What I Hate the most about EMS

[Ridryder911]

I actually thought of this before reading the opposite thread. We can all come up with the goodies but really what is the real bad of things. Maybe just venting, but after three decades, I can truthfully say I am really discouraged with EMS and not my employer. The lack of desire to perform excellent patient care, the lack of motivation of wanting to improve the system for the future.

I was asked about becoming a Paramedic in a coffee shop... I was about to give my standard declaration of how heart warming, self fulfilling in nature, yes to save a life.. yadda.. yaddaa.. then I thought to myself

Should I really recommend this profession to anyone?

Hmm.. I now have my doubts. Why would I (a nice and thoughtful person) recommend such a profession to someone? When this job is usually composed of non-professionals or those that choose not to be professionals? Seriously, as a civil person should I suggest a profession that continually to refuse to grow, continue to pay such low salaries that many of its members are on government supplements to get food? Now, instead of going forward many much rather take an easy or alternative route to correct or worse do nothing?

Would you recommend a job to a friend that would require them to work more than 40 hours a week? Almost every Holiday, extreme hours? Would you recommend them to take this job knowing they would have to have another job. No? How many of you have just one job, or how many other medics you know work only one EMS job?

Should we really recommend a so called profession that its members love to whine and gripe about the profession, yet many choose not to participate in changes (such as legislation, law changes). What would you honestly advise the future of EMS to be?

In review of quality standards, EMS is usually a joke. How many EMS you know of have a formal TQI program and truly require in service education and accountability? Now, in comparison; what is the percentages of those with and those without? How many in Supervisory roles have a formal education or can write a formal letter? now let's look at administration. How many Directors where hired on the "good ole boy" system? Did they "work" their way up or was it strictly a "business" position? Now, compare that with other health professional management positions... again EMS as a profession presents itself as a joke. That it is. Now let's be truthful.

Education? Really, do we have education or rather do we promote training? If you don't know the difference, you are trained. Would it not be nice if EMS Instructors were required to have at least the same level education as a Kindergarten teacher? Wow! One can teach how to do tracheotomies with a 40 hour class & GED but one cannot teach little Johnny to color within the lines... Do we not see something very wrong here? Even more strange, many in this profession does not even know the difference between being licensed and being certified or even know which one they are. Yeah, a real knowledgeable profession.

Let's look at the majority of the persons now entering most EMS don't give a **** (you can place your favorite foul word) about EMS or health care. Majority only care enough to pass the test to get the patch to get onto a Fire Service EMS. The reason for this is not really providing medical care, it is for the benefits and lower call volume. Again alike oil and vinegar does not mix, neither doe Fire Service and EMS. Sorry, both are respected profession but are NOT nor will ever be the same.

Unfortunately, Fire Service assumes they will "save" EMS but compare and really look at he systems and what their intent are, and one will see they will probably be the demise of EMS. Only requiring minimal standards, pursuing lower testing requirements and lower interest in true medical care, rather focusing on Public Safety which EMS is NOT. Now here is a bet.. the majority of you will not be in EMS within the next 3-5 years. So what can we expect with a continuous turnover, when the Senior medic has two to five years service?

Do you know of another profession that would be against accrediting educational institutions? Seriously, does this not make one wonder of those that are in it? Would you imagine reading about engineers protesting that their educational systems was required to be accredited. That such educational systems would be too hard or worse they may not be able to pass the test? What would you think the next time you drove over a bridge or stand in a tower building?
Now, we wonder why the public thinks of us as a joke?

How many other professions have to defend and beg for their existence? Do you see PD being absorbed into another division... i.e Sanitation/Law Enforcement. Yet, many EMS has to justify their positions, even though they are making three to four times the number of responses and bringing in money to support themselves. Yeah, this makes a lot of sense?

How many of you know of three or more Paramedics that have been in field EMS (not education, management or fire related) more than 10-15 years? Is this a profession, you would recommend someone to?


So in the real world, should we truly recommend such a profession to a person seeking a new career or profession. Would this be fair? We all know how infectious the EMS bug is. It's alike a virus that infects many but we know the outcome of viruses, don't we?

Not to be totally negative, but how are you going to change things and make this profession to be better?

R/r 911

 

[Veneficus]

I actually thought of this before reading the opposite thread. We can all come up with the goodies but really what is the real bad of things. Maybe just venting, but after three decades, I can truthfully say I am really discouraged with EMS and not my employer. The lack of desire to perform excellent patient care, the lack of motivation of wanting to improve the system for the future.

I was asked about becoming a Paramedic in a coffee shop... I was about to give my standard declaration of how heart warming, self fulfilling in nature, yes to save a life.. yadda.. yaddaa.. then I thought to myself

Should I really recommend this profession to anyone?

