cosgrojo

Now that sir... is funny.

Free coffee for all on-duty public safety, 25% discount off food for EMS and PD... Double menu price for Fire Fighters... I kid... I kid... Fire Fighters count too...

LMAO... why do you think I want to own a restaurant....

Over the course of this thread I believe that I have been sufficiently educated on how all the other Allied Health Professionals attained professional status through education. I see that it worked for them, and concede that it was a template that met with success. I just think that the variables in EMS are different. The fractured nature of the industry, the variety of different service types, regional treatment differences and protocols, economic variables (i.e. Urban EMS vs. Volly Rural squads), and most pervasive, intention (lack thereof) of the current crop to make EMS a professional career. There are many other factors as well that make the template of individually taking the "bull by the horns" an incredibly long and fruitless road to hoe. I don't dispute it worked for others, I dispute that it will work for EMS. I own that criticism... but it is a personal decision based on what I truly want to do. I don't have a problem sleeping at night. I know that I put in more time learning my current craft than the majority of my co-workers... and that disturbs me, because they intend on staying in the industry. I spend a lot of time learning advanced interviewing techniques and researching areas of interest outside of my scope of practice... I just don't get a degree or certificate for it. Unfortunately, EMS has never been judged by its best practitioners. EMS is always judged by our worst. Unless (in my opinion) the education and training is implemented across the board, forcing our weak links to either leave or attain respectability, we will continue to not gain the confidence of our Medical Directors. If the leaders of the Medical community want EMS to get better, they will have to lead the charge, because as you have pointed out, too many in EMS oppose it. While I agree that if everyone in EMS demanded higher education and increased standards, it would produce the changes that you suggest, I just don't see it happening... we should find another way. I think that we are closer to agreement now than we were at the beginning, and I think that says something for both of us. It's been a good debate, a bit chippy at times, but I've enjoyed it. I'd also like to add that I don't particularly enjoy being "lumped" into other people's ideas and words. I prefer to be evaluated on my words alone, and on several occasions I have been "lumped" in with Herbie. So I will suspend just this once my dislike for being lumped. I think that Herbie has had a number of salient observations and points that have gone unheralded. I think that he added a dimension to the argument that I was unable to, and was needed for the discussion. I don't know Herbie, never traded PM with him, so I not suckling at the teat of friendship here... just wanted to show some appreciation. Besides... I don't want Vent to think that I only give compliments to her.

Something tells me this was not a case of "adrenaline" bolus. If they were all jacked up responding to a "welfare check" type call, then they truly are the captains of whacker nation. This seems more of a product of laziness and oversight. Regrettable, unfortunate, and avoidable... but it happened. I'll let the powers that be decide the punishment, but I could see this happening to just about anyone. My observational powers are not always at peak levels... so I do have some (not a lot) of sympathy for these guys. Flasurfbum- I have to check every time I roll in and out of the bays. We don't have garage door openers in that majority of the stations I work at, and the ones that do are "open" only, so we have to be out of the truck to close the bay.

This is not exactly true... and it is not your fault for not knowing the specifics and intricacies of my life. So no points deducted for coming to that reasonable conclusion. I got the Bachelor's to try and become the next major captain of industry. Since that has failed... miserably I might add, I discovered a talent and passion for creating a menagerie of different food stuffs. It just so happens that the education in Business has given me an understanding on how to go forward with my goals. While I appreciate your comments, and even your compliments to my well-written posts... I too, fail to see the irony involved in this. It would certainly be ironic if I had set out to be the best, most well-educated EMS provider possible and while pursuing this goal I stumbled into a bakery one day as the current baker quit in a fit of rage, and I was offered a quick tutorial and offered a job... thus changing my goals and passion for medicine. Not exactly my position. I actually agreed with you that I would prefer a degree requirement, you simply considered my agreement to be invalid because I do not have a degree in the medical world. If the standards changed, and they told me that I had to get a degree within a certain time-frame, or become unemployed and my certification obsolete... I wouldn't be that upset. In fact I would applaud the changes and either comply, or wish the industry good luck in the future as I mosey into the EMS sunset. To ensure change, the standards must change. Vent, you correctly assess that EMS providers in general have an aversion to higher education (for various reasons, and many only get into the industry for a quick career, or to become a Fire Fighter), but then you say that the only way to improve is to all of these providers who will not pursue said education, to pursue that education. You are asking for the leopard to change its spots. My contention remains that in order to enact the type of progressive education you (and I) desire for EMS, it has to be REQUIRED. Make that education mandate, and people will be forced to comply, or seek other employment. As an example, see the Florida medical director who booted all those medic's for not complying with his regional requirements. If people at that level make the demands, then we will see change. If I do it, it benefits me and my patients, but not necessarily the industry as a whole (except incrementally). *edited for misplaced comma*

