Guest guest Posted October 29, 2005 Report Share Posted October 29, 2005 Looking at the credits at the end of the document, I have to wonder why they would want to keep EMS in the domain of the trade school folks? I saw a lot of folks with nifty titles and lots of letters after their names, but who chose these folks to draft the document? What was the selection process, and were these the folks best qualified to draft this type of document? Crosby EMT-B " Education is our passport to the future, for tomorrow belongs to those who plan for today. " -Malcolm X This email and its attachments, if any, are intended for the personal use of the named recipient(s) and may contain confidential, privileged, or proprietary information. If you are not a named recipient, or an agent responsible for delivering it to a named recipient, you have received this email in error. In that event, please (a) immediately notify me by reply email, ( do not review, copy, save, forward, or print this email or any of its attachments, and © immediately delete and/or destroy this email and its attachments and all electronic and physical copies thereof. Thank you. ________________________________ From: [mailto: ] On Behalf Of Bledsoe Sent: Saturday, October 29, 2005 2:38 PM To: EMS-L@...; ; Paramedicine Subject: National Scope of Practice Final Document I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2005 Report Share Posted October 29, 2005 Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2005 Report Share Posted October 29, 2005 Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2005 Report Share Posted October 29, 2005 Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 In a message dated 10/29/2005 11:26:04 PM Central Standard Time, petsardlj@... writes: The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. therein, I suspect, will be the problem...too many of the bureaucrats will take the Scope of Practice not as a minimum, but as a maximum....and use it to set not starting standards, but 'do not cross' limits. ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 True enough. I have to agree with Dr. B's assessment in addition to yours. This document seems to more limit what EMS is than describe what EMS can do. That's my take anyway. Crosby EMT-B ________________________________ From: [mailto: ] On Behalf Of krin135@... Sent: Sunday, October 30, 2005 8:27 AM To: Subject: Re: National Scope of Practice Final Document In a message dated 10/29/2005 11:26:04 PM Central Standard Time, petsardlj@... writes: The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. therein, I suspect, will be the problem...too many of the bureaucrats will take the Scope of Practice not as a minimum, but as a maximum....and use it to set not starting standards, but 'do not cross' limits. ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 True enough. I have to agree with Dr. B's assessment in addition to yours. This document seems to more limit what EMS is than describe what EMS can do. That's my take anyway. Crosby EMT-B ________________________________ From: [mailto: ] On Behalf Of krin135@... Sent: Sunday, October 30, 2005 8:27 AM To: Subject: Re: National Scope of Practice Final Document In a message dated 10/29/2005 11:26:04 PM Central Standard Time, petsardlj@... writes: The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. therein, I suspect, will be the problem...too many of the bureaucrats will take the Scope of Practice not as a minimum, but as a maximum....and use it to set not starting standards, but 'do not cross' limits. ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 My skepticism with this document, as with similar documents, comes into play because many (if not most) that read it will not define the word minimum properly, but will instead use this as the bar that they seek to achieve. We can all name numerous EMS Education programs that strive to meet the minimum standards. On the other hand, how many programs can be named that have consistently set their standards higher and higher in spite of the exceedingly low standards set by the various regulatory and testing agencies? I wasn’t a fan of this document even before the first draft was released. I have major problems with the use of the phrase “Scope of Practice”. Legally, this phrase (and this document) can and will serve as restraints on our up and coming profession. You can rest assured that the personal injury lawyers can’t wait for documents such as these to appear so they can use them against those being regulated. They said there would not be another release of the “DOT NSC”. Government loves to take something that works (even somewhat), break it up, reorganize it, clap a shiny new cover on it and call it “the cure all to end all cure alls”. Instead of taking the last thing we had and updating it to meet the needs of EMS today, we threw it out, and wrote a document that in my humble opinion sets us back at least 10 years. Keep in mind that this documents may have the effect of increasing standards in some areas of the country, but I feel it’s detrimental to us here in