Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 Please excuse while I throw my two cents on the table about the whole NR exam plan. With the state having such a shortage on medics as it is why in the world would you want to make any harder to get certified, and once you do get certified it takes an act of congress to recertify. It has been said that the NR has a very high failure rate (could someone please find the difference on failure rates between the Nr and the current state exam?) I understand the whole objective is to make the test more accreditable in the hope of bringing in more money but lets face reality if you make it harder people are not going to want to take it. Many people have a hard time passing the state exam as it is not due to lack of knowledge but due to stress. EMS needs people who can perform the skills needed to help people in their time of need, not people who are lucky enough to pass a test. The people who are trying to make it harder are the people who will never have to take the test. Right now the smartest thing to do for new prospects is go to nursing school get your RN and then challenge the medic test. Not only will you be able to make more money but its easier to recert. But, this causes a problem, if you are an RN why in the world would you want to work the streets for less money than you would make in the hospital??? I just ask one thing, for the people who are making it so difficult to take the test their self and then post their scores on the server. I bet that the failure rate is higher than the passing rate, and NO I'm not doubting anyone's intelligence, I'm only trying to prove a ppoint that this is not the right way to go. Mersiovsky EMT-I mimer256@... --------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 I don't want to make this personal, but I feel this post is out-of-line. While the state test is no joke, it's not the hardest exam I've ever taken, either. There are many contributory factors, such as the type and length of paramedic program you went to, the resources available in your area and your class size, but overall, the pass/no pass depends on you. Blaming the NR test for a higher failure rate only seems to say that you want lower standards, and I don't think you'll find many people on this list who want lower standards. You make a complaint about pay, and I state that the only way to increase pay is to make medics a more precious commodity. Increasing education requirements and raising the testing standard will produce fewer medics, that's sure. But fewer, higher trained medics may well be more productive and beneficial than a flood of less-qualified folks. And, they'd get paid more. Supply and demand. The /risk/ to that is people deciding paramedics aren't as necessary and allowing others to perform their work. But that's a risk that's managable on many fronts, and is the subject of another whole post. Lowering the testing standards is not the correct way to increase the number of medics on the street. And I don't agree that there is any need to increase this number. While rural areas may not have paramedics, how loudly are they really complaining? Not to be heartless, but if people want something, they find a way to get it. Whether it be through direct funding or through a legislative approach, they make change happen. Remember, EMS is *not* a required service in the state of Texas. Paramedic care is not mandated anywhere. It's optional for each jurisdiction. Mike Need help understanding > Please excuse while I throw my two cents on the table about the whole NR exam plan. With the state having such a shortage on medics as it is why in the world would you want to make any harder to get certified, and once you do get certified it takes an act of congress to recertify. It has been said that the NR has a very high failure rate (could someone please find the difference on failure rates between the Nr and the current state exam?) I understand the whole objective is to make the test more accreditable in the hope of bringing in more money but lets face reality if you make it harder people are not going to want to take it. Many people have a hard time passing the state exam as it is not due to lack of knowledge but due to stress. EMS needs people who can perform the skills needed to help people in their time of need, not people who are lucky enough to pass a test. The people who are trying to make it harder are the people who will never have to take the test. Right now the smartest thing to do for new prospects is go to nursing school get your RN and then challenge the medic test. Not only will you be able to make more money but its easier to recert. But, this causes a problem, if you are an RN why in the world would you want to work the streets for less money than you would make in the hospital??? I just ask one thing, for the people who are making it so difficult to take the test their self and then post their scores on the server. I bet that the failure rate is higher than the passing rate, and NO I'm not doubting anyone's intelligence, I'm only trying to prove a ppoint that this is not the right way to go. > > > Mersiovsky EMT-I > > mimer256@... > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 " Mike , LP " wrote: I don't want to make this personal, but I feel this post is out-of-line. While the state test is no joke, it's not the hardest exam I've ever taken, either. There are many contributory factors, such as the type and length of paramedic program you went to, the resources available in your area and your class size, but overall, the pass/no pass depends on you. Blaming the NR test for a higher failure rate only seems to say that you want lower standards, and I don't think you'll find many people on this list who want lower standards. You make a complaint about pay, and I state that the only way to increase pay is to make medics a more precious commodity. Increasing