The fire extinguisher is not just for show
This.Any type of advocacy for paramedics not having at least an AA/AAS cracks me up.... Fire department and old people love the idea though! ;-)
That’s a great read.Here was an interesting read I saw on Facebook. https://www.yumpu.com/en/document/read/62721460/educator-update-summer-2019/7
Read the article on my phone- it was difficult! But one thing mentioned was EBP. I don't know if EBP is taught in medic school, but it is taught in nursing school (BSN). Perhaps a selling point for degrees?Here was an interesting read I saw on Facebook. https://www.yumpu.com/en/document/read/62721460/educator-update-summer-2019/7
Did you actually look at what the references said? And did you note that out of all the references (removing the NHTSA ones), 3 deal with people leaving EMS or keeping people in EMS, one is a joint position statement, and 3 are actually EMS related sources, with the rest involving taking assumptions from other groups and saying it should apply to EMS? And two references are from the 90s.....Umm, did you see all of the references?
One thing nursing did well was tie reimbursement to degrees. Hospitals that want higher reimbursement rates need to have 80% or more of nursing staff with a BSN. That has been the reason for the big push for degrees in nursing recently.
I honestly think paramedics should be at minimum an associate degree. I believe general education such as psychology, writing classes, stats are both part of the core education of any degree but very useful for a paramedic. Add in more robust prerequisite such as full a&p with a lab, microbio, biology, chem, round it out with paramedic school and you have yourself an AA degree. Yes not all programs will be able to adapt... Harborviews program will have to change, but I believe we will have better providers.
My head is bowed! As stated, I read it quickly on my phone. You obviously took more time than I did. Kudos.Did you actually look at what the references said? And did you note that out of all the references (removing the NHTSA ones), 3 deal with people leaving EMS or keeping people in EMS, one is a joint position statement, and 3 are actually EMS related sources, with the rest involving taking assumptions from other groups and saying it should apply to EMS? And two references are from the 90s.....
the article also states many assumptions (with increased education will result in increased salaries, and with increased pre-requisite classes will make the paramedic certification (since it's the state issued cert that lets you practice, and you need to maintain not the degree) more valuable, completely ignoring the question of where is the additional funding going to come from, as well as saying that providing degrees will make it easier for paramedics to leave the field to pursue other venues.
And of course, it ignores the critical question: if EMS degrees are needed, and important to the profession, and would make everything better, including better pay and better patient outcomes, why are we not mandating an EMS degree (not a generic AAS or BS, an associates degree in EMS) for all existing providers (which NYS did with their nurses and BSNs, and if they don't get them in X number of years, their nursing licenses are suspended until they do), and only forcing this increased cost and training length on new members of the profession?
Did you also consider the author's biases when you evaluated the content of this article, which was written in NAEMSE newsletter? The author is an educated individual; She obtained her bachelors in Biomedical sicneces 15 years before she became a paramedic; her masters is in Fire and EM administration. However, her primarily role has been that of an educator, a role she has had a role she has held since 2001, after being a paramedic for 5 years (she has continued to work as a flight medic until 2009 and recently went back to it part time). She is also a faculty member and program director at the local community college teaching EMS, so she has a financial interest (at a professional level) in transitioning from a shorter certificate program to a longer degree program. So the bulk of her experience isn't from that of an ambulance paramedic, but that of an educator (which I will 100% should require at least an associates, if not a bachelors degree for full time faculty, with a preference to a masters) and a flight medic. And she doesn't had a degree in EMS at any level.....
BTW, I have my bachelors degree, and am working on my masters.... and I know some people who have bachelors and masters degrees (and one PhD) who work as paramedics who make the same amount as a certificate-only paramedic working on the same ambulance.
how about before we push for a major major change to our professional, we complete the research to validate our thinking? It's not like there isn't a large enough pool of both degreed and certified paramedics out there....All we can do immediately is extrapolate from allied professions till we are able to do our own research as a profession.
By that logic we should NOT be using CPAP in the prehospital setting as there is NO research that shows that CPAP is beneficial in the prehospital setting (least there was none when King County Medic One came out with their statement on why they do not use CPAP and that was the reason given (about 4 years ago now)).how about before we push for a major major change to our professional, we complete the research to validate our thinking? It's not like there isn't a large enough pool of both degreed and certified paramedics out there....
no research at all? what about https://www.emsworld.com/article/10323777/prehospital-use-cpap which is from 2005, or Kosowsky J, Stephanides S, et al. Prehospital use of continuous positive airway pressure (CPAP) for presumed pulmonary edema: A preliminary case series. Prehosp Emerg Care 5:190–196, which was published in 2001? Looks like there is plenty of research, if you chose to look for it.By that logic we should NOT be using CPAP in the prehospital setting as there is NO research that shows that CPAP is beneficial in the prehospital setting (least there was none when King County Medic One came out with their statement on why they do not use CPAP and that was the reason given (about 4 years ago now)).
your entitled to your opinion, just as I am to mine. But I think EMS should be doing our own research, not taking the research of others and hoping we can duplicate it in a different environment with several different variables. I will agree, there might be benefits; but before we go all in and half cocked again based on questionable ideas that "in theory" make sense, (remember, every patient needs 15 LPM via NRB, and only gets a NC if they can't tolerate the NRB), lets do the research. Instead of increasing the time that every new paramedic needs to spend in class, and drastically increasing the cost for a paramedic certification (because that's the current bar, not the degree), lets demonstrate why the current system is insufficient, using scientifically validated research.I just happen to believe that we can use other allied health professions research to show that their might be benefits to use doing the same.
