everyminutesucks.com

Hello again. I get home and decide to check on any updates and did not expect to see this.... Wow I have only quickly read over the posts but I think that it needs to be noted that when talking about the UK or elsewhere. There are already MAJOR differences between how things are done in the US and elsewhere. I think before I left it was left off at us "the US" needing to increase our standards to something more resembling yours. Our medic training programs (correct me if I am wrong or if your location differs) do not have "degree in pre-hospital care, practice for 5 years minimum and then apply for medic which is another year full time at uni plus another 6 months of placements etc to earn your post graduate diploma of intensive care paramedic practice". We have 1000 hours aprox of uni or tech school as the only requirement. In my area most of them have jobs as medics before they are finished with school. We have very very lax requirements compared to yours. What I was getting at in my posts earlier was that we need something more like what you now have. As far as my using "RN" repeatedly in my posts I will leave up to debate. I am used to RN's in my area, the lower class is a LPN and they don't hold a candle to our medics. There is no requirement for a medic to even have a 2 year degree. They get out of high school (post secondary? if that is the same for you. sorry i can't remember they are about 17-18 years old anyways.) go through 1 year of Medic training (or an accelerated program that last from 3 to 6 months!) and presto bob's your uncle and your a Medic. That is what I was getting at. Again there are some good medics here but most of them have gotten that way from experience not training. In my area again they are often the most senior and experience person on a rig even with an EMT-B partner and have all of 6 months under their belts... Scary In that case I would hope there were 2 medics but it does not always happen. They are it! I work in a system that has Medic/EMT units and if you ask the medics they hate it. Our EMT's don't know crap. Experience or not. I blame most of that on the company I work for and the very very crappy training they have. Again lets not forget that we are not comparing apples to apples here. I made the mistake myself first thinking I was talking to another from the US. I was wrong. We first need to compare the differences in requirement here and abroad before anything else. And Oz as far as the pay. Congrats. But that is far from the case here. In Minnesota a medic starts from about $12.00/hr to $16.00 per hour. Nurses start somewhere aprox. around $24.00 to $32.00 and have far better overtime rates from 2X to 3X per hour so $48.00 to $72.00 up to $96.00 /hour. Again this is ballpark so dont quote me on the rates. So you have it much better in the pay department, and probably due to the fact you have more training than our medics.

Well thanks everyone for a fun night! My shift is over now and I'm going home. Hope to talk to you again. Have a great day! Happy Holidays Ed

Well thanks for that bit of insight Dustdevil. I was not aware of that. I think that would be an awesome idea as well. If you could tell, there was a little bit more than just the devils advocate thing going on there , but mostly that was it. I would still love to see higher expectations here in the states as well. I have seen to many EMT-B's that couldn't make it suddenly show up one day with a Medic patch and I will never understand that...

I guess you have me there with the hospital clinicals that are needed with the RN. I have not heard of anything offered as a double in nursing/prehospital. That doesn't mean that it isn't here but I have never heard of it and I'm guessing that there would be a lot more of my coworkers going for it if there were such a program. If that were an option everywhere and it could be standard then I would be happy with that. (of course if I really cared and were not just playing devils advocate )

WOW I haven't done this for a while. Kind of fun. Thanks from saving me from a night of boredom at work Bushy! This could go on for ever. I love it. Back to the subject. Ok then. Make the standard higher than that of an RN. An RN equivalent degree with the additional prehospital skills training. Define it however you want. But never the less who would not benefit from Medics with a bachelors in nursing? AND prehospital skills. (aside from the life long EMT-B's we are leaving hanging in the breeze here :wink: ). I still think the association with RN would better serve the street, pay wise at least. Or are you suggesting a lower level of training than a RN? I know you are pushing the prehospital skills and I agree they are necessary and could still be industry specific but a major part of the medic degree is the same as nursing. Nursing just takes some of it farther. But those additional skills could also serve the pt's that medics treat.

I'm saying pt care specific. If you want a nursing equivalent degree in prehospital care that is fine. But then I think you are handicapping all of those dead end medics that injure their backs, or just tire of workiing on the street and want a job change. Unless they are interchangeable (and then what is the point of separating the 2?). Many more possibilities with the same classification. As well as the pay. Medics could finally argue to be paid what they are worth....

Sorry, I guess I'm not sure to which part you are referring... Would it not be better if they were all Intensive Care?

