Steps in Professionalizing EMS

[ExpatMedic0]

AAS degree similar to a 4 year degree? Not even close.

Everyone I know who has completed the AAS for Paramedic in Oregon has taken around 3 years to do so. It does require A&P 1,2 and 3, plus your paramedic program and all the other college classes the RN's take. Of course a 4 year degree is more education... but I think compared to some other country's standards for a bachelors it might be runner up.

So far only Oregon and maybe one other midwest state requires a 2 year degree. I believe you also stated Oregon still allows you to practice as a probationary Paramedic until you finish your degree. If that is the case then the two year degree is not even required for entry. There are also 48 other states that have an entry education of 600 - 1000 hours of training with no college education required with many FDs and ambulance services doing their own training without being accredited by CoAEMSP.

On the contrast other parts of the U.S. only require 600 hours of training. So it really just depends on your state... To judge the entire country is not accurate

Oregon allows some current Paramedics who file reciprocity the ability to complete there AAS within 1 to 2 years after being hired. If you do not complete it in that time frame your cert gets yanked. Also Its no easy task for someone, there is a lot of red tape and you supervisor physician has to write you a letter of recommendation.

The U.S. also has over 50 different EMS "certs" and some states use different names for "Paramedic". Different states also use different certifying exams. We have the most fragmented EMS education of any civilized country in the world.

As stated on the international EMS board from a UK professor. If you want to see the best EMS system in the world go to the U.S. If you want to see the worst EMS system go to the U.S.

We also have very few requirements when it comes to education for instructors in EMS here in the U.S. which gives us the minimually educated and trained teaching those who have slightly less education and training.

I would hope that the Paramedics in your state have the Associates as required for Oregon and not all have given an IOU to the state promising to get the degree. Those that have Bachelors may also not have the degree in anything EMS. As well, other healthcare professions are already requiring a degree higher in their discipline since they believe their 2 year degree entry is rather pathetic. That includes the RN and the RRT.

We pump out RT's and RN's from community colleges with equal to or less education than our Paramedics around Portland. They go strait to work doing the same thing as there counterparts with bachelors with around the same pay.

Your state is also not that large. However, the stats on your success rates have not be widely published yet if at all. Other states have had varying success with RSI since intubation rates in some parts of the U.S. suck to where that skill is going to the wayside for alternative airways such as the King or Combitube. Other areas have totally eliminated pedi intubation.

I wouldn't brag about all the systems here in the U.S. that just have "skills" and very little education to back up the why and hows especially in a country where many of the providers argue against education. You yourself agrued against it in your earlier posts and thought it was stupid for Oregon to make you get a degree.

To claim that I argue against education is incorrect. I am frustrated with aspects of the OREGON 2 year degree for Paramedics. Some reasons I am frustrated about it relate to many things.
1. I was working on completing an accredited AAS for paramedics from another state, Oregon is throwing a hissy fit about it because its similar to the majority of other states AAS programs for Paramedics and "not like Oregon" which requires 3 years to complete for a 2 year degree. If they want so much more education than most other states AAS programs then they should just require a bachelors or lower there AAS standards IMO.
Its also frustrating to know I can work across the river in Washington with the same scope, no degree at all and make the same rate of pay. Its equally frustrating to see Oregon has had this degree for 10 years and we still make significantly less than RN's and others from the same community colleges with same degree. The other flaw in Oregon degree program is that they will accept a bachelors in any field from anyone... I could complete a bachelors degree from phoenix online in underwater basket weaving and they will accept it.

What about you vent, why do you not have a bachelors in EMS if your a paramedic supporting more education. Or if your a healthcare provider so hell bent on the subject why do you not have your M.D. or at least PA? You do claim to have what appears to be close to as much time in college as a M.D. yet your still an allied health care provider with the same scope of practice and job as the rest that went to community college.

 

[MrBrown]

Degree Paramedics are a good idea, they are the way of the future ..... however I do have my concerns about the Paramedic degree program when in this part of the world they are new idea, and the old "vocational" training programs are not that long dead.

