Paramedicine

Paramedicine Academic Coordinator

Amy Marshall
(308) 398-7479
amarshall@cccneb.edu

Paramedicine Program Director

Russell Blackburn
(308) 398-7479
russellblackburn@cccneb.edu

Associate Dean of Instruction – Health Sciences

Sarah Kort (402) 460 – 2194
sarahkort@cccneb.edu

Dean of Instruction – Health Sciences

Paulette Woods-Ramsey
(402) 461-2463
paulettewoodsramsey@cccneb.edu

Paramedicine Program Medical Director

Dr. Mike McGahan

Requirements

All students must meet the minimum requirements to enter the program:

• College Application
• High School, Home School or GED Transcript
• Official College Transcripts (If applicable)
• ACT, COMPASS, of ASSET test scores
• Current healthcare provider CPR certification
• Current EMT license
• Proof of current vaccinations
• Approved background check

The student is also required to have an interview with the program director before the student will be approved for admission to the program.

Accreditation

Our Paramedicine program is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) on the recommendation of the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP)

To contact CAAHEP:

Commission on Accreditation of Allied Health Education Programs 
1361 Park Street  
Clearwater, FL 33756  
727-210-2350  
www.caahep.org

To contact CoAEMSP:

8301 Lakeview Parkway, Suite 111-312 
Rowlett, TX 75088  
214-703-8445 
FAX: 214-703-8992 
www.coaemsp.org

NREMT Pass Rate for 2014 is 86 percent
Positive Placement is 100 percent
2014 Cohort Attrition is 0 percent

After a review of the Functional Job Analysis for the Paramedic Profession, specific technical standards have been identified as critical to the success of students in the Paramedicine Program. By defining these standards students are made aware of the technical requirements all enrolled students will be expected to accomplish and are required for successful completion of the Paramedicine Program. By establishing these technical performance expectations this will enable students to provide safe and professional practice with or without reasonable accommodations. These standards were not designed to be exclusionary. All students of the Paramedicine Program will be required to read, discuss and agree to these established technical standards. Students will also be required to sign a document attesting that they have read, understand, are able to comply with and are physically able to meet these established technical standards and agree to comply with these requirements. The Paramedicine Program is prepared to provide reasonable accommodations to accepted students who have documented disabilities. Students with disabilities who wish to request accommodations under the Americans with Disabilities Act must follow the College's procedures.

Due to the specific physical requirements of the tasks required in the prehospital emergency environment, students will be expected to perform all psychomotor skills as indicated by industry standards.

Although accommodations may be considered on a very limited basis, each situation will be considered on a case by case basis. There are specific accommodations that are not permitted because of compliance requirements of the essential job functions of a Paramedic as outlined in the job function description.

The Functional Job Analysis outlines and describes exactly what the job functions of the Paramedic are and all students must be certain that they possess the ability to perform these job functions as described. Some of these required tasks or abilities are:

