NYCEMS9115

I also have had one-way correspondence with NYS DOH EMS to add the CCEMTP into the Paramedic Curriculum and have it only available as a Associates Degree Program. The time line will be 10 years for all NYS Paramedics to get the CCEMTP and AAS. Of course I've heard nothing. Hence one-way correspondence. I've been at this for 1 year now... In addition, many had rejected my notion to change the NYS Paramedic. Claiming less people will pass and many will not do this job. I'm sorry but we need to separate the Paramedic from the EMT-B; where almost anyone can be an EMT-B. That's not good. I've pitched the idea to increase class hours, add more rotations, and require all candidates to have a HS/GED Diploma. It seems like I'm just talking to the wall.

Well put. I agree with the principle of your statement. I totally agree but like you said; most will belly ache. No one, who can do something about this will do anything. Not the NHTSA, DOT, NAEMT NREMT NAEMSE, NASEMSO, and the rest of the Alphabet Clans; they will let EMS remain stagnant. Its up to the individual to just do it on their own. Many people don't need extrinsic factors to make them get an education. Its survival of the fittest; I guess.

I wish you all the best. Its good to see people progress; stagnation is such a waste. The way you debate and make an argument shows the confidence you have. You have a pure quality to succeed. I'm just catching up. I became an EMT in 1995 and a Paramedic in 1998. It took me a decade and a half, after HS to figure out that education is important and necessary. I've applied to numerous EMS and Executive Director Positions. All told me the same thing; my resume is impressive but I lack the Educational Experience they were looking for. Could they all be wrong? No they are right. That's why I've been going to College PT since 2005. I received my AAS in Paramedics in 2008. I am pursing my ASN for Summer of 2012; then my RN/NCLEX. I am set to go for my BPS in Fall 2012. I'm 35 now; so I will be 40 when I get my Bachelors but you have to work until your 67; if the govt has its way; 69. All the best...

I fully agree with you. I am on board. Too bad the people who can do something about it won't because they will lose votes in their bid for re-election. So how the Republicans took the House in 2010. See how, Pres. Obama is changing his strategy as he seeks re-election. The Directors of HHS in the Federal and Regional Levels are appointed and expendable. You want to keep the job; do as what the Politicians say....

Okay. You're a Paramedic who wants to progress further in the field. Here are current job postings. Hopefully, its in your area or an area you can relocate to. Fernandina Beach, FL; Division Chief of EMS and Training http://www.emsjobcenter.com/c/job.cfm?vnet=0&site_id=12090&jb=7837254 Glenwood Springs, CO; EMS Program Faculty http://www.emsjobcenter.com/c/job.cfm?vnet=0&site_id=12090&jb=7807047 Bend, OR; Director of EMS and Structual Fire http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7865967 North Syracuse, NY; EMS Executive Director http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7807058 Roanoke, VA; EMS Program Faculty http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7807069 Cincinnati, OH; EMS Program Faculty; Visiting Professor http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7807062 Greenville, SC; Marketing Director http://www.emsjobcenter.com/c/job.cfm?vnet=0&site%5Fid=12090&jb=7819831 Sumpter County, FL; Chief of Fire and EMS http://www.emsjobcenter.com/c/job.cfm?vnet=0&str=26&site%5Fid=12090&jb=7708371 Chester, VA; EMS Faculty http://www.emsjobcenter.com/c/job.cfm?vnet=0&str=26&site%5Fid=12090&jb=7794119 These are some great positions outside the Ambulance but you need a Degree. Good Luck...

You can't assume the average Paramedic will be against having a Degree. Ex. Someone wants to be a Respiratory Therapist; you need a degree. An Occupational or Physical Therapist; you need a degree. A Registered Nurse; you need a degree. A Physician Assistant; you need a degree. A Social Worker; you need a degree. A Radiologist Technologist; you need a degree. Where talking about an Associates Degree; its like people complaining about getting a HS/GED Diploma. If we want progress in EMS or progress in this world you need a degree. Standards must be set. We need to look at the future; not now. Disgruntled people will always be disgruntled, regardless. What's wrong with some College Anatomy & Physiology I/II, Microbiology, Mathematics for Healthcare, English I/II, General Chemistry, Introduction to Psychology, Developmental Psychology, Introduction to Sociology, and an Elective? This is how the Prerequisites for the A.A.S. in Paramedics look like. The Bachelors and Masters are not required but many employers who are hiring for EMS Director positions are asking for it. What's the big deal if the Colleges/Universities come up with a B.S. and/or M.S.? They've come up with Bachelors and Masters in Emergency Management and Preparedness. Education only helps; it never hurts. But you're right an AEMT-P, AS or AEMT-P, BS or AEMT-P, MS or AEMT-P, PhD is still just an AEMT-P... However, you're right that people need the money factor to do things.

