We don't need "training" in EMS

[medic417]

So you really do believe education is a waste.

No. Even if you only learned to type a full sentence that is readable it is not a waste. You would be surprised what the brain retains even if very little effort is put into it.

Education is a choice. The fact that one does stick it out through a college degree shows they know a little about the benefits of an education even if they don't admit it or appear disinterested. They could easily leave the college.

Do you know how many Art History or some other Liberal Arts majors get well paying jobs with major companies or government agencies just because of that piece of paper? It didn't matter what they had the degree in. It just mattered that regardless of their opinion about education they still FINISHED what they started. I am of course talking about a 4 year degree but even a 2 year degree is an accomplishment or at least an initial step.

But Vent again the piece of paper got them the job, not the education. You have met as many and probably more people than me w/ piece of paper but no education. If you use learning a proper sentence as education then you would also have to argue that the 10 week Paramedic wonder also got educated as he can draw up a syringe of meds. Both are education by your argument.

Sorry I can't stop myself as much as I want to as I believe we need higher education in EMS. Maybe an anti education person has taken over my brain. Help.

 

[VentMedic]

But Vent again the piece of paper got them the job, not the education. You have met as many and probably more people than me w/ piece of paper but no education. If you use learning a proper sentence as education then you would also have to argue that the 10 week Paramedic wonder also got educated as he can draw up a syringe of meds. Both are education by your argument.

Sorry I can't stop myself as much as I want to as I believe we need higher education in EMS. Maybe an anti education person has taken over my brain. Help.

So you believe a person can learn ABSOLUTELY NOTHING by getting higher education?

You believe there is NO social interaction or discussion even between students that can pass on something new to that person?

Do you not think showing up for class does not teach some type of responsibility and establish some maturity?

I believe even the most disinterested person or dead beat can accomplish something from 4 years of college. While it is not difficult it does take some effort. If one puts forth that effort, there will be something in their college years that they will learn.

Do you realize that many of the "blue collar" jobs now have 2 and 4 year degrees? Coal Miners, Welders and Construction workers have all seen the need for higher education to do what had been thought of as strictly labor type jobs.

I can not believe we are about to enter the year 2010 and these anti education attitudes still exist. Some parents consider themselves a failure if they can not find a way to get their kids through a 4 year college. Kids are also striving for good grades or even a sports scholarship to get into a decent college. Grants and scholarships have made it much easier but still some can struggle. But yet, if you have even spent any time on a university campus you will find students holding down fulltime plus course loads as well as full time jobs. Yet, so many in EMS feel 600 hours of training way too much.

The college students that make the effort to finish will be successful even if they just work as a barista. They know what they have accomplished regardless of how they express it. Even if they don't wave that piece of paper in everyone's face, they may engage in a slightly more intelliegent conversation that they may not have been capable of doing prior to college. That may make the difference in their customer service.

It is a shame that so many in this profession have your attitude towards education. I just don't understand why some shun even a 2 year college degree. There are so many opportunities out there and EMS has yet to explore most of them. As long as the education level remains at a few hundred hours of training, EMS may never know what what it can accomplish.

BTW, what is your highest level of education?

 

[medic417]

So you believe a person can learn ABSOLUTELY NOTHING by getting higher education?

You believe there is NO social interaction or discussion even between students that can pass on something new to that person?

Do you not think showing up for class does not teach some type of responsibility and establish some maturity?

I believe even the most disinterested person or dead beat can accomplish something from 4 years of college. While it is not difficult it does take some effort. If one puts forth that effort, there will be something in their college years that they will learn.

Do you realize that many of the "blue collar" jobs now have 2 and 4 year degrees? Coal Miners, Welders and Construction workers have all seen the need for higher education to do what had been thought of as strictly labor type jobs.

I can not believe we are about to enter the year 2010 and these anti education attitudes still exist. Some parents consider themselves a failure if they can not find a way to get their kids through a 4 year college. Kids are also striving for good grades or even a sports scholarship to get into a decent college. Grants and scholarships have made it much easier but still some can struggle. But yet, if you have even spent any time on a university campus you will find students holding down fulltime plus course loads as well as full time jobs. Yet, so many in EMS feel 600 hours of training way too much.

The college students that make the effort to finish will be successful even if they just work as a barista. They know what they have accomplished regardless of how they express it. Even if they don't wave that piece of paper in everyone's face, they may engage in a slightly more intelliegent conversation that they may not have been capable of doing prior to college. That may make the difference in their customer service.

It is a shame that so many in this profession have your attitude towards education. I just don't understand why some shun even a 2 year college degree. There are so many opportunities out there and EMS has yet to explore most of them. As long as the education level remains at a few hundred hours of training, EMS may never know what what it can accomplish.

