Paramedic Practitioner? Masters degree and future of EMS

0theories

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I'm fairly new to this field but receive(d) my education in Oregon where an AA is required for paramedic licensure. As an aside I already have a BS (used to be a riparian ecologist) so I just have to take the ems classes to qualify. What's hard for me to believe is that most paramedic programs don't require A&P (or chemistry or micro bio...)! I'm only starting the paramedic (2nd year) portion of the program, so maybe they teach you everything you need to know... But A&P takes almost as long as the entire paramedic class to complete. It would be like getting only half the education without it.

So... I'm all for making a degree required (eventually a BS I think like they're starting to do for nursing here). Maybe the pay for higher educated paramedics would go up, and then they'd start hiring EMT-Bs again :)
 

EpiEMS

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All medics in all systems have the daily potential to see very sick patients. I don't think that having longer or shorter transport times should determine the level of provider that you get. I think defining what constitutes ALS at a national level, and setting appropriate educational requirements will help to improve EMS nationwide. We do a disservice to our patients when some systems are very much on the cutting edge, using evidence based practice and embracing the new science, while others are not. ETCO2 usage, pain relief, back boards to name a few of these contentious issues. When the research has been done and the consensus made, then we all need to be carrying out best practice.
No disagreement on the front that all medics (all providers, even) in every system have the potential to see very sick patients. And I certainly don't disagree that there should be more national definition (at least, as a baseline) for what constitutes ALS and what evidence-based practices should be implemented. What I'm questioning is the need for lots of ALS availability when transport time to a top-tier hospital is <10 minutes - especially for the times where ALS is conventionally seen as a value-add (multiple-trauma, cardiac arrest) despite evidence to the contrary (i.e. OPALS studies).
 

ExpatMedic0

MS, NRP
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I think where they link up is in the disconnect between what EMS providers typically do/see in a normal shift, versus how they are currently trained and what the needs of most patients are.

One of the biggest failings of the EMS system is that it still requires virtually every patient to be transported to the ED.
agreed %100

Most American paramedics receive fairly in-depth training in a very narrow scope of practice. Typical training focuses solely on recognition and short-term management of acute, life-threatening emergencies, and completely eschews anything involving the assessment or management of chronic conditions or the provision of even very basic primary care. This results in a provider who is only able to provide useful care to very few people - only very sick or injured patients - everyone else needs to be taken to the ED to be assessed and cared for by someone else, even if all the patient needs is a few sutures or a course of antibiotics, and even if the patient would be better served with a referral to a clinic rather than a visit to the ED.
Agreed, but this in my mind is what's so special about the concept of a paramedic. I don't mean to sound corny, but there is something fascinating about the concept and its romantic to me. Paramedics do receive fairly in depth training concerning a narrow specialty. Out of hospital acute emergencies. In many countries they are the only healthcare providers other than doctors who are doing certain advanced procedures and somewhat autonomously orchestrating acute emergencies and various other forms of calamity and chaos. Aside from just performing advanced technical skills during a resuscitation it goes beyond just that. Even for example, just the concept of reading an ECG, understanding it, and diverting to the cath lab is an incredible accomplishment for any healthcare system and society. The concept of a paramedic is great, and I think it was a good invention and we are doing great work but....
You are right, the training is so incredibly limited to "here and now"( and that's necessary sometimes) but the majority of our calls are managing the patient's chronic non-communicable diseases, thats whats killing people nowadays, sometimes the need to go the ED, sometimes not. The question is... where do we draw the line and where should our job begin and end, if in a theoretical world where paramedic practitioners roam the streets with masters degrees? How do we stay unique masters of acute life threatening emergencies in the prehospital environment while also preventing some hospital admissions and being educated enough to recognize when someone does not need to go to the ED, versus when someone does; yet remain up to par on acute life threats in pseudo austere environments and non clinical settings(i.e. the prehospital environment)?
 

MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
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Some here are advocating for Federal involvement. Be careful, you might get what you wish for.
 

MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
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The BSN push started years ago and has its supporters and detractors. It's bigger now with hospitals trying to achieve magnet status. I would opt for an Associates degree as being adequate. A&P and Micro definitely!
 

ExpatMedic0

MS, NRP
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ya I worked in Oregon, I can confirm that. Not sure who the other is but I know some other states (like Texas and another one) require it for a paramedic licence versus a paramedic certification. My last employer required a degree, but that is an international contracting company.
 

Christophire

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While I think this is eventually a worthy goal, I think we should first concentrate on increasing the baseline education for paramedics. It is nothing short of amazing that EMS providers are afforded any sort of respect within the medical community given that many (most?) paramedics do not even a possess a two year degree in their field of study. How can we say we need masters level practitioners providing autonomous care when we struggle with the degree of autonomy that we already hold?

It is important to not get a head of ourselves. While I would like nothing more than to eventually be able to be in some sort of graduate EMS program (masters or not), I would rather see the majority of paramedics (who serve the very vast majority of our patients) have an education that allows them to become a true part of the healthcare team
Were I do understand where this is coming from, however it is not just the medic class alone if you do not go the was it be route. There are prerequisites and also having to obtain your basic key first and most move up the ladder to army then aemt-p as so on. All together your certification takes around 4 years where you also need to re certify. I have gone the nd route and I am currently pollinators practitioner status as well adding other conc concentrations such as athletic trainer and advanced cardiology and pulmonologist curriculum. I also teach rn, pa in acls pals etc..


where I am proud of my degrees, in order to be successful the medic course is intense in its concentration.
 
