Experience...

Experience seems to be something of a determining factor in hiring. Ask any fresh faced college graduate with a liberal arts degree and mountain of debt about how many jobs these days seem to require 3-5 years experience to get in the door.

This might be becoming more and more of a problem because a fair amount of job applications these days are done online, and they are high-graded by a computer before a human being even gets to see them (See this Click-Bait Fluff Article I pulled from the Google)

Unless you are working for a fairly large municipal service or a hospital, we in EMS are lucky to avoid a fair amount of those systems. 

But that doesn't preclude EMS folks from having to deal with specific absurdities when it comes to getting a job, the single biggest hurdle that I think exists is that nebulous idea of Experience.

Earlier in my life in EMS, I made the mistake of assuming that since I had an EMT card, I would be able to get a job. 

I am lucky enough to have come into EMS from the outside. I wasn't a fire fighter, I wasn't a volunteer, my dad, mom, uncle Jon Jon...whoever, wasn't involved in our little corner of public service. 

Given my previous work history, I made the mistake to assume that EMS was a job, that I should get paid to do, so the idea of just showing up and volunteering until someone decided I had enough experience to be given a paycheck didn't occur to me either. And that isn't something I think should happen anyway. We are professionals and should be treated as such.

So I soon figured out that the only place that would hire me is probably a place I didn't want to work, but to get into paramedic school I needed experience so I took a full time job at a For-Profit transfer company.

I worked there for 4 months before I applied for Paramedic school, I had my 50 "calls" on the record and I passed the application process and started Paramedic school probably 7 months after I got a job trucking dialysis patients 0.3 miles back and forth 3 times a week (we did other stuff too).

Surprisingly, I did just fine in Paramedic school having never been on a 911 call prior to starting. 

Eventually I got another job at a service that actually does EMS, and surprisingly, I did just fine.

But anyway....

Oftentimes, administrators and managers and supervisors seem to put a premium on experience when hiring, when they should probably weight other factors nearly as much as it.

Things such as affect and professionalism. Trying to quantify such things is much more difficult than filling in the ____ years experience someone has.

The truth is when we say experience, what we really want is Wisdom...I've always like the saying:

Knowledge x Experience = Wisdom

So if you have a provider without appropriate knowledge, it doesn't matter if they have 20 years experience. From what I have seen, years experience oftentimes in inversely proportionally with quality of provider...something something one year experience repeated...blah,blah,blah. It seems to me that the best providers we have tend to cycle out to other careers in 5-10 years because EMS isn't a place people make careers in when they have a passion for medicine, but that's a whole other problem, and is central to the issue of relying on experience as a measure of a decent provider.

I can carry on about this for another thousand words, but we all know it's about who you know anyway. So if you want a job, go call your Uncle Jon Jon down at the Fire Station.

Is it just me...

Or does this place smell a little like Dunning-Kruger?

Top 3

top three things that don't need to be said during a patch (in no particular order)

• the phrase "cardiac history"
• whether the patient is "resting comfortably"
• the patient's allergies

Adventures in online Medical Control

"Hey this is Paramedic Survivor from Rural Ambulance in the back hills of Town-with-plenty-of-Sick-People, who is this?"

"This is Dr. White"

"How do you spell that?"

"Like the color"

"Oh...We are currently doing CPR on a 67 year old male for over 20 minutes now, unknown down time, the patient is intubated with etc02 of 20s-30s. We've given 5 rounds of epi, half an amp of d50, an amp of sodium bicarb, and the patient has been in asystole the whole time. I'm looking for permission to terminate efforts"

"Um, okay...hold on a sec"

Pause.

Pause.

Pause.

Pause.

Probably a minute and a half goes by.

"What do the patient's pupils look like"

"Fixed and Dilated."

"Is there family there, what do they want you to do?"

"I've spoken to his wife, and she is comfortable with us stopping"

"Okay...um...I think...yeah you can terminate efforts....you've done everything you could...I....it's appropriate....There isn't anything else you could have done"

I appreciate the (somewhat unnecessary) caring and empathic tone. It's 1:30 in the morning.

It's always fun to figure out whether the Doc that picks up the phone is an attending or new resident.

Like the one time the Doctor told me "Do whatever you need to make him comfortable" when I called after I used up all my standing order pain meds.