EMT Basics are trained in prehospital care. The medical training that a paramedic has is far higher than any EMT-B. What I mean is the training it takes to function on an ambulance. The medical education that a nurse has is higher than a paramedic and they could be easily trained to work on an ambulance. Granted there are other aspects of prehospital care that a nurse does not have but they could be trained in them as well. They still meet the requirements to work on an ALS ambulance with a EMT-B Cert. At least in Minnesota. I don't believe that having a requirement for medics to be trained to the level of RN's would be throwing the job at the hospital. Why does having nurses on rigs constitute eliminating your job? If you are after a higher level of education such as degreed paramedics then why not just say that it should be a 4 year RN? That is not a real stretch to have 2 yr medics in school for 2 more years. It was not long ago when EMT-b was the standard. There were no paramedics. Now paramedics are becoming the standard. I don't think it will take too long before it is a 4 year RN as the standard. There is already a huge push nation wide for RNs in hospitals. They don't staff medics in most hospitals. What is to say that won't happen in the field as well? Or why shouldn't it? I take this one back. That was just dumb. I should have known better than to say that. My bad. :oops: Again I want to stress that I am only playing devils advocate here. I am not saying that I want to eliminate anyones job. I am only saying that if you are after a higher standard. Medics over EMTs then why should we not look at RNs over Medics. That could be the standard. If we are raising it to eliminate EMTs and make Medics the standard then we could still benefit from Medics trained as RNs. Why is one good and not the other? If there is an easily obtainable increase in training for Medics why wouldn't we want that? In the end the pt would receive care from someone with an even higher level of education. How would that be bad?

The "training" in prehospital care is minimal. A RN or MD could be trained just as easily and quickly as a EMT-B. After that the difference I think this thread was about was the level of education that the personnel had. There are already RNs trained on ALS rigs as EMTs and that function at a higher level than the medics that they work with. I think that EMT-B's have their place, I don't like systems that don't use medics. But where is the benefit of 2 medics? Right now we have only 1 county that requires 2 medics on a rig. We still have problems with some of the medics we have irregardless of whether there were 2 of them. And some of them could use better training as well. So I don't think the paramedic standards are high enough as it is. Not that they all do a bad job. Some of them are EXTREMLY good at their jobs. BUT a lot of them could use more education as well. So again I say why stop there.

Then we could have Paramedic First Responders. :wink:

Wouldn't putting 2 RNs on a rig be raising the standards? Why just go for double medic rigs when we could just as easily go for 2 nurses? Or Doctors? Don't get me wrong. I am all for raising the bar. I wouldn't trust half of our medics with my family let alone our EMT-B's. But where do you draw the line? Just a question thats all. If 2 EMT's is not as good as 1 medic/1 emt or 2 medics, then why should we be happy with 2 medics when we could just as well go higher and require all medics to be trained as RN's? And after that go up from there. Who says that the highest level of care in the field has to be a Medic?

No disrespect to Medics but where do you draw the line?? With those arguments would it not be better then to have nothing by MD's respond to calls? They are far more educated than medics. Or how about nurses? That is a much closer step up but they do have far more education as well... If we can find the money for 2 medics then why not 2 docs. or 2 nurses? It has also been shown that bls providers have higher save rates on severe trauma calls because the spend less time trying to diagnose the pt and are much more likely to load and go. Again I am just trying to play devils advocate here. I don't think the answer is to just dump more money into a system that is already floundering as it is. (the healthcare system) It is increasingly difficult for hospitals and ambulance services to get reimbursement as it is. And while I want the best for my family and myself as well, I can not justify an increase in costs like that for pain meds or a lot of other things. I hope I didn't ruffle to many feathers.

Hello everyone. I am a dispatcher in Minnesota and we DO use a priority dispatch system. I don't care for it at all myself because it was designed to be used by dispatchmonkeys with no ems trainging at all. I understand the need since most dispatch centers have a severe problem getting qualified applicants and often have to resort to the undesirables to fill a seat. This is the first that I have heard of this program and if it were used properly it could help. BUT that would mean fixing the problems that are already abundant in the system. Undertrained employees, undisiplined employees. The same things that you are worrying about with the different system are already a problem. We have other services in the area that will determine that a 911 rig is not necessary and will a) set up another service with scheduled units to pick up the pt when they can get to it they will tell them to call themselves. This does not reduce the transports to the hospital but it does lighten the load on the 911 rigs. I think that it is a MAJOR problem because they will often tell them to call us to see if we have an interfacility bls rig available and we will pre-arrival the call again and determine that it should have gone with the original service via a 911 unit. Since we can't send one of our ALS rigs due to PSAs we have to tell them to call 911 again. It sucks, it is terrible pt care and these other services (which are state/county services not private) should be sued or held accountable in some other way. The only way that I would endorse a system in which they were sending non emergent MD/RN/NP to the scene was if it was still in the same timely manner that you would send a rig to the call routine. It would still have to be an immediate response and they would have to have the ability to transport themselves if they needed to. While there are a couple of dispatchers that I work with that I trust to properly triage a call because they have street experience and have shown to be competent and they do not trust the software we use either and will happily override it and send a rig lights and sirens instead of routine, most of the rest have probably contributed to the death of a pt at one time or another already. (sorry for all of the ranting.... can you tell I love my co-workers :wink: ) Anyways as I was saying the program could help to reduce some of the unneeded costs but it should not cause a delay in the response of whatever type of unit being sent. The pt should always come first. While I do think you can triage some calls over the phone it should mainly be to give additional help WHILE someone is on the way. Not be used to delay care. There are just too many calls that I would be stumped if I were on scene myself, let alone over the phone. There would be too many mistakes made. You call. We haul.