Lots of testing, Little pay
Has anyone thought about how much we study and test for a career that pays as little as EMS does?
The normal argument is that Paramedics tend to consider themselves equal or at least similar to most nurses they know. Nurses tend to know a lot about their specific area of care, and I know some nurses that are amazing in their knowledge and patient care skills. The thing is, that is not the average. I really have met quiet a few nurses that really have very little clue what they are doing, other than that they do exactly was the doctor says and only that. Mind you, I am sure there are medics and EMTs out there like that but with their protocols. The thing is, medics make half of what a starting nurse makes in this area. Half. They each have specialized training for their area. From my experience medics are more prepared to deal with unstructured situations out-of-hospital. Medics have standing orders/protocols that make it easier for them to deal with a wide range of issues without having to contact a doctor (medics and intubate (tube down throat) a patient where 99% of nurses can't.) There is also the legal issue that outside a hospital, a nurse is only able to deliver first aid until EMS arrives. They may be knowledgeable and skillful, but the laws reflect that nurses are for hospitals and clinics (near doctors) and EMT/Paramedics for out-of-hospital.
Now, I know some arguments from nurses tend to say EMT/Paramedics are just for advanced first aid and are not their equal. Well, EMS professionals do like to talk about their latest trauma run, but medical (non-trauma) are overwhelmingly more common. Paramedics do a lot of sick-person care. Now, an average run for me could take an hour and a nurse in the hospital could be with that same patient for days. But, I know the ER nurse will pass this patient off as quickly as he can. Also, how long do you think a nurse in a doctor’s office or convenient-care office would be with this patient? In those cases it would be almost zero. Those tend to be the ranges of patient care I see from nurses...zero to hours to days of intensive care. So, why is a medic making half the pay of the nurse who gets your vital signs and leads you to a room in the doctor's office?
Well, I am ranting. Maybe it is the cold medicine talking. I'm curious to see if anyone comments about this one. I'd like to see if anyone with no EMS or Nursing experience would have something to say. Perspectives from the outside are sometimes helpful. So, if you are a random reader and actually have made it though this whole posting; please let me know what you think.
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Go to www.salary.com if you want to find your own numbers. Also note that education *could* be different for a nurse and a medic, but they are not always. Some medics have Associates degrees and some have Bachelors. Same for nurses (Associates or Bachelors).
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Does this all come down to supply and demand? The demand for nurses is high right now. But since the demand has pushed the pay up, it has increased the size of some nurses egos. Thoughts?
The normal argument is that Paramedics tend to consider themselves equal or at least similar to most nurses they know. Nurses tend to know a lot about their specific area of care, and I know some nurses that are amazing in their knowledge and patient care skills. The thing is, that is not the average. I really have met quiet a few nurses that really have very little clue what they are doing, other than that they do exactly was the doctor says and only that. Mind you, I am sure there are medics and EMTs out there like that but with their protocols. The thing is, medics make half of what a starting nurse makes in this area. Half. They each have specialized training for their area. From my experience medics are more prepared to deal with unstructured situations out-of-hospital. Medics have standing orders/protocols that make it easier for them to deal with a wide range of issues without having to contact a doctor (medics and intubate (tube down throat) a patient where 99% of nurses can't.) There is also the legal issue that outside a hospital, a nurse is only able to deliver first aid until EMS arrives. They may be knowledgeable and skillful, but the laws reflect that nurses are for hospitals and clinics (near doctors) and EMT/Paramedics for out-of-hospital.
Now, I know some arguments from nurses tend to say EMT/Paramedics are just for advanced first aid and are not their equal. Well, EMS professionals do like to talk about their latest trauma run, but medical (non-trauma) are overwhelmingly more common. Paramedics do a lot of sick-person care. Now, an average run for me could take an hour and a nurse in the hospital could be with that same patient for days. But, I know the ER nurse will pass this patient off as quickly as he can. Also, how long do you think a nurse in a doctor’s office or convenient-care office would be with this patient? In those cases it would be almost zero. Those tend to be the ranges of patient care I see from nurses...zero to hours to days of intensive care. So, why is a medic making half the pay of the nurse who gets your vital signs and leads you to a room in the doctor's office?
Well, I am ranting. Maybe it is the cold medicine talking. I'm curious to see if anyone comments about this one. I'd like to see if anyone with no EMS or Nursing experience would have something to say. Perspectives from the outside are sometimes helpful. So, if you are a random reader and actually have made it though this whole posting; please let me know what you think.
***
Go to www.salary.com if you want to find your own numbers. Also note that education *could* be different for a nurse and a medic, but they are not always. Some medics have Associates degrees and some have Bachelors. Same for nurses (Associates or Bachelors).
***
Does this all come down to supply and demand? The demand for nurses is high right now. But since the demand has pushed the pay up, it has increased the size of some nurses egos. Thoughts?
posted by MidwestMedic at 16:10
2 Comments:
This is a tough issue, but I think it does come down to a perverted supply and demand.
I have a Ph.D. from Johns Hopkins University and four years of post-doc training at the National Institutes of Health. I likely make 1/3 to 1/8 of what others make with J.D.'s or M.D.'s and similar levels of training. My job is very different than theirs (I have a lot of autonomy and part of my job is to think original thoughts and write them down for other dweebs to read), and there are a LOT of people who want my job, and in the final analysis not many jobs available (and certainly few good ones). Universities can pay someone like me well and "only" cough up $75k a year (believe me, most of my peers make less, I know it, and I am thankful).
My experiences with EMS (I volunteer as a medic and did my ride time with a paid agency in an area with 10's of k of people) is that there are a LOT of EMS workers in smaller areas with no B.A. or B.S., and some with "only" high school, who can train to be an EMT or higher in a year or less. For of a lot of these people, they see EMS as a noble profession vs selling cars, managing a store or working middle management. I think they are correct. However, there are enough of them that the agencies can pick and choose, and replace them every five years when people start to get cranky about pay, hours, and benefits. Part of the reason they can do this is that the public has NO F’n idea what kind of pre-hospital care they get relative to what they COULD get, if everyone who runs an ALS call has the equivalent of a P.A. in emergency medicine. People don’t know, and they certainly don’t want to pay for it until it is too late to make a difference (that is, for the 20 years before their crushing chest pain, they don’t want the higher taxes or insurance payments to have quick, definitive care, and the day they want it, it is too late to pay for it).
Sorry for the long comment. You brought up a point that interests me…
DJ
Wow, an amazingly good comment. Thank you very much DJ. Please come back again sometime.
I really do lean towards the supply-demand answer. I was more rant than logic when I wrote this blog. But, I would definitely support medics becoming more of a Bachelor of Science degree than and Associates. True, it would cut the applicant pool down quite a bit and we might loose the chance to get some amazing people. But, this is what it is going to take to start moving this career up in stature.
Yes, people do not want to pay for anything that does not have instant gratification. But, private EMS systems do want to either, even when they are having hard times getting medics (like where I live). But, I believe supply and demand will eventually kick in and move some of that up. Heck, I'm seeing ever rising sign-on bonuses, now we need to get past that for something more long-term like better pay.
Again, thanks for the great reply.
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