Paramedic Practitioner? Masters degree and future of EMS

zzyzx

Forum Captain
428
90
28
"I am working on my general Ed to get my AS degree, but just as something to do cause I am bored on my 5 days off each week. Not because it is a requirement or that I am learning anything extra that will help me be a better paramedic. Knowing all of the bones in the body doesn't help me out any: I can't go to the ED with a patient and tell the doctor which bone in their hand or foot they broke without a x-ray."

I think in the future you will be surprised to find that all this knowledge that you are now learning, and that you at first didn't think was useful, will pay off by making you more knowledgeable about the larger world of medicine, and you will thereby be a smarter, better paramedic, a real professional.

In paramedic school they teach you the basics, which means you learn one thing and that thing is something that you can directly use day to day. To get beyond just knowing the basics, you have to learn a lot more things that initially may not seem all that important. However, once you piece together all these bits of knowledge and you have a better understanding of medicine, you will know things that will make you better at what you do every day. Think of basic paramedic schooling as a very direct way of learning, but to go way beyond that you need to learn things in a more indirect way.
 

DPM

Forum Captain
419
27
28
If McDonalds workers can get higher wages, EMS providers with higher education can do the same. Just because they WANT to pay is peanuts, doesn't mean they HAVE to.

As far as cost goes, making an AS in Paramedicine could well be cheaper than the current module. 60 units x $50 is only $3,000. The units would have to be over $100 each to come close to the amount I paid, and over $300 each for a different school in my area.

Private post secondary higher education, aka Medic Mills, do not help our profession. This would be an easy transition with great benefit.
 

SandpitMedic

Crowd pleaser
Premium Member
2,230
1,196
113
Look, where you went to school is not the issue. I do concur that the minimum standard should be an associates degree.
However:
The only limitations you have are the ones you place on yourself.
You have to be willing to go beyond your bubble and seek out opportunities that others will not.
It all comes down to personal motivation and ambition.
 

Tigger

Dodges Pucks
Community Leader
7,268
2,215
113
I don't know why there is so much hostility in this tread, but it will not be tolerated moving forward.

Competitive services are starting to want degrees. Some (two sadly) states require it. There are in fact agencies that pay extra for a degree (one of my tiny part time employers does, and we are not alone). Slowly but surely, it will behoove paramedics to at least have an associates degree. And those that have degrees first will be the ones that work for the respected agencies and get the leadership promotions. It may not have been that way in the past, but that is hardly a reason to not seek more education. It's an investment in yourself.
 

EMTinCT

Forum Crew Member
70
16
8
Grandma went to a Nurses Practitioner who nearly killed her. I just wasn't impressed with the Np as she seemed uncertain and unskilled. The Np wrote a prescription for twice the lethal dose of a muscle relaxant. The pharmacist refused to fill it and called the Np to explain.

A few months later we went to the ER where grandma was seen by a smart guy in a white coat. He was cool, calm, and collected. He knew his stuff. We kept calling him doctor but it turns out he's a PA. A what? A PA, I told grandma. Grandma still calls him doctor but it turns out he really is a PA but he just knows his stuff super well.

I'd be happy for him to come to our house and take care of her. If the Np showed up I'd call the cops.
 

Tigger

Dodges Pucks
Community Leader
7,268
2,215
113
Grandma went to a Nurses Practitioner who nearly killed her. I just wasn't impressed with the Np as she seemed uncertain and unskilled. The Np wrote a prescription for twice the lethal dose of a muscle relaxant. The pharmacist refused to fill it and called the Np to explain.

A few months later we went to the ER where grandma was seen by a smart guy in a white coat. He was cool, calm, and collected. He knew his stuff. We kept calling him doctor but it turns out he's a PA. A what? A PA, I told grandma. Grandma still calls him doctor but it turns out he really is a PA but he just knows his stuff super well.

I'd be happy for him to come to our house and take care of her. If the Np showed up I'd call the cops.
I would hardly say that this indicative of the quality care of provided by NPs. There are bad providers of all levels.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,120
2,816
113
Grandma went to a Nurses Practitioner who nearly killed her. I just wasn't impressed with the Np as she seemed uncertain and unskilled. The Np wrote a prescription for twice the lethal dose of a muscle relaxant. The pharmacist refused to fill it and called the Np to explain.

A few months later we went to the ER where grandma was seen by a smart guy in a white coat. He was cool, calm, and collected. He knew his stuff. We kept calling him doctor but it turns out he's a PA. A what? A PA, I told grandma. Grandma still calls him doctor but it turns out he really is a PA but he just knows his stuff super well.