Texas. I find it rather amusing that this is being sold as the “National” Scope of Practice, but it appears that less than 50% of the states will adhere to it. E. Tate, LP Danny wrote:Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 My skepticism with this document, as with similar documents, comes into play because many (if not most) that read it will not define the word minimum properly, but will instead use this as the bar that they seek to achieve. We can all name numerous EMS Education programs that strive to meet the minimum standards. On the other hand, how many programs can be named that have consistently set their standards higher and higher in spite of the exceedingly low standards set by the various regulatory and testing agencies? I wasn’t a fan of this document even before the first draft was released. I have major problems with the use of the phrase “Scope of Practice”. Legally, this phrase (and this document) can and will serve as restraints on our up and coming profession. You can rest assured that the personal injury lawyers can’t wait for documents such as these to appear so they can use them against those being regulated. They said there would not be another release of the “DOT NSC”. Government loves to take something that works (even somewhat), break it up, reorganize it, clap a shiny new cover on it and call it “the cure all to end all cure alls”. Instead of taking the last thing we had and updating it to meet the needs of EMS today, we threw it out, and wrote a document that in my humble opinion sets us back at least 10 years. Keep in mind that this documents may have the effect of increasing standards in some areas of the country, but I feel it’s detrimental to us here in Texas. I find it rather amusing that this is being sold as the “National” Scope of Practice, but it appears that less than 50% of the states will adhere to it. E. Tate, LP Danny wrote:Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 What do the lawyers on this list think? I would be interested to hear their take. Crosby EMT-B Clipped for courtesy... RE: National Scope of Practice Final Document \ There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 What do the lawyers on this list think? I would be interested to hear their take. Crosby EMT-B Clipped for courtesy... RE: National Scope of Practice Final Document \ There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 So what is the answer? I'm not trying to be a ninny here, but really, what will it take? The FD's want EMS in the step child role, the drafters of the Scope document want EMS in the step child roll, so what are those who want to see a better EMS to do? Crosby EMT-B RE: National Scope of Practice Final Document How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 So what is the answer? I'm not trying to be a ninny here, but really, what will it take? The FD's want EMS in the step child role, the drafters of the Scope document want EMS in the step child roll, so what are those who want to see a better EMS to do? Crosby EMT-B RE: National Scope of Practice Final Document How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 Get a degree in accounting. _____ From: [mailto: ] On Behalf Of Crosby, E Sent: Sunday, October 30, 2005 10:36 AM To: Subject: RE: National Scope of Practice Final Document So what is the answer? I'm not trying to be a ninny here, but really, what will it take? The FD's want EMS in the step child role, the drafters of the Scope document want EMS in the step child roll, so what are those who want to see a better EMS to do? Crosby EMT-B RE: National Scope of Practice Final Document How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I'll never forget the 1st day of the Fire Academy. The Dean came into the classroom and " laid down the law " . If you fail 4 tests (daily exams) during the next 12 weeks, you fail the program. If you.... yada, yada, yada. Having been involved with one of the most well respected EMS Education programs in the state for the previous 7 years, I was impressed that the fire service wasn’t at all like I had heard with their minimum educational standards. I sat there in my seat thinking this was going to be a hard program, and that I was going to learn how to become a firefighter. Then, he paused………and said, “Our job is NOT to teach you to become a firefighter, our job IS to teach you how to pass the state exam.” With that single sentence my darkest thoughts of fire service “education” were exhumed. I sat there worried about the program and how difficult it was going to be because they had made it out to be something difficult. It turned out to be one of the easiest courses I ever took, I scoff…… The National EMS Scope of Practice Model - Setting the Minimum Standards for EMS Training Programs for the Minumim EMS of the 21st Century. Tater Bledsoe wrote:How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I'll never forget the 1st day of the Fire Academy. The Dean came into the classroom and " laid down the law " . If you fail 4 tests (daily exams) during the next 12 weeks, you fail the program. If