paramedicmike

If you read the book Band Of Brothers by Stephen Ambrose, or watched the mini-series of the same name, you know of this man. He died a few days ago. Rest well, Sir. You've earned it.

Excellent advice listed so far. I will second the need for professional attire, updated resumé and a smile when you go in. Cover letters, however, can be tricky. Generally, a cover letter should be specific for the job to which you're applying. If you have a specific job in mind at the hospital, for example, then take in a cover letter specific to that job. Having a generalized cover letter isn't necessarily bad. But it doesn't really let the HR people know what, specifically, you're applying for (unless you fill out an application... see below). Going in to the hospital and finding the HR department is a good idea. Every hospital with which I've been affiliated or into which I've taken patients has had job postings outside HR and the ability to fill out an application on site. Be ready to fill out an application in addition to leaving a resumé (and cover letter if you're prepared in this manner). This means you'll probably have to have people you can list as a reference. So make sure you talk to people ahead of time and make sure they'll agree to be a reference for you. Don't hesitate to ask questions about how the process works. But don't pester them, either. They have your application in hand and if you treat them poorly the recycle bin is always close by. Along that line, get the names of everyone you talk to. If you can grab their business card you'll get their name and business mailing address. Send them a thank you note. It doesn't have to be elaborate. But it goes a long way to helping you stick out in the mind of the people who review applications/resumés and make hiring decisions. Good luck.

Insults? Seriously? He got the support he came here for. He asked his questions and got answers. Just because he didn't like the answers doesn't mean he wasn't supported. Um... no. EMS = Emergency Medical Services. Sometimes the best progress for EMS comes in the form of weeding out those who are in this for the wrong reasons. I'm not sure what the OP's reasons are. But to express desire in his/her very first post that a major concern is available OT then one has to question the motivation. No, it wasn't. Grammar, punctuation and spelling are important. In fact, this has come up very recently in several threads here by a poster who was misunderstood from the very beginning simply because he wrote like he was a 12 year old sending text messages. The OP here made several references to items that only s/he knew the meaning of expecting people to somehow understand what was typed. If nobody understands what you're trying to communicate the problem doesn't lie with everyone else... it lies with the one trying to send the message. Sometimes support doesn't come in the form of rainbows and cotton candy. Sometimes, a slap in the face is the best support someone can receive. In this particular case we might have to. The OP is claiming to have made statements that appear nowhere in the original post. *Then* the OP copped an attitude when questioned. If beating it to death makes it clear that coming across as a junior high student is inappropriate, especially when asking for employment advice, then it needs to be done. Otherwise, especially given the attitude, I don't this s/he will get it.

Woah! A R/r911 sighting! A rare thing, indeed, these days!

The word "Chicago" appears nowhere in your original post. Nor does it appear in your profile information located on the left of the screen under your screen name. Nowhere in your original post do you state you're in Chicago. So unless you expect people to read your mind you need to spell out exactly what you mean instead of relying on random clues that only you understand. Do you consider the advice offered "useless" simply because it doesn't tell you what you want to hear? Welcome to the real world. Nobody's going to blow rainbows up your skirt simply because you think you deserve it. Good luck, anyway.

Hello. And welcome. Microsoft stopped supporting some versions of Windows XP in 2006. Please contact Microsoft for specific details. However, I'm sure you could still find someone in the IT field who could help you rack an XP server system. Please learn to spell and punctuate properly. If you can't spell, if you can't use proper punctuation and grammar, if you can't write without using text message abbreviations, you won't get hired. Yes, this applies to PROFESSIONAL internet forums like this one as well. If you're looking to support yourself on an EMT-B income I hope you are skilled at living frugally. Even if overtime is available, which is a question you need to ask perspective employers, EMT-B wages are not conducive to living a comfortable life. So you could either work all the time in order to support yourself and have no life, or your can strive to create some balance between work and having a life. The latter is harder to do on an EMT-B income but it is so ridiculously important. If you're looking for the names of good employers in your area you might want to tell us where you are. Then you might want to check Google. With regards to what to look for in potential employers, well, that is long and varied. A good safety record is important. Total benefits package is important. The maintenance of their ambulance fleet is important. How management treats their staff is important. Turnover is important. A lot depends on what you want in your employer. Ultimately, however, my advice is to go to college and start your career from there. Good luck.