education requirements and raising the testing standard will produce fewer medics, that's sure. But fewer, higher trained medics may well be more productive and beneficial than a flood of less-qualified folks. And, they'd get paid more. Supply and demand. The /risk/ to that is people deciding paramedics aren't as necessary and allowing others to perform their work. But that's a risk that's managable on many fronts, and is the subject of another whole post. Lowering the testing standards is not the correct way to increase the number of medics on the street. And I don't agree that there is any need to increase this number. While rural areas may not have paramedics, how loudly are they really complaining? Not to be heartless, but if people want something, they find a way to get it. Whether it be through direct funding or through a legislative approach, they make change happen. Remember, EMS is *not* a required service in the state of Texas. Paramedic care is not mandated anywhere. It's optional for each jurisdiction. Mike Need help understanding > Please excuse while I throw my two cents on the table about the whole NR exam plan. With the state having such a shortage on medics as it is why in the world would you want to make any harder to get certified, and once you do get certified it takes an act of congress to recertify. It has been said that the NR has a very high failure rate (could someone please find the difference on failure rates between the Nr and the current state exam?) I understand the whole objective is to make the test more accreditable in the hope of bringing in more money but lets face reality if you make it harder people are not going to want to take it. Many people have a hard time passing the state exam as it is not due to lack of knowledge but due to stress. EMS needs people who can perform the skills needed to help people in their time of need, not people who are lucky enough to pass a test. The people who are trying to make it harder are the people who will never have to take the test. Right now the smartest thing to do for new prospects is go to nursing school get your RN and then challenge the medic test. Not only will you be able to make more money but its easier to recert. But, this causes a problem, if you are an RN why in the world would you want to work the streets for less money than you would make in the hospital??? I just ask one thing, for the people who are making it so difficult to take the test their self and then post their scores on the server. I bet that the failure rate is higher than the passing rate, and NO I'm not doubting anyone's intelligence, I'm only trying to prove a ppoint that this is not the right way to go. > > > Mersiovsky EMT-I > > mimer256@... > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 " Mike , LP " wrote: I don't want to make this personal, but I feel this post is out-of-line. While the state test is no joke, it's not the hardest exam I've ever taken, either. There are many contributory factors, such as the type and length of paramedic program you went to, the resources available in your area and your class size, but overall, the pass/no pass depends on you. Blaming the NR test for a higher failure rate only seems to say that you want lower standards, and I don't think you'll find many people on this list who want lower standards. You make a complaint about pay, and I state that the only way to increase pay is to make medics a more precious commodity. Increasing education requirements and raising the testing standard will produce fewer medics, that's sure. But fewer, higher trained medics may well be more productive and beneficial than a flood of less-qualified folks. And, they'd get paid more. Supply and demand. The /risk/ to that is people deciding paramedics aren't as necessary and allowing others to perform their work. But that's a risk that's managable on many fronts, and is the subject of another whole post. Lowering the testing standards is not the correct way to increase the number of medics on the street. And I don't agree that there is any need to increase this number. While rural areas may not have paramedics, how loudly are they really complaining? Not to be heartless, but if people want something, they find a way to get it. Whether it be through direct funding or through a legislative approach, they make change happen. Remember, EMS is *not* a required service in the state of Texas. Paramedic care is not mandated anywhere. It's optional for each jurisdiction. Mike Need help understanding > Please excuse while I throw my two cents on the table about the whole NR exam plan. With the state having such a shortage on medics as it is why in the world would you want to make any harder to get certified, and once you do get certified it takes an act of congress to recertify. It has been said that the NR has a very high failure rate (could someone please find the difference on failure rates between the Nr and the current state exam?) I understand the whole objective is to make the test more accreditable in the hope of bringing in more money but lets face reality if you make it harder people are not going to want to take it. Many people have a hard time passing the state exam as it is not due to lack of knowledge but due to stress. EMS needs people who can perform the skills needed to help people in their time of need, not people who are lucky enough to pass a test. The people who are trying to make it harder are the people who will never have to take the test. Right now the smartest thing to do for new prospects is go to nursing school get your RN and then challenge the medic test. Not only will you be able to make more money but its easier to recert. But, this causes a problem, if you are an RN why in the world would you want to work the streets for less money than you would make in the hospital??? I just ask one thing, for the people who are making it so