Your right but its not reducing or eliminating Medicare and Medicaid. Its holding patients accountable. In reality I'm for educating the patient; redirecting them to proper resources. However, it must be done professionally but it can't be done in NYS; its not in Protocol. I've sent letters to HHS regarding copays for Ambulance Transports; Emergency and Non-Emergency. Also, I've suggested premiums for Medicaid and Medicare Part A recipients. In addition, I've proposed that the current Medicare Tax should be renamed the HHS tax 1% added to it... This is probably the only way to sustain the MC/MK programs... Thanks...

I already mentioned that. So, we agree. We need to transport these patient because its not about what we can do but if we took them to the ER or not. If I did 5 transports and you did 5 RMAs; I made the service money; you didn't. Healthcare is a business, unfortunately. But the issue of my original entry is DOCUMENTATION not patient care. All the best...

That isn't going to happen. You've heard of Medicaid? Optional copay? Means no copay. Given oxygen, start an IV, traction splinted, 12lead ECG, med admin, ET, needle decompressed, paced, cardioverted, CPR, and defibrillated; MEDICAID pays just under $140. So knowing that; we shouldn't transport everyone. Especially on Medicaid. Right? But what's 1,000,000 x 0? $140 is better than $0. You can't bill for a visit, counseling, and treatment. Transports is the only thing you can bill. Insurances do have an ALS and BLS rate but Medicaid is not insurance... 99%? You should footnote that. I'm sure its a tad less than that. Now I need to footnote.

Then NYC is way behind. I've sent letters and emails to NYC REMSCO regarding RSI and admitting it into the Training and Protocol. I have not heard anything; I been at this for over a year...

What care are you talking about. Definitive care? EMS doesn't provide that kind of care.

They were Municipal Providers, probably unionized; it will be difficult to just de-certify them. That's a different argument.

In NYS, the EMT Course is 110hr long. Its worth 3 credits in a University/College. My argument is that it needs to be more in depth. I believe that there needs to be more hours of practice and lectures. EMT need to do more than 1 rotation; 5 Ambulance and 3 ER clinicals. EVOC/Emergency Vehicle Operations Certification needs to be added. Assisting ALS skills like setting the IV, Advance Airway, and ECG application. Mandatory CMEs in order to recertify. Currently, you don't need a HS Diploma and you can have a criminal record. There is an optional rotation; ER or Ambulance. Not all skills are tested. Majority of EMTs are Volunteers. There are Associates Degrees in Paramedics offere in the US. Its not mandatory to have a degree to be a Paramedic. There are many Private Certificate Programs. As for Bachelor Degree in Paramedics; its not common. I could find only 3 Universities which offer the BS in EMT-P in the US. I've proposed for this kind of change; degree only with BS and MS in Paramedics but many of my peers are against my stance on this. I'm glad to see someone as respected as Dr. Bledsoe feels the same or at least has similar feelings...

We need to forward this to a news media source. We need to educate the public. We need to advise them of their choices. We need to direct them to the proper resources. Ok. Let's Re-Educate the aforesaid Providers regarding DOCUMENTATION. Remind them about signatures on the Call Report on Refusals. I hope we can agree on this... We will not so; let the bashing restart again...

