Staying at emt level

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arctic2

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I've noticed there are a few people who stay at the emt basic level for years. I worked with an emt who has been an emt basic for 20 years. I'm just curious as to why some people are content with staying at the emt level? There's nothing wrong with it in my eyes. It just looks like everybody works as an emt for a year and jumps into medic school or jumps into medic school right after emt.
 
It's traditionally a pretty low paying, entry-level job. Many people who are drawn to EMS are Type A personalities. Those people, by nature, want to do more and lead the scene. That's not something you can normally do as an EMT basic. If you want to learn more and do more, it's a natural progression to move to paramedic school after working as an EMT.

I also know people who have been EMTs for 20 years, and are entirely content to stay at that level of care.

I think it is also system dependent. If you work for a BLS transport agency, such as one of the fire departments in Sussex County Delaware, there's no reason to become a paramedic. You make 20 bucks an hour and drive the ambulance. Good work if you can get it.
 
I worked with a very classy, smart paramedic who was on the tail end of his career...approaching retirement as in 5 years or less to go. With already 20 years in service and several years volunteer prior to that, he let his paramedic lapse and reacquired his EMT. He spent his last few years on the job very happy with very low stress...started on happy note, ended on happy note. :)
 
Some systems make it pretty easy to do this -- look at Boston EMS, they have EMT-level officers. FDNY used to have something similar, too, I think?
 
As said before, I think it depends on the system, around here the city fire requires you to get your medic within 3 years of getting hired, if not then you gotta show yourself out. County fire requires you to get your medic to be promoted to driver/engineer.
 
pogoemt said:
As said before, I think it depends on the system, around here the city fire requires you to get your medic within 3 years of getting hired, if not then you gotta show yourself out. County fire requires you to get your medic to be promoted to driver/engineer.
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That has to be one of the most misguided promotional requirements I've ever seen.
 
DEmedic said:
That has to be one of the most misguided promotional requirements I've ever seen.
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I think the reason they do it is because fire is the dedicated ALS provider in our area and it encourages ff's to get their medic.
 
As many have pointed out, it all really depends in the area you work for. For example in Los Angeles county it makes perfect sense to get your paramedic if your a firefighter or plan on going with a FD than getting it for a private ambulance that isnt the sole 911 als provider. I have been a EMT for the past 3 years and will be at that same level of care until me and my wife have enough saved up that i can go part time and go to medic school without any children. Besides i would like to have a lot of experience under my belt and master my skills. Some EMTs go to medic school after 6 months being new to the field and some wait 20 years to get their nursing degree. It all depends if life allows you to and what you enjoy the most.
 
I've met a few of these EMT's out there. Simply put, they are amazing people who know how to help us newer EMTs.
 
I personally thought I would go to Medic school a year or so after completing my EMT-B but I've found I want to specialize in Behavioral Health and have decided to get my BA in Addiction Studies along with my EMT-B. My partner is finishing up her Law Enforcement degree and EMT-B. She is also staying at the EMT-B level and getting her BA is Law Enforcement/Criminal Justice.

I really just think it depends on you personally. Is staying an EMT for 30 years bad? Of course not. Is going to Medic school right away bad? Not at all. It all depends on you.
 
Interestingly, the pay difference isn't huge between Primary Care Paramedics (PCP), our BLS and Advanced Care Paramedics (ACP) our ALS. As a result many medics here stay BLS throughout their careers. My service pays for ACP and I'm entering the upcoming class where with only 8years on the job I'll have one of the highest seniorities. People settle down, have families and don't always have the time (or if work isn't paying for it the money) to commit to another year. Certainly it's more common for those looking to advance to also have gone ALS but it's not a prequisite.
 
WolfmanHarris said:
Interestingly, the pay difference isn't huge between Primary Care Paramedics (PCP), our BLS and Advanced Care Paramedics (ACP) our ALS. As a result many medics here stay BLS throughout their careers. My service pays for ACP and I'm entering the upcoming class where with only 8years on the job I'll have one of the highest seniorities. People settle down, have families and don't always have the time (or if work isn't paying for it the money) to commit to another year. Certainly it's more common for those looking to advance to also have gone ALS but it's not a prequisite.
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Do services get reimbursed more for ALS transports in your neck of the woods?
 