you.... yada, yada, yada. Having been involved with one of the most well respected EMS Education programs in the state for the previous 7 years, I was impressed that the fire service wasn’t at all like I had heard with their minimum educational standards. I sat there in my seat thinking this was going to be a hard program, and that I was going to learn how to become a firefighter. Then, he paused………and said, “Our job is NOT to teach you to become a firefighter, our job IS to teach you how to pass the state exam.” With that single sentence my darkest thoughts of fire service “education” were exhumed. I sat there worried about the program and how difficult it was going to be because they had made it out to be something difficult. It turned out to be one of the easiest courses I ever took, I scoff…… The National EMS Scope of Practice Model - Setting the Minimum Standards for EMS Training Programs for the Minumim EMS of the 21st Century. Tater Bledsoe wrote:How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 I'll never forget the 1st day of the Fire Academy. The Dean came into the classroom and " laid down the law " . If you fail 4 tests (daily exams) during the next 12 weeks, you fail the program. If you.... yada, yada, yada. Having been involved with one of the most well respected EMS Education programs in the state for the previous 7 years, I was impressed that the fire service wasn’t at all like I had heard with their minimum educational standards. I sat there in my seat thinking this was going to be a hard program, and that I was going to learn how to become a firefighter. Then, he paused………and said, “Our job is NOT to teach you to become a firefighter, our job IS to teach you how to pass the state exam.” With that single sentence my darkest thoughts of fire service “education” were exhumed. I sat there worried about the program and how difficult it was going to be because they had made it out to be something difficult. It turned out to be one of the easiest courses I ever took, I scoff…… The National EMS Scope of Practice Model - Setting the Minimum Standards for EMS Training Programs for the Minumim EMS of the 21st Century. Tater Bledsoe wrote:How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 10:00 AM To: Subject: RE: National Scope of Practice Final Document I have read the document again and this is what I found. Under " Role of State Government " the wording states: " Each State has the statutory authority and responsibility to regulate EMS within its borders and to determine the scope of practice of State Licensed EMS personnel. The National Scope of Practice Model is a concensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among states: it does not have any regulatory authority. By that statement it limits the authority of the document. This could be a good thing. The legislature or others may attempt to interpret this to mean " You must be licensed or we can make changes. " If EMS personnel are licensed within the state that cannot be done. A good thing? There does appear to be wording associated with going above the minimum set skill levels and not skipping levels, again this only suggests not to do this it does not specifically limit it. There is also wording that can be construed as to what a Paramedic is, namely " an allied health professional " . I see this only as a possible description such as " grouper " , " cod " , and " Bass " they are still all " Fish " . Is this type of wording really all that important? I see a level not unlike EMT-Intermediate, it is called an AEMT or " Advanced Emergency Medical Technician " . Where is the big difference? Throughout the whole document I see only minimum set standards. There appears to be nothing in the minimum standards that are not at the level of what we have now. These standards are what we teach in EMS classes now. Maybe there is still something I am missing or is it that I say potato ( po-tay-toe) and you say potato (po-ta-toe)? Bledsoe wrote: You should really read the comments on some of the other lists. The only people in support of the document are those who wrote it. Texas has a lot to lose in this. In Texas, the medical directors have the authority to establish the practices. For example, a medical director may want EMTs to use EpiPens and nebulizers. Thus document would give the lawyers, politicians and regulators a somewhat legal opportunity to stop such a decision. But, the fundamental problem is much deeper. A Scope of Practice document should be a general overview of a profession. This reads like a trade. For example, a welding SOP document might saw, " a certified welder must understand the nature of various metals and demonstrate mastery of brazing, gas welding, stick arc welding, wire fed arc welding, TIG welding and so on. " This is exactly what we have in this document. An EMT has these skills, a paramedic these, and so on. The document should make a general statement: " An EMR should have the education and skills to care for a patient with critical injuries for the first 10 minutes. " A paramedic should have the education and skills to care