I was having a conversation with @Medic_marshall regarding what I think EMS in the U.S. needs to do to advance. I believe the levels of licensing should be in line with the international community. I have heard a lot of push back from paramedics in the U.S. about changing the title of EMT to paramedic and having a progression similar to this:
Paramedic, Advanced Paramedic, Critical Care Paramedic, Community Paramedic. Every out of hospital provider in EMS can be identified with the word “paramedic”, allowing the public to have a single title to identify with our profession. I asked a question on all of the social media sites I watch.
Hey RN people. Does it bother you that people call LPNs nurses and you nurses? Does it matter that you are both nurses?
Registered Nurses and Licensed Practicing Nurses have vastly different scopes of practice. I wanted to know if an RN is bothered by the fact that both levels of licensure are called nurse.
There was a small response by the nursing community, and most did not have an issue with LPN and RN being called nurse. A firefighter/paramedic, who asked that I remove her twitter name, had an issue with LPNs who did not know how to administer high flow oxygen. We had a lengthy exchange of words, which I will repost for your benefit.
@DetailMedic: It bothers me and I’m not a nurse. But you can tell the difference when that “nurse” has the patient on 15L O2 by cannula.
Me: why does it bother you? Would it bother you if EMTs were called paramedic?
@DetailMedic: I spent 6 months to get EMT and 2 years MORE for paramedic. But sure, I’ll let the EMTs take you to the hospital
Me: so a title matters to you? The Critical care medics should hold that over regular medics?
@DetailMedic: Because my official title is Firefighter/Paramedic and no other reason.
@DetailMedic: Critical care medics have every right to their title as they have more training and there is a difference.
@DetailMedic: Why is it “holding it over” anyone? I worked FAR harder to become a PM than I ever did to for EMT. An EMT is not a medic.
Me: My Official title is “Donor Center Coordinator”
@DetailMedic: ??? So?
Me: Honestly, changing the naming structure would bother you? Paramedic, Advanced Paramedic, CCP, Community Paramedic?
@DetailMedic: A moot point in this discussion. If there wasn’t a difference there wouldn’t be a difference in titles.
@DetailMedic: I’m not saying an EMT is an ALS provider. I’m suggesting we change the names so we are all called paramedic.
@DetailMedic: A firefighter 1 is not as well trained as a firefighter 2, but the are both firefighters.
@DetailMedic: Well bully for you. You can call it whatever you want.
Me: my question is why does it offend you to call you an advanced paramedic & EMT a paramedic? It won’t change your role
@DetailMedic: Because you haven’t earned it. Period.
Me: why is it so personal to you? I don’t understand.
@DetailMedic: Because it comes off as a short cut. You didn’t earn the title. I want to be called nurse but I didn’t earn that either.
@DetailMedic: I spent 6 months to get EMT and 2 years MORE for paramedic. But sure, I’ll let the EMTs take you to the hospital.
@DetailMedic: You want to be called paramedic then go get the two years of college education and hours and hours of clinicals.
Me: does it bother you when some one calls you an ambulance driver?
@DetailMedic: I’m sorry you think my title has no meaning, but I value it as a representation years I’ve put into it.
Me: I am not trying to offend you, I just think EMS in my country needs a PR facelift.
@DetailMedic: You don’t get a facelift by claiming to be something you’re not. An EMT should be a proud EMT and WORK to be a paramedic.
@DetailMedic: It’s not ok to call yourself a paramedic in THIS country if you’re not. People are fired/prosecuted for misrepresentation.
@DetailMedic: It’s not ok to call yourself a paramedic in THIS country if you’re not. People are fired/prosecuted for misrepresentation.
Me: EMTs in other countries are called paramedics, they have a similar scope as our basics.
@DetailMedic: BTW, saying you became a “paramedic” just so you could drive the ambo is completely disrespectful. People’s lives are no joke
@DetailMedic: My colleagues and I are not unskilled monkeys and yeah, it takes brains, education, skill and a level head to do our job.
@DetailMedic: So yeah, you might have been talking about yourself, but in categorizing your job, you’re demeaning us all.
I tried to recreate the conversation in the correct order to the best of my ability. I did not change a single word said.
She went on to post on her blog about this conversation, you can read that here (Sorry folks, she removed the blog post. She stated that I was getting trashed in her comments section and removed the post because “you’re not worth the negativity. I really hope you can look yourself in the mirror”). She said:
So lets give all the EMTs Paramedic patches and cut them loose. I expect hat if you identlify yourself as a paramedic, that you can intubate, give various drugs (WITHOUT a consult) and you know what the F you’re doing. I don’t have the time or the patience to hold your hand on scene.
Well, lets stop that misconception. I am not advocating that we allow people to practice beyond their scope. I never said we should promote an EMT to paramedic without the education. I am suggesting that we rename the levels of certification.
And by the way, you’ve just devalued the EMT patch. I guess that accomplishment doesn’t matter. Let me tell you something about the EMTs I’ve had the good fortune to work with. They do all of the BLS skills so I don’t have to.
Now she accuses me of devaluing the EMT, and at the same time says that EMTs do basic skills so she does not have to. CPR is a basic skill. No ALS experience required. I’ve done a lot of CPR in my day, licensed as a paramedic. I do agree that a good EMT is an essential part of the team.
In conclusion, @rescue_monkey states in his bio that he ”became a paramedic just so I could drive the ambulance”. Wow. I’m really glad I don’t work with you. Thanks so much for taking this job seriously. I just became a firefighter so I could wear all that gear and stand around looking like a hero.
Yes, she is correct, I do state on this blog that ‘I became a paramedic just so I could drive the ambulance’. It is a bit of sarcasm, likely inappropriate, and I should change that statement. You can however teach a monkey to perform the skills of a paramedic. You cannot teach the monkey critical thinking, and that’s what sets us apart.
She never actually mentioned that she posted a blog about this discussion to me. I just wanted to understand her perspective a little, and read her blog. I will admit that sometimes I say things that are inappropriate, but I believe this was just a discussion between two people with differences of opinion and hold no malice. I actually want to know why people are dead set against change.
What do you think?
Addendum:
Me: A discussion between two people on opposite sides. http://ow.ly/atkqq @DetailMedic (I included her twitter handle so she would know that I wrote a response)
@DetailMedic: I don’t appreciate this at all.
Me: why not? You blogged about the conversation. Why can’t I?
Me: If something is factually wrong, let me know and I will correct it immediately.
@DetailMedic: I removed my post because you were being trashed in my comments section. I really hope you can look yourself in the mirror.
She said: I stand by my words. How about telling all of us what your PARAMEDIC certification number is?
Me: You removed the blog post because I was being trashed in the comments section? That’s very nice of you
@DetailMedic: No, it’s just not what I want on my page. You’re not really worth the negativity. I really don’t care about you.
Me: Also, if you have no factual complaints, I will leave my post the way it is.
@DetailMedic: You offered to remove my twitter name (in writing). Do it.
Me: I will honor that request.
I noticed she demanded to know my certification numbers, but she wants to remain anonymous. While I can understand the desire to remain anonymous, you really shouldn’t demand information that you are willing to provide yourself.
So I removed her twitter handle from the blog post. She blocked me and I can no longer see her posts (Glad I wrote this blog tonight). I added her twitter ID back, her account is a public one, she engaged in public discourse therefore, she has no reasonable expectation of privacy when it comes to her tweets.
I see your POV. On scene, most outside people don’t understand or realize there is a difference in our level of training. They don’t know the difference between EMT and Medic. They care that we are there to help. Firefighters are firefighters, nurses are nurses, cops are cops… then we have basics and medics… A renaming of the levels isn’t an issue of how long you’ve been in training, or to be meant as disrespect. It helps create a better understanding for the outsiders to see what we do. Either way, call me an EMT or a medic… doesn’t bother me. I show up and do my job.
So you promised to remove it (as you stated above) and then put it back? That’s not really an honorable thing to do. Seems a bit bitter to me.
She should have nothing to worry about, since she stands by her every word. I had removed the twitter ID, but decided it was easier to read with a twitter handle. I still linked to her blog, left a tag in the post with her twitter ID, and there were half a dozen people involved in the entire conversation. It’s no real mystery who I was talking to on twitter. Since this is my blog, I have the right to change my mind to suite the narrative. If she has issues with this, she can contact me.
stumbled onto this looking around for ham radio stuff. I am an ER RN CEN…That being said, as long as “yall” get the patient here to the ER safely and appropriately, I call you by your name..(lol) I refer to everybody collectively as EMS. So even if you drive or start a line or IO or intubate, I don’t really care, it’s a team effort, as long as I get report, and some heads up you are on the way. I respect ALL of you equally, “yall” do an important job, and are a vital part of a multi-jurisdictional effort to take care of people. Kinda hard to drive and do CPR at the same time isn’t it? EMS goes out into the sh** and chaos everyday, to do what they do. I get to hang in the AC working in a “relatively” stable enviroment …except for that random “IVE BEEN STABBED” walking in POV. Me personaly, I don’t get too caught up in the minutia. An EMT or Paramedic, and LVN or RN…we are ALL a gear in the machine. I am aware of the technical practice limitations (more or less) between the different EMS personel, and really don’t get focused on it, or their titles. I have been a nurse aide, the LVN, and now RN in my nursing career. WE ALL have a part. I am a nurse, that happens to also be an RN. So no..I don’t get offended about LVN’s being called nurses. Because they ARE. …p.s. 15liters per nasal cannula? oh my! Talk about clearing out the sinus’s ! …….
Changing the names is a cosmetic thing. Personally I don’t see the benefit, and am a little confused, so in your scheme paramedic = emt, and advanced paramedic = aemt/emt-i, but then what equals paramedic now? Critical care medic is a seperate cert either ccemt-p through UMBC or FPC/CCPC through BCCTP. So there is nothing to current paramedic. But saying that we need a PR fix by changing names doesn’t fix the underlying problems, poor training, poor CE, limited scope, EMS transport abuse, etc. Before you worry about names we should worry about Paramedics that only carry first line ACLS drugs, can’t do a dosage drip calculation, don’t know how to pull a 9 lead ekg from a 3 machine, can’t give pain management because they don’t know how to safely give fentanyl. We need to lobby for higher standards, emts should have to get an associates degree and medics should have to get a four year degree. As for the community paramedic thing there arent enough programs teaching it to even worry about it, how many people on here carry antibiotics on their truck or can drop a vertical mattress? Those are the things that our community paramedic program teaches and we are able to do.
I was an EMT before I became a nurse and my husband is a paramedic. I believe what it all comes down to is not what you’re called, rather why you do what you do. Does it really matter if the lay person doesn’t know your exact title, or how many letters you have behind your name? What matters is the standard to which you preform your skill set and standard of care. So why do you do what you do? For recognition or for patient outcome? No one questions you about your credentials before you start CPR on them. But once you’ve saved a life is it a pat on the back from those around you or your own satisfaction in knowing you helped do something amazing?