I naturally have some hesitation about letting anyone who lacks maturity and basic human respect, on to an ambulance... but I do not believe that these traits are age-based. I have seen just as many immature and horrifically incompetent 30 year old new EMT's, as I have seen 18 year old ones... actually I have probably seen more of the 25-30 crowd than the 18-20. I think that it all comes down to the individual. If the class was good enough, and hard enough, it would weed out the ones truly not committed to the job to begin with. I say let them through, let the class, and then the job sort them out. I wouldn't let anyone under 18 practice care on a patient though... strictly for legal purposes. Wouldn't want to have someone who does not have the legal rights of an adult, make decisions about patient care. If you can't sign my refusal form... you can't provide care... bottom line.

You can deny the inference if you like, but it has been a pervasive tone to your posts throughout the thread. You accuse me earlier of not reading your posts, and I apologized for misinterpreting your 2 vs. 4 year entry level concerns. Clearly you haven't been paying attention to my posts well if you haven't caught that I have indeed achieved your precious "higher education." I have a Bachelor's degree. I have a BS in BAD with a minor's in both Marketing and Economics, I graduated Summa Cum Laude, I am currently pursuing interests in education, teaching, and going through the process of opening my own restaurant in the next 2 years. I just also happen to be an EMT who loves to know as much as I can about the Industry and it's care modalities. I have decided, however to pursue other interests more passionately than I have EMS and Medicine. So is your next stance that higher education is only important and valid if it is in the Health Care realm? So education is only important if it is in what YOU have and education in? Should I be penalized in your mind because I have chosen to pursue multiple interests in profession and education? Should I pigeon-hole myself into one area, despite the fact that I like other things as well? Apparently I should just engulf myself in just Health Care so that Ventmedic can appreciate and respect me. Your definition of successful education remain narrow and obtuse. Nope, you were clean on #94... congratulations... copy and paste appears to be your specialty. YES, YES, YES... a thousand times over, YES! It would be WONDERFUL, but it is not realistic under the current climate of EMS. We all agree that it is a horrible reality, but it is a reality nonetheless. If it was realistic, and the majority of people felt the same, it would have happened already. It is not going to happen the way you want it, so I say again, let's move on and start making realistic recommendations, and forgo the finger-wagging. I sincerely applaud you for your passion and your idealism. Both attributes will serve you well in any endeavor that you pursue. If I could mandate that only people with your attitude are allowed into the medical community, I would, but I can't. I have given Ventmedic credit for her correct assessment about the sad state of education for the past, current, and near future of EMS. These concepts are not new, they are not being disputed, and they add nothing to the potential bettering of the Industry. No one has doubted Vents experience and knowledge, and she is a benefit to wherever she works, and a benefit to this community... I just don't agree with her argument tactics and her refusal to admit certain realities. Other than that, I have learned a lot from her over the years I've been on this forum. Enjoy the day people, 3 minutes to FOOTBALL.

Excellent Post. A couple of years ago we got into a similar education debate on this forum, and after we went on for ages exclaiming the need further education, and stop volunteering our time, I asked how do we fix it? The Thread petered out rather quickly s/p that question. I agree with all of what you say, and have long held the belief that through organization, cooperation, and negotiation, we can reach the goals of independent profession. Obviously it would be difficult to completely flesh out the template in which to proceed because things never work the way in which we foresee... but I like the skeleton format that you have presented in your second paragraph. I also agree with your assessment of the general workforce in EMS (the same that Ventmedic has been correctly espousing). These are real challenges to change, especially if we continue to be a fractured and fragmented industry. The major difference, in my view, between EMS of today, and Allied Health professionals of old, is the presence (or lack thereof) of a progressive guiding force. I feel pretty certain that not all RN's and RT's were on board with increased standards and responsibilities without immediate recompense. They were required to make those changes because both the medical world and their professional leaders were mandating these changes. EMS does not have this coordinated leadership to enact change. At this point in the game, it would be difficult to accomplish these changes in the same manner because of past practice. JPINFV- Far be it from me to speak for someone else... but as I read Herbie's post, I interpreted it to mean exactly what you said. Independent practice in the US system is not an appropriate goal for EMS because it isn't allowed in almost all of US health care. We are a Nation of Check and Balances... at least that's what we are supposed to be.

