Starting Medic in January...

[Piper76]

It has been a long time since I last posted, but have been lurking about. I completed my EMT-B in May and began working for a private company in August after completing rookie school.

I started out on a BLS truck and moved to an ALS unit after a month or so. This career change was the best thing I have ever decided to do. Of course going from making 50K a year to 9/hr sucks, but overall I am WAY happier!

That being said I am starting medic school in January and can't wait to begin learning more and advancing my skills.

Thanks to all for your posts and insight that I have been secretly gleaning the last few months!

 

[HappyParamedicRN]

Dude or dudette you need towork as a basic, in my oppinion for at least two years in a busy 911 system before you even think of medic school!

Happy

 

[anestheticmedic]

Ive worked as a basic in Detroit for the last 2 years and just got my medic license. I'd advise you work 2-3 months as a basic. 2 years to learn to be a good basic is ridiculous. Also, you'll become a much better basic by working your a$$ off in medic school

 

[Piper76]

Dude or dudette you need towork as a basic, in my oppinion for at least two years in a busy 911 system before you even think of medic school!

Happy

Dude or Dudette. I see you are an RN. I suppose you spent at least 2 years as an ER Tech in a busy metropolitan ER before you even thought of nursing school.

I was a Geologist for 7 years. Should I have quit high school and worked at a quarry for at least 2 years before I even THOUGHT of going to college for my degree in Geology?

 

[Veneficus]

Dude or dudette you need towork as a basic, in my oppinion for at least two years in a busy 911 system before you even think of medic school!

Rant on:

Please forgive me, but everytime I hear something like this it never sounjds any better.

First, you know what Basics do in busy urban EMS systems I have worked in?

The help backboard people, spike IV bags, and drive.

Not exactly something that requires 2 years of experience.

Second, what kind of experience you get matters. A rural medic or EMT will usually have more to do with the patient than the busy guy who taxis 15 ALS calls to the hospital every 10 minutes performing minimal interventions.

Whoever promotes this "you should get x experience as a basic" should be banned from EMS and all of its components for life. It is absolutely stupid.

Rant off.

 

[TransportJockey]

Dude or dudette you need towork as a basic, in my oppinion for at least two years in a busy 911 system before you even think of medic school!

Happy

So the basics I work with in a slow rural 911 system should never think of becoming medics? I'm glad I never thought this thought process made any kind of sense.

 

[sir.shocksalot]

Rant on:

Please forgive me, but everytime I hear something like this it never sounjds any better.

First, you know what Basics do in busy urban EMS systems I have worked in?

The help backboard people, spike IV bags, and drive.

Not exactly something that requires 2 years of experience.

Second, what kind of experience you get matters. A rural medic or EMT will usually have more to do with the patient than the busy guy who taxis 15 ALS calls to the hospital every 10 minutes performing minimal interventions.

Whoever promotes this "you should get x experience as a basic" should be banned from EMS and all of its components for life. It is absolutely stupid.

Rant off.

I respectfully disagree. While I don't think two years is needed before paramedic school, I truly believe that experience is vital to success in medic school, and as a field medic. From a clinical stand point, basic experience is worthless; learning to drive, operate a strecher, spike a line, and stock and clean a rig will not have any real influence on your abilities to provide solid medical care. However experience will tell you if you want to stay in this job and give you the opportunity to see EMS how it is, not how it appears to be. We aren't heroes and months/years can go by without getting a dramatic save, more often then not we are supportive of patient's needs while we give them a ride.
Furthermore, some time as a basic will allow you to be comfortable being in charge of an ambulance and a scene. I know a lot of people say, "that's what rides are for." But considering that some programs graduate with as little as 300 hours of ride time and 150 or less hospital time, graduates don't have the necessary contact time to adequately manage a scene or a critical patient without soiling their britches. Should your state have agencies that provide extensive orientation time for new employees and provide adequate education and clinical experience in school then a zero to hero route should be doable. Each state is different and each area is different, get a feel of how area ambulance agencies feel about "zero to hero" medics.
I can tell you that going to medic school in CO without any basic experience is a very bad idea, zero to heroes in CO are frowned upon and not likely to be hired or make it through an FI process.

Basically take advice from others with a grain of salt and evaluate the system you live in, each place has different opinions/views about paramedic education, and often entirely different systems of paramedic education.

 

[emtpche]

I agree new EMT's should work on a rig for 6 months minimum. I think they should start off on BLS unit to get pt contact and work on their pt assessment. I remember when it was required to have 6 months full time on rig before you could apply to medic school.

