Problems with the EMS Training/Education system.

[Guardian]

Stevo, I'm glad you care, thanks for your service (that goes without saying but i'm trying not to look like an A-hole here)

I think I finally grasp you point of view. You think ems is fine the way it is...am I wrong? I think we could improve ems tenfold with increased education requirements and money. The old saying, you get what you pay for is right most of the time. Maybe your volunteer service is great, I know mine is...but, I see a lot of volunteer services that provide sub-par BLS to pts who need ALS and sadly, their communities don't even know they're being short changed.

Have you told that northeastern paramedic graduate the truth yet?...it doesn't matter, she'll find out soon enough on her own. She'll find out that her degree means nothing because all we care about is stupid certifications. She'll find out that she'll make 28k/year just like every other paramedic. She'll see good people leave constantly for "real jobs". Has she announced her plan to become a nurse yet?...only a matter of time. Why are all the "good ones" leaving? Could it be the lack of pay, and professionalism...I think so. If we increase education requirements and pay, then suddenly hobbies and part-time gigs become respectable careers and professions, that's what I want to see happen.

 

[jeepmedic]

Trauma you have to look at who is left. The organial two are still there and are the only two who care about the squad. The rest are there to pump up there ego's for what I do not know they will never leave because they can not run things anywhere else. One of them already proved he could not make it somewhere else. (DOOOOOh Doooooh dumb.) I think we know who this is.

But you are right they have ran off the best now they are stuck with the rest.

 

[Guardian]

Well... here goes my two cents worth, and I guess it will get me in trouble, but here goes.

The agancy where I spent many years as a volly before I bacame paid made a big mistake. Maybe this is not related directly to the education thing, but it is related to the volly thing.

That agency when I first went there only had two paid providers, Mon-Fri, 8-5. They were EMT-CT's if I remember correctly. One may have been a shock trauma at the time. At the time, we had approx. 100 members, who were actively pulling thier volunteer duty shifts. We had more volunteer ALS providers than any other volunteer agancy in the state. They were very picky as to who became members, and they had that right at the time.

The membership came up with this bright idea of hiring 24/7 staffing. They called it the "career support staff". They were to be there to run calls when the volly's were tied up, or when the BLS trucks needed ALS. We put on a 24/48 scheduled staff. And our problems were born, and that squad made in my opinion the biggest mistake of thier time. Our volunteer members started slacking off, because the career staff were there and being paid to run calls, and they were not. Some, not all of the career staff, got egos. It has evolved to a 24/72 schedule now, and they don't just have 2 paid on a shift, they now have 3. They have lost almost all of the original members, with the exception of about 3 or 4. The career staff is running the squad now, and volly's no longer are appreciated. They got more calls covered before they went to this system. They had better turn outs for squad functions, and our meetings were always full and running over. There was respect there for eachother and the senior members. If you were a rookie, you knew it. You did not do anything without permision from your shift leader. There was quality there when it was volly based.

I said all that to say this. I think where we had our down fall is when we tried to get fancy and have a full paid staff. Although I work now for a squad who is going to the 24/7 paid coverage, I don't like to see it, even if it means job security for me. It has taken one of the best, and biggest squads in our state down and down fast. Now, no one respects that squad anymore. Since they went all paid, they have ran off more good providers than they will ever see.

That is my opinion.

No, Fedmedic, not all of the career support staff was bad. It mainly got bad after the initial group started going thier seperate ways.

Interesting, why did you'll try and get fancy in the first place, was it because you'll couldn't staff your units with enough ALS providers? I have a friend who is a member of the Charlottesville Rescue Squad in Virginia and they're one of the best volunteer agencies I've ever seen, maybe they could give you'll some advice. I agree that mixing career and volunteer should be avoided but it sounds like you'll probably didn't have any choice.

 

[jeepmedic]

Steveo I am not going to slam volunteers I am one. I am the EMS Capt. for my local Volunteer Fire and EMS. So I know how valuable the volunteers are. We have a contract service that runs calls that are not covered in our County. To date we have not turned over any calls. This includes the Frenquent Flyers or the major Trauma calls. But I continue to see reports that state "C/O stomach pain. took vitals, transported to hospital." and this is on a 15 to 20 transport time. Then they only have one set of vitals on a Pt that they have been with for over 30 min. This is the things that I think need to change and the only way you do this is by education.

