I've spent some time today reading over at The Social Medic's blog, specifically, his post On Why Basics Matter More Than You Think.
He talks about how nearly 2/3 of EMS Professionals are EMT-Bs, and thinks there needs to be a change to a system that supports those people and their position better.
I think there are two separate situations going on.
Many places, there are people who start out as an EMT-B, with a goal of moving onwards and upwards. They know from the start that they plan to take the medic class. Also, in many places (perhaps the same ones, but not necessarily) there are people who value paramedics, and see anything less than that as some sort of lower life form, or at least, less status.
In that situation, being a Basic is perhaps not a typical goal, or a pleasant place to be. It's hard to do your best work when the people around you don't value what you do.
A different situation is where there are people who DON'T plan to move above the Basic level. A lot of paid fire departments require their firefighters to be Basics, but only provide BLS, so there's no reason for any of them to go to a higher level unless they're going to be working two jobs (which some do). A lot of volunteer fire departments also only provide BLS, so there is no reason for their members to go to a higher level, if they plan to stay a volunteer.
I guess that's a long winded way of saying that I don't think every Basic plans to move on. In some places there is a lot of support for, and sometimes, pressure to, take more classes and become a medic, but not everywhere, by any means.
Another thing Dave mentions on his blog is about conferences focusing on ALS topics.
I have a few thoughts about that, but haven't been to enough conferences to really see how common that is or isn't.
I think in order for conferences to have better BLS offerings, there needs to be more people out there excited about teaching BLS topics. That is a possible direction for people to go in, who don't plan to certify beyond Basic- good, solid, BLS education. It would be a great direction to encourage people in who have the interest and aptitude for teaching. A lot of the classes and conference sessions I've been to have been taught by medics, even if they are BLS topics, but two of the best teachers I've had overall were my original Basic instructors- both of whom were Basics themselves.
Another thing to consider is that there is a lot of information out there. Some of it may be ALS, as far as being about things Basics can't do in the field, but I think much of that is interesting and useful to know. The more I understand about what the medics are looking for and what they need to do, the better I can support that effort, and the better overall care my patient will get. I think the Intermediate class made me a much better Basic, really.
There is something I'd change if I were in charge, though.
My observations of conferences and training events so far suggest that most people who are out getting training on their own time are happier to take classes that don't have tests or practical, hands on, requirements. I don't know how much of that is that many of them don't really want to be training at all, but are required to, and how much is related to test anxiety, but either way, some things need to change. I'd like to see people more excited about actual hands on training, and in order for that to happen, there needs to be excellent teachers, and encouragement for people to move out of the "as little as possible" mindset.
I'm not so sure I agree that EMS needs to go "back to basics," as much as I think people should be encouraged to wring the most out of it that they can in the first place. That original Basic class covers so much, and so little, at the same time. I'd love to see more people encouraged and excited about really learning that material, rather than doing "just enough." I think there would be more people teaching great BLS conference sessions if there was more demand for great BLS topics, and there would be more demand if more people were encouraged to go learn all they can, and supported in doing so. If that's "back to basics," then yeah, let's do that.
This post is a little disjointed. Sorry about that. I'm typing it in the middle of a birthday celebration, with my kids yacking at me. Time for cake!