thegreypilgrim
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To make a Bachelor of Science degree (in EMS/Paramedicine) a requirement of paramedic licensure in the US (seeing as nearly all other developed countries have already adopted this standard)?
What would it take...
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8jimi8
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we've been waiting all these years for you to tell us...
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thegreypilgrim
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I obviously don't have the answers.
I mean I know it would take slaying the Fire Department/Private Sector/Nursing Association beast that would resist such an idea at all costs, but I really have no idea how to do that.
LucidResq
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This isn't anything I'm super knowledgeable about, but I guess it would, in part, involve eliminating volunteer EMS and shifting more towards municipal or third-service based entities rather than fire-based or for-profit companies.
JPINFV
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A drastic shift in the culture of EMS and eliminating the fire department as a primary provider of paramedic services.
8jimi8
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just curious why you including nursing associations. i never knew they were holding EMS back from higher education...
especially since they have their own arguments about making 4 year degrees mandatory.
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thegreypilgrim
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I definitely agree, but with regard to the cultural shift I foresee something of an intractable problem. I don't see how to instill a more intellectual-friendly culture, without implementing university degree programs to attract the sort of person EMS needs (i.e. the sort of person who would've otherwise gone into science, or pre-med, or pre-PA, or something like that) to replace all undesirables we presently attract.
I would also anticipate some serious resistance from nursing associations along with fire departments (particularly here in California).
LucidResq
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Yeah, I agree with Jimi, why nursing associations?
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thegreypilgrim
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I suppose it's more of a regional thing. I live in California, and here, nurses have deeply entangled themselves in EMS. That is, they do a lot of CCT, HEMS, and EMS education. Paramedics here function more like nurse-extenders than physician-extenders, and RNs have actually gotten themselves officially defined as higher medical authorities than paramedics in our state legislation. For instance, when paramedics call medical control in California, they don't speak to a physician, they speak to an RN with a MICN (Mobile Intensive Care Nurse) credential. Nurses also do most of the QA/QI, continuing education, and management type duties for EMS here. The BRN here wields considerable political power for some reason, and tends to view paramedics as competition and, therefore, something to be stifled.
They are a large reason why paramedics are not allowed to function as medics in hospital EDs in our state; and, tend to resist (read: strike down with great vengeance and furious anger) any and all attempts to increase the functions and responsibilities of EMS in our state.
As an example, last year when we were having all that pandemonium about Swine Flu, the state EMS Authority proposed the notion of utilizing paramedics to assist in administering flu vaccines. Well, as of today not a single paramedic in this state has administered a single mL of any sort of vaccine (at least not to my knowledge) - largely because of resistance from nursing associations.
In short, if paramedics are to be more educated, that would mean there could feasibly be competition for all the CCT, HEMS, education, management, & disaster planning aspects of EMS that presently is done predominantly by RNs in California.
Like I said though, I think this is a regional thing.
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Shishkabob
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The argument could be made that for a good degree, a portion of a 4 year Paramedic degree would be focused upon community Paramedicine, and nursing organizations aren't exactly lining up to support the idea of community Paramedicine.
But I'm just playing devils advocate here.
But I'm just playing devils advocate here.
B.A. In Paramedicine
The University of Washington this year just started (or are about too) a Bachelors Degree for Paramedicine... Obviously you have to have an Associates degree, along with Anatomy/Physiology classes and maybe some other medical designed classes.
I've thought about "attempting" to go for my B.A. In paramedicine after I complete my Paramedic training. I'm also 'thinking' about going for my RN but I still have 2 years of pre-reqs to complete prior to doing either one. Also finding the $$$ to help pay for it? Easier said then done in most cases, especially for the UW!!
EMT-B, CPR/AED/First Aid Instructor:
The University of Washington this year just started (or are about too) a Bachelors Degree for Paramedicine... Obviously you have to have an Associates degree, along with Anatomy/Physiology classes and maybe some other medical designed classes.
