What's it mean?

[hometownmedic5]

I disagree. There are a few reasons. The two big ones are fire unions and private, for profit ambulance services focused on making money, not delivering patient care. It's unlikely either of these two entities will welcome any advances in EMS education until Medicare and the private insurers mandate that ALS means a degree. And since these two groups of entities own the majority of the ambulances on the road, they matter. (I understand the fire unions don't "own" ambulances, but you get my point)...

No, its going to have to happen another way. I really only see one path that would work and that would be an organization like the NR mandating the degree for certification. Then the issue would be forced.

 

[DrParasite]

Honestly, looking back 19 years (damn, time does fly), I never expected to be in EMS as my full time profession. in 2001, I temporarily relocated to NYS, and went through their EMT program, and was asked if I want to make this my profession; I clearly said no (only one person in the entire class was looking to do that), but it was something I enjoyed doing on the side. Fast forward 3 years, and I'm working full time in a 911 EMS system, primarily in a small city but going out in the suburbs too. As well as going some inter-facility runs. A few years later, and I've accepted a new position, this time in a much larger city, but assigned to EMS communications and Special Operations. And when staffing permits, I get to play on the ambulance. I've worked during several major snow storms, Superstorm Sandy, the Superbowl, and even made the front page of the newspaper. And after I relocated to NC, decided to go to paramedic school. So I don't consider myself a newbie, and I've been around the block once or twice.

Truth be told, the love I once had for EMS isn't there anymore. I look at my former coworkers and see they don't know as much as I thought they did. I see how poorly some paramedics treat EMTs, and it annoys me. And then I see how many paramedics want to be great providers, but they have their hands tied by operational policies, restrictive protocols, or lack of resources to do the job. I also find providers who, quite honestly, don't want to do the job they are being paid to do. They get visibly angry that they have to go answer a call (I know, how dare someone tell me to go assist someone in need??)

And after I moved to NC, I find that even paramedics, who are always in demand and are the backbone of the NC EMS system, are making $35 to 45k a year, which is great if you a single guy, but many still end up working lots of OT so they can have extra funds so they can live comfortably.

@VentMonkey, you asked what it means to me? EMS is an abused resource, where Grade A+ service is expected with Grade C funding. There might be some unicorns out there, but the vast majority of EMS systems (at least many that I have seen) rely on another service to stop the clock (because they don't have enough units), are moved around like chess pieces from street corner to street corner.

I've seen ambulances that were part of the FD, where the junior guys were on the ambulance until a spot on the engine opened up, and seen a FD give 20% of their funding to suppression, yet 80% of their calls are of the medical nature.

I would LOVE to see a degree be required to be an EMT. I don't ever care if it's an associates in basketweaving, if shows you have a basic understanding of the collegiate system, and passed college level English. Otherwise you get grouped in with this shining member of society:

I do think that a degree in EMS is a waste of time, unless the entire degree with 100% EMS focused. Every class should be directly applicable to the EMS world, particularly the clinical aspect. Too many people (myself included) treat EMS as a part time gig, or a stepping stone to something else, where they can do it once or twice a week and be as good as a full time dedicated employee (cough cough almost every FD that does EMS cough). And yes, I think Paramedic school should be either 2 years (if you already have a Bachelors degree) or 4 years if you don't. And yes, make every class directly applicable to EMS.

Make it harder to become an EMT, and harder to become a medic, make it harder to do the job part time, because you need to do it full time to keep up with the current best practices. I have 0 problems with volunteers who do EMS on the side, but this should be a full time commitment. and not an Earn Money Sleeping commitment, but rather something where you are expected to do the job full time to maintain competency.

Will it be rough on the private companies? sure. hopefully it puts them out of business. Pay everyone a living wage, and hire the providers into careers with livable salaries. EMS cannot survive solely on insurance reimbursements; if the public wants a service, they should be expected to pay for it. The days of getting something from nothing are over. If you want Grade A service, than you need to provide Grade A funding.

 

[EpiEMS]

I do think that a degree in EMS is a waste of time, unless the entire degree with 100% EMS focused. Every class should be directly applicable to the EMS world, particularly the clinical aspect.

