Re: National Scope of Practice Final Document

[Guest guest]

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

[Guest guest]

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

[Guest guest]

My " prevailing thought " is pretty much the same as yours, Dr. Bledsoe. And

thank you for speaking up. Voices like yours should help us all to be able to

put the brakes on this thing - at least for Texas. Now, you mentioned Wisconsin

and said other states have also said they will not adopt the document. Is there

anyway we could generate a list of who and how many are against it for folks to

present at the next GETAC session?

Jane Hill

-------------- Original message from " Bledsoe " :

--------------

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

[Guest guest]

My " prevailing thought " is pretty much the same as yours, Dr. Bledsoe. And

thank you for speaking up. Voices like yours should help us all to be able to

put the brakes on this thing - at least for Texas. Now, you mentioned Wisconsin

and said other states have also said they will not adopt the document. Is there

anyway we could generate a list of who and how many are against it for folks to

present at the next GETAC session?

Jane Hill

-------------- Original message from " Bledsoe " :

--------------

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

[Guest guest]

Dr. Bledsoe, this is the part where I have to step to the side and disagree with

you. While I DO agree that there are probably still certificate programs that

are out there that are a part of the problem, not part of the solution, there

are also certificate programs out there that turn out an excellent product. I

have worked in the college environment and I have also worked in the

" certificate program " environment. Just because something is based in a college

and requires a degree doesn't make the course good - I know that for a fact. I

have seen good college based programs and bad ones - just like the disparity

between some certificate programs.

I think the problem with this document is what we were discussing earlier -

about the tendency for lawyers and other folks in positions of power who will

want to use this to set ceilings and use the document AGAINST EMS folks and

agencies in an attempt to prove claims, make money,whatever. I also know that

some physicians will do the same - hold the service to the document only due to

FEAR of potential liability otherwise. I know that NR will attempt to hold us

from the testing standpoint to the document as well. But heck, we currently use

their First Responder and I85 tests which don't test what we currently teach for

the most part in Texas. So how would that be different?

Anyway, the issue around education that will be a problem is " accreditation. "

While I believe in the concept and think that accreditation is a goal we should

look toward in the future - maybe something that we should achieve nationwide in

ten years - I DON'T think it should be placed as an immediate requirement as

this document seems to indicate. First, the accreditation process is expensive

and programs need to plan to find the budget to do it. Second, the accrediting

organization was behind on going through the process on the few that apply was

the last thing I heard, so I don't see how they could even begin to do all the

programs in the nation in the time frame indicated. Third, the accrediting

agency seems to have made indications that they intend to restrict that process

to college based or college affiliated programs - I think Lee posted

something about that with quotes from their current document in an earlier

thread - Lee if you would care to elaborate. Anyway, again, we are throwing the

baby out with the bath water by wanting to eliminate strong and good certificate

programs just because they are not college based. And fourth, I have yet to see

any proof that " accredited " programs overall provide better education than

" non-accredited " programs.

We need to be very careful, folks, as we enter this phase where we will now how

to work with DSHS, the medical directors, the educators, and the EMS services to

make sure that Texas does the right thing. We already know that we are

experiencing a shortage of EMS personnel at least in Texas. I think that it is

theoretically possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just my personal

opinion.

Jane Hill

--------- 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

[Guest guest]

Dr. Bledsoe, this is the part where I have to step to the side and disagree with

you. While I DO agree that there are probably still certificate programs that

are out there that are a part of the problem, not part of the solution, there

are also certificate programs out there that turn out an excellent product. I

have worked in the college environment and I have also worked in the

" certificate program " environment. Just because something is based in a college

and requires a degree doesn't make the course good - I know that for a fact. I

have seen good college based programs and bad ones - just like the disparity

between some certificate programs.

I think the problem with this document is what we were discussing earlier -

about the tendency for lawyers and other folks in positions of power who will

want to use this to set ceilings and use the document AGAINST EMS folks and

agencies in an attempt to prove claims, make money,whatever. I also know that

some physicians will do the same - hold the service to the document only due to

FEAR of potential liability otherwise. I know that NR will attempt to hold us

from the testing standpoint to the document as well. But heck, we currently use

their First Responder and I85 tests which don't test what we currently teach for

the most part in Texas. So how would that be different?