• Must be able to lift, carry and balance up to 125 pounds individually or 250 pounds (with assistance) from a wheelchair or stretcher, to and from beds, treatment tables, chairs, etc.
• Possess fine and gross motor function necessary to perform patient care activities with the ability to frequently reach, lift, and use manual dexterity in the manipulation and operation of equipment, accessories, as well as for the use/creation of immobilization devices.*
• Ability to lift all devices (up to 50 pounds).
• Ability to interpret written, oral, and diagnostic instruction.
• Ability to use good judgment, remain calm in high-stress situations, and remain focused.
• Ability to work effectively in an environment with loud noises and flashing lights.
• Ability to function efficiently throughout an entire work shift, sometimes for up to 24 hours without jeopardizing the health and safety of patients, self or co-workers.
• Ability to calculate weight and volume ratios and read small print, both under life threatening time constraints.
• Ability to read and understand English language manuals and road maps.
• Ability to accurately discern street signs and address numbers.
• Ability to verbally interview patients, family members and bystanders.
• Ability to document, in writing, all relevant information in prescribed format in light of legal ramifications of such.
• Ability to communicate clearly (verbal, written, nonverbal, and technically), with all members of the health care team and patients.
• Ability to converse in English with coworkers and hospital staff as to status of patient.
• Ability to bend, stoop, and crawl on uneven terrain.
• Ability to withstand various environmental conditions such as extreme heat, cold, and moisture is vital.
• Ability to work in low light, confined spaces and other dangerous environments.
• Ability to perform all required tasks to the highest quality patient care.
• Possess good manual dexterity.
• Ability to communicate verbally via telephone and radio equipment.
• Possess sufficient visual and aural acuity to observe lectures, demonstrations and clinical situations in the practice of health care professions. This is necessary to report visual observations of patients and equipment operations as well as to read patient's medical records and medical information. Aural acuity must be adequate enough to hear the patient during all phases of care as well as to perceive and interpret equipment signals. Tactile and somatic senses must be intact to provide appropriate responses and intervention.
• Possess the emotional health required for full use of the intellectual abilities, demonstration of good judgment, prompt and safe completion of all responsibilities, and development of mature and effective relationships with faculty, classmates, preceptors, and patients. Must be able to work cooperatively with others, adapt to rapidly changing environments, think clearly and tolerate physically and mentally challenging workloads under stressful situations. Additionally, students must demonstrate moral reasoning and ethical behaviors.
• Have sufficient problem-solving skills to include measuring, calculating, reasoning, analyzing, evaluating, and synthesizing with the ability to perform these skills in a timely fashion. Periodic examinations, both written and practical, are an essential component of the health sciences curriculum. In order to progress through the curriculum, students must successfully fulfill examination requirements. (Documented by meeting program admission status).

NOTE: Male and female students will be expected to lift and carry patients of various sizes on a stretcher, stair chair, backboard, or other lifting devices and by emergency carries. Each student's must carry his or her share of the load. There are no exceptions to this requirement.

Specific functional/technical standards are hereby established and are required guidelines for all students registered in the Paramedicine Program at Central Community College. All students are expected to satisfy all standards in order to participate within the program and to qualify for participation in industry professional standards and practice.

Occasionally situations may occur that are not specifically addressed within established policies and procedures. Best judgments, practices, and professional ethics should guide students and faculty.

The public safety profession requires a high level of moral and ethical behavior. It also demands a superior demonstration of professional behavior at all times. Students wishing to participate in pre-hospital emergency care educational programs and eventually work in the profession must understand that they become an integral part of an elite profession upon enrolling in the EMT/AEMT/Paramedicine Programs. All students are expected to demonstrate the pride, integrity and wholesomeness demanded by the profession at all times. Students found to demonstrate attitudes and/or behaviors that are not in compliance with this standard of behavior or to be in violation of established policies and procedures, whether written or not written will be removed from the program. All professional standards will be established by the program faculty.

The Functional Job Description, documented at the beginning of this section, outlines the required psychomotor skills and job functions of the emergency medical services profession. These skills and job functions are an absolute and essential component of the function of the EMS professional. By establishing these guidelines, students and faculty can understand the accommodations permitted for all Paramedic students.

The following specific issues pertain to students participating in the Paramedicine Program:

• Students cannot be discriminated against on the basis of a disability in the offering of educational programs or services.
• There can be no accommodation during screening, evaluation or course examinations that will compromise or fundamentally alter the evaluation of skills that are required to function safely and efficiently in the profession.
• Students who have received an accommodation during the course need to fully understand that there is a separate process for requesting an accommodation for the written certification exam and eligibility for an accommodation is determined on a case-bycase basis. In other words, just because a student was allowed an accommodation during the course does not guarantee an accommodation for the National Registry of Emergency Medical Technicians (NREMT) exam. Documentation confirming and describing the disability should be submitted according to policy for consideration.

Prompt and regular attendance is required in all courses. Students who miss more than 10% of the scheduled hours of individual paramedicine courses will be notified of their attendance status, and required to meet with the Program Director. Missing more than 20% of the scheduled hours will result in automatic failure of the course. Collectively, throughout the program, the student will be held accountable to the same attendance policy. If the student is absent for 10% of the scheduled hours of the entire program, the student will be notified of their attendance status, placed on program academic probation. If the student is absent for 20% of the scheduled hours of the entire program, the student will be fail the course. The course may be repeated at the next time it is offered.

