Under it I imagine Roy saying "Don't worry Johnny, one day we'll be a profession rather than a trade, just you wait."
Well, he's still waiting.
The folks over at Webster's say a profession is:
A field in which one is in a paid occupation, especially requiring prolonged training and qualification.
We can argue the merits of 2000 hours, but that is certainly prolonged and we do require a state license and there is even a list of folks who passed a special test and get "registered." It would appear that, technically, we're there. You can relax, Johnny.
However, ask any EMT struggling to get by if they feel part of a larger Profession and they'll likely tell you no.
Reader Garrett Kajmowicz shot an email to me asking the following question in regards to being considered a profession:
"How many professions exist where you aren't allowed to buy your own tools?
As it stands, as a paramedic, can you go online and buy your own supply of medications? How about diagnostic equipment like a heart monitor? I think that some form of legal independence is going to have to exist as a part of the trade to profession shift, though I don't know when, where, or how.
Thoughts?"
Interesting question there, but I'll have to go with no. Being able to purchase our own tools won't steer us one way or the other. Case in point, no one would argue that being a pilot is not a profession because the pilots do not own the planes.
By the way, now that I work at the airport most of my bad analogies will be aircraft related. Sorry for the inconvenience.
Being recognized as a profession takes time. A long time. Some will argue that we need an over arching Federal office to oversee licenses, skills and practices. I agree and disagree at the same time. While many similarities can be drawn looking to our close cousins the fire service (started as slaves chained to street corners) and nursing (started as prostitutes) who both have National level organizations, cabinet positions and offices in DC, we still have no idea what we are so where would our federal agency live?
Are we in the public safety business or the public health business?
Both need to be filled but with drastically different professionals in drastically different fields of specialization.
Our trouble is that we still sit on the fence and cry that the other kids won't let us play when both teams are a player short. Do you want 911 or Community Paramedicine? Can't do both. Those who say you can are the same who say you can't be both a firefighter and a competent Paramedic.
In the past I've caught flack for suggesting I was competent in both, but have since specialized. As my position required more focus on EMS I had to pick a side. And did.
I say pick one and run with it. A community can certainly offer (and would be doing a dis-service not offering) both services, but not using the same person.
You want to run 911? I need you also swim certified, low angle rescue certified and in haz mat and active shooter training. I need to put you in harm's way.
You want to do Community Paramedicine? I need you back in school. Advanced A&P, pharmacology, psych, social work, community planning, administration and education and none of this community college stuff, I need you in the cadaver lab with the pre meds.
Two distinct professions can emerge from our little trade house if we want it enough but back to the original comment from Garrett, no, I don't think buying my own LifePack 30 (Are we up to the 30 yet?) will make me part of a Profession.
Only I can do that by lifting up my co-workers, my agency and my passion for patient care. I would hope we are all doing the same.
What do you think of Garret's thought? Will being able to order a monitor, ambulance and medications, the tools of our trade, allow us to become a profession? If so, how? If not, why not?
Tell me in the comments.
Comments
Think about it. In most states, a Paramedic's license technically is only valid while at work, on duty, while being "overseen" by your project medical director. Which means that when off-duty, even when presented with an acutely ill or injured patient, we don't have the legal authority to perform advanced skills or interventions, regardless of the patient's need or our ability. An off-duty Paramedic is not a Paramedic, they are a first responder (or whatever they're calling it these days). I suppose, technically, they're not even a first responder, they're a lay person with a little more knowledge but no additional ability to help.
How unfortunate that states believe that I have forgotten how to intubate, start IVs, administer proper doses of medications, etc. because of the clothes that I'm wearing. How unfortunate that if I happen to be traveling through another state, I have no license to practice in the event that it became necessary. Does my ability to assess a patient, identify and manage life threats, perhaps get a head-start on treatment while waiting for an ambulance? Obviously, I shouldn't be giving antidysrhythmic medications or anything without the benefit of cardiac monitoring, but if I have a sudden onset of chest pain, pale, cool, diaphoretic, with a low blood pressure and clear lungs, AND I have access to the tools necessary, why is it illegal for me to start a line and give a bolus while waiting for the ambulance?
We're going to have a lot of difficulty being recognized as a true profession as long as all of our ability to legally act is tied to our employers, rather than our education, licensure and skills.
And I believe that if we got our acts together enough to force the world to treat us as a profession and start letting us run the "out of hospital medical services" ball game, we could have community paramedicine and 911 service co-existing under the banner of "Paramedic Services Agencies," although I do agree that they require a different enough skill set to warrant separate "community paramedic" and 911 positions within that theoretical organization. But that line is a lot more gray area than the line between us and the fire service.