BTW, what is your highest level of education?

My point is many get the degree while only doing the minimum, just like in many EMS programs.

I'm working on pre-school right now, maybe I'll continue to kindergarten. h34r:

 

[VentMedic]

My point is many get the degree while only doing the minimum, just like in many EMS programs.

But the minimum still consists of somewhere around 64 semester credit hours for a 2 year degree and 128 for a 4 year degree. Few are going to call that a "minimum". Some may choose an easier major but still 4 years is a decent commitment.

That is the same at almost any college/university you attend in the U.S.

One doesn't have the opportunity to move from Oregon to Texas if they want a "lesser" 4 year degree. You still have to finish the college credits. However, for Paramedic with the same move, you go from a 2 year degree requirement to 600 hours of training.

I'm working on pre-school right now, maybe I'll continue to kindergarten. h34r:

Those that haven't taken the first steps toward higher education usually present the more emotional and irrational arguments against education.

 

[medic417]

But the minimum still consists of somewhere around 64 semester credit hours for a 2 year degree and 128 for a 4 year degree. Few are going to call that a "minimum". Some may choose an easier major but still 4 years is a decent commitment.

That is the same at almost any college/university you attend in the U.S.

One doesn't have the opportunity to move from Oregon to Texas if they want a "lesser" 4 year degree. You still have to finish the college credits. However, for Paramedic with the same move, you go from a 2 year degree requirement to 600 hours of training.




Those that haven't taken the first steps toward higher education usually present the more emotional and irrational arguments against education.

But you do not even have attend, just show up and pass exams, at many colleges. I have seen many college students send a recorder with another student and end up passing and getting credit. How is that education? Heck even the online education that you seem to love so much requires much more effort than that.

So point is on paper they have lots of college hours yet really never set in and got any education. Heck you can even challenge many college courses for full credit.

 

[VentMedic]

But you do not even have attend, just show up and pass exams, at many colleges. I have seen many college students send a recorder with another student and end up passing and getting credit. How is that education? Heck even the online education that you seem to love so much requires much more effort than that.

So point is on paper they have lots of college hours yet really never set in and got any education. Heck you can even challenge many college courses for full credit.

You are speaking without the experience of obtaining a college degree.

Why haven't you gotten a degree?

Online education that I seem to love so much? The only comments I have made about this is that it is very appropriate for some lecture classes. I am not an advocate of it for the sciences such as chemistry and A&P which still need the benefit of a lab.

Yes you can challenge a course but that doesn't mean you'll pass to get the credit. Also, not all classes are eligible for challenge.

As far as the recorder in class, that is a smart idea if the eduator doesn't keep a copy of his/her lecture for viewing/listening through the internet or library. The student is still taking the time to listen to the lecture and felt motivated enough to have it recorded. That does not show a disinterest but rather caring enough not to miss something if there is a reason not to attend the lecture that day. I have even recorded many of my classes when I worked the night before and new I was not at my best for listening or I borrowed someone's recording. I do not consider myself a minimalist when it comes to education because of it.

Go to college and then you can speak educatedly about education.

This is just ridiculous and irresponsible to try to convince some of the very young members here that they will get no benefit of higher education. Obtaining their education now will benefit them throughout their careers and they won't reach the age of 50 kicking themselves for not having that education when standards are raised or their backs are wore out and they need to find another profession.

 

[medic417]

You are speaking without the experience of obtaining a college degree.

Why haven't you gotten a degree?

Online education that I seem to love so much? The only comments I have made about this is that it is very appropriate for some lecture classes. I am not an advocate of it for the sciences such as chemistry and A&P which still need the benefit of a lab.

Yes you can challenge a course but that doesn't mean you'll pass to get the credit. Also, not all classes are eligible for challenge.

As far as the recorder in class, that is a smart idea if the eduator doesn't keep a copy of his/her lecture for viewing/listening through the internet or library. The student is still taking the time to listen to the lecture and felt motivated enough to have it recorded. That does not show a disinterest but rather caring enough not to miss something if there is a reason not to attend the lecture that day. I have even recorded many of my classes when I worked the night before and new I was not at my best for listening or I borrowed someone's recording. I do not consider myself a minimalist when it comes to education because of it.

Go to college and then you can speak educatedly about education.

This is just ridiculous and irresponsible to try to convince some of the very young members here that they will get no benefit of higher education. Obtaining their education now will benefit them throughout their careers and they won't reach the age of 50 kicking themselves for not having that education when standards are raised or their backs are wore out and they need to find another profession.

You presume what you do not know concerning my education. Attacking my education no matter how great or how smart does not support your side.

