quint

I feel that there has be to be some time to develop by themselves. To develop autonomy, and self confidence. as knowledge of their strengths and weaknesses or limitations.

R/r 911

Hell even us hose monkeys go through a "probationary" period after we are certified firefighters. Why should you not have a 6 month/1 year/ whatever "probationary" or internship period, to make sure the skills taught are the skills being used?

AK, I agree with you, but I want to fix the problem without causing others. When schools do career days, you rarely see EMS or hell even fire involved in the event. It is usually after schooling before anyone considers going into EMS. I agree in the degreed program, but how are students supposed to select it without it being known to get an education in EMS before you head back to the family ranch.

I am not pointing fingers to anyone in this post, but I see a lot of "we should get rid of this" without weighing the consequences, much less putting an effort in to anything off the computer.

It doesn't make a difference whether you are a volunteer or paid when it comes to training and industry standards. If a training/education standard is set for all agencies, then all agencies would have to abide by it. Lets just remember that just because you had 10 million hours of training, doesn't mean you are a better provider unless you actually learned something. We need to keep it practical and keep in mind that small towns USA outnumber by far those "urban" area's you all think should be modeled after. The rural citizens deserve the best care their own communities can offer.

And as a side note.........the paid vs. volunteer thing is nothing but a bunch of crap. There are good/great and bad/terrible providers on both sides......so stop puffing up your chest just because you do it for a living. I do this for a living, but routinely interface or work with volunteers who are just as good as the paid folks. So grow up, move on and discuss a practical standard that would provide good care to all of our country not just urban area's.

This is a profession regardless of pay.

=D>

Here is my point.. For the most part we agree that education should be brought up, but my concern is not for the rural basics and medics, it is for the people who live in rural areas that at some point will be patients. Now with that said how do we come up with a solution to the education problem?

Can we take it to an actual national system, and have rural agencies cetified to a certain level to get the patient close enough for a more advanced medic unit from an urban area to intercept?

Alright, so maybe we need to back up and cover this again, this is a thread about education! Not whether or not to eliminate volunteers, but how would you expand their education. It is also not a thread about some made up fantasy certification level of a basic who wants the glory of ALS without the time invested. And I have yet to post ANYTHING about the public!

So, if anyone would like to respond to my questions without diversion, please do so.

This would force these smaller areas to upgrade to paid services, as has already been discussed in great detail. Volunteer services are not helping anyone, and I will leave it at that.

I don't understand where you are coming from with this statement. I am talking of ambulance districts with 10,000 or less people, that are still too far out for "paid" city providors to cover. If they are gone who covers these areas?

How exactly is it not a big deal for the urban providers? They still have to pay for their education, most don't get paid to attend classes, and even fewer get paid time off to attend. They also have to make the decision between educating themselves and providing for the "family".

In a "urban" environment you have short commuting distances to class which makes time management a lot easier, and a bigger pool of students, in rural settings you have to deal with items such as calving, harvesting, planting of crops, and that is just spring/summer, plus lower population.

Yes, there are problems to be worked out, but the system must elevate itself before we can realistically expect to be treated as a profession.

I agree whole heartedly, but I disagree with "cutting the fat" before you have an organized effort and a solid plan.

Alright I am merely taking up the suggestion of starting a new thread for debate! (Dust if this is already covered extensively please point it out and we can move to thtat thread)

If a specific plan sparks debate, please form a new thread. Questions for clarification on specific items are welcome.

Wouldn't this move cause EMS to remain a bastardized service, with no real direction? True, it is probably better than the present, but I can't help but think that it would only keep things the same.

Nationwide, the standards need to be the same for every provider level. The ABEM would be a good place to secure the standards.

Increase the educational requirements. Perhaps an AS level degree for entry level providers, and the BS for all ALS. Of course, pay scales will have to increase accordingly.

Eliminate the Intermediate level altogether. It has outlived it's utility. The rural departments that hold on to this level so adamantly, need to realize the increase to full paramedic is well worth it.