While I am wholly in support of requiring a degree as the qualification for entry into the practice of emergency care, I would question your suggestion that "[e]very class" should be EMS related. Look at nursing degrees - many BSNs require a material amount of non-nursing work. The fact is, to be a professional, you *have* to be broadly educated - otherwise, it'll be awfully hard to navigate the multitude of environments (legal, regulatory, public information) that require communication skills, data interpretation, etc.

We'd be remiss in having a 4-year degree requirement if our paramedics are walking around unable to interpret p-values.

 

[hometownmedic5]

I don't ever see a degree requirement for the BLS level as it currently exists. The majority of BLS providers are either doing the renal round up or first due in a tiered system.

Whatever their function, there is nearly a never ending supply of people willing to bls for free. The wages increase that would go with even an AAS in BLS will never show returns for the agency or company.

Paramedics, maybe, if we can get some damn unity in this business; but I can't ever see a world where a BLS degree will work.

 

[DrParasite]

While I am wholly in support of requiring a degree as the qualification for entry into the practice of emergency care, I would question your suggestion that "[e]very class" should be EMS related. Look at nursing degrees - many BSNs require a material amount of non-nursing work.

Yeah, I heard that line of crap when I went to get my BS.... But there were plenty of classes that were such a waste of time, didn't benefit me at all, but were needed to get my degree. And I know several BSN students (who are adult age and went back to school and when I was in college), they agree that the nursing classes were what was important; the rest was just fluff. If you want to take other classes, double major, find yourself, whatever, I am not stopping you; but all the fluff won't make you a better provider.

The fact is, to be a professional, you *have* to be broadly educated - otherwise, it'll be awfully hard to navigate the multitude of environments (legal, regulatory, public information) that require communication skills, data interpretation, etc.

With all due respect, no you don't. If you go to law school, how many of your classes are not related to being a lawyer? If you go to medical school, how many classes are not related to being a doctor? Are those people not professionals?

This is why I like trade schools and community college's continuing education programs; they have one purpose, and one purpose only: to build you up enough to do that job, and to do that job well. No fluff, no extra content to make you well rounded, every minute you are in class is designed to get you to the goal. And they are typically shorter than degree programs, and at the end, you test for your certification (or take the Bar exam, or med school boards).

It's one of the reasons many people are turning away from 4 year colleges, because they spend some much time on fluff, and when students graduate, they still don't know what they want to do. Or they are 100,000 in debt, and can't get a job because they have all this theory and no real experience..

The only downside is you don't get college credit, so when you want to go further and get that degree, you need to start over, despite putting in a lot of work to pass the initial program. But a ADN takes the same NCLEX as a BSN, who (I am assuming) takes the same NCLEX to be called an RN, and at the end of the day, they are all nurses.

 

[hometownmedic5]

.
With all due respect, no you don't. If you go to law school, how many of your classes are not related to being a lawyer? If you go to medical school, how many classes are not related to being a doctor? Are those people not professionals?

Many, many of the credits you'll take on the path to a doctorate have nothing to do with your major. English courses, humanities, sciences, the list is endless.

 

[VentMonkey]

I agree a degree in EMS that focuses more on the clinical aspect would be great. I'm sure 1 semesters worth each of critical care, and community medicine topics wouldn't be impossible to manage; Creighton's is a full semester basically.

As far as other courses, EMS management is still pretty pertinent and should be part of the degree as whole still. The basic gen ed courses prior to entrance in to the program are fine, though personally as a paramedic with "experience", and who's managed to keep their NR it would be nice if they counted for a good amount of the prerequisite knowledge pertinent to a degree in a field that they've (clearly) already chosen to pursue as a career; maybe that makes me a bit selfish, or lazy though.

 

[DrParasite]

Many, many of the credits you'll take on the path to a doctorate have nothing to do with your major. English courses, humanities, sciences, the list is endless.

I'll double check with my brother, but I'm pretty sure he didn't take any science classes in law school.....

I guess reading comprehension should also be a required class, despite not being EMS related.