I'd be happy for him to come to our house and take care of her. If the Np showed up I'd call the cops.
This is one of the dumbest things I've ever read on this forum.

I've met plenty of stupid paramedics. Does that mean all paramedics are stupid? Of course not.

2x the lethal dose? I call BS on that, anyway.
 

EpiEMS

Forum Deputy Chief
3,426
926
113
Start with associates. Get the nation standardized.Do that first. go from there.
This, a thousand times, this. Standardizing a baseline is totally the way to go.

Biggest problem is cost: No service that I know about pays extra if a paramedic has a degree.
When I went through Paramedic school in 2003-2004 it was about $6,000 (that my FD that I was PT at paid for) same class with an A.S. Degree (students attended same classes I did for the paramedic part) was $11,000. If we don't get an award at the end it is hard to push for everyone to pay more for it.
I would say that the cost issue is more that they see no incremental value-add provided by a degree. It's not like having a degree expands your scope (or their ability to bill). On the other hand, for example, an ER having a PA or NP allows them to bill more, while a paramedic is a paramedic as far as billing is concerned, no?
 

DPM

Forum Captain
419
27
28
@SandpitMedic - first off, congratulations are due. You've made the most of things, and clearly put in the work and soon you'll reap the rewards.

But do you think that a well educated paramedic should be the standard, or the exception?

I'm also pursuing higher education, as I'm sure many on this thread are, but as long as the industry standard is night school and the bare minimum of CE's then we're doing ourselves a disservice.
 

Akulahawk

EMT-P/ED RN
Community Leader
4,563
977
113
I am working on my general Ed to get my AS degree, but just as something to do cause I am bored on my 5 days off each week. Not because it is a requirement or that I am learning anything extra that will help me be a better paramedic. Knowing all of the bones in the body doesn't help me out any: I can't go to the ED with a patient and tell the doctor which bone in their hand or foot they broke without a x-ray.
Anatomy in and of itself doesn't unless you actually follow through with the physiology part of the course and actually start understanding how the systems interact with each other. Then if/when you take biomechanics, things really start to gel... and you start gaining a much deeper understanding about why we do certain things and also, when NOT to do certain things.
In paramedic school they teach you the basics, which means you learn one thing and that thing is something that you can directly use day to day. To get beyond just knowing the basics, you have to learn a lot more things that initially may not seem all that important. However, once you piece together all these bits of knowledge and you have a better understanding of medicine, you will know things that will make you better at what you do every day.
I'll expand upon this a little bit more, I think. I was an athletic trainer long before I became a Paramedic. I use the basic knowledge from that initial background (and it made both nursing school and paramedic school easier) several times a day now and back when I actively worked in the field a few years ago. There are things that I do and know that I consider as "basics" and that stuff goes beyond the basics of either nursing or paramedicine. That stuff allows me to develop a line of questioning that helps me figure out what's going on with the patient very quickly. On more than one occasion, that has led the provider to change their priority of who to look at next and what to look for/order even before they see the patient.

Also, simply knowing what's normal across the body systems can also fine-tune your "sick, not-sick, oh-crap" assessment skills...
 

ExpatMedic0

MS, NRP
2,212
241
63
I'll expand upon this a little bit more, I think. I was an athletic trainer long before I became a Paramedic.
I think Athletic Trainers are one of the best educated allied health professions. I don't know about your area, but from my experience no one seems to know anything about them, they are a mysterious provider lurking in the shadows of healthcare. I had one for a partner when I was a medic for a women's roller derby and I learned a lot from the guy.
 

jwk

Forum Captain
411
77
28
I would hardly say that this indicative of the quality care of provided by NPs. There are bad providers of all levels.
A large part of the problem with NPs is there is no national standardized curriculum. The quality of the educational experience is all over the map. Sorry Remi, I'll have to disagree with ya - the idea of an NP ordering double the correct dose is far from a rare event if my experience is an indicator.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,120
2,816
113
A large part of the problem with NPs is there is no national standardized curriculum. The quality of the educational experience is all over the map. Sorry Remi, I'll have to disagree with ya - the idea of an NP ordering double the correct dose is far from a rare event if my experience is an indicator.
Of course someone somewhere could order an incorrect dose of a med. This would not be the first time in history that it has happened, and NP's certainly aren't the only practitioners who make mistakes.

But TWICE the LD95? Not impossible I suppose, but EMTinCT clearly has an anti-NP agenda, so I still call BS on that story.
 

Summit

Critical Crazy
2,400
910
113
I had a MD order a lethal dose of metoprolol. Hey does that mean MDs are bad?
 