Anyway, the issue around education that will be a problem is " accreditation. "

While I believe in the concept and think that accreditation is a goal we should

look toward in the future - maybe something that we should achieve nationwide in

ten years - I DON'T think it should be placed as an immediate requirement as

this document seems to indicate. First, the accreditation process is expensive

and programs need to plan to find the budget to do it. Second, the accrediting

organization was behind on going through the process on the few that apply was

the last thing I heard, so I don't see how they could even begin to do all the

programs in the nation in the time frame indicated. Third, the accrediting

agency seems to have made indications that they intend to restrict that process

to college based or college affiliated programs - I think Lee posted

something about that with quotes from their current document in an earlier

thread - Lee if you would care to elaborate. Anyway, again, we are throwing the

baby out with the bath water by wanting to eliminate strong and good certificate

programs just because they are not college based. And fourth, I have yet to see

any proof that " accredited " programs overall provide better education than

" non-accredited " programs.

We need to be very careful, folks, as we enter this phase where we will now how

to work with DSHS, the medical directors, the educators, and the EMS services to

make sure that Texas does the right thing. We already know that we are

experiencing a shortage of EMS personnel at least in Texas. I think that it is

theoretically possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just my personal

opinion.

Jane Hill

--------- 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

[Guest guest]

Dr. Bledsoe, this is the part where I have to step to the side and disagree with

you. While I DO agree that there are probably still certificate programs that

are out there that are a part of the problem, not part of the solution, there

are also certificate programs out there that turn out an excellent product. I

have worked in the college environment and I have also worked in the

" certificate program " environment. Just because something is based in a college

and requires a degree doesn't make the course good - I know that for a fact. I

have seen good college based programs and bad ones - just like the disparity

between some certificate programs.

I think the problem with this document is what we were discussing earlier -

about the tendency for lawyers and other folks in positions of power who will

want to use this to set ceilings and use the document AGAINST EMS folks and

agencies in an attempt to prove claims, make money,whatever. I also know that

some physicians will do the same - hold the service to the document only due to

FEAR of potential liability otherwise. I know that NR will attempt to hold us

from the testing standpoint to the document as well. But heck, we currently use

their First Responder and I85 tests which don't test what we currently teach for

the most part in Texas. So how would that be different?

Anyway, the issue around education that will be a problem is " accreditation. "

While I believe in the concept and think that accreditation is a goal we should

look toward in the future - maybe something that we should achieve nationwide in

ten years - I DON'T think it should be placed as an immediate requirement as

this document seems to indicate. First, the accreditation process is expensive

and programs need to plan to find the budget to do it. Second, the accrediting

organization was behind on going through the process on the few that apply was

the last thing I heard, so I don't see how they could even begin to do all the

programs in the nation in the time frame indicated. Third, the accrediting

agency seems to have made indications that they intend to restrict that process

to college based or college affiliated programs - I think Lee posted

something about that with quotes from their current document in an earlier

thread - Lee if you would care to elaborate. Anyway, again, we are throwing the

baby out with the bath water by wanting to eliminate strong and good certificate

programs just because they are not college based. And fourth, I have yet to see

any proof that " accredited " programs overall provide better education than

" non-accredited " programs.

We need to be very careful, folks, as we enter this phase where we will now how

to work with DSHS, the medical directors, the educators, and the EMS services to

make sure that Texas does the right thing. We already know that we are

experiencing a shortage of EMS personnel at least in Texas. I think that it is

theoretically possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just my personal

opinion.

Jane Hill

--------- 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

[Guest guest]

If I wanted to go to those schools, I would have. Being a vet, I could

have used my GI Bill to get a degree in whatever I wanted, but I chose

to be an EMT (and I don't think I made a wrong choice). I have been

fortunate enough to find a job that lets me be an EMT (among other

duties), plus making a good wage doing it, and time away from work that

allows me to do the VFD first responder thing. The only down side is

that neither place has protocols or equipment (meds, etc) for an EMT-I

or Paramedic. That being said, that doesn't mean that I don't care

about EMS or intend to stick out my bottom lip move on to something else

so I can make more money. I've been doing this since '97 and been

involved in different first responder capacities since '88. I'm not

some know it all punk kid out to save the world, just trying to help out

in my corner of it.

I thought part of the purpose of this list was to exchange ideas on how

to improve EMS, not encourage folks to go elsewhere. If that is how

things are going to be, then the best and brightest will move on, EMS

will not benefit from them, and EMS in America can become known

worldwide as a second rate entity. Looks to me like the losers will be

the ones in the laying down in the back of the ambulance, but hay,

that's just my view. I've seen stuff on this list about organizing and

such, but then along comes this scope draft made by people who are

supposed to be near the top of the food chain, which is supposed to have

been sabotaged by some in the fire service to keep EMS as second

stringers to them. All I asked was what we could do. At least I didn't

get 'join EMSAT' for an answer (if I thought it would help, I would).

