Clinical Time for EMT-B Students

Replies to This Discussion

Permalink Reply by Jim Zablosky on January 19, 2009 at 8:15pm

Jeremy,
I went to EMT Class in 1991 and we were required to spend time in an ER or Ambulance service, I am getting old and do not remember the number of hours. But, I think this is a good thing and should be brought back.

▶ Reply to This

Permalink Reply by Ken Roberts on January 19, 2009 at 9:03pm

Jeremy,

I too had to do clinical time for my EMT-B MAST certification a couple years after Jim and I believe it was 16 hours in an ED doing vital signs and 16 hours on a truck which at that time was an ALS truck since paid BLS was a little hard to come by. I felt that it was a good idea then and still do today. I also did alot of ride alongs with MEDIC 49 to get a better picture of what I was getting into and to get rid of some of those good old butterflies prior to being let go on my own. I have run into an EMT or two that has told me in the middle of a call that " this stuff is awsome I have never gotten to ride in an ambulance before". WOW! I'm sure the look on my face was priceless but atleast I then knew what to expect and what not to ask the provider to do. I know that the program that is run through my current employer does require the students to do ED and truck time on both a BLS unit and an ALS unit prior to completing the course. It would be nice to see this come back to being a state requirement.

▶ Reply to This

Permalink Reply by Kimberly Blee on January 19, 2009 at 9:13pm

Jeremy,

I agree with adding clinical hours back into the EMT classes. My experience over the past few years is that EMT's are usually extremely nervous and unsure when they are thrown into the field right out of class, especially the ones with no previous experience at all. Not to mention it always seems to happen that one of their first calls is a bad one. Veteran EMT's and / or Paramedics may not always be at the call, if at all. I am a strong believer of students gaining clinical experience with veteran providers prior to being thrown into the "real world" At the least, EMT students should have 12 to 16 hours of ER experience and 24 to 40 hours of truck time. Paramedic students have a large amount of clinical time they are required to complete during their training, not to mention the time they must put in to get a required amount of calls to obtain their medical command. Some may argue that this is due to the skill level difference but BLS always comes before ALS. Aside from the skills, there is learning how to handle and communicate with the patient, their family, bystanders, hospital staff and other providers. EMT students should be given the same benefit of some type of clinical experience.
I know some have done this on their own until they felt comfortable taking charge of a call but why not just make it mandatory that way we can assure that all students have the same opportunity and experience.
I remember my clinical time when I went to EMT class many moons ago, I do not remember the hours but I do remember the events and the people that were there to make my clinical a rewarding learning experience.
I know many providers, BLS and ALS, myself included, that are more that willing to take students and introduce them into the real world of real patients and uncontrolled environments. I would very much like to see this brought back into the BLS curriculum.

▶ Reply to This

Permalink Reply by John W. Magyar on January 19, 2009 at 11:35pm

I agree with adding clinical & truck time back into the requirements for EMT certification. You all have some great points and your rationale is sound. How can we expect a new EMT to perform adequately when they have had little to no On the Job Training?
Now, how do we accomplish this task? How do we get this issue in front of the decision makers?
How do we prove that adding more hours to the EMT training for clinical and truck time is worthwhile? With Recruitment & manpower problems being what they are, will the state even consider looking into this? Lets hope so. Has anyone made an attempt to contact their regional EMS Council, PEHSC or the Bureau of EMS to alert them of our concerns? Maybe a group letter signed by some experienced providers to PEHSC might not be a bad idea.

▶ Reply to This

Permalink Reply by Ron on January 20, 2009 at 8:35am

Yes, I strongly believe that ride time should be an essential part of the EMT-B ciriculum!!!

▶ Reply to This

Permalink Reply by Pete Manhart on January 20, 2009 at 11:09am

When i took my classes in 1990 they required the clinical time when i took the class again in 2004 i felt sorry for the students coming out into the field. They were certified and at this point have never been in contact with a patient. I was glad i had the clinical time my first call happened to be a trauma call and i was first on scene with a QRS. I dont feel some of the new students are comfortable being with patients.

▶ Reply to This

Permalink Reply by Terry on January 20, 2009 at 6:23pm

I agree 100 % there shold be clinical if it wasent for me running on the MICU while takinf my emt class I would not be even half the emt I am now. (not that I am the greatest). The medical profession is a constant learning profession in which every person has his or her own way of getting things done and you need the clinical time so you can develop your own before having to put it to the test.

