Medic School Without Experience?

[daedalus]

Im glad this question was asked. I just finished my EMT-B and had the time of my life in school. I've worked for years in menial jobs since I dropped out of high school and it was great to think I would be able to pursue a career that was important and also a professional job.

I have been trying to decide whether to go straight to Paramedic school or attempt to get 911 experience under my belt. It seems like there are strong arguments for either decision.

I have an oppertunity to volunteer with a 911 squad which seems really interesting but the downside is the call volume is not much more than 1000 a year.

The other problem is that I am almost 25 and this seems very old for EMS which surprised me. If I wait I could be almost 27 before I became a Paramedic! I worry that I will not find work at that age with so many other medics having been working since their early 20s.

I honestly don't know what the right decision is.

There is no strong argument for getting time on a truck. Its dogma and tradition that cause people to tell you "dude, you gotta have 911 experience before medic school, otherwise you will fail".

I really do not see where handing things to a medic on a 911 unit will help you when you are trying to study the immune response in detail for your first pathophysiology test. I do not see how getting to drive code will help you assimilate the massive amount of pharmacology you will have to learn. Spiking bags at work also is no good when it comes to learning the krebs cycle. In fact, I am the one with the least amount of 911 work in my medic class and have the highest grade.

By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.

 

[SeeNoMore]

I guess I was trying to say there are arguments for the benefits of both, if not the absolute necessity. I have no doubt what you are saying is true, and that someone who works hard can do very well in Medic school and make a great Paramedic. By the same token, in can not hurt to have at least some experience in Ambulance operations and BLS before school either.

Ill probably end up spending a year on a truck. It just feels like a long time to wait and like I said, I got into this late. Thanks for the advice though, and good luck in school.

 

[TransportJockey]

The only reason I had any time on a truck is because I was working while taking all my pre-reqs. I was trying to get into medic ASAP. And I actually haven't worked on a truck, except for internship, since beginning of the cohort

 

[46Young]

The thing is the medic who only depends on street smarts doesn't have the education behind them to know how much harm they are doing. Also, the street smart medic who doesn't have time for all that book learning will go through a PDQ medic mill just to get on the street and avoid all that education stuff.

The educated Paramedic we are referring to has spent time learning and applying their knowledge in clinicals and not just running amok on the street looking for shortcuts.

So yes, the medic mill products who rely only on street smarts that have little education to back up what they are doing should be eliminated. I also don't even see how an EMT fits into the equation.

I was referring to medic gaining street smarts as a basic, on a dedicated BLS rig, and then going through a quality medic program. A medic mill product is no better than an EMT-I, educationally speaking. I agree with the need for a stronger educational foundation and a structured internship program. There are things that can only be learned on the street, with no safety net.

 

[46Young]

There is no strong argument for getting time on a truck. Its dogma and tradition that cause people to tell you "dude, you gotta have 911 experience before medic school, otherwise you will fail".

I really do not see where handing things to a medic on a 911 unit will help you when you are trying to study the immune response in detail for your first pathophysiology test. I do not see how getting to drive code will help you assimilate the massive amount of pharmacology you will have to learn. Spiking bags at work also is no good when it comes to learning the krebs cycle. In fact, I am the one with the least amount of 911 work in my medic class and have the highest grade.

By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.

Having a high grade is vitally important, but is only one side of the job. I've seen new medics with a solid educational background choke under pressure when on their own. If you've always had a preceptor as a safety net, it will be difficult function on your own, never having done so before. If you're too shaken up and nervous to get the BLS done, how can you provide effective ALS? I've repeatedly seen nervous mistakes such as starting an IV, monitor, 12, NTG, and forgetting O2. Fumbling with spinal immobilization, or splinting, dangerously extending onscene time. Starting a line on a trauma pt before doing a full ITLS survey. Forgetting about lung sounds until much later in the incident. Not attempting repositioning of the hypotensive pt prior to pharmocological intervention(with respect to respiratory status). Not knowing how to remove the pt in extremis from a residence with narrow stairs, tight corners, and various other obstacles. If you don't have a trauma weave, you can make stirrups out of cravats to prevent the pt from sliding down the backboard. Forgetting to continue CPR on each landing of the multi story building. Not watching the BLS to ensure proper CPR, being preoccupied with recalling protocols. Worrying about a room air O2 sat while the pt is sucking wind. Forgetting to properly dispose of sharps during a hectic situation. These are all repeatedly observed mistakes by new medics that didn't do well under pressure, at least not well enough to properly implement BLS prior to advanced interventions. You'll find out when you are actually finished with class, and are required to function on your own as a paramedic, not a student as you are currently.I know medics who couldn't backboard a pt, or perform effective Cx compressions, never having had to do so, as they were doing only ALS stuff, and using BLS for CPR. Not everyone has the resources to relocate or travel to attend a medic program that is superior to the one in their region. As such, one needs to make up for shortcomings elsewhere, on their own.

