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Hello! My name is Becca Horton, and I'm currently a senior at Roanoke College in Virginia as well as an EMT. As a part of my final thesis, I am conducting research on EMS experiences and personality attributes. The study consists on an online survey that should only take about 10 minutes to complete. The study has been approved by the Roanoke College Institutional Review Board. The information from the surveys will prove beneficial for the entirety of the EMS community as a whole. The link is below. Thank you for your help! https://roanoke.co1.qualtrics.com/jfe/form/SV_3JdOwd2cTUQBgj3?fbclid=IwAR12vNgykj9bc6LzesOgI0nYMr2o_3II0DeHp2cCLu4ljgXYHXDB27_YKdc
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I agree. I was flabbergasted at what my pain management doctor did an how he treated this patient I brought to him. that is why I reported him with his refusal to treat the patient initially. thank goodness he relented and treated her appropriately in the end and I have to admit that she was treated very very appropriately and tolerated a very rough ride back to our facility with minimal pain as he wrote orders for pain relief on the trip. If she began to exhibit any pain on the trip back she had orders for meds.
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Analgesia does not inhibit or prohibit adequate or accurate evaluation of a patient or a patient's pain. It's discouraging to see from this discussion that there are providers out there, specifically the two docs 1EMT-P encountered, who are unaware of this by both literature and direct practice.
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I second Dusts comment - from the grave But couldn't you call the receiving facility and ask them for orders? Tell them that the wussy doc sending the patient won't give orders and the patient needs them I'll tell a little story had a patient, history of brittle bone disease, going on a 2 hour transfer for a pain management consult. 2 lane roads all the way, terribly kept up roads. Was given a 10mg toradol PO pill and 15mg demerol prior to leaving the sending facility(it was the facility I worked at as a hospital based EMS medic). 1 hour prior to leaving she was given this huge dose of meds 20 minutes into the transfer, the roads get the best of her and she starts to cry out in pain. we are now out in the boonies, no cell service, we are also in the ambulance with the broken antenna so no radio service. So I go ahead and work via our standing orders for pain, start an IV, give her 25mcg's of fentanyl and some zofran. that does the trick for about an hour. I then dose her again. All the while trying to make contact with the receiving and the sending hospital with NO luck. When we get there, the pain management doc goes nuts, he says I specifically said no pain meds on the transfer so I could evaluate her pain when she got here. I told him the road condition and how much she was in pain. He in front of the patient said He didn't care and refused to see her. I told him that he would have to discuss that with her physician and that I would be making a complaint to the Missouri Medical Licensing board for his neglecting to treat the patients pain as well as making a complaint to the STATE. (I did this by the way). He did agree to treat her now that the pain meds were on board for 2 hours and he said he guesses that he could go ahead and see her since she was here. The patients family was really pissed off at the doctor, and myself and my partner were thanked by the family for making the patient as pain free as possible during the drive. We transferred her back to our hospital with new pain orders from the pain doctor after he saw what this patient had going on, I wrote all this up in my patient care report. Let my EMS medical director know what happened. Our director of nursing reported me to the State bureau of EMS for prescribing medications without a license (I gave med's based on standing orders - he(nursing director) didn't like that we had standing orders for anything). the state came in, investigated, found me without fault since my medical director backed me and my ED nurse manager and EMS supervisor backed me as well due to radio failure and cellular failure. I told the director that I could have easily have reported this to the State as well due to the poor medication orders given for this patient as we all know that JCAHO and Nursing care everywhere feels that pain control is the new 5th vital sign. 6 months down the road, there were mass layoff's (firings of 8 ER nurses and 6 paramedics - and I was the first to go on the day of the purge). I know why, but hey, it sometimes sucks to be a patient advocate against such shitty nursing/physician care. Tje state did find out about the failure to treat pain but it was a fall out of the complaint I made against the receiving pain physician and hospital she was transferred to, not the place I worked at but I don't believe my hospital was cited for this situation. I do k now that I had to sit with an investigator and my supervisor for about 2 hours going over my run report and the entire transfer. but the investigator was a nice lady and it wasn't too bad.
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This war on drugs have not stopped the use nor even slowed down the amount of illegal drugs coming into the use nor state to state. Only law abiding citizens are suffering!!!