I have seen pros and cons of EMT's on ALS rigs. Lot of them become complacent with their skills set as they have less pt contact. It does not matter if they work a busy system in a large city or slow rural area. What does count is the persons drive.

 

[Veneficus]

I respectfully disagree. While I don't think two years is needed before paramedic school, I truly believe that experience is vital to success in medic school, and as a field medic. From a clinical stand point, basic experience is worthless; learning to drive, operate a strecher, spike a line, and stock and clean a rig will not have any real influence on your abilities to provide solid medical care. However experience will tell you if you want to stay in this job and give you the opportunity to see EMS how it is, not how it appears to be. We aren't heroes and months/years can go by without getting a dramatic save, more often then not we are supportive of patient's needs while we give them a ride.
Furthermore, some time as a basic will allow you to be comfortable being in charge of an ambulance and a scene. I know a lot of people say, "that's what rides are for." But considering that some programs graduate with as little as 300 hours of ride time and 150 or less hospital time, graduates don't have the necessary contact time to adequately manage a scene or a critical patient without soiling their britches. Should your state have agencies that provide extensive orientation time for new employees and provide adequate education and clinical experience in school then a zero to hero route should be doable. Each state is different and each area is different, get a feel of how area ambulance agencies feel about "zero to hero" medics.
I can tell you that going to medic school in CO without any basic experience is a very bad idea, zero to heroes in CO are frowned upon and not likely to be hired or make it through an FI process.

Basically take advice from others with a grain of salt and evaluate the system you live in, each place has different opinions/views about paramedic education, and often entirely different systems of paramedic education.

then the medic education in CO is a failure and needs to be revised.

If a person with 120 hours of average EMT-B training is qualified to work independently, than a person with 750 should be more so.

If a paramedic education was the minimum required to work on a unit what would happen then?

Since there are not a large amount 911 services that hire basics and the positions are tough to come by anywhere, there would be an extreme shortage of medics everywhere.

I am sorry, but if anyone needs basic experience for any length of time then perhaps a different career field might be a better choice.

If a service does not provide a proper internship/orientation for medics to pass the FTO process, that is a failure of the service not of education and certainly not because of provider experience, that is a very poor shifting of blame.

I find it difficult to believe as a medic and medic instructor that EMS is the only healthcare field that promotes experience over initial education.

EMS will never be more than ambulance drivers with that mentality. "Professional" status is nothing more than a pipe dream.

 

[sir.shocksalot]

then the medic education in CO is a failure and needs to be revised.

If a person with 120 hours of average EMT-B training is qualified to work independently, than a person with 750 should be more so.

If a paramedic education was the minimum required to work on a unit what would happen then?

I would hardly say any one with 120 or even 750 "hours" of training is qualified to work on an ambulance, and I would also say that medic education in CO is far from being a "failure" but I would agree whole-heartedly that it, like everywhere, needs to be revised. It is expected that a medic in Colorado has at least some experience on an ambulance; how long is rather irrelevant and up for debate.

Since there are not a large amount 911 services that hire basics and the positions are tough to come by anywhere, there would be an extreme shortage of medics everywhere.

I am not of the opinion that a basic needs 911 experience to be a good medic, they just need to spend more than the 2 rides from basic school on an ambulance.

I am sorry, but if anyone needs basic experience for any length of time then perhaps a different career field might be a better choice.

If a service does not provide a proper internship/orientation for medics to pass the FTO process, that is a failure of the service not of education and certainly not because of provider experience, that is a very poor shifting of blame.

Perhaps services in your area have the money to keep paramedics in orientation or in an FTO process for long periods of time, that isn't the case in CO. Even the best agencies in CO with a lengthy orientation time expect that you can communicate with patients, drive an ambulance, operate the cot, take an accurate and reliable BP in a moving vehicle, and not sh*t your pants on a call.

I find it difficult to believe as a medic and medic instructor that EMS is the only healthcare field that promotes experience over initial education.

EMS will never be more than ambulance drivers with that mentality. "Professional" status is nothing more than a pipe dream.

I hate to point out, but what initial education. EMS has some of the lowest requirements for entry of any field, certainly any healthcare field. I don't think the way the system works is right, I truly wish schools provided enough education/clinical time and had high standards of entry so that Joe Shmoe off the street can walk into a lengthy Paramedic education program and walk out able to run a call and spout off kinds of pathophysiology knowledge. Unfortunately they don't, and until they do I will always encourage basics to work for a little bit before continuing on. People always point at Nurses or Doctors and say they never had to work at a lower level, however they raised the bar of education for themselves; and until we do raise the bar and we get rid of patch mills for fire departments, initial paramedic education will never be adequate.

