OF CAREER CLARIFICATION..
I am equally (if not more) frustrated by the repeated comment “Why wouldn’t you just go to med school?”.
During the World Wars the governments (firstly the French, but others soon followed) realized that physicians could not treat patients laying in the middle of a battlefield and soldiers could not survive without a doctor. So, smartly, they got a few strong men that couldn’t shoot straight or fight worth a darn to start running into battle and haul injured people out. It was the first formation of an ambulance service. In the 1960’s the USA implemented the first civilian prehospital care in Cincinnatti. The systems for the next 10-15 years were Load and Go systems. They scooped up sick and injured people and took them to the hospital. In 1973, EMS systems became regulated requiring education, a certain amount of manpower and equipment, and standard of care. And since then it has only advanced more and more. It is still one of the newest fields of medical sciences.
Emergency Medical Services is a science. A beautiful, complex, and important science. We go through 2 years of University level training and 2 years of in-field training just for certification (typically done simultaneously if you don’t have to have a job also). If someone wishes to receive a bachelor’s degree there are two additional years on top of that of Art’s and Sciences classes. So.. to the world: if you think we go through this much to throw people in the back of an ambulance and drive to a hospital, you are sadly. SADLY. mistaken.
Emergency Medical services isn’t just a paramedic either. There are those who specialize in dispatching (which I think would be one of the hardest jobs). They have to gather enough information from a short telephone call to get all the appropriate people on scene including law enforcement, power companies, poison control, health departments, animal control, firefighters, epidemologists, bomb squads, social services, extraction services (such as jaws of life) etc etc. (from a phone call that averages 1-2 minutes long with a caller thats typically hysterical). Emergency rooms are hiring more and more EMT’s in emergency rooms to run heart machines and as other techs. They work side by side with nurses and usually push more drugs, start more gastro-tubes, do more intubations and IV’s, and read the EKG’s more than the nurses.
A paramedic is trained to enter a situation where people are at their very most vulnerable. People are pissed off that you’re there and can be dangerous, hysterical, and terrified. A paramedic has to walk up on these situations with no background information and administer thorough care out of 1 suitcase of equipment with the help of one partner. We diagnose based on what we feel, hear and see. We cannot hook up a machine and look at the abdominal cavity or at bones and organs in order to make a diagnosis. We are expected to push the appropriate drugs, transport patients (all patients no matter if they are obliterated, violent, 900 lbs, on the 47th floor of a building with no elevator, handicapped, or any other impossible factor), calm the family and bystanders, administer care and get them to the hospital for further treatment, and all typically in about 9 minutes.
Doctors have a responsibility to be masters. There is nothing higher than a doctor, they have the most responsibility and liability of any profession. They HAVE to be up on the most recent research, and be the best at every aspect. It is their job to form the medical profession. Patient care is usually only a minor part of an actual doctor’s true responsiblity. Give most doctors a small suitcase of meds and equipment and tell them to do what we do, in an unsterile environment, and they will probably admit that they do not have the proper training.
Nurses, Paramedics, Physicians, and specialists of all types are vital to the medical profession. Their jobs are completely different though. So, sorry if I don’t pack up my lunch and skip off to medical school tomorrow. There are a lot of steps to getting there for one, but two, the world needs to stop thinking that paramedics drive the people to hospital, nurses put the bandaids on and physicians do all the hard stuff. Because that’s just wrong. And STUPID. Hopefully no one will have to learn the hard way how important a paramedic is, but I wish everyone would understand. ((and vote to finance their local systems too)). A good paramedic is not only the difference between a good and bad hospital experience, it is also the difference between life and death. If you have 3 minutes to have a breathing tube put down your throat, or are about to deliver your baby in your living room, or are laying in a pile of your own blood in shock, or throat is closing after an allergic reaction, or find your child lifeless laying in their crib, or your teenager overdosed on a bottle of vallium a bottle of Jack Daniels, or your great grandmother peacefully passed away in her recliner… you’ll be darn glad that a few people out there decided not to go to med school.
I’m not trying to say I will never go to medical school, but the best doctors in the emergency room are the ones that have the common sense of a paramedic. There’s enough strong drugs and technologies out there that it’s easy to forget the basics and get caught up in the easy ways out. Because a great doctor would stop bragging about being Pre-Med, forget about the status and title, and get their nose out of a book long enough to spend a few years before medical school in a hospital or with sick patients. Because that is what it’s all about after all.