New Standards/Levels

[Kookaburra]

I think it would be rather interesting to get someone from Oregon's perspective on this topic as they are the only mandantory degree state. I would also be curious to hear how their pay rate stacks up to the rest of the U.S.

Hi, I've been following this discussion for a bit - I'm currently going to Paramedic School in Oregon. I already have my BA, but I'm getting an additional AAS for Paramedicine. Unfortunately, I can't tell you how the pay stacks up, because I haven't worked in a paid position at all - for people just entering into EMS, the expected route is to get your paramedic ASAP after Basic. (Also, all of the payscales I've seen for the State include professional firefighters, so they're skewed.)

I was shocked when I started doing research into becoming a Paramedic, I had assumed that it was a 4-year degree, at least. Personally, I will always be for increased educational requirements. Especially basic math and writing - I shudder when I see some of my compatriots make basic spelling and grammar mistakes.

[Kiwiology]

I was shocked when I started doing research into becoming a Paramedic, I had assumed that it was a 4-year degree, at least. Personally, I will always be for increased educational requirements. Especially basic math and writing - I shudder when I see some of my compatriots make basic spelling and grammar mistakes.

I'm right up with you there mate. Many of my friends (particulary American ones) have a fundamental lack of basic spelling and grasp of the English language. My sister is ten years my junior (so she is 13) and I am shocked at the poor standard of grammar and lingustic ability both she and her friends have.

Our clinical management group has recently told us it's not acceptable to put text langauge in our patient care reports and to stop doing it! u no dat sux eh m8 wen da medics put txt lingo in pcrs ... fml!

A lot of my peers also have problems with basic math and oral communication ability. Now I am hardly one to talk because I do have a bit of a s-s-s-s-s-stutter especially when I get n-n-n-n-n-n-nervous but I can speak the King's English and do so quite well. It is a fundamental requirement when dealing with other people that you can talk to them and maintain a certian level of tact and political correctness.

Generally I think the education requirements for my generation are certianly less than those of our parent's and I shudder to think what our kids are going to be required to learn (or not learn). One of the Canadian presenters at the International Rountable on Paramedicine conference here in NZ last week said we've simply bred a generation of "trophy children" who expect reward for doing what is expected of them; I think it probably ties in to, well, if we water the standards down and reward them for doing it, they won't feel left out or left behind or w/e.

It really does concern me.

[cosgrojo]

Your statements led me to believe you did not read my posts as I did not say the 4 year degree should be the entry level. Associates will do to start.

I've read every word to all of your posts Vent... but there are a lot of words, and I apologize if the 2 vs. 4 year degree got lost in translation. But I think I was accurate in assuming that you would want increased standards... eventually gaining entry with a 4 year degree. And again, I don't have a problem with it, in fact I am an advocate for it. I just don't think it is fair to accuse those who do not go above and beyond the standard that is being asked of them, of being uneducated rubes (even though there are some). My point remains that we should increase the standard across the board, and reap the rewards of that implementation, not try and do it individually. If I decide to increase my own education for myself, great... but if everyone is forced to do it together (mandated by a national governing body), then real progress can begin to be made.

Teachers don't make much more than that and they make their decision to go to college on purpose.

Incorrect statement. Starting pay for a teacher in the State of New Hampshire (not the most progressive when it comes to economy or pay) is a little more than 28,000 dollars a year (depending on the district). At only 170 days or so a year of working at 7 hours a day, that averages to about 23 dollars an hour of work completed... far more than the new paramedic with a 2 or 4 year degree. Not to mention that their rate of pay increases much more dramatically with years of service. (To be fair... and my wife, who is a teacher, is providing the information, they do a lot of work outside of the classroom, but are not compensated for it.) EMS also has to do work outside of our paid hours, it is called con-ed.

Do you honestly think a higher wage is going to encourage some to go to school? Why should they if the money is flowing in?

Absolutely I do, I would be a fool to think that economic stability is not a factor in career and educational decisions. If you increase the standards, you need to make it appealing for people to go through the educational process... increase the size of the carrot at the end of the stick. Why do people go to college? To make a better wage than those who do not. The ones that go through just for the intellectual aspect are rare.

Again, review the history of EVERY other health care profession including nursing to see how they have accomplished their status. EMS is now well over 40 years old and other professions have made their stance noted, with education in as little as 15.

Again, EVERY one of these professions had an organization or Association backing these changes, upping the requirements. EMS does not have this, and until they do, we will only see piecemeal changes. This may be alright for you, but those who want real change need to recognize the need to organize.

