PeachyMedic

I work at a rural service we run 2 ambulances and a rescue truck. The problem here lately is on my shift we are slow during the day and run all night or run all day and night. Our standard operating guidelines state we are not allowed to go to sleep until after 4 pm due to the billing office located in the front of our station. I think this is very unreasonable we don't get to pick when our calls come in so we should be able to sleep when we can!

There are many good points made in the previous posts. I feel like there is a place for APP in EMS. Maybe not all of the practices of an APP described are best suited for every EMS service but for the area I work and live in we would greatly benefit from most of the practices. Alot of what was described in the articles on the medical side would work, but some things wouldn't due to not having the capabilities to support the proceeders. Lets face it EMS is not viewed as a professionals and until the mentality of the public, county officals, and medical directors change some services will continue to be held back. As far as the education goes I do feel like we (paramedics) should have an associates degree. What better way to give us some backing and to be taken more seriously as a profession. And for the EMS angecies that feel like their people aren't proficient in their skills due to lack of education that sounds like more of an internal problem to me and needs to be handled through QI and training. I work in a rural service and don't have the luxury of a hospital right around the corner. In most parts of the county I am at least 20 min from our local hospital which is limited in what they can handel and anywhere from 35-45 min away from a trauma center and thats just transport time. So think about how long a patient has to wait after they call 911 to get to an appropriate hospital. I feel like some of the things that paramedics would be able to do as an APP would greatly benefit the patient and isn't that what our goal is to provide the best care to our patients. I can say without hesitation that the paramedics that are at the service I work for are all proficient, we have to be. I may not work in a big city but I can bet you that most rural medics have the experience, if not more, in a shorter amount of time then a medic in a larger city. With all the changes in modern medicine why would you think EMS wouldn't be included in these changes and I am glad to see that there are people who realize it.