Now I am NOT trying to down play education, which alot of you interpret me as doing, but I do have some questions and concerns.

I do agree with a "nationalized" system instead of state by state regs.

I do have concerns with going to an AS and BS requirement, what would be the bridge to cover the transition, you couldn't just apply it over night.

Intermediate, while it may not be practical in an urban setting is still viable in rural settings IMHO.

As far as rural departments "holding" on to stuff, how would you propose they obtain the higher education? They would have to quit their family supporting job to obtain the proposed education. I know to urban personnel it is not that big of a deal, but most rural providors do the job as a volunteer whether fully or paid on call/paid by call, and their is no second option due to travel times from urban areas.

Pre-response request, don't turn this thread into a shooting match just because you disagree with what I have said on education.

:shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock:

Oh no tell me it isnt true....QUINT agrees with RID on something.......never thought this day would come...

later

Terri

Sure it will ITK, but only with people that talk out their mouth! :wink:

To be able to proclaim, the title Paramedic one would have to have at least 1 year minimum or documented experience.

EMT position would be for non medical services such as rescue, LEO, 1'st responders, etc..

R/r 911

Rid, I don't know if I am agreeing with your statements for the same reason you wrote them, but I agree.

Why should we try to change it. Basic's like you will continue to overstep your education, kill a few patients and then the public will demand changes. Thank you for doing our work for us. Much appreciated.

I have a name for Paramedics, since you are an EMT-Basic I suggest you call us Sir! After all I address my superiors, MD,s & RN's, with the respect they deserve, why don't you?

Peace,

Marty

P.S. I agree with weasel 108, that truck is looking awful dirty.

Please show me where I have overstepped my quals!

You are not my superior, for all I know you are simply posing as a Paramedic on the internet to feel good!

Don't need to be threatening or aggressive to get your point across. Excessive punctuation isn't helpful, either. We're not here to bash. We come here to communicate, and just because someone may not share the exact same beliefs as you does not mean that they are on a high horse, or are a 'Paragod'. That's not bashing, that's an opinion.

We're here to communicate, not to send invites or size shoes.

WTF??

What pansy pushing corner of the world did you come from? I did not threaten nor was I any more aggressive than anyone else here!! Telling someone to get off their high horse or I will shoot it is threatening??? Maybe, if you really own a high horse and are afraid I will kill it! Man what is this world coming too!! Do me a favor leave the policing to the moderators!

I did not come out swinging I simply posted MY opinion about Paramedics, if that doesn't fit in your peace loving hippy world don't read the thread!!!

And quint, I'm not a "paragod" especially since, as I have mentioned before, I am just a student. Don't fault me because I think that anyone who responds to a medical emergency should be educated.

I will give you as much as you give me, you want to bash on my "education" at the basic level, I will come right back at you guys with your faults, otherwise that just wouldn't be fair now would it????

As I have said before but ignorance seems to cloud the issue so pardon the caps I want you to see it...................I BELIEVE IN EDUCATION!!!! But don't fault me for liking where I am as a basic, if you want more go for more, but don't bash on me for what I am and what I do!!

Hmmmm... Because private companies like having a cheap "Paramedic Assistant/Driver" and because Fire Chiefs love sending FF's through a $400 EMT-Basic course, and then having them driving a $500,00 fire truck to a medical scene to build up their call volume.

As far as getting rid of the Basic level, correct me if I'm wrong but isn't Canada doing that right now? The problem with the Basic level is systems are doing exactly what this thread is about. They are constantly trying to push the envelope of Basic skills without furthering the educational requirements. I'm sorry an 8hr course on med administration is not enough to be giving any kind of medication. Don't take it personally Basic's but there is no reason for a Basic to be giving meds. I'll say it again just because you can is not the same as you should.

Peace,

Marty

:joker:

P.S. The 'paragod' term is getting really old, please come up with something new!

Great for Canada, but I am not there nor care to visit!!

