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Paramedic degree and recruitment

One of the most often utilized arguments in the debate over paramedics and associate degrees is it will be a barrier to entry. What if this is the wrong tact? Could lack of recognition over a degree, in fact be what is preventing potential paramedics from becoming actual paramedics?

Just as there is no evidence-based data that degrees making a better paramedic, I couldn’t fathom survey data that exists measuring how many do not pursue paramedic because of concomitant degree.

This is something that’s been smoldering in the back of my mind for a few months. All I had was anecdotal accounts picked up from reading myriad sources over years. And observations of cultures that put a premium on a college education. I have to look no further than my wife’s parents. My father-in-law constantly informs my kids they can become a doctor, engineer or teacher; according to him, they have no choice. He is foreign-born and I can’t help but wonder how many cultures eschew paramedicine because there is no degreed prestige behind it?

Two items appeared in my Twitter timeline. I could no longer remain silent.

First, a “look inside” becoming a paramedic had a pull quote that spoke volumes [H/T NYC EMS Watch]. According to WJRT, Flint (MI) Assistant Fire Chief Edwards said EMS is “a great stepping stone for people looking to pursue other careers in the medical field.” Hey, on your way to a degreed medical position, why not stop in as a paramedic to get some real life experience! Flexible hours helps you go to school to be something else.

The second tweet was from Dale Loberger [HP_EMS], who expressed a desire to find common ground in this debate after reading EMS is Not Nursing! by Chief Becker. The crux of Chief Becker’s post lies on EMS’s high reliance on volunteers and different method of reimbursement. Both valid points. However, they are used as barriers to end debate on the topic.

After reading his post, I must ask: Are paramedics so good degrees are not needed; or so low on the cognitive hierarchy that degrees are unattainable? This is a somewhat facetious question. While I honestly do not think he questions intelligence, stating that EMS is different from nursing sets us apart. But without elaboration, there is room for doubt. I surmised from reading from several fire-based EMS writers, resistance to degree requirement is funding based. I get fire departments come from a tax-dependent, fixed-budget world. Half of my household’s income depends on local voters approving a tax levy or bonding bill every other year. In spite of this, school teachers must possess an undergraduate degree to work. And in Minnesota they fight for stringent educational requirements!

One line in Chief Becker’s article needs more exploration. He asked, “Since when is having a college degree evidence of being a professional?” Is he referring to a collective profession or individuals being professional? In my opinion, a college degree shows that an individual professional joined ranks of a profession by gaining more knowledge. Degrees are usually required for licensure, board certification or privileges. Unless one went to a so-called diploma mill, he or she has done significant work to earn a degree.

Do we want EMS to be a trade or profession?

If we work toward the latter, we may attract a more diverse workforce made up of those who represent cultures where degrees are an expectation.

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Discontent Breeds Distrust and Confirms Bias

I am not a very fast writer. My vacillation and rewriting means I miss the hot take. Case in point: An unidentified bearded man in jean shorts scrawled scandalous messages and awful claims on ambulances and buildings owned by FDNY. In my queue there currently sits draft number two of a post on public perception of EMS. More specifically, how social media griping fuels public distrust of EMS.

This rewritten piece originally began as my thoughts on lambasting EMS on social media. It was timely that this serial tagger struck. With several FDNY personnel able to keep jobs in the sunlight of past illegal behavior, it surprised me little that a person would label (literally) ambulances with horrible things. While I did not search out any

But this is what I was beginning to see. When lawsuits are made public, current and former employees (anonymous posters who identify themselves as such) concur with facts of the case. We cannot ignore all of these discontents as simply fed up. Some may have legitimate complaints; the majority just want to assign misplaced hatred or distrust of whatever on the large company. But when someone, posting with “authority of knowledge” by having worked for the agency being sued, claims this is standard operations for the company, it brings disrepute upon those who employed. We all know a few who struggle, but they do not represent the workforce as a whole.

It began affect me!
I am an insider. I sit around the picnic table and hear the gripes and suffer the same poorly thought out schemes. Yet I am not on social media broadcasting issues making them appear to be similar to every single ambulance service. My employer has had some press-worthy data breaches. Looky-loo nurses perused medical records of those they shouldn’t have and it made the news. As a result, I’ve sat in the ambulance deflecting suspicious inquiry of me, and my integrity when it comes to the electronic medical record (EMR) system.

But that is less hurtful than another EMS provider doing something stupid. No, let me say this: It is more hurtful to see a string of replies on social media that confirm all ambulance services are like this. That is not a quote; rather it is a generalization of any number of ways some anonymous malcontents inflict disrepute on his or her former employer.

I will not name the most derided multi-state provider of EMS care in the country. Suffice it to say, I’ve read some very negative things about the company. Enter “I hate [this company]” and you’ll likely find a sub Reddit. Anyone with a gripe against this company, EMS providers, poor service, “corporate America” or any popular diatribe will find their biases confirmed.

This summer I had the pleasure of traveling to two cities where this outfit provides EMS. I couldn’t help but wonder if the two crew members in there were proficient, happy, caring about those they encounter, overworked, so incompetent through the mismanagement of their overseers, etc. Some of those claims are legitimate; others are not and are painted with a broad brush. But I’ve had it so ingrained from reading social media posts I see their rig and fear for my life should I need an ambulance. I can reasonable decipher the list and extract those issues with legitimacy. The general public may not.

Who do they really hurt?
So who pays for such foul reputation? Not the company. Because of the Keyboard Warrior, an underpaid and overworked EMT or paramedic struggles to care for an untrusting patient who fears he or she may not make it to the hospital.

This is horrible to think. I say to those disgruntled internet posters, where do these multi-state companies get their employees? Do they fly in out-of-towners who couldn’t care less about who they treat or what they do to the community? Or do they employ local people? That is about as close as I will come to defending any ambulance service. My aim is not to prove a subset of employees wrong. I just want to remind them there are still people working there who care for people.

Ok. We know you hate your employer (or former employer). And you have grievances. But can you pause for a few seconds to reconsider a Tweet or Facebook post that harms current EMS professionals and the system people rely on?