[Kookaburra]

Again, EVERY one of these professions had an organization or Association backing these changes, upping the requirements. EMS does not have this, and until they do, we will only see piecemeal changes. This may be alright for you, but those who want real change need to recognize the need to organize.

Forgive such a rookie question, but is there a reason the National Registry hasn't developed into a professional organization/union? Seems like the logical place to start something like that. If we develop a professional organization, and only award full voting membership to those with a degree, that would accomplish both the increased education requirement and professional association requirements.

Seriously y'all, where do we start with something like this? I want to help, and I have the boundless energy and enthusiasm of youth! Even though I have -.9 years of experience, I want to be a part of a profession that I can take pride in.

[cosgrojo]

Forgive such a rookie question, but is there a reason the National Registry hasn't developed into a professional organization/union? Seems like the logical place to start something like that. If we develop a professional organization, and only award full voting membership to those with a degree, that would accomplish both the increased education requirement and professional association requirements.

Seriously y'all, where do we start with something like this? I want to help, and I have the boundless energy and enthusiasm of youth! Even though I have -.9 years of experience, I want to be a part of a profession that I can take pride in.

Good question. I know a few people who work for the NR... and I know that they want increased standards in general (some more than others). Unfortunately they are not effective because the States have the power to make regional demands upon their EMS system. Unless they can figure out away to wrest control away from the States (and Fire), it will be a long road to hoe. I do think that this will be the best way to attack the issue. EMS needs to be recognized as a separate entity first. If EMS is continued to be viewed as a Fire off-shoot (this is not a fire bashing statement), and not allowed to succeed or fail based on our own necessity and merits, we will have a hard time gaining these standards we desire.

National Registry doesn't have a great record of taking a tough stand on these issues. It's a shame, because they are the ones in a position to force the most change. The fear is (and this is an educated guess) that if they make the requirements too onerous, that the majority of the States will balk at the expense of the education, it's under-educated populace would revolt from it's membership, and cast the National Registry aside. This may or may not be a legitimate concern, but it is worth noting.

I suggest that you get involved in your States training and evaluation process, get to know the players in your area, and go from there. Often times you will find that the factors involved are never as simplistic as we make it appear in our on-line conversations (although sometimes they are). There are real fears, real politics, and real factors that face these people everyday... usually just enough to prevent them from taking a strong and concerted stand.

I haven't even mentioned the major hurdles of regional Medical control at the State and local levels, difference between treatment modalities between rural and urban EMS, the variety of different types of services... all with a different level of input... We have a very complicated system. The more I hear of the NZ system and others in foreign lands, the stranger my system appears.

[fireflymedic]

Forgive such a rookie question, but is there a reason the National Registry hasn't developed into a professional organization/union? Seems like the logical place to start something like that. If we develop a professional organization, and only award full voting membership to those with a degree, that would accomplish both the increased education requirement and professional association requirements.

Seriously y'all, where do we start with something like this? I want to help, and I have the boundless energy and enthusiasm of youth! Even though I have -.9 years of experience, I want to be a part of a profession that I can take pride in.

The NR passes the buck to the NAEMT - if you look on the web site they advertise the NAEMT and I believe you get a free year with them when you register (I know you used to - don't know if that's still the case). However, the NAEMT needs a swift kick in the rear to get jumpstarted to do anything as far advocating for EMS as currently they are doing nothing. They want to take dues, use them to promote the thing more, but they are doing very little to further EMS education or benefit us. Shame, because they could do some good.

[VentMedic]

My point remains that we should increase the standard across the board, and reap the rewards of that implementation, not try and do it individually. If I decide to increase my own education for myself, great... but if everyone is forced to do it together (mandated by a national governing body), then real progress can begin to be made.

Forced? You realize that most of the other professions have learned to encourage a degree higher long before it happens. Forcing is counter productice. This conversation about education proves that.

Incorrect statement. Starting pay for a teacher in the State of New Hampshire (not the most progressive when it comes to economy or pay) is a little more than 28,000 dollars a year (depending on the district). At only 170 days or so a year of working at 7 hours a day, that averages to about 23 dollars an hour of work completed... far more than the new paramedic with a 2 or 4 year degree. Not to mention that their rate of pay increases much more dramatically with years of service. (To be fair... and my wife, who is a teacher, is providing the information, they do a lot of work outside of the classroom, but are not compensated for it.) EMS also has to do work outside of our paid hours, it is called con-ed.

I don't see how my statment is incorrect.

Teachers don't make much more than that and they make their decision to go to college on purpose.

Don't teachers also have to take a certain amount of continuing ed to keep their certification?