If you don't like what basic's are permitted to do CHANGE IT or accept the invite to shut up!!

Ditch the attitudes and I will give you a new name, but for now if the shoe fits...........

I, actually, currently have a different path in mind. Why are their still classes? Because the FD wants to train people at a lower level and the IFTs can charge more then just sticking a gurney and an O2 tank in the back of a van and transporting that dialysis or discharge that way.

If FD's get it done or if Ambulances pull their head out of their wallet, makes no difference to me!!

Good you you. The average basic is still under-educated. You have to talk about the average person, not the exceptions.

If you want them to have MORE education then make it happen, if you can't then stop whining

I'm not going to apologize for trying to improve this profession at all levels. The only way to improve it is by increasing the amount of education to be considered competent to start. You have to know the faults before you fix them.

I don't care if you do or don't feel like apologizing! Either fix stuff or shut up!!!

Um, what you do on scene is actually up to the person with the highest level of medical education. Hopefully, that will be at least a paramedic. Your only choice is to limit yourself by not embracing higher education for yourself or higher standards for your level.

In all actuality what I do on scene is MY choice, I made the choice to be a basic so get off your high horse before I shoot it out from under you!!

What I'm saying is that giving a drug without understanding either why the patient needs it or what it does is stupid. EMT class teaches the how and when, but not the more important why.

Oh, and I'm a basic, so it's not some sort of "paragod" mentality with me. While I would love a larger scope of practice, the idea of basics who lack even a basic understanding of physiology also getting that same scope scare me to no end. Things like understanding why you need oxygen is, actually, so basic that it's taught to high school students. Personally, I want the people transporting me to have more then a high school understanding of biology. Unfortunately, too many providers lack even that. Because of this, the basic scope is so dumbed down that our indications for a nasal cannula is that the patient can't stand a non-rebreather (and the NRBs are dumbed down, as it is, so that we don't kill the patients if we don't connect it to oxygen).

The fact is that the EMT- B level of training is not enough to understand WHY we're doing what we're doing. This makes us dangerous, unloved, and, ultimately, unneeded in a 911 system.

One last point. I have no advanced training. I do have more education, though, then the average basic. There is a difference.

Then here is an idea for you if you think basics are such a bad deal.........BECOME A PARAMEDIC, if we basics are so G'damn dangerous why are there still classes being taught? Why are certificates still being issued? There are enough medics out there that if basics were so dangerous they could get them wiped out.

Good for you guys getting more education, but it is pretty damn ignorant of you to make the assumption that I have not furthered my education, I just simply choose to stay at the basic level rather than be lumped in with crappy attitudes that are displayed proudly on this site.

You had to have known when you went to EMT class what you were getting into, if not then the blame lays on you. If the PARAGODS want to get rid of basic's then do it, otherwise stop bellyaching and bashing on other levels and professions, this relates back to my you aren't professionals because of attitude.

And BEorP I have no issue with being a driver but it's my choice not yours!

ZippyRN I have never once said to have dual basics or even hinted at giving them seniority, nice attempt at a spin though!!!

Again attitudes and egos prevail!!!

A BASIC IS A BASIC

if you want advanced training then go for it, I have nothing against education AT ALL! I do have problems with EMT-B's wanting more for less, which is what this thread was about and I have problems with Paramedics wanting to get rid of basics because they are too basic. I also have a problem with the king shit attitudes that you guys come out of class with, there is a reason I am a basic..........I ONLY WANT TO BE A BASIC and if checking pulses and applying O2 is all I want to do that is all I will do.

if you guys would slow down and READ you would see my problem is the same as yours just through different eyes and words, but you are ALL hell bent to justify and prove your worth that you see something you disagree with and get tunnel vision

Quint........ DUCK!

As B's, we are under-educated. The fact is there is so little physiology in our training that we are woefully unprepared for any variation from our training. Protocols, unfortunately, are all we have to base our patient care on. But that point has been beaten to death, and a little investigation into this site would have prepared you for the onslaught you are about to experience.

