manchmedic

I'm in agreement with much of what's been said, and I would have considered doing things differently had I known what I know now. I've been an EMS provider for 18 years, 6 of them as a Paramedic. I'm happy doing my job, but I'm also looking at mobility issues. The other thing I am considering is how long I'm going to be able to work on the street, which is a motivator behind my looking at RN licensure. My wife is also an RN - she's been at it for a little over 30 years, and she's being really supportive about my decision to pursue nursing. A lot of advice I've been given involves using what you already know - it's also been said here. And - I have no intention of giving up my Paramedic license. I'm going to find a way to use them both. Good luck to you!

I have to admit something. First, when I read the thread, I jumped in without taking a closer look at who the audience was. I shouldn't go off half-cocked when I'm talking about a totally different system and environment than the one I work in. For that, I apologize. With respect to regulation in Canada, I think you and I are on the same page, Fenders. Regulation is paramount if the system is to work the way it is intended to, and if there is none up your way, then I can understand your (and medics who are worth their salt) frustration. An issue we run into down here in a lot of local EMS systems is that there is no unionization. Because of this, pre-hospital providers get hosed when it comes down to pay, benefits, etc. And that's a problem. Personally, I'm pretty fortunate in that I work for an agency that it ultimately owned by a hospital, and they do an above average job of taking care of us and what we need. With respect to the jumper: that sounds like an awful situation. As far as getting to where the patient was, I can't speak for the actions of the EMS crew that was on scene, but unless there was a compelling reason for them to go that slowly (things that come to mind are whether or not there was access to where the patient landed, if the area was safe, anything like that) they should have been more proactive in getting to where the patient was. And as far as I'm concerned, patient isn't dead until confirmed dead. Thanks for putting up with my posting. This is a great thread - worth the time of conversation, in my opinion.... :typing

Okay - no offense intended.... I was simply making a point about regulation, nothing more. As I said, I have no clue how EMS is regulated in Canada. I imagine there are similarities, but I don't know that.

I forgot to mention that Flight Medics are a whole different breed of Paramedic. While they have all of the same skills and experience as the rest of us, they go through further schooling and have to be qualified as flight paramedics in most places. I know this because I went through such a program last fall. The program I went through was run and taught by nurses, medics, and physicians. It was an excellent educational experience.

okay - first time poster in this (or any) forum. i feel sort of compelled to comment on this post, so bear with me: i've had some pretty scarey experiences with paramedics, both personal and professionally. my mom fell and had almost passed out and when the paramedics arrived i told them what had happened, assessed her myself and had told them that she needs to go to the hospital and get xrayed as i think there may be afracture. the guys were appareantly experienced and told my mom to ly on the couch and asked her to flexion with th eknee bent both legs. then they determined from that that she had no fracture. i was furious that they made a diagnosis ont he spot. they are there to treat and transport. they ended up not taking her, nothing was signed, i grabbed my mom and took her to the hospital i worked at, sure enough was a right hip fracture requiring surguery and a partial hip replacement. it appears, just based on what you say here, that you had an ems crew that either didn't know what they were doing, or they didn't care. in either case, stuff like that makes the rest of us look bad. and this type of care is simply bad medicine. i hope your mom is doing better after this experience, and i am sorry for what happened to her. i've been an ems provider for 14 years, and i know that if i ever did anything like what you describe, a couple of things would happen to me. first, there is no doubt in my mind that i would be terminated from my job. second, i would likely be the target of a lawsuit. not only that, it's an unregulated profesion (which bugs me) and the traingin is only 1 year. i also disagree with using paramedics on flight care as int he states they use properly trained critical care nurses with years of experience. if you work in the states and go for flight they will give you some paramedicine training. rn's in both the states and here are at a level higher than the paramedics. you would have a better chance of getting into med school as a degree rn than a paramedic. you need to have a degree first and they will laugh at you here if you apply to med school as a paramedic. while i will agree with you that rn's are indeed the higher level of care (i am happily married to an rn that has nearly 30 years in the field, and she and i have this discussion regularly), i take exception to the statement you make about ems being non-regulated. in this case, i will respectfully say to you that you are wrong. emt's and paramedics in the u.s., anyway, are indeed regulated at multiple levels. since i am not licensed or certified anywhere outside of the u.s., i can't speak to that. i don't know what canada's requirements and regulations are, and frankly, i don't need to know them unless i intend to work there. at the federal level we're regulated by the u.s. department of transportation, and the standards of training and education for all levels of ems originate from there. in fact, any educational or academic institution in the united states that offers ems programs has to, by law, conform to the different curriculum standards for each level of care. they are set by year; for example, emt-b's at trained using the dot 1994 curriculum, emt-i's at either the 1985 or 1998 curriculum (depending on the state where the emt-i is licensed) and medics are at the 1998 curriculum. it is also my understanding that the dot is currently working on updating the curriculum at all levels, and anyone trained with an earlier curriculum will have to bridge up to the new level of training within a window of time. i don't think any of that has been made public yet. also, 38 of the 50 states as well as guam, puerto rico, and the u.s. territories in the pacific utilize the national registry of emergency medical technicians for testing and certification. if you work as an ems provider for the federal government (and this includes military personnel) you are required to be nationally registered. the testing process is nothing to joke about, and i can promise you that if you are a nurse and try to go through the process without any bridge training or anything like that, you will fail. finally, each state regulates ems and how providers are licensed, how continuing education requirements are fulfilled, disciplinary issues are handled, and all of the same stuff that nurses deal with in terms of their licensing. contrary to what you say, we are not an unregulated bunch. i am licensed in three states (nh, massachusetts, and maine), and while the patient care protocols differ in all of the places i work, the regulations are all very similar, and they all have teeth. we are required to do things right where i work. we are also required to be professionals, and to be any less would result in loss of privileges to practice and, in some cases, loss of license. as for training and the length of programs, there are minimum requirements for each level: basic and intermediates are each at 140 hours of training, and paramedics are at approximately 1500 hours. in most places, that is didactic only, not including internships, clinical rotations, and field practice. i went for just over 18 months before i had everything completed. that includes working at a full-time job in addition to all of the time commitments for school. additionally, there are 4-year ems programs out there, and i know three people that graduated from two of them: the one at george washington university and the one at the university of maryland. both fine programs, both of which produce excellent basically-trained paramedics. as for medical school, one of the people that graduated from umbc's program just got accepted to dartmouth medical school. and to my knowledge, he didn't get laughed at when he went for his oral interview. i apologize for the length of this post. however, i felt a strong need to set the record straight. i am not a nurse; i am a paramedic. while i have the greatest respect for the nurses i work with and for what they know and what they do, i am very proud of what i do, and i take offense when my profession is slammed in any way.