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I contacted the ED Physician, he said to contact the receiving ED Physician which I did three times. Neither Physician wanted to address this patient’s pain. Their reason was they couldn’t assess her if she was medicated. I explained to the Physicians that the patient was in severe pain and that she needed medicated, when I arrived I spoke with the Chief of Trauma and Anesthsia both of which agreed with me that the patient needed medicated and that the ED Docs were both wrong. The patient was given 100 mcg of Fentanyl IV, 4 mg of Zofran IV and an additional dose of Ketamine
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I've been in for thirty years and don't have a degree. I started out as a jolly voli FF who went on to get his EMT-A and then finally his P-card. When I was working overseas, I met a lot (more than a dozen) people who went to overseas schools and obtained their paramedic "degree" who could quote ad nauseum from their P books, but when it came to actually doing hands on in the field, they couldn't do sh*t. There were even some who didn't even know how to change the regulator on a D tank. Some of these guys went to Aussie universities. Some came here. I even had one "degreed" medic asking me how to operate an EZ-IO in the middle of a code. This was after I had already asked him previously if he had any questions about anything. Granted, these were foreign medics, and not US medics. But they left a very bad taste in my mouth for anyone who feels that a degree makes them better than me and my education through the School of the Street. I'm sure that, just like anything else nowadays, a requirement will come out making a degree a requirement. It will somehow translate into a good thing for someone. I don't think that it will for those cash-strapped cities that have a majority of of their population on welfare and don't have the economic base to afford a degreed staff, or the rural areas that have no cash base due to being farming areas that have no major industrial tax base. You get away from the urban areas, and the majority of the services are volunteer or paid-on-call. How could they afford these people? The money needs to come from somewhere. How do you pay more, if you can't even afford the basics. Literally. Just my old, crotchety, non-degreed, two cents worth. 😉😎
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It is pretty easy to get started. You need to take an instructor class, buy the video's and manikins. Once all this is completed you are all set. For manikins depending where you get you instructor training you may be able to rent them to start. All this can be done for less then a $1000.
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So is this website still relevant? 30 yr paramedic here. Not much shaking here. Be safe Out There! Jake
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Paramedic Degree Requirement
Just Plain Ruff replied to ma2359's topic in Training - Everything Else
I totally agree with you PM - (paramedicMike). it takes saving, possibly a company match or tuition assistance or assistance from family or a student loan. My example was extreme on the +30K that I'm still paying back after 10 years or so but the ROI for my investment has not been returned. My parents paid for my paramedic course which was 2400 total but I did not get a degree out of it but I already had one - it was a BA in Admin of Justice, or I was just finishing it up, can't remember that far back. Hell I cannot remember yesterday let alone 20+ years ago how things went. But I do remember the lifepack 5 and mast pants and how to put them on. I'm all for paramedic degree's be they associates or bachelors. I think for a run of the mill field medic an associates degree is appropriate but for someone who wants to be a supervisor/FTO/higher up manager then a Bachelors degree is essential. Just my .000000002 cents as my opinion be that I no longer truly practice is really worth just that. .0000002 cents. I wonder what dust would say on this thread. -
The cost of the JCCC program you linked is under $6K for Johnson County residents and a little over $7k for other Kansas residents for the entire program (tuition information here). That's a little cheaper than current tuition for the program from which I graduated. (When I went there it was cheaper than current rates dictate.) That's not an up front cost. That's over the entire two year course of study. It may require some budgeting (like not buying that light bar for your car and maybe a couple pair of Dickies instead of that one pair of 5.11 pants) but it can be done. In many places trade schools are through the local community college. Cost won't be that much different. This can be done. As mentioned up-thread Oregon already requires paramedics to have a degree and have done so for years. As EMS education improves and, with it, the standing of EMS as it's own legitimate component of emergency medicine wages will improve. The industry needs to stop making excuses for why we can't. We need to start advocating for why we *can*.