Does you wife not find it strange that a Paramedic with a 6 month education can make more than what she does with a 4 or 6 year degree? Our teachers in FL average $42k per year. The teachers had 6 years of college to "choose" their career path but yet they still did the education time. Does you wife believe her education is necessary or that it was a complete waste of time and does little to benefit her students? Maybe a teacher's assistant with a few weeks of training could do just as well as your wife. Do you think the parents would want someone with a few weeks of training teaching their kids over an educated teacher? It is unfortunate that the wages of the teachers are so low compared to their education and that they no longer enjoy job security. But, many of those who have been laid off have easily found employment due to their education.

Here are the numbers for one county that has a third service and FDs.

Starting pay (based on experience) is as follows:

Part time EMT : $12.41 - $17.70 p/h (maximum 160 hours per 2 week pay period)

Full time EMT : $44, 525 - $65,478 annual

Paramedic I : $46,845 - $68,890 annual

Paramedic II (credentialed) : $49,187 - $72,334 annual

Paramedic Company Officer : $55,077 - $80,995 annual *

Paramedic/Firefighter I : $52,220 - $76,794 annual

Paramedic Firefighter II (credentialed) : $55,875 - $82,169 annual

Paramedic/Firefighter Company Officer : $72,615 - $106,787 annual *

Even healthcare professional must do continuing ed as well inservices just to stay current. I can easily clock 300 hours every renewal and spend over $3000 out of pocket besides what my employer pays just to stay at a working minimum.

I guess what I find appalling is that those who argue against even getting the education for themselves is their failure to see where it could benefit their patients. Those in the other health care professions understood whatever excuses they could offer against education were useless as soon as patient care was made the issue.

The primary reasons education for healthcare providers in other professions was raised were for patient care and safety. The higher wages just happened to follow. EMS seems not to be looking at what it can do for the patient but what the patient should do for EMS. This selfishness is the true downfall and failure of many EMS systems whether they are FD based or whatever.

Forgive such a rookie question, but is there a reason the National Registry hasn't developed into a professional organization/union? Seems like the logical place to start something like that. If we develop a professional organization, and only award full voting membership to those with a degree, that would accomplish both the increased education requirement and professional association requirements.

The NR is ONLY a testing agency. Every health care profession has its own national testing agency. The difference between other health care professions and EMS is the others use their national exam exclusively in every state where as EMS does not. Some states still have their own EMT and Paramedic exams as well as many other levels of certs inbetween.

EMS needs a strong national association. The educators need to raise their standards and encourage more instuctors to take part in their national association.

The NR passes the buck to the NAEMT -

No buck passing. The NR is doing what it is contracted to do...write and adminster tests.

RT has the NBRC.

RN has the NCLEX.

PT has the NPTE.

They administer their credentialing exams nationally.

Edited October 17, 2009 by VentMedic

[HERBIE1]

The primary reasons education for healthcare providers in other professions was raised were for patient care and safety. The higher wages just happened to follow. EMS seems not to be looking at what it can do for the patient but what the patient should do for EMS. This selfishness is the true downfall and failure of many EMS systems whether they are FD based or whatever.

Pretty strong statement here, not to mention extremely condescending and arrogant.

It also shows a lack of understanding of the issues involved here.

We get it. You think all the problems of EMS will magically disappear if everyone received more education.

Your opinion, and you're entitled to it, but based on conversations I'd had over the years with old time RN's, their opinions and experiences differ quite dramatically from your claims. They had the same concerns and problems that we talk about here- respect from doctors, acceptance of them as professionals, chronic shortages, understaffing, burnout, hours, high turnover rate, benefits, and pay. They still have many of these same issues.

Nurses were finally able to move to earn BSN's and MSN- not for patient care and safety, but to move up the career ladder to supervisor, educator, and management positions for better working conditions, pay, and respect.

[VentMedic]

Pretty strong statement here, not to mention extremely condescending and arrogant.

It also shows a lack of understanding of the issues involved here.

I just happen to have a couple different credentials, education and over 30 years of experience both in and out of the hospital. I am on a couple of state committees for education. I am also an educator but now find that teaching nurses and RTs more rewarding as they know they the importance of education.

We get it. You think all the problems of EMS will magically disappear if everyone received more education.

Nothing happens overnight but getting an education is less ridiculous than getting a significant pay increase handed to you for doing nothing to improve patient care and safety.

Your opinion, and you're entitled to it, but based on conversations I'd had over the years with old time RN's, their opinions and experiences differ quite dramatically from your claims. They had the same concerns and problems that we talk about here- respect from doctors, acceptance of them as professionals, chronic shortages, understaffing, burnout, hours, high turnover rate, benefits, and pay. They still have many of these same issues.

