't. What is worse, they voluntarily give up this power for things like state wide protocols. (A medical director friend of mine is currently struggling with this. He can't raise the bar higher because the State fixed the bar in 1990)

As I discovered, even being a physician no longer influences EMS practice. Myself and yet another medical director had a conversation on how her medics don't think she has any "street cred" and so they resist all of her efforts to change.

The rank and file no longer even recognize the street cred of docs who are current or former medics like they used to. With every excuse from "You have forgotten what it is like" to "just because you raised yourself doesn't mean the rest of us want to." My favorite: "This is not a job for smart men, it is a job for working men." (A fancy way to say dumb laborer, and it was multiple EMS providers who said it)

They see Fire and EMS as the last bastions of hope for a vocational laborer to have an admired role in the civilian world. It is not that they are incapable, most I have met are extremely capable. But they lack the desire to change from an age of industry to an age of knowledge. It is not the first time in history this has happened. But they constantly drag people who can transition down. What is worse, most of the leadership believes this, and whether it is moral or not, pleasing your leader is how you become a leader yourself, not by making a stand for what's right. That is how you go about needing to look for another job.

I don't see why EMS CAN'T change, it seems like we don't WANT to change.?

Exactly my point.

I love EMS. I would love to spend my career as a single-roll EMS provider and eventually move into a supervisory and/or QA/QI roll. Add in rescue and TEMS and I'd be a happy camper. Unfortunately, unless something drastic changes or I get lucky, that doesn't seem like it's going to be an option without driving myself to the brink of insanity.

Fortunately, there is an easier solution...

http://www.westcorkrapidresponse.ie/pre-hospital-medical-emergency-training/

There has to be a better answer to this problem than "move on". Like I just said, I don't want to move on, I chose this career because I'm passionate about it. I love going to work every day. How many jobs out there allow you to show up, grab 200K plus of gear, then head out into the world and act with near complete autonomy besides going where the radio or CAD terminal tells you? Not many.

Are you passionate about it enough to take yourself to the next level? To move to where you can be what you want?

What's it going to take to change us from a vocation to a profession?

The evolution of US society in the exact opposite direction it is currently taking.

 

[Wheel]

Which is why Linuss and I are going to start lobbying for increased education standards in EMS, he just doesn't know it yet.

I don't see why EMS CAN'T change, it seems like we don't WANT to change. Like Vene said, we have a minority of providers who are actively trying to better themselves and our chosen career path from a vocation to a profession. However, until that minority turns into the majority the ones who are trying to improve don't have a whole lot of options.

I love EMS. I would love to spend my career as a single-roll EMS provider and eventually move into a supervisory and/or QA/QI roll. Add in rescue and TEMS and I'd be a happy camper. Unfortunately, unless something drastic changes or I get lucky, that doesn't seem like it's going to be an option without driving myself to the brink of insanity.

There has to be a better answer to this problem than "move on". Like I just said, I don't want to move on, I chose this career because I'm passionate about it. I love going to work every day. How many jobs out there allow you to show up, grab 200K plus of gear, then head out into the world and act with near complete autonomy besides going where the radio or CAD terminal tells you? Not many. What's it going to take to change us from a vocation to a profession?

I'm struggling with this myself right now. I really love what I do, and I see potential for growth in the profession. I just don't know if there are enough like minded people who will voluntarily finish degrees and lobby for others to do the same to justify reimbursement and to make ourselves relevant.

 

[Tigger]

Apparently there must be some sort of error on the original reply I posted because I could have SWORN I already stated a response to that. Here, let's try again.



The IAFF, other fire unions, and firefighters in general, are trying to keep the bar low as to keep recruitment easy so they can go "Hey we can run ambulances! Give us they money!"



NOT the whole of EMS.

There are no doubt many EMS that want to raise the bar, but it seems shortsighted to fix all the blame on the fire service.

It is not in many for-profit companies best interest to see an increase an education and the subsequent increase in difficulty in recruiting. Eventually more educated providers are going to demand more money. I don't know what will happen first: will EMS providers go out and get more education in expectation for more money or will they be paid to upgrade their education?

I don't think the answer matters to most in for-profit EMS, no matter how they get there, better educated providers will have to be paid more and that hits the bottom line.

 

[Handsome Robb]

Now medical directors could hold the key to fixing this by flexing their muscle, but the fact is they don't. What is worse, they voluntarily give up this power for things like state wide protocols. (A medical director friend of mine is currently struggling with this. He can't raise the bar higher because the State fixed the bar in 1990)

As I discovered, even being a physician no longer influences EMS practice. Myself and yet another medical director had a conversation on how her medics don't think she has any "street cred" and so they resist all of her efforts to change.

The rank and file no longer even recognize the street cred of docs who are current or former medics like they used to. With every excuse from "You have forgotten what it is like" to "just because you raised yourself doesn't mean the rest of us want to." My favorite: "This is not a job for smart men, it is a job for working men." (A fancy way to say dumb laborer, and it was multiple EMS providers who said it)

This is just sad.

I don't necessarily think statewide protocols are a bad thing, provided the physicians creating and overseeing them are progressive and motivated to further EMS, rather than leave us stuck in the 90s like your friend's area is, for example.

I think another thing that would help would be a restructuring of the NREMT. Not saying get rid of it. Quite to the contrary, I believe that if we truly want to further EMS and move towards recognition as a profession rather than a vocation we are going to need consistency at the national level. The 12407813403917428 different EMSAs, counties and states all requiring different things and levels of education across the country isn't the answer. With that said, the way the NREMT is setup now is definitely not the answer. This is definitely something where we could use some help from our nursing healthcare team members in using their system (The NCSBN, National Council of State Boards of Nursing) as a model for unifying our own.

But that is another thread on it's own.

They see Fire and EMS as the last bastions of hope for a vocational laborer to have an admired role in the civilian world. It is not that they are incapable, most I have met are extremely capable. But they lack the desire to change from an age of industry to an age of knowledge. It is not the first time in history this has happened. But they constantly drag people who can transition down. What is worse, most of the leadership believes this, and whether it is moral or not, pleasing your leader is how you become a leader yourself, not by making a stand for what's right. That is how you go about needing to look for another job.

Again sad, but very true.

Fortunately, there is an easier solution...

http://www.westcorkrapidresponse.ie/pre-hospital-medical-emergency-training/

Looks like an awesome setup. Unfortunately I don't live in Ireland and can't volunteer to support myself. Be an awesome side gig though!

Are you passionate about it enough to take yourself to the next level? To move to where you can be what you want?

I like to think so. The question is what is that going to take? There are agencies out there that would absolutely allow me to spend my career in single roll EMS. The problem is the locations of these agencies. Work is extremely important, but I personally think loving where you live is just as important.

The evolution of US society in the exact opposite direction it is currently taking.

Well that's not an answer I wanted to hear

Sorry if this is kinda broken and tough to read.

 

[Shishkabob]

There are no doubt many EMS that want to raise the bar, but it seems shortsighted to fix all the blame on the fire service.

Seeing as how they are 1/3 of the providers of EMS, they have without a doubt the biggest union with the most clout, and the average civilian think most EMS is run out of the FD... I don't. Most surely the majority of the blame can be pinned on them.


People who don't want to do EMS, actually doing 1/3 of EMS and having political sway? Yeah, that's not doing any harm...