Tigger

Dodges Pucks
Community Leader
7,268
2,215
113
I think Athletic Trainers are one of the best educated allied health professions. I don't know about your area, but from my experience no one seems to know anything about them, they are a mysterious provider lurking in the shadows of healthcare. I had one for a partner when I was a medic for a women's roller derby and I learned a lot from the guy.
No doubt. They also practice relatively independently, which is not a coincidence. Spending three years in mostly sports medicine role did a lot for me, and more than a just "these are all the muscles and how they work" type thing. Sports medicine is all about identifying how an injury will effect the rest of the body, which is a valuable thought process. Too often in EMS it seems we can only see the obvious illness or injury and do not bother to consider where else the injury may be manifesting itself.
 

MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
530
139
43
There a lot of ADNs looking for good jobs that probably also said "half the time, sign me up!"

And then the industry changed and they're stuck. I know BSN RNs that work in SNFs that are waiting for decent jobs to open up. Eventually that might well become the case for EMS.

This came up on the facebooks today: http://www.wral.com/news/local/video/14892531/

DCEMS is a premier service that is competitive to get on with and I expect this trend to continue, though I don't see it happening as quickly as nursing, which has its collective act together.
Tigger,
Your comment is accurate to a degree (no pun intended!). There are ADNs that are hired right after passing the NCLEX-RN but it depends on the school's reputation as well as the location. Our grads from Keiser University Jacksonville, FL are 100% hired. NCLEX-RN pass rate is over 90%.The program is a 16 month ADN. It is extremely fast-paced and that's one of the reasons I am going there. At 57 yo, time is short! Our Program Director has made our program tops in the area over the others which makes Keiser grads attractive without the BSN. And the BSN is a post-hire requirement; Enrolled in a BSN program within 1 year and degree attainment usually within 3-5 years.
IMHO, a Paramedic Practitioner would not be a good idea. As previously stated, there are PA's and NP's.
 

Tigger

Dodges Pucks
Community Leader
7,268
2,215
113
Tigger,
Your comment is accurate to a degree (no pun intended!). There are ADNs that are hired right after passing the NCLEX-RN but it depends on the school's reputation as well as the location. Our grads from Keiser University Jacksonville, FL are 100% hired. NCLEX-RN pass rate is over 90%.The program is a 16 month ADN. It is extremely fast-paced and that's one of the reasons I am going there. At 57 yo, time is short! Our Program Director has made our program tops in the area over the others which makes Keiser grads attractive without the BSN. And the BSN is a post-hire requirement; Enrolled in a BSN program within 1 year and degree attainment usually within 3-5 years.
IMHO, a Paramedic Practitioner would not be a good idea. As previously stated, there are PA's and NP's.
There are plenty of great programs and ADNs out there. But surely it is clear that the nursing industry is moving towards BSN being the base level, or else they would not require it post hire. Also, I'm not sure 100% hired means, as we all know not all jobs are equal. I am sure that many (if not most) nursing school grads are hoping for a job at some sort of respected medical center, but many may end up initially settling for less prestigious employment. Yes they are hired, but maybe not where they had hoped.

As an aside, I am not convinced that there is no need for clinical graduate level studies for EMS providers. Other countries with successful prehospital care systems have graduate certificate programs in place for their "Intensive Care Paramedics" or whatever they call them. There aren't many of them, but it seems to be that there might be some benefit in teaching critical care transport medicine at a higher level than what is done here. It doesn't need to be a master's degree by any stretch, but such classes should probably be at that level. The same could go potentially go for community health type education as well, though my agency is currently doing alright with teaching them through the community college (though sadly they are currently non-credit). When it comes to leadership I think that is well served by existing Public Administration programs.
 

MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
530
139
43
100% hired by hospitals. No LTC, etc.
 

triemal04

Forum Deputy Chief
1,582
244
63
Of course someone somewhere could order an incorrect dose of a med. This would not be the first time in history that it has happened, and NP's certainly aren't the only practitioners who make mistakes.

But TWICE the LD95? Not impossible I suppose, but EMTinCT clearly has an anti-NP agenda, so I still call BS on that story.
Huh...guess you've never heard of someone mistaking gram for milligram...or milligram for microgram...or any of the other ways you could accidently write the wrong dosage...

There's lots of agendas out there apparently.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,120
2,816
113
Huh...guess you've never heard of someone mistaking gram for milligram...or milligram for microgram...or any of the other ways you could accidently write the wrong dosage...

There's lots of agendas out there apparently.
Sure I've heard of that. But that's not what he was talking about. Maybe you should re-read the original post on this topic.

The only agenda here is the one where someone tries to prove that one group of practitioners is inherently incompetent, yet another group is virtually infallible, using a singular and likely inaccurate anecdote.
 

Top