The old vocational training schools were run by the ambulance services for thier Officers who were employees; as such they were expected to turn up to class and be in a fit and proper state to undertake and pass the required education, it was an employment requirement.

Students on the degree are not subject to the same level of standard; I know at one point a "pass" on the Ambulance Service of New South Wales' training program was 90% or above, I believe ours was 80%. Nursing students and airline transport pilot students (both groups I have experience with) are (by virtue of thier professional bodies, the nursing council and civil aviation authority respectively) are expected to attend 85% of classes and have "pass" minima of 80%. Paramedic students can get away with standard academic rigor of turn up whenever you feel like it and 50% pass is acceptable, although this may vary from program to program.

Clinical exposure of a Degree program may vary considerably and often pales whem compared to the old vocational program where Ambulance Officers' were on the road full time for X weeks then rotated back into school for Y weeks for a period of Z - generally two years to become a qualified Officer. It is a common complaint that students do not get adequate road time to consolidate thier knowledge and skills, but this is what the graduate year is for I spoze.

I also have a severe problem with the mismatch that exists between the University and the Ambulance models of selection and testing. The University system looks at your capability academically while much less emphasis is placed upon this by the Ambulance Service who looks for your non-acaedmic traits like experience, maturity, problem solving which are arguably more important than how much you know out of a book. I have said it before and I will say it agian; you can teach cardiology and V/Q mismatch but you cannot teach maturity and how to talk to people when they are spinning out, seeing deamons because they are on PCP and waving a sword at you. I do not believe some of these 19 year old Paramedic students are in any way suitable for the harsh realities of being on the road and a constant complaint of Paramedic degree administrators is the lack of maturity some of the students have.

That said I am for a Paramedic Bachelors Degree as the minimum entry-to-practice standard and it is becoming increasingly common around the world outside of North America however I do have problems with the way it's been setup and administered. Perhaps we need to move the pendilum a little more back toward an on-the-job system which has proper academic rigor and awards a Degree.

 

[JPINFV]

Students on the degree are not subject to the same level of standard; I know at one point a "pass" on the Ambulance Service of New South Wales' training program was 90% or above, I believe ours was 80%. Nursing students and airline transport pilot students (both groups I have experience with) are (by virtue of thier professional bodies, the nursing council and civil aviation authority respectively) are expected to attend 85% of classes and have "pass" minima of 80%. Paramedic students can get away with standard academic rigor of turn up whenever you feel like it and 50% pass is acceptable, although this may vary from program to program.

A 50% threshold is unacceptable, however if proper educational support tools are provided, then I don't really care how often students show up for lectures (attendance to lab/skills sessions, however, is important). Most medical students, for example, get away with showing up to lectures when ever we feel like it. Of course most medical schools also provide note packets and, at a minimum, audio record lectures (my school has a program that sychs up audio, video, and what ever is being displayed automatically and automatically posts the file to the student portal). Obtaining knowledge is more important than the vehicle through which said knowledge is provided. Also, some professors are just plain terrible teachers where the time in class would be much better spent studying.

 

[MrBrown]

A 50% threshold is unacceptable, however if proper educational support tools are provided, then I don't really care how often students show up for lectures (attendance to lab/skills sessions, however, is important). Most medical students, for example, get away with showing up to lectures when ever we feel like it. Of course most medical schools also provide note packets and, at a minimum, audio record lectures (my school has a program that sychs up audio, video, and what ever is being displayed automatically and automatically posts the file to the student portal). Obtaining knowledge is more important than the vehicle through which said knowledge is provided. Also, some professors are just plain terrible teachers where the time in class would be much better spent studying.

You are correct, some do not learn well in classroom situations and I know that for some classes I simply never went and got high grades because I studied on my own.

