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should we do away with EMT certification


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Well, let me just say again that I'm not trying to downplay the role of the EMT-P or say that RN's are superior. They both have different roles in the EMS process and are equally important IMO.

I feel like the topic has strayed somewhat from where it originally was and that maybe some of my statements are going to be taken the wrong way. A lot of my misconceptions probably come from that all my experience is with the Army, where things are handled much differently. Even the Army Nurses are trained with a more combat oriented environment in mind.

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Sorry Ruffems, I thought we were chatting[/font:22342f3b1c] about ems topics. Didn't realize I had to provide copies of Texas DSHS "Rural EMS Reports" with any statements I made. Actually, I'm a relative new-comer to EMS. When I started seventeen years ago, we needed help out here in the boonies. Now, we still need help. And no, these folks may think they live in the country, until they come to west Texas. We take all the help we can get. My service is fully volunteer and will continue to be in the future. The folks that run these calls day and night all have day jobs. They can't afford the time off to get further certification, and couldn't afford it if they did. We hope a few of those we train will love patient care so much that they'll work in a neighboring paid service, and get those higher certs. Then, we can utilize them when they're here. I did that years ago, and now 'on call' for my home service whenever I'm home.

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Actually, I'm a relative new-comer to EMS.

That is painfully obvious. There was not one correct statement in either of your posts here.

And you apparently know even less about nursing than you do about EMS.

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Since EMTs (B, P, other letters) are operating without direct supervision of a physician, shouldn't that mean that they should be more self reliant and need more education than an RN who operates under direct supervision?

You know, when I bring that point up amongst the powers that be, I get a lot of blank stares. This seems pretty obvious to me, but to apparently lots and lots and lots of other people, it just doesn't click. Go figure.

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RN and paramedic are two vastly different fields. You really can't compare the two. Just as you really can't consider an EMS provider educated with the current system in place.

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RN and paramedic are two vastly different fields. You really can't compare the two. Just as you really can't consider an EMS provider educated with the current system in place.

I agree that there is no comparison. However, that does not invalidate the value of contrast. There is enough contrast between the two to help us understand that there is no comparison, as illustrated by JP's point, above.

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Whether a particular state calls its recognition of EMS field providers "certification" or "licensing," is merely a matter of semantics in my opinion.

We must recall that, in all states, all medical interventions by any level field EMS provider (EMT, basic, advanced, CCT, medic, et al) require a physician medical director. As EMS providers, we do not in any state enter into a direct contract of employment or service with our patients. Our authority to act derives from our medical director.

Thus, to me, "certification" is really the more appropriate term because the state board "certifies" that we meet the training and currency requirements, then a company or government agency employs us to provide our services to the public under the authority of its license and under the direction and control of its medical director.

Frankly, other than the obvious job-preservation issues, it has never made any sense to me for any jurisdiction anywhere to require that an ambulance be DRIVEN by a paramedic. In my mind, the public would be much better served by requiring basic EMS training (like an EMT-B) plus advanced defensive driving training for the driver. Sure, it's NICE to have two medics on scene, and in a severe enough case, it can be essential to the best possible patient care, but we will never ALWAYS be able to provide the best POSSIBLE care. Heck, it would be better to have three medics on all rigs, so that two could treat while one just monitors and records. But, in the real world, this is no more of a possibility than having an MD on every rig.

Lastly, just for the record, in my years on the streets, I have come to the firm conclusion that, just like a truly proficient secretary can make even a clueless executive look pretty darn good, a really good EMT ("basic") can vastly improve the overall performance of the medic/EMT team. In truth, I'd rather have a really good EMT as a partner any day as opposed to a poorly trained and unmotivated medic.

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In my mind, the public would be much better served by requiring basic EMS training (like an EMT-:( plus advanced defensive driving training for the driver. Sure, it's NICE to have two medics on scene, and in a severe enough case, it can be essential to the best possible patient care, but we will never ALWAYS be able to provide the best POSSIBLE care.
Could you explain how the public would be better served by an EMT driver than a paramedic driver? It IS nice to have two medics on scene and many many systems have succeeded in having this.

In truth, I'd rather have a really good EMT as a partner any day as opposed to a poorly trained and unmotivated medic.
Well, sure, but why would you accept a "poorly trained and unmotivated medic"? You wouldn't put up with a "poorly trained and unmotivated EMT" would you? How come people always leave out the "really good medic" option when they say this?
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well, I agree. Dirty black socks has no field experience. If he did, he would realize just how lacking RNs really are. No, Paramedics don't need extra training, they already have a base knowlege above what RNs do. Ivasive, goss life-saving skills, every day. It's what we do.

sorry that is utter utter rubbish, most RNs have forgotten more than the average US EMT ( regardless of letter after their name ) has been taught

RNs do invasive 'goss' ( i preseume the OP means gross ) life saving skills every day IF they work in Emergency care , it's very easy to compare people who work in one or two settings with people who work across a huge number of settings and specialities, there are doctors who haven't cannulated since they got onto their higher specialist training but it doesn't make them 'lacking' as an Doctor unless they choose to misrepresent themselves ...

compare like with like, to be told i'm lacking when the only thing i'm lacking is the employer paid for thetre placement to get my advanced airway knowledge converted into better experience ... given i have an indepdent scope of practice can adminster medication on my own initiative andperform all the skills and more of the 'normal' Paramedics, plus all the other skills i have to have to work as an RN in an emergency care setting ... ( it starts with the AMTS and ends with closing wounds in layers after performing regional anaesthesia via urinary catheters, plaster of paris and removing foreign bodies from eyes / wounds ...

several of our registrars and consultants prefer me to assist them with procedures such as tube thoracostosmy rather than another Doctor on the basis of experience and they'd rather i asssit a new to the procedure doc with them hands off supervising when it comes to teaching ...

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