Hmm.. I now have my doubts. Why would I (a nice and thoughtful person) recommend such a profession to someone? When this job is usually composed of non-professionals or those that choose not to be professionals? Seriously, as a civil person should I suggest a profession that continually to refuse to grow, continue to pay such low salaries that many of its members are on government supplements to get food? Now, instead of going forward many much rather take an easy or alternative route to correct or worse do nothing?

Would you recommend a job to a friend that would require them to work more than 40 hours a week? Almost every Holiday, extreme hours? Would you recommend them to take this job knowing they would have to have another job. No? How many of you have just one job, or how many other medics you know work only one EMS job?

Should we really recommend a so called profession that its members love to whine and gripe about the profession, yet many choose not to participate in changes (such as legislation, law changes). What would you honestly advise the future of EMS to be?

In review of quality standards, EMS is usually a joke. How many EMS you know of have a formal TQI program and truly require in service education and accountability? Now, in comparison; what is the percentages of those with and those without? How many in Supervisory roles have a formal education or can write a formal letter? now let's look at administration. How many Directors where hired on the "good ole boy" system? Did they "work" their way up or was it strictly a "business" position? Now, compare that with other health professional management positions... again EMS as a profession presents itself as a joke. That it is. Now let's be truthful.

Education? Really, do we have education or rather do we promote training? If you don't know the difference, you are trained. Would it not be nice if EMS Instructors were required to have at least the same level education as a Kindergarten teacher? Wow! One can teach how to do tracheotomies with a 40 hour class & GED but one cannot teach little Johnny to color within the lines... Do we not see something very wrong here? Even more strange, many in this profession does not even know the difference between being licensed and being certified or even know which one they are. Yeah, a real knowledgeable profession.

Let's look at the majority of the persons now entering most EMS don't give a **** (you can place your favorite foul word) about EMS or health care. Majority only care enough to pass the test to get the patch to get onto a Fire Service EMS. The reason for this is not really providing medical care, it is for the benefits and lower call volume. Again alike oil and vinegar does not mix, neither doe Fire Service and EMS. Sorry, both are respected profession but are NOT nor will ever be the same.

Unfortunately, Fire Service assumes they will "save" EMS but compare and really look at he systems and what their intent are, and one will see they will probably be the demise of EMS. Only requiring minimal standards, pursuing lower testing requirements and lower interest in true medical care, rather focusing on Public Safety which EMS is NOT. Now here is a bet.. the majority of you will not be in EMS within the next 3-5 years. So what can we expect with a continuous turnover, when the Senior medic has two to five years service?

Do you know of another profession that would be against accrediting educational institutions? Seriously, does this not make one wonder of those that are in it? Would you imagine reading about engineers protesting that their educational systems was required to be accredited. That such educational systems would be too hard or worse they may not be able to pass the test? What would you think the next time you drove over a bridge or stand in a tower building?
Now, we wonder why the public thinks of us as a joke?

How many other professions have to defend and beg for their existence? Do you see PD being absorbed into another division... i.e Sanitation/Law Enforcement. Yet, many EMS has to justify their positions, even though they are making three to four times the number of responses and bringing in money to support themselves. Yeah, this makes a lot of sense?

How many of you know of three or more Paramedics that have been in field EMS (not education, management or fire related) more than 10-15 years? Is this a profession, you would recommend someone to?


So in the real world, should we truly recommend such a profession to a person seeking a new career or profession. Would this be fair? We all know how infectious the EMS bug is. It's alike a virus that infects many but we know the outcome of viruses, don't we?

Not to be totally negative, but how are you going to change things and make this profession to be better?

R/r 911

This needs to be printed on the first page of every EMS textbook in print.

I like to think EMS is like a crack additction, you know it's bad for you, but you just can't pull yourself away

The funny thing is the more I try to help the EMS profession, the more the "professionals" tell me I don't get it.

 

[boingo]

Interesting thread. I was working a shift last evening in a different station from my usual with a new EMT on the BLS truck who was reading an introduction to EKG text. We started talking, she is thinking about starting medic school soon. My partner was having trouble with the whole idea of this young and impressionable girl spending time and money on medic school when there are so many other opportunities for a medical career, or profesion. I can't say I blame him, as a whole, education is a joke, and unless you work for system such as mine, the job is kissing *** to some fire department, or working for them. I have two kids, and if either of them where considering EMS, I'd probably kick them in the *** and send them off to college. Now, don't get me wrong, I've committed my life to EMS, its my profession, I've spent years continuing my education, and have had the opportunity to work and learn from some of the best medics and doctors in the nation (my opinion). Its just that overall, EMS is broken in the U.S., and I'm not sure if its ever going to get better in my lifetime. If I could guarantee this girl an ALS job in my system, I'd tell her to enroll tomorrow, but, like life, there are no guarantees, and I'm afraid the money could be invested better elsewhere.