Bitter OLD TIME RNs who are jealous of the new BSNs coming in with fresh idesas. These RNs could have transferred to a different department or hospital easily if the working conditions were so horrible. Next time you talk to them, tell them to retire or find a job outside of patient care. If they are this bitter, they are useless to the patients as they are wasting more time on their own attitudes than doing their nursing duties. Regardless of how hard the job is, good nurses will still do what is best for the patient even if that means getting an education. The LVNs did it.

Not all "old time" RNs hate change. In fact most do welcome it. Nursing is not easy and those that welcome change often do see the benefits in their job or at least understand it better. We still have Paramedics who push meds just because they can without understanding them or those who hold a Parmedic card just because they want to join the FD and have absolutely not understanding of medicine or patient care. They just want the money and the benefits. The 3 month wonder schools are churning out half-arsed Paramedics who thought Third watch was cool. Two years of actual education might give one a chance to ponder their decision and to grow up a little when they realize there is patient care responsiblity as part of the job.

Nurses were finally able to move to earn BSN's and MSN- not for patient care and safety, but to move up the career ladder to supervisor, educator, and management positions for better working conditions, pay, and respect.

No, there are many BSNs working in patient care. In fact, most of our new hires are BSNs. It seems to have become something that is expected especially if you do have plans to work a specialty such as one of the ICUs, Flight, CCT, OR, transplant, organ procurement etc. But, most of them see a value to just education where ever they world as they are literate and enter with more maturity after spending 4 years in college accepting the responsibility that comes with it.

This is my world every day regardless if it is on a helicopter or in a hospital. I see first hand the importance of education. Of course if you want to hear all negative comments about education you can always find someone willing to complain. However, they made the choice to be and to stay in that profession and where they are.

The statement I made in bold is used by almost every profession when they are petitioning for higher education or higher reimbursement from insurances. It is also used by many health care professionals when petitioning again Medicare cuts for home care regardless of what benefit it might be to the provider. Look at the collaborative statements on the NP and PA websites about reducing the load in EDs. Look at what they also are doing in their professions to raise their education so they can petition for change to provide patient care and safety.

[HERBIE1]

I just happen to have a couple different credentials, education and over 30 years of experience both in and out of the hospital. I am on a couple of state committees for education. I am also an educator but now find that teaching nurses and RTs more rewarding as they know they the importance of education.

Nothing happens overnight but getting an education is less ridiculous than getting a significant pay increase handed to you for doing nothing to improve patient care and safety.

Bitter OLD TIME RNs who are jealous of the new BSNs coming in with fresh idesas. These RNs could have transferred to a different department or hospital easily if the working conditions were so horrible. Next time you talk to them, tell them to retire or find a job outside of patient care. If they are this bitter, they are useless to the patients as they are wasting more time on their own attitudes than doing their nursing duties. Regardless of how hard the job is, good nurses will still do what is best for the patient even if that means getting an education. The LVNs did it.

Not all "old time" RNs hate change. In fact most do welcome it. Nursing is not easy and those that welcome change often do see the benefits in their job or at least understand it better. We still have Paramedics who push meds just because they can without understanding them or those who hold a Parmedic card just because they want to join the FD and have absolutely not understanding of medicine or patient care. They just want the money and the benefits. The 3 month wonder schools are churning out half-arsed Paramedics who thought Third watch was cool. Two years of actual education might give one a chance to ponder their decision and to grow up a little when they realize there is patient care responsiblity as part of the job.

No, there are many BSNs working in patient care. In fact, most of our new hires are BSNs. It seems to have become something that is expected especially if you do have plans to work a specialty such as one of the ICUs, Flight, CCT, OR, transplant, organ procurement etc. But, most of them see a value to just education where ever they world as they are literate and enter with more maturity after spending 4 years in college accepting the responsibility that comes with it.

This is my world every day regardless if it is on a helicopter or in a hospital. I see first hand the importance of education. Of course if you want to hear all negative comments about education you can always find someone willing to complain. However, they made the choice to be and to stay in that profession and where they are.

The statement I made in bold is used by almost every profession when they are petitioning for higher education or higher reimbursement from insurances. It is also used by many health care professionals when petitioning again Medicare cuts for home care regardless of what benefit it might be to the provider. Look at the collaborative statements on the NP and PA websites about reducing the load in EDs. Look at what they also are doing in their professions to raise their education so they can petition for change to provide patient care and safety.

Why do you insist on creating and then attacking strawmen?

First with the education statements you attribute to me, and now with nurses and their history.

For the nth time, I have no issue with education. You insist it is the key to getting changes in EMS, and I take exception to that for the reasons I listed.

I'm done- you don't want to discuss or debate, you want to lecture and build strawmen.

Knock yourself out.