Sorry if I sound torqued, I don't mean to come off that way (well...

maybe a little), but I believe in what we do at all levels, and that we

are all an important part of the process of trying to get injured or ill

people to the help they need.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of E. Tate

Sent: Sunday, October 30, 2005 10:45 AM

To:

Subject: RE: National Scope of Practice Final Document

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

[Guest guest]

If I wanted to go to those schools, I would have. Being a vet, I could

have used my GI Bill to get a degree in whatever I wanted, but I chose

to be an EMT (and I don't think I made a wrong choice). I have been

fortunate enough to find a job that lets me be an EMT (among other

duties), plus making a good wage doing it, and time away from work that

allows me to do the VFD first responder thing. The only down side is

that neither place has protocols or equipment (meds, etc) for an EMT-I

or Paramedic. That being said, that doesn't mean that I don't care

about EMS or intend to stick out my bottom lip move on to something else

so I can make more money. I've been doing this since '97 and been

involved in different first responder capacities since '88. I'm not

some know it all punk kid out to save the world, just trying to help out

in my corner of it.

I thought part of the purpose of this list was to exchange ideas on how

to improve EMS, not encourage folks to go elsewhere. If that is how

things are going to be, then the best and brightest will move on, EMS

will not benefit from them, and EMS in America can become known

worldwide as a second rate entity. Looks to me like the losers will be

the ones in the laying down in the back of the ambulance, but hay,

that's just my view. I've seen stuff on this list about organizing and

such, but then along comes this scope draft made by people who are

supposed to be near the top of the food chain, which is supposed to have

been sabotaged by some in the fire service to keep EMS as second

stringers to them. All I asked was what we could do. At least I didn't

get 'join EMSAT' for an answer (if I thought it would help, I would).

Sorry if I sound torqued, I don't mean to come off that way (well...

maybe a little), but I believe in what we do at all levels, and that we

are all an important part of the process of trying to get injured or ill

people to the help they need.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of E. Tate

Sent: Sunday, October 30, 2005 10:45 AM

To:

Subject: RE: National Scope of Practice Final Document

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

[Guest guest]

If I wanted to go to those schools, I would have. Being a vet, I could

have used my GI Bill to get a degree in whatever I wanted, but I chose

to be an EMT (and I don't think I made a wrong choice). I have been

fortunate enough to find a job that lets me be an EMT (among other

duties), plus making a good wage doing it, and time away from work that

allows me to do the VFD first responder thing. The only down side is

that neither place has protocols or equipment (meds, etc) for an EMT-I

or Paramedic. That being said, that doesn't mean that I don't care

about EMS or intend to stick out my bottom lip move on to something else

so I can make more money. I've been doing this since '97 and been

involved in different first responder capacities since '88. I'm not

some know it all punk kid out to save the world, just trying to help out

in my corner of it.

I thought part of the purpose of this list was to exchange ideas on how

to improve EMS, not encourage folks to go elsewhere. If that is how

things are going to be, then the best and brightest will move on, EMS

will not benefit from them, and EMS in America can become known

worldwide as a second rate entity. Looks to me like the losers will be

the ones in the laying down in the back of the ambulance, but hay,

that's just my view. I've seen stuff on this list about organizing and

such, but then along comes this scope draft made by people who are

supposed to be near the top of the food chain, which is supposed to have

been sabotaged by some in the fire service to keep EMS as second

stringers to them. All I asked was what we could do. At least I didn't

get 'join EMSAT' for an answer (if I thought it would help, I would).

Sorry if I sound torqued, I don't mean to come off that way (well...

maybe a little), but I believe in what we do at all levels, and that we

are all an important part of the process of trying to get injured or ill

people to the help they need.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of E. Tate

Sent: Sunday, October 30, 2005 10:45 AM

To:

Subject: RE: National Scope of Practice Final Document

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

[Guest guest]

We are experiencing an EMS shortage here because of pay--not inadequate

numbers of grads. I had dinner in Queensland with 4 EMS people who all make

in excess of $60,000 US dollars per year (1 was a dispatch supervisor), have

6 weeks paid vacation per year, and work federally-mandated 38 hour work

weeks. All are required to have diplomas (the same as our AAS degrees) and

paramedics are only trained based on need (keeps the work force constant).