I have no problem with my students recording lectures for review but I disagree with them not attending except on exam days.

And I have not said a college education is worthless I have said those that only got the piece of paper have no education. And you keep saying they got the hours. That is no different than your argument against the current EMS education, just focused on the hours.

I am really hating pretending to be on the anti-education side but you keep leaving big openings that demand attack.

For all our young readers you will benefit yourself by getting an education. I mean go to the classes, listen, take notes, do research, get educated and you will be better for it. If you want to be in EMS get a Paramedic degree so the time spent on that education will transfer towards another degree should you decide a change is in order.

 

[VentMedic]

You presume what you do not know concerning my education. Attacking my education no matter how great or how smart does not support your side.

BTW, what is your highest level of education?

I'm working on pre-school right now, maybe I'll continue to kindergarten.

I asked you what your education level was and you gave a smart arse answer. At that point in this discussion it only demonstrated an anti-education attitude.

I take education very seriously especially for those in this profession. I would be very upset with an EMT instructor if he/she told my 17 y/o that education was a waste of time. I personnally would not want my kid to be even an ambulance driver without an education. At least then I would know there are choices available for their future.

Unfortunately we do know discouraging higher education happens when the instructor and role model is Bubba the Great who can do all this and didn't need no book learnin'.

 

[Foxbat]

So is it possible to be a great doctor without pre-med?

This is how it works in many, if not most, countries, including Western Europe and ex-USSR. Students go from high schools straight to medical institutes and colleges to become doctors, nurses, PAs, etc. and there are plenty of great healthcare providers there.

 

[46Young]

Requiring a two year degree just for entry into the EMS field as well as four year degrees (or more) would probably weed out many individuals who enter the field just for kicks, an easy way to make money, adrenaline junkies, Rescue Randys, basically most of the wierdos and those who use it solely as a stepping stone.

The field can't move forward until we remove the LCD's.

 

[46Young]

We seem to have a serious communication problem here. I did NOT type anything about treating and releasing being okay as education stands now nor did I in anyway promote it.

I was reflecting off your statement that if additional scope was allowed, you wanted tort reform.



My statement was that if a Paramedic wants additional scope of practice they should be held accountable and not given a free ride.

I'm not asking for immunity from liability due to malpractice, but instead a reasonable amount of protection from frivolous lawsuits, provided we are making competent pt care decisions. Our society is a litigous one. I'm concerned about individuals who would be looking to make a fast buck off of us, including those who may use a suit to avoid paying a bill. I don't want to lose my license or put my family in the poor house due to someone's greed.

The thing that I like about operating under an OMD's protocols is that, based on our findings and reassessments, we can validate our (correct) pt care decisions and be able to defend them well in a court of law if needed. the attorney says "what was your Dx?" I say, I made no Dx, that right is reserved for an MD. We have S.O.P's, standing orders and protocols under our OMD. I found A,B,C. I therefore treated for X,Y,Z per protocol/OLMC.

 

[MrBrown]

This is what really kills me, even here. We need a basis of education and training; for example

- You need to be educated about fluid compartments, osmolarity, tonicity, diffusion, mediated diffusion, cellular respiration and ventilation, shock, heamostatis (clotting) and then trained how to insert an IV cannula and run a bag of fluid.

- You need to be educated about cardiac anatomy and physiology, the cardiac action potential, intra/extracellular catons/ions, the sodium/potassium pump, Einthoven's triangle, acute coronary syndromes and how to interpret an ECG then trained how to acquire one

Education and training are not the same, just like oxygenation and ventliation are not the same.

 

[medic417]

I asked you what your education level was and you gave a smart arse answer. At that point in this discussion it only demonstrated an anti-education attitude.

I take education very seriously especially for those in this profession. I would be very upset with an EMT instructor if he/she told my 17 y/o that education was a waste of time. I personnally would not want my kid to be even an ambulance driver without an education. At least then I would know there are choices available for their future.

Unfortunately we do know discouraging higher education happens when the instructor and role model is Bubba the Great who can do all this and didn't need no book learnin'.

Again I have not said education is a waste of time. I have said some get a piece of paper but that piece of paper does not equal education. Yes they are ahead in life later when they realize they need a real education as that piece of paper helps them get a higher degree. But it is just a piece of paper if they failed to apply themselves.

Yes many seem to discourage advancement of education in EMS even many with multiple degrees.

 

[thegreypilgrim]

I don't know of any agencies give their medics autonomy regarding treating and releasing pts. All pt care situations that result in the pt bring released post treatment require refusals. Some areas have protocols to forego spinal motion restriction if the pt falls under certain parameters. Some agencies allow medics to declare a "no need for EMS" if it's warranted after evaluating the situation. I can understand releasing a pt after suturing a lac and giving a tetanus (under protocol) as well as G-tube replacements.