 

[csly27]

Wow, I am not even sure what to make of all that. It could be because I am still a student. Have yet to do my ride along even. I am so excited to become a member of ems that i cant wait. I tryed the whole medical assistant thing now that was a joke if ever there was one, but that could be because i dont like drs offices would rather go to the er. I know kinda twisted but what can I say.

My father was a combat medic in nam, then an emt when he got out So I guess I got the medical gene. But it is all I have wanted to do. I have finally gotten a chance to go back to school and take the class And I am doing well have maintained a b average not great but well. My husband is inthe army, and we are being relocated in feb. When we get to where we are going I want to join the fire acadamy and then medic school. People say that these are supposed to be diffrent professions,but the way I see it is... Everyone, leo, fire, and, ems should all work together as a team to ensure that everyone gets the treastment that they need right?

Leo's are supposed to help keep our scene safe, fire puts out the fire and we treat any pt that we come into contact with right? So why does everyone talk down about the other feilds. I want to be a ff/medic so that I am able to do both and help that many more people. Sounds like a good plan to me. Or it could be that I am not jaded yet in this feild. I do not have the experience or the knowledge in this feild yet. I love to learn new things and to help people I feel that is what I was put here to do.

I am sure people will critize me for wanting to do both. I also think that by being in this feild My children will gain the knowledge to help because it is something that they want to do, not something They have to. My 10 year old is falling in love with this feild as well he reads along with me in my book and he helps me study as does my husband. all of my kids have been my pt to help me in my assesments. Both in mock and in life lol. I like knowing that if something does happen to my family I can help them instead of being a bonehead and freaking out.

I know ridryder911 had mentioned that coming to a scene of a family member or friend would be one of the worst possable situations. I beleive that is true. However with that being said I would rather have myself show up on scene to a family member because I know that I could be there for them and know that I am or rather will be trained to do what needs to be done, and can be there for the entire thing instead of getting "that" call. Call it controlling if you want and mabey it is to a point but that is just my opinion on that situation. Would it be hard? would it suck? Hell yeah but at least I would be there right from the start.

I guess what I am trying to say is that from what I have heard the ems system is not in the best shape. And the question was would I recommend this job to someone I know? well I cant answer that because I have not been there yet. How can I make a diffrence well all I can say to that is I can go out there and do my best to make people better to the best of my abilitys. I do plan to further my education because without it I cant do what I need to do. Or what I want to do. Who knows mabey in 3-5 years I will feel diffrently than I do right now. But then again mabey not. Wow I think this is my longest post yet lol.

I have gotten checked off on part of my skills already, My final is on Jan 12th, My ride a long is coming up after the first. I am truly excited and terrified at the same time. Sometimes I think what if I am not good enough. That scares the hell out of because in my heart that is all I want. But I have a great instructor and family and they all have faith in me. so wish me luck.

 

[Laur68EMT]

Not to be totally negative, but how are you going to change things and make this profession to be better? R/r 911

Very interesting. What do you feel would be the best approach to making change? Do you suggest small steps in our own backyards?

 

[Ridryder911]

Wow, I am not even sure what to make of all that. It could be because I am still a student. Have yet to do my ride along even. I am so excited to become a member of ems that i cant wait.

This is not a jaded conversation and not being rude, truthfully you are correct. You do not what to say; because you cannot say anything yet. How do you really know what is best in EMS or both worlds. How much do you really know about EMS? Did you study what is in the challenged EMS profession before entering the profession or just want to enter the public service arena because of the benefits? Remember, your in a class just above First Aid level, and has this really prepared you for a health care profession? Alike the CMA it is just a crude entry level.

I challenge you to remember this post in 10 years (if you are still in EMS or Firefighting) and think of this.

Hence, part of the problem in EMS. Most do not really study, investigate the profession before entering. Alas if I was to ask the basic components of an EMS system, majority would fail. Yet, most feel they are an expert within it. Again, pre-enrollment screening should be performed before entry. A good discussion of what EMS involves and what it does NOT involve.... the truth.

R/r 911

 

[Epi-do]

I wish I knew where to even go to begin to change things! Is the answer writing letters to Senators and Congressmen? Is it better to do this at the state or federal level? Should letters be written to the state office that controls EMS? WHO do I approach?

At the simplest level, we need to practice what we preach. I am planning on picking up the two college level A&P classes I need to complete my Associates degree for paramedicine. I have also found several additional classes I would like to take - some at the college level, some through continuing education.

We need to stop fighting amongst ourselves and pull together if we ever hope to truly see anything change. Medic vs. basic, paid vs. volly, green people vs. purple people - it doesn't really matter. Being a professional is about educating yourself, and putting your best foot forward in all situations.