difficult to take the test their self and then post their scores on the server. I bet that the failure rate is higher than the passing rate, and NO I'm not doubting anyone's intelligence, I'm only trying to prove a ppoint that this is not the right way to go. > > > Mersiovsky EMT-I > > mimer256@... > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 This is exactly what I didn't want to get into. I don't claim that Licensure vs. Certification determines how qualified anyone is to practice paramedicine (and I refuse to get into a conversation where we " whip em out and measure em " ). I do claim that higher standards, such as those originally envisioned in the Licensure proposals, produce more qualified medics. There is a difference, however, in the way certain laws and regulations relate between " licensed medical personnel " and " certified medical personnel. " In the prehospital arena, this is moot. But following through with other threads on this list, it may come to pass that there is a middle ground - fixed-location services provided on an emergency basis in an out-of-hospital environment, in conjunction with other medical specialties, from PA's to NP's to RN's to RRT's, each with a different level of training and each under different regulations w.r.t. their certification, licensure and scope of practice. If NR doesn't recognize licensure *at all*, as they do not now, there may be a liability involved if Texas is serious about moving paramedicine into the environment of medcial personnel licensed to practice prehospital medicine with a defined baseline scope of practice independent from that of a protocoling, licensed physician. This benefits both paramedic and physician - paramedic in that paramedicine becomes a true medical art with a defined role, scope of practice and and career definition, and physician through lessening the responsibility riding on their medical license to a degree. Of course, it's all pre-specualtive right now, but it's a good place to be looking (forward, that is). And I'm not convinced that the National Registry is *really* as forward looking as many of those in Texas who are trying to drive EMS seem to be. Either way, their testing standards seem to be higher, and I think higher testing standards produces more qualified medics if you look at everyone from the time they are initially certified/licensed. What you suggest with regards to the practicing of advanced skills at a lower level of certification is done now - there are services in texas where EMT-I's give IV Epi for first line pulseless arrest, under protocol. The difference, however, is that the medical director assumes more risk in this than allowing paramedics to push first-line epi because there is no defined training standard for an intermediate to push epi. The medical director determines benefit, determines training and retraining, and oversees the actual implementation, then risks his license for his people to perform *any* skill, even those " above " their level by definition. And if schools consistently turn out medics of whom only half pass the exam, I daresay those school will not be in business long because they are not teaching enough of the cirriculum or they are not appropriately teaching to the student population. The push for greater (respect, pay, benefits, need - pick which one you want) for medics needs to be twofold - increased education and requirements so that the medical community respects us, and increased legislative effort so that the legislature and public understand us. You state that rural areas generally pay better than urban areas. Can you back up this claim? I have seen other posts on the subject, including those of RDodson, that suggest otherwise, as rural areas lack the funding to make this a reality. In fact, the highest paying services in the state that I know of are primarily urban (personally, and of course this is conjecture not stated fact, as I don't have the numbers to back it up either). Does anyone have the numbers to back this up? And what if those medics working for multiple services were content to work for only one - they made enough money and had the right schedule to live comfortably just working for one? That would leave a service needing a medic, making medics a " hotter " commodity, and to a limit (established by revenue, primarily) would increase salaries, benefits and attractive schedules. The higher salaries, etc. bring more people into the field and justify the increased education requirements needed for entry. Unfortunately, now, the only place we seem to have control to start is by increasing the required education for entry, which creates a shortage, which raises salaries, which attracts people, which alleviates the shortage (in theory, of course!). The plus-side to this is that we can raise educational and entry-requirements *now* with fewer considerations *because* EMS isn't required. The ensuing shortage will *force* a re-evaluation in many areas that don't have (or won't have after a shortage) paramedic coverage, should it become " mandatory. " And just like many places have volunteer fire departments and reserve police officers, many volunteer EMS services will still exist. We're not talking about the end of the volunteer, we're talking about the beginning of a true profession and career, recognized in the medical community and by the public at large. Again, I answer that the testing situation as it was *was* broke. Compromised tests, mis-keyed result sets, and aging cirricula all led to the need to create new tests. Creating new tests required input, and input led to a bid process that apparently garnered no bids, but attracted interest from NR, which is how we got where we are today. Mike ----- Original Message ----- > Thank you Mr. for helping me make a point. You stated " Paramedic care is not mandated anywhere " then why are people going to risk losing money. I personnaly