I agree that their is no evidence degree programs are better than

certificate programs. Also, there is little evidence that paramedics are

even beneficial. But, requiring math and English and some other courses ca

help the paramedic be a better problem solver. If EMS is to evolve (and it

appears it will not), paramedics need to be trained as independent

practioners and not technicians and must be good problem solvers. Every

program in the world where there is independent practice (medicine,

dentistry, chiropractic, physicians assistants, nurse practioners, physical

therapists), a degree of some sort is required as is some general academic

preparation. How can you teach ethics based upon the limited amount of

material we put in our texts? 70% of paramedic education programs tell us

through market surveys that they want more detailed paramedic books and

materials. A few want less--(some complain that buying 5 books is asking too

much). There is nothing to prevent current credential programs from being a

part of a college program. I know you do a good program (my name is on your

web site as a faculty member). But, for every program you do, there will be

three programs cranking out graduates that have 700 hours of education and

use the least sophisticated textbook on the market. How can we say--let's

keep this program and do away with that one?

BEB

_____

From: [mailto: ] On

Behalf Of je.hill@...

Sent: Sunday, October 30, 2005 11:18 AM

To:

Subject: RE: National Scope of Practice Final Document

Dr. Bledsoe, this is the part where I have to step to the side and disagree

with you. While I DO agree that there are probably still certificate

programs that are out there that are a part of the problem, not part of the

solution, there are also certificate programs out there that turn out an

excellent product. I have worked in the college environment and I have also

worked in the " certificate program " environment. Just because something is

based in a college and requires a degree doesn't make the course good - I

know that for a fact. I have seen good college based programs and bad ones -

just like the disparity between some certificate programs.

I think the problem with this document is what we were discussing earlier -

about the tendency for lawyers and other folks in positions of power who

will want to use this to set ceilings and use the document AGAINST EMS folks

and agencies in an attempt to prove claims, make money,whatever. I also

know that some physicians will do the same - hold the service to the

document only due to FEAR of potential liability otherwise. I know that NR

will attempt to hold us from the testing standpoint to the document as well.

But heck, we currently use their First Responder and I85 tests which don't

test what we currently teach for the most part in Texas. So how would that

be different?

Anyway, the issue around education that will be a problem is

" accreditation. " While I believe in the concept and think that

accreditation is a goal we should look toward in the future - maybe

something that we should achieve nationwide in ten years - I DON'T think it

should be placed as an immediate requirement as this document seems to

indicate. First, the accreditation process is expensive and programs need

to plan to find the budget to do it. Second, the accrediting organization

was behind on going through the process on the few that apply was the last

thing I heard, so I don't see how they could even begin to do all the

programs in the nation in the time frame indicated. Third, the accrediting

agency seems to have made indications that they intend to restrict that

process to college based or college affiliated programs - I think Lee

posted something about that with quotes from their current

document in an earlier thread - Lee if you would care to elaborate. Anyway,

again, we are throwing the baby out with the bath water by wanting to

eliminate strong and good certificate programs just because they are not

college based. And fourth, I have yet to see any proof that " accredited "

programs overall provide better education than " non-accredited " programs.

We need to be very careful, folks, as we enter this phase where we will now

how to work with DSHS, the medical directors, the educators, and the EMS

services to make sure that Texas does the right thing. We already know that

we are experiencing a shortage of EMS personnel at least in Texas. I think

that it is theoretically possible that we could worsen that situation by

adopting this document and setting ourselves up for more issues, but that is

just my personal opinion.

Jane Hill

--------- 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

[Guest guest]

That's just the point, Dr. B. You can't pick and choose - not that way anyway.

But I personally don't want to be thrown out with the bathwater when I KNOW we

produce an excellent product. There has to be another solution than forcing

everything into a college environment. I have students who take our classes and

still go and work on their degrees at colleges - credit by exam for the EMS

classes and then finish the other core classes their (math, sciences, history)

and get a degree. Others come to us because they don't WANT to get a degree for

whatever reason, and I am ok with that. Even the college based programs usually

have a certificate program too so that they can target that population. I have

found that the older students aren't as keen on the degree thing most of the

time -they just want to work or volunteer for their communities. Most of our

students when I was at TJC who wanted a degree were the young ones fresh from

high school.

I understand what you are saying about professionalism and pay levels - things

that can come with a degree. But I also hear every day about folks saying, " I

got my degree and my license, and it has gotten me nothing. " I hear

administrators saying that the reason it has gotten them nothing is because of

the reimbursement situation and how moneys to run EMS services are dwindling,

pretty much nationwide. I was an administrator, so I know there is truth to

that. So there ARE no easy answers to any of these things and I personally do

not think the Scope of Practice document is one of the answers - certainly not

the overall solution.