We need to start by addressing the dismal education required to enter EMS. Require all programs to be accreditted. Mandate college level A&P for ALL LEVELS of providers. Stop training people and increase the amount of education required to even enter the profession. Plenty of people say they want to see changes, but most of them never act upon those desires. Change takes time, and the sooner we can band together and demand that change, the sooner it can begin to happen.

Granted, some things will take time to change, but others can be accomplished more readily. Make the screening process for entering classes more stringent. Ask applicants why they want to enter the program, and when the answer includes "so I can get a job as a firefighter" or "because I eventually want to be a (enter any other medical profession you can think of here)" think long and hard about whether or not that individual is the best choice for EMS. How often do you hear someone say, "I am going to med school so I can be an attorney,"? It doesn't happen. People go to med school because they want to be doctors. It should be the same for EMS. Canidates should be applying to classes because they want to work in EMS. Decreasing turnover and those leaving the profession is a big step in presenting ourselves as professional, as well as increasing the knowledge base out there for newbies to turn to when they need help. Encourage those that have been around the block multiple times to gain the neccessary education to be effective managers, leaders, and instructors. Encourage them to develop research studies that can help further EMS as it's own branch of medicine and improve the care we can provide to our patients. Other healthcare professionals have gotten to where they are by being educated, having strong leadership within the ranks, and developing their own voice to demand changes and specify what they want those changes to be.

Increasing education does several things. First and foremost, it makes us better providers. It will weed out all of the Ricky Rescues that are only doing it for the t-shirt. It will make people begin to take us seriously as a profession. Then, and only then, will we be able to move forward and make other changes - move away from certification and demand liscensure, improve pay and benefits. Wouldn't it be nice to be able to only have to work one job and be able to live reasonably, instead of having to work 2, 3 or even more jobs just to make ends meet?

Along with improving (beginning to???) education, we need to standardize our levels of care. Whether we have only EMT and Paramedic, or some other variation, it needs to be the same across the board. Naturally, different areas of the country are going to have different needs, so supplement with additional appropriate training and local protocols. However, there is no need for state A to have 3 levels of care providers and state B to have 5 different levels. Then there is state C, which like state A, has only 3 levels of care but they are completely different that those of state A. Regardless of where you are, if you walk into a hospital you know that a cardiologist is going to take care of your heart, an oncologist deals with cancer, etc.

Ultimately, we are responsible for the future of EMS. Only we can shape that future to be a success or a failure and the best way to do that is to lead by example. Accept nothing but the best from those around you, and demand that they do the same.

 

[pumper12fireman]

Having worked in systems WITH fire response and currently in a system WITHOUT fire response, I'd have to agree that we (EMS and fire) are NOT the same. A little background- started out of a combined Fire Academy/EMT class, started at a fire department that did not transport. Training was always focused on fire. EMS calls were bad things. We were "firemen" not EMT's. I no longer work there. I do now work for a different fire department, however, we transport and have no fire response. So, you work on the ambulance. I had to be taught how to be an EMT and not a stretcher jockey.You are an EMT/Medic FIRST. Yeah, most guys like fire calls, but I feel that the care level provided at my current department is much, much better than at my previous department. But, in my area, most systems are like mentioned above. The guys are "firemen" and riding the ambulance is for a rookie or it's a punishment. But, with the lack of funds/fires, how are fire departments supposed to remain "professional"?? EMS seems to be the loser here in funding our "fun" on the fire department...

 

[daedalus]

I wish I knew where to even go to begin to change things! Is the answer writing letters to Senators and Congressmen? Is it better to do this at the state or federal level? Should letters be written to the state office that controls EMS? WHO do I approach?

At the simplest level, we need to practice what we preach. I am planning on picking up the two college level A&P classes I need to complete my Associates degree for paramedicine. I have also found several additional classes I would like to take - some at the college level, some through continuing education.

We need to stop fighting amongst ourselves and pull together if we ever hope to truly see anything change. Medic vs. basic, paid vs. volly, green people vs. purple people - it doesn't really matter. Being a professional is about educating yourself, and putting your best foot forward in all situations.

We need to start by addressing the dismal education required to enter EMS. Require all programs to be accreditted. Mandate college level A&P for ALL LEVELS of providers. Stop training people and increase the amount of education required to even enter the profession. Plenty of people say they want to see changes, but most of them never act upon those desires. Change takes time, and the sooner we can band together and demand that change, the sooner it can begin to happen.

