No matter what your view is on what constitutes a “legitimate” request for an EMS response, we all agree (or in theory, should agree) that a patient calling 911 is experiencing a bad day. Even the lowest acuity call deserves a response from an educated, competent, and ideally, compassionate, caregiver, regardless of certification level.
As I look at some of the Internet and Facebook forums devoted and dedicated to EMS, I see a lot of posts full of spelling errors. I see a lot of posts asking questions that either shouldn’t be asked in a public forum or should be considered common knowledge in emergency medicine. And of course, I see posts begging for help on passing the National Registry exam on the student’s sixth and final attempt. Many times, I ignore these posts and shake my head. Sometimes, I let my snarky humor emerge. My good friend and fellow blogger, EMS Artifact, used to give these shining exemplars of the future of EMS a Mickey D’s job application as a helpful hint.
Why do I not always encourage little Johnny or Susie to “be all they can be” and be a real lifesaver? Simple.
Emergency medicine is too important to lower our standards to the point that everyone gets a trophy — or a gold colored National Registry patch. This is why I refuse to coddle students, tolerate poor patient care, or be supportive to the person who asks for help on passing Registry on their sixth attempt. We’re in the business of caring for the weakest and most vulnerable of society. That demands high standards. And if you’re complaining about the lack of professional respect or financial stability in EMS, then we should be setting the standards for excellence — not minimal competence.
If this makes me a paragod or an arrogant prick, then so be it. Maybe we need just a few more paragods or arrogant pricks in EMS.
This is just a symptom of filtering people at the wrong end of things. The pass rate for medical school and subsequent licensure testing is 95% or so…because all the dummies are weeded out by physics, Ochem, and MCAT.
My guess is that those also weed out some potentially good doctors as well.
While that’s sad; having a (relatively few) good candidates lose out protects the profession as a whole by culling those who won’t succeed. EMS is no longer willing to do that…which is even more sad, and unfair to everyone.
When I was in medic school (as a vo-tech 30 years ago) things were different. You had to have experience. This made sense, since there were no BLS internships. You had to interview for a spot in class. We had 100 applicants & 50 interviews for my class of 24. 17-20% of the students washed out…most in the first 4 weeks. Of the survivors; nearly all passed registry on their first try. None needed more than twice.
Today, they make it too easy to get in and complete paramedic school. That does a disservice to everyone.
I am in total agreement with Dr.X
But I would also like to just point out that EMS education, as it currently is set up, doesn’t actually reflect what EMS does.
Look at how many hours are spent on end-stage emergencies. How often do EMS providers actually see these?
We talk about compassion and capability on low-acuity calls. Most patients from EMS to the ED are low acuity.
Perhaps I am not very popular, but I think it is crazy we spend 100% of EMS education on what amounts to maybe, maybe, 5% of the calls. Then after we build these EMS providers into life saving machines, we complain when they don’t want to be bothered with anything that is not life and death right now.
That is setting them up to be disgruntled.
It also doesn’t help when you have high visibility EMS agencies supporting this idea that paramedics are only for life and death.
But how to fix the issues?
We have the fire services who, very often, care little about EMS, but need the certifications to capture the EMS budget to prevent having to staff back nationally to about 40%, where it maybe should be.
The EMS agencies who have, often, accepted that EMS is a low budget job. That are motivated not to promote excellence, but instead to keep the employment pool massive, but uneducated, so that wages will stay low.
Low wages and low standards combined with relatively high educational costs nearly guarantee the exclusion of those more professionally motivated, thereby keep those most likely to fight for change out of the field where they will be troublesome to employers.
Volunteers who are, often, motivated to keep educational standards low, citing their already overwhelming commitment of time, making education an unfair, socially ungrateful, burden.
Unless you’ve been in EMS for a long time, work for the fire services, live with and have mom and dad paying your bills, or get arroused at the thought of running lights and sirens through traffic, there is almost no reason to enter/stay in the field, right?
In no way am I pretending that I’m the example that EMS should follow, so my comments don’t come from a place of arrogance, but what appears to me to be necessity.
Without professionals, there can be no fixes. Without getting paid, there will be no professionals. Without professionals there will be no increase in pay….
I just made myself a little bit dizzy…
well said Mike.
I agree, but I’m a little more prone to help those kids out in passing their certification exam, simply because so many of them are unwittingly cheated of a quality education by shady or incompetent instructors.
It’s no fault of the kid that the first indication he/she was taught incompetently is the inability to pass a ridiculously easy certification exam.
And all too often, they were kicked out the door with a certificate and absolutely no followup support. Too many instructors have the attitude, “Class is over, my job is finished.”
+1 and like Kelly’s comment. Thanks.
Asking for help on an internet forum in the hours/days before the 6th attempt is an act of desperation.
Making a face-to-face, personal appeal after a first or second attempt is a strategy to find and use resources to achieve success which should be rewarded and encouraged with friendly and actionable tips and resources to succeed.
Agree 100% with the post and the comments as well. So what do we do about it?