The human body responds the same whether in hospital and outside of the hospital. Clinical trials (of meds and equipment) can be applied in hospitals, doctors offices, ambulances, and prison medical units, because regardless of the location, the human body should respond the same way.Kind of like EMS using hospital research that showed benefits to patients who go CPAP and extrapolating it to the EMS world.
finally, someone sees it!!Dr. Parasite, I think you're going full apples to oranges here. I'm sure you are highly intelligent, and you've got all your ducks in a row however,
I'm not opposed to raising the bar; I'm opposed to the way this change is supposed to be implemented, which requires raising the bar only for new people. I'm not opposed to raising the bar, provided raising the bar will be be beneficial to everyone, and not just more costly for future generations or paramedics. I'm not opposed to increased educational requirements in the area of business and management, especially for supervisors, educators, and administrative positions; in fact, I think it's long past due, but I think if we are going to change the entry level standards, we should have some validatable data justifying the push from within EMS, not taking research from others and applying it to EMS and hoping it works for us as it did for them. Sidenote: you don't need to be a paramedic to do research, but having an MS or PhD does help, esp when dealing with all the statistics and other data analysis that makes my head hurt.I have to ask. Why are you so staunchly opposed to raising the bar for paramedics, and why do you find it necessary to for an outside entity, such as a reimbursement organization or insurer, to come out and say "you need this degree for this amount of reimbursement?" Why does CMS or the state have to come out and say, "ya'll need degrees by X date?" Should we not be entitled to police ourselves in this regard and to voice our opinion as paramedics and prehospital EMS professionals about the direction of our own field?
The argument made was higher education = rising wages. The example of social workers, who work in hospitals too, demonstrates that is not always the case. Similarly. you can't compare the wages of an MD or PA to that of a medic; apples and orange. RN and RT might be more applicable, if they are both in a hospital based system, especially if they are funded out of the hospital general budge and not just what money they make on ambulance transports... what about the fire service (I know, dirty word, but you can't ignore the largest employer of EMS personnel in the US), or in the private for profit EMS world?Should we base our probable outcomes on those who have done what we are arguing to do and whom are closest to us on the professional medical spectrum (RN, RT, PA, MD), or should we go based on what the social workers have accomplished with their degree requirements? Apples to oranges, in my opinion.
you misunderstood... I'm not against any of that; however I am against implementing it the way many people want to implement it (for the new people only, not the current paramedics), as well as arbitrarily raising the standards without showing a prehospital need for the standard to be done. Maybe I was wrong, and there is no need for a paramedic to know anything about the lymphatic system, so expecting them to be familiar with it is both unnecessary and unreasonable. I don't know, but if they can pass the NRP exam not knowing about it, and paramedics for the last 20 years haven't needed it, how important is it?You're rallying from the rooftops about why we shouldn't push for higher education, barriers to entry, and a better overall professional outlook by providing antiquated and barely comparable analogies. Also, by your own measurement, a paramedic who doesn't understand what the lymphatic system is, yet has a patch and a p-card, is indeed embarrassing. Why not push for a degree program that includes a true one-year A&P course to be the standard as part of an AAS in EMS and certification for the NREMT? Wouldn't getting away from the dogma of the backboard be the equivalent of getting away from the dogma that a paramedic should take a one year certification class to get out there on the ambulance and practice clinical medicine?
nurses absolutely did research, which was how they got the 80% BSN rule tied to reimbursement rates. Also, that's a BSN, not a BS and RN cert; that's a key difference, one many in EMS are failing to see. Nurses have a completely different funding model, lobbying group, and, quite simply, don't have to worry about becoming too expensive, and then getting outsourced to a lower bidder (which has happened to several well paying municipal EMS agencies in NJ).Why do we need an evidence based medicine study to look into our educational standards as a profession? Did the nurses or the PAs do a medical study about increasing their barriers to entry and educational requirements for degrees/certifications/licensure ? Is there a randomized controlled trial for that? Was that required? Did it work for them with/without a "study"? Taking a look around (as many of us have stated) would lead one to believe it has been of great benefit and reward for professions who have upped the ante in recent history. Meanwhile, we sit here debating the practices of reimbursement bodies and allow the nurses to live rent free in our heads.