Returning Vets to be fast tracked medics to ease shortage

[Richard B the EMT]

Correct me if I am wrong but was it not the influx of Medics from Vietnam that became the first Basics back in the 70's?

As someone who started working ambulances in 1973, I believe you are correct. I also admit that we could both be quite wrong.

Any former Army Medic/Navy Corpsmen, who are also historians, and also date back to that era, care to chime in on this?

I also remember an "Emergency!" episode, where a new LACoFD Fire Fighter/Paramedic had to be yelled at by Johnny and Roy, and the On Line Medical Control crew at Ramparts Hospital, as he was messing up, and almost killing patients, by following out-of-place Vietnam Army Medic protocols, instead of those followed by the LACoFD Fire Fighter/Paramedics.

[Dustdevil]

the paramedic shortage is a myth

How so?

In at least four ways right off the top of my head:

• 1. The number of either certified/licensed paramedics (and educated medics who have expired, but are eligible) in this country is not particularly inadequate. The shortage is not in medics. The shortage -- just like the nursing shortage -- is in people who choose to remain in the field.

2. As alluded to above, the "shortage" is is self-perpetuating because of the actions of those in system administration and management, who intentionally drive medics out of the field in order to keep salaries low. If you are intentionally running off your workforce, you do not have a manpower shortage. You just have shitty management.

3. Poor management also contributes to the illusion of a shortage, because they FAIL to maintain a career that attracts candidates to the rural areas, or is even attainable by those living in the rural areas.

4. Fire departments pump out paramedic classes by the thousands every year, only to utilise those medics for only 2 to 5 years before sending them to a fire truck for the rest of their career, further increasing turnover.

• We sucker thousands of people a year into going to paramedic school with the promise of a professional career. Then, having not done the basic research before going to school, they learn that they have to be a firemonkey just to get a job, and being a 5'3", 200 pound female, they simply aren't getting that job in this lifetime. Consequently, there's one more "paramedic" that never makes it into the EMS workforce.

There is not a single place in the United States that claims a "shortage" that is not directly to blame for that shortage. There is no shortage of medics. There is just a shortage of medics who will work for them.

[jsadin]

Now there is an intelligent, well thought out post. It is the complete opposite of the previous one-liner stating "the paramedic shortage is a myth" which offered nothing but a random statement with no substance.

[AZCEP]

I'd like to see DOT/NHTSA/DHS/DHHS or whomever is holding the leash at the federal level this week to mandate a change in how resources are allocated.

It makes no sense to have urban centers with short transport times oversaturated with ALS providers that don't get enough exposure to calls when the rural areas try to make due with a BLS crew. Move some of the urban providers into the rural setting where they will actually make a difference.

Probably a discussion for another thread, but it just came to mind again. :roll:

[Richard B the EMT]

The problem is demographics, if only in part. It would be great if there was more Paramedic/ALS coverage in the more rural areas, where transport times are longer due to distance.

However, while I keep boasting of my home, New York City, having transport times not usually exceeding 15 minutes, due to the number of "9-1-1 Authorized" receiving hospitals, please remember the extensive traffic jams, and the population of 8 million residents. Ambulances are deployed by population densities, in anticipation of the likelihood of a call coming in. Also, the call volume keeps rising, both the ALS, the BLS, and, unfortunately, the BS. That last is being addressed, but I will discuss it in other strings.

[Dustdevil]

I really think that, when all is said and done, this will be nothing but talk. National Registry is a private corporation that is not under the jurisdiction of such legislation. States will not drop the National Registry in order to comply, just like they wouldn't drop the NLN to fast-track them as nurses. And besides, paramedic is already as fast tracked as it can possibly get. You already have 90 and 120 day programmes out there. What are we going to do, give the military medics a 60 day discount? Nigga pleeze. :roll:

There is a reason that these people cannot be fast tracked. It is because their experience can rarely be quantified. It's easy to ASSume they're all trauma experts, but the fact is that they are not. In fact, few are. Likewise with non-trauma knowledge and experience. Some have it. Some don't. You simply don't know. I've had three different experienced corpsmen spend an hour together trying to get an IV on me, and I have excellent veins. They've never been out in the field. They've spent their entire two to four years in a hospital or clinic, where fifty other corpsmen are competing for those IV sticks. I've worked with a lot of army 68W "Trauma Specialists" who have never seen a GSW, and have been treating sore shoulders and sore throats for four years straight. And we want to just automatically fast track these people to being the sole emergency provider in the field for the most serious and vulnerable patients in society? Suurrrre! Real smart idea.

Listen, there is no doubt that these people have a lot more on the ball than your average EMT school applicant. In fact, almost all of them are EMTs. But they still lack the same pre-requisite foundation as every other non-collegiate medic school applicant. Their education is really not significantly better than any other EMT-B headed for medic school. More of it? Sure. But immediately relevant to EMS education? Nope. A lot of military medic education is by OJT. And again, there is simply no way to qualify or quantify their individual experience. And experience is -- as already established -- neither a good preparation for paramedic school, nor a good predictor of paramedic school success anyhow, so it's pointless.

Now, if they want to mandate some sort of "affirmative action" that puts vets at the head of the eligibility line for traditional paramedic school, avoiding all the bullshit political hoops that so many schools require (fire affiliation, street experience, residency, GPA, etc...), I'd be all for that. I would even support allowing EMTs with military training and at least four years of active duty experience in that MOS to be allowed to test for EMT-I. Both would be positive things for EMS, and would even serve to help both the vets and the systems. But putting these people into some special-ed, accelerated class, or attempting to just drop them in as is not helpful to anybody. Personally, I wouldn't want to be that "affirmative action" medic who everybody knew did not get the same education that they did. Seriously.

