"What's in a name?" Dr. Bledsoe's article

We've got a few paramedics here that have (and a few more who are close too) PhDs in the field. Not MDs or doctrates of anything else....literally Drs of Paramedicine. I wonder how they'll go in the field.

Granted they don't tend to do many shifts now days with their academic commitments but I would be interested to see how they fare turning up to an ED and introducing themselves as Dr...LOL

We've spent a bit of time looking at various documents significant to the history of EMS, the (US) National EMS research agenda being one of them. How has the development of EMS "investigators" and academics come along since publication?
 
Melclin said:
We've got a few paramedics here that have (and a few more who are close too) PhDs in the field.
Click to expand...

Many of the Ph.D.s, like the one I have been working on, is in education. There few if any programs that are actually "Paramedicine" by degree at that level.

The higher education will be benefiicial in pushing for educators and not just instructors who only have the same certificate level of education they are teaching. Example: EMT teaching EMT students. Medic mill grads teaching more medic mill student.

As the education level of the "instructors" increases, it will bring about a different role model. Now, in some places, it is Bubba teach by what Bubba does and this is how Bubba does it and Bubba don't know why it works but sometimes it works for Bubba.

Also, right now in the college programs, many of the chairs or department heads are RNs. This is also true in some of the state EMS offices where education is still regarded with importance to obtain a position.

The field of research could also be given more credibility as more Paramedics with higher education take an interest to spur on more studies and to keep everyone on their team interested in the hows or whys the academic side is just as important as the "skill".
 
Paramedic Maurice White Jr., a paramedic with the Creek Nation EMS Service who was recently assaulted by an Oklahoma State trooper,
Click to expand...

It's clear where Dr Bledsoe stands on this.
 
Thanks for clarifying that Rid. The only issue I see with that is field internship time. For insurance/state purposes wouldn't the students need at least some level of EMT? (I don't know much about that side of things, I'm just thinking out loud here.)

Vent, it may be clear to you and I, but I don't think it's that clear to laypeople. Where I used to work people would get confused between the LPNs and ANPs. My point is that at generally you find all those different designations at different places, making it less easy to confuse them. Where as EMTs and Paramedics are often found at the same place at the same time.

I was also comparing CNAs to MAs and LPNs on a functional level, not necessarily comparing the details of how each profession is managed. ie if all 3 of those work in an primary care office, they will likely all have the same scope.

I agree that it's silly some states have 8 different EMT levels because they have EMT Defib or EMT IV. I also agree that there should be set scope taught, and Employers can allow skills within that scope as they see fit.

I think the issue arises when an employer wants someone to do something outside of their designated scope. If individual employers and individual medical directors expand the scope who is ensuring those people really know what they are doing? The state is. When I worked under and expanded scope as a Paramedic our standing orders and training program had to be approved by state medical board. We didn't get a special designation, but I can see where states would want to create designations so there is one set training and testing standard without them having to individually assess each case.

I'm not sure there is going to be a way to stop that from happening unless things change on a national level, and there are nationally designated pre-hospital responder levels and scopes of practice that are applied to all states.
 
Aidey said:
Vent, it may be clear to you and I, but I don't think it's that clear to laypeople. Where I used to work people would get confused between the LPNs and ANPs. My point is that at generally you find all those different designations at different places, making it less easy to confuse them. Where as EMTs and Paramedics are often found at the same place at the same time.
Click to expand...

Patients don't always need to know every detail of what everybody on scene is supposed to do. That patient may have a need for a Paramedic in another county where that person might be functioning under a very limited scope of practice. Also an EMT might intubate in Ohio and not in Indiana. Or, they might intubate in one county in TX and not in another.

The patient just needs to know who you are at that moment and what you can do for them. They don't need to know your entire autobiography. I have seen many NPs and even MDs appear at a bedside to answer a call light and do something a CNA might do and not go into detail about their title because it wasn't relevant. Sometimes we educate one patient at a time and may sometimes have to choose that time wisely.

Whenever I introduce myself to a patient I give my name, title and a very brief description of who, what and why. Any other details will be on the relevance and situation with enough info to make them comfortable with me. It is about their emergency or illness and not about my life story.

Nurses also like to keep things uncomplicated and sometimes just the title "nurse" will do even if there is a Ph.D. behind their names. Many nursing educators do have Ph.D.s but when in the clinical settings, they respond to the word "nurse" also when a patient calls and may not feel the need to flash anymore education if it is to just give a patient a sip of water.

Once EMS figures out and get over their own identity crisis as well as insecurities, then they can educate the public.

RT has actually made their profession easier while eliminating the "tech" word. They raised the education to a degree and only have 2 credentials: Certified and Registered Respiratory Therapist. The education now qualifies them for the Therapist title but they must meet additional national testing requirements to make Registered. Thus, two board exams and a clinical simulation to get to that credential. The difference is who is then allowed to work in the ICUs or on specialty teams.
 
VentMedic said:
Whenever I introduce myself to a patient I give my name, title and a very brief description of who, what and why.
Click to expand...
Unfortunately, it's here that problems could arise and potentially contribute to the general public having even less understanding of what a paramedic (or EMT for that matter) can do. I'm all for removing the vast majority of state certs out there and mandating that there are only 3 nationally (maybe 4 but that's a stretch), but there does still need to be a difference in the names, if only to avoid confusion (I know, good luck with all the variables in EMS from region to region) on the public. Look at Canada; while everyone is a "paramedic," there are still primary, advanced, and critical care paramedics; couldn't get away from differentiating between the levels.