Jane Hill

--------- 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

[Guest guest]

You stay committed to EMS. You never accept only the minimum in your training or

your care. Always make your stance know by doing just what you are now. When

you get tired of doing those things and you want to quit, find someone else that

feels the same way as you and pass the torch. If you cannot find someone else

you either let it go or continue on.

There is no rest for those who want more, or for those who want more for their

profession.

" 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

[Guest guest]

>

> We need to be very careful, folks, as we enter this phase where we

will now how to work with DSHS, the medical directors, the

educators, and the EMS services to make sure that Texas does the

right thing. We already know that we are experiencing a shortage of

EMS personnel at least in Texas. I think that it is theoretically

possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just

my personal opinion.

>

> Jane Hill

>

On a side note, however, the equation relating supply and demand

could actually work for us here. If there exists a critical

shortage of EMS personnel, salaries would theoretically increase.

The nursing profession has/had the same problem with they set the

minimum requirement for providing nursing care at the RN level at

the associate degree level. Here in the RGV, there are 3 nursing

programs (STC, UTB, and UTPA) which accept a limited number of

applicants per term. Speaking from a general point of view, RNs are

paid at least $10 more per hour than a paramedic. In summary, it

might not be such a bad thing for there to be a worse shortage than

there is now, from a medic's economic stand-point, that is.

-Alfonso R. Ochoa

[Guest guest]

But, with EMS NOT being an Essential service, who's to say that " they " don't

just staff ambulances with 2 ECA's? There is NO law that says an ambulance

service HAS to be ALS/MICU, and when you start talking about an arbitrary

raise in salaries do to a " shortage " of paramedics, city managers will just

do what they've always done, find a cheaper way to do it, with less.

This salary/professional recognition/Shortage issue isn't going to be fixed

magically. One sure fire way to lose what you have, is bet it all on a long

shot.

$0.02

Mike

Re: National Scope of Practice Final Document

>

> We need to be very careful, folks, as we enter this phase where we

will now how to work with DSHS, the medical directors, the

educators, and the EMS services to make sure that Texas does the

right thing. We already know that we are experiencing a shortage of

EMS personnel at least in Texas. I think that it is theoretically

possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just

my personal opinion.

>

> Jane Hill

>

On a side note, however, the equation relating supply and demand

could actually work for us here. If there exists a critical

shortage of EMS personnel, salaries would theoretically increase.

The nursing profession has/had the same problem with they set the

minimum requirement for providing nursing care at the RN level at

the associate degree level. Here in the RGV, there are 3 nursing

programs (STC, UTB, and UTPA) which accept a limited number of

applicants per term. Speaking from a general point of view, RNs are

paid at least $10 more per hour than a paramedic. In summary, it

might not be such a bad thing for there to be a worse shortage than

there is now, from a medic's economic stand-point, that is.

-Alfonso R. Ochoa

[Guest guest]

You would THINK that would be the case and it may actually develop into that

with systems that are tax-based and heavily supported. I doubt if you will see

those changes in the private ambulance industry or even the hospital based

services. With privates, they are limited by reimbursements, as previously

discussed. There is only so much money to go around and salaries actually take

up 3/4 of most annual budgets already. As for hospital based, my experience

with them shows that many of them consider the ambulance a " necessary evil " .

One that allows them to get patients out of their hospitals and to others when

privates won't carry them because they won't be reimbursed due to very stringent

medical necessity rules. They also consider their 911 systems a way to feed

INTO their emergency departments and make money through that route. Most seem

to accept that the EMS portion is going to be a money loss situation if you make

their numbers stand alone from the rest of the hospital system, but they will

hang onto them for the other reasons. However, most are NOT ready to increase

salaries significantly - it is like pulling teeth to get them to recognize the

need for a decent wage for these folks. They look at how much they make a year

and say, " They are doing just fine. " What many of them refuse to look at is HOW

MANY HOURS those folks have to work to make that yearly wage. That is when the

blinders go on for them.

Anyway, we will see. But I do NOT believe that a National Scope of Practice is

what is going to get us there...

Jane Hill

-------------- Original message from " Alfonso R. Ochoa " :

--------------

>

> We need to be very careful, folks, as we enter this phase where we

will now how to work with DSHS, the medical directors, the

educators, and the EMS services to make sure that Texas does the

right thing. We already know that we are experiencing a shortage of

EMS personnel at least in Texas. I think that it is theoretically

possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just

my personal opinion.

