scott33

It will differ from state to state, but I would guesstimate around 600 clinical hours. Way less than the UK / EU in any case. I would also guess that contrary to the UK 50/50 theory and practice ratio, my RN program has been around 80/20 (in favor of theory). Again, this may differ, depending where you are in the US.

Half of my nursing classes (full semester) have been in the general liberal arts and sciences. Proficiency in 1st year-level A&P, Mathematics, Microbiology, Chemistry, Psychology, Sociology, and a couple of electives, has to be shown before you step foot in a hospital. I believe this is different with the 4-year BSN programs.

As we work by GPA (grade point average) in the US, anything lower than 75% in the above courses will usually not get you into a nursing program these days; anything less than 75% on your core nursing classes is a failure, and will get you binned from the program (70% in some Universities).

I was once told by one of my Profs, that the whole idea of nursing school is to get you to pass your boards; the real learning doesn't even start until you are working as an RN. Something I have to agree with to an extent.

The RN program here is similar to the old pre-project 2000 RGN programme in the UK, in that it allows you to work anywhere upon graduation (peds, OB, Psych, adult etc).

As a new-grad, if you are employed in one of the more specialized RN positions (OR, ER, ICU etc) you can expect to be on mentored orientation for up to 1 year (depending on the facility) which is another ~ 2000 hours of hands-on. Difference being, you get paid for it.

we run the rig as both BLS and ALS

Same thing with my department.

OK Zippy... :roll:

more aobut the quality and depth rather than the quantity of bums on seats

Fine, but how often do they get to use these extended skills? How often do SJA actually run codes? How many cat A calls, do the SJA cover on a daily basis as a matter of routine (including emergency respose to and from the scene within the 8 minutes)? Big difference.

Training should go way beyond that of the minimum requirements to get your EMT-B / AA2 cards. On the job training should go on for years (particularly as a volunteer) on a building block basis, as you put it. I don't see how progression can be made, when you are not frontline ambulance crew. Whether or not SJA training is more in-depth, is irrelevant when you cannot utilize what you have learned. I could read a book on how to fly a 747; it doesnt make me a good pilot.

I agree with you, the hours for EMT-B is not enough, and on its own teaches very little. However, that is our entry-level certification...not our highest Accolade (non-HCP). The EMT-B is of no use if you are not a member, in good standing, of a corp or FD. Big insurance issue.

maybe the cat c 999s and Urgents i've gone to on Support shifts were just an illusion, maybe the inter-hospitla transfers were just an illusion as well....

Category C Non life-threatening calls = not an emergency.

and resentment from NHS ambulance staff,

don't believe the hype

I don't...but I do believe my Brother; an NHS SRP of some 10 years.

You still haven't convinced me that the AA2 is in any way, shape, or form, a " bit more than an EMT- Basic". The comparison between drug interventions, airway management interventions speak for themselves (I forgot to add IM Narcan in some states).

Apologies to the SJA members on the UK forum. Nothing personal. :wink:

Education increases my confidence in a provider.

No argument there.

And if EVERY SJA member were able to utilize their skills and education they trained so long for, on a daily basis, I would be eating my words.

However, they are not, and never have been, a front-line emergency service, and rarely get to answer 999 calls on their own. What does this do for skill-retention?

I wish I could say differently, but they are very much resticted in their scope, and therefore, incomparable with the Basics in the US who in most cases, answer up 911 calls daily (with or without ALS).

Not having a dig, its just the way it goes in the UK. The NHS still run the roost.

ZippyRN wrote: first respondershave ap lace - but that place it probably best met by current US EMT_B qualified staff

ZippyRN wrote: i'm not sure there is a place for providers with 120 or so hours of training on emergency ambulances

Firstly, the EMT-B should be seen as just that... a basic EMT. An introduction to prehospital emergency care.

However, (Zippy) comparing them to UK FR's or SJA AA2 is doing EMT-B's a discredit. I am not going to have a go at either, but I think you personally, are basing your opinion solely on the basis of training hours. You said in another post, it took you 6 years to become part of an ambulance crew in SJA. ("SJA member for 17 years, 10 as an adult member 4 as ambulance crew"). It shouldn't take 6 years to get on a rig; you could be an MD in that time. I assume you took a leave of absence.

The EMT-B curriculum is normally covered over 6 or so months (not including pre-entry requirements of various corps / FD's; which in my case, included the equivalent of FAW and FPOS). All final practical assessments for the EMT-B (from a random 15 or so stations) are taken in one day. There aren't separate courses / modules for AED, splinting, spinal immobilization, moving and handling, trauma & medical assessment, med gasses etc (as there are in SJA). It's all covered in 1 course. The written final covers any, and all, of the above.

This 1 course also includes hospital-base clinical rotations, and precepted ambulance practicum assessments, through having current status as a riding member of (or affiliation with) an ambulance corp / FD. This adds considerably to your much-quoted figure of 120 hours, which is for classroom time alone.

EMT-Bs can also use (with some state additions or restrictions):

· Nebulized albuterol

· Epi-pen, epi SQ

· Blood sugars / Oral glucose

· Activated charcoal

· Pediatric AED

· GTN / ASA for C/P

. Combitube

. PASG

They can:

· Pronounce life expired

· Request medivac at their own discretion

· Set up, and act as, incident command at an MCI

Most of the US forum users will not see what the big deal with this is... until they compare it to the SJA scope of practice, which you have stated on this forum is a "bit more than a EMT- B when it stands alone". This is simply incorrect, and maybe you can provide us with a link to their SOPs, and not just your opinion, which is entirely biased. I am NOT talking about SJA members who just happen to be HCP's. I mean the plumbers, the teachers, and the bankers, who make up much of the US voluntary system. This is where the big difference lies.

Some parts of the US ONLY have coverage by EMT-Basics. They don't go calling the "real ambulance service" when things go tits-up... They are it, and they have to work with what they have, and in a few places thats all that is needed. Again, there is NO PLACE in the UK, where the SJA are the sole prehospital providers for the area. It will never happen.

UK FR's neither drive, nor operate from ambulances (I am sure there have been some exceptions) So I don't know what analogy you were trying to make with them. They have their role in the UK, but have little in common with US EMTs.

I think we all agree the EMT-B is a fairly fundamental, easy course, and a stepping-stone to the really interesting stuff. But you and I both know they have way more scope than your "Advanced" SJA provider. I admire SJA vollies (I think that's the word) who would stick out the fragmented training, the militaristic bureaucracy, and resentment from NHS ambulance staff, just to volunteer in their limited capacity. All power to them; but lets put things in perspective... A slower pace of learning doesn't mean more advanced training.

See you on the other side of the pond...

PS...

ZippyRN wrote: if you use decent european or japanese sports touring bikes like a Pan European or a BMW rather than an asthmatic, slow, poorly balanced, poorly handling, twin, chrome laden be tasselled heap that passes for a motorcycle in much of the US - panneirs and top box

Totally with you on that