Granted, some things will take time to change, but others can be accomplished more readily. Make the screening process for entering classes more stringent. Ask applicants why they want to enter the program, and when the answer includes "so I can get a job as a firefighter" or "because I eventually want to be a (enter any other medical profession you can think of here)" think long and hard about whether or not that individual is the best choice for EMS. How often do you hear someone say, "I am going to med school so I can be an attorney,"? It doesn't happen. People go to med school because they want to be doctors. It should be the same for EMS. Canidates should be applying to classes because they want to work in EMS. Decreasing turnover and those leaving the profession is a big step in presenting ourselves as professional, as well as increasing the knowledge base out there for newbies to turn to when they need help. Encourage those that have been around the block multiple times to gain the neccessary education to be effective managers, leaders, and instructors. Encourage them to develop research studies that can help further EMS as it's own branch of medicine and improve the care we can provide to our patients. Other healthcare professionals have gotten to where they are by being educated, having strong leadership within the ranks, and developing their own voice to demand changes and specify what they want those changes to be.

Increasing education does several things. First and foremost, it makes us better providers. It will weed out all of the Ricky Rescues that are only doing it for the t-shirt. It will make people begin to take us seriously as a profession. Then, and only then, will we be able to move forward and make other changes - move away from certification and demand liscensure, improve pay and benefits. Wouldn't it be nice to be able to only have to work one job and be able to live reasonably, instead of having to work 2, 3 or even more jobs just to make ends meet?

Along with improving (beginning to???) education, we need to standardize our levels of care. Whether we have only EMT and Paramedic, or some other variation, it needs to be the same across the board. Naturally, different areas of the country are going to have different needs, so supplement with additional appropriate training and local protocols. However, there is no need for state A to have 3 levels of care providers and state B to have 5 different levels. Then there is state C, which like state A, has only 3 levels of care but they are completely different that those of state A. Regardless of where you are, if you walk into a hospital you know that a cardiologist is going to take care of your heart, an oncologist deals with cancer, etc.

Ultimately, we are responsible for the future of EMS. Only we can shape that future to be a success or a failure and the best way to do that is to lead by example. Accept nothing but the best from those around you, and demand that they do the same.

Post of the year!

I know that Rid 911 is upset and tired of preaching and preaching and no one ever getting it. But I do see him changing minds, just as he and ventmedic changed my mind. I truly believe in the power of people. Lets start local and ask our local programs to up the interview process and the pre-reqs. As more and more programs start this, we can write to legislator to abolish the two week EMT schools. Small steps.

 

[Veneficus]

At the simplest level, we need to practice what we preach. I am planning on picking up the two college level A&P classes I need to complete my Associates degree for paramedicine. I have also found several additional classes I would like to take - some at the college level, some through continuing education..

You sound motivated, but many in the EMS profession are not. They prefer 16hour certs to academic education.

We need to stop fighting amongst ourselves and pull together if we ever hope to truly see anything change. Medic vs. basic, paid vs. volly, green people vs. purple people - it doesn't really matter. Being a professional is about educating yourself, and putting your best foot forward in all situations..

here is the first problem, certain agencies do not want to put forth the time or money to inccrease standards. I have struggled for more than a decade to try and convince them.

We need to start by addressing the dismal education required to enter EMS. Require all programs to be accreditted. Mandate college level A&P for ALL LEVELS of providers. Stop training people and increase the amount of education required to even enter the profession. Plenty of people say they want to see changes, but most of them never act upon those desires. Change takes time, and the sooner we can band together and demand that change, the sooner it can begin to happen..

You seem to underestimate the efforts of people who tried. Not just myself, but people who worked far longer and harder than I. We are a small minority.

Granted, some things will take time to change, but others can be accomplished more readily. Make the screening process for entering classes more stringent. Ask applicants why they want to enter the program, and when the answer includes "so I can get a job as a firefighter" or "because I eventually want to be a (enter any other medical profession you can think of here)" think long and hard about whether or not that individual is the best choice for EMS. How often do you hear someone say, "I am going to med school so I can be an attorney,"? It doesn't happen. People go to med school because they want to be doctors. It should be the same for EMS. Canidates should be applying to classes because they want to work in EMS. Decreasing turnover and those leaving the profession is a big step in presenting ourselves as professional, as well as increasing the knowledge base out there for newbies to turn to when they need help. Encourage those that have been around the block multiple times to gain the neccessary education to be effective managers, leaders, and instructors. Encourage them to develop research studies that can help further EMS as it's own branch of medicine and improve the care we can provide to our patients. Other healthcare professionals have gotten to where they are by being educated, having strong leadership within the ranks, and developing their own voice to demand changes and specify what they want those changes to be..

many people leave EMS for other healthcare professions because of the lack of support, education, opportunity, and respect. I didn't start my career with the idea of becomming a physician, but that is where the path has led.Many nurses I know were medics first. But again, for the same reasons as I, they moved on.