 

[terrible one]

By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.

a guy in my class had the 4th highest grade and failed his internship because he had no experience. it goes both ways. all you are doing is reading the material and not practicing it in stressful situations when you need it. the book cant teach you everything in every single situation.

 

[VentMedic]

a guy in my class had the 4th highest grade and failed his internship because he had no experience. it goes both ways. all you are doing is reading the material and not practicing it in stressful situations when you need it. the book cant teach you everything in every single situation.

What are clinicals for?

Just like the EMT-B, if it takes you very long to realize your arse is in a dangerous place, you probably don't belong in EMS. Does it really take you 3 years to know that gun shots in your direction is bad?

Stressful?

The ones who usually get stressed out the most are those who have had the comfort of being an EMT-B too long where they know the Paramedic has the ultimate responsibility. Then, when they are put into that seat, they fall apart because they have become so accustomed to having someone else in the lead while they believe they are saving the Paramedic.

Again, it is usually those who have little education that continue to argue against it.

 

[triemal04]

Why is it that so many times the same threads come up with the same responses again and againandagainandagain?

Simply saying that "you will learn everything that you know in your paramedic course" is not entirely accurate, as is using the CNA before RN argument. It's not entirely false by any means, but there is a little more to it that often times is left out.

The amount of time that is required for clinical (in hospital) and the internship (field) varies widely, as does what the student/intern is allowed to do. In some states the amount of time an internship lasts is as little as 200 hours with 40 ALS pt contacts...think about it, that's less than a month of full time work. Do you really think that will help truly prepare someone to work in the field on their own? Of course, that isn't necessarily a problem; some agencies expect this, and are willing to spend the time, effort, and money in getting their new hires up to speed before letting them loose on their own...strange, but it's usually these agencies that don't have a problem with people leaving... Others expect people to come in fully prepared and throw them to the wolves right off the bat...not necessarily a problem if your internship consisted of well over 1000 hours, but if it was short...could be a problem. This is where prior EMT experience could help. (and by EMT experience I mean working in a 911 system paired with a paramedic...though that doesn't always work out)

If you come into the internship already being comfortable in talking with pt's, police, nurses, doc's, family, bystanders, nut jobs, and everyone else we encounter, it makes things much easier; not having to learn how to gain a rapport with people gives you more time to focus on how to be a paramedic. The same goes for the basic skills; backboarding, splinting and the like. While it doesn't take much time to master those, it still takes time away from being able to learn other things, and, depending on where you go, you may not have the luxury of a lot of time.

Unfortunately, most of the jobs that people find as EMT's are not 911 related, or only a tiny percentage of the calls are; interfacility transports all the way. While this can be a learning experience, more than likely it won't be, and will lead to learning poor habits, attitudes and lousy pt care. So really, that isn't recommended.

There really isn't a perfect answer. You need to look at your own comfort level in talking with random people and being able to function in stressful situations, the length of the paramedic internship, how the local services (or wherever you want to work) train their new medics, and the type of job you'd really get as an EMT. For some it may be better to work as an EMT for a year, or during medic school. For others it won't.

Again: having experience as an EMT in a 911-based system can be a good thing and beneficial before going on to paramedic school. It also can be detrimental unfortunately. There is no strict answer that will work for each person...look at how long your field internship will last, the call volume for the agency it will be with, all the things said above and in 46young's post; yes, you will learn all that (hopefully) during the internship, but, how well you learn them and everything else that you are supposed to be learning will depend on multiple factors, with the length of that internship being a large factor; if it's short you may have problem down the road when you start working as a paramedic. Hell, just look at some of the posts on this forum for proof of that. (with that said I'm not advocating mandating prior experience as an EMT, rather revamping the entire education structure)

Oh...and arguing that RN's aren't required to be CNA's...if the above didn't make it clear them even blunter: RN's have much, MUCH more time spent on clinicals than paramedic students (which isn't a bad thing)...so the comparison is pretty lousy.