Grading

All course work that is not evaluated on a pass/fail basis will use the following grading scale:

Grading Rational

Attendance is worth 25% of overall grade. You must have a minimum of 80% attendance.

Daily assignments are worth 10% of final grade.

• Quizzes, homework, lab time, other assignments.

Unit Tests are worth 20% of overall grade.

Final Comprehensive test and skills test are worth 45% of overall grade. No retest is offered.

All courses must have a minimum of a C- 77% or higher to continue on in the program.

Skill Stations

All skills will be tested several times throughout each semester and graded on a pass/fail only. It is required that all skills are passed. If a student fails a skill attached to a course, the student will fail the course. If a student fails the final skills testing or Mock National Registry Skills Test, the student will not qualify to sit for National Registry Testing.

Clinical Courses

Grades for clinical courses will be obtained from:

Students are required to input the data from their clinical shift within 48 hours, if the student inputs their data after 48 hours, they will penalized and receive the following scores:

Journal entries, Discussion Boards, and Fisdap entries. The final grade of the clinical course will be the combined, collective, average of these. 

1. The student must demonstrate the appropriate conduct that includes: integrity, honesty, confidentiality, accountability, punctuality, and adaptability. The student must also demonstrate appropriate manners and a positive attitude toward their patients, families, health professionals, staff, peers and instructors. Examples are: tactfulness, good listening, communication skills, initiative, cooperation, respectfulness, sympathy, empathy, self-confidence, courtesy, pleasantness and caring.
2. Students will achieve and maintain all pre-clinical requirements including: form, current Basic Life Support - Health Care Provider certification, and annual TB skin testing in order to participate in clinical instruction. If TB skin testing is contraindicated, a note from the primary health care provider must be placed in the student’s file. Failure to maintain these requirements will result in the student being unable to receive instruction in the clinical area.
3. In compliance with federal Health Insurance Portability and Accountability Act (HIPAA) rules and regulations, all students receiving education, training or clinical experience and faculty members supervising such individuals, who have access to or use protected health information shall:
   • Participate in training covering HIPAA Compliance Plan.
   • Be subject to the clinical facilities policies governing behavior, patient care and privacy.
   • Sign an individual agreement to be bound by the terms of such policies.
   • Maintain confidentiality when utilizing health care information and be subject to sanction, including exclusion from the specific facility, for violation of such policies.
   • Be governed as members of clinical facility’s workforce for HIPAA purposes.
4. Stealing will be dealt with on an individual basis by the faculty and administration.

1. The student must be in a state of good health to participate in clinical learning activities. Illnesses and/or health problems (mental or physical) must be reported to the assigned instructor and proper interventions taken.
2. An ill student will not be allowed in the clinical setting and may be dismissed to his/her home or encouraged to seek medical attention at the discretion of an instructor or preceptor.
3. Medical verification of an illness may be requested by the paramedicine instructor prior to attending the clinical course if symptoms suggest illness. A statement of health status is required from the personal physician when more than three consecutive days are missed.
4. For safety purposes, when pregnancy is identified, a doctor's statement to continue in the paramedicine program activities must be on file.
5. The student will be provided information and be required to participate in periodic safety drills in the cooperating agencies and on campus.
6. Counseling is available through student services.
7. Worker's Compensation does not cover students enrolled in paramedicine courses. All costs related to illness or injury at the campus or clinical sites are the responsibility of the student.
8. Due to the nature of the business, situations may arise that could question the safety of the student. In these situations, it will be up to the clinical institution or the preceptor to allow the student access to the situation.
9. The student will not be allowed to use tobacco products during class or at clinical sites.
10. The will be responsible to remain current with their vaccinations throughout their attendance within the paramedicine program. If a student does not remain current with their vaccinations, they will not be able to attend clinical sessions.
11. For the safety of the students and the instructors, professional and sterile techniques will be utilized during every lab session, if a student becomes exposed or is subject to an accidental needle stick, then procedures of the paramedicine program will be followed. 