will not pay to take an exam that has an incredible failure rate. Also, you stated " higher trained medics may well be more productive and beneficial than a flood of less-qualified folks " so what you're saying is that if I get my NREMT-P than I'm more qualified than you LP. If I was in Administration in a hospital based service my employees would train with the medical director and get signed off to perform advanced skills before I would fork out the money for my people to have to go school for an extended period of time for probally half of them to fail the cert exam. Either that or run an ALS service.The way to make medics a more precious commodity is not to make it harder to gain cert but to continue to lobby at the legislative level. Also there is a need for paramedics, rural areas generally pay better than in urban areas, so in ten years when the amount of paramedics decrease urban areas will be hurt more because people will go to higher paying companies. Why fix something thats not broke? In rural areas there are many medics from all levels that work for more than one service primarily due to the fact that there is a shortage. In my opinion I just dont think that Mr. 's response answered any one question I posted. 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Guest guest Posted December 10, 2001 Report Share Posted December 10, 2001 --- Mersiovsky wrote: > ...Many people have a hard time passing the > state exam as it is not due to lack of > knowledge but due to stress. Sir: You might be correct in this assertion. However, if a person can't control his or her stress enough to take a written test in a quiet, air-conditioned/heated, well lit auditorium, do you really want this person providing prehospital emergency services in the cold rain at 2 a.m.? Food for thought. stay safe - phil __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2001 Report Share Posted December 11, 2001 Just two cents worth (again)..it depends on what you are defining as rural. A rural area outside of Houston, Dallas or Austin is by definition in better shape than one outside of El Paso or even Lubbock for that matter. Those in West Texas for the most part don't have a tax base (read property tax exemptions on ag land and such) to support EMS and most, if they haven't gone under already, are always struggling to find ways to stay afloat. I can give you people ot talk to in the areas I am talking about, just contact me. Also, Presidio is just now paying minimum wage per hour and that is across the board. When I worked there I made 60 $ a day on call, which works out to 2.50/hour. Given that any transport call was at least 4.5 hours long, I made 11.25$ for an average call. If the call was a wreck, with extrication, it could be as long as 7-8 hours which would work out to a whopping 17.5-20.00$ of what the local politicans like to call " actual work " . Because the transport times were so long, other employers were usually not willing to hire you, which is understandable when they can't afford to loose an employee for most of the workday most of the time(they were only paying minimum wage as well). And all this was an experienced paramedic with a B.S. (the M.S. came later) and a Coordinator/Instructor cert and all the bells and whistles in the adjunct courses. Even now they run with one paramedic and one EMT as everyone has had to leave. So please rescind the argument that rural medics are making more than urban, because it is not true. > This is exactly what I didn't want to get into. I don't claim that > Licensure vs. Certification determines how qualified anyone is to practice > paramedicine (and I refuse to get into a conversation where we " whip em out > and measure em " ). I do claim that higher standards, such as those > originally envisioned in the Licensure proposals, produce more qualified > medics. There is a difference, however, in the way certain laws and > regulations relate between " licensed medical personnel " and " certified > medical personnel. " In the prehospital arena, this is moot. But following > through with other threads on this list, it may come to pass that there is a > middle ground - fixed-location services provided on an emergency basis in an > out-of-hospital environment, in conjunction with other medical specialties, > from PA's to NP's to RN's to RRT's, each with a different level of training > and each under different regulations w.r.t. their certification, licensure > and scope of practice. If NR doesn't recognize licensure *at all*, as they > do not now, there may be a liability involved if Texas is serious about > moving paramedicine into the environment of medcial personnel licensed to > practice prehospital medicine with a defined baseline scope of practice > independent from that of a protocoling, licensed physician. This benefits > both paramedic and physician - paramedic in that paramedicine becomes a true > medical art with a defined role, scope of practice and and career > definition, and physician through lessening the responsibility riding on > their medical license to a degree. Of course, it's all pre-specualtive > right now, but it's a good place to be looking (forward, that is). And I'm > not convinced that the National Registry is *really* as forward looking as > many of those in Texas who are trying to drive EMS seem to be. Either way, > their testing standards seem to be higher, and I think higher testing > standards produces more qualified medics if you look at everyone from the > time they are initially certified/licensed. > > What you suggest with regards to the practicing of advanced skills at a > lower level of certification is done now - there are services in texas where > EMT-I's give IV Epi for first line pulseless arrest, under protocol. The > difference, however, is that the medical director assumes more risk in this > than allowing paramedics to push first-line epi because there