 

[JPINFV]

So then, basically the argument isn't for working as an EMT-B first, it's about making clinicals longer.

 

[triemal04]

So then, basically the argument isn't for working as an EMT-B first, it's about making clinicals longer.

Unfortunately I can only think of how to say yes in about 3 different languages, but if I could come up with more...

That's one of the biggest problems with changing how we teach new paramedics; yes, the classroom portion absolutely needs to be longer, but so does the field internship. Think about it, why do doctors, RN's, PA's, and I'm guessing RT's all spend thousand(s) of hours or YEARS after the classroom part is over learning how to apply what they learned in a real-world setting? Because it can take that long to really learn what you are doing. If you end up somewhere that has a short internship (and there are plenty of accredited college programs that are otherwise very well regarded that still have short ones) having a little prior knowledge and experience may be beneficial. Or it may not.

It might be a cop out, but there really isn't a perfect answer for this. It really will depend on the individual, where they go to school and where they would be getting their EMT experience to determine if it's a good or bad thing.

 

[VentMedic]

I've been using the quantity of 3 years in my posts because that is approximately how long it may take to get a two degree.

Ideally one would get the EMT-B and not wait a year to start with the science prerequisites. I can not see working for a year if you do not have enough A&P to even know what your are assessing. And, a live patient gives you a great "lab" to study by. Too many EMT-Bs believe they must wait to take any additional classes. Some RT departments won't hire for any entry level position such as O2 jockey or equipment tech unless they are already enrolled in the RT program AFTER they have already completed their prerequisites. Nursing programs may also be like this. Once all the prerequisites are complete and the first official semester of nursing school is done, the student may apply for a CNA cert and get on with a hospital which may then pay the rest of their way.

Other healthcare professions often are required to get their prerequisites completed before even apply to their program of choice. Then, they start their classes for their future profession. This also frees up time to add more clinicals. Some RT and RN student will do not less then 24 -36 hours of clinicals per week besides classroom. This is full time patient contact with several patients and only a couple of scheduled breaks.

In summary, any time you spend as an EMT-B without being enrolled in some type of class that will promote your learning is wasted.

 

[terrible one]

The ones who usually get stressed out the most are those who have had the comfort of being an EMT-B too long where they know the Paramedic has the ultimate responsibility. Then, when they are put into that seat, they fall apart because they have become so accustomed to having someone else in the lead while they believe they are saving the Paramedic.

Again, it is usually those who have little education that continue to argue against it.

dont agree at all.

 

[VentMedic]

dont agree at all.

Well since there is not that much difference between an EMT and a Paramedic in many areas of California, I can understand your comment.

 

[terrible one]

edit nevermind

 

[VentMedic]

only 1000 hours more education.
you may be content with 20 year old paramedics with no experience working on your loved ones but not me.

Again, your state scope of practice is not very impressive. As well, in many counties, EMT-Bs and not Paramedics work the CCTs. But, of course, the MICN is required on most of them because of the lack of sufficient protocols for the Paramedic.

I also hope you are not bragging about 1000 hours. That truly is not much although it is about 200 hours more than some states but CA also hasn't put a stop to the ALS engine sleep overs in that hour count.

How I hate speaking terms of just hours of training when EMS is over 40 years old!

 

[terrible one]

not bragging just stating its about 5x more in depth than emt

 

[46Young]

Triemal said it better than I ever could. I'll go with those posts.

 

[Ridryder911]

The old .."must have BLS" or "BLS first over ALS".. is nothing more than propaganda T-shirt and patch vendors love to sell to uneducated providers.

Just how much experience does one have to have to learn to load a cot, apply oxygen therapy and take vital signs? Geeez... if it takes a person a year to learn those basic skills and apply them, maybe those are not the type of people we need in medicine!

C'mon basic skills are just that... basic! Repetitive practice makes one able to provide competency. Those of us that are in education realizes that upon the chain of level of hierarchy; EMT skills are not difficult and are just very simplistic. That is not an anecdotal statement but from researched studies.

Experience is great, is it essential no. Whom would I rather have? Someone that knows what they are doing both clinically and that can apply it.

Experience is great but way over rated.

R/r 911

 

[atropine]

yes definately go to medic school

 

[Noctis Lucis Caelum]

yes definately go to medic school

class starting june 16th ^_^