As far as referring pts to urgent care facilities, txp drunks to detox and such would require a true Dx. My understanding is that this right is reserved for doctors only. My understanding is that medics can only offer a "suspected diagnosis", nothing more....So, who besides doctors have the autonomy to treat and release pts without protocols or oversight from a higher medical authority?

I think a case can be made for being able to refer pts to urgent care and/or sobering centers without making a formal "diagnosis". Obviously with the increased scope of practice for paramedics in this scenario there would have to be various legal reforms and updates in local policies/protocols to account for these new features of pre-hospital care. As I understand, most jurisdictions permit paramedics to determine in certain situations that no services are needed. You do a thorough assessment and exam of the patient and you determine that there are no apparent life-threats - this is not anything new or something paramedics do not do already. In fact this is done all the time when paramedics downgrade patients from ALS to BLS transport. If you ever find yourself in court one day and an attorney asks you, "Why did you arrange for my client to be transported by a lower medical authority? What was your diagnosis so you felt this was appropriate?" You need not answer with a diagnosis, the correct response is simply, "I completed a thorough assessment and exam of my patient in accordance with Advanced Life Support parameters and the patient was not found to have any anomalies. There was no immediate threat to life or limb, hence BLS transport is completely appropriate."

Not every patient you release at the scene is done so "Against Medical Advice." They do not all need to sign your release form, and having them sign it anyway does not provide any liability protection in such scenarios because there is no medical advice which they are going against.

You don't need to make a formal diagnosis to determine a patient to be stable. If you can release a patient at the scene and it's not an AMA situation already, why can you not just refer them to urgent care? Especially in this hypothetical scenario with increased paramedic education and scope of practice? Same things with ETOH patients and sobering centers. I'm not talking about being able to enroll them in a rehab facility, but just taking them to a facility that can protect them from themselves until they sober up. They already have such facilities in places like Santa Barbara and Oakland here in California where police officers (people with no medical training or at most a First Responder cert) can transport drunks to. Why is it different for EMS?

Why couldn't Medical Directors draft protocols for these sorts of things? Even if you have to call in to medical control and get the attending physician's approval to defer to urgent care or sobering center, why can't this work even under a paramedic's "suspected diagnosis"?

 

[atropine]

Why couldn't Medical Directors draft protocols for these sorts of things? Even if you have to call in to medical control and get the attending physician's approval to defer to urgent care or sobering center, why can't this work even under a paramedic's "suspected diagnosis"?[/QUOTE]

Because of "liability", thats why no MD's will sign off on something like this. They have way mor to lose than a $13.00 per hour job/hobbie.^_^

 

[medic417]

Why couldn't Medical Directors draft protocols for these sorts of things? Even if you have to call in to medical control and get the attending physician's approval to defer to urgent care or sobering center, why can't this work even under a paramedic's "suspected diagnosis"?

Because of "liability", thats why no MD's will sign off on something like this. They have way mor to lose than a $13.00 per hour job/hobbie.^_^[/QUOTE]

Actually there are a number of Medical directors that do allow taking patients to clinics rather than ER. And often this is done by the Paramedic w/o calling medical control. These medical directors are more involved and know their Paramedics thus trust them.

 

[JPINFV]

Because of "liability", thats why no MD's will sign off on something like this. They have way mor to lose than a $13.00 per hour job/hobbie.^_^

To be fair, I wouldn't sign off on allowing what most of the fire medics in Southern California do anyways. Guess that's why they aren't allowed to interpret 12 lead ECGs, right?

 

[rescue99]

Because of "liability", thats why no MD's will sign off on something like this. They have way mor to lose than a $13.00 per hour job/hobbie.^_^

Actually there are a number of Medical directors that do allow taking patients to clinics rather than ER. And often this is done by the Paramedic w/o calling medical control. These medical directors are more involved and know their Paramedics thus trust them.[/QUOTE]

Yep..It's in our protocols to call first but, we can take some etoh and psych patients to intake centers.

 

[thegreypilgrim]

Why couldn't Medical Directors draft protocols for these sorts of things? Even if you have to call in to medical control and get the attending physician's approval to defer to urgent care or sobering center, why can't this work even under a paramedic's "suspected diagnosis"?

Because of "liability", thats why no MD's will sign off on something like this. They have way mor to lose than a $13.00 per hour job/hobbie.^_^

Yeah if we're talking about the system as it currently is. Things would probably be different if the changes I was waxing hopelessly about earlier would be put into effect. Reading things in context usually aids understanding.

 

[medic417]

What is wrong with the quotes. Keeps crediting wrong people with the quotes.