EpiEMS said:
Do services get reimbursed more for ALS transports in your neck of the woods?
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No reimbursement: Ontario. We're funded entirely from the public purse. 50% of operational expenses come from the province, 50% from the Upper Tier Municipality (County, Region or City). Capital expenses come from the municipality though province may provide grants. A $45 co-pay is collected for all transports but this goes back to the provinces general treasury not the service. Almost all services are municipal 3rd but a couple are contracted out.
 
WolfmanHarris said:
Interestingly, the pay difference isn't huge between Primary Care Paramedics (PCP), our BLS and Advanced Care Paramedics (ACP) our ALS. As a result many medics here stay BLS throughout their careers. My service pays for ACP and I'm entering the upcoming class where with only 8years on the job I'll have one of the highest seniorities. People settle down, have families and don't always have the time (or if work isn't paying for it the money) to commit to another year. Certainly it's more common for those looking to advance to also have gone ALS but it's not a prequisite.
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What is the difference in the scope of practice between a Primary care paramedic and a advanced care paramedic? Not familiar with Canada's EMS
 
WolfmanHarris said:
No reimbursement: Ontario. We're funded entirely from the public purse. 50% of operational expenses come from the province, 50% from the Upper Tier Municipality (County, Region or City). Capital expenses come from the municipality though province may provide grants. A $45 co-pay is collected for all transports but this goes back to the provinces general treasury not the service. Almost all services are municipal 3rd but a couple are contracted out.
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Makes sense given a national healthcare system. So, what if the patient, in the clinician's opinion, does not need EMS transport? Can you guys initiate refusals?

FFPRN16 said:
What is the difference in the scope of practice between a Primary care paramedic and a advanced care paramedic? Not familiar with Canada's EMS
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High level, my understanding is that the Canadian PCP (who will have a lot more education - 2 years, in most provinces), typically has the same or similar scope to the National Scope of Practice Model AEMT, while the ACP is closer to the U.S.'s Paramedic scope of practice (per the same model). However, this differs by province. Here's Toronto's EMS website for an example scope of practice. For an additional reference, here's the Paramedic Association of Canada's scope of practice model.
 
EpiEMS said:
Makes sense given a national healthcare system. So, what if the patient, in the clinician's opinion, does not need EMS transport? Can you guys initiate refusals?
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Nope. Despite education standards Ontario is only just starting to change our regulatory framework to reflect the reality of
911. Soon we should start to see assess treat and refer programs (treat and release) and transport to alternate destinations (including non-transport w/ referral to walk-in or urgent care).

Right now my service is in Phase 1 of a multi-phase 5+ year research project that will explore this. Current phase is to track all EMS patients through their hospital stay and discharge to develop a clear picture of what happens with our patients after offload and develop predictive criteria for which patients are likely to benefit for alternative pathways to care.

In this area the province of Alberta is at the head of the pack. I especially want to highlight their assess treat and refer program for palliative and end of life patients. It's a phenomenal, collaborative, compassionate program. I don't have the detailed documents available on my phone but here's a pamphlet and a Google search should find some of the directives. https://myhealth.alberta.ca/HealthTopics/Palliative-Care/Documents/peolc-ems-atr-brochure-final.pdf

Alberta is also doing assess treat and refer for stable SVT that converts w/o complications and a few others.

For scope of practice the links above pretty much cover it with the exception that Toronto does things differently since they rolled out the first ALS in Ontario back in the 70's. Nowhere else has Lvl 2.

Scope doesn't tell the whole story though. While there are differences in drugs/interventions between a PCP and ACP the education is such that they're speaking the same language.
 
Really interesting stuff! Canada's system clearly has some advantages over ours (much as I'm loathe to admit it ;)).
 
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