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Paramedic Degree Requirement
Just Plain Ruff replied to ma2359's topic in Training - Everything Else
This I can't help but agree with but the thing I have to call into question is this, our pay already sucks big donkey balls and putting a loan payment on top of our responders already meager living(wages) could put some of them into deeper hock or debt. Do you also then embrace the programs that offer loan forgiveness (which almost no-one can qualify for - I know, I've tried to qualify for them) and saddle these providers for the next 20 years with payments that never ever ever ever ever seem to go away just so we as a profession can spout those hallowed words "our profession is a degreed profession" there is a great meme out there that shows two men side by side one guy it shows that he has student debt, a degree where it's hard to find a job and is in debt up to his eyeballs the other guy went to trade school, has no debt or minimal debt, got a trade, and just turned off the guy in the above sentences power. I know not a great analogy but I have 27K in student loans still after 12 years for a Masters in project management that I was given this really polished song and dance from Keller Graduate school of management that it would help me become a higher paid consultant but honestly it has not, I'm just paying 232.00 for the next 15 years. -
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This is simply a survey for a college class of mine. I'd appreciate it if you go through and respond to it. It's part of a research portion of a paper. The following link is the Google Forms survey. https://docs.google.com/forms/d/e/1FAIpQLSdhfi204oxOQkP1g43a09WVTajws7imwgzh_8wCjPW08MfySA/viewform?usp=pp_url
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Not bad, Mike. I like the composition requirement. I like the sociology requirement. I really, *really* like that there's an ethics component. For an associates level program it's a good start. Ultimately, I'd like to see something like that become the entry level requirements for a BLS provider. I'd like to see a bachelor's degree become entry level education for a paramedic. The course of study outlined in your local program is similar to the one for the degree awarding program I completed. (I had a computer skills class that I had to complete.) For a bachelor's program one should, yes *should*, have to take additional classes like psychology, history, even literature and philosophy in order to complete the program. There is a benefit to a well rounded education. In EMS we deal with every part of the population of the area in which we work. Having a broad educational base as a foundation for the technical knowledge and skill training will only serve to help us in dealing with the very people we serve. Speaking more broadly there seems to be an increasing sense that education is somehow a bad thing. It is not. Education, in all it's forms, is a GOOD thing. There is nothing wrong with leaning something new. There is nothing wrong with increasing our knowledge base. Having a broad educational foundation will only help not only in dealing with other people but with improving the overall functionality of society.
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Paramedic Degree Requirement
Just Plain Ruff replied to ma2359's topic in Training - Everything Else
So question, what are the true benefits of having a degree? Not sniping but do medics truly need american history and other similar courses or can we build a EMS bachelors or Associates degree that focuses specifically on what medics(not talking about EMT's here) need to be successful. I cannot cut and paste the screenshots here but here is the Johnson county community college paramedic curriculum for AAS in Paramedic. here's the link - http://catalog.jccc.edu/degreecertificates/emergencymedicalscience/emergency-med-science-aas/ If this was the norm - then this might not be a bad framework but to add all the extra's such as history, and sociology courses - it sort of loses it's luster. just my 2 cents which is often worth less than 2 cents. -
This is an excellent question. I'd argue that we don't need to reinvent the wheel. I'd also argue that this will not be an overnight fix. It will take time and will require patience. As loathe as I am to make this comparison look at nursing. Nursing used to be a diploma or certification only educational program. Now it's at least an associates program. It some places nursing jobs are only available to BSN applicants. It didn't happen overnight for them. It won't happen overnight for us. For EMS I think NREMT has sort of started this process. Paramedic programs need to be accredited (as of 2013) by the Commission on Accreditation of Allied Health Programs. This is a good first step. It's been this way for six years now. The next step might be to require accreditation at a degree awarding institution by a certain date. Then require new those earning new certifications after a certain date hold at least an associates degree. It'll be a multi-step process undertaken over years to make the change. There will probably be some grandfathering in of older providers and/or a grace period during which providers will need to complete a bridge course of sorts (similar to the RN to BSN programs that are out there). There will be push back from old school EMS-ers (No degree is going to help me start that IV any better!) and fire departments (What do you mean our medic mill that pushes out paramedics from a condensed program only so they can ride an engine isn't good enough?). Like old school nurses and old school nursing diploma programs, they will lose. As to why there is a shortage in some areas you have to look at a larger picture. Is there a shortage of just EMS-ers? Or is there a shortage of everything else? RNs? Docs? PAs/NPs? Access to basic services? Why is that? In a lot of cases because it's rural and there's little incentive to undertake the effort. Stop relying on the volunteer aspect which, ultimately, cheapens us all and accurately value the services provided by educated EMS providers. Do this and I think you'll see a change in the shortage. (Maybe not fix entirely, but certainly lessen the shortage.) Under no circumstances am I arguing this will be easy. It won't be. There will be a lot of push back from a lot of entrenched special interests. Until we fix education, however, nothing will change. Fix education, align ourselves as legitimately educated, degreed, licensened *MEDICAL* providers and not some haphazard add on to another public safety agency, and every problem currently facing EMS will go away.