Alex, I seriously doubt you're trying to start a dialogue. You've done nothing but demonstrate that you're not willing to listen to advice if it doesn't support what you're already saying. You have, repeatedly, demonstrated that you're unwilling to accept advice and constructive criticism in an effort to help you improve your presentation. You have, repeatedly, demonstrated that you don't know what you're talking about in terms of medications and why they're on or not on the ambulance. You have repeatedly demonstrated either complete ignorance of, or an unwillingness to engage in, research to support your position. You have received an awful lot of good advice from many people here. Most of that advice has been pretty consistent in its content. You've received an awful lot of patience from people who've responded to your posts. If you're only interested in having people agree with the manner in which you're going about this, this might not be the best place to continue posting. It seems pretty clear that while people don't disagree with what you're trying to do, there seems to be pretty consistent disagreement with both how you're going about getting it done and your qualifications to get it done. If you're interested in pursuing this issue, please heed the advice you've been given so far in your multiple threads here. If you're interested in only listening to people agree with your methods and practices, it seems pretty evident that this isn't it. Please. Get a clue.

My comments from your thread on proposed changes to the provider structure in New York are valid here. Your grammar is atrocious. Your inability to write complete sentences is embarrassing. Your failure to create any kind of logical argument to support your position is laughable. Your failure to offer any kind of current medical literature to support your missing arguments is... well, given your history here so far... is not unexpected. The links you provide are either broken or are so generic as to immediately label your message not worthy of the attention of the reader. Your desire to implement change is laudable. But based on everything you've presented here so far you don't stand a chance to change anything. My suggestion, aside from what I wrote in your provider overhaul thread, is to go back to grammar school and start there. I think you'd be much better off in achieving your goals if you just started over.

This forum is absolutely directed towards asking questions. However, when undertaking a research project, I think you'll find people are more receptive to your inquiries if you demonstrate that you've done some basic research on your own before demanding help. The information you're looking for is easily accessible on the web. If you had come here and said something to the effect of, "Hey guys. I'm looking for info related to this particular region and can't find it online. Can anyone help?" I think you would have gotten a much better response than what you've received from the demanding tone present in both your text message style and sentence fragment style posts. Pick an area you want to research and then go to Google. If you still can't find it, then ask. But expecting people to do your research legwork for you is both disingenuous and irresponsible.

Does Google not work in New York City?

NREMT.org has a page with state EMS office contact information. If you're looking to gather information on the potential for reciprocal consideration of your EMS certs you're going to have to contact the EMS office in each respective state to which you're interested in moving.

CHBARE has it right. You just don't know what you don't know. And it's that multi-layered not knowing that seems to be influencing your resistance against what you're considering to be irrelevant education. The counter arguments you offer are also irrelevant to the the overall point of education. The point isn't to focus on all the individual aspects of a particular course and apply them broadly (like your example of chemical bondings and cardiac arrest survival rates). The goal of these particular courses is to make sure an individual understands the individual components of a subject while, at the same time, increasing one's understanding of the larger picture within that field of study. Being able to broadly understand the big picture of a subject like chemistry can allow application of those individual components when it comes to certain patient care activities. Moving on from there, paramedics *do*, in fact, both diagnose and prescribe medication. What do you think you're doing during a patient encounter? You're conducting an assessment, in some cases performing diagnostic tests, making a determination of what's wrong with your patient (which is a diagnosis) and prescribing a treatment in the form of either medication that a paramedic is allowed to administer or additional intervention so as to relieve the symptoms. This is the very foundation of the job paramedics do. Now, that being said, we are not providing a *definitive* diagnosis. We can complete an assessment and make a diagnosis. Often times we're correct. But it's the transport to a hospital for physician assessment that either confirms our diagnosis as correct or reveal findings not available to us that prove our diagnosis wrong that makes paramedicine what it is.