 

[trainSTAT]

A little off topic but I have to say it... In response to JeepMedics earlier question to me about the acceptance of our courses in Virginia. Our featured course about how to respond to a RDD incident is one that I think is of critical need in our field. That being said, if anyone in VA want to take it I will discount the course cost by 50% for them since there is no guarantee the CEU's will be accepted.

Contact me at robert@trainstat.com if interested.

Oh and my 2 cents on the whole volly issue. I left EMS as a full time gig because there was not much of a career (AKA money) in it. I still keep my certification current and if I ever get some free time I'll go back to volly'ing. Otherwise, my contribution will be to help change the way we learn - be part of that education that might help support higher pay in the long run.

 

[Ridryder911]

I found this on another EMS forum on the same topic at hand, interesting analogy......

"Here is a tidbit for y'all to keep in mind.

Whenever you say, "I can do everything that a blank (Intermediate, Paramedic, RN, MD, etc) can except for (or but)" basically you are saying you are something that you are not.

It is a disclaimer in an attempt to garner credibility and respect. If you want to be the something you are trying to equal yourself to, then go to school. Otherwise, don't try to convince the rest of the world that you are something that you are not.

For example, if you are an EMT-CC or CRT that can utilize 90% of the skillset of a Paramedic with only 50% of the education, who would you rather have treat you or your family?

You can train any lay person to start an I.V, intubate, decompress a chest or give any plethora of medications (training) versus teaching that person the who, what, where, when, why and how to come to the decision to do it (education).

These are examples of why EMS is at the crossroads that it is"......

(thanks Keveki)


R/r 911

 

[Stevo]

Have you told that northeastern paramedic graduate the truth yet?...it doesn't matter, she'll find out soon enough on her own. She'll find out that her degree means nothing because all we care about is stupid certifications. She'll find out that she'll make 28k/year just like every other paramedic. She'll see good people leave constantly for "real jobs". Has she announced her plan to become a nurse yet?...only a matter of time. Why are all the "good ones" leaving? Could it be the lack of pay, and professionalism...I think so. If we increase education requirements and pay, then suddenly hobbies and part-time gigs become respectable careers and professions, that's what I want to see happen.

She's just a kid, smart and dedicated, and yeah she'll not make diddley around here. I haven't the heart to tell her she's city bound to make a living at it Guardian

IMHO, if anyone attends a university for a year, they have the right to seek professional accomodations.

however, it is arguable to assume the same status for anyone with a couple hundred hours of training, don't you think?

Whenever you say, "I can do everything that a blank (Intermediate, Paramedic, RN, MD, etc) can except for (or but)" basically you are saying you are something that you are not.

It is a disclaimer in an attempt to garner credibility and respect. If you want to be the something you are trying to equal yourself to, then go to school. Otherwise, don't try to convince the rest of the world that you are something that you are not.

i can recall when my state had only 6 emt-p's Ryder the fact that we have many more now, and any level of als intercept is due to a grass roots outcry.

in fact, we worked at the district level here for over 2 years to get an als int. stationed at the hospital. it was trashed by the nurses union because they didn't like medic's 'stealing their work' hanging out in the e.r. bettween calls

the hospital administrators backed right down, the state balked, and it died after 2 friggin' years of emt's in the field voicing advocacy.

so your point is greatly misleading if you think emt's do not recognize and/or do not wish for advanced care. One can not be in this biz for very long without being confronted with this reality.

meanwhile, we have had it up to our eyebrows with unfunded federal mandates taking up our time and patience while we are trying so hard to tow the line.

we wish to evolve, as any good ems does. but we wish to evolve on our own terms and at a rate that does not alienate the good folk we already have.

leaving us at the mercy of beauracrats has already produced enough detrimental effects for us to dismiss them as not living the reality we do every day

~S~

 

[trauma1534]

Interesting, why did you'll try and get fancy in the first place, was it because you'll couldn't staff your units with enough ALS providers? I have a friend who is a member of the Charlottesville Rescue Squad in Virginia and they're one of the best volunteer agencies I've ever seen, maybe they could give you'll some advice. I agree that mixing career and volunteer should be avoided but it sounds like you'll probably didn't have any choice.

