should we do away with EMT certification

[bigj1130]

As far as volunteering, I believe most professions have some kind of volunteer services. Doctors, nurses, police all have access to some kind of volunteer work. Is a physician who volunteers at a clinic or a school ruining the life of some other physician? What about someone who volunteers time to educate others? Are they evil and unprofessional?

To answer your question that you posed. I think you are leaving out a huge thing. A physician that is paid somewhere and volunteers somewhere else is a little different than the EMT-B who has their certificate just to volunteer.

I have only been to New Jersey to get a connecting flight never setting foot outside of the terminal. So I am not going to say that the health care system in NJ is good, bad or indifferent. But having read the rest of your post about it it definitely sounds broken.

I wholeheartedly believe that a health care system managed by paid career professionals is the way to operate. Not because of dedication or motivation, But because of education. A career paramedic that is worth his/her salt is always trying to stay on the cutting edge. That paramedic will continue to educate themselves because it his or her career and therefore enhance the care provided to the public who after reading your post you seem dedicated to providing good care. I am not going to step on toes or bruise egos here but lets face it I can provide more and better care to the public as a paramedic than you can as a basic, it's just the way it is. So really the way I see it even if it is less paramedics providing care to more people, It is still more care to more people. Also your one ambulance for multiple communities point, while valid, can be easily handled through mutual aid agreements.

To better our profession, EMS needs to be paid and professional and taken out of the hands of volunteers. To allow communities the choice of volunteer EMT-B service just because it is the status quo is foolish and a detriment to that community. And I am not saying this just because I am a paramedic and would really love the career opportunity of New Jersey, or to even advocate more paramedics all over the country, I am an advocate of BETTER Paramedics all over the country, to provide the best prehospital care possible

[defib_wizard]

What is wrong with having EMT's handle BLS calls and allowing Medics to attend to ALS calls?

Who decides ALS vs BLS? I am sincerely asking. Explain your system so I can understand its "differences".

We run (if possible ) 2 full time paramedic / emt crews. they trade calls and back each other up. If only one crew is acls and the other is dual bls then the medic unit is first response on all 911 calls, bls takes non-emergent transports ( if bls level ) and 2nd out 911 calls. if the bls crew is responding to a critical call they have some choices. If the medic unit is able to respond ( drop their pt and go they will do an intercept. If not a helicopter can be called or they can load and go to the hospital ( the ever popular diesel bolus ).

Sometime we only can staff two bls crews, they take turns and back each other up. Not the best system but you do the best you can with what you have. We are also private and paid.

[tamaith]

is the place where para lives dirt poor. i heard of some towns not having money for ems/ fire/ police thats why there are volly s i lived in a one horse town for a few years that there were 3 paid cops and the ems / fire were vollies. also for me where i live( phila) to get into the 911 system either as a basic or medic 95%of the time you have to vol first to get the experience before a company will hire you for a paying position.

[4kids]

As far as getting rid of EMT's period...WHY? What is wrong with having EMT's handle BLS calls and allowing Medics to attend to ALS calls? Or having EMT's assist the Medics?

First I guess it only fair to start by saying that I'm a basic in Maine, and have been for 16 years. I would have liked to have moved up in licensure but to due having kids and health issues haevn't been able to due that as of yet. I was supposed to be start the I-99 this past spring but had to post pone to a health issue. My ultimate goal is to start the 2 year paramedic program once my youngest starts school next year. Right now my commitment is to be with her as she's a special needs child.

Ok, so now how do you differentiate between what is BLS and what is ALS?

So para if what I'm understandly correctly from that past several pages of posts is that a sprained ankle would be considered a BLS call. Can we safely assume that?

However, until we know the circumstances on how they've sprained their ankle do we dispatch just a BLS crew, ALS crew or BLS crew with ALS on standby? Because how did they sprain their ankle? Alot things are not always what they appear or what they are even dipatched.

I myself have personally been on some of the simpliest little calls, that started as nothinhg more than a simple sprained ankle/sprained wrist, etc, etc, etc. And that pt has had an anxiety attack and that call has now turned into an ALS and I've had to call for backup enroute to the hospital. Now some of these calls I've been on to begin with had started with a paramedic telling me it was a basic call and have transfered care over to me a basic in order to keep ALS coverage in town.

Two things could have prevented this from happening:

1 the paramedic not clearing

2 me not being a basic

take your pick

Now I'm not saying I think I made the worst mistake becoming a basic. It was a stepping stone up from being a CNA. It gave me a chance to see if this was something I wanted to do. I'm still utterly amazed at the fact that I only needed 10 hours of clinical time for my class when I needed 80 hours of clinicals to be a CNA. But I've learned that this is not the level I want to stay at. I want more. Reading books and taking extra mini classes and grilling my paramedic husbands brain is not enough for me. I need and want more. Unfortunately my wanting more runs second when it comes to my kids.

I don't have a big issue with basic's as I am one, but if given the chance to help restructure the license levels would I say totally get rid of basic level. Nope why? Admit it guys. Come on.

We do make good band aid placers, we do make good first aiders at the fairs, we do put on a good open house, we do decent routine transfers. And I'm sure this will more than likely infuriate a few basic's I'm sorry if it does but like I said I've been a basic for 16 years, been there done that. I also know what our license level allows us to do and honestly other than 02 we're really nothing more than CNA's with an EMS license.

