Most Emergency Medical Service providers in the United States are volunteers. Paid professional providers are statistically the exception rather than the rule. Volunteers providing emergency medical coverage to their communities are invaluable assets. They are required to maintain a certain level of proficiency to continue to certify at the national and state level. This is done mainly by continuing education hours. There is a small but stubborn subgroup however that are hobbyists. We need to do our best to weed those individuals from our ranks.
We all know who these folks are. They hold the same EMT rating as we do but they haven't provided patient care in years. They instead prefer to jump in the front of the ambulance to drive. They sport the "We do the same thing as a Doctor but at 80 mph" shirt or the "You better behave or I get to see you naked" shirt. They show up to calls in dirty clothes and open toed shoes.They have joined the squad as a status symbol or as a social group. They do not take the onus placed on them by the community seriously.
When a 911 call goes out the individual or family that calls has an expectation in this country of prompt, professional response. As EMS providers we owe them the best service possible when they are at their most vulnerable. These folks allow us into their house, we hear intimate details about their lives. They are looking to us to fix the problem. How we present ourselves,our professionalism, skill and decisiveness is what will provide that comfort. If we waste our training opportunities, if we don't take our responsibility seriously then we are doing the public a disservice.
Do some self examination. Are you a professional or a hobbyist?
I have been a member of emergency medical services since 2006. I have worked or do work in a volunteer based service ,private for profit based and County government affiliated EMS system. Prior to that I spent 22 years in one of the most dangerous and demanding jobs in the United States Military. Where real life and death decisions were made in training and combat on a regular basis. Where people died on training jumps and by the hand of the enemy. So I am going to lay out some truth here.
Truth #1
EMS providers are not "heroes". Individual providers may do heroic deeds but 99% of the time the job is pretty mundane. Are we any more heroic than a nurse or doctor if all we do is establish an IV and administer some pain medication? The answer is no. In those situations EMS providers are doing the job they are paid for. Before anyone gets their panties in a bunch I also wholeheartedly think the term "hero" and the phrase "thank you for your service" are terribly overused in the context of our military as well. It is all very disingenuous. Heroes do heroic things. This is heroic: Benevidez MOH Citation as is this Medic refuses to leave man with grenade lodged in leg. Putting a pressure dressing on a laceration is not.
Truth#2
EMS providers pay is for shit. As a Paramedic I get paid between $10-$13 per hour. At the security firm I manage an individual can walk in off the street and with a high school diploma or GED and make the same amount to guard a pallet of bananas. I had to go through thousands of hours of training, spend thousands of dollars on tuition and have to attend continuing education to maintain my proficiency. Depending on the call I may literally have someones life in my hands or have to dispense narcotics or other drugs. I was once told that you get paid for responsibility and not how hard you work. This holds true in most professions but not EMS. Most EMS providers I know work at least 2 jobs to stay afloat. I personally work a full time job in the security industry and two parttime EMS assignments. The pay levels are abysmal.
Truth#3
Truth #2 is more than likely because of a actual or perceived lack of professionalism within our own ranks. EMS in the United States needs to raise the bar of professionalism. Volunteers and paid services should be held to the same standards. At a minimum it should be required that a Paramedic acquire an associates degree. Pay should be based on experience and training much like nurses. To advance you should be encouraged to get a B.S. As long as EMS providers wear shirts like this:
We will never be taken seriously. EMS needs to UFY
This post is a bit overdue. I originally meant to write it last summer but due to reasons of which I will speak it didn't get written. Once it was appropriate to post I had simply forgotten until it just occurred to me that I had never brought closure to my Paramedic journey. So a bit of a recap. I started in Emergency Medicine in 2006 when I took an EMT-Basic course on a whim to see what it was all about. I graduated and didn't due much with that skill. When it came around for my 2 year renewal I discovered it was easier and cheaper to renew if I was actually running on a service. I started volunteering on a local ambulance service and the rest is history. Eventually I got hired for a paid EMT position. I progressed to EMT-Intermediate and I took the class for Advanced EMT although I never finished the written exam. More on that later.
Being a paramedic had always been in the back of my mind but in 2012 I realized I needed to get in the 2013 class at my local community college or it wasn't going to happen. Several reasons for his. They only accepted applicants once a year, my GI Bill eligibility would expire in 2014, and The National Registry of EMT was phasing out my current rating. It was go back down the chain or go up by 2016. So January 2013 found me sitting in the classroom as an new paramedic student. Fast forward 15 months and I graduated from the program in May of 2014 with a AAS degree in Paramedicine. That was all good and well but really only made me eligible to be nationally registered. The degree means I had completed the training I still needed to take the required practical (hands on) skills test and the written exam. Ask any Paramedic and they will tell you that theses tests are very difficult and definitely a right of passage.
The day of the practical I was nervous and very concerned about my performance. Not knowing exactly what to expect I had poured over numerous youtube videos in a final effort to cram for this hands on exam. I was really concerned about the static and dynamic cardiology stations:
As luck would have it I passed those stations with no problem. I did however have to retest the very last station I had tested. This was one of the oral stations where you were given a medical or trauma scenario and had to verbally relate in great detail how would handle the scenario, There were 2 of these stations during the test. I was surprised when they told me I had failed that station as I thought for sure I had done well. Good news was I only had to retest 1 station, bad news was I totally fell apart on the retest and was a no go. So this meant I had to pay another fee and drive 150 miles to retake the one station I had missed twice at the first available opportunity. So 2 weeks later I did just that. I was even more nervous than originally because now if I failed I would have to retest the entire practical after paying for a refresher class. But things went my way that day and I was in and out in less than 2 hours having passed the practical. I breathed a sigh of relief. But now I had to pass the written test.
Myself and National Registry of EMT written tests have a long and sordid history. These tests are adaptive meaning they base your questions on how well you are doing answering the other questions. They are also highly regulated. Here I write about my troubles with other tests:
What I didn't write about was the fact that I took the AEMT written test 3 times and never passed it. I eventually stopped trying putting all my eggs in the paramedic basket. So I studied for my written test and when I showed up to take it I was apprehensive but hopeful. When I left the test center I really had no idea how i did. Well I bombed it failing 4 out of 5 sections. I was crushed. So I doubled down, spent money on a pay study site as well as the free one I already had. I gave it 4 weeks and tried again. This time when I left I knew I had not done well. I was not surprised at all to see that I had failed again. At this point counting AEMT and EMT-Intermediate, I was 1 for 8 in my last 9 attempts at an NREMT written test. Not very good odds. I was crushed and serioulsy doubting if this was something I could do. I had some long talks with a friend that I consider my EMS mentor and he told me some things that helped me feel better about the results but not the process. So I studied and studied some more. I approached the test center to take my last and final chance with the confidence of a gnat. As I answered questions I was feeling more and more confident however. This time was different somehow. I actually started getting optimistic. After the test I hoped against hope. I tried not to think about it for 36 hours until I forced myself to check my account to see if I had passed. Miracle of miracles I had passed!! I finally was a paramedic. Things have moved swiftly since then, I am working as a paramedic at 3 different services on a PRN basis. I still have much to learn OJT but my long academic journey is over.
Just a short update for those that care. I am entering into my last and final semester of the paramedic course. It has been a long haul with just a few more hills to climb. I am hoping in May I will be able to write a post on how I passed the psychomotor and written exam. At this point clinicals are consuming my life but there is light at the end of the tunnel. Wish me continued success and a bright future full of many routine transfers and naked old people
