My response to the chairman of the medics division of NAEMT

[Punisher]

I'm a member on the EMS-L mailing list and the chief paramedic for the NAEMT has his panties in a twist over the show Saved....he posted the letter he sent to TNT and I replied making a point that apparently the organization really needs to find more productive things to do with their time if they are that concerned about this show and how it negatively portrays paramedics (speaking as someone who has actually had sex in the back of an ambulance all I have to say to that is :roll: ).

Well he laid into me about how much the NAEMT does for EMT's, providing a laundry list of legislative things they've done....OK fine....but it was the tone with which he responded. So here's what I said back to him:

Daniel:

I am not trying to get in the way of anything, I'm just calling it as I saw it. Apparently I was incorrect and I'm willing to admit that. It's fully my intention to help advance things, not hinder them. Now the only response I have other than to put my tail firmly between my legs and retreat somewhat now that I've been corrected is in regards to rural EMS.

Also seeing as I was on a volunteer department with 11 EMS providers (myself, 8 EMT's and 2 first responders) for approximately 2500 residents and a major highway, I don't think the condescending nature of your comment about how most of America is served by volunteers is necessary. I've never been to Alameda, but I'm betting money there probably isn't a community totally dependent on volunteers within 30 miles.

Put it this way: rural hospitals are having horrible times recruiting physicians, nurses, RT's, lab techs and other specialists. I don't think the AMA, ENA, AARC, ASCP or any other group would look at their respective shortages and go "Well, we can't advance our career field because it might further screw up the shortage". While I can't speak for any other career field than my other job (RT), they are doing quite the exactly that- they are raising the requirements at the same time there is an alleged shortage (it's more a shortage of people willing to do the work asked of them than an actual shortage of manpower; I've yet to see a hospital (out of the dozen or so I've worked at) that hasn't been OVERstaffed with RT's), but yet look at RT magazines and you hear the common refrain of how we are all overworked and underpaid, that there is this horrendous shortage, still the educational requirements continue to rise. There is talk of there being a requirement of a bachelors degree as the entry level educational standard within the next decade....but back to EMS.....

So basically what I'm asking is this: do you think it's better to continue down the path we are on with EMS education, which in 95% of locations would allow a person who wouldn't be able to become licensed in any other field to marginally pass and be turned loose on patients, simply because of shortages which do exist? I guess it boils down to whether you would rather field mediocre or often outright dangerous EMT's and medics rather than further diminish the number of warm bodies you can put on rigs. Actually there is more than a passing chance a lot of those warm bodies being put on rigs with insufficient education and practice is what is contributing to the cold bodies being unloaded at the ED's if you look at the evidence coming out of retrospective studies of intubation, etc.

I'm not advocating associate's degrees for EMT's or anything of that sort, but I don't believe doubling the training time from 3-4 months to 6-8 months would seriously impact the overally turnout rate, and it would probably significantly increase the quality of the graduates or at least help to weed out the slow, weak and stupid that are simply in it for the adrenaline fix. I do think eventually requiring a bachelors degree for ALS providers and retooling the paramedic program standards to be something more akin to a physician assistant than the current approach would be a good idea.

As I said in the first paragraph of this....I apologize for being misguided. I didn't realize all the legislative dealings NAEMT had going on- but honestly, what have any of those contributed to improving the care we deliver to our patients? None of that...I'll stay out of your way trying to fix the political "policy" issues if you stay out of the way of those of us with more immediate concerns....I don't know....things like improving survival rates for our patients, etc. In fact, that is my sole concern, and I wish you all would not assume I'm just some smartass without any reasoning behind what I am saying..... By the way, no ETOH was involved in our dinner....thanks for the assumption that because we all disagreed, we must have been drinking. You don't see me assuming that because you disagree with me that you must have been dropped on your head as a child or anything along those lines so don't get snippy with me OK?

This reminds me that having the ability to see problem differently than everyone else is not acceptable in most EMS circles, even when something productive might come out of that difference in opinion. It's also a very major reason why you see the EMS brain drain....no one with higher level supratentorial function wants to stay in a career field that is underpaid, overworked and basically has no room for advancement- unless of course you can get a cushy position as a chief paramedic for a fire department. Combine that with the large amount of time this field spends chasing it's own tail.....no wonder this is a stepping stone rather than a career choice.

Feel free to message me off list if anyone else wants to discuss this. In closing just let me ask for your pardons having said anything at all on this, but I'll be on the porch if you need me....I see someone is already on the cross.

Stephen R................., CRT, EMT-I

[Dustdevil]

I'm not advocating associate's degrees for EMT's or anything of that sort...

I am.