General chem is the basis and prerequisite for organic chem. While I do recommend organic chem, the OP is inquiring about preparation for an EMT-I class. While we are actively encouraging paramedic school, I can only comment about the question he asked. Were the OP to ask about paramedic school I would have suggested o-chem, too. The OP is, so far anyway, working on a limited time frame. General bio, in all of the many colleges/universities I've attended, has been a prerequisite for A&P. It lays the foundation for scientific thinking (often times in combination with general chem). It also lays the groundwork for a general understanding of life sciences. A good bio course will include information on basic genetics, cell function, metabolism and other basic functional concepts that are vital to understanding how the human body works but were not included in any of the undergraduate or graduate level anatomy courses I've taken. Microbiology is directly applicable to the many microbes we encounter every day both on the job and off. Sure, we can spout back the patient has MRSA but do you really know what it is? Do you understand how it works? How it grows? How it survives? How to kill it in your ambulance? How about strains of Mycobacterium? How about the many bacterial sources of PID? Did you know you can get gonorrhea in your eyes? It's true! Kind of reinforces the idea that we should be washing our hands for both patient and self protection. A good micro class will lay the ground work for understanding things we can't see but can still make us sick. Lastly, nutrition is important. How many diabetics do we encounter? Wake them up with some D50 and then what? Give them some orange juice with sugar mixed in? Why? Because you saw someone else do it? If we have a basic understanding of food and how the body processes it we can suggest something a little more appropriate to their immediate needs. This isn't to suggest we become a dietary consultant. But if we can't understand the bigger picture in terms of physiological process, including types and processing of nutrients, then we have failed our patients. Every class I've listed I consciously use every day at work. I even held back in terms of what I use and what I think is important (e.g o-chem). Hope this helps answer your question. And I hope nobody routinely gives their diabetic patients OJ with sugar mixed in after waking them up. Seriously!

Add another vote to the column of bypassing EMT-I and going for admission into a paramedic program. There are several classes you can take to help prepare you for paramedic school. A&P is certainly high on that list. Also included are, algebra, english, writing/composition, nutrition, general bio, general chem, psychology (general and developmental), sociology, microbiology and nutrition. These are just a few of the basic classes that would prove to be beneficial prior to enrolling in a paramedic class. Yes, the list is a bit long. With your current program starting in August there is plenty of time to complete a good number of these courses, however. If, as has been strongly recommended, you elect to skip EMT-I and go straight to paramedic, you'll probably have a little while longer to complete these classes before the start of paramedic school. There is no such thing as too much education. There *is* such a thing as too little education. The more you can get the better off you and your patients will be. Please don't skimp on this. Good luck!

Interesting you would complain about this given these other lines from your post: and: Nevermind the multiple uses of "w/" to abbreviate the word "with" outside what's been quoted. I'd be interested to see what your charts look like after this post. Wow! Look! More abbreviations and acronyms! Who'd have thought it would be coming. In self advertisement form no less. Very interesting, indeed. With regards to the OP, I'm constantly amazed at the lack of instruction in how to properly document a patient encounter afforded to EMT and paramedic students. I'm more amazed at the lack of basic spelling and grammar principles held by those writing the reports I QA.