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MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
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Were I do understand where this is coming from, however it is not just the medic class alone if you do not go the was it be route. There are prerequisites and also having to obtain your basic key first and most move up the ladder to army then aemt-p as so on. All together your certification takes around 4 years where you also need to re certify. I have gone the nd route and I am currently pollinators practitioner status as well adding other conc concentrations such as athletic trainer and advanced cardiology and pulmonologist curriculum. I also teach rn, pa in acls pals etc..


where I am proud of my degrees, in order to be successful the medic course is intense in its concentration.
IS this humor or satire? What you wrote makes no sense. ND route? Pollinators practitioner? LOL! You teach RN, PA, etc.?
 

johnrsemt

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So Oregon will only hire brand new paramedics with a 2 year degree, over paramedics with 10 or 20 years of experience without a degree? With the exact same medical training?
When I went to paramedic school, it was in a program that we could do it with or without a degree; $10,00 difference. Medical part was exactly the same, it was another year to get the Associates degree. Clinical hours were the same. People that spent the extra money, came out of school and made the same amount of money. People that their fire departments or EMS services paid there way, didn't pay for the degrees, so they had to pay the extra $10K out of pocket.
Some that I talk to now (2004 is when we graduated) said that they wished they hadn't spent the extra money. Only one of the 12 said she has ever made more money with the degree than without, and that was $0.50 more an hour.
 

Pond Life

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On the whole most paramedics pay for their own degrees here in the UK. The Para degree costs about £14K ($18K) but if you're sensible you often find grants for all degrees and courses after that. If you stay int eh ambulance service your pay will remain low. But go outside of the service and it can be very rewarding financially.
I certainly am making loads more money as a result of having my degrees and the experience that goes with it than a normal paramedic here in the UK and Im not alone. I think the expectation now is that paramedics do their basic degree, go on the road for a few years and specialise with an MSc and then move on, up or sideways.
Paramedic earns £27K ($35K), Specialist paramedics about £31K ($40K) and Advanced Paramedics £44K ($57K). Most of the advanced paramedics I'm working earn between £65K ($84K) and £85K ($110K).
 

Jambow

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NC effective jan 1 21, currently the paramedic students can take a hybrid a&p class - (non college credit)
5. The required Anatomy and Physiology course shall meet or exceed the requirements listed in the Continuing Education Master Course List of the NC Community College System. Courses that are currently accepted include:
• BIO- 163: Basic Anatomy and Physiology
• BIO- 165 & 166: Anatomy and Physiology I & II (Must complete both sections)
• BIO- 168 & 169: Anatomy and Physiology I & II (Must complete both sections)

NC has Certificate, Associates and Bachelor programs - I think after 2021 a lot of them will transition to Associates programs
Many of the large metro areas already has an Associates as their minimum qualifications

I 100% agree that we need a standard of education in our field of work
 

DrParasite

The fire extinguisher is not just for show
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NC effective jan 1 21, currently the paramedic students can take a hybrid a&p class - (non college credit)
That course is also known as A&P for paramedics... and has been around for years; it's a joke. It's often offered online, and the reason it's a non-college credit course is because they, the community colleges, know that no one would ever give you any credit for it. The fact that it hasn't been required previously is disturbing (although many NC cert programs did incorporate it into their paramedic class before this mandate.).

You can't even compare what hybrid A&P teaches you to a true, 8 credit program (A& P I and II, with a hands-on lab for both classes).
 

FiremanMike

EMS Coordinator
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Before taking an A&P course, I would highly suggest that you evaluate the portability of that course.. There are many courses out there, but they don't always give you credit for future endeavors.

TBH, the traditional 1 semester of gross anatomy and then 1 semester of physiology gives you the most options downstream and are generally accepted everywhere. My own nursing program wouldn't accept the combined A&P 1 and 2 classes (which are both offered at my college and designed specifically for medical professionals), they require the traditional setup.
 

Akulahawk

EMT-P/ED RN
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My own nursing program wouldn't accept the combined A&P 1 and 2 classes
If the material covered was academically identical to what is covered in a more traditional Anatomy and (then) Physiology course of study, they should, or at least offer a "case by case" consideration of your courses. Unfortunately this is one of those instances where an institution doesn't want to look any deeper than what they've already approved and done because they know what's generally taught in one kind of course vs what's taught in an A&P integrated program. Their "systems" probably just aren't designed to cope with anything other than a Gross Anatomy course and a Physiology course.

The Community College District that I did my RN program through used integrated A&P, 2 semesters, to cover the entire material. However their evaluation systems could easily handle an Anatomy course and Physiology course, they just figured you did a full year of study after doing it either way. I'm a little bit more of a fan of integrated A&P courses as you learn the physiology as you learn the anatomy, essentially you learn what it does and how it works. I suspect that it is a bit easier to teach how various systems interact when teaching just physiology.
 

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