Texas politics are a mess. Although the state has an economy bigger than that of many countries, the legislature meets only every two years. And, believe it or not, the Texas constitution is so poorly written that it has been amended 432 times. Those of us in Texas EMS had little hope of ever getting EMS on the legislative radar screen. But in 2004, Firefighter/Paramedic Armando Mando Martinez (Weslaco) was elected to the Texas House. That was a good thing. One of the first bills introduced by Rep. Martinez was HB 992, which directed all Associate Degree nursing programs in the state to guarantee admission of licensed paramedics with priority over other applicants into their nursing programs.
As you might expect, the nursing lobby began having Prinzmetal Angina over this proposal. EMS personnel were excited. Initially, it seemed like a good thing. But as I thought about it, it was actually one of the worst things that could happen to EMS. Allow me to elaborate.
EMS, for many decades now, has struggled to be recognized as a bona fide health-care profession. Educational and performance standards have been greatly enhanced. Degree programs, both undergraduate and graduate, are now available in EMS. It appears that EMS is on the verge of the recognition it has so long desired. But we re sending mixed messages to EMS providers by offering admission to nursing programs. We are thus taking our best and brightest and sending them out of the profession to nursing school. I must say this is not just a Texas phenomenon. Many states have scholarship programs that promote the transition from paramedic to nursing. Even JEMS, on whose Web site I am writing this diatribe, offers a $5,000 scholarship each year to prehospital personnel who want to go on to nursing school. Again, these scholarships are directed at our best and brightest.
I can't fault anyone for leaving EMS for better pay. In the early 1980s, I decided to go to medical school because I didn't see a stable financial future for my family in EMS. But why can t we take these scholarships and encourage students to pursue educational opportunities in EMS and not nursing? There s a need for EMS managers with Master s of Business Administration degrees, educators with Master s and Doctoral degrees, and researchers with Master s and Doctoral degrees. Let s not send our best and brightest to nursing. Let s keep them in the profession. In some ways, I wish the United States were like Australia, where, in certain states, there s a waiting list for nurses who want to join the ambulance service because it has better pay and benefits.
EMS is at a critical juncture. As our educational standards are improving, so will the pay (although this concept is being harmed by selected EMS programs who crank out unlimited numbers of paramedics with minimal training hours and by EMS operations whose only job requirement for paramedics is that they have both a patch and a pulse).
Thus, I ask you to implore the powers that be to redirect these scholarships to EMS education and not nursing or medical education. Let s keep our best and brightest in the profession. We need them.
For information on Texas HB 992, click here.
Editor s note: In addition to several other educational programs and joint sponsorships, JEMS offers a nursing program scholarship in an effort to foster a culture of continued education. By this endorsement, JEMS is not promoting an advancement out of the discipline but rather an enhancement of its providers. It is our hope that talented EMS professionals seek to challenge their minds and skills with further training in order to grow as emergency health-care providers for the benefit of their patients.