A Little Concerned.....

[Jayfly95]

Hi everyone.
I wanted to go through the EMR program to begin getting my foot in the door as a path to being a Paramedic. One slight wall stands in my way, and it always discourages me from starting.

I have a number of friends, and relatives as well employed in BCAS as EMR's and some are PCP's.
All I constantly hear from them and their friends or co-workers are EMR's are a blight on the Paramedic profession :/ (Go figure.. did I mention that YES, some of them were EMR's as well for 3+ yrs.)

I understand an EMR is under-qualified next to a PCP, but correct me if I'm wrong, but they would have had to go through THE EXACT same path to get to PCP and above right?

Why is it I am always hearing so many negative thoughts about people who are EMR's trying to do the SAME THING as many others have gone through?

I want to do my EMR, working rural or remote is fine by me for now to slowly build up ANY slight experience, then within a year or so do my PCP, or EMT if i have to go out of province to complete.

why's it so wrong to be an EMR who is striving to get his PCP down the road?

Is this how all Paramedics look at EMR's trying to go through the ranks?, or just a regular scenario of another group of arrogant Paramedics blowing smoke up their own arse?

Just wanted to know the real deal from others outside this group of "friends".

[1Hoser]

Sounds to me like these so called friends don't really understand what this game is about. The Patient. We (EMS, health care providers, fire, cops) are all there to help people in need and should be respected on that basis alone. We are a team! And your absolutely right every medic starts out in the same place....probably a CPR course, and from there we choose our path. Do the course dude and don't listen to ridiculous talk like that. Then when your a CCP and they are still PCP's you can show them more respect than they showed you.

[radar81]

I think it depends on the Region, there are a lot of EMR's in region 1 essentially North of Victoria Including myself Region 2 Metro Vancouver and the outlying areas are mostly PCP or up unless its a transfer car (correct me if Im wrong), Ive just started but I have a bunch of Friends who are PCP's I have not heard them say anything like this you get the odd ribbing. You will have egos no matter what organization you go to Fire Police and EMS.

I also know a few who got their PCP and got on car only to realize that this job was not for them, they wasted a ton of money and time to get a license that really does not help with other job prospects other then healthcare. Going with the EMR getting on car and seeing if you truly love the job is the best way to go, at least you can work while getting your PCP, the process to get on with BCAS can take a bit, it took me almost 6 months some only take a month. I intend on getting my PCP eventually once the Labour issues are worked out and its not a big hassle getting the Precept done.

The biggest thing you can do is go into it with an open mind, know you protocols and if there is something the PCP can do for the Pt let them jump in and push their protocols. Unfortunately BC has adopted the EMR name but decided to dump a bunch of additional protocols on it to allow you to work on car. The EMR is a good base from which to start the PCP program, it will give you a bit of a head start on the Pt Assessment model and some of the Protocols and treatments. We all go to licensing and have to pass the exams they are not exactly a cake walk there are not many who get away on the first try with out having to do a remedial paper or have to complete another skill station or outright have to do the who practical again, the written is not easy either. Licensing is just as hard on EMR's as PCP's as hoser said we are all here to do the same job we all start in the same place some of us decided to take a different path.

Usually for the most part you will hear Paramedics bitch about Fire anyways, then Fire and Paramedics will both bitch about the police.

[fire_cracka]

well an EMR and PCP have a different scope of practice but really an EMR is almost as effective. PCP have a few protocols that EMR's dont but some are uneccessary. for example,

a narcotic overdose can be treated with a BVM perfectly (you can even speed up the bagging and watch the person regain conciousness/slow down back to sleepy time) so narcan is just nice, NOT needed. also drug overdoses are rarely just an opiate.

the hypovolemic protocol (IV of normal saline for bleeding) has been widely debated to whether it is beneficial or possibly harmful.

anaphylaxis is rarely used around here but a true lifesaver

ventolin is indacated(usually) in people who already have a salbutomal inhaler, the reason they are calling 911 is that the drug isnt working for them

Emr's have almost the same cardiac protocal
same with pain management

giving D10 IV is much better but once again, rarely the deciding factor

the biggest difference between an EMR and PCP is the knowledge of anatomy/physiology/pathophysiology that helps you take a quick thorough and relevant history
really all we want is to put the Pt on 02 and get them to a hospital to dell a doc whats up.
study hard and be willing to learn and you can be more effective than a lazy PCP

[firemedic379]

Interesting problem and I can relate.

The best thing I did was not listen to what anyone thought about my choice about my career. "Oh it’s too hard to get hired", or "I am going to go to bum F*** to get hired" were common comments that I had to endure.

Back in the day, the old EMA 1 was a scary experience. The EMR (I teach the program here in BC) gives you enough information to complete a basic call and that is about it. Like Radar in Lake Cowichan, it’s a long run to Cowichan District with the hypovolemic, brady patient and as an EMR there is nothing really you can do.

