In preparation for my quest for the disco patch, I started looking at reciprocity requirements throughout the country and I came to one conclusion: being a paramedic and trying to move is very frustrating. For the life of me though I cannot figure out why this is.
When I went through paramedic school so many years ago, we had a mix of people in my class: there were two of us from New Jersey, many from Massachusetts, one of New Hampshire, and a few from Connecticut. We went through our Massachusetts approved paramedic class, but not all of us tested in Massachusetts. A few of my classmates decided to go directly down to Connecticut and test there, as they had no intention of working in an EMS system in the great Commonwealth.
Here is how it went: the classmate that I sat right next to who got the same training as I did, took the same tests, did the same amount of field and clinical time drove across a boarder that was less than twenty miles to the south a took a test that was not identical to mine but similar. Both of us passed. She worked for a service south of that boarder, and I worked for one to the north of it. Despite the fact that our training was identical, in order for us to work in each other’s states we each would have more hoops to jump through to again prove our worth as a paramedic.
Now, expand that out to a more national scale. Some states accept certifications from other states as being just as good as certs from their own. Others only accept National Registry. Still others feel that National Registry is not even good enough and they require you to come in and take their state’s test. Still another state on the west coast requires National Registry, a state certification, and then clearance within the specific county you choose to work in if you want to care for their sick and injured.
Then there are Oregon and Texas. Add on to that a minimum of an Associate’s Degree. While I feel that these two states are right on point and just may be the only two that are actually getting it right, the gross disparities from state to state create quite a hardship for any paramedic that wants to go someplace else.
It is time for us to get out of our respective sandboxes and head for the beach. The sand there is just as easy to play with, and it is a lot easier to play with others. States, like those kids in the sandboxes, need to learn how to share their paramedics better with others. It is time to do away with the variety of different means of certifications and decide on one. This is the one thing that I hope the field EMS Bill (HR 3144 if you haven’t heard of it) will give us: standardization.
While the saying might always be true that “when you’ve seen one EMS system you’ve seen one EMS system” the same does not go for paramedics. Each and every one of us receives similar training. Not identical training but similar training. If states want to maintain their own standards that’s fine but they should be loose enough to allow in experienced providers from different systems.
It should not be such a challenge for me to gain experience and knowledge from different systems. Realistically, it should be a piece of cake, and until we realize that, we are going to continue to have paramedic shortages, and people who are unhappy in their current situations with no way out. Unhappiness feeds burnout. Burnout destroys quality patient care, and when that quality patient care goes away, our patients suffer, and outcomes suffer.