is no defined > training standard for an intermediate to push epi. The medical director > determines benefit, determines training and retraining, and oversees the > actual implementation, then risks his license for his people to perform > *any* skill, even those " above " their level by definition. > > And if schools consistently turn out medics of whom only half pass the exam, > I daresay those school will not be in business long because they are not > teaching enough of the cirriculum or they are not appropriately teaching to > the student population. > > The push for greater (respect, pay, benefits, need - pick which one you > want) for medics needs to be twofold - increased education and requirements > so that the medical community respects us, and increased legislative effort > so that the legislature and public understand us. > > You state that rural areas generally pay better than urban areas. Can you > back up this claim? I have seen other posts on the subject, including those > of RDodson, that suggest otherwise, as rural areas lack the funding to make > this a reality. In fact, the highest paying services in the state that I > know of are primarily urban (personally, and of course this is conjecture > not stated fact, as I don't have the numbers to back it up either). Does > anyone have the numbers to back this up? And what if those medics working > for multiple services were content to work for only one - they made enough > money and had the right schedule to live comfortably just working for one? > That would leave a service needing a medic, making medics a " hotter " > commodity, and to a limit (established by revenue, primarily) would increase > salaries, benefits and attractive schedules. The higher salaries, etc. > bring more people into the field and justify the increased education > requirements needed for entry. Unfortunately, now, the only place we seem > to have control to start is by increasing the required education for entry, > which creates a shortage, which raises salaries, which attracts people, > which alleviates the shortage (in theory, of course!). The plus-side to > this is that we can raise educational and entry-requirements *now* with > fewer considerations *because* EMS isn't required. The ensuing shortage > will *force* a re-evaluation in many areas that don't have (or won't have > after a shortage) paramedic coverage, should it become " mandatory. " And > just like many places have volunteer fire departments and reserve police > officers, many volunteer EMS services will still exist. We're not talking > about the end of the volunteer, we're talking about the beginning of a true > profession and career, recognized in the medical community and by the public > at large. > > Again, I answer that the testing situation as it was *was* broke. > Compromised tests, mis-keyed result sets, and aging cirricula all led to the > need to create new tests. Creating new tests required input, and input led > to a bid process that apparently garnered no bids, but attracted interest > from NR, which is how we got where we are today. > > Mike > > ----- Original Message ----- > From: " Mersiovsky " <mimer256@y...> > > > Thank you Mr. for helping me make a point. You stated " Paramedic > care is not mandated anywhere " then why are people going to risk losing > money. I personnaly will not pay to take an exam that has an incredible > failure rate. Also, you stated " higher trained medics may well be more > productive and beneficial than a flood of less-qualified folks " so what > you're saying is that if I get my NREMT-P than I'm more qualified than you > LP. If I was in Administration in a hospital based service my employees > would train with the medical director and get signed off to perform advanced > skills before I would fork out the money for my people to have to go school > for an extended period of time for probally half of them to fail the cert > exam. Either that or run an ALS service.The way to make medics a more > precious commodity is not to make it harder to gain cert but to continue to > lobby at the legislative level. Also there is a need for paramedics, rural > areas generally pay better than in urban areas, so in ten years when the > amount of paramedics decrease urban areas will be hurt more because people > will go to higher paying companies. Why fix something thats not broke? In > rural areas there are many medics from all levels that work for more than > one service primarily due to the fact that there is a shortage. In my > opinion I just dont think that Mr. 's response answered any one question > I posted. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2001 Report Share Posted December 11, 2001 I have to agree....even though our hourly rate is good, we still have to work long hours and we sure do not get paid for the whole twenty four hour period we are on call. I am happy where I am here in West Texas, it is just depressing sometimes to be on call and not get paid for it. I am curious, is there any good medic jobs in the carribean. s carribeanmedic6 wrote: Just two cents worth (again)..it depends on what you are defining as rural. A rural area outside of Houston, Dallas or Austin is by definition in better shape than one outside of El Paso or even Lubbock for that matter. Those in West Texas for the most part don't have a tax base (read property tax exemptions on ag land and such) to support EMS and most, if they haven't gone under already, are always struggling to find ways to stay afloat. I can give you people ot talk to in the areas I am talking about, just contact me. Also, Presidio is just now paying minimum wage per hour and that is across the board. When I worked there I made 60 $ a day on call, which works out to 2.50/hour. Given that any transport call was at least 4.5 hours long, I made 11.25$ for an average call. If the call was a wreck, with extrication, it could be as long as 