It's not meant as a slight at all. This has come up in different discussions on this site before as well. This very argument, doing away with the ridiculous notion of BLS before ALS, is part of the reason why this site doesn't have a BLS or ALS specific forum anymore. It's called appropriate patient care and it applies to everyone from basics up through physicians. To follow your argument you would have to require EMT training for physicians before they could even continue with medical school because "BLS comes before ALS". My argument is simply stating that a comprehensive educational program should teach this as an ingrained part of the curriculum. Supporting clinical time should build on lecture based lessons. This is how medical school works. This is how nursing school works. This is how paramedic school works in many places across the country. This is exactly my point! You're *not* teaching them to be EMTs. You're teaching them to be *paramedics*. A comprehensive curriculum starts at the very beginning and teaches students what they need to know in order to function as at that level. You're not supposed to be replacing EMT school. You're supposed to be teaching people to be paramedics. Shortchanging them of that knowledge is deficient. Assuming they have that knowledge is dangerous. Perhaps we are looking at two different levels of leadership here. But to follow the argument you've just put forth with this statement I'll again go back to my argument that a proper educational program will provide enough education AND experience to allow a brand spanking new paramedic to function as necessary during his/her first day on the job. This is, after all, why there is a clinical component to training... to provide experience. Yes, we can ignore time spent. It's the style of education that's important in this comparison. The method of education, didactic and clinical, each building upon the other, is what's at play. Time is a separate issue entirely. Please see my above comments. We're not talking time. We are talking style and methodology of instruction. I also disagree with your assumption that physicians are the only ones dealing with the most critical patients. PAs, NPs and nurses are increasingly seeing, treating and dealing with critical patients before, and often times, depending on location, in place of physicians. Before you argue that PAs and nurses are dependent practitioners, which they are, they don't always have to have a physician present in order to practice. In many cases they work under the same model that paramedics do with knowledge/education, protocols/guidelines and some form of medical consultation available (phone, radio, internet). They may not necessarily carrying sick CHF-ers downstairs but they're still providing critical care interventions without the benefit of a physician standing over their shoulder telling them what to do much like paramedics do now (who are also, coincidentally, dependent practitioners). Then why not advocate for a more comprehensive educational program that will incorporate sufficient clinical time to teach people how to function at the paramedic level in *all* aspects of their job instead of hoping the remember something from the time spent functioning in a different job altogether? I think we're both on the same page regarding the change that needs to be seen in terms of paramedic education. I'll take chbare's idea of a three year education requirement for paramedic and raise it to a full bachelor's degree requirement. My argument, for the sake of this discussion, is simply a comprehensive paramedic program should provide both the didactic knowledge AND the clinical experience necessary to produce paramedics who can competently function as a brand new provider. I think schools that rely on prior experience to fill the gap in their education programs are doing a disservice to their students, the public and health care as a whole. You have no way of verifying knowledge. You also spend a lot of time breaking bad habits/practices in order to get them to do things the right way. So why not take someone that can be molded correctly from the start instead of wasting time trying to break bad habits just to start all over again? It's not true nationwide. While true that many major urban areas use some sort of fire based EMS system it's not the case everywhere. Take New York City for example. The FDNY runs EMS (poorly but that's another issue). There are many hospitals that run paramedic level services in NYC to supplement FDNY EMS. Also, don't limit yourself to big cities. Many suburban areas surrounding big cities run non-fire based EMS. The greater Philadelphia metro area is an example. Philly itself is a fire based system. The surrounding counties, in fact most of the counties in PA, run EMS as non-fire based services. You still get big city feel without the burden of dealing with the FD. To follow this line of thinking, and just to give you something else to consider, nursing offers better chances of reciprocity in terms of your license than does paramedic. This is more the case for a traditional nursing school. The Excelsior program that was previously mentioned has had some troubles with this (for example, last I checked California would not allow anyone with a nursing degree from Excelsior licensure within the state no matter if that person was licensed in another state or not). Keep in mind, too, that at least Oregon now requires a college degree before they will grant state certification to any paramedic. Other states have considered this and may enact something along these lines in the future. But as far as I know Oregon is the only state to have this requirement in place. These two points would play well with the idea of completing nursing school first and then completing paramedic training. Also, you have stated a few times that continuing education is your priority. Continuing your education is strongly recommended. However, I'm sure a good number of people who frequent here have either said this themselves, or know people who have said it only to get trapped in EMS and never make it back to school. DO NOT LET THIS HAPPEN TO YOU! If you choose EMS first do not allow yourself to get trapped in EMS. It is *very* easy to get trapped. You must fight this with everything you have. Just throwing that out there for your consideration. Ultimately, the decision is yours. What other questions do you have? There are so many more debates that could spawn from this thread.

Here's what I think should be prerequisites to an EMT-B program: Bio 101/102 Chem 101/102 College level algebra English History Composition/writing World Religions Philosophy Anatomy & Physiology Microbiology Organic chem Nutrition Sociology Psychology Well, at least that's what I can think of off the top of my head. Good luck.