>

> Jane Hill

>

On a side note, however, the equation relating supply and demand

could actually work for us here. If there exists a critical

shortage of EMS personnel, salaries would theoretically increase.

The nursing profession has/had the same problem with they set the

minimum requirement for providing nursing care at the RN level at

the associate degree level. Here in the RGV, there are 3 nursing

programs (STC, UTB, and UTPA) which accept a limited number of

applicants per term. Speaking from a general point of view, RNs are

paid at least $10 more per hour than a paramedic. In summary, it

might not be such a bad thing for there to be a worse shortage than

there is now, from a medic's economic stand-point, that is.

-Alfonso R. Ochoa

[Guest guest]

VERY good point, Mike.

Jane Hill

--------- Re: National Scope of Practice Final Document

>

> We need to be very careful, folks, as we enter this phase where we

will now how to work with DSHS, the medical directors, the

educators, and the EMS services to make sure that Texas does the

right thing. We already know that we are experiencing a shortage of

EMS personnel at least in Texas. I think that it is theoretically

possible that we could worsen that situation by adopting this

document and setting ourselves up for more issues, but that is just

my personal opinion.

>

> Jane Hill

>

On a side note, however, the equation relating supply and demand

could actually work for us here. If there exists a critical

shortage of EMS personnel, salaries would theoretically increase.

The nursing profession has/had the same problem with they set the

minimum requirement for providing nursing care at the RN level at

the associate degree level. Here in the RGV, there are 3 nursing

programs (STC, UTB, and UTPA) which accept a limited number of

applicants per term. Speaking from a general point of view, RNs are

paid at least $10 more per hour than a paramedic. In summary, it

might not be such a bad thing for there to be a worse shortage than

there is now, from a medic's economic stand-point, that is.

-Alfonso R. Ochoa

[Guest guest]

That should have been " make your stance known " . Typing too fast.

Danny wrote:You stay committed to EMS. You

never accept only the minimum in your training or your care. Always make your

stance know by doing just what you are now. When you get tired of doing those

things and you want to quit, find someone else that feels the same way as you

and pass the torch. If you cannot find someone else you either let it go or

continue on.

There is no rest for those who want more, or for those who want more for their

profession.

" 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

[Guest guest]

I have to step in and ask a question. It has been brought up that other states

do not want this to go forward. Jane asks that a list be generated for the next

GETAC meeting.

My question has two parts. What specifically are the states against? Are

the programs in the states that are against the scope of practice better at EMS

education than Texas?

If you are going to try to stop something, yet you still want change and a

better plan; why not understand the problems so you can come up with solutions?

I still do not see any wording in this document that would lock anything into

place. I do understand there are those that will try. There has to be vigilance

to make sure we are going down the right path.

I bring up education because that seems to be where we ultimately come back to

each time we discuss better EMS.

Change is never an easy thing. Change scares people for whatever reason. I

don't believe we need to stop the process all together. The document is out

there. Is there a problem with taking this and revamping it to suit Texas? Or

saying " here is the National Scope, Texas has done one better (as we usually do)

and go forward instead of halting progress because it scares us?

Taking this, revamping it, and giving it to DSHS to place into regulation

poses what problem?

je.hill@... wrote:

My " prevailing thought " is pretty much the same as yours, Dr. Bledsoe. And

thank you for speaking up. Voices like yours should help us all to be able to

put the brakes on this thing - at least for Texas. Now, you mentioned Wisconsin

and said other states have also said they will not adopt the document. Is there

anyway we could generate a list of who and how many are against it for folks to

present at the next GETAC session?

Jane Hill

-------------- Original message from " Bledsoe " :

--------------

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

[Guest guest]

Same issue with the " National Registry " .

Dave

" E. Tate " wrote:

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.

The comments contained in this correspondence are the sole responsibility of the

author. They do not necessarily reflect the thoughts, feelings, or opinions of

my employer, or any other group or organization that I may be, am perceived to

be, have been or will be involved with in the future. They are my own comments,

submitted freely and they are worth exactly what you paid for them.

---------------------------------

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[Guest guest]

Danny;

I agree with your response. I feel that most of the resistance in the EMS field

as far as the National Scope is concerned is two-fold. First, there is an actual

basis for resisting the education requirements. I came from the up-state, rural

areas of New York, where most (not all) but most services are volunteer. They

can not afford to have there people required to be AAS holders in order to

practice. With that said I understand the educational requirements, but they

can't take there people " off line " untill the educational requirements are met

(for the AAS). I know some excellent Paramedics and Critical Care medics up

there, some of which will never go to school and earn an AAS in Paramedicine.