7-8 hours which would work out to a whopping 17.5-20.00$ of what the local politicans like to call " actual work " . Because the transport times were so long, other employers were usually not willing to hire you, which is understandable when they can't afford to loose an employee for most of the workday most of the time(they were only paying minimum wage as well). And all this was an experienced paramedic with a B.S. (the M.S. came later) and a Coordinator/Instructor cert and all the bells and whistles in the adjunct courses. Even now they run with one paramedic and one EMT as everyone has had to leave. So please rescind the argument that rural medics are making more than urban, because it is not true. > This is exactly what I didn't want to get into. I don't claim that > Licensure vs. Certification determines how qualified anyone is to practice > paramedicine (and I refuse to get into a conversation where we " whip em out > and measure em " ). I do claim that higher standards, such as those > originally envisioned in the Licensure proposals, produce more qualified > medics. There is a difference, however, in the way certain laws and > regulations relate between " licensed medical personnel " and " certified > medical personnel. " In the prehospital arena, this is moot. But following > through with other threads on this list, it may come to pass that there is a > middle ground - fixed-location services provided on an emergency basis in an > out-of-hospital environment, in conjunction with other medical specialties, > from PA's to NP's to RN's to RRT's, each with a different level of training > and each under different regulations w.r.t. their certification, licensure > and scope of practice. If NR doesn't recognize licensure *at all*, as they > do not now, there may be a liability involved if Texas is serious about > moving paramedicine into the environment of medcial personnel licensed to > practice prehospital medicine with a defined baseline scope of practice > independent from that of a protocoling, licensed physician. This benefits > both paramedic and physician - paramedic in that paramedicine becomes a true > medical art with a defined role, scope of practice and and career > definition, and physician through lessening the responsibility riding on > their medical license to a degree. Of course, it's all pre-specualtive > right now, but it's a good place to be looking (forward, that is). And I'm > not convinced that the National Registry is *really* as forward looking as > many of those in Texas who are trying to drive EMS seem to be. Either way, > their testing standards seem to be higher, and I think higher testing > standards produces more qualified medics if you look at everyone from the > time they are initially certified/licensed. > > What you suggest with regards to the practicing of advanced skills at a > lower level of certification is done now - there are services in texas where > EMT-I's give IV Epi for first line pulseless arrest, under protocol. The > difference, however, is that the medical director assumes more risk in this > than allowing paramedics to push first-line epi because there is no defined > training standard for an intermediate to push epi. The medical director > determines benefit, determines training and retraining, and oversees the > actual implementation, then risks his license for his people to perform > *any* skill, even those " above " their level by definition. > > And if schools consistently turn out medics of whom only half pass the exam, > I daresay those school will not be in business long because they are not > teaching enough of the cirriculum or they are not appropriately teaching to > the student population. > > The push for greater (respect, pay, benefits, need - pick which one you > want) for medics needs to be twofold - increased education and requirements > so that the medical community respects us, and increased legislative effort > so that the legislature and public understand us. > > You state that rural areas generally pay better than urban areas. Can you > back up this claim? I have seen other posts on the subject, including those > of RDodson, that suggest otherwise, as rural areas lack the funding to make > this a reality. In fact, the highest paying services in the state that I > know of are primarily urban (personally, and of course this is conjecture > not stated fact, as I don't have the numbers to back it up either). Does > anyone have the numbers to back this up? And what if those medics working > for multiple services were content to work for only one - they made enough > money and had the right schedule to live comfortably just working for one? > That would leave a service needing a medic, making medics a " hotter " > commodity, and to a limit (established by revenue, primarily) would increase > salaries, benefits and attractive schedules. The higher salaries, etc. > bring more people into the field and justify the increased education > requirements needed for entry. Unfortunately, now, the only place we seem > to have control to start is by increasing the required education for entry, > which creates a shortage, which raises salaries, which attracts people, > which alleviates the shortage (in theory, of course!). The plus-side to > this is that we can raise educational and entry-requirements *now* with > fewer considerations *because* EMS isn't required. The ensuing shortage > will *force* a re-evaluation in many areas that don't have (or won't have > after a shortage) paramedic coverage, should it become " mandatory. " And > just like many places have volunteer fire departments and reserve police > officers, many volunteer EMS services will still exist. We're not talking > about the end of the volunteer, we're talking about the beginning of a true > profession and career, recognized in the medical community and by the public > at large. > > Again, I answer that the testing situation as it was *was* broke. > Compromised tests, mis-keyed result sets, and aging cirricula all led to the > need to create new tests. Creating new tests required input, and input led > to a bid process that apparently garnered no bids, but attracted interest > from NR, which is how we got where we are today. > > Mike > > ----- Original Message ----- > From: " Mersiovsky " <mimer256@y...