▶ Reply to This

Permalink Reply by Dave Prince on January 21, 2009 at 6:50am

Jeremy,

I agree that this is what needs to happen. In the three states I have run EMS DE,AZ still required that we get X amount of hours in the Truck and an ER or Emergency Clinic . When I came to PA they had me go thru the EMT class with a great instructor Cheryl Snyder now Walters. The state had no requirement at this time but she pushed us a bit to get our feet wet and not only on the trucks but if we had to volunteer in an ED. So far everyone on here seems to like the idea my question now is this? How do we get the state to add this to the requirements for an EMT Cert.

▶ Reply to This

Permalink Reply by Matthew RJ Siko on January 21, 2009 at 3:21pm

I think other questions need addessed along with these regarding the EMT-B certification:

Is Street and ED time the only thing that should be added?
Is it time for a total revamp of course?
If we are going to require the students have Street and ED time then are all instructors going to be required to have met this requirement?

My general point is this... If we are going to change the program lets do it right the first time.

▶ Reply to This

Permalink Reply by John W. Magyar on January 21, 2009 at 11:37pm

Hey Dave. Good seeing you tonight at SEHSC mtg. Do you think the council will consider starting an RR&R Committee? I think its time that those of us left in EMS need to start promoting some change. Too many things are wrong with EMS these days and we keep getting inundated with more BS like the Red Flag Rule. I still think a parade in Hbg. would be a Great idea. LMAO. Later, John

▶ Reply to This

Permalink Reply by Dave Prince on January 22, 2009 at 7:15am

John it was alos nice to see you and Yes I do think they will do something. To what degree I am not sure at this point. I think you gave them alot to think about the problem will be that like alot of places you have the good old boys club and when that rears it ugly head even great ideas go no where. I seen people offer to join on a committeand where turned down. How can they sit there last night and say the want and need help but then turn people away. That will cuse people to pull away.

▶ Reply to This

Permalink Reply by John W. Magyar on January 22, 2009 at 1:51pm

Dave and Chris - After reading all the great posts on our Pa. EMS Providers Group and hearing all the comments and opinions of people who "really" care about EMS, I have come to a conclusion. Picture this cuz I can't draw, especially on a puter. It is drawn in a semi-comic format.
Envision a nice ambulance on the left side of the page with 2 smiling techs. ready to respond to an Emergency. This picture represents EMS 15+ years ago when their primary responsibility was to deliver high quality pt. care.
On the right side of the page, envision an overloaded ambulance (EMS Today) with 2 techs looking like they are ready for the rubber room. On top of the ambulance are heavy boxes labeled: PCR, CQI, Poor Economy, Low reimbursements, Manpower shortage, HIPAA, Homeland Security, Red Flag Rule, Licensure, etc., etc., etc., The tires on the rig are flat. Both techs are scratching their heads wondering "how in the hell are we going to go on the next call"?
Now that I have painted the picture of "then and now" side by side, what conclusion can we draw from this? My conclusion is that we are in a mess. That was a profound statement, huh!!! How can we keep adding more and more stuff on top of the current rig when the tires are already flat? How can we expect to deliver better pt. care today and into the future in the shape
we are in right now? Our hands are tied. We can't even begin to think about advancing pt. care tomorrow when we struggle to meet all the demands that have been placed on EMS so far. EMS used to be fun. The majority of the time we were training and advancing our skills and we had the time to concentrate on our primary mission of delivering good pt. care and being able to respond quickly with qualified personnel. It seems today like there are TOO many other things EMTs and Medics have to be concerned with to devote their ultimate and focused attention on the patients.
The good news is that there are some of us who are tired of seeing this "EMS Abuse" happen and have just a little energy left to focus on our current problems. We can't go on a call with flat tires. We have to concentrate on fixing the flat before we can even consider adding more complications to the mix. Compliance with all the rules and Regs is great but how important are they when the rigs are paralyzed or dead?
That brings me to the conclusion that a bunch of us need to get together and do 3 simple things.
1) Identify our most important problems
2) Devise a plan to correct those problems
3) Implement & monitor the plan
How can we do this? Lets think outside the box for a minute. If for some reason(s) it can't get accomplished through the local regional EMS Councils, then what about an outside Assn. whose purpose is to get this job done? JJ and I have talked about this numerous times. Is this a step in the right direction? I think so. Is it possible? For sure. Do we have enough dedicated and interested people in EMS to make it happen? I hope so.
I would appreciate your thoughts and those of others who are concerned with the current state of EMS today.
Be safe out there. I'll leave you with a little quote from me.
"EMS is NOT just a business".

▶ Reply to This

▶ Reply to This

• First
• Previous
• Next
• Last