National Registry

[Lithium]

Hello all,

I'm curious what our American friends think about their National Resgistry organization? As you may or may not be aware, up here in Canada, reciprocity between provinces is a HUGE hurdle to jump over for medics looking to move outside their province of original training.

It's become a little easier with some programs now being granted CMA (Canadian Medical Association) accreditation. This just means that, that specific program has met minimum requirements and teaches that paramedic level to the national scope.

Anyways, if you could let me know what you think of the registry in general, how the exams/practicals are, if it truly is beneficial for moving between state to state and any other issues you can think of ...

Thanks!

peace

[Ridryder 911]

Although this always appears to be a hot topic, I have found that most medics are very ignorant of the NREMT, the organization, the purpose, funding, etc.

Many assume that it is a branch of EMS, or some authority, etc.. All it is a testing agency... short and simple. Their main purpose is to administer accredited tests, that it was designed for to maintain a list (registry) of EMT's and now purpose is to give entry level tests of the EMT through Paramedic level. It is a non-profit agency.

I personally, have some problems of the idealogies of the NREMT and also at the same time believe that without it there would be fewer EMT's nationwide.

Whenever EMS really matures, and actually design a workable system, that consists of licensing boards in the state(s) and then agree to a national exam, we will continue to have a fragmented system. It is a shame that EMS has such an ego, instead of education.

The Registry continues to do what its main mission, promote a standardized examination, and have states adopt and allowing reprocicity from other regions. With this transfer and movement of EMT's of all levels could be easier and promote the professionalism of EMS.

Be safe

R/r 911

[tinman694]

With all that people have to say about the NREMT, why is it that nursing has the NCLEX and no one seems to have a problem with that? It is also a testing body which promotes nursing in much the same way--through administering an entry level test, which is nationally (and for the most part internationally) recognized.

Personally, I think the standardazation is the only method by which EMS will progress into a viable profession. Having to sit for a board only makes it fair to all who must meet the minimum standard of care expected for any profession. Many seem to think that it is only about wanting money--which would play a part--but in the near term-with NREMT moving forward to adaptive testing, I think it will become more of a standard by which entry level personnel are tested and evualuated on what they learned.

Why can't we all just get along?

[Dustdevil]

Agreed. The problem is, since NR has no legislated authority, they can't achieve the same things that NCLEX has achieved. NCLEX can raise its standards and the nursing schools will raise theirs. The nursing schools applaud elevated standards. They want their graduates to excel and graduate with more than the rock-bottom minimum level of knowledge. They take pride in it. The opposite is true in EMS. If NR raised its standards, the schools and fire departments would just cry and whine about it, forcing states to pull their participation.

Consequently, while the concept of the NR is excellent, they still keep their standards way too low. And they also still have serious problems writing test questions that make sense. But again, none of that invalidates the concept of a National Registry.

[AZCEP]

The biggest misconception that I've found is the idea that NREMT is accepted everywhere. This is an unrealistic expectation with the current environment. Every state has a number of regulatory bodies that decide they do or don't want to allow NREMT to be accepted in their location. Some places allow NREMT with added focus on how their standards are different. Some allow NREMT, but require a practical or written test on top of it. Some will go so far as to allow NREMT, then when you go there, they will give you a state pharmacology exam.

Is it optimal, probably not, but it is significantly better than not having it. If the local administrative bodies could come to an agreement on what the standard should be, maybe we could do away with it.

[Dustdevil]

If the local administrative bodies could come to an agreement on what the standard should be, maybe we could do away with it.

Hmmm... I was thinking if the local administrative bodies could come to an agreement on what the standard should be, it would be a validation of NR, not a way to do away with it. After all, if everybody agreed on the standard, there would be no need for each and every state to pay the enormous expense of developing and administrating their own exam. That was the case with NCLEX and FLEX.

To answer the original question, the concept of a National Registry is awesome. In fact, it is ideal. It works great for nursing, medicine, and most other licensed professions. Mobility is a snap for those professions. But NR is a long time from realising the dream here in the US where political forces across fifty states work to keep standards low and can never agree on what exactly the standards or scope should be. But remember, it was a very, very long time before national standards were adopted for nurses and doctors too! It's a long, bumpy road, but we can and must get there.

[Lithium]

See, that's the whole issue. I for one, would love to be able to develop and implement a body similar to the National Registry for Canada. In my opinion, it would assist with reciprocity quite easily, and for those of us who want to move between provinces, would provide a way to do such that.

Then the issue comes up, who is this organization responsible to? Each province? No, that would complicate things because each province (err, state) has their own ideas of what a PCP, ACP and CCP can do. Quite frankly, if I could attain licensing in Alberta as an ACP, I'd be there in a heartbeat.

So, I would have this organization responsible to the CMA. Each test following CMA standards for the PCP, ACP and CCP.

Any Canadians out there agree? Disagree?

More input from our fellows of the south, you already have this organization, how would you tweak it?

peace

[bassnmedic]

In a nutshell.........National registry is a JOKE. I have a problem with a private organization that has attempted to sell everyone that being NR means you can go anywhere and work. The test questions and concepts are ridiculous. My wife is an EMT-I (NR) and attempted to gain reciprocity in Florida, well Fla. requires her to re take NREMT I no matter that she already is one.

My personal belief is that there does need to be a national standard of care and training, but it should not be by a private/for profit organization. Maybe, place EMS under Homeland Security and have a national training curiculum and Standard of care so that all states can provide the level of care.( i.e. The service I work for does Retavase and RSI, even in Atlanta where I came from doesn't do that.

[Dustdevil]

Every other medical profession utilises a private, non-governmental organisation to administrate their national examination. Why is it you feel that EMS is somehow incapable of doing so?

And you may be the only person in America with any faith in DHS.

[akflightmedic]

In a nutshell.........National registry is a JOKE. I have a problem with a private organization that has attempted to sell everyone that being NR means you can go anywhere and work. The test questions and concepts are ridiculous. My wife is an EMT-I (NR) and attempted to gain reciprocity in Florida, well Fla. requires her to re take NREMT I no matter that she already is one.

Florida does not have nor recognize the Intermediate level, so I do not know what you are talking about.