What would happen if the NREMT required a degree?

[ExpatMedic0]

I figure instead of hijacking another thread or going off topic, I'll just start my own.

So I ask you, what do you think would happen if the NREMT required a college degree for Paramedic or even EMT certification? What do you think this would do for us (EMS) as a profession/career and why?

Thoughts, ideas, comments, opinions?

 

[CFal]

A degree for Paramedic I can see arguments for, but for EMT it would be the death of EMS

 

[TransportJockey]

A degree for Paramedic I can see arguments for, but for EMT it would be the death of EMS

Maybe ems as we know it in the us needs to die. And then get a proper ems system like some other countries have.
I would be all for requiring at least an associates to work on a bus, with a high level medic being a bachelors degree minimum.

 

[Carlos Danger]

So I ask you, what do you think would happen if the NREMT required a college degree for Paramedic or even EMT certification? What do you think this would do for us (EMS) as a profession/career and why?

I think requiring a 2-year degree would have little impact. Those entering EMS would have to spend a little more time in school, and community colleges would offer bridge program for those already practicing. I think it's be a positive but would have little real impact on anything.

If they required a 4-year degree, I think you'd see the NREMT die because no states would require it anymore.

I do not see a 4-year degree being commonplace - never mind mandatory - anytime soon.

 

[Mariemt]

It would be the rural areas that would suffer. The towns with only a few calls a week where they can't staff full time medics and rely on volunteers.

 

[EpiEMS]

Require 30 undergraduate credits (1 year of undergraduate study) for EMT or an Associates in any other field (a la Texas Paramedic) and an Associates in EMS for Paramedics or a Bachelors in any other field. Then ratchet it up, as needed, with the goal of making paramedics a bachelors trained profession at the minimum, and AEMT a bachelors in anything else or an Associates in EMS.

It would be the rural areas that would suffer. The towns with only a few calls a week where they can't staff full time medics and rely on volunteers.

The volunteers probably cost as much as full time folks, when you add it all up.

 

[Clipper1]

Other professions (RN, RT, RRT, OT, PT, SLP) encouraged the professionals in their profession to get a degree or a degree higher long before it ever became mandatory. This made the transition a mere formality when it came time to be the entry point into the profession.

We saw this with nursing back when the diploma to degree transition took place in the 70s and now with over 50% of the RNs holding BSNs, the transition there should be in about 10 years for many states. RTs took 20 years to transition to Associates and then 5 more to complete it. OT, SLP and PT (an old profession) have had long range goals set over several decades which is how they achieved their professional foot hold with CMS. They have also keep up with their research to show their worthiness in healthcare.

Just the degree alone will be nothing unless your profession has something to show how it improves quality of care.

The education models for transition in healthcare are there and so are the degrees. But EMS seems to want to reinvent the wheel.

But, then EMS also has already imbedded itself by "progressing" to a higher level with another quick cert level for "community Paramedics" which is at least a Bachelors or Masters in other countries. So, why spend time in college if you can do it all with very little extra school time? I think there was also a discussion here where skills made you just as marketable as those with education in other countries.

I also agree that some states would just drop the NREMT like Michigan threatened to do with the school accreditation requirement.

 

[Rialaigh]

requiring an associates wouldn't do jack. I could probably find an "online associates program" and have one in less than 6 months.

I am probably one of the few people that really doesn't see a huge benefit in requiring tons more education for EMS. That education could be very well spent on other career fields that need it more.

 

[terrible one]

The fire unions would be pissed!

 

[CFal]

The fire unions would be pissed!

Not in Rhode Island, fire depts don't use NREMT. And anyways, most unions have it in contract that having a degree gives them more money.

 

[ffemt8978]

Not in Rhode Island, fire depts don't use NREMT

And if the NREMT required a degree, a lot more agencies would stop using it. Realistically, it would spell the end of the NREMT.

 

[CriticalCareIFT]

1-States would drop NREMT and administer own state exams

2-Those states that don't drop it would see a abundance of bridge programs spring up all over the state (online and hybrid) or some type of "grandfathered in" clause where you do some CME or some other nonsense.

How would you reply to old timer medics who would say "I am doing this job for 15 years, why should I all of a sudden go to college? To do the same job that I already perform with the same protocols and get paid the same?"

I truly don't understand anyone that wants to stay in EMS as a career, you get shi-ted on everyday, pay sucks, no advancement, working EMS should fuel your efforts to get a real degree and find a real career.

 

[ExpatMedic0]

For those that think it would be the end of the NREMT or no state would go for that, I would have to disagree, and here is why.

Example 1: If that is your case, then how do you explain for example, nursing, which did not use to be a degree. It has found a way to transition to a degree. Although there are a handful of diploma/certificate RN facilities still out there, but its pretty much extinct. I did not see people throwing out the NCLEX exam when this happened. Why is that? Also, how about RT's?

