Really getting discouraged...

[reaper]

Problem there!

When that post was done you had 3 of 14 replies were from medics at the time. That is not a lot of consensus on the subject.

It all depends on the person. Personally I don't think you even need EMT before Paramedic. But until the education catches up with the rest of the health field, we are stuck with it.

 

[firetender]

The only people I have ever heard say "you need experience as an EMT before paramedic school" have all been EMT's. I have never heard a medic say this. .

You've not been paying attention to me and a lotta other medics

 

[firetender]

None, but I think what he was meaning is that he wants it to be like second nature to us... to do over and over again so it's going to be easy for us. I guess I can't really explain what he meant to you but I do understand it.

Two words; Scene Management, for starters AFTER you learn how to be with people in need

Too many people minimize the complexities of handling humans and scenes.

But that argument is puking all over this site. I say, if you can't find an EMT job go to the degreed school and then when you run into the real world we'll help teach you how to think like an EMT!

 

[firetender]

Modern day paramedicne is not about skills. It is about knowledge. .

EMT means supporting knowledge with skills; in effect, establishing a foundation from which knowledge is applied.

(the neverending debate!)

 

[MonkeySquasher]

But aside from that little anecdote, go back to the volunteering scenario. What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?

Because they actually lose financially, McDs takes customer service a lot more serious than most EMS or IFT agencies. They actually put you through customer service training. (So does Wendy's for that matter.) So now the McDs grill cook has more customer service training than many EMS providers.

Well, does the person who works at McDonald's have to deal with a critically ill or injured person?

It'd be terrible for a person to take EMT-B then immediately go into Paramedic school only to find out two years later that he or she can't stand the sight of blood and guts. If that person had gotten some experience as an EMT-B first, he or she might not have wasted two years and several thousand dollars.

I believe you both raise very valid points, among other people.

It's true, while EMS is strongly customer service-driven, we are not properly trained to actually serve the patient's needs, only support them medically. As firetender stated later, dealing with humans and keeping order during chaos are the two "basic" skills that a person must know before becoming a fulltime EMT, let alone a Paramedic. The two key things that make a good Medic (or EMT) are being able to deal with things (see above) and solid assessment techniques with knowledge base to back it up. All of the skills we perform could be taught to monkeys. But ABCs, A+P, Pathophys, immunology, and formation of a good DDx are what separate Paramedics from everyone else.

I actually think Basic classes don't screen enough. My fire company CICs the EMT-B class twice a year. Starting in January, they're requiring proven competency of math/reading/english at a high school/GED level. My Medic class requires a college-level math and english class, and some form of prior experience. Though they've waive the "prior experience in EMS" a few times, I've seen what that can produce. "prior experience" is a relative term, as Vene points out. I can think of a few EMT-Bs at my fire company... They've been EMT-Bs for atleast 2 years. They go on a good number of calls. There's almost always a higher level of care, they're NEVER in charge of patient care, and rarely do anything other than ask about allergies, ask for patient info, and maybe do a set of vitals. They know nothing, but technically "have 2 years experience". As JJR touched on, the turnover rate of EMT/Medics within 1 years is pretty high, and even higher within 5 years, due to people finding it wasn't what they thought it would be.

I have to side with Vene also, that outside of the experience dealing with people and chaos and keeping a level head, everything else can/should be taught in the class. My Medic class teaches us everything from the ground up and assumes nothing... We're re-taught CPR, Med/Trauma assessments, re-taught immobilization and KEDs and everything else possible. Because the instructors want to be sure we're all being taught the correct way, and all on the same page. And I gotta say, I enjoy it.

 

[emsfire3924]

Wow this has spun way off track from me posting I couldn't find a job lol.
Just wanted to update this... A couple days after I posted this I got a job!

 

[Veneficus]

"Experience is a fine teacher, but only a fool can learn from no other."
--(not really sure who said it)

I didn't go right to paramedic school, it took me a few years to decide I wanted to after becomming an EMT. What I discovered was that I would have been better served myself, and would have better served my patients, had I gone straight to paramedic school.

I have also taught medic school for 7 years before I became too busy with other pursuits. In my direct observation, when EMT education was downgraded to a skills based class and medic was upgraded with at least a rudementary basic science component, the things you could learn as an EMT were nullified.