Before we delve too deeply into this, you should remember many of the arguments I've presented in these very forums arguing for an increase in the educational requirements for EMS providers than what is currently mandated. I am a very pro-education person and believe that short changing anyone in the education process (including reduced acceptance requirements as well as reduced completion requirements) is a bad thing. The argument you're presenting appears very similar to the "BLS before ALS" argument that many EMTs try to present. All of the points you've just mentioned are part of providing appropriate patient care. It is dangerous for an educational program to assume proficiency at any part of the job for which they're providing education. It is also irresponsible to not start with the basics as the foundation of your educational program before moving on to more advanced issues. So unless I'm reading this incorrectly, and that you're assuming skill proficiency of your students, I have many questions as to the quality of the program for which you're teaching. So why isn't your program providing adequate education in how the system works? Honest question. Because if you're not providing that type of education, in combination with the medicine, then you're doing a disservice to your students. The leadership required of a brand new medic is not the same as one who's been on the street for ten years. There is a difference between entry level leadership at the level at which one is working and leadership developed over time. Paramedic leadership can't be gained as a basic. Nor does the inadequate training and job requirements of basic level providers provide adequate preparation to be leaders at the paramedic level. If you want to compare it on an hour by hour basis, no. The comparison isn't there. If, however, you want to compare the two in terms of preparation for the requirements of the job, then you have a more solid comparison. Medical students are taught the basics from the very beginning. Their knowledge and experience is built from there. Through both their didactic and clinical preparation they are taught how the system works. They're also, through the same process, taught how to effectively lead and function within their role. Paramedic programs should prepare their students the same way. Between didactic and clinical aspects of the program students should be taught how the system works while, at the same time, be taught both how to function effectively and lead from their position. The field training an employer (should) offers should take care of the specialized training specific to the organization. It should also hone the leadership skills required of that provider within that organization to better prepare him/her for the leadership requirements that will come with gained street time. If a paramedic training/educational program isn't offering their students sufficient didactic and clinical time to adequately grasp and apply at least the basic concepts of the role of a paramedic then they're falling woefully short of their obligation and responsibility to their students. Which is exactly why paramedic programs need to be all encompassing and teach everything they can from the very beginning including material that would be covered in an EMT class. Failing to include this material does not reflect well on the program. This takes us back to the "BLS before ALS" argument. It also takes us back to the "provision of adequate and responsible patient care" response. It also raises the question, again, that if you're not preparing your students for this from the very beginning then just what, exactly, are you teaching? On the contrary. I'll refer you to how I opened this very response. I have never argued for shorter or more streamlined training of paramedics. Nor will I ever argue for shorter or more streamlined training. In fact, many times here in these very forums (and elsewhere) I've argued that the minimum requirements for EMS providers should be drastically increased from their current and inadequate minimums. That being said, however, doesn't negate the fact that while there are many things to consider while doing the job, it's not rocket science. A student who applies him/her-self can and will succeed. I never argued that the jobs were the same. My argument deals solely with educational preparation. Education *must* start with the very basics and build from there. Medical students are educated in this manner. Nursing students are educated in this manner. Physician assistant students are educated in this manner. Radiology students are educated in this manner. Physical therapy students are educated in this manner. Social workers are educated in this manner. The list goes on. Starting with the basics does not require prior experience before moving up to the next level. It should be all encompassing in the education program. You missed the point I was trying to make. Perhaps I could've worded it a little better, too. My point was, as Ruff previously argued, was that candidates for medical school don't need to have worked as medics or nurses prior to admission. Nurses don't need to have been CNAs or LPNs prior to acceptance to nursing school. Medical school may required an educational foundation prior to admission. But it does not require work experience. Many nursing programs don't require more than a high school degree, either... especially bachelor's programs. (Coincidentally, a BSN is increasingly becoming the standard for entry level nurses. This isn't being seen everywhere yet. But it's coming.) On this point you and I agree completely. Unfortunately, it seems we disagree on how that goal of adequately training candidates should be completed. I still maintain that a complete and thorough paramedic educational program will provide everything needed for a paramedic candidate to function adequately as an entry level hire. There is no reason why an academic program can't take a motivated individual with no prior experience and completely and thoroughly prepare him/her to function effectively as a paramedic. As a result of this belief, I have to seriously question the programs that don't appear to do this.

Agreed. There are plenty of places out there where you can work as a paramedic without having to double as a firefighter. What you're pointing out with Florida being such a fire centered system has been discussed here before, too. The concern is that with so many departments requiring their hires to be a paramedic prior to hire or as a condition of employment, people who don't really want to be paramedics are earning the certification simply to be a FF. Then, when it comes down to it, you've got people who don't want to do the job of a medic functioning as a medic because they're *forced* to... not because they *want* to. Just out of curiosity, are you in a position to move away from Florida? Or do you prefer to stay there? No wrong answer... just wondering.