The perfect example of why would be a pt that is seen several times; first by paramedic A (a paramedic by today's standards) who treats their problem as thoroughly as they can and next by paramedic B (an EMT by today's standards) who can't do more for them than place them on O2. Think it might confuse the pt a little and lead to further misunderstanding of EMS?

Not to get into the middle of that debate (doesn't bother me either way), but the same could be applied to the NP with a PhD calling themself "doctor." You have to figure, that if you are in a hospital/clinic, and someone walks up to you and introduces themselves as "Dr. So and So," that the natural assumption is that they are an MD, or DO. Despite having earned the right to call themselves doctor, depending on the situation, it might not be the best choice of introductions. Of course this could change if more and more NP's reach that level and continue to provide increasing amounts of primary care, but right now...

Forgetting all that, Bledsoe is right, names aside, the final goal should be to be providing appropriate medical care, no matter if you are a paramedic, EMT, paramedic 5, advanced EMT 2 or so on and on and on.
 
In the hospital, the average patient will see more than 50 DIFFERENT healthcare providers of various levels and titles and still manage to get through their stay very well. Some here are placing too much emphasis on what to be called and appear to be easily offended if a little elderly lady doesn't automatically know they are a Paramedic.

Florida has used only EMT and Paramedic for at least 4 decades and have managed to keep the confusion to a minimum when petitioning for tax reforms. Simplify the levels to just 2 - 4 different ones and then worry about someone who mistakenly calls you an ambulance driver.

Most in EMS are clueless at to the titles of the people in the hospital. Few can tell the difference between a certified Phlebotomist or a Lab Technologist with a Masters or Ph.D. As from the various conversations here, few in EMS understand various titles of nursing.
 
Vent, it's not about being offended, and we aren't talking about when the designations are EMT and Paramedic. I'm talking about if we renamed everyone Paramedic. That is what I was referring to in my post, not if there were two different designations.
 
To do away with all of this name game, part of the problem is EMS being so intertwined with volunteers and FDs. A bachelor's of science in Paramedicine should be the entry level requirement for our field. No basic, advanced, or intermediate EMTs.
 
I don't think we need to do away with EMTs entierly, that may be a bit excessive.
 
Aidey said:
I don't think we need to do away with EMTs entierly, that may be a bit excessive.
Click to expand...

Why not? Staff trucks as dual medic units.
 
Dual medic units, depending on the area aren't necessary. On an ambulance that only has 3-4 runs a shift do they need 2 medics and the additional cost that comes with that? What about a BLS IFT truck?

On a busy ambulance that runs 10 or 12 calls a shift 2 medics makes more sense because they can divide the runs between them, preventing either from being totally buried.

I think nearly every other level of provider has a lower level that works in the assistant capacity, I don't see why Paramedics should be any different.
 
Well, in low call volume areas do you really need a truck and an engine at the fire department?

Why not just throw a few ladders on the engine and do away with the truck?
 
jtpaintball70 said:
To do away with all of this name game, part of the problem is EMS being so intertwined with volunteers and FDs. A bachelor's of science in Paramedicine should be the entry level requirement for our field. No basic, advanced, or intermediate EMTs.
Click to expand...

In Sept 2010 The paramedic program I will be applying to will lead to a BSc in paramedicine. The program is a joint program by Centennial College and the University of Toronto.
 
JPINFV said:
Well, in low call volume areas do you really need a truck and an engine at the fire department?

Why not just throw a few ladders on the engine and do away with the truck?
Click to expand...

You need both if they don't have hydrants.

That aside, different trucks are for different jobs, so I don't think it's an equal comparison. The way I see it, we have different levels for different roles, which makes sense to me.
 
jtpaintball70 said:
No basic, advanced, or intermediate EMTs.
Click to expand...

Horrible idea.

Basics, while the education is lacking, are invaluable. Can still be used as first responders by FD. Can do BLS IFTs, as mentioned. What about areas of the country where it's next to impossible to entice a medic to go out there, let alone 2 for a single shift, and 6 to cover 24/7?



If anything, up the education of EMT, but it'd be naiive to say they are useless and get rid of them throughout the country. Heck, Canada, who everyone "looks up to" for EMS, still has an EMT-B equivalent.
 
Last edited by a moderator:
Aidey said:
I don't think we need to do away with EMTs entierly, that may be a bit excessive.
Click to expand...

Why do you argue to keep the EMT-B at the level it is now? Is it to make yourself as a Paramedic look better? Or, would you be jealous that they might have as much if not more education than you do now and might be able to do the same skills?

Nursing also used these arguments initially when the CNAs wanted to get certs as PCTs which is about another 500 - 700 hours in addition to the CNA. The RNs felt alittle challenged by having the CNAs increase their skills and understanding. They also used the argument of supervising unlicensed staff. That was over 15 years ago and most hospitals now encourage their CNAs to upgrade to PCT. What the RNs found was those with more education and training were less of a worry because they now understood some of what they had been doing as a CNA. You won't hear an RN tell a CNA not to advance although many will tell them it is best to go the whole route to RN but just the same they will not tell someone to stay with the little education and skills a CNA has.

Why should EMS be any different? Why do we continue to tell EMT-Bs to stay just as you are with 110 hours of training?

And for additional training/education I am also not talking about a 3 hour inservice with 3 passes on an intubation dummy as advancement. In all honesty, the additional skills and letters tossed at EMTs with 110 hours of training is just another way of keeping some happy so the cheap labor can continue.

So why do some continue to argue to keep the EMT-B at such a low level? It is definitely not for their benefit. If one wants to raise the professional standards of EMS they should include the EMTs also. Imagine if all the EMT-Bs had their education/training raised to a comparable level in Canada. That by itself would make medic mills and two weeks EMT farms a thing of the past.
 
You must log in or register to reply here.
Back
Top