May 19-25, 2019, is the 45th annual National EMS Week. The National Association of EMTs and the American College of Emergency Physicians are working to ensure that the important contributions of EMS practitioners in safeguarding the health, safety, and well being of their communities are fully celebrated and recognized. Last year I asked will you be EMS Stronger in 2019. Let’s look back at a landmark year in EMS:
The American Ambulance Association issued the results of a member survey on caregiver turnover. The respondents were third-service, commercial and not-for-profit. The “weighted” overall annual turnover rate for caregivers in this study showed:
- 31% Part-Time EMT
- 28% Part-Time Paramedic
- 24% Full-Time EMT
- 17% Full-Time Paramedic
The results filled in some questions raised by the first ever state-wide report on EMS wages, working conditions and industry profile in California.
We started to develop a fatigue management program that is based on the research completed by Dr. Daniel Patterson’s group. There remains resistance in moving away from a 24-hour or 48-hour work shift. A colleague shared this information about the independent contractors that are drivers:
To keep the Lyft community safe, you must take a full, uninterrupted 6-hour break for every 14 hours you’re in driver mode. These 14 hours in driver mode do not have to be consecutive.
Uber is requiring drivers to take a six-hour break after 12 hours of accumulated service. The company plans to use location tracking to determine the amount of time drivers have been working, and will disable the app after they hit their limit.
There are two Department of Transportation mandated regulations concerning working hours. One is 60 hours worked in 7 days, the other 70 hours worked in 8 days. All UPS drivers fall under one of these two requirements. The actual scheduled work for an individual driver depends on local delivery volume.
Physician EMS Subspecialty Growth
It took 18 years and the retirement of some foes, but our emergency medicine colleagues are recognized as EMS specialists by the American Board of Medical Specialists. There are about 70 physicians enrolled in EMS fellowship roles this year. It is the largest and fastest growing ABEM credential, with 625 certified EMS physicians as of March 2019. (Perina 2019)
Fire Service Opposition to Associate Degree Requirement for Paramedics
Three ems professional associations issued a position paper published in Prehospital Emergency Care advocating that, by 2031, paramedic candidates sitting for the National Registry exam have an associate degree. The national fire service organizations are united in their opposition to this requirement.
… the culmination of a collaborative and inclusive two-year effort to create a bold plan for the next several decades. Building on the foundation established by the landmark 1996 EMS Agenda for the Future, EMS Agenda 2050 lays out a vision for EMS systems that serve the needs of patients, families, clinicians, and communities.”
American Paramedic Association “manifesto”
A new practitioner-focused association issued its “Paramedic Manifesto” to professionalize paramedic practice through autonomy and self-regulation.
2018 National EMS Scope of Practice Model
Defined parameters of various duties or services that may be provided by an individual with specific credentials. Whether regulated by rule, statute, or court decision, it represents the limits of services an individual may legally perform.
The Scope of Practice Model has been utilized by the states as a means to increase regulatory uniformity in emergency medical services (EMS) for over a decade. Core to this document and the practice of every licensed health professional is compliance with four domains intended to serve the legal and ethical obligation of States to ensure the public is protected from unqualified individuals.
What will you do to be EMS Stronger in 2020?
Will you do something that improves your physical, mental, professional, financial or spiritual condition to become EMS Stronger in the next 12 months? Only you can make a difference, not your EMS agency, the federal government, local authorities, some guy on the internet or your boss.
Walking My Talk
I have started a four-year adventure that will provide new skills and experiences so that I can make a different impact on EMS. This means that I am cramming to understand higher-level mathematics, statistics, and economics this summer. No gain without pain.
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Perina, Debra (2019 March 1) “EMS is Our Specialty: How We Got Recognized in the House of Medicine” EMS State of The Science 2019: A Gathering of Eagles XII. Dallas, Texas.