For clarification, I do think that you should have all your prerequisite courses completed prior to the paramedic curriculum (that was my reference to a 2 year program if you already have a Bachelors) or spending the first 1 to 2 years of your 4 year program getting your core classes out of the way (English, general sciences, math, etc). But if you are actually in the paramedic curriculum, after you have successfully completed any and all prerequisite classes, 2 years of EMS focused classes should be more than doable (although depending on what you add to it, you might need more than 4 semesters).

I would love to see 4 years of 100% EMS focused education, but I understand that you need to complete your basic core classes prior to spending time in how to be a paramedic.

BTW, if you think being a well rounded student will help you be a better paramedic, I suggest you read this: https://www.washingtonpost.com/news...ll-rounded-student-its-better-to-be-t-shaped/

 

[mgr22]

With all due respect, no you don't. If you go to law school, how many of your classes are not related to being a lawyer? If you go to medical school, how many classes are not related to being a doctor? Are those people not professionals?

Not sure about law school or med school, but engineers have to take lots of non-engineering courses. I didn't enjoy most of them, and I'm not going to say they all made me a better engineer or a better medic, but some of them did because they broadened my knowledge of things people like to talk about. When some of those people are clients or bosses or patients, believe me, it's worthwhile.

 

[hometownmedic5]

I think you're missing the point.

Before law school, you earn a bachelors degree, which involves all the usual undergrad courses, including all the non law(medicine, engineering, etc) courses...

 

[VentMonkey]

I think you're missing the point.

Before law school, you earn a bachelors degree, which involves all the usual undergrad courses, including all the non law(medicine, engineering, etc) courses...

His post sounded like that's what he'd eluded to, but perhaps I misread it.

This is all great stuff though, showcases some very bright individuals within this industry are still very much out there, thanks all.

 

[EpiEMS]

With all due respect, no you don't. If you go to law school, how many of your classes are not related to being a lawyer? If you go to medical school, how many classes are not related to being a doctor? Are those people not professionals?

To get in to law school, you are generally expected* to have a bachelors degree. And there are no pre-requisites - they expect a well rounded student. For medical school, you also are also generally expected* to have a bachelors degree, plus required coursework (some of which is totally unrelated to the scientific practice of medicine - but medical schools wants to make sure incoming physicians are able to read and interpret writing/convey information cogently).

No fluff, no extra content to make you well rounded, every minute you are in class is designed to get you to the goal.

So, unless something is 1:1 related to your field, it's not important to have in your educational program?

But a ADN takes the same NCLEX as a BSN, who (I am assuming) takes the same NCLEX to be called an RN, and at the end of the day, they are all nurses.

Sure, but BSNs are given higher pay, more leadership roles, etc. etc.
(And have better career advancement potential - I've yet to hear of an APRN program that will admit an ADN that doesn't have at least a bachelors in another field.)

* I say generally because there are some articulation agreements where you're granted your BA/BS after a year of medical school, having started in what would otherwise have been a senior year of undergrad.

 

[VentMonkey]

"Life saver" vs. "life sustainer":

A sub thread to this thread. A quote I find enlightening from time to time is "Lifesavers is a candy". I certainly feel that (as mentioned previously within this thread) there are times when we "save a life", but it isn't the ROSC patient or the AMI patient; i classify them more in the life-sustaining category.

Saving someone's life is often a lot like mentoring- it's often vague, and not directly apparent to the person performing such duties. Rarely is it every glamorous.

Do you think college courses, advancing educational requirements and standards, and raising the entrance bar will transform these thought processes by promoting a different outlook from the beginning to any potential candidate looking into such a program?

I know we beat the parallels between nursing school and us in pretty hard, but again, I can't really recall many nurses saying things like "I really wanted to get into nursing school to save a life.", etc.

 

[EpiEMS]

Do you think college courses, advancing educational requirements and standards, and raising the entrance bar will transform these thought processes by promoting a different outlook from the beginning to any potential candidate looking into such a program?