> > > > Thank you Mr. for helping me make a point. You stated " Paramedic > care is not mandated anywhere " then why are people going to risk losing > money. I personnaly will not pay to take an exam that has an incredible > failure rate. Also, you stated " higher trained medics may well be more > productive and beneficial than a flood of less-qualified folks " so what > you're saying is that if I get my NREMT-P than I'm more qualified than you > LP. If I was in Administration in a hospital based service my employees > would train with the medical director and get signed off to perform advanced > skills before I would fork out the money for my people to have to go school > for an extended period of time for probally half of them to fail the cert > exam. Either that or run an ALS service.The way to make medics a more > precious commodity is not to make it harder to gain cert but to continue to > lobby at the legislative level. Also there is a need for paramedics, rural > areas generally pay better than in urban areas, so in ten years when the > amount of paramedics decrease urban areas will be hurt more because people > will go to higher paying companies. Why fix something thats not broke? In > rural areas there are many medics from all levels that work for more than > one service primarily due to the fact that there is a shortage. In my > opinion I just dont think that Mr. 's response answered any one question > I posted. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2001 Report Share Posted December 11, 2001 There are many positions open and for good reason. It is poorly run, poorly financed and in general chaos thanks to the micromanagment of the Government here, It would be akin to jumping from the frying pan to the fire. Just a for instance: on the island I live on, there is one (some nights two) ambulances located mid-island for a population of 60,000 people. It takes an average response time of 30-60 minutes for the rig to arrive. very sad > > This is exactly what I didn't want to get into. I don't claim that > > Licensure vs. Certification determines how qualified anyone is to > practice > > paramedicine (and I refuse to get into a conversation where we " whip > em out > > and measure em " ). I do claim that higher standards, such as those > > originally envisioned in the Licensure proposals, produce more > qualified > > medics. There is a difference, however, in the way certain laws and > > regulations relate between " licensed medical personnel " and > " certified > > medical personnel. " In the prehospital arena, this is moot. But > following > > through with other threads on this list, it may come to pass that > there is a > > middle ground - fixed-location services provided on an emergency > basis in an > > out-of-hospital environment, in conjunction with other medical > specialties, > > from PA's to NP's to RN's to RRT's, each with a different level of > training > > and each under different regulations w.r.t. their certification, > licensure > > and scope of practice. If NR doesn't recognize licensure *at all*, > as they > > do not now, there may be a liability involved if Texas is serious > about > > moving paramedicine into the environment of medcial personnel > licensed to > > practice prehospital medicine with a defined baseline scope of > practice > > independent from that of a protocoling, licensed physician. This > benefits > > both paramedic and physician - paramedic in that paramedicine > becomes a true > > medical art with a defined role, scope of practice and and career > > definition, and physician through lessening the responsibility > riding on > > their medical license to a degree. Of course, it's all > pre-specualtive > > right now, but it's a good place to be looking (forward, that is). > And I'm > > not convinced that the National Registry is *really* as forward > looking as > > many of those in Texas who are trying to drive EMS seem to be. > Either way, > > their testing standards seem to be higher, and I think higher > testing > > standards produces more qualified medics if you look at everyone > from the > > time they are initially certified/licensed. > > > > What you suggest with regards to the practicing of advanced skills > at a > > lower level of certification is done now - there are services in > texas where > > EMT-I's give IV Epi for first line pulseless arrest, under protocol. > The > > difference, however, is that the medical director assumes more risk > in this > > than allowing paramedics to push first-line epi because there is no > defined > > training standard for an intermediate to push epi. The medical > director > > determines benefit, determines training and retraining, and oversees > the > > actual implementation, then risks his license for his people to > perform > > *any* skill, even those " above " their level by definition. > > > > And if schools consistently turn out medics of whom only half pass > the exam, > > I daresay those school will not be in business long because they are > not > > teaching enough of the cirriculum or they are not appropriately > teaching to > > the student population. > > > > The push for greater (respect, pay, benefits, need - pick which one > you > > want) for medics needs to be twofold - increased education and > requirements > > so that the medical community respects us, and increased legislative > effort > > so that the legislature and public understand us. > > > > You state that rural areas generally pay better than urban areas. > Can you > > back up this claim? I have seen other posts on the subject, > including those > > of RDodson, that suggest otherwise, as rural areas lack the funding > to make > > this a reality. In fact, the highest paying services in the state > that I > > know of are primarily urban (personally, and of course this is > conjecture > > not stated fact, as I don't have the numbers to back it up either). > Does > > anyone have the numbers to back this up? And what if those medics > working > > for multiple services were content to work for only one - they made > enough > > money and had the right schedule to live comfortably just working > for one? > > That would leave a service needing a medic, making medics a " hotter " > > commodity, and to a limit (established by revenue, primarily) would > increase > > salaries, benefits and attractive schedules. The higher salaries, > etc. > > bring more people into the field and justify the increased education > > requirements needed for entry. Unfortunately, now, the only place > we seem > > to have control to start is by increasing the required education for > entry, > > which creates a shortage, which raises salaries, which attracts > people, > > which alleviates the shortage (in theory, of course!). The > plus-side to > > this is that we can raise educational and entry-requirements *now* > with > > fewer considerations *because* EMS isn't required. The ensuing > shortage > > will *force* a re-evaluation in many areas that don't have (or won't > have > > after a shortage) paramedic coverage, should it become " mandatory. " > And > > just like many places have volunteer fire departments and reserve > police > > officers, many volunteer EMS services will still exist. We're not > talking > > about the end of the volunteer, we're talking about the beginning of > a true > > profession and career, recognized in the medical community and by > the public > > at large. > > > > Again, I answer that the testing situation as it was *was* broke. > > Compromised tests, mis-keyed result sets, and aging cirricula all > led to the > > need to create new tests. Creating new tests required input, and > input led > > to a bid process that apparently garnered no bids, but attracted > interest > > from NR, which is how we got where we are today. > > > > Mike > > > > ----- Original Message ----- > > From: " Mersiovsky " <mimer256@y...> > > > > > Thank you Mr. for helping me make a point. You stated > " Paramedic > > care is not mandated anywhere " then why are people going to risk > losing > > money. I personnaly will not pay to take an exam that has an > incredible > > failure rate. Also, you stated " higher trained medics may well be > more > > productive and beneficial than a flood of less-qualified folks " so > what > > you're saying is that if I get my NREMT-P than I'm more qualified > than you > > LP. If I was in Administration in a hospital based service my > employees > > would train with the medical director and get signed off to perform > advanced > > skills before I would fork out the money for my people to have to go > school > > for an extended period of time for probally half of them to fail the > cert > > exam. Either that or run an ALS service.The way to make medics a > more > > precious commodity is not to make it harder to gain cert but to > continue to > > lobby at the legislative level. Also there is a need for > paramedics, rural > > areas generally pay better than in urban areas, so in ten years when > the > > amount of paramedics decrease urban areas will be hurt more because > people > > will go to higher paying companies. Why fix something thats not > broke? In > > rural areas there are many medics from all levels that work for more > than > > one service primarily due to the fact that there is a shortage. In > my > > opinion I just dont think that Mr. 's response answered any one > question > > I posted. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2001 Report Share Posted December 11, 2001 On Mon, 10 Dec 2001 19:17:09 -0800 (PST) Mersiovsky writes: > EMS needs people who can perform the skills > needed to help people in their time of need, not people who are > lucky enough to pass a test. > I have passed the state paramedic exam three times and and the National once and by no means consider myself lucky, but a person who puts a lot of time and effort into doing well and continuing to update my knowledge in my chosen field. Bruce D. Daley NREMT-P > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2001 Report Share Posted December 12, 2001 We have lots of experience with " exam anxiety. " We have had students who were top performers in scenario situations but who could not take a multiple choice exam and pass. As I have stated over and over, exams tell us little about one's ability to provide intelligent and competent medical care in the pre-hospital setting. Exams favor the verbal learner, the reader, and the cultural equivalent of the person who wrote the exam. As I have said over and over, verbal skills, communication skills, reading skills, critical thinking skills, problem solving skills, psychomotor skills, attitudes, and many other factors have to be assessed. Some are strong in one area, weak in others. The blessed few are strong in all. They go on to become neurosurgeons, cardiologists, or trauma docs. They don't work for $7.50/hr. We flounder about trying to find simple solutions to complex problems. Simple solutions seldom are definable. Wouldn't it be nice if we could get off the notion that any one sort of evaluation truly measures performance and find a multi-faceted approach to evaluation and certification/licensing? Yeah, it would, but it would cost money, which nobody wants to spend. gg E. Gandy, JD, LP EMS Professions Program Tyler Junior College Tyler, TX Quote Link to comment Share on other sites More sharing options...
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