Then since its in the Constitution; we should ignore it. Gangbangers its fine to go to the gun shop. Hey, just keep trafficking illegal guns; file the serial numbers. Hey what's with the bottle for that 4y/o? Give him a gun. Why learn martial arts; that's not self defense; here's a gun. There's no regulation; so its fine. Here's your HS Diploma and your gun. So I carry my gun on my waistband. Can I get that gun; that AK. Hollowtip; armor piercing bullets. Sawed off shotgun hand on the pump. Throw your guns in the air and buck, buck like you don't care. Let me bust a cap on that fool. Extra clips in my pocket so I can reload and explode. Shoot them: yeah, shoot them up. Peel your cap, fool. I'd pulled out my nine; bust a cap I your eye. All these were from songs; suggested as expletive lyrics. Since, its Constitutionally protect; I demand that they remove the expletive lyrics warning off any songs who talk about a gun. I am sorry that I offended someone's Constitutional Right. My bad. At least I can admit when I'm wrong. Am I? Tell me where I can bring my shotgun? I need to know. Can I bring it into a Sporting Event, an Amusement Park, a School, a Museum, or a Church? I'm going to bring it to the next CME. You know what; on a scene of a call. Maybe I'll make an appt to see my Internist; I'll bring it then. At the next PTA meeting; it may liven the mood. How about at a funeral? How about at a parade or a fair. I'll definitely stay strapped... Thanks for educating me on the Constitutional Right to bear arms. You have a gun for sale? I'll pay for postage. Make sure the serial numbers have been filed off. Thank you...

We need more guys like Uncle Ben... It maybe a constitutional right but firearms needs to be highly regulated. No one is saying you can't own one but there is too much irresponsibility when handling a firearm. Gun shows sell guns to everyone; no background check as mandated by law. It can't be that easy to buy a gun. If you want a gun; apply and get your license; that's it. What's the big deal? If you have something to hide; you'll fight this type of mandating. If you want to buy or have a gun; you'll get the license. Its not a big deal... http://articles.nydailynews.com/2011-01-30/news/27738365_1_gun-dealers-illegal-guns-semiautomatic-weapons http://www.gunshowundercover.org/ http://forum.pafoa.org/national-11/110703-man-gun-show-jailed-selling-gun-illegal-alien-w-tx-drivers-license.html http://www.mayorsagainstillegalguns.org/html/federal/gun_show.shtml http://www.wtnh.com/dpp/news/crime/illegal-guns-blamed-for-bridgeport-shootings http://www.cityofboston.gov/news/default.aspx?id=4927 http://northernny.ynn.com/content/top_stories/535490/auburn-man-sent-to-jail-for-having-illegal-gun-used-in-accidental-shooting-of-boy/

In NY the gun laws are strict. You need permits or licenses. The process is very thorough. I don't have a gun license or permit but I do have a shotgun which is legal to purchase w/o a permit. I feel all firearms need to be regulated; some States are too lax. Just like you need a License to drive; you should have one for firearms and it needs to be renewed yearly; a thorough background check and firearm safety classes mandatory. Great power comes with great responsibility.

http://www.mountsaintvincent.edu/SupportFiles/Files/bba_and_bps_Paper_Application_4.pdf

You've ever heard of a BPS, a MPS, or a DPS Degree? School of Professional Studies? Basically, its a Degree for Adult Learners who have no college, some college, or have Degrees and they want to Advance their Educational Portfolio. This program is internationally recognized and it is available in Local, State, and Private Universities. Its geared so you can work and still go to school. They accept transfer and life credits; anywhere from 60-90 credits or no credits at all. Most Universities discount the tuition for students in the School of Professional Studies. So, if you have a BS/BA you will have all the credits accepted and you take classes for the MPS. If you have a MS/MA they will accept all the credits you have and you take the classes for your DPS; which is equivalent to a PhD but your emphasis is on practical application rather than on academia and research. I have an AAS in Paramedics and will have my ASN by 2012. I plan to enter the College of Mount Saint Vincent for my BPS in the Fall 2012; the tuition is $330/credit; normally its $495/credit. They planned out 3 classes a semester; so I will be done in 3 1/2 years. It will cost me roughly $19,000 for my BS. That's great for a prestigious Private University Education. I plan to go for my MPS soon after; maybe my DPS but let's get the BPS done first... Just thought I would share. All the best. http://www.mountsaintvincent.edu/3644.htm