for all types of emergency patients for the first hour " Leave the decision as to skills and education to the state and medical directors. In medicine (DO or MD), the students learn pretty much the same stuff. However, some schools are oriented toward training generalists and others specialists. Also, the schools vary their curricula to meet their perceived needs. In rural states, medical graduates may need better OB skills than in urban states. The schools and states have the ability to adapt accordingly. The National SOP is really the same thing we have. It was a trade-off to the big fire departments who have the dilemma of keeping their employees current in both EMS and firefighting (also haz-mat, bombs, inspections, etc). After all, they are first charged with operating fire trucks and the EMS education has to take a back seat. When someone on another list wrote, " This project had the potential to boost EMS education and in turn practice several notches by requiring paramedic training to be at the associate degree level. Unfortunately, the medical component of EMS lost out to the public safety component. This is truly a shame. " , Dave Cone, MD (who was involved in the document) wrote, " We tried. Believe me, we tried. " BEB _____ From: [mailto: ] On Behalf Of Danny Sent: Sunday, October 30, 2005 12:26 AM To: Subject: Re: National Scope of Practice Final Document Dr. Bledsoe; Perhaps you could expand on your comments, please. I did not see anything that would limit the Scope of Practice to a trade status. I saw some things that might put all of EMS on the same " beginning " page. I believe that this might be something to start with. I saw no language that would limit anything being expanded upon. I only saw language that would keep the, shall I say, " Standard " for initial certification or licensure at a minimum. There was language there that would still allow for advanced care to be given. I saw nothing that made a statement about not allowing a Medical Director the ability to put into play those skills they felt were necessary. Did I miss something? Where is it a problem to place all of us across the nation on the same page? Is there a real problem or is it a territory issue? Is there something else that needs to be added to this? Is there language that would limit what we do embedded in the " Scope of Practice " that I missed? I don't seem to see where the status of the science is not reflected. The way the scope is written does initially seem to limit things, but ; I did not see any key words that would lock anything into place. I have read it a couple of times myself. Please share your perspective. Bledsoe wrote: I have reviewed the final National Scope of Practice document several times and like it less each time. In my opinion, it will hold EMS to trade status instead of a profession. Many states, such as Wisconsin, have already stated they will not use the document. I have heard similar comments from other states. Thus, what is the point of a " consensus " national scope of practice document if half of the states all do their own thing? It is hard for me to understand the logic behind this document. It certainly does not reflect the status of the science as we know it. While we had input as medical directors and providers, I don't think much of the input was heeded. Anyway, I was just wondering what the prevailing thoughts are in regard to this. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2005 Report Share Posted October 30, 2005 Go to nursing school, pharmacy school, law school, medical school (this list can go on forever) like all the best and smartest medics before you........ " Crosby, E " wrote: So what is the answer? I'm not trying to be a ninny here, but really, what will it take? The FD's want EMS in the step child role, the drafters of the Scope document want EMS in the step child roll, so what are those who want to see a better EMS to do? Crosby EMT-B RE: National Scope of Practice Final Document How many times have you read on this list that paramedics want parity with nurses? " I can do what they do. " " We should be paid the same. " However, all nurses have an Associate's degree. The original scope of practice required an associate's degree for paramedic (like virtually every other country in the world). But, the lobby from the big fire departments were successful in getting certificate programs put through. Thus, kiss your chances of parity with nursing and increased salaries good bye. This document relegates EMS to the stepchild role it has had for years--especially in regard to the fire service. Sure, the fire departments like their personnel to have degrees in fire science or similar disciples. But, a degree in EMS is worthless to them. There will continue to exist a market for certificate programs cranking out more paramedics than their are jobs. Good for me as they will buy books. Bad for EMS as the simple equation of supply and demand will keep the salaries low. BEB Quote Link to comment Share on other sites More sharing options...
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