Nobody disagrees with you on this point... for the hundredth time. You agree , I agree, Herbie agreed, Kookabura agrees, we ALL agree. Now let's stop yelling for the purpose of yelling, and come up with a plan to fix it. For all of your bluster, you have not once tried to come up with a Global solution, just banging the drum for incremental, personal change. You are so into griping about your perception, you have failed to look at this issue in the manner that it was initially presented. What do you think of the changes, and how can we make it better? Instead you have spent the majority of your time arguing in circles, blatantly changing the argument to fit your narrow view, and providing nothing substantial toward furthering the discussion. Despite that your reputation meter keeps going up... I think my mind must be going wonky... You've made more spelling mistakes in your last two posts than I have in all of my posts combined, yet you are the highly educated "alphabet soup" provider, and I the undereducated fool. If you want the standards raised, start with the spell check.... besides I've never liked the number 14 anyway.

Apparently you wouldn't, because you are not listening to what I am saying. I am not saying give them money and hope they get more education. I am saying increase the standard of education, then reward them with more money. I'm not sure how you could see otherwise. Yes, so do we... but theirs is often paid for by their school district in the ubiquitous "work-shop" days. Just like EMS, they can choose how much education they want to receive after the minimum is achieved. Their minimum just happens to be higher than ours, AND, they have a strong union presence and established educational standards. She would... if it were true. There are no 6 month Paramedic programs that I know of in my area. The Medic "trade" schools are 1 1/2 year courses, and a lot of programs are now being offered in technical colleges, awarding 2 year associate degrees for completion. I can not speak for Florida... but if you are putting Medic's through in 6 months... I would be concerned. BTW... you changed the criteria with your reply. We were comparing entry level to entry level, then you gave average salary for Teachers in FL. If beginning teachers with no experience get paid 42k to start... we live in the wrong state. Now you are fixing the numbers. 160 hours a pay period, I haven't been able to work 80 hours a week in a while. It is not an appropriate comparison... your numbers are useless. Based on your entry level EMT base pay of 12.41, with a regular 40 hour work week that is $25,812.80. Based on starting Medic pay of $46,845 on a 40 hour work week, that is $22.52 an hour... Starting medics in FL get paid 22 an hour? Doubt it. This argument has been about entry level education... let's not change it to average just to suit your position. Don't go hiding behind the fact that this is a posting "copy/pasted" from the County either. If you are going to do the leg work, find out what it means first, and apply it to the issue at hand. No one is disputing the benefits of education, despite your assertion that we are... been reading Mein Kamph recently? Finally!!! You have made sense. This statement has been the crux of my argument the entire time... of which you have soundly ignored the entire time. If more energy was put toward this end and less toward trying to intimidate and shame people into education, we might affect some change some day.

Recent discussions about standards of care got me thinking... are their any other countries' EMS systems that are as inexorably linked with another service (i.e. Fire/Police...sometimes)? Or are they stand alone entities, judged and evaluated based on their own performance/need? I've read many threads about treatment protocols and education, but I can't remember if we ever discussed this aspect. I think that it could serve as a valuable distinction between the level o' standards, and possibly explain some of the fundamental differences between the U.S. and others.