Let me clarify something. We went to 24/7 paid staff as I recall, because the Board at the time wanted to keep up with the changes in EMS, and they wanted to be bigger and better than the other squads around by having a paid staff on full time. It was not the fact that we could not cover our calls. And as far as ALS volunteer converage, the quality of providers we had at that time was nothing less than the very best. They just thought it was a cool thing to do at the time. Made us look good. You would have to know these people to understand. They didn't realize that they were literally cutting thier nose off to spite thier face.

As I said before, it was ment to be "career support" staff. In other words, they were there IF we needed them. Fedmedic could shed better light on it as he was one of the first career support employees that they hired. They were not there for first calls, atleast that was not the original plan in hireing them.

As far as Charolettsville RS giving us advice, yes, maybe now, they could try to give that squad advice, but they wouldn't listen. I'm sure that at the time before all these changes took place, they might could have learned a thing or two from us.

 

[trauma1534]

Guardian, I'm curious. How long have you been in EMS? What level of training are you? What type angecy do you work for? Are you paid or a volly? Just wondering.

 

[Fedmedic]

Ok, I am going to try to explain this without getting too long winded.
I was a volunteer at this agency that had more good volunteer ALS providers than probably any other agency in the state. We actually needed the 9-5 providers paid because it was hard to find volunteer ALS providers that were available during the day. But we could put 2-3 volunteer ALS trucks on the road easily any other time. Which was a good amount of trucks for our call volume. Then the board decided it was a good time to progress as an agency and move to 24/7 coverage. So they hired a full compliment of ALS providers that were there to support the volunteer staff, (i.e. when no other ALS truck was available). It turned into the career staff would run the "good calls" because they were career and leave the "crap"calls to the volunteers. The career staff started running the place and ran off almost all of the volunteers. Now they can only put one truck on the road most of the time, and if a second call comes in one of the local volunteer firefighters will come pick up a truck and hope some sort of provider will meet them on the scene. That agency has ran away more good ALS providers than most agencies in this state have ever had. I can attest to this. And yes, I started out as a volley with that agency and went to career staff, and yes I got the big head, the problem was the agency wasn't paying any money or have any benefits as compared to any 3rd service agencies across the state line. So I went to a large agency, running 20 calls a shift in an urban setting(paramedic boot camp) and my big head went away. I went in working with 20 year paramedics running 20 calls a shift, I didn't have anything to say they wanted to hear. That is when I became humbled. I am now a much better paramedic. But that agency is another story. I hope this helped Trauma1534.

 

[Stevo]

i was also a call man on a full/volly dept a while ago Fedmedic, and we had a chief that wasn't exactly a people person. In fact he imposed a number of standards that washed out quite a few callmen, and alienated many others. (i held my ground)

next thing we know, there's ad's in the papers for call men. so instead of accomodating and maintaining what they had, they became a revolving door.

much of this was the animosity the chief himself imposed, when he further tried to play politician he was summarily ousted.

imho, whatever is imposed for education and/or other standards can not affect the simple formula of supply/demand , or people go without

now let me tell you about my main gig. i'm a master electrician with an inspectors certification, attachment licenses, etc etc. My trade fought for standards , continued ed, licensure, etc for decades.

we took it to levels these days that years ago many in the trades would have given their eye teeth to realize.

along that ride we gained more perephrial orginizations than dones has pills, all of whom were vieing for position and power.

so.....

anyone here want to call an electrician this time of year for a minor problem, and see what you get?

i'm sure most of you grasp the anology i'm trying to make, it just won't work for ems if we go the same route

health care is a basic human right my friends, unfortunatley we are living in a country where capatalism is for the poor, while socialism is reserved for the rich, and this is not so...

~S~