As I look at EMS’s stagnation in comparison to nursing, I have a thought. Nursing has made it where a Registered Nurse is the minimum level of entry to almost any acute care role — and where an associate’s degree is the minimum education level at best.
If we’re going to push the EMS degree narrative, we need to ensure that paramedics become the de facto provider of acute prehospital care. The Emergency Medical Technician should become the Certified Nurse’s Aide of prehospital medicine — in other words, not associated with acute care — except in a first responder role. As a friend and colleague of mine noted, an EMT’s skill set makes an immediate difference in a few cases — rapid defibrillation, tourniquet application, and the use of an Epi-Pen. Interestingly enough, those are all skills taught in the American Heart Association’s First Aid curriculum, once again providing credence to my belief that EMT education merely adds on to a general course in first aid. While we’re at it, in my ideal world, EMT and paramedic education would be separate, albeit with a track to advance from EMT to paramedic. You don’t have to progress from CNA to LVN to RN, although there are programs for LVNs to transition to RN. We should do the exact same for paramedics.
Combine that with defining the role of a paramedic (which I see as rapid assessment, stabilization, and initial treatment) in statute and zealously protecting that role from intrusions by any other profession and you might actually get EMS to become more like nursing. In my view, nursing has succeeded for three reasons. First, nursing defines what it is. Second, nursing makes sure that no one else intrudes on their defined role. And finally, nursing is willing to engage in the political process to protect their role.
Let’s not do what Canada does and call every EMS provider a paramedic. Let’s reserve the paramedic title for those who actually do what a paramedic does. We don’t lump physician assistants and physicians together. Let’s keep paramedic OUR title. Of course, that also requires us, as paramedics, to educate the public and our government about what we do — which seems to be the one thing that we are still either unable or unwilling to. See also: the general public, other healthcare professionals, and government officials mixing the terms ambulance driver, EMT, paramedic, and first responder.
In summary, we need to define what a paramedic is, protect said role, and ask the public to demand paramedics. As the advertising slogan goes, “Accept no substitutes.”