USCISMEDIC

The question of the day and most every day... "what do have to do next"? The major problem in EMS throughout the country is that no one has the answer to that question - uniformly. Every state, and in many cases every county may answer it differently. Decisions on your future should be made after you thoroughly research the options within your reach both intellectually and financially. Do not look at getting a paramedic or an associates degree as the end of the game... but more of a stop on the way to the end. Please please look beyond the lights, sirens, drugs, tubes, and promises of sleepless nights to see where you want you life in 5, 10, and 20 years. Just some rambling from an old paramedic. Best of luck.

I am so pleased that some of you have read my post and replied...! I must admit that wrote the entry quickly and while being tired... and therefor it may be a little off from what I really meant to say. However, was is clear from all the posts is that the EMS industry has many many dedicated, intelligent and enthusiastic people in it. We all agree to disagree and we agree its messed but... we continue to try. I will admit that overall for those paid in the industry the pay is poor... from a pure ambulance/EMS perspective. For those of use that sometimes practice our beloved trade within other areas such as law-enforcement, the pay is better. I have been fortunate to have risen through the ranks had the opportunity to see and experience many types of EMS systems. When I mentioned that we "need to know our place", the comment was made in meant to be in the context of knowing that we are not in the other categories and we cannot parallel them or use them as examples. We are EMS in many forms... and often, many levels of education. PAs as well as nurses have disparate training programs that include 2 year programs (for nurses), 4 and 5 year programs for PAs and RNPs. But what they do have as an advantage is the minimum requirement for post high school formal education. Some states do not honor 4 year PA program grads... so we are alike but not. Those states that have licensed paramedics have increased over years but still remain fairly unified in the educational requirements (college). Again, not all but many. Yes, we coming back to education. And... I will be the first to admit that there are many many great EMTs and Paramedics that do not have a college education. I grew up in EMS with a degree... I continue to regret that I did not get my ass up and into college earlier. Yes, my paramedic program did come with a boat-load of college credit but it was not all that we should have. I wont go on and one... but I appreciate the opportunity to throw thoughts out to others that have the same goal in mind - EMS Success. Mike

WOW... a great topic, but one that parallels those other ones with the pitfalls of discussing politics or religion. You just cant get all to agree. I would like to offer my opinion... given my nearly 30 years of EMS experience that includes volunteer, paid, EMT, Paramedic, Instructor, hospital based, helicopter, chiefs etc etc. I have developed a bit of an opinion like most other type "A's in the business.... As an industry and/or profession we have come a long way... but clearly not far enough. Much like other "professions" such as nursing, we have had rocky start due to being poorly organized, poorly led (at the state and federal levels), poorly educated (going back to the poorly organized), and often poorly funded. We have a range of "providers" that go from the guy (or gal) who has a 24 hour first-aid and CPR card set that just drive to the very experienced and over-educated Flight Nurse/Paramedic/PHD/etc. We have volunteers that provide service up to 100 hours a week to highly paid FT professionals that work 40 and no more! I realize that I am preaching to choir and stating the obvious, but without setting the stage i would not be able to use it all in my opinion. First and foremost, it is not work arguing when it comes to the battle between whether or not we should have volunteers. It is a loosing battle to try to just have paid professionals. That does not mean we should not have standards that are close those that paid persons often have to meet. The second and a very serious one is the fact that EMS personnel must understand where they stand in their own shop before they try to compare themselves or get parity with nurses etc. EMTs with 120 hours of education must stop asking for equal pay to a nurse, police officer, or FT Fire Fighter. Paramedics must follow that lead as well. EMS as an industry should develop its own pay scales and industry standards. One simply cannot compare 120 hours of class to 4000 hours of class not to mention the differences in competencies and responsibilities. Yes,,, we can all start IVs better that any nurse (or at least most) and most paramedics can out intubate the average ED doc. That does not change the fact that we have different chosen roles and responsibilities and educational requirements. With all that said, where do we need to go and what do we need to do to push EMS a little farther forward... A two side approach - Lessen the negativity (as mentioned above) and increased self regulation with clearly defined missions, educational requirements, and standardized certifications or licensing. A national approach that addresses the clear issue of uniting EMS into an industry standard. To date, the only industry standard to emerge is that people need some form of oxygen and eventual transport to the hospital. We must stop EMTs from thinking they are paramedics or nurses and we must stop paramedics from thinking they are nurses or physicians. We are who we are and we must accept it. We must accept the fact that EMS as a whole cannot gain professional status across the board until there is an educational requirement. And yes... we may have to suffer the pain of knowing that the minimum may be a BA/BS for a paramedic who wants to "practice". We must accept that there will be areas that are served by volunteers. Though I do agree that we should not EVER lessen our standards just because they dont get paid.... after all it was their choice. I apologize to anyone I may have offended... that is definately not my intent. This topic will be a hot one for many many years.