In 1996, FISDAP was created by educators working across institutional and geographic boundaries to solve common problems. They continue to foster nationwide collaboration, recognizing that the health care community is its own best resource.

FISDAP Skills Tracker

The FISDAP Skills Tracker is a web application that archives students' experiential learning, sparks critical thinking skills, reports students' achievement and growth, and aids program accreditation and self-study. Central Community College requires each student to log patient contacts and hours onto the Skills Tracker within 48 hours of completing their shift.

FISDAP Scheduler

FISDAP Scheduler helps view a centralized schedule. Scheduler is to be utilized for open lab and field practicum shifts.

FISDAP Testing

Use of secure testing to prepare Paramedic students for certification and their professional careers. FISDAP offers valid and reliable exit exams and unit exams. More than 97% of students who pass the FISDAP exit exam also pass the NREMT exam in one attempt.

Why can't we see which questions the students missed?

Rather than showing you the exact 200 questions from the exam, we provide students with a Learning Prescription. The Learning Prescription outlines in detail the recommended study areas, based on questions answered incorrectly. The Learning Prescription also breaks down what types of questions they missed: Knowledge, Application, and Problem Solving.

Educational experts advise that it is better for the students to focus on the topics they missed so that you can review the material with them and better target their studying. Otherwise, students have a tendency to want to memorize the correct answers to our questions—questions they won’t see again on the NREMT.

Skills Lab

Throughout the program, students will be required to prove efficiency and competence of the skills within the scope of practice of a paramedic as prescribed by the National Standards Curriculum and the State of Nebraska. Skill labs will be conducted within different controlled settings (ex. Open lab, scheduled practice night or a random mock ambulance call), per the discretion of the instructor and the paramedicine program.

Skill Progression

As the student progresses through the program, they will be required to successfully perform a specific number of skills to be complete the program. Skills will be tracked through the use of FISDAP Skills Portfolio and Skills Tracker. All skill attempts will be tracked; however, only those that are successful shall count toward the student’s required count. Students will not have the ability to perform skills during their clinical experience until they have been signed off by the instructor.

Skills Testing

Each individual lecture course could have skills tied to the theory portion of the course. The student will be evaluated through the use of prescribed skill sheets provided by the National Registry of EMT’s. Skill sets from both Basic Life Support (BLS) and Advanced Life Support (ALS) providers. The student is required to pass all skills evaluation at the end of each course, term and program. As stated within the Grading section, failure of the skills evaluation will result in a failing grade of the course. Failure of one of the end of term comprehensive skills evaluation will place the student on program academic probation. Failure of two of the end of term comprehensive skills evaluation, the student will be recommended for program dismissal. Failure of the comprehensive skills evaluation at the end of the program will render the student ineligible for National Registry testing. 

Practicum Policies

• Prior to the beginning of the clinical phase of the Paramedicine Program the applicant must have a current CPR, current licensure as EMT-B an EMT (at a minimum) immunization records, current TB skin test, and an approved background check on file.
• The Health Sciences Programs are designed to prepare graduates for licensure. A variety of clinical experiences are provided so that theory and practice are integrated under the guidance of the clinical instructor or clinical preceptor.
• Students will complete any orientation process that is required by the location in which the clinical time is scheduled.
• Students cannot perform any skills they have not been approved to perform by the instructor.

Practicum Attendance

• Attendance at the practicum location is required, if the student has scheduled.
• All students must report to their practicum assignment no less than 30 minutes prior to the start of their shift.
• If a student is absent or tardy, he/she must notify the clinical instructor no later than thirty (30) minutes before the beginning of an assigned shift. Failure to comply will result in an unexcused absence and jeopardize the student remaining in clinical and the program.
• Students with unexcused absences from clinical (failure to notify a lead instructor) may be placed on probation (first time) or dismissed from the program (second time). Prolonged illness or multiple absences may prevent attainment of course objectives resulting in an incomplete or failing grade in the course. The instructor of the clinical course will maintain a record of attendance.

Tardiness

Tardiness is not tolerated. In the event of tardiness, the student must call the charge nurse/shift supervisor of the assigned clinical area and the Instructor to inform them of the anticipated time of arrival.