Even when dealing with people, the more knowledge you have, the better you can relate to them, or give them the assurance or information they need. Knowledge imparts some level of confidence.

Learning how to handle a scene is not something you should get by trial and error, it is a critical skill that needs to be imparted by effective an capable leadership. By capable mentors. Unfortunately even the best EMS systems because of the independant nature of EMS are not very capable at imparting this critical skill. If you really and truly are determined to learn it, the fire service, law enforcement, and the military are much better places.

Dealing with people requires empathy. There are several psychological theories detailing that certain people are predisposed personality types. But I don't think many are predetermined to fail, they just have to work harder than those predisposed to succeed.

Like any social skill, you get better at it by interacting with people. If you are at any service with a low call volume, your interactions are limited. Worse still they are reinforced by a very small peer group. It is not conducive to gaining a braod understanding, acceptance, and ability with people.

We present a great deal of proof positive experience, even I am part of it, but the perspective I offer on this topic is from the point of view of "if I could go back then and know what I know now."

In truth if I was asked this question 15 years ago if you should go right to medic school, I would have said "no, get experience as an EMT first." But I was lucky, my EMT experience was strongly positive and not by my planning. Never rely on luck.

I have seen EMS practiconers of all levels with more than a decade of experience in EMS park trucks in flammable spill puddles at MVAs. Box themselves in at mass casualty events, and even cut off all means of egress from potentially hazardous scenes. Not because they weren't smart or experienced, but because nobody ever taught them to recognize these things.

"Poor is the student who does not exceed his master."
--Leonardo Da Vinci

 

[MonkeySquasher]

I have seen EMS practiconers of all levels with more than a decade of experience in EMS park trucks in flammable spill puddles at MVAs. Box themselves in at mass casualty events, and even cut off all means of egress from potentially hazardous scenes.

....you're not by any chance from my area, are you.... Haha

 

[CAOX3]

Fuuny, when I was thinking of going to paramedic school a few years back, I went for the interview. I asked do you need my transcripts for my Anatomy and Physiology credits, they said oh you dont need that.

Hmmm.... it was a pre-req for my EMT class

 

[Veneficus]

Fuuny, when I was thinking of going to paramedic school a few years back, I went for the interview. I asked do you need my transcripts for my Anatomy and Physiology credits, they said oh you dont need that.

Hmmm.... it was a pre-req for my EMT class

are you suggesting the DOT curriculum requires that or that requiring A&P is a majority of cases in EMT programs around the nation?

 

[MrBrown]

One of the appendicies in the DOT Paramedic cirricula lists a whole bunch of A&P objectives which seem quite reasonable .... I bet dollars to donuts that no Paramedic program teaches them tho.

 

[Veneficus]

One of the appendicies in the DOT Paramedic cirricula lists a whole bunch of A&P objectives which seem quite reasonable .... I bet dollars to donuts that no Paramedic program teaches them tho.

I was referring to the EMT basic curriclum.

The objecties of most of the paramedic curriculum are not really taught, they are simply bullet points given for memorization.

One of the largest problems is who is teaching US EMS, usually people with no more education than paramedic class offers + 5 years experience in many places.

I have met and worked with instructors who never spent a day in a basic science class.

 

[MonkeySquasher]

I was referring to the EMT basic curriclum.

The objecties of most of the paramedic curriculum are not really taught, they are simply bullet points given for memorization.

One of the largest problems is who is teaching US EMS, usually people with no more education than paramedic class offers + 5 years experience in many places.

I have met and worked with instructors who never spent a day in a basic science class.

Yeah, that's why I love my instructor. Has a BS and was actually in Med school 2 years until he realized he would rather work in the streets and teach. He's very knowledge-oriented and we actually have PAs and MD/DOs help in lab instruction. And we actually follow the "expanded scope" portions of DOT curriculum, which I actually enjoy. Almost makes me want a personal otoscope for my rig. Haha

 

[Medicnextdoor]

Why?

Before you go to all of the expense, try to find out "why" you aren't getting the job. If there is a bd job reference, bad credit reference, arrest record - you know what I mean.

A good EMT with a good employment record (it doesn't have to be in EMS) should be able to get a bite....