There are even ways around the financial issues surrounding going to paramedic school. There are plenty of financial aid, grant and scholarship programs out there to help reduce to out of pocket expenses associated with going to school. Many schools even have financial aid offices to help with the process. While there may be a brief wait for the applications to go through, it shouldn't be so long as to drastically limit one's ability to enroll in the program.

Ruff has it right. A solid paramedic program will offer sufficient clinical and ride along time to adequately prepare a paramedic candidate. To make it sound like you will gain the needed experience to be a paramedic only after having spent time as a basic is disingenuous and demonstrates a pretty thorough ignorance of the educational preparation of paramedics. I disagree, too, with the idea that "nothing about EMS is easy." There are a lot of things in EMS that are easy. This isn't rocket science. This isn't to say it doesn't offer a challenge from time to time. But you're not engaged in neurosurgery, either. Paramedic education, in an established and accredited program, will offer the foundation needed to produce an entry level paramedic. Just like nursing school will offer the academic foundation to produce an entry level RN. Just like medical school will provide the academic foundation to prepare entry level MDs (who are prepared for specialty training in a residency program). There's a reason other educational programs don't require experience at a lower educational level first. It's a waste of time and does nothing to prepare students for the rigors of educational training at the level required for the profession. Just like everything else in EMS, why do we insist on thinking differently?

Nicely done, Croaker. Very nicely done, indeed.

My guess is that one of these boneheads heard about the practice either second hand or by reading a snippet of an article somewhere and thought, "Hey! That sounds easy enough!". Then, without either training or intelligence, gave it a try resulting in the burns. Idiots.

This is the first link that come up when I googled "pediatric IV light". They are pretty common in pediatric settings... at least the two local children's hospitals have them all over the place. The page I linked above also has several links to publications regarding the product (including one to a JEMS product review in October 2005). I have not read in detail the publications linked so I can't comment on their content. How did this pediatric patient you're referencing get burns to his palms and soles? You don't say. Did the crew use a halogen flashlight in an attempt to look for veins? Or were there already burns and they were using a light to try and see something through the burnt tissue? I can't say this was something taught in a paramedic classroom. But I have received training on how to use a device similar to what I linked above in a con-ed setting.

This is a topic that has come up frequently here. To start, I have to agree with LS. If you want to be a nurse then go to nursing school. If nursing is your goal then working in EMS will only get in the way. Find a good nursing program and work on earning a seat in the next available class. If, however, paramedic is really what you're interested in, then go to paramedic school. I disagree with Fiznat that you need to be a basic for a while before going to paramedic school. A good, accredited paramedic program will be able to adequately prepare a dedicated student, EMS background or not, to function and thrive as a paramedic. Be careful with the Excelsior nursing program. Some states will not accept online education for nursing. That means that if you go through the Excelsior program and pass the NCLEX (nursing boards), the state in which you wish to be licensed may deny licensure based on where you obtained your education. I don't know what Florida's position is with regards to online initial education for nursing. But it would be well worth checking out. Short answer? It wouldn't. Nursing and paramedicine, while sharing some similarities, are greatly different. You would do *much* better in the long run to be a nurse first and then come back for your paramedic certification than you would be the other way around. You're right to be skeptical. You're right to be asking questions. To better help you, however, we need to know what it is you really want to do. Why do you want to be a medic? Why do you want to be a nurse? Simply because it seems like the next step? Why not PA school? Why not medical school? Are those not logical next steps? When you figure out the answers to these questions you'll not only be better preparing yourself for where you want to go but you'll help us in terms of being able to focus answers to your questions a little more directly. Lastly, LS mentioned it above but it's so important it's worth repeating. Do NOT start down the road of taking shortcuts to where you think you want to be. If you're going to do this (medic, RN, whatever) do it right from the start. Don't cut corners. Don't sneak through. Don't half-ass anything. If you think it's worth doing it's worth doing right. You will come out much better in the long run.