Conversely in the more populated areas of the country getting the educational

requirements is not that hard of a deal. I can see the frustration (I now share

in that) when we of the EMS field are looked at as the ugly " step child " of the

pre-hospital medical field and those in the Nursing

field. I say to those in the Nursing field that look at us funny, come and ride

with us, see what we do, understand us don't reject us. Most Paramedics would

gladly welcome a nurse if the end result would be a greater understanding of our

profession in the medical field. For those of you in our field who haven't seen

the writing on the wall get you education in order (either by night classes or

on-line) give our profession some backing. Just look at what most Paramedics can

do in the pre-hospital setting today compared to the " ny and Roy

environment " That is my feeling anyway.

Thanks

Pat

This message created by: W.

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[Guest guest]

Danny;

I agree with your response. I feel that most of the resistance in the EMS field

as far as the National Scope is concerned is two-fold. First, there is an actual

basis for resisting the education requirements. I came from the up-state, rural

areas of New York, where most (not all) but most services are volunteer. They

can not afford to have there people required to be AAS holders in order to

practice. With that said I understand the educational requirements, but they

can't take there people " off line " untill the educational requirements are met

(for the AAS). I know some excellent Paramedics and Critical Care medics up

there, some of which will never go to school and earn an AAS in Paramedicine.

Conversely in the more populated areas of the country getting the educational

requirements is not that hard of a deal. I can see the frustration (I now share

in that) when we of the EMS field are looked at as the ugly " step child " of the

pre-hospital medical field and those in the Nursing

field. I say to those in the Nursing field that look at us funny, come and ride

with us, see what we do, understand us don't reject us. Most Paramedics would

gladly welcome a nurse if the end result would be a greater understanding of our

profession in the medical field. For those of you in our field who haven't seen

the writing on the wall get you education in order (either by night classes or

on-line) give our profession some backing. Just look at what most Paramedics can

do in the pre-hospital setting today compared to the " ny and Roy

environment " That is my feeling anyway.

Thanks

Pat

This message created by: W.

---------------------------------

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[Guest guest]

Danny;

I agree with your response. I feel that most of the resistance in the EMS field

as far as the National Scope is concerned is two-fold. First, there is an actual

basis for resisting the education requirements. I came from the up-state, rural

areas of New York, where most (not all) but most services are volunteer. They

can not afford to have there people required to be AAS holders in order to

practice. With that said I understand the educational requirements, but they

can't take there people " off line " untill the educational requirements are met

(for the AAS). I know some excellent Paramedics and Critical Care medics up

there, some of which will never go to school and earn an AAS in Paramedicine.

Conversely in the more populated areas of the country getting the educational

requirements is not that hard of a deal. I can see the frustration (I now share

in that) when we of the EMS field are looked at as the ugly " step child " of the

pre-hospital medical field and those in the Nursing

field. I say to those in the Nursing field that look at us funny, come and ride

with us, see what we do, understand us don't reject us. Most Paramedics would

gladly welcome a nurse if the end result would be a greater understanding of our

profession in the medical field. For those of you in our field who haven't seen

the writing on the wall get you education in order (either by night classes or

on-line) give our profession some backing. Just look at what most Paramedics can

do in the pre-hospital setting today compared to the " ny and Roy

environment " That is my feeling anyway.

Thanks

Pat

This message created by: W.

---------------------------------

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[Guest guest]

That is kind of where I am going in asking the questions. The education has to

be there. We have to find ways to educate those who do not have the resources

available. EMS being different from other medical or safety related professions

has to develop a strategy to train and educate our personnel. I personally

envision a system not unlike Australia where EMS is considered the pinnacle of

ones career and not, we get into EMS to springboard us to Nursing where we can

make a better living. Will it happen? Only if we get on the same page. I see

the National Scope of Practice as a way to get on that page.

Do I believe there will be attempts to derail the operation? Yes I do. It is

happening now.

I still believe that if there are major concerns with the document as written

there appears to be nothing to stop changing it to suit Texas. I believe putting

this document as the minimum standard is not a bad thing.

If you don't want to be known as an Advanced EMT, Texas says " EMT-Intermediate

is the same as Advanced EMT " . Is there a major difference in the level as

explained in the document and what is now EMT-Intermediate? I don't

particularly see, but I have been know to be wrong (very rarely but it happens);

where the major difference is. Ladies and Gentlemen lets get on board and start

somewhere with being a group to be heard. Only then will we be able to steer

our profession in the right direction. It has been stated many times before me

that being a large group instead of scattered squads is when we will be heard.