[paramistress]

In our system, the 911 Dispatcher makes the decision of BLS/ALS. In NJ Paramedics can only work out of a hospital. Joe Blow cannot start a paid service or AMR cannot come into NJ and put an ALS truck on the road, it is ILLEGAL! Also, Medics must ride 2 to a truck and (with a few exceptions) cannot transport. So the Medics meet the (usually volly) BLS truck and one gets on to treat and the other medic follows the bus to the hospital. Do we think that this is the best systesm, ABSOLUTELY NOT! Many of us have worked and will continue to work to improve our system, but for the time being, it is what we have and we make the best of it. I am not taking jobs from other people, the state is...and I am working to change that. But for the time being, without volunteer EMT's, the EMS system in NJ would be nonexistant!

[reaper]

In our system, the 911 Dispatcher makes the decision of BLS/ALS. In NJ Paramedics can only work out of a hospital. Joe Blow cannot start a paid service or AMR cannot come into NJ and put an ALS truck on the road, it is ILLEGAL! Also, Medics must ride 2 to a truck and (with a few exceptions) cannot transport. So the Medics meet the (usually volly) BLS truck and one gets on to treat and the other medic follows the bus to the hospital. Do we think that this is the best systesm, ABSOLUTELY NOT! Many of us have worked and will continue to work to improve our system, but for the time being, it is what we have and we make the best of it. I am not taking jobs from other people, the state is...and I am working to change that. But for the time being, without volunteer EMT's, the EMS system in NJ would be nonexistant!

NJ is where a lot of states were, 50 years ago. Some how all the other states have changed things. There are only two reasons why NJ is still like it is.

1. No one is joining together to make the changes.

2. No one wants the change for the better, because they like it the way it is.

If ever EMS person in the state lobbied the state, there would be change.

As far as your statement about EMS being non existent if there was no vol's, You are kidding right???

If you all stopped showing up tomorrow, what do think would happen?

I can tell you. The state would have an emergency meeting and change the laws.

Almost every county would rush to put a paid service together. They would not allow EMS to go away. The state would hold all the liability!

Since you would never get all the whackers to walk away, at least start gathering forces and head to the state capitol. You march on the capitol with lots of news coverage, I guarantee you there will be change. Pretty dam quick!

[spenac]

without volunteer EMT's, the EMS system in NJ would be nonexistant!

Then all volunteers walk away and I am positive within 24 hours the policy makers will start emergency changes that will provide much better care for the people you want to help. Within hours you will have started the transition to a paid system. You will have forced the people that have taken advantage of you and other volunteers to make immediate changes that will benefit us as EMS professionals but more importantly will lead to even better care being available to our patients.

[Fifthkid]

In NJ Paramedics can only work out of a hospital. Joe Blow cannot start a paid service or AMR cannot come into NJ and put an ALS truck on the road, it is ILLEGAL!

I'm confused by this statement.

Unless there is more than one New Jersey EMS website, the rules that I found state that anyone can come into the state and start an ambulance service. That includes using paramedics.

I could not find any restriction to paramedics must be hospital based or have to have 2 medics per truck. If I've missed that, could you please direct me to the regulation.

I also saw that the term volunteer in NJ referred to a service that did not charge patients for services provided. It said nothing about you personally as an EMT, working for free.

Who's paying for the fuel and supplies? If you are charging the patient for the service, then by NJ law, you are not a volunteer service.

As to your statement that dispatch determines whether a call is BLS or ALS, what if they are given incomplete or incorrect information? It happens all the time around here. And I'm sure it happens elsewhere. Why play the muck around with BLS having to call for ALS? It's a waste of time and resources and delay of patient care.

[Cowboy7427]

Well, I now have a headache after reading all the complaining about the JUST BASICS not playing the role of being useful in the EMS system. I'm too tired to argue, and It would be pointless. We (Non Paragods) know what you think of us, and I myself could care less. For those Teams out saving lives with us useless basics. We will be there to carry you when you start to fail. "And yes you will one day- Nobody is perfect.. Headed to a new forum..

Bye

[letmesleep]

I guess I don't understand the thought process behind NOT wanting to be at the top. As EMS professionals we are known as being and having a type A personality, do we not? With such a profound personality, how is it that any of us choose to stop trying to be the highest licensure known to our profession? Why do some of us get so comfy with being second best? It amazes me how personal some of the "die hard" EMTs on this thread are getting, and spend so much time and energy explaining that they "can't change" because it is what it is, and telling the medics here that they will "save" us one day. How do you plan on saving me other than taking a bullet, or stepping in front of that speeding car so it misses me all together? Will you save me by placing an airway? Carrying equipment? Washing the floor of the truck when the call is done?

As I have stated, I have been working with my partner for quite some time now, and we are family. She has been an EMT for approx 18 years now, but is finishing up her medic degree within the next year. It took her some time to realize that she needed to continue to the next phase of her career (and yes, I did push a bit), but she is getting it done. EMT level is a necessary part of this job, but it is a step on the way up the ladder. Why place the ladder in front of you if you are only going to stand on the first rung?

Makes NO sense to me!