Where to start?

Skip Kirkwood asks “how do we change it?” in response to my post on the prevailing apathy that is so rampant in EMS. I think a good start is with national recognition, and a national certification.

I have long been a proponent of the National Registry of EMTs. They do a lot more for EMS than most know, and they receive a lot of what I perceive to be unwarranted criticism.

With the incredible disparity in required education from state to state, I think the NREMT would be well positioned to be a leading force in a true National registry. The NREMT is moving in the right direction with their requirements for education from accredited schools to be eligible for their certification.

The NREMT is also moving in the right direction with their obtaining accreditation from The National Commission for Certifying Agencies (NCCA). The NREMT sets standards for their members, and the NCCA ensures that those standards are “credible for ensuring the health, welfare, and safety of the public.”

The NREMT has set a standard, and ensures competency of the EMS personnel who are Nationally Registered.

Nurses are required to be “registered,” why aren’t (or shouldn’t) paramedics be required to be registered as well?

Before being critical of the NREMT, and asking how a test can “ensure competence,” provide another answer. Enlighten me how you would ensure competency of EMS personnel. Should we continue with the disjointed, state-by-state EMS certification/reciprocity process that we have now, or should there be cohesion, and a clear understanding from everyone what it means to call someone a Paramedic?

I think the future of EMS is dependent on a unified vision and understanding of what EMS, who we are, and what we do.


  1. The problem with the NREMT is that their recertification requirements are stuck in the 1980s. Their plan to eventually require registrants to take the same test for every two years is even worse. In fact, the requirement to recertify every two years is an insult and major obstacle to EMS becoming a profession.

    That’s if for now. Look for a forthcoming rant, uh I mean, post about the joke that EMS has become.

    Profession? I’d settle for a trade about now.

    • I’m not sure where you obtained the info that NREMT is going to require recertification by examination every two years, but that is not accurate information. From what I understand, the changes will be finalized in 2014, to go into effect in 2016.

      Why does recertification every two years bother you? I’ve never thought it to be onerous.

  2. Jodi Riker says:

    Apathy begins at home the classroom, or in the ER. I started in 1969 so my view is little skewed. Most people could pay their hospital bills over time. Ambulances calls expensive but not outrageous. Men were paid more than women, and women’s rights haven’t quite made the front page. I made $1.15 an hour and a man $1.45.

    But we cared about our patients. It wasn’t always the highest technology, I remember making cardboard splints out of cardboard boxes.

    Now what I see his doctors treating patients for one item in 15 minutes. Not doing an exam only lab work ups to see if they are on drugs. I see us treating the machines not the patient. Patients are wise to the fact if you want to be seen sooner then you call an ambulance. Some one triages you sooner. You get a bed sooner and you don’t wait in the lobby.

    When I had a patient I do have to confess to knowing more of a patient’s history that I probably do their name. That the patient always got was my best. Whether with hand holding. or airways and ambu bag. You were there with the patient. Your tools were your hands, eyes and ears. You started with a patient from the scene to the ER or direct admission.

    And you saw the family if the ride did not go as well as you and they had hoped.

    Though with the onslaught of people not having insurance emergency room has become a dropping point for all needs medical dental trauma and etc… Doctors are burned out EMTs are burning out it’s a job to get you through till the end of school so you are better qualified to do a career.

    Some schools are beating out desire and compassion of good students. The desire to do this job when they get into the field is gone. More stress than ever. So they shut out the sceen and don’t deal with it. I call it stuffing it in to the footlocker.

    I took a class on EMT when I move to a new state. We started out with 30 students. The course is taught in 10 weeks four days a week with Saturday’s for clinicals.

    Most of the class was returning war veterans. It was taught on a military base with one instructor, as we found out there was no money for a second instructor so parts of the class were eliminated.

    We had people ranging in age from 18 to 56.When the class ended we have 12. And only four made a grade. Three had no interest in going into the EMS Field. One was a veteran and the one was a band manager and the other was a girl who taken the class twice. She was a fire groupie (her words not mine)and was sick at the sight of blood in photos, The vet was moving out of state. The Last was a Fire Fighter and for him it was a last ditch effort to pass.

    So why did I take the course? It been a while and since it been in the field. I’ve been asked this step up and be an the EMT for search and rescue. My score as 95 but it was not enough to get certified. After being in EMT for over 30 years and leaving the field in 2000, I was told unless I scored 100% of the 1000 question test. I could not be certified in the state that I was living in. Nor would I be allowed to take the National EMT test.

    If you want apathy I have it now. I did not when I started, but the unnecessary hurdles in the political play of county vs. county and state vs. state has become more of a turf war that a reciprocal agreement contract. I could not even volunteer my time to an agency that needed it.

    I subsequently left search and rescue and became a homebody. I have many things to offer. But I’m too young to retire a too old for paper route. Even though, I helped mentor the four classmates who scored 100 percent.

    This state labeled me a failure.

    • I have no idea what you are trying to say, and frankly, I don’t believe you.

      Which state requires a prospective EMT candidate to pass a 1,000 question exam without missing a single question?


  1. […] a Captain Chair Confessions the old Captain asks Where To Start? One part of his post suggests that we need a national certification process as a first step and […]

Speak Your Mind