Paramedic Professionals Essay

Although paramedics work alongside other emergency services and health care providers, they are not classified as health care professionals, therefore, working independently from these organisations and autonomously within their own state ambulance organisations. Through exploring the evolution of paramedic practice and their role as a health care provider, the current status of paramedics as a semi profession is explained along with what further development is needed before they become a recognised profession. In understanding how paramedics work autonomously within their own state based organisations, the concept of scope of practice and evidence based practice is explored. Finally by discussing how paramedics are independent, we establish paramedics’ role and position within the Australian Health Care System. A paramedic is a health care professional At present in Australia, paramedics are not classified as registered health care professionals. (Smith 2012) Instead, paramedics are widely regarded as semi-professionals with the potential to become a fully recognised profession in the near future. The definition of profession and the guidelines to become a recognised profession are not black and white. Professions Australia defined a profession as ‘a disciplined group of individuals who adhere to ethical standards and who possess special knowledge and skills in a widely recognised body of learning derived from research, education and training at a high level. ’ (Allied Health Professions Australia 2008: 8) Whilst Wilinsky (1964) describes 4 key elements that are essential for the process of professionalization. These include; the implementation of a unified code of ethics and regulations, attaining professional licencing, registration and accreditation, the establishment of university study and education and the development of full-time occupation and formation of occupational territory. Over the past 20 years the roles of paramedics have changed rapidly, with changes still occurring at the present. Paramedics have transitioned from ‘stretcher bearers’ knew as ambulance officers, to todays’ paramedics who are full time workers and are able to administer extensive pre hospital care. Along with the changes to the nature of the paramedics’ job, there has also been a significant change in the way paramedics are trained. ‘Training for paramedics has transitioned from on the job training provided by State and Territory Ambulance Services to vocational qualifications and more recently, higher education (University) sector qualifications. ’(Williams, Brown, Onsman 2012: 6) These changes to higher education training and full time employment, has allowed for paramedics to move one step closer in becoming a recognised profession. A review of common professional traits suggests two main areas where the discipline falls short and it is that paramedics do not have ‘national registration and regulation resulting in professional self-control and accreditation’ and they do not nationwide qualifications that link from tertiary education to the paramedic services (Williams, Brown, Osman 2012: 1) Firstly, registration in the context of health care professionals, is the process of licensing and registering clinicians to practice at a uniform national standard of care. Productivity Commission 2005 in Williams, Brown, Osman 2012: 7) Registration allows for consistency in education and training nationwide, and ensures paramedics work within the provisions of their scope of practice. (Council of Ambulance Authorities 2008) Secondly, there are no national university standard degree competencies or a national curriculum in relation to paramedic training. This leads to an inconsistency between the curricula taugh t to paramedic students. This is further aggravated by ambulance services as they work independently from the Australian Health care System and of the universities as well. Williams, Brown, Osman 2012) In conclusion, without the implementation of nationwide registration, licensing and education qualifications, paramedics will continue to be recognized as a semi-profession. Operating autonomously Paramedics are allied health care providers who are operating autonomously at a state level within their own ambulance services. The United States National Library of Medicine defines autonomy as the ‘decisions and the freedom to act in accordance with one’s professional knowledge base. (Nurs 2010: 1) In the paramedic profession this knowledge base is known as a scope of practice. Within each state based paramedic organisation, there is legislation and guidelines that outline the scope of which a certain qualified paramedic can work in. Scope of practice refers to ‘the ext ent to which providers may render Health care services and the extent they may do so independently and the type of diseases, ailments, and injuries a health care provider may address and what procedures and medication they can provide. ’ (Prats ;amp; Katz 2012: 13) For example, in Queensland, whilst out on road paramedics have the freedom to make their own decisions and judgments based on their knowledge, as long as it is legal in the legislation of the Queensland Ambulance Service Ambulance Service Act 1991 (Qld) and within the scope of practice of the paramedics qualifications. (Queensland Consolidated Acts 2010) As paramedics gain further knowledge and undergo more training, the scope of practice of this paramedic will increase. The larger the scope of practice, the more autonomously the paramedic is able to operate. Currently in Queensland there has been an increased awareness of poorer patient outcomes and difficulties in accessing medical help in rural and remote areas. (Horizon 2007 in O’Meara 2011) In an attempt to increase positive patient outcomes, expanded scope roles have been introduced into the Australian Health Care System, allowing certain paramedics to apply skills and protocols for which they were not originally trained. (Sterling, Pedler, Walker 2007) This increases the paramedics’ autonomy within their field which allows them to work for better patient outcomes. Paramedics are also highly autonomous as they frequently use evidence based practice as a means of new research and technique. In the pre hospital care environment, ‘rather than making decisions about practice actions based on routine and traditionally taught methods, paramedics use evidence identified from well-constructed studies as a basis for the clinical decisions and behaviours. ’ (Curtis ;amp; Ramsden 2011: 111) Evidence based practice occurs through ‘integrating individual clinical expertise with the best available external clinical evidence from systematic research. (Sackett ;amp; Rosenberg 1996: 1) This can only occur when an individual is given autonomy within their field of work. In conclusion, as paramedics have the freedom to make decisions within their scope of practice and can utilise evidence based practice, paramedics are autonomous within a state level. Operating independently within The Australian Health Care System Although paramedics work alon g-side the Australian Health Care System, paramedics are independent of this system. The Houghton Mifflin Company 2011 defines independent as being ‘not governed by a foreign power; self-governing. Paramedics are governed by their own state based organisations and are separate and independent of the hospitals and the Australian Health Care System. When dealing with any misconduct or inquiries, unlike nurses and doctors whose governing power is the Australian Health Care System, paramedics approach their own state based organisation. In conclusion, even though the paramedics work in conjunction with other health care providers both in and out of the hospital setting, paramedics governance is independent of other health care services and the Australian Health Care System. Willis, McCarthy, Lazarsfeld-Jensen and O’Meara 2009) Conclusion: In conclusion paramedics are autonomous and independent health care providers who work along-side the Australian Health Care system. Alth ough paramedics work alongside other emergency services and health care providers in both the in and out of hospital care environment, they are not classified as health care professionals. But with the implementation of nationwide curricula and ethical standards, paramedics can move from a semi profession to fully recognised profession. Paramedics have the freedom to make decisions within their scope of practice and can utilise evidence based practice, making paramedics autonomous within a state level. Through the broadening of paramedics’ scope of practice in certain environment such as rural areas and through the use of evidence based practice we see efforts to increase positive patient outcomes. Finally, paramedics are independent from the Australian Health Care System as they are self-governed by their own state based organisations.