• A student will be considered tardy if he/she does not arrive at the assigned clinical unit thirty (30) minutes prior to the start of the assigned shift.
• Two (2) tardy occurrences will be counted as one (1) unexcused absence.
• The student must remain in the assigned area for the entire shift except for approved breaks. Students may leave their assigned area for one 30-minute lunch/dinner break. One 15- minute break for each 4 hour period worked may be taken. Breaks and/or meals may not be taken at the end of the shift. The student must request permission from the charge nurse, preceptor, or instructor before leaving for break or meals.

Clinical Schedule / Notification Procedure:

Scheduling of clinical shifts is done through the instructor. Students may only participate in clinical experiences that have been scheduled by the instructor.

Student Code of Conduct:

The conduct of the student reflects upon the individual, clinical site, Central Community College, and the Paramedicine profession. Therefore, the student must conduct himself/herself in a professional, mature, manner at all times. Any student may be dismissed from the program for unacceptable behavior. Students will adhere to all policies in this manual and any additional Central Community College policies. Failure to comply with policies will result in disciplinary action and possible dismissal from the program. It is the student’s responsibility to be aware of all clinical requirements, college requirements, and the requirements for completion as stated in the syllabus. Students are responsible for understanding and observing the provisions of the Student Conduct Code.

Absolutely NO alcohol, drugs, or medications will be ingested by students 24 hours prior to or during a clinical assignment. The exceptions are prescription medications that are required to maintain health and/or manage chronic medical conditions, Advil or equivalent, and Tylenol or equivalent. Prescription narcotics or other medication (including over-thecounter) that has the potential to impair your judgment and/or your ability to function should not be taken 24 hours prior to clinical or during your clinical shift. Violation of the drug and alcohol provision will result in immediate expulsion from the clinical site and permanent dismissal from the Paramedicine Program.

Any improper/illegal conduct or unsafe act at the clinical site will result in automatic, permanent expulsion from the site and the Paramedicine Program. Should the student become injured, receive an accidental needle stick, or is exposed to any infectious disease during the clinical experience they MUST IMMEDIATELY CONTACT THE EMS INSTRUCTOR and complete the required documents. (See Student Safety Section)

Scope of Practice:

In the clinical setting, the student can perform any activity identified in the scope of practice of a Paramedic as defined by the National Standards Curriculum and the State of Nebraska.

All medications must be administered only under the direct supervision of a registered nurse, paramedic preceptor, physician or class instructor. The student is expected to be knowledgeable of all information concerning each medication prior to administration in the clinical setting.

WHEN THE STUDENT IS NOT PARTICIPATING IN A COURSERELATED CLINICAL EXPERIENCE, HE OR SHE IS BOUND BY THE SCOPE OF PRACTICE FOR THEIR EXISTING LEVEL OF CERTIFICATION.

ANY SKILLS YOU MAY POSSESS BEYOND THOSE OF A PARAMEDICINE STUDENT ARE PROHIBITED WHILE YOU ARE A PARAMEDIC CLINICAL STUDENT. VIOLATION OF THIS DIRECTIVE WILL RESULT IN IMMEDIATE AND PERMANENT EXPULSION FORM THE PARAMEDICINE PROGRAMS AT CENTRAL COMMUNITY COLLEGE.

STUDENTS WHO PRACTICE OUTSIDE THEIR SCOPE OF PRACTICE DURING NON-SCHOOL RELATED EXPERIENCES ARE IN VIOLATION OF THEIR EXISTING CERTIFICATIONS. THEY MAY BE DISCIPLINED OR DROPPED FROM THE PARAMEDICINE PROGRAM.

Supervision:

The student must be under constant supervision during the clinical phase of training. Physicians, registered nurses, and paramedic preceptors in each of the clinical areas will provide direct supervision.

Clinical instructors may also provide supervision during clinical visits. The clinical instructor and assigned preceptor are responsible for both teaching the student and observing their performance of procedures outlined in the objectives.

Clinical Agency Policies:

All Central Community College personnel and students are expected to abide by the rules and regulations of the clinical facilities utilized for clinical experiences. Clinical agencies