Good question. I know a few people who work for the NR... and I know that they want increased standards in general (some more than others). Unfortunately they are not effective because the States have the power to make regional demands upon their EMS system. Unless they can figure out away to wrest control away from the States (and Fire), it will be a long road to hoe. I do think that this will be the best way to attack the issue. EMS needs to be recognized as a separate entity first. If EMS is continued to be viewed as a Fire off-shoot (this is not a fire bashing statement), and not allowed to succeed or fail based on our own necessity and merits, we will have a hard time gaining these standards we desire. National Registry doesn't have a great record of taking a tough stand on these issues. It's a shame, because they are the ones in a position to force the most change. The fear is (and this is an educated guess) that if they make the requirements too onerous, that the majority of the States will balk at the expense of the education, it's under-educated populace would revolt from it's membership, and cast the National Registry aside. This may or may not be a legitimate concern, but it is worth noting. I suggest that you get involved in your States training and evaluation process, get to know the players in your area, and go from there. Often times you will find that the factors involved are never as simplistic as we make it appear in our on-line conversations (although sometimes they are). There are real fears, real politics, and real factors that face these people everyday... usually just enough to prevent them from taking a strong and concerted stand. I haven't even mentioned the major hurdles of regional Medical control at the State and local levels, difference between treatment modalities between rural and urban EMS, the variety of different types of services... all with a different level of input... We have a very complicated system. The more I hear of the NZ system and others in foreign lands, the stranger my system appears.

I've read every word to all of your posts Vent... but there are a lot of words, and I apologize if the 2 vs. 4 year degree got lost in translation. But I think I was accurate in assuming that you would want increased standards... eventually gaining entry with a 4 year degree. And again, I don't have a problem with it, in fact I am an advocate for it. I just don't think it is fair to accuse those who do not go above and beyond the standard that is being asked of them, of being uneducated rubes (even though there are some). My point remains that we should increase the standard across the board, and reap the rewards of that implementation, not try and do it individually. If I decide to increase my own education for myself, great... but if everyone is forced to do it together (mandated by a national governing body), then real progress can begin to be made. Incorrect statement. Starting pay for a teacher in the State of New Hampshire (not the most progressive when it comes to economy or pay) is a little more than 28,000 dollars a year (depending on the district). At only 170 days or so a year of working at 7 hours a day, that averages to about 23 dollars an hour of work completed... far more than the new paramedic with a 2 or 4 year degree. Not to mention that their rate of pay increases much more dramatically with years of service. (To be fair... and my wife, who is a teacher, is providing the information, they do a lot of work outside of the classroom, but are not compensated for it.) EMS also has to do work outside of our paid hours, it is called con-ed. Absolutely I do, I would be a fool to think that economic stability is not a factor in career and educational decisions. If you increase the standards, you need to make it appealing for people to go through the educational process... increase the size of the carrot at the end of the stick. Why do people go to college? To make a better wage than those who do not. The ones that go through just for the intellectual aspect are rare. Again, EVERY one of these professions had an organization or Association backing these changes, upping the requirements. EMS does not have this, and until they do, we will only see piecemeal changes. This may be alright for you, but those who want real change need to recognize the need to organize.

Since I am not opposing education, and have at every step implored people to get the best education that they can... I continue to be befuddled by your statements. I suppose it is evidence of your vast superiority to me. I will just agree with you then... and nonsensically tap the +1 tab at the bottom of your posts.

That first sentence is a gross misinterpretation of what Herbie actually wrote. At no time did Herbie state that hospital staff don't need no edumacation. Where are you coming up with this stuff? I agree that the higher the standards, the higher quality of individuals will be attracted to the Industry... provided that compensation and benefits are comparable to other industries with similar standards. Before you misinterpret that statement, let me say that I am not looking for any handouts, and I am not making excuses, just stating that people don't go to school for 4 years expecting to make 14-16 dollars an hour. It may happen, but it is not a decision many people will make on purpose. To attract the people you want we will have to offer appropriate compensation for the level of education you want to require. Your last statement quoted is both equally pompous and assumptive. Why must you assume everyone with an education would have similar ideas, and make similar statements? People don't always fit into the narrow rubric you have provided. paramedicmike- In order for this educational change to take place we first must organize as a profession, agree upon what the education will entail, and make sure that our organization is strong enough and influential enough to force the changes we suggest. That is not easy, if it was... it would have happened already. If it is your position that you think that if we all individually get Bachelor degrees in pre-hospital medicine (which, by the way do not exist everywhere) then the industry will magically bend to our will over time... well... let's just say that I disagree. Without a National presence that exerts influence and mandates change inside and outside of the Industry, I do not see the widespread educational changes that we all so desire.