Increasing education does several things. First and foremost, it makes us better providers. It will weed out all of the Ricky Rescues that are only doing it for the t-shirt. It will make people begin to take us seriously as a profession. Then, and only then, will we be able to move forward and make other changes - move away from certification and demand liscensure, improve pay and benefits. Wouldn't it be nice to be able to only have to work one job and be able to live reasonably, instead of having to work 2, 3 or even more jobs just to make ends meet?.

I agree, many don't.

Along with improving (beginning to???) education, we need to standardize our levels of care. Whether we have only EMT and Paramedic, or some other variation, it needs to be the same across the board. Naturally, different areas of the country are going to have different needs, so supplement with additional appropriate training and local protocols. However, there is no need for state A to have 3 levels of care providers and state B to have 5 different levels. Then there is state C, which like state A, has only 3 levels of care but they are completely different that those of state A. Regardless of where you are, if you walk into a hospital you know that a cardiologist is going to take care of your heart, an oncologist deals with cancer, etc..

this was suggested, but the attempt at implementation is so poor that many EMS advocates including physicians who are former medics oppose the attempt because it promotes skill training over education and puts a cap on the functions of medics based on skills performed, not educational credentials. If I remember correctly you needed a 4 year education for 3-4 more skills, all of which are becomming more common in EMS. That would be one year per skill. Not a smart idea.

Ultimately, we are responsible for the future of EMS. Only we can shape that future to be a success or a failure and the best way to do that is to lead by example. Accept nothing but the best from those around you, and demand that they do the same.

best of luck.

 

[Shishkabob]

People who think that since they have more education then someone else in the same profession, they are well within their rights to talk down to others.

But that's every profession.

 

[Veneficus]

Post of the year!

I know that Rid 911 is upset and tired of preaching and preaching and no one ever getting it. But I do see him changing minds, just as he and ventmedic changed my mind. I truly believe in the power of people. Lets start local and ask our local programs to up the interview process and the pre-reqs. As more and more programs start this, we can write to legislator to abolish the two week EMT schools. Small steps.

I taught at a program that almost went under because they increased standards and everyone went to the medic mills. (several good instructors with vision lost their positions to this) In my area in the US, if you eliminate volunteers and firefighters from class, you'd have 1-2 students a semester. Colleges would not support that.

 

[Epi-do]

here is the first problem, certain agencies do not want to put forth the time or money to inccrease standards. I have struggled for more than a decade to try and convince them.

I am not going to assume you are referring to FDs here, but I know that locally that is who this statement would best apply to. It is just one of many reasons why we need to really evaluate the marriage of fire/EMS. I know there are plenty out there who are against it, and we can only hope that someday someone will listen to those voices.

You seem to underestimate the efforts of people who tried. Not just myself, but people who worked far longer and harder than I. We are a small minority.

It isn't a matter of underestimating the efforts of those who have tried/are trying. It is the fact that it is a minority. More people need to care and put forth some effort to assist those already involved in the fight.

many people leave EMS for other healthcare professions because of the lack of support, education, opportunity, and respect. I didn't start my career with the idea of becomming a physician, but that is where the path has led.Many nurses I know were medics first. But again, for the same reasons as I, they moved on.

These are not the people I am referring to. Over time, people, their lives, wants, and desires change. Furthering your education, and continuing to grow as a person are completely normal. Whether moving on for reasons similar to those you have stated, or being forced to do so due to injury or some other unforeseen circumstance, is one thing. Entering an EMT class because it will "look good on my application for XXX school" is something different entirely.

 

[daedalus]

I taught at a program that almost went under because they increased standards and everyone went to the medic mills. (several good instructors with vision lost their positions to this) In my area in the US, if you eliminate volunteers and firefighters from class, you'd have 1-2 students a semester. Colleges would not support that.

Not around here. My EMT program was taught by a MSN/NP and a B.S. in paramedicine, and education was held over "training". The folks in my class and area take EMS pretty seriously. Take a look at Ventura County EMSA is you wish.

If the area program where you lived went under because of increased educational standards, legislate to shut down the medic mills and soon a shortage of EMS personal will force the public and politicians to embrace the new standard of EMS education that will be born at both the local and national levels.

If your not part of the solution than you are a part of the problem. You may be able to sit here and cut down EMS now there the end of med school is in sight but do not think for one second that we are broken beyond repair, because if thats the case you need to match into a nice Derm residency and leave us alone.

 

[mycrofft]

There are three prerequisites for positive change in EMS:

1. A finite talent pool, or one which cannot be inflated by pumping half-trainees into service.
2. Legislation which sets realistic and care-oriented standards.
3. The ability to say "No, Sir!", even to the point of denying the employer your labor or refusing certain practices.