We call a line that is recorded, I think it would be fun to listen to some of the conversations.

Understanding Program Accreditation

Full Disclosure: I chose an expensive fully accredited Paramedic Program 

Right now, Paramedic Education is somewhat in flux, because recently the National Registry has required Programs to be accredited for students of those programs to test the National Registry.

Here is more information about that...

In my experience there are two camps when it comes to education in EMS.

There are those that see it as a barrier to working, and those that see it as a benefit.

Not to be cliche, but lets say you have a child or a parent that needs EMS. When the paramedic shows up, they are wearing a t-shirt that says "I chose to be educated at a program because it was the fastest and/or the cheapest!"

Would you trust that Paramedic?

The opinion of anyone who doesn't think that accreditation of Paramedic Education is a good thing should be questioned. Once we can be held to higher standards, we can start asking for what we are actually worth. Look into the history of Nursing.

But anyway, if you read the article in the link above, it talks about the Commission on Accreditation of Allied Health Education Programs or CAAHEP.

This group does accreditation for a bunch of different education programs, the list is here.

So how do you know if the program you are looking at is fully accredited? Just search your program here

That is a neat website, because you can search for programs that are newly accredited, recently lost accreditation, as well as programs that have something called a "Letter of Review".

Here is what CAAHEP has to say about that...

Letter of Review is NOT a CAAHEP accreditation status, it is a status granted by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) signifying that a program seeking initial accreditation has demonstrated sufficient compliance with the accreditation Standards through the Letter of Review Self Study Report (LSSR) and other documentation. Letter of Review is recognized by the National Registry of Emergency Medical Technicians (NREMT) for eligibility to take the NREMT's Paramedic credentialing examination(s). However, it is NOT a guarantee of eventual accreditation. 

Now I understand money is money, but I remember calculating it out. When I started school, the company I worked for would foot the bill for Paramedic School if you were in good standing. They called it a "scholarship" but really they would deduct funds from your paycheck until you had paid them back. But if you worked for them for 3 years, you would supposedly get your money back.

But here is the kicker. The bump that I would've gotten in pay, not including any overtime, would've have been more than enough to cover the cost of school within the first year of working as a Paramedic. So the 3 year commitment made no sense.

So anyway, the point to this anecdote was to show that money really shouldn't be much of a consideration when it comes to Paramedic School, because that money will be made back pretty freakin' quickly. If you think $10000 is a lot of money, go ahead and ask your friendly local intern at the Emergency Department about student loans. Obviously doctors make a lot more money, but it takes a significant amount of time to pay off their loans, even at the higher paycheck.

I don't know if I've already told that story here.

But anyway, I remember hearing some guy on NPR talk about the "Student Loan Crisis" and he said that your total student loan load shouldn't be more than your expected annual salary getting out of school.

I hope that anyone reading this is going to be making more than $10000 a year.

Granted, the only experience that I have is my own, but it was nice to here from preceptors "Yeah, students from (my program) are usually really good. Some students from other places didn't have a f**k'in clue"

Wait a minute....what did they mean by "usually"?

Leave your comments below...

I once...

I once met a fellow in a hospital.

He was a patient transport tech. He was the guy that moved folks around the hospital.

He could tell the liters per minute setting on an oxygen tank by listening to the hiss it made.

White Cloud

Haven't posted in a while because nothing particularly exciting has been happening in these last few months...really.

I work in a fairly rural system, so going an entire shift without a call isn't unheard of.

I am considering applying for a part time job at another service. I have a few choices.

One service is somewhat familiar to mine, but with a Community Access Hospital as it's Medical Resource Hosptial.

One service is the most busy in the area by far, but in terms of protocols is fairly behind the times(calling Medical Control for benzos for a patient actively seizing).

One service is a Community Hospital Based 911/Intercept Service. The Paramedics work in the ED when they aren't on calls.

In terms of possibilities I guess things are pretty varied. I know folks who work at all three services, so I guess we will see what happens.

I've probably lost 30 pounds since finishing Paramedic School, finally able to do the things outside I like doing and not eating crap all the time probably has something to do with that.

Still haven't worked a code yet as a medic, but I'm sure there will be plenty of those.