SA Firefighter

Thanks everyone for the replies...and I appreciate being in the company of other EMS professionals. Even with just a few replies, the vibe is similar to other on-line forums and on the road. Here's my opinion...in NSW the additional skills and drugs are all smoke and mirrors. Anyone can suture or give nerve blocks. ECPs are there to make clinical risk decisions. That's why it takes 50 weeks to qualify as an ECP. And that's why we target sub-acute cases. I'm also an ICP and find the big trauma jobs easier to do because generally they're pretty straight forward. But an adult presenting with mild vertigo? What are the differentials there? What specifically do I look for? What neuro tests should I do? Antiemetic and discharge for GP follow-up? As an ICP, the system is not set up to discharge the patient from care (although the patient may refuse/decline transport). And so generally the option is tranport and the clinical risk is managed by presentation to the ED.

Don't get me wrong. I'm not slagging ICP's. Just highlighting that there are different degrees of clinical risk that an ICP and ECP manage. Besides, I think an ECP has little advantage over an ICP for what the ICP specialises in anyway - acute care.

So what does it all mean? To be honest, I dunno. I joined the job to be an ICP. If we did all ECP work, well then yes, maybe they should hire community nurses to do the job. I'm not a nurse and don't want to be a nurse and I'm not going to give up my ICP status to be an ECP. But if they keep a blended role where I have additional options to manage a patient and where we can successfully demonstrate a model whereby paramedics can operate as truely autonomous clinicians, then I think everyone wins.

Cheers.