I've thought about "attempting" to go for my B.A. In paramedicine after I complete my Paramedic training. I'm also 'thinking' about going for my RN but I still have 2 years of pre-reqs to complete prior to doing either one. Also finding the $$$ to help pay for it? Easier said then done in most cases, especially for the UW!!
EMT-B, CPR/AED/First Aid Instructor:
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The enemy of my enemy is my friend
I would support a nursing take over of EMS.
As many EMS agencies of all stripes from Privates to FD, and even some 3rd services seem to want to be a vocational labor group and actively fight against higher education standards and for years (read decades) only the most minimal progress despite the herculean efforts of forward thinking EMS leaders; I think the only way realistically forward is to make a RN license a prereq for taking the paramedic course.
Nursing has a very pro education agenda. While I think parts of the agenda are definately misguided and an insult to the noble profession of nursing by trying to be medical school light or moving towards a "management" role with hands off patient care and a focus on research that serves almost no purpose but to further "nursing science," whatever that is, the core of the nursing curriculum is absolutely suited to be the prereqs for an EMS professional.
Let's face it, look at the way many of the California EMS providers view EMS on this very forum and honestly tell me you want to expand their scope and role without further education. Tell me how that in any way benefits the patients?
Politically advancing EMS has proved to be impossible. EMS agencies and providers as well as impotent trade organizations that don't actually commit to positions that would help EMS because it might anger part of the membership, has sewn its own doom.
I would testify for legislation in person for free that a nursing takeover of EMS is absolutely in the best interest of the patients.
I would support a nursing take over of EMS.
As many EMS agencies of all stripes from Privates to FD, and even some 3rd services seem to want to be a vocational labor group and actively fight against higher education standards and for years (read decades) only the most minimal progress despite the herculean efforts of forward thinking EMS leaders; I think the only way realistically forward is to make a RN license a prereq for taking the paramedic course.
Nursing has a very pro education agenda. While I think parts of the agenda are definately misguided and an insult to the noble profession of nursing by trying to be medical school light or moving towards a "management" role with hands off patient care and a focus on research that serves almost no purpose but to further "nursing science," whatever that is, the core of the nursing curriculum is absolutely suited to be the prereqs for an EMS professional.
Let's face it, look at the way many of the California EMS providers view EMS on this very forum and honestly tell me you want to expand their scope and role without further education. Tell me how that in any way benefits the patients?
Politically advancing EMS has proved to be impossible. EMS agencies and providers as well as impotent trade organizations that don't actually commit to positions that would help EMS because it might anger part of the membership, has sewn its own doom.
I would testify for legislation in person for free that a nursing takeover of EMS is absolutely in the best interest of the patients.
What would it take? Too much!
It has taken over a decade and a lot of *****ing, backwards and forwardsing and very heated debate to get the BHSc Degree made mandatory here.
Now mind you the Degree is only for Paramedic, for Intensive Care Paramedic (ALS) that requires something called a Post Graduate Certificate, which is between a Bachelors and Masters.
It has taken over a decade and a lot of *****ing, backwards and forwardsing and very heated debate to get the BHSc Degree made mandatory here.
Now mind you the Degree is only for Paramedic, for Intensive Care Paramedic (ALS) that requires something called a Post Graduate Certificate, which is between a Bachelors and Masters.
Ridryder911
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It would only take the insurance companies (including medicare) to want justification in payments. Short and simple. Education and professionalism will be excelled where and when the bucks go...
For example, since many are comparing EMS to nursing; really look why nursing have proceeded to academia in lieu of OJT or hospital based nursing programs in which was so popular? Educated nurses knew and demanded that the system be changed, they became involved where it really counts.. the pocket book!
They became active in insurance review and payers, fees and reimbursement programs, administration to ensure that their voice be heard, and finally became entangled in JCAHO in which almost all hospitals want accreditation to ensure timely payments. By being involved they have mandated and ensured that their profession will always be taken care of .. and regulated by nurses for nurses. Look at their Board of Directors per each state... how many non-nurses are involved in their overview and regulatory means? Now,compare this with EMS....