Example 2: Australia. Australia's Paramedics use to be a vocational trade with no degree. I spoke with a close colleague of mine who is a flight medic and ICP in Australia about the Australian EMS education issue and he said the following

"yes I have been in the system long enough to compare & contrast the transition from unskilled drivers/stretcher bearers to vocational tradesman's assistants to university education & professional autonomy."

It should be noted, they require a minimum bachelors degree now with post graduate opportunities available.

How do you explain the 2 examples above?

Although this discussion is strictly hypothetical , thinking like "That is the way we have always done it", "that wont work", ect ect.... is why we are in the rut we are in people... Our paramedics make 40k a year with private ambulance and the rest of the worlds make 80-100k+ doing the same thing.

 

[joshrunkle35]

1-States would drop NREMT and administer own state exams

2-Those states that don't drop it would see a abundance of bridge programs spring up all over the state (online and hybrid) or some type of "grandfathered in" clause where you do some CME or some other nonsense.

How would you reply to old timer medics who would say "I am doing this job for 15 years, why should I all of a sudden go to college? To do the same job that I already perform with the same protocols and get paid the same?"

I truly don't understand anyone that wants to stay in EMS as a career, you get shi-ted on everyday, pay sucks, no advancement, working EMS should fuel your efforts to get a real degree and find a real career.

Well, if I understand correctly, nurses were grandfathered in. Additionally, consider that a person that has worked in EMS since 1990 knows a lot more than when they went to school. If I understand correctly (because I was not a paramedic then), things like C-PAP, various splinting devices, fibrinolytics and today's pre-hospital cardiology and treatment is different. Advances in medicine mean a lot more information. The person without a degree has most likely continued learning over time and has amassed much more information than a bachelor's-level degree.

I don't think that people who already work in the field should have to go back to school, but I definitely think that there is so much information that could be learned that I would fully support future students having at least an associates degree. I am currently completing an Associates degree in EMS/Fire and one of the major benefits is the access to ALS training: post-paramedic school, and then also a lot of rescue tech courses. In addition, all of the simple basic courses like math, English, etc make a person well rounded and figure into things like report writing or drip calculations/drug dosages. Also, with federal and state standards on how many have to graduate, schools are incentivized to plan in things like "pre-paramedic" courses that focus on things like biology and chemistry, which I also believe makes for a more "well-rounded" person. I don't know that an Associates degree can actually be completed in 60 credits, many pre-requisites like EMT basic and pre-paramedic coursework didn't count towards my degree. I am at over 100 semester credits and still haven't graduated. I haven't taken any "remedial" coursework either. Because this is the case, I would advocate for a Bachelor's level degree, simply because despite what you read on paper, the difference may actually be 3 years vs 4 years, rather than the traditional 2 yrs vs 4 yrs.

I think this would help bring Paramedicine into the "Allied Health" fold.

 

[triemal04]

And if the NREMT required a degree, a lot more agencies would stop using it. Realistically, it would spell the end of the NREMT.

Bingo. Everyone needs to remember that NREMT is a testing agency. They don't set or enforce standards for the nation, just for those who want to use their test. And there is no requirement that any state use it.

If anyone was to ever get serious about requiring a degree it would be tied to medicare reimbursements, and to a lesser extent private insurance; require the provider holds a specific degree before medicare will pay a dime for the treatement they gave.

 

[triemal04]

For those that think it would be the end of the NREMT or no state would go for that, I would have to disagree, and here is why.

Example 1: If that is your case, then how do you explain for example, nursing, which did not use to be a degree. It has found a way to transition to a degree. Although there are a handful of diploma/certificate RN facilities still out there, but its pretty much extinct. I did not see people throwing out the NCLEX exam when this happened. Why is that? Also, how about RT's?

Example 2: Australia. Australia's Paramedics use to be a vocational trade with no degree. I spoke with a close colleague of mine who is a flight medic and ICP in Australia about the Australian EMS education issue and he said the following

"yes I have been in the system long enough to compare & contrast the transition from unskilled drivers/stretcher bearers to vocational tradesman's assistants to university education & professional autonomy."

It should be noted, they require a minimum bachelors degree now with post graduate opportunities available.

How do you explain the 2 examples above?

Although this discussion is strictly hypothetical , thinking like "That is the way we have always done it", "that wont work", ect ect.... is why we are in the rut we are in people... Our paramedics make 40k a year with private ambulance and the rest of the worlds make 80-100k+ doing the same thing.

You're talking about 2 vastly different things than American EMS.

RN's have to take the NCLEX; there is no other alternative. For EMS there is; any state can create their own test without any issue, complication, or change in reimbursements. I suppose you could argue that the same could have happened for RN's back in the day, but I don't believe there was ever the mishmash of different tests for RN's that there are for paramedics (could be wrong on that, admittedly). That's part of why it would be so easy to drop the NREMT; there are allready lots of states that have their own test, and, let's face it, it would be very simple to come up with a paramedic test anyway.