Something must be getting lost in translation here Vent. I am not discounting a good education, and I implore all that have the financial wherewithal to get the best education available, to get the best education available (no matter what endeavor it is toward). I was not making the argument that the IAFF is holding us under their thumb. I was saying that the IAFF has a successful marketing machine, and we do not. I, unlike others, do not hold the Firemonkeys responsible for our position, I think we should blame ourselves for allowing it to take place, if the role were reversed, we would do the same to them. We are scattered in EMS, we do not have an organization that has the power to enforce change unilaterally, and then benefit from it by being our national mouth piece. As you mentioned, it is difficult to address EMS in legislation because of the numerous definitions of an EMS provider. It is going to take more than personal decisions to make the change to Nationally recognized profession. We can all choose higher education, but unless we have an organization behind us, we will not truly benefit from this education. I have not really been arguing against you Vent, I have been trying to add the supplementary pieces to your argument that will make your education mean something. I've been to "higher education," Vent. I have graduated from Higher education, I have been to town meetings, I have been involved in the legislative process. So stop making assumptions about my experiences based on your own beliefs, and that if I have done these things then I would understand the complexities of which you speak. I'm sure that you didn't mean those is a derogatory fashion, and you probably were using the "you" as a general term for those who haven't done those things. But it is still possible to have similar experiences and draw dissimilar conclusions, and that does not decrease the validity of either. The only reason that I am still in EMS is that I enjoy it. I truly love my job. I can't do it forever, and I am slowly devising an exit strategy, I will not be in EMS when it finally makes it's jump to a recognized profession, but I would like to think that I helped clear the path for some.

No need to be sorry, I'll take your confusion as a compliment.

Just a Basic my dear... And I do utilise the on-line con-ed sites, I just despise spending money.

Once again, I agree with almost everything you say here. But it is not a complete diagnoses of the issue. It is too simple to conclude that if we all get degrees, we will be paid more, and respected in both the legislative and medical worlds. I will argue that it certainly is about advertisement. Everything is about marketing. Do you think the purse holders actually care about the scope of practice or the length and breadth of EMS education? I don't think they do. I think that they care about what they were told and what they believe...which can be summed up with marketing. Lobbyist groups that get the majority of governmental funding... marketers. Firefighters that get increased wages, job security, and benefit despite a decline in services needed and rendered... have an aggressive marketing component (IAFF). It is not about what is best for the people and the patients to them, it is what you can sell them on. Certainly you can more easily sell them that we are professionals if we all have gone to an accredited university. How long will we have to do that before we get re-compensated with higher wages and benefits? Who will be there to market on our behalf once we've changed the standards? Currently we have no one. Unless National Registry becomes exponentially more powerful in the near future, and actually is recognized nationally, we will not have that support that we need. It is much more than simple education... if you want to get down to it, it is much more about organization. I am not arguing against education, I'm pointing out some of the potential pitfalls, and trying not to disrespect those that have already gone through the processes that you so despise (educationally).

Holy Cow... The town has been trying to convince me to convert to natural gas, and away from oil... don't think so now...

Welcome... and sorry about spenac... we never should have elected him as director of the greetings committee. It is a failure of us all.