There are side issues, such as how to serve areas not able to support a
full-time, paid, all the bells and whistles EMS; how to ensure that the EMS services actually make enough money to survive the backbreaking costs of insurance/medical supplies/vehicle and other infrastructure; how to provide service at a cost which people can afford.

I personally feel some events need to occur:
1. A union or professional association with a recognized registered bargaining arm. It may seem counterintuitive, but being in cahoots with AFFF is not the worst thing to be doing as long as EMS is not subsumed; you need as much muscle as possible.
2. Government-provided EMS at the EMT-Basic and Paramedic levels, with transport. If this is done using the FD as the "scaffolding" through which to dispatch and station it, firefighters must stop cross-manning except and unless they are fully and voluntarily qualified, then never dual-tasked (to corrupt staffing figures). An independent medical chain of authority must exist, with a medical person at the top, not a fire chief, as good-intentioned as the chief may be. Perhaps firefighters on firefighting assingment may practice EMT-B, but only if they are there and EMS cannot be awaited due to pending loss of life.
3. Private EMS to carry out wheelchair van, interfacility transfer, and other calls not requiring the extension of EMERGENCY care. (Mobile ICU's, etc., would be private and paid through insurance etc. unless a government entity chose to go into it). Hold private EMS to the same standards as government agencies.
4. Cut the frilly categories, go back to EMT-A and EMT-P, then let individuals earn seperately accredited certificates in such specialties as first responder, wilderness, "intensivism", SAR, disaster, and other categories. If you want to give drugs, start IV's,. etc., then you need to become a Paramedic, period, no "EMT-IV" or other "hamburger helper" approaches to allow people to practice outside their scope.
5. Make it illegal for any employers to independently certify then utilize people in certain skills instead of hiring or training them in recognized categories. Bundle skills into coherent categories (start with EMT-A and EMT-P) and require techs to train and certify into a category, not in particular skills. (Currently many states allow employers to do this with LVN's, but that is evaporating).
6. Make EMT-A and -P training profitable for private and public educational insitutions and have educational requirements for them to meet just as they do for other medical professions.
7. Discipline individuals and agencies skirting these requirements.

For areas not able to field their own EMS, how about the military? Currently medics and med techs are not given much practicum outside a hospital, and Reservists are deployed without any sometimes. Who has plenty of airevac aircraft and people with them needing practical experience? (Why do fisherman and boaters get better service, through the mighty Coasties, than citizens of rural Nebraska or Alaska?).

Personally, start here and now. Before you shut off youir computer, write letters and emails to your representatives in Congress, to the President, to your County and state representatives. Identify yourself, then calmly write to them that the system is broken, and it can be fixed without bankrupting the nation or the citizens. When someone decides to "go union", you find out who is behind it; if it makes sense, then do it. And personally get the highest training and follow the most ethical and patient-centered practices you can!

 

[mycrofft]

But I digress...

I hate being required to suffer abusive patients because it might make them mad, when they are consciously seeking drugs or other goodies from me.<_<

 

[csly27]

This is not a jaded conversation and not being rude, truthfully you are correct. You do not what to say; because you cannot say anything yet. How do you really know what is best in EMS or both worlds. How much do you really know about EMS? Did you study what is in the challenged EMS profession before entering the profession or just want to enter the public service arena because of the benefits? Remember, your in a class just above First Aid level, and has this really prepared you for a health care profession? Alike the CMA it is just a crude entry level.

I challenge you to remember this post in 10 years (if you are still in EMS or Firefighting) and think of this.

Hence, part of the problem in EMS. Most do not really study, investigate the profession before entering. Alas if I was to ask the basic components of an EMS system, majority would fail. Yet, most feel they are an expert within it. Again, pre-enrollment screening should be performed before entry. A good discussion of what EMS involves and what it does NOT involve.... the truth.

R/r 911

Benefits? yeah right. that must be it, or it could be the cool uniform. I may not have a lot to say about it yet but I will. do you honestly think that everyone goes into this profession just for those reasons? Well if you do you just met someone who is not enering this profession for that reason. I am going into ems because that is where I want and need to to be.

I could be a stay at home mom if I wantd to to, But I need and want to be out there making a diffrence in the world.Even if it is just a small diffrence that no one even really notices. I realize That I will be called every name in the book, me kicked at, spit on, vomited on and even worse. I get that I am ok with that.

I have done research, I do know the basic components of ems. I also realize that the emt-b class is just a step above first aid. Do I think that makes me 100% prepared? Not a chance, there is no book, or story that an instructor can tell or a video that I can watch that will prepare me for what is out there. All I can do is study hard and go out there and do what I was taught, learn from the mistakes that I know I will make. As long as I learn from them and continue my education I will do great. I am not going to become an experienced emt overnight, I would be an *** to think that.