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Just a bit of insight / opinion from one of those non-US degree requiring countries.. I just spent that last 25minutes trying to articulate the merits of having a degree in EMS, however, both my rationale and frustration cannot be summarised in a single online post so I'll just agree with what Mike already said. One quick point to consider...when you look at some of the better known services in the US (medic one, wake co, Boston, etc), what are these services doing that have people are standing in line for jobs and what type of people are willing to put in the effort vs an easy employment mom and pop provider or even a well paid fire/medic job?
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@emt2359 Where you are right there is a shortage in some areas but in most of those areas are volunteer run agencies. I have seen a lot of these areas moving to a paid staff. part of EMS's problem in the US I feel is Volunteerism in Emergency Services. With a wage increase and more opportunities will bring more people quality providers to the field. EMS needs to be viewed more as a Career, not a hobby
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I agree with Mike with a higher standard of education will come with more respect as a profession. With this I believe salaries will improve as well. I have an an AAS in Paramedic Technology, In the US that only really helps you in two states: Oregon where a degree is required to be a paramedic and Texas which leads to being licensed instead of Certified but you can work as a certified Paramedic. If you look at some international systems a lot have higher standards. For example in Canada where pay can be 2 to 3 times what it is here, just to become a Primary Care Paramedic, which is their equivalent to the US EMT-B it is required to obtain a 2 year degree once complete and after 3 years of experience they can move on to Advanced Care Paramedic which is an additional year of training. Places in New Zealand and Australia require a Bachelor Degree to obtain empoyment as a Paramedic.
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@paramedicmike , I do not disagree with you. But how does the process get started? If we require new EMTs to have degrees or to attend programs that require substantially more education and course work the industry risks a decline in new EMTs entering the profession. In many areas, there is a shortage of EMTs already. Thoughts?
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New bill wants to record every EMS transport in Maine
paramedicmike replied to ma2359's topic in EMS News
Several services I worked for had dash cams. A couple aircraft for my flight service had cockpit cameras and voice recorders. I think a camera in the back will face some serious HIPAA challenges. -
<--- Has an EMS degree. EMS-ers have long complained that they are viewed as the "red-headed step children" or whatever industry they're trying to pawn themselves off to on that given day. Unfortunately, many are unwilling to do what it takes to change their circumstances. Want to be taken seriously? Create entry standards that are more challenging than becoming a barber. Want to be taken seriously? Require basic education standards that go beyond a high school diploma. Want to be taken seriously? Create entry standards that show that those pursuing this as a career give a damn about what they're doing. Fix EMS education and it will have a positive impact on every single other problem facing EMS in the US. Every. Single. One.
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I agree that emotions can take away from the facts, but we must also recognize that this is an emotional issue. But as far as facts, what is creating the momentum to have Paramedics degreed?
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Paramedic Degree Requirement
Just Plain Ruff replied to ma2359's topic in Training - Everything Else
Oh here we go on this site. It's all over facebook - truly strong feelings about this subject. Let's keep it civil and factually appropriate - no emotions please. That's what has derailed most of the facebook threads - emotions and emotions don't make facts. -
New bill wants to record every EMS transport in Maine
Just Plain Ruff replied to ma2359's topic in EMS News
who is the keeper of the tapes? who is the keeper of the privacy of these patients? Who has access to these tapes, does the legislature address this in the bill? I've known some truly shady providers and there are some douchebag shit heads out there and it's a shame that we now have to have this type of protection out there for the patient but I'm more a proponent of this bill for the provider's in case they get a accusation lodged against them that isn't true. It has always been the patients word against the medic/provider and on this site as well, we've always crucified the medic before the true facts have been known in some cases, that in essence the patient made it up. then the providers life is ruined. So as long as the tapes are kept private until needed, only authorized people can see the tapes and the media can't get them until the investigation is in full swing, then I'm for this legistation.