We are far from under educated, we are Basics plain and simple no two ways about it........you knew that when you took the course! If you want to be "advanced" go for it, your patch will then read "PARAMEDIC" which is how it should be! If you are lacking in skills or education you did not investigate what you were getting into, I am full aware of what is coming and I welcome it, because I love fired up people that's how shit gets accomplished, not by whining about it on a flippin internet site. you want advanced skills go to school and get a job as a Paramedic otherwise stick to the basics

Ever wonder why those with an education never argue against having it?. It is not the attitudes that will be the demise, it is rather most are trained (and poorly) not educated. Read journals often? Read any EMS medical research lately?.. Over all what is being described?.. It is that basics should do more?.. hmmm no. Is it that poor performance from lack of education is increasing poor outcome and treatments? .... awww... yeah!

Can one honestly and truthfully argue against education ? Albeit, it is only a 2 - 3 yr program (yes, it should be a minimum of 4 years). Patients in an emergency situation(s) deserve to have at least someone with that level of education to perform a detailed assessment, with interpretation of those findings and deliver treatment. How can one logically argue against such? Please, explain and inform us how this is to be true?

R/r 911

Rid I do not disagree with education and advanced care......I do disagree paying two paramedics for their skills when one of them has to be the driver (not much use for ALS skills behind a steering wheel, although I am sure dust will make an argument for that one). Why should a hospital trip get expensive just so you have an equal to talk to.

LMAO! Jealousy is not pretty. :roll:

Being uneducated is a sin. Being too stupid to recognise it is a crime.

That is what will be the demise of our profession.

And by the way, until you are properly educated, you aren't even in "our profession," much less qualified to speak on its future.

Open invite for you to come and educate me Dust!!!! And the last I heard from you was whining and complaining about not being on the same level with us lowly firemen when it comes to money and respect, considering fire is taking over EMS I am qualified to speak of how I am ramming you out of your "profession".

two people who have AT LEAST two years of education and that no one with 120 hours of training will ever show up to help my family members. But we don't need this debate again

do I bow now or after I catch my breath???? Paramedic attitudess will be the demise of our profession, so get as much praise as you can for your two years "ed"

Maybe you should check on that again WWW.doh.state.fl.us/mqa/EMT-Paramedic

EMT candidates who are currently certified in good standing by another U.S. state or territory or by NREMT will take the NREMT written assessment exam

Maybe I no understand the english very well.............I do not see no EMT-I nowhere on that site.

PORTLAND, Ore. - An Oregon man who went to a hospital complaining of a headache was found to have 12 nails embedded in his skull from a suicide attempt with a nail gun, doctors say.

Surgeons removed the nails with needle-nosed pliers and a drill, and the man survived with no serious lasting effects, according to a report on the medical oddity in the current issue of the Journal of Neurosurgery.

The unidentified 33-year-old man was suicidal and high on methamphetamine last year when he fired the nails - up to 2 inches in length - into his head one by one.

The nails were not visible when doctors first examined the man in the emergency room of an unidentified Oregon hospital a day later. Doctors were surprised when X-rays revealed six nails clustered between his right eye and ear, two below his right ear and four on the left side of his head.

The study did not say how long the nails were, and a hospital spokeswoman refused to release that information. A photo published in the study suggests the nails range from 1 1/2 to 2 inches long.

No one before is known to have survived after intentionally firing so many foreign objects into the head, according to the report, written by Dr. G. Alexander West, the neurosurgeon who oversaw the treatment of the patient.

The man at first told doctors he had had a nail gun accident, but later admitted it was a suicide attempt.

The nails came close to major blood vessels and the brain stem but did not pierce them. The patient was in remarkably good condition when he was transferred to Oregon Health & Science University in Portland, where the nails were removed.

The patient was later transferred to psychiatric care and stayed under court order for nearly a month before leaving against doctors' orders.