I agree that they should pre-screen people before taking these kinds of classes. There are only a few in my class that actually want to enter into this profession why they are there in the first place is beyond me, they will never make it. I also agree that cma and such is a crude entry level, been there done that, with that being said everyone has to start somewhere right?

I will look back in ten years and remember reading a post that made me want to work that much harder to prove that there are people out there that want to go into this profession for the right reasons not the wrong ones.

 

[marineman]

The problem that many people here see as far as being a firefighter/medic or firefighter/emt is that they should both be full-time careers requiring 100% dedication of education to truely be competent at either one. You say you could be a stay at home mom if you wanted implying that you have kids which we all know are another full time job. Do you truely think you're ready and able to put 100% dedication into 3 full time jobs and still stay out of the padded room?

Others may have different opinions about fire services having medics but here's my view. I think it's great that in urban areas firefighters are required to be EMT-B's and I also think it's great that an engine responds to all of our EMS calls as first responders. My problem is when a fire service operates the ambulance itself and their thought process behind assigning people to the ambulance. It was mentioned that in most fire services that operate an ambulance it is used as a punishment or it is for rookies to prove themselves. That leads to people that want nothing to do with EMS operating an ambulance and requires people that want nothing to do with EMS to become paramedics. If a fire service wants to operate an ambulance that's great but they need to be completely independant. They need to hire Medics (or EMT's) for the ambulance and only for the ambulance, these medics shouldn't need to have any fire education as they're not in that job to be firefighters, they're there to be medics and operate the ambulance. They should hire firefighters to be firefighters only and not require that they're medics because they will not have the option of working on the ambulance unless they have applied for that position. That will be the biggest step forward as far as preventing people from entering this profession for the wrong reasons. You look around any paramedic class and you will see that 75% of the students are there because they want to be career firefighters but they can't get a job as a firefighter unless they have their medic certification. After class how much effort do you expect these people to put into furthering their medical education when all they want to do is put the wet stuff on the hot stuff?

As for the topic at hand, I think a good push to make would be to talk to the boss of our respective companies and start a push to get them to only hire medics with an associates degree or higher. If we can get enough companies on board with that line of logic we can mediate the education requirements ourselves without requiring congress or any other government body. The benefit to the company is better bargaining power against the fire departments by proving that we now have more educated and better trained medics and will be able to provide a better service to the community. With that fire departments will be forced to either give up their service area or upgrade their training requirements. I know in some areas where medics are hard to come by in the first place this could be a tough push but well worth the effort as it will benefit everyone in the end. Even if it's just a smaller step like requiring 2 semesters of college A&P in order to be hired we are still mediating entry level education requirements at our level and we can continuously push until we are satisfied with the requirements.

Outside of that I think the NREMT is doing us a big favor by only certifying medics from accredited schools, the problem being that the requirements to be accredited still do not provide an adequate education.

In conclusion for those that read this far or for those that are too lazy to read it and want something brief, I feel there are too many problems coming from too many levels within the current EMS system to be addressed all at once. Those of us pushing for higher education and training standards are the minority so I think at least amongst ourselves we need to dedicate ourselves to all fighting the same issue at the same level until it is corrected and use a systematic approach to solving problems one at a time. Our efforts will go un-noticed with few of us hitting things at all levels for different reasons but if we make a unified effort at a single level we may have more push. If you read all of that you deserve a prize.

 

[boingo]

I have no idea why you would think its good to send a $500,000 truck full of water to every EMS call. Do you send an ambulance to every alarm, dumpster fire, water leak or lock out?

 

[Veneficus]

Not around here. My EMT program was taught by a MSN/NP and a B.S. in paramedicine, and education was held over "training". The folks in my class and area take EMS pretty seriously. Take a look at Ventura County EMSA is you wish.

If the area program where you lived went under because of increased educational standards, legislate to shut down the medic mills and soon a shortage of EMS personal will force the public and politicians to embrace the new standard of EMS education that will be born at both the local and national levels.

If your not part of the solution than you are a part of the problem. You may be able to sit here and cut down EMS now there the end of med school is in sight but do not think for one second that we are broken beyond repair, because if thats the case you need to match into a nice Derm residency and leave us alone.

My point was that it is one thing to sit and talk about lofty goals, but yet another to bring them to reality. The low standards and medic mills have been legislated into effect by powerful lobbies. You may have been fortunate, just like I was, to be educated at a very outstanding paramedic program in your area, but it is not common. Medic mills are opening in states they never existed in before. It's not that I don't want higher standards and a respectable EMS profession, its that we need details on how to actually do it. EMS will be repaired, but I am hoping it will not have to crash before it can be, for the benefit of those still involved.

What do you propose as a step in getting current EMS providers to embrace education over training?