I don't think there is a real chance that this will work. I think it's just a feel-good measure to win some votes. If it passes, it will still be forgotten or discarded as unworkable, and won't put a single mil medic in advanced status.

[triemal04]

In at least four ways right off the top of my head:

• 1. The number of either certified/licensed paramedics (and educated medics who have expired, but are eligible) in this country is not particularly inadequate. The shortage is not in medics. The shortage -- just like the nursing shortage -- is in people who choose to remain in the field.

Now hold on, you're being a bit disingenuous here. The number that needs to be looked at isn't the total number of certified/licensed paramedics out there, but, as you said, the number who are still in the field, or trying to get a job in the field. And while I wouldn't say that there is really a national shortage, I think the number would be significantly lower if you remove those who won't/can't do this job anymore. And if it were truly to get low enough (not there yet) then sure, it would be a shortage. If you need 10 medics and have 30 certified but only 5 who are willing to work as one, you've got a shortage. If someone has moved on with their career and still happens to be certified...well, if they aren't going to be working as a medic then why should they count?

2. As alluded to above, the "shortage" is is self-perpetuating because of the actions of those in system administration and management, who intentionally drive medics out of the field in order to keep salaries low. If you are intentionally running off your workforce, you do not have a manpower shortage. You just have shitty management.

I wouldn't say it's to keep salaries low, but yeah, piss-poor management definitely contributes to people not wanting to work on an ambulance anymore. But again, regardless of why, if someone isn't willing to use their certification, then they shouldn't be looked at as a potential paramedic, and regardless of why the problem exists, it is there, self-perpetuating or not. I wish that our system wasn't as screwed up as it is, but it is what it is and we can't ignore all the consequences of it.

3. Poor management also contributes to the illusion of a shortage, because they FAIL to maintain a career that attracts candidates to the rural areas, or is even attainable by those living in the rural areas.

Again, I agree, poor management is to blame, but that doesn't' mean that it isn't still part of why some areas can't attract new medics, and it doesn't mean that it won't be a cause of a future shortage.

4. Fire departments pump out paramedic classes by the thousands every year, only to utilise those medics for only 2 to 5 years before sending them to a fire truck for the rest of their career, further increasing turnover.I'm not sure what this has to do with the myth of a national paramedic shortage.

• We sucker thousands of people a year into going to paramedic school with the promise of a professional career. Then, having not done the basic research before going to school, they learn that they have to be a firemonkey just to get a job, and being a 5'3", 200 pound female, they simply aren't getting that job in this lifetime. Consequently, there's one more "paramedic" that never makes it into the EMS workforce.

If you don't research your future career, that's your own damn fault far as I'm concerned. Again, not sure how this applies.

There is not a single place in the United States that claims a "shortage" that is not directly to blame for that shortage. There is no shortage of medics. There is just a shortage of medics who will work for them.

I'm not sure where you were going with this. If you can explain it a little better that'd be great.

For the record I don't believe that there is a national shortage. I agree, many services are unable to find medics because of poor leadership, and many people who are willing to learn to be a paramedic seem to tend to not want to go to, or go back to, a rural area, causing problems there. Does this mean that we need to churn out even more paramedics? Nope, just that American EMS needs to be streamlined, revamped, overhauled, whatever word you want to use. Yet another sign really.

Far as the original topic, I was going to go off about how idiotic this was and how it'd never fly, but I think that's been done to death so far. I'll just say that giving returning military medics preference into getting into a real paramedic program and the money to go through it would be fine with me.

[terr0154]

As someone who lives in MN and spent great a deal of time looking for a job in EMS before finding one, I can safely say that Klobuchar has her head up her butt. This is not just my opinon btw but the general consensus of most emt-b's and medics residing in this great state. We are in a recession, and we need a hell of a lot more jobs, not more people to compete with!

[Dustdevil]

Triemal, I'm not really sure how to reply to that. I explained it as precisely as possible. You agreed with each and every point I made. But then you still somehow disagree with my premise.

The bottom line is this statement: "There is no shortage of medics. There is just a shortage of medics who will work for them."

In other words, no amount of increase in paramedic production addresses the so-called shortage, because turnover is not decreased. In fact, if you flood the market with even more qualified (using the term loosely) medics, you only decrease value, increasing turnover. If increased supply does not cure a shortage, then obviously, there is no shortage, only the appearance of a shortage.

It's like talking louder to somebody who doesn't understand English. They still aren't going to understand you. You have to do something different, not just increase what you are already doing.

[triemal04]

Naw, I agree for the most part with your original premise; just some of the points you brought up I have minor disagreements with. Some of your explanations for why the paramedic shortage is a myth seemed a bit skewed. Semantics maybe, I guess part of my point is that turnover does need to be looked at; at the very bottom line it doesn't matter (ok, it does, but not for this type of argument) why people aren't willing to stay paramedics, only that they aren't. You seem to be saying that because the cause of people leaving the field is poor management it doesn't count.

But yeah, doing the same thing again and again doesn't work, and creating 10 times the paramedics every year when 80% won't work as one for an extended period of time won't fix it either. The entire system needs to be redone here.

Or maybe I've just been up for to long. Damn...it sucks getting old.