Vent- I do not disagree that having a measurable "number" of hours or credits helps in the advertisement of the profession... and in no way was I arguing against that. My number of accrued hours/credits do not define me as a professional... others may define me that way because of it, but that is a bias that I do not own. My point is that it doesn't affect the Quality of the education. My whole argument is that I wish we were able as a society to judge people of any profession by their individual merits, rather than an arbitrary number of hours completed. Since that is not the way the world works, I concede that increasing these blocks of hours/credits is probably the way to increase our respect in the hearts and minds of the public/medical world et al. Unfortunately, often times it is economy that holds people back from enrolling in the so-called "good" programs. There will be an opportunity cost to raising the standards in the manner that you wish... most likely in the short term, less people interested in the profession because of the amount of money and time spent to get a 14-16 dollar an hour job. I think firefly hit on something important as well. As long as reimbursement rates are the way they are, and percentages of paid runs stay where they are, the services will still not be able to increase the pay for all of this newly gained education. If they start paying us more for our now "profession," where is the money coming from and who's getting cut to afford it? What I don't like is reading and listening to providers cast aspersions upon other providers simply because of the program that they took, and the number of hours that they accumulated sitting in a class room or standing in clinicals waiting for an opportunity to do a skill. If we can as a group hold each other accountable for our actual ability, rather than the "my school was better than yours" mentality, then we will be in a position to move forward. If we want to better EMS, shouldn't we learn to accept each other first? If we don't respect each other, how are we going to be respected by others? This phenomena does not hold to just which school you went to either. How many times have you heard a co-worker (hey, maybe even yourself... I know I've caught myself saying it) say something derogatory toward another EMS provider simply because of the service that they work for? Some services have crap reputations, and there are some people that think that if you work for that company, then you must be a sub-standard practitioner. Firefly- Very good post... you raise a lot of points that are very interesting, of which I do not have the answers either. I would like to comment on your CEU discussion. I am always struggling to find CEU's. It is certainly not because I don't spend a considerable amount of my own time researching and bettering myself. Rather that I don't go to "authorized" trainings haphazardly thrown together by someone that isn't passionate about the training. I also despise paying for con ed. There are free con-ed classes put on by my service semi-occasionally, but I live an hour away from where I work. I own the fact that I could acquire these trainings more frequently than I do, but are they any better than the information that I am attaining on my own? The countless discussions on this very web-site... the numerous links provided by the denizens of this community... the diverse off shoots that those links provide... the outrageous amount of time I spend on my services computer in between calls utilizing webmd...are they worth less than the hours offered by the bored out of their skull con-ed instructor? I do not think that the con-ed system that we have in place is worth much. I think that it actually hurts the majority of providers in rural settings... especially those who get their con-ed exclusively through fire departments. People who take an active role through personal education are not rewarded for their efforts. Con-ed is like the Borg... you must assimilate. Not to mention that one of the States I work in will not allow me to count con-ed if it is on a subject above my licensure level. There is only so many times that I want to learn about splinting and nasal cannula's. Herbie and P_instructor- Thank you for your kind words.

Hours or credits.... really? Neither matters. Arbitrary units of measure do not define the quality of the education. There are tech schools that are just as good if not better than college and university schools. As someone who went to a traditional college (with a good reputation) and graduated with a BS in BAD, I can tell you I was quite under-impressed with my educational experience. I have taken classes at "Tech" schools since and currently teach for a "trade" school, and feel that the education provided is on par or better than that of traditional colleges. The people who are teaching at these trade schools teach with more passion then their tenured counterparts... and it makes a difference. It is the curriculum that matters... it is the quality of the educator that matters... and it is the quality of the student matters. Now I understand that these factors are not really able to be broken into easily deduced numerical values, and thus makes it difficult to quantify, but they should not be ignored because it is easier to. My feeling is that any educational endeavor that its' quality is judged by the "credits" or "hours" it takes to complete it, is probably not worth taking it. I don't care if your basic class took 120 hours or 400 hours... if you know what you are supposed to know and you have been taught even the slightest bit of professionalism, then you are OK to ride with me. While I am all for increased education and increased standards, I do not buy in to some of the elitism that we some times espouse in conversation here at the city( of which I have participated). I read a lot about bashing "medic-mills" and "tech schools," and while I understand why we don't like them, sometimes I get the feeling that we are downgrading the providers just for having taken that program. I do not believe that the program or the school makes the provider. Any educational experience is what you make of it. Sure it can be easier if the program is top notch, and your instructor is top notch, but they don't have to be for a student to take the bull by the horns and overcome the inadequacies of their program. If I were to start tomorrow to read every paramedicine book that there is, completely engross myself in learning everything about being a paramedic, would my knowledge mean less because I didn't have an "instructor" tell me to read it? Of course not... knowledge gained is knowledge gained. Obviously, I would be violating many laws, and possibly some civil rights, if I were to take the practical portion of it into my own hands... but I think reasonable people will see my point... which is... judge a provider on his own merits first, then move on to figuring out who is to blame for their quality. This was not directed at anyone by the way... just a rant I've been feeling coming on for a while, and it kinda fit into this discussion. This is more of a self-check than it is a referendum on anyone else. Thank you, and have a nice day!

If the feeling was a semi-chronic condition that he had felt before... than I probably would not have boarded either. If it was a new feeling that the patient "thinks" is fatigue based on his 60 mile a day biking habit, I probably board. Thank you for posting your experience. Just this morning I should have boarded someone that I didn't... it is a suck feeling when you think you might have messed up, but are not sure. Weird thing is, in my case, nobody asked me why I didn't board... I think I'm the only one who even thought I should have.