The biggest thing is time, lifestyle and where you want to be in 5 years. The EMR will give you a great background for the PCP, allow you to work on car and gain experience and get your foot in the door.

One major drawback is pay. I have no clue what an EMR rate is now but it’s low. Not that the PCP is any better but your 5 year service rate is now based on time in the position, so it will take 5 years to earn it once you have the PCP.

If you have any questions please feel free to send me a message.

Fire_craka:
High flow 02 and a BVM will work decently for increasing the O2 saturation of the patient but does nothing for removal of the opiate from the haemoglobin. This doesn't include the problems with gastric distension as we don't have any advanced airway protocols air will be going into the stomach. Secondary problem with narcan as a protocol is the half life is shorter than the opiate and thus need to be transported. If you stop bagging the patient the opiate is still bound to the haemoglobin and narcan is the only way to remove it.

So as an EMR the protocol for an unconscious diabetic is to give a half pack of glucogel to a max of 2 tubes. It takes approx. 10-20 mins for a PO med to absorb if swallowed which if you read the packaging is the ideal way of administration. Unfortunately most situations patients are unconscious and you are depending on absorption via the mucous membrane which is faster but not as effective. Patients that are hypoglycaemic need either glucagon which is a PCP protocol or D10 to regain consciousness. Far superior and best patient care and the D10 doesn't strip the liver of the sugars which has way less secondary issues for the patient.

Ventolin: INDICATIONS
Chief complaint of shortness of breath in a patient with a history of asthma or chronic obstructive pulmonary disease (COPD).

As a PCP, a ventolin inhaler is not the protocol. Nebulized ventolin is the treatment and is decently effective at delivering the medication provided the patient is not completely blocked. Yes it’s the same medication the delivery model is way more efficient

My relief is in so I will continue this another day.

Cheers,

Derek

[Jayfly95]

Thanks for the clarification from the responses^_^

I'll be beginning my EMR in May or June.

Does anyone know of any stations in the BC interior that are in need of an EMR at least and such?

I seen the choices in stations that frequently hire EMRs on the BCAS website, but I would like to choose one that highly needs a new medic, vs one that doesn't particularly need one but will take me anyways if I just applied there as one of my choices.

Call volumes not a top priority, I would just like to go to a place that NEEDs a new member and I can get my feet wet for awhile XD

[North_of_60]

Does anyone know of any stations in the BC interior that are in need of an EMR at least and such?

I seen the choices in stations that frequently hire EMRs on the BCAS website, but I would like to choose one that highly needs a new medic, vs one that doesn't particularly need one but will take me anyways if I just applied there as one of my choices.

Call volumes not a top priority, I would just like to go to a place that NEEDs a new member and I can get my feet wet for awhile XD

Where abouts in the Interior are you looking????
I know that stations in the Peace are always looking for and in need of people (Hudson's Hope, Tumbler Ridge, Chetwynd) if you wanted to come up this way.

Good luck with your EMR and getting onto a station. The other advantage up here is that you can do some patch work to keep the bills paid and then work on car on your days off.

Let me know if I can help any more. Stay Safe,

North of 60

[unglunk]

You make such a solid point. I saw this same attitude from my EMT preceptors back in 1999, about myself and every other student. It seems like either the EMT's are dumping on students, or the Paramedics are dumping on the EMT's and students. I think people really forget where they came nk a big part of the problem is that a lot of these guys figure, hey I was dumped on so why should this guy have it any better.

I have only had the chance to precept 3 PCP's over the years, but I went in to it thinking that i'm not going to be a part of this vicious cycle, and I hope my approach catches on. I didn't baby these guys, but I treated them with the respect I would want, and tried to mke it a possitive experience. I feel the profession has a lot of turnover and that a big part of it is due to being treated so poorly at the student or entry provider point. My attitude is the preceptor works for the student; he/she is there to provide guidance to that guy/girl that he/she once was. If they don't feel this way, they should not be precepting.

Keep plugging along, not everyone shares your buddies attitudes.

[Bobafett]

You have to suck it up and follow the steps, at least in Alberta EMR-> EMT-A(PCP) -> EMT-P (ACP) you have no choice . EMRs don't know anything its not their fault that's the level they are trained to . I have worked with new EMR's that say and do dumb things , i just tell them if i look at you like this *stink eye* its time for you to stop talking now and move aside lol
Personally i have had for the most part good experiences with all levels , there are always rotten apples but you need to develop thick skin and just roll with the punches we all started at the bottom.

[Paraone]

Your so called friends and other paramedics you so speak of sound like the guys that should not be in the EMS profession. EMRs are just as skilled as PCP paramedics, just like mentioned above, we have a few more protocols that is it. I have worked with some great EMRs over the past year and half and some not so great. I also have worked with some not so great PCPs. All and all we are all here to do a job, and in now way does a EMR medic get in the way or hamper the system in way! Do what you want to do!!