Please let's not use the old .."but they have 200 years ahead of us" excuse. It was not until the mid-60's early 70's that nursing changes really occurred.
Fortunately for my nursing profession actually became in the legislative process as well and ensured that a uniform and selective process be made for the profession. This is unlike the fragmented and disjointed systems of EMS. No set regulatory requiring no more than a pulse and maybe a GED to enter a program and to graduate reading one text book probably written at a elementary reading level with lots of pretty pictures and diagrams.
The real reason is many. No desire to increase due to no reimbursement values, no drive within the profession to really make it a profession (hence why, there is still volunteer EMS), no drive for those in EMS administration to want or desire for changes (no reimbursement changes to offset salaries).. and truthfully the public could care less... again; our own fault for not educating and regulating, marketing ourselves.
Nurses have been pushing the 4 year degree for decades... it won't happen either. Again for some of the same reasons mentioned in EMS debate. It's almost a dead issue within the nursing profession, and has self regulated itself by those with a higher degree will be able to move upward where those that don't have the degree will not be able to.
R/r 911
For example, since many are comparing EMS to nursing; really look why nursing have proceeded to academia in lieu of OJT or hospital based nursing programs in which was so popular? Educated nurses knew and demanded that the system be changed, they became involved where it really counts.. the pocket book!
They became active in insurance review and payers, fees and reimbursement programs, administration to ensure that their voice be heard, and finally became entangled in JCAHO in which almost all hospitals want accreditation to ensure timely payments. By being involved they have mandated and ensured that their profession will always be taken care of .. and regulated by nurses for nurses. Look at their Board of Directors per each state... how many non-nurses are involved in their overview and regulatory means? Now,compare this with EMS....
Please let's not use the old .."but they have 200 years ahead of us" excuse. It was not until the mid-60's early 70's that nursing changes really occurred.
Fortunately for my nursing profession actually became in the legislative process as well and ensured that a uniform and selective process be made for the profession. This is unlike the fragmented and disjointed systems of EMS. No set regulatory requiring no more than a pulse and maybe a GED to enter a program and to graduate reading one text book probably written at a elementary reading level with lots of pretty pictures and diagrams.
The real reason is many. No desire to increase due to no reimbursement values, no drive within the profession to really make it a profession (hence why, there is still volunteer EMS), no drive for those in EMS administration to want or desire for changes (no reimbursement changes to offset salaries).. and truthfully the public could care less... again; our own fault for not educating and regulating, marketing ourselves.
Nurses have been pushing the 4 year degree for decades... it won't happen either. Again for some of the same reasons mentioned in EMS debate. It's almost a dead issue within the nursing profession, and has self regulated itself by those with a higher degree will be able to move upward where those that don't have the degree will not be able to.
R/r 911
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redcrossemt
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Hadn't thought about it this way before; but you make an excellent point.
redcrossemt
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So how do we increase the reimbursement values?
mycrofft
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Roger, Rid
Also, we again run out of solid semantic footing..what IS "EMS"?.
Nursing hit that reef with RN's versus LVN's, and certificate RN's versus degree RN's.
As I posted elsewhere earlier, EMT's, go back to school, get your degrees and MD's or work in case management or insurance or legislation, and get the science going to develop an independent body of knowledge, start unions, and have enough money out away (and stop bying guns, motorcycles, Xboxes with 50" plasma screeens) to be able and willing to strike if necessary.
Also, we again run out of solid semantic footing..what IS "EMS"?.
Nursing hit that reef with RN's versus LVN's, and certificate RN's versus degree RN's.
As I posted elsewhere earlier, EMT's, go back to school, get your degrees and MD's or work in case management or insurance or legislation, and get the science going to develop an independent body of knowledge, start unions, and have enough money out away (and stop bying guns, motorcycles, Xboxes with 50" plasma screeens) to be able and willing to strike if necessary.