It’s us. Or rather, I should say it’s what my high school history teacher called “the dirty unwashed masses.”
These are the people who hold EMS back. These are the people who want the shortest, quickest course they can find. These are the people who say “just teach me the skills.” These are the people who are the “cannon fodder” who are willing to work at minimum wage for a fly-by-night transfer company. These are the people who can’t follow the simple instructions to obtain their National Registry certification or obtain a state certification. These are the people who can’t string together a comprehensible sentence.
I’ve heard before that physicians write EMS protocols to the lowest common denominator. Having seen some of the posts on several EMS sites, I’m inclined to understand why.
And until we set higher standards to be a medic of any level and to remain a medic, we have only to look in the mirror at why RSI is a rarely granted privilege, why endotracheal intubation is going away, and why community paramedicine will most likely remain mental masturbation.
In other words, this is why we can’t have nice things to play with.
Sorry to rant. I’ll go back to my legal work now.
EMS needs higher educational standards and better lobbying. It’s crazy that someone can do a one month crash EMT course and then do an accelerated paramedic program (even online) and be a paramedic in less than a year total. Until then, nursing will be a considerably better career move. It’s a shame, because EMS is amazing but it’s hard to argue that 24 hour shifts, increased responsibility, dangerous work, and much higher stress is worth half the pay of being an ER nurse which is an easier and less stressful job.
Education is a serious issue in EMS. I’ve run into plenty of EMTs (of all levels) who don’t even have basic literacy skills – imagine THOSE charts being pulled up in a court of law as part of a massive legal case… The ability to write articulately and the ability to comprehend the science AND the pharmacology of what we do is crucial… I think a return to the days where you had to be a basic for a while before you could even consider paramedic school would also help; there are plenty of paramedics who have no comprehension of basic-level skills, and over-use their toys.
Wes…You should step back for a minute and take the “Emergency” out of EMS. It’s a shame that we have been stuck with that label since the beginning. It really should be mobile medical services. Take a good look at Wake County, Medstar in Fort Worth, and many other Community Paramedic Programs. They are doing a lot of very good things to improve the health, decrease costs, and improve response capabilities. I admit that when I got involved in EMS in the early 80’s, I thought it was exciting and a worthwhile endeavor. Now, I would much rather prevent someone from being intubated and/or going to the hospital than intubating someone and giving them a 50/50 chance of survival. We can run around handling emergencies just fine-but preventing the emergency is really cheaper and better for the community. Give it some thought before you throw the community health paramedic out with the bath water.
No, on the contrary, Doc, I support the expanded roles for EMS. What I’m saying is that until we improve education, both continuing and initial, we are doomed to be stagnant. We can’t jump forward until we ensure that medics are ready for it.
All attempts to date by the NREMT to upgrade requirements are met with the always effective efforts of Fire Fighters and private ambo and shut down. Vested interests in this country call the shots.
The Big 3 anti-progress groups are IAFF, IAFC, and NVFC. Private ambulance groups don’t even come close to their influence.
What’s holding us back is not “us”, it is “them”. What allows this to continue is the hero worshipping mentality fostered by strong public relations and our own failure to confront it in a united and effective manner.
EMS needs to be separated from the fire services completely. Whether it be private or public, EMS and ambulance services should be an equal branch of public safety, treated the same as fire and police.
Emergency Medical Service, like any medical service, is a complex enough discipline that it should be the primary focus of the people who practice it. Fire service proficiency is equally complex and time-consuming to maintain. There is not enough training and on-duty time for any one person to be adequately proficient in both.
It will be easier to improve education and educational requirements if EMTs and paramedics focus solely on medical service; this will weed out those who want the EMS title just to improve their chances at a fire career.