I am a big proponent of education, I think we need a minimum of a associates degree, and ideally a BS. I think a good foundation from education will easily replace any experience needed to function as a medic. Unfortunately we just aren't there yet.

And to the OP, just ask your local agencies what they think, each state is different with what they expect, you might be fine with no basic experience.

 

[Veneficus]

It is expected that a medic in Colorado has at least some experience on an ambulance; how long is rather irrelevant and up for debate..

But what is the purpose and value of that experience?

911 service and IFT are certainly not similar experiences.

If there is not a clearly defined objective or purpose to such experience, how can it be used as anykind of logical measurement?

I am not of the opinion that a basic needs 911 experience to be a good medic, they just need to spend more than the 2 rides from basic school on an ambulance.

I think we have found our common ground.

Perhaps services in your area have the money to keep paramedics in orientation or in an FTO process for long periods of time, that isn't the case in CO. Even the best agencies in CO with a lengthy orientation time expect that you can communicate with patients, drive an ambulance, operate the cot, take an accurate and reliable BP in a moving vehicle, and not sh*t your pants on a call.

No, infact FTO processes in my home state a pretty much nonexistant. The day you get your medic card, is the day you are most likely the lead medic on your unit.

As such, the education prepares you for that. Enough to be proficent? I don't think so. But if you cannot communicate at least basically with patients, operate the cot, and take an accurate BP in a moving vehicle, you will certainly not make it to your certifying exam.

Sh*ting oneself on a call is one's own problem.

I hate to point out, but what initial education. EMS has some of the lowest requirements for entry of any field, certainly any healthcare field. I don't think the way the system works is right, I truly wish schools provided enough education/clinical time and had high standards of entry so that Joe Shmoe off the street can walk into a lengthy Paramedic education program and walk out able to run a call and spout off kinds of pathophysiology knowledge.

More that we agree on.

Unfortunately, this latest "curriculum" I forsee being worse instead of better. Not because of lack of effort on the creators, but because of the combination of lack of capable educators and lack of increased time requirements.

Let's face it. You can add all the basic and clinical science you want, but if you don't allow time for it, all you get is disconnected bullet points to remember or associate on a multiple choice question.

If you don't have instructors who have been educated to basic/clinical science past what is in a paramedic text, how do you expect them to teach it properly?

Unfortunately they don't, and until they do I will always encourage basics to work for a little bit before continuing on.

I had some exceptional experience as a basic myself, but I understand that many will not ever be afforded such opportunities.

In order to encourage or require experience, I really think there must be a defined tangible benefit that is available to all. Otherwise all that is really being accomplished is hoping people will gain something positive.

Playing the odds of developing erroneous preconceptions, poor patient care habits, being disgruntled by what they had hoped for vs. what they got in the EMS job lottery, (further degrading their ability or care) or gaining the positive things possible with experiece, if they were all equal (which they are not) the best you could hope for is that 1/4 of their experience was beneficial or positive. Since only a handful are likely to be part of the benefits, I would estimate that the chances a Basic gets positive tanglible experience probably at around 5-10%.

How much negative impact is worth that?

You can argue people might see EMS is not for them, but that is skewed as well. For example, if I go to EMT School, then straight to paramedic school and get hired on a 911 unit my experience might very closely match my expectations.

If I go to EMT school and wind up on IFT with Joe's Minimum Ambulance Company, I might never make it to paramedic school. Does it mean that I wasn't cut out for EMS? That I couldn't be a great 911 provider?

What if I went from 0 to hero and got hired in a hospital or another nontraditional field EMS employment open to paramedics but not basics?

See what I am saying that "experience" cannot even accurately reflect if you will enjoy your future job?

People always point at Nurses or Doctors and say they never had to work at a lower level, however they raised the bar of education for themselves; and until we do raise the bar and we get rid of patch mills for fire departments, initial paramedic education will never be adequate..

I share your frustration with these entities, but unfortunately, more providers than not are antieducation, antidiversification, and antiforward thinking. It is what makes the most capable and motivated providers which EMS really needs move on to better prospects. It is the ultimate brain drain.

I think we need a minimum of a associates degree, and ideally a BS. I think a good foundation from education will easily replace any experience needed to function as a medic. Unfortunately we just aren't there yet..

More agreement. But I question if US EMS will get there at all. I really think change is going to be dictated to US EMS economics and interests that will not have the best interests of EMS at heart.

At least the providers stuck in the past will be able to say they brought their own doom. I mean, "It was somebody else's fault."