NYCEMS9115: Hey... Where is the PCRs for John Doe, Juan Doe, Jane Doe, Hey Mon Doe, Curry Doe, and Wong Doe?!? Provider: Oh! They were RMAs... NYCEMS9115: Okay. Where are the PCRs?!? Provider: I just finished them. Here... NYCEMS9115: (Looking at one PCR) Okay, Juan Doe refused, looks okay (Pauses). Where is his signature?!? Who witnessed it? Provider: (Silence) NYCEMS9115: HELLO?!? Provider: Ummmmmm.... NYCEMS9115: Let me see the others! Provider: Others?...?...? (Looking puzzled) NYCEMS9115: Yes! OTHERS!!! Provider: Oh. I didn't get one. Well, you see (Hands moving around) they didn't want to go. Well they didn't need to go. They refused. Ummmm?...? Well, I didn't know; I mean it was busy. I mean I was tired... NYCEMS9115: Well...... Wong Doe died; family said you told them to call the PMD in the morning... Is that true? Provider: I didn't say it like that. The guy didn't speak English: so it was hard to decide. The ER didn't have a Chinese Translator off hours and the Patrol Supervisor was on a 4 Alarm Fire. The patient seemed fine. NYCEMS9115: WTF! The family is suing; they took him to the ER themselves and the patient died of a MI. Did you even do a 12Lead or V/S? Provider: Yes, I did vitals but I left the monitor in the truck. You see it was a BLS call. It came over as a sick. The guy didn't c/o chest pain. He was c/o SOB; his lung was clear. He was old so I just thought he just needed rest and see his PMD in the morning. NYCEMS9115: Did he want to go to the ER?!? Provider: I told him that since he's talking he's not SOB; his lungs were fine because it was clear. His heart was okay because his vitals were fine. NYCEMS9115: How about the others: Curry Doe, Jane Doe, and Hey Mon Doe? Provider: What about them? They didn't need an Ambulance. NYCEMS9115: You need to write incident reports on all of them and you need to contact your Union Delegate. Confucius says, "Lazy Provider who don't document will be in hot water."

So I really don't see why were posting things like; not all patients should be transported, EMS are knowledgeable Providers, patients sometimes don't know when to call 911, we can provide emergent care to the sick or injured, or just because you need to go to the ER it doesn't mean you need an Ambulance. We're talking about not DOCUMENTING; your verbal recollection is nice but if the written version is not the same or at least similar to the oral one; then it means nothing in the Court of Criminal or Civil Law. That's what's being pondered on. The 2 cases; the Provider's documentation was lacking or not done at all. Attorneys will have a field day with them. We need to learn from their mistakes; not justifying them...

Kiwimedic wrote: Documentation If it is not written down: it didn’t occur. Comprehensive documentation must include: • Details of patient assessment and findings. • An assessment of the patient’s competence. • All treatment and interventions provided. • What was recommended and the reasons why. • A summary of what was said to the patient and/or family. • A summary of what the patient and/or family said. • Why the patient was not transported. If the patient is not transported then the patient copy of the PRF must be given to them. This is something that they should have done. They didn't do this; that's the issue. Lazy, stupid, jumb, retarded, etc; that's what they are. Most prudent Providers know to do this...

It is the failure to document properly and/or completely. That was the downfall of the Providers in the 2 incidents. They could be great Providers. Valedictorians in class. Recipients of numerous Service Awards, Received the key to their respected City. Published articles in EMS. Pioneers of the industry. All that doesn't negate that they didn't complete the task at hand; paperwork documentation. That is all..... RichardB; ask any new NYS EMT #300000 or higher; if they received EVOC and PCR writing in their original course. How many rotations did they do; which one? ER or Ambulance. Most will tell you something which will make you go "Huh?!?" I have first had experience. I teach Medic Students at a College; many are new EMT's #385000 and higher. They tell me first hand I didn't learn that in school. I have many new hires number #380000 and higher, fresh out of school who don't know how to write a basic PCR and do not know how to operate an Ambulance. That is my arguement with NYS DOH EMS. Some course go above and beyond the State requiremnt; many just stay on par with the State and to tell you the truth par is not good. NYS doesn't ask for much... We do work in the same system who have gone downhill over the last decade.