By Dan Limmer
A recent article in the Press-Republican from upstate New York titled “Editorial: State must reduce obstacles to EMTs” stated: “Ever-increasing state training requirements are thinning the already strained ranks of emergency medical technicians and costing communities money.”
Hogwash.
Yup. You heard it. Hogwash. I totally agree that volunteer EMS has personnel issues. But reducing the hours of training or lowering standards isn’t the answer. Those approaches are wrong for two reasons.
First, EMS training can be held in a variety of different ways to reduce both hours and the overall burden of training. The difference between 120 and 170 hours of education isn’t going to be the sole deciding factor in whether a volunteer takes a course or not. I’m not saying training hours aren’t an important part of the decision—but I don’t believe they are the only factor.
We’ve been stuck in the 2-nights-per-week-and-Saturday EMT class format since we had Cadillac ambulances. Our “lecture” sessions for EMT class are bloated and ineffective in terms of both class time and retention of material.
In a blog post last year, I talked about how an EMT class was taught successfully with 60 hours of class time. Classes were active and centered around dynamic application of the students’ online learning. The remaining portions of the training were completed asynchronously at the convenience of the participant. This class format allowed an island EMS system to gain EMTs they needed to stay in business. Limmer Education will gladly share the schedule and the dynamic exercises used to create this and subsequent classes.
Now for the second reason. Once members get certified and join volunteer organizations, other factors such as raging political and interpersonal battles, popularity contests, lack of mentoring, and general dissatisfaction cause agencies to lose far more people than does an extra 50 hours of education.
People will stay where they’re valued and believe they belong. They’ll also commit to the training when they perceive it to be expertly delivered, valuable and necessary. We should spend more time making our agencies friendly and our training amazing than we do complaining about the hours necessary to complete a mediocre educational experience.
Given a population, only X number are potentially very good EMS providers, and only Y are very good EMS instructors. Lowering standards is inflationary; asvwas aimed for in 1970, you will get more of each, but quality drops. In prehospital EMS concentrating upon treatment (more-definitive) versus stabilization (prep for timely transport and treat enroute) this translates into iatrogenic death due to misadventure, overtreatment, or delay of definitive care.
We stopped allowing under-educated volunteers as dentists, midwives, even veterinarians. Train and pay/benefit/respect both prehospital EMS educators and practitioners as professionals, not “better than nothing” cheap help. Put the chain of command in medical hands, not fire or law enforcement or local politics.
(That means instructors with degrees and experience, not “trainers” with a script a’la Red Cross.)
I think your last statement is very, very important. Without the quality educators our future EMT classes are doomed.
It’s upsetting that all these stories about how EMT class is “too long” originate from our area (I am from the Plattsburgh-Clinton/Essex County area). The class is long, it is tiring sometimes. But it is worth every minute. To be completely honest, I think it should be longer. We can’t shorten and hurt our patient care because some of the old timers think that class is too long.
From a recruitment and retention standpoint, it doesn’t help anyone that people are publicly complaining about class length. What more obvious way to push new volunteers away than whine to them before they even pick up the application?
Compared to other healthcare careers, the EMT class is minimal, yet EMT’s demand respect. It is time we stop throwing a hissy fit, get up off the floor, and put some actual effort into our volunteer shortage. Running an organization isn’t about being popular and being the top responder anymore-it’s about leadership.
If we tell our students and volunteers that our classes are too long people will believe they are too long. Many do the same thing for their squad training. We broadcast the burden instead of the value.