The simple answer is "absolutely." The complicated answer is that it will filtering the pool - the people who want an easy credential to go be a "life saver" will say, "that is too hard" and will not even bother (or, will try and then fail). More directly, the people who go into EMS to "save lives" are not the same people who would go into this field if there were higher entry requirements.

 

[hometownmedic5]

I've noticed that you only find the "hero" types at the lower levels in healthcare. I don't think I've never met a hero trauma surgeon; but the amount of technicians(emergency, radiology, dialysis etc) that believe they are the glue holding the whole medical system together is staggering.

 

[VentMonkey]

Given that this forum is intended (IMO) to help new candidates, there has to be some way to help instill that, even on here, even now without the aforementioned changes in educational standards...at least I'd like to think so.

 

[EpiEMS]

I've noticed that you only find the "hero" types at the lower levels in healthcare. I don't think I've never met a hero trauma surgeon

I think the reason is clear - education (plus age, you know, because after 4 years of college, 4
years of medical school, and 4+ years of residency, you're well into adulthood).

Given that this forum is intended (IMO) to help new candidates, there has to be some way to help instill that, even on here, even now without the aforementioned changes in educational standards...at least I'd like to think so.

I think a careful response to a question about "what is EMS like?" is warranted - providing pros and cons, while letting the newbie do their own calculus is the way to go.

 

[VentMonkey]

I think a careful response to a question about "what is EMS like?" is warranted - providing pros and cons, while letting the newbie do their own calculus is the way to go.

I agree, however, being in that age range that isn't quite dinosaur-ish, but is by no means new, fresh or green we often lose perspective which in turn creates disconnect and a gap, then a wall, between ourselves and these newer providers.

I don't intend to be a "meanie", I'm just me, but boy how it is refreshing to see younger providers who are willing to learn and listen, not hear, actually listen to the "elders".

However, as the seasoned providers we need to do a better job showing them the correct way which begins with understanding of "what it means", and may lead to less burn out based on false hopes on their behalf.

 

[hometownmedic5]

I think the reason is clear - education (plus age, you know, because after 4 years of college, 4
years of medical school, and 4+ years of residency, you're well into adulthood).


I think a careful response to a question about "what is EMS like?" is warranted - providing pros and cons, while letting the newbie do their own calculus is the way to go.

I came across this severa years ago:

Dear New EMT Class,

Welcome to the profession whose entry-level practitioners — you, in a few months — rank 4th from the bottom in the Bureau of Labor Statistics salary rankings. The only people paid less than you are pre-school teachers, dishwashers and meatpackers. The guy riding on the back of the garbage truck, or holding a sign at a highway construction zone, makes more money than your EMT instructor. Likely, a lot more.

And none of those people are required to make life-or-death decisions. You will.

It is a profession where the line-of-duty death rate is comparable to firefighters and police officers. For those of you who aspire to flight paramedic status, that particular niche is by far the most dangerous profession in America — ahead of loggers, miners, and Alaska crab fisherman.

It is a profession whose divorce, suicide and substance abuse rates soar far higher than the general population. The average career expectancy of an EMT is five years.

Five years.

Some of you will go on to jobs in nursing or other healthcare fields. Those of you that don't move on to nursing or PA school will leave EMS with a career-ending back injury, or leave EMS healthy but not whole; jaded and cynical, your idealism burned away in the furnace-like reality of our profession, your faith in the innate goodness of man gone like so much ash and smoke up the chimney.

You'll be disrespected
You will be disrespected by patients and bystanders who don't know any better, and belittled by doctors and nurses who should. And many of you will endure the abuse for free labor, donating your services as volunteers.

So why do I tell you this? Well, they call it informed consent, a concept you'll learn about in the first few chapters of that EMT textbook you're carrying. Before you agree to the abuse you're about to suffer, it's only fair that you know what you're getting into.

And it's not what you think.

You will sift through broken glass and twisted metal, wade through urine and feces and vomit, weather heaping torrents of verbal abuse from the people you're trying to help, all for the prospect of a few dollars on payday, and perhaps…just perhaps…a show of gratitude now and again.