Please take this as an opportunity to form the beginning. Change what major

problems there are and lets go. I still have not seen anything on major

differences. I am still asking those who have seen them to put them on this list

for all to see.

I will go back to a statement I have made before. Lets see the major changes

not just I say potato (Poe-ta-toe) and you say potato (Poe-tay-toe). Prove me

wrong. I am waiting.

wrote:

Danny;

I agree with your response. I feel that most of the resistance in the EMS field

as far as the National Scope is concerned is two-fold. First, there is an actual

basis for resisting the education requirements. I came from the up-state, rural

areas of New York, where most (not all) but most services are volunteer. They

can not afford to have there people required to be AAS holders in order to

practice. With that said I understand the educational requirements, but they

can't take there people " off line " untill the educational requirements are met

(for the AAS). I know some excellent Paramedics and Critical Care medics up

there, some of which will never go to school and earn an AAS in Paramedicine.

Conversely in the more populated areas of the country getting the educational

requirements is not that hard of a deal. I can see the frustration (I now share

in that) when we of the EMS field are looked at as the ugly " step child " of the

pre-hospital medical field and those in the Nursing

field. I say to those in the Nursing field that look at us funny, come and ride

with us, see what we do, understand us don't reject us. Most Paramedics would

gladly welcome a nurse if the end result would be a greater understanding of our

profession in the medical field. For those of you in our field who haven't seen

the writing on the wall get you education in order (either by night classes or

on-line) give our profession some backing. Just look at what most Paramedics can

do in the pre-hospital setting today compared to the " ny and Roy

environment " That is my feeling anyway.

Thanks

Pat

This message created by: W.

---------------------------------

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[Guest guest]

That is kind of where I am going in asking the questions. The education has to

be there. We have to find ways to educate those who do not have the resources

available. EMS being different from other medical or safety related professions

has to develop a strategy to train and educate our personnel. I personally

envision a system not unlike Australia where EMS is considered the pinnacle of

ones career and not, we get into EMS to springboard us to Nursing where we can

make a better living. Will it happen? Only if we get on the same page. I see

the National Scope of Practice as a way to get on that page.

Do I believe there will be attempts to derail the operation? Yes I do. It is

happening now.

I still believe that if there are major concerns with the document as written

there appears to be nothing to stop changing it to suit Texas. I believe putting

this document as the minimum standard is not a bad thing.

If you don't want to be known as an Advanced EMT, Texas says " EMT-Intermediate

is the same as Advanced EMT " . Is there a major difference in the level as

explained in the document and what is now EMT-Intermediate? I don't

particularly see, but I have been know to be wrong (very rarely but it happens);

where the major difference is. Ladies and Gentlemen lets get on board and start

somewhere with being a group to be heard. Only then will we be able to steer

our profession in the right direction. It has been stated many times before me

that being a large group instead of scattered squads is when we will be heard.

Please take this as an opportunity to form the beginning. Change what major

problems there are and lets go. I still have not seen anything on major

differences. I am still asking those who have seen them to put them on this list

for all to see.

I will go back to a statement I have made before. Lets see the major changes

not just I say potato (Poe-ta-toe) and you say potato (Poe-tay-toe). Prove me

wrong. I am waiting.

wrote:

Danny;

I agree with your response. I feel that most of the resistance in the EMS field

as far as the National Scope is concerned is two-fold. First, there is an actual

basis for resisting the education requirements. I came from the up-state, rural

areas of New York, where most (not all) but most services are volunteer. They

can not afford to have there people required to be AAS holders in order to

practice. With that said I understand the educational requirements, but they

can't take there people " off line " untill the educational requirements are met

(for the AAS). I know some excellent Paramedics and Critical Care medics up

there, some of which will never go to school and earn an AAS in Paramedicine.

Conversely in the more populated areas of the country getting the educational

requirements is not that hard of a deal. I can see the frustration (I now share

in that) when we of the EMS field are looked at as the ugly " step child " of the

pre-hospital medical field and those in the Nursing

field. I say to those in the Nursing field that look at us funny, come and ride

with us, see what we do, understand us don't reject us. Most Paramedics would

gladly welcome a nurse if the end result would be a greater understanding of our

profession in the medical field. For those of you in our field who haven't seen

the writing on the wall get you education in order (either by night classes or

on-line) give our profession some backing. Just look at what most Paramedics can

do in the pre-hospital setting today compared to the " ny and Roy

environment " That is my feeling anyway.

Thanks

Pat

This message created by: W.

---------------------------------

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