EMT to Paramedic Progression

[dropdeded]

I seem to be pretty much alone (at work) in my thoughts on becoming a Paramedic as far as the progression of learning goes. My history so far, a year and a half doing some BLS and mostly ALS transfers, and just over 6 months running 911 in a rural setting. My intent is to run 911 in a Metro setting for a couple years before moving on to Paramedic. I am pretty consistantly told not to wait. This is me personally believing that I would be a much better Paramedic having "paid my dues" as a well rounded EMT. It seems that EMT's are dime a dozen, but GOOD EMT's (more than just a "helper") are a little harder to find. I do work with some really good Medics that spent minimal time as EMT's, but most seem just average unless they put in some time as EMT"s.

Am I thinking too much on this or what

Your thoughts appreciated.

ed

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[viostorm]

If you truly want to be a paramedic, I suggest you go do it. It is good that you are thinking about this stuff and won't forget the importance of BLS.

But, medic school is already two years away, so although you might not be ready today, I bet you will be ready in two years when you are getting done with school. Especially if you continue working up until that time.

I think it is important as you progess to find someone you can apprentice with, you respect their care and their ethics and want to take care of patients like they do.

Good luck!

 

[Karl_Hungus]

I had worked for 1 and a half years as an EMT-B (Ambulance volunteer and ER tech, concurrently) before starting paramedic school. I consider that time invaluable in preparing me for the program. I also consider that time sufficient: Any more time would have been just that, more time. You won't prepare for every situation as an EMT-B, there's a certain amount of sink-or-swim as a paramedic student that can't be avoided.

Get your feet wet as an EMT, learn how an ambulance service works, how the general flow of an EMS call goes, and then move on if you know you're going to end up in a higher position. Otherwise you're just treading water.

Congratulations on your decision to go on to P, truly a unique job and experiences you can't get anywhere else.

 

[emtcsmith]

I became an EMT-B in July 2004 and started running on an ambulance that Decemeber. Because of a turn of fates in my college I started Medic School in August.

I think a good year or two of BLS time is probaby best for most people. But depending on your comprehension level and drive you learn it can vary. BLS before ALS is always the rule so knowing BLS and knowing it darn near perfect is key. I will admit I lost alot of my skills not running for six months after I finished EMT school and it took alot of time to get it back. It all comes down to being able to do a solid assessment because without that you won't be able to do anything else.

If you want to do it, go for it. There are very few medics and there will be a demand for them now and more then ever in the next twenty years.

 

[canjosh]

Just to add my $.02...don't underestimate the value of working as an EMT in an ED. If you want to learn a lot before you finish medic school, the volume/diversity of patients is higher in the ED or ICU. You could work in a place like this while you're in medic school, and be well prepared to hit the streets when you finish.

 

[fiznat]

I disagree.

I've said this before but I dont feel like ED EMTs (or ED techs, whatever the title is) get any real valuable experience. I've been spending a lot of hours in a few (lvl 1) EDs for my paramedic clinical rotations and I never see techs do anything interesting. Usually they follow a steady routine of setting up beds, getting vitals and the occasional finger sticks. They have no voice as far as treatment and do ZERO assessment. Not exactly the ideal kind of training imo, and that doesnt even consider the fact that ED tx is completely different from in the field tx.

I donno, maybe its different where youre from- but if you live anywhere near CT haha I'd strongly reccomend against it.


As far as the original question I'd reccomend at least 2 years experience as an EMT before moving on to medic. There is a LOT to learn as an EMT, even beyond the basic BLS skills. Things like scene control, how to talk with patients, how to remain calm in stressful situations, what order to do things in, how to prioritize, etc are all things that you need to pick up on your own. In my opinion, nothing but experience will get you good at that kinda stuff.

 

[OSUdoc08]

I disagree.

I've said this before but I dont feel like ED EMTs (or ED techs, whatever the title is) get any real valuable experience. I've been spending a lot of hours in a few (lvl 1) EDs for my paramedic clinical rotations and I never see techs do anything interesting. Usually they follow a steady routine of setting up beds, getting vitals and the occasional finger sticks. They have no voice as far as treatment and do ZERO assessment. Not exactly the ideal kind of training imo, and that doesnt even consider the fact that ED tx is completely different from in the field tx.

I donno, maybe its different where youre from- but if you live anywhere near CT haha I'd strongly reccomend against it.


As far as the original question I'd reccomend at least 2 years experience as an EMT before moving on to medic. There is a LOT to learn as an EMT, even beyond the basic BLS skills. Things like scene control, how to talk with patients, how to remain calm in stressful situations, what order to do things in, how to prioritize, etc are all things that you need to pick up on your own. In my opinion, nothing but experience will get you good at that kinda stuff.

I agree with you. In the hospital, you serve the fuction as a nurse aid, and help them with menial tasks.

Out in the field you are saving lives AND saving paramedics.

 

[canjosh]

You serve in the function of nurse aid if that's all you want. If all you want to do is change sheets and take vitals that's fine. My time as a medic has been about 50/50 hospital and 911 MICU + 1.5 years of fixed wing peds/neo critical care. I'm here to tell you, where I've worked, I learn much more per shift in the hospital. No, I'm not first up to control the airway in the ED...but I'd certainly be second if the EM physician had trouble...because I've made sure I'm seen as a Paramedic...not a tech, nurse aid, etc. I had the same opinion that ya'll do about 'techs' when I did clinicals too. Some places hire nursing students, CNAs, or MAs to fill those slots. But, I've seen a definite trend towards EMTs and Paramedics filling those positions in EDs and ICUs. I currently work in a small community ED now, to work in the ED you have to be medic with 1 year experience and ACLS/PALS. Obviously, they're looking for a little more than a linen changer. If you develop close relationships with physicians/PAs in an ED, I guarantee that the volume of useful clinical knowledge you'll gain will be more than if working as an EMT on the box.
Of course, on the ambulance you'll see the ins and outs of daily life as a paramedic, but you're already being exposed to that now.
Bottom line, being a paramedic isn't all about intubating, pushing drugs, etc. It should be an exercise of the brain, and the hospital can be a great place to develop and expand the underlying smarts that you need to be a great medic on the streets.

 

[deleted6669]

I worked as an ed tech/emt-D for 5 yrs before medic school in a rural hospital. they staffed me OR a nurse so I had to do everything the nurses do in most places:
initial traige/vs/h+p
start iv's/push iv meds/draw blood/give im and sc injections/neb tx/ekg's/splint/1st assist lac repairs/etc
this was around 20 yrs ago and I'm guessing they wouldn't let a tech get away with this now but it was great experience at the time......

 

[canjosh]

We can't 'officially' give meds where I work, but it does definitely occur 'unofficially' with meds that are within a medic's scope. The problem is the Nurse Practice Act, which is great for nurses, but really destroys the team approach when it comes to working with other clinical providers, like medics. The medic's relationship should always be with a physician or PA, instead of subordinate to nurses, which is basically what most nurses want. Where I work, the staffing requirement is EMT-P or RN for one position per shift. So basically we do a lot of hands on care, and as much pt assessment as we want. In addition you're always first assist on the invasive stuff/lac repairs/joint reductions, etc. It may not be as heroic appearing as working in the field, but you're likely to learn a crapload.