To school or not to school that is my question

[mobey]

I am finishing off my PCP (EMT) this nov. and have the opportunity to go into ICP(EMT-A) the next month, part time. Thoughts? should I go for the ALS before working BLS, I do have experience as EMR, not like Ive never done a call. Would I be better off working full time PCP while schooling ICP or would I get too frusterated by knowledge vs scope? anyone who has worked one level while learning another I would appreciate your thoughts.

[Lithium]

The opinions on this are varied. Personally, if you're capable of going straight to ALS, I would advice you to do so. Just be prepared to rustle some feathers along the way as well.

When I was in ACP school but still working my normal PCP shifts, if I happened to be with an ACP at that time, I found they were rather helpful on calls. If it was an ALS call, they often elected to allow me to run it from a theory portion, and they would perform any of the necessary delegated acts (electrical therapy, med administration etc). Of course if I was way off-base with treatment modalities, I was reverted to just 'driver' and we talked about it after the call was finished.

Anyways, like I said, be prepared to receive some flack from your colleagues. Going from BLS to ALS with no experience is similar to attempting to climb Mt. Everest without oxygen. Few have accomplished it, most would tell you it can't be done and you have to be a little crazy. :wink:

Best of luck either way.

peace

[Dustdevil]

Going from BLS to ALS with no experience is similar to attempting to climb Mt. Everest without oxygen. Few have accomplished it, most would tell you it can't be done and you have to be a little crazy.

Completely disagree. There is absolutely no support for that claim. No other medical professional makes you practise at a BLS level before admitting you to the ALS portion. Nurses, physicians, PA's and respiratory therapists practise ALS from day 1. Either you're smart enough, or you aren't. A few years of BLS practice will not make you any smarter. Your ability to bandage, splint, and drive an ambulance will simply contribute nothing to your ability to grasp advanced education.

Go for it. ASAP.

[Ridryder 911]

I agree with Dust, too many are making performing BLS care too big a deal, it is a job, you should be prepared to do it. Many want to stress the BLS, because they are unable to find such career performing ALS or feel inadequate themselves. Really folks, once you are educated in patient care BLS and ALS intertwine, and if you really are proficient then BLS skills will be automatic. How many vital signs, and placing oxygen, splinting does one have to do to become "experineced enough?"... Get experience performng both at the same time ... real patient care..BLS/ALS.

Like Dust described, other health care providers never start at lower level then work themselves up...

R/r 911

[scootyboy2]

this is my thought. If you go straight from bls school to als school you wont pick up any "street" habbits the the state and/or National test dont like. Further more what you have learned from the bls class more than likely will be fresh in your mind.

[vs-eh?]

I, like Lithium, did my ACP diactic and clinical while I was working full time as a PCP. I agree fully with what he said.

You have to understand the perspective that we are coming from. It is basically unheard of and near impossible (I think there is litterally only one college) to go from PCP directly to ACP. ALL colleges (but one) REQUIRE you to have a minimum amount of employment as a PCP (varies between say 6 months to 3 years) before application to ACP school.

If you are young or "new" and are ALS? You are either flight or you bypassed "the system". This is almost universally frowned upon in EMS across Ontario.

This whole "BLS before ALS means nothing, all you do is bandage and split and drive" or the "picking up bad BLS habits" arguement must be totally from a US perspective. Honestly, I have never heard of such a blanket statement referring to PCP's here.

What I find most amazing is that you advocate pushing people through from BLS to ALS with minimal/no AUTONYMOUS road experience. Sorry, there is more to EMS than procedures, again, talking to patients, controlling the scene, whatever. So, you go straight from your 150 hour education to whatever education for ALS. From what I have read there is still a REDICULOUS amount of clinical and preceptorship time that the majority of your EMT-P's do. No OR tubes? 3 field tubes? People asking why they can't give romazicon? 250 hours preceptorship? Like seriously, unless you have a tonne of people on scene with similar ALS scope I can't see it working out well.

Honestly, the picture that is painted a lot of the time here is the EMS in the US is one big GONG SHOW.

Good luck.

PS - Spell check no worky, and I can't spell. Forgiveness please.

[hammerpcp]

I hate to admit it, but I agree with Dust on this one. Lithium and VS-eh are demonstrating the prevailing attitude here in Ontario. I have yet to hear anyone logically justify it though. As you said Dust, there is no reason why with the right amount of training before hand (of course) a new graduate could not practice ALS skills. It is only this way because that is the "way we've always done things". This is not a progressive or productive way of thinking, yet it seems to be the popular mind-set in EMS today.

[Dustdevil]

Exactly. Brought to you by the same people who brought you rotating shifts that take you from days to nights with no rest and are designed solely to burn you out before you can retire. And uniforms that make you look like a cop. Tis bullshit.

Because something is the "prevailing attitude" and "way we've always done it" does not in any way qualify it as good.

The truth is, all the vets just want you to "pay your dues" as an ambulance driver because they don't want anybody getting there faster than they did. And the schools require experience not because it makes you a better student, but simply as a way of thinning the heard of applicants and assuring that those already trying to make a living in the profession get the earliest chance to upgrade. Nothing wrong with that. But simply put, it's just bureaucracy. It's not of any benefit to you.

If you can get in, get in. Do it now.

[Defiant1]

mobey, i have one bit of advice for you... DO WHAT YOU WANT! my recomendation would be to take about a year to get feild experiance, get comfortable with your skills. that's all that i can give you for advice. as others have said, either way, good luck

[RaceMedic]

all in all yes Dust is right. It is BS, IF you can get in to medic school now by all means do it. IF you are unsure as to whether or not you can handle it, well then take a yr or what ever and work as a basic or I. I do however recommend getting you I before medic .. The programs i am familier with spend only a day maybe two on IV IM SC injection skills then your on your own ... Im sorry but i do believe that is part of professionalism and being great at what you do ... I pride myself on my ablilty to give nearly painless injections and IVs to my PT's in the same amount of time it has taken many seasoned " nail drivers" to do it while causing some major pain.

In addition .. Dust , i can only speak for the nursing programs i deal with .. but yes the do require what could be considered BLS before ALS. They require certification and work history at the CNA level before admittance to the RN or LPN programs. that may be different there or where your used to. as i said i can only speak what i know.

Like i said first ... IF you can handle EMT-B to P with out a break ... DO IT !!! if not ... then sit back and work it it will only get better.

Race