 

[ExpatMedic0]

"Modern" EMS at the ALS level is still fairly new as a career compared to many other health care professions I believe? I met a guy who claimed to be in the first class of trained paramedics back in the 70's or whenever. The sad thing was if he was telling the truth, he did not make enough to retire :-(

 

[VentMedic]

Everyone I know who has completed the AAS for Paramedic in Oregon has taken around 3 years to do so. It does require A&P 1,2 and 3, plus your paramedic program and all the other college classes the RN's take. Of course a 4 year degree is more education... but I think compared to some other country's standards for a bachelors it might be runner up.

Look at the description of an AAS degree versus a Bachelors degree and not how long it took you to complete an AAS degree.

Oregon allows some current Paramedics who file reciprocity the ability to complete there AAS within 1 to 2 years after being hired. If you do not complete it in that time frame your cert gets yanked. Also Its no easy task for someone, there is a lot of red tape and you supervisor physician has to write you a letter of recommendation.

Yet other professions know what their minimum entry is before applying for a license.

As stated on the international EMS board from a UK professor. If you want to see the best EMS system in the world go to the U.S. If you want to see the worst EMS system go to the U.S.

I was not talking about individual systems but rather the fragmentation of the U.S. EMS system as a whole.

We pump out RT's and RN's from community colleges with equal to or less education than our Paramedics around Portland. They go strait to work doing the same thing as there counterparts with bachelors with around the same pay.

Do you not realize that RTs and RNs have a nationally known minimum for entry? They can not have a degree less than an Associates? However, employers can set their hiring standards higher. It often doesn't matter about the pay but the best qualified with adequate education. Did you know that many, many other professions require no less than a Bachelors and that includes health care and business? Why should EMS and nursing be the least educated?

What about you vent, why do you not have a bachelors in EMS if your a paramedic supporting more education. Or if your a healthcare provider so hell bent on the subject why do you not have your M.D. or at least PA? You do claim to have what appears to be close to as much time in college as a M.D. yet your still an allied health care provider with the same scope of practice and job as the rest that went to community college.

Very simple. At the time I was getting my degree in EMS, the Bachelors for EMS was barely heard of but even in the 1970s some of us did make it a point to get at least an Associates. The Bachelors in Cardiopulmonary Science gave me a great clinical edge that also benefited my goals in EMS as it pertained to critical transport and Flight. A PA degree would also not have gotten me a job in the NICU. Of course, the NP would have been a great choice with a doctorate if I had gone the nursing route.

I think the debate has always been that higher education is only for managers and nonclinicians. I am proof that people who do patient care can have higher education. But then Physical Therapists and soon NPs will need a doctorate. Other allied health professions do want the Masters. Lab personnel in hospital labs and research facilities have Masters. Have you never looked at other healthcare professions to see what is required of them before you jump to some conclusion? Do you also realize that educators for other professions require a Masters minimum?

 

[VentMedic]

"Modern" EMS at the ALS level is still fairly new as a career compared to many other health care professions I believe? I met a guy who claimed to be in the first class of trained paramedics back in the 70's or whenever. The sad thing was if he was telling the truth, he did not make enough to retire :-(

Actually the first trained class was in the 1960s. Freedom House was the first trained modern ALS ambulance service but because that was during times of racial tensions, they have never been acknowledged properly. EMS is one of the older allied health professions and has been around for over 40 years.

By the mid 70s some states already had the 2 year degree in EMS established and were graduating educated Paramedic which was a good thing considering the scope of practice and skills we did back then. However, greed and ignorance kept that from becoming the minimum entry level education.

 

[MrBrown]

Some systems choose to operate all ALS however this is not accepted industry standard.

In this part of the world the health professions legislative framework will soon recognise two levels: Paramedic and Intensive Care Paramedic. This will in time, become the standard just like nurse and nurse practitioner, registrar and consultant (resident and attending) etc

That does not mean we will operate an "all ALS" system but that we will come online with other professions who have a common base entry level and then one or more sub-specalties, in ambo's case ALS (Intensive Care).