I'm here to tell you that what you've been promised is a lie, if only a little white one. When you're green and idealistic, the romance and thrill of EMS is powerful. All of us were adrenaline junkies at some point. Plus, there's a decent chance it might even get you laid. What's not to like?

You won't save that many lives
But you will soon discover the hidden truth, the one that drives most people out of our profession:

We don't save that many lives.

Lifesaving may be what we train for, but the opportunity to actually save someone comes all too rarely, and when it does present itself, the outcome depends more upon luck and timing than our skills. In my career, I've had my share of code saves. Some of them even made it out of the hospital alive. Others hung on just long enough for their families to tell them goodbye. I've made the critical diagnosis, gotten the tough airway, turned around the crashing asthmatic, and stabilized the shocky gangbanger with multiple unnatural holes in his person. I've needled chests, paced, defibrillated, and cardioverted, and given countless drugs.

But, other than a handful of exceptions, I can't state with any certainty that my actions were the difference between life and death. In that handful of exceptions, all but one or two were saved simply by applying the techniques that any John Q. Citizen with a basic first aid course could have done. Ask your instructor if you don't believe it's true. They'll tell you the same thing.

The reality of the profession
The reality of your profession isn't exciting rescues and cardiac arrest resuscitations twice a shift. Your reality will be dialysis transfers and people who can't poop. It will be toothaches at 3:00 am, and you'll have to maneuver your stretcher around five parked cars to get to the front door, and weave your way through five able-bodied drivers to get to the patient with a complaint so minor you can't believe they called 911 for it.

So why, if you're not going to save all that many lives, should you even bother?

You should bother because EMS is a calling. Even when you leave EMS, it never really leaves you. It's what Henry David Thoreau meant when he said, "Do what you love. Know your own bone; gnaw at it, bury it, unearth it, and gnaw it still."

You should bother because, even if we're not saving lives, what we do matters. It matters in ways unnoticed by us, to people you may not even remember tomorrow.

You should bother, because EMTs are privileged to play in life's great game. Too many unlucky people watch the action thunder by, stuck at a desk, or watching it on television at home.

You should bother, because it's the little things that matter. Most of your patients are ignorant of your skills. Few of them understand the technology you wielded so expertly. But they'll remember the smile you gave them, or the way you tucked the blanket in to ward away winter's chill, or the way you stood in the rain, getting drenched as you held the umbrella over them as your partner loaded them in the rig. They'll remember calm competence, and gentle speech.

They'll remember the joke you made to lighten the tension. They'll remember those things and more, and they'll remember your face long after you've forgotten theirs.

You'll be remembered
They'll remember you because, even though they were just another call to you, you were a major player in a defining event in their lives. They'll come up to you, years after the fact, and say, "I remember you. You took care of me when I had my heart attack."

And likely all you did was apply oxygen and take them to the hospital. Maybe you helped them with another dose of nitro or encouraged them to take an aspirin — really nothing they couldn't have done themselves. But you're the one they remembered, and you're the one they thanked.

You should bother, because in the tapestry of human existence, you get to contribute your own unique stitch. You get to make your mark in ways that cannot be quantified on a spreadsheet or a profit and loss statement. Not everyone gets to touch the life of another, but EMTs do.

You should bother, because when people are at their most vulnerable, they will invite you into their homes and tell you things they won't even tell their priest. And they'll expect you to make it better somehow. I'm not sure you understand now how profound an honor that is, but hopefully one day you will.

The question is, can you be worthy of that honor?

If you think so, then welcome to EMS. Do us proud.

Written by Kelly Grayson, NRP, CCEMT-P
Copied from https://www.ems1.com/ems-advocacy/articles/894089-Joining-EMS-Heres-what-youre-really-getting-into/ To post here.

I don't know that it's "perfect", but it's certainly a start.

 

[cruiseforever]

I've noticed that you only find the "hero" types at the lower levels in healthcare. I don't think I've never met a hero trauma surgeon; but the amount of technicians(emergency, radiology, dialysis etc) that believe they are the glue holding the whole medical system together is staggering.

That's because they went from hero to god.