The nursing profession also seemed to have figured out that holding a degree would eventually lead to higher reimbursement rates, higher pay, and the ability to do more for patients (let's save the arguement about whether or not that is needed for another day). EMS hasn't got that yet.

Australian EMS is nowhere as large as EMS in the states, nowhere near as fractured, and when it started it went down a very different road than it did here. Many of the problems we face they don't and because of how their entire medical system runs never did, and even the way that EMS providers are used is very, very different.

 

[Carlos Danger]

For those that think it would be the end of the NREMT or no state would go for that, I would have to disagree, and here is why.

Example 1: If that is your case, then how do you explain for example, nursing, which did not use to be a degree. It has found a way to transition to a degree. Although there are a handful of diploma/certificate RN facilities still out there, but its pretty much extinct. I did not see people throwing out the NCLEX exam when this happened. Why is that? Also, how about RT's?

You're talking about 2 vastly different things than American EMS.

RN's have to take the NCLEX; there is no other alternative. For EMS there is; any state can create their own test without any issue, complication, or change in reimbursements. I suppose you could argue that the same could have happened for RN's back in the day, but I don't believe there was ever the mishmash of different tests for RN's that there are for paramedics (could be wrong on that, admittedly). That's part of why it would be so easy to drop the NREMT; there are allready lots of states that have their own test, and, let's face it, it would be very simple to come up with a paramedic test anyway.

You both have good points.

Keep in mind that a BSN is still not required of nurses, and while the percentage of RN's holding a BSN is increasing steadily, ADN programs are not going anywhere anytime soon. There is actually a fair amount of debate still over whether it is necessary or cost-effective to require a BSN, and whether it is wise for the industry to keep pushing for higher education as hard as it is.

I don't know how nursing came to be so well organized and cohesive, to be honest. How did it come to be that every state requires the NCLEX? How did the CCNE (the agency that accredits nursing programs) come to have such influence over the industry? Why is the ANA so much more powerful than the NAEMT? Learning a little about these things would be a worthwhile project for anyone really intent on helping push EMS in the same direction.

But while I think nursing probably holds some good lessons for EMS, I think the two are different enough that they maybe shouldn't be compared as often as they are. Maybe an allied health profession makes a better model for EMS to follow? Respiratory therapy.....

 

[triemal04]

You both have good points.

Keep in mind that a BSN is still not required of nurses, and while the percentage of RN's holding a BSN is increasing steadily, ADN programs are not going anywhere anytime soon. There is actually a fair amount of debate still over whether it is necessary or cost-effective to require a BSN, and whether it is wise for the industry to keep pushing for higher education as hard as it is.
While a BSN isn't required, an associate's still is. We can argue all day long about how "neccasary" a BSN is, and how much more is actually learned (or not learned potentially) about patient care with a BSN. What matter's though is that the minimum required education really is required and enforced for EVERYONE, AND it meets an easily seen, easily understood, and quantifiable level; an associates degree.

I don't know how nursing came to be so well organized and cohesive, to be honest. How did it come to be that every state requires the NCLEX? How did the CCNE (the agency that accredits nursing programs) come to have such influence over the industry? Why is the ANA so much more powerful than the NAEMT? Learning a little about these things would be a worthwhile project for anyone really intent on helping push EMS in the same direction.

But while I think nursing probably holds some good lessons for EMS, I think the two are different enough that they maybe shouldn't be compared as often as they are. Maybe an allied health profession makes a better model for EMS to follow? Respiratory therapy.....

Honestly, I think it probably happened with nursing and not with EMS at this point for a couple reasons.

EMS has been very fractured ever since it started. From the beginning there have been multiple competing groups attempting to provide it, and often times butting heads over how it should be done, and what is needed to do so. Makes it very different to come up with anything close to a consensus, or to make any strict requirements and innovations. Not so much with nursing.

Nursing has always been a profession. I'm sure plenty of people will freak out, but the simple fact is that there are a large amount of volunteer EMS providers out there who lobby to keep the standards low. The reasons why matter very little for the most part, and it doesn't change the fact that requiring extra education when so many people do this as a hobby and not as a career will be very hard. Even getting the two different groups to see eye to eye and speak in a cohesive fashion can be next to impossible.

We don't need to compare what we do medically to nurses, but I do think we should be looking at what they've done to get where they are a lot more.

 

[lightsandsirens5]

And if the NREMT required a degree, a lot more agencies would stop using it. Realistically, it would spell the end of the NREMT.

Which would be wonderful...

 

[Christopher]

The fire unions would be pissed!

We've added an associates onto everybody's development plans who do not have a degree already at our fire department. Not every fire department drags their knuckles.