EMS getting put down.

Veneficus

Forum Chief
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I agree with your first 2 paragraphs, and largely the other 2 but I just want to point some things out to the gallery who may be reading.

I just see everyone pushing their kid to a college education, even if little johnny is dumb as a box of rocks. I see way to many kids working at walmart, because they cannot find that dream job in political science. To many people are getting a degree in a field that has no job openings. Parents need to think of the future and steer their kids in the right direction..

Not everyone should go to college. If you do go to college and get a degree in a field that is not in demand, or has a changing demand nobody is to blame but the degree seeker. Research your field. If the cost of a degree is more than the money you will make, it might be time to look for something new.

There are several worthless degrees, like business. Many successful business people had successful ventures prior to going to school. They then went back to school to hone their money making skills.

Many degrees and jobs requiring an education require people with a considerable amount of drive. Simply applying for a job because you have a degree that matches will likely not do it for you. As an example I will use broadcast communications. The competition is high, even with a degree, you might never work in the field if you are not aggresive enough.

There is also a such thing as "the entry level position" if I owned a successful business, no way would I let somebody fresh out of school with no experience run a division or a department. They might have to start in the same position as somebody without a degree and work their way up. When it comes time for promotions though, somebody with a degree has a history of long term success and maybe a major failure. I would promote that person than somebody who is good but never failed at anything. You just don't know if they will come unglued when they do. Plus both will have the knowledge and skills learned on the job, the one without the degree may not have the knowledge or skills applicable but not learned OTJ.

We will always need the service workers to keep the world running and we will always need the higher educated to steer it in the right direction. But, there has to be a balance between the two. Not everyone is cut out for higher education, so do not let them feel bad about having a career that could make them happy. I encourage any kid to follow what they want in life. Do not worry about the money or the status. If you are not happy with what you do, then you will never be happy in life.

For sure. This coming from the guy who wanted to be a municiple firefighter that didn't do EMS. (I was young once too) But that job largely does not exist anymore. So just like the guy whos goal was to get a union job at GM, the vocational jobs change over time, so vocational people need to remain flexible and be willing to change the service they provide when the old one is no longer valuable.

The other caviat is how many jobs there really are. You don't have to be an economist to figure out that if there are 1000 plumbers and work for 100 that some are going to be out of luck. If the local electric company is has positions for 5 linemen and 2000 apply (sounds almost like a FD) somebody will be hungry.

When the supply outstrips the demand in an area, like here, once great wages decline. That can make a middle class living nothing more than a dream.

Once the service and vocational positions are filled, what does everyone else do? The current unemployment numbers show that employers will take a chance on somebody with a degree, no matter how meaningless it is, before they take somebody without one.

The only solutions my personal economist (aka wife) tells me would work in today's society in the US is to eliminate minimum wage and expect a lower standard of living in order to create microeconomies or to basically have an aristocractic economy, where those who have an education make a lot and those who do not make next to nothing as they take service jobs for those that have. (she is an expert at this stuff and it sounds logical to me) But when you do either "skilled" labor really takes a major hit.

I'll leave it to the readers to judge which we are moving to.
 

46Young

Level 25 EMS Wizard
3,063
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I feel that this discussion of the need of blue collar to higher ed (college) is perfect for EMS.

This is my vision; Move EMS from the Dept of Transportation to its own governing body. Make a national license (just like nurses.) Make the entire emergency department, from transport to PT release part of the EMT regimen. Yes, remove all the respiratory therapists, techs, RN's, etc. I would like to see five or six levels of EMTs just like levels of enlistment in the military, from E-1 to E-7. Everyone is fully trained in the basics of assessment, and treatment you can then add specialties like x-ray tech and so forth in front of their level, or for a better term, rank.

The emergency dept. does not need to be military in nature but rather a fully functioning unit with the same basic education. EMS is trained for emergencies now let's use our abilities to the fullest potential, blue-collar to full professional. :blush:

You're talikng about taking what's currently a two year degree at best and adding adding additional clinical/skills sets from other professions that have four year degrees. We're taking about BSN's, RRT's, X-Ray Techs for starters. Sure there's some overlap, but we're taking about making an E-7 EMT an expert in upwards of four or five professions. How many years of school would that take, and how would the EMT possibly maintain proficiency is each area? In addition, in each area, there are subspecialties, such as a CCRN, NICU nurse, PICU nurse, etc, just for one field. Any acute IFT's may have a nurse, RT, and an MD from the appropriate specialty riding with the EMT/medic. If just having an RN or BSN were adequate, there wouldn't be NICU teams, PICU teams, etc. Any nurse would do.

This is also why I believe that EMS won't progress clinically past the EMS AAS for the forseeable future in the U.S. I don't feel that much extra is needed for 911 txp, and for IFT's the most severe pts will get a team, some combination of a nurse, RT and MD. Basically, if you're a medic, and you really enjoy IFT and want to do more, you're not going to attempt organization to lobby for increased clinical content to the paramedic curriculum. You're going to go for your BSN, and then work towards a chosen specialty as a txp nurse. You know that your compensation, job security, career advancement, benefits, etc. will easily trump whatever EMS is offering.
 
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MrBrown

Forum Deputy Chief
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I would like to see five or six levels of EMTs just like levels of enlistment in the military, from E-1 to E-7

No way bro that is just not how systems worldwide are going. Less levels that are more highly educated and equipped is the way to go.

Canada and New Zealand have three levels, Australia, South Africa and the UK have two and most of Europe have two as well; one of which is either a CC RN or a Doctor (but they wear blue jumpsuits for crying out loud!).

All we need is something like this:

- Patient Transfer Officer: somebody to drive Nana home, maybe a first responder course at most

- Ambulance Paramedic: BHSc year degree with 12 lead interpretation, cardioversion, defib, ASA, GTN, nebules, glucagon/glucose, inhailed and parenteral analgesia, IV fluids, adrenaline, anti emetic, naloxone, midaz etc

- Intensive Care Paramedic: Graduate degree with specialist ability to perform RSI, thrombolysis, steriods, chest decompression etc

You can also look at Extended Care Paramedic or Community Care Paramedic who can do indwelling catheters, Rx, x ray referrals, alternate pathways etc.

This is pretty much how Australia and NZ are currently setup except we are scoping the ECP/CCP roles.
 

JPINFV

Gadfly
12,681
197
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Make a national license (just like nurses.)

Except there is no national nurses license. National exam? Yes. National license? Nope. Requiring a national license is unconstitutional in the sense of being outside of the purview of the federal government.

Make the entire emergency department, from transport to PT release part of the EMT regimen. Yes, remove all the respiratory therapists, techs, RN's, etc. I would like to see five or six levels of EMTs just like levels of enlistment in the military, from E-1 to E-7. Everyone is fully trained in the basics of assessment, and treatment you can then add specialties like x-ray tech and so forth in front of their level, or for a better term, rank.
Why reinvent the wheel? Are we also going to banish physicians from the ED as well?
 

alphatrauma

Forum Captain
311
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regale me

I think the position of PA should be removed entirely from all aspects of patient care.

I would LOVE to hear more on this!
 

Roam

Forum Crew Member
30
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0
Nice! I knew this would start a discussion, no ED Doctors remain, they are the professional oversight or officers; Captains. PA's remain as a type of field LT. The rest are sub-specialties with the same basis in EMS training.

Think of it this way, I am a BU3. My specialty is building, I am a third class petty officer and supervise a squadron of four. Now, even though my specialty is in building I still am well versed in all the basics of weaponry, squad formations, command structures, communication, etc. My point is why can't the EMS structure work in this manner. Everyone, top to bottom is trained as an EMT-B (this will be boot camp or OCS if you are an ED) they are thoroughly versed in the basics of transport and assessment then choose their specialty. This is where emergency department personnel originate, they could even attend the same programs as typical techs with the exception of thier speiclized EMS training.

No, even in the military an E-7 is knowledgeable in the basics of all things military but are masters of their MOS or specialty. I knew more about building and framing than my ET commanding officer.

Just thoughts gentlemen, have fun!
 

JPINFV

Gadfly
12,681
197
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Because not everyone needs to be an EMT-B and the vast majority of EMT-B training is either already in place (since very little progresses past basic first aid) for the providers who need it or useless. Additionally, specialties don't really work in the same manner as military ranks. One does not necessarily progress from ED tech to lab tech to RN or any other such consideration.
 
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ExpatMedic0

MS, NRP
2,237
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No, even in the military an E-7 is knowledgeable in the basics of all things military but are masters of their MOS or specialty
But guess who makes the calls at the end of the day... the Brand new 20 year old butter bar with no experience at all.
 

mycrofft

Still crazy but elsewhere
11,322
48
48
With all due respect, this is like walking into CHEERS

..and listening to Norm and Cliffie rehashing the same old same-old. Or, to quote Meredith Wilson,

"You can talk, you can talk, you can bicker, but it's different than it was".
"No it ain't! But you gotta know the territory..".

http://www.youtube.com/watch?v=JZ9U4Cbb4wg

I see this scene taking place in an extended (REALLY extended) modular with a bunch of emergency medical technicians of various letters and certs.

Oh, and the de facto national nursing standard is the NCLEX, but nowadays employers don't care as long as the nurse will do as their told and not kill anyone. Sometimes that's a balancing act.
 

Sasha

Forum Chief
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Nice! I knew this would start a discussion, no ED Doctors remain, they are the professional oversight or officers; Captains. PA's remain as a type of field LT. The rest are sub-specialties with the same basis in EMS training.

Think of it this way, I am a BU3. My specialty is building, I am a third class petty officer and supervise a squadron of four. Now, even though my specialty is in building I still am well versed in all the basics of weaponry, squad formations, command structures, communication, etc. My point is why can't the EMS structure work in this manner. Everyone, top to bottom is trained as an EMT-B (this will be boot camp or OCS if you are an ED) they are thoroughly versed in the basics of transport and assessment then choose their specialty. This is where emergency department personnel originate, they could even attend the same programs as typical techs with the exception of thier speiclized EMS training.

No, even in the military an E-7 is knowledgeable in the basics of all things military but are masters of their MOS or specialty. I knew more about building and framing than my ET commanding officer.

Just thoughts gentlemen, have fun!

Because EMS is health care, not the military....
 

Veneficus

Forum Chief
7,301
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I would LOVE to hear more on this!

The more of them I encounter and see them "at work" the less respect I have for them.

The only thing they seem interested in is telling everyone how highly educated and smart they are while only wanting responsibility for the most basic and benign of care that could easily be done by a nurse. They also seem to like to follow protocols so simplistic and benign that it makes EMS look like cutting edge education in their quest to not be responsible for their decisions.

I'll top it all off with the lack of commitment to medicine because going to medical school is too hard, or too expensive, or takes up too much time from other things.

If you are going to be billed for service, make sure you get it...

From a doctor
 

Roam

Forum Crew Member
30
0
0
But guess who makes the calls at the end of the day... the Brand new 20 year old butter bar with no experience at all.

Oh, don't we LOVE butter bars! My old Senior Chief loved it every time he saw a new one and had to break him in as to who REALLY ran the show...
 

mycrofft

Still crazy but elsewhere
11,322
48
48
Try being a twelve-year 2nd Lt in the same unit you were enlisted.

five is four.
 

firetender

Community Leader Emeritus
2,552
12
38
Isn't this where it started?

why do people think EMS is an easy career choice. I find it extremely offending that people dont take us seriously.

Perhaps they take us TOO seriously.

We are the street cleaners.

We are the people that remove the dead, deformed, ill, debilitated, suffering and injured from the sight of the rest of us.

To face the afflicted, the individual must face his or her own mortality. Some day, he or she may be on the wrong end of our stretcher. Who wants to think about that? Paradoxically, the job we were trained to do -- removal from sight -- is the same job that makes us invisible.

Our "system" has been developed such that taking responsibility for ill-health or injury is no longer evenly distributed throughout the community. It is assigned to a select cadre of technicians who remove the afflicted from the community setting, treat them in an institutions (often transferring them from one to another), and then releasing them "fixed". If they can't get fixed they are remanded to another institution until the time for the final institution -- the funeral home -- comes around.

Did you know, hospitals were once considered places that people went to to die? Once the AMA MANDATED that baby deliveries be done in the hospital, the image changed. All of a sudden, word went out that hospitals were a place people were BORN, the image changed and people, rather than avoiding them, began to go to them.

We need to start doing more "home deliveries".
 
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