A Candid Response To A Cause For Concern...

I want to take a break for a moment regarding posting about nursing school and address the responses to an article that I read this past week. These responses bring me a great deal of concern as they speak to the heart of the point of this blog - increasing the respect, practice, and salary of the paramedic. 

However, to stay true to the blog, I will quickly report that I've realized that while the content in my A&P course and Algebra course are far deeper than that experienced in paramedic school, I am not finding it horribly difficult. It is requiring the expected amount of studying, etc, but there is nothing so great that I have been unable to overcome it. Algebra has been a greater struggle than A&P, as would be expected with my weakness in math, and we'll see how I fair after Monday's second exam of the semester. My second A&P exams were last week, on which I received a 95%, losing 4% for careless mistakes, and 1% for an actual wrong answer. 

Now back to the point of today's blog... It is important to refer to the article I am speaking... EMS1 Article: "A collegedegree requirement for paramedics: Is it just B.S.?" 

My post today will address this sampling of responses to the article: 

"Yes...we should go into debt to make 14 bucks an hour...." 

"This is a horrible idea" 

"No, Common Sense first and foremost. I've see to many medics that should never have passed EMT-B" 

"Why should we have to go to college and do that much more only to make what we do now? I call bs." 

"Doesn't being a certified paramedic or emt mean you have a degree of sorts.i think it is a waste of time and money. There are a lot of people that can go to school and get degrees, but it doesn't mean they are going to be any good in the field" 

"I think you would make a better medic with 4 years of field experience vs 4 years book reading. But that's just me" 

"university degrees don't weed out the troublemakers, university degrees also don't give you the life experience needed for this job, unless alcohol poisoning is becoming a prerequisite" 

"No it isn't what do I need a degree for! Are they going to pay us anymore if we get a degree!" 

"If you want to have a degree in healthcare, go become a nurse. If you want to be on an ambulance, plenty of ambulance companies hire nurses. The issue doesn't seem like standard of care, as much as degree $$. I don't disparage education, but I can't get behind this. To much at stake for to many people." 

So... my response to all this is...

Currently, I am enrolled in an RN ADN program after having been a Paramedic for 16 years and receiving an Associate's in Paramedic Education and Management. Bear in mind, I only received the AAS.PEM last year. That said, the nursing degree requires two semesters of Anatomy and Physiology + Lab, Microbiology, English, Speech, Psychology, Algebra, and Sociology for completion, along with our nursing core. It is irrefutable that I have learned more in the A&P courses here than I have ever seen taught in paramedic school. 

Take the word degree out of the picture and ask yourself, honestly, would you be better at what you do if you knew more? Would you hold a greater degree of respect in the allied health and clinical health settings if your peers knew you were required to have the same level of knowledge that they had, with a different specialty? If wages are your point of contention, note that there is a clear increase across all fields when higher degrees are required in the job description. Lastly, and most importantly, wouldn't a higher degree of knowledge put us in a position to better understand disease processes and subsequently learn to treat them more effectively? 

I agree whole-heartedly that paramedics are not paid to what the potential of the profession has to offer. That said, the profession has not earned an equivalent place at the table alongside nurses and other allied health professionals that have a comprehensive understanding of A&P, pathophysiology, microbiology, anthropology, and a firm grasp on basic and abnormal psychology. If prehospital providers have any hope of moving forward we ABSOLUTELY must understand that an increase in our educational base as a profession is necessary. There are a number of individuals in EMS with EMS-specific degrees that do not see an increase in wages. The reason that exists is because the minimum qualifications do not require a degree, and management (of which I used to be a member) can, and do, base their employees' salaries off of what they can pay minimally to meet, what they believe, will get the job done. If there is no reason by proof of either education or increase in skill level and protocol to increase wages, they will not increase. 

I am not an advocate of higher education for the sake of education or without a requirement that the individual entering the EMS field has a solid handle on the practical components required to do the job. To suggest such a thing is ludicrous. Further, I do not believe that just any curriculum would be appropriate for EMS - We have the ability to compile our own curriculum and ensure that it meets the needs of not only the practitioner, but the employer, and most importantly, the patient. Take a look at the originating article and scroll down to two gentleman by the names of Marc Colbeck and Ben Hoffman. They present systems in Australia, New Zealand, UK, and Canada where there is a requirement for higher education and their paramedics are reaping the benefits in both remuneration and autonomy of practice.

To address the inquiries regarding whether or not patient care offered by those who have a higher education would be better than a certified/licensed person... There is a reason paramedics are unable to work in the ICU. We do not have the education. Period. It is a far cry from understanding acute signs and symptoms and stabilizing a patient for 25 minutes to thoroughly understanding what the causative factors of an illness are. 

If, as I have read, we are no more than EM(Technician) Paramedics... Emphasis on Technician... Then I say we have no excuse for how we are treated, and our profession had better become used to being viewed as a trade. We will not hold the respect that our counterparts have. Ever. We will always be paid poorly and seen as individuals who, while we garner respect in the shadows of the fire department, will never hold our own. 

Please note, however, that my view is not based in how well (or poorly) we are paid, which is the point of contention that I have read time and again. Rather, my view is with a grounded understanding that with education comes an increase in performance; with education comes a greater capacity to be involved in industry decision-making at a broad level; with education comes respect from not only our counterparts but those who set our protocols; with education comes the capacity to better treat our patients because we will understand the body better than the watered-down excuse of A&P that is delivered in paramedic school now. 

I hope that one day, the educated paramedic will not have had his time in school be nothing more than a skills course injected with A&P, psychology, or anthropology when it was necessary to discuss a specific acute condition, but rather the paramedic will be a practitioner that is capable of understanding the patient on a level now understood by nurses and above... not because of the degree they hold, but because of the courses they were required to take to earn that degree. That said, anyone who states they attended college and earned a degree and are unable to use what was offered, in my opinion, was asleep. Even in the most "irrelevant" courses, I have taken away something that I can offer the patient. 

I am saddened by the overwhelming push against increasing the educational requirements for paramedics. I get that there is a fiscal component to earning a degree, but at every step in my education, the more I know, the more I've commanded in salary. I, along with a number of my fellow practitioners, administrators, and educators, are those that, while some see it as putting the horse before the cart, are the ones that see what EMS can be. We will not sit idly by and allow the complacent to continue to complain about wages, respect, decrease in protocol, and overall dissatisfaction with their job situations while, in the same breath, denounce any mention of something that might move us forward and assist in alleviating these concerns.

Please understand that I say all of this with the utmost respect for the work done every day on the streets. I was one of the paramedics working 96-120 hours per week when I started. I get it. It's hard. It doesn't seem fair. But I was taught that if I wanted more, I had to EARN it. I do not DESERVE anything that I have not earned. As I look at nursing salaries, I see them rise with every degree earned. Why are EMS professionals so amazingly disillusioned that they don't have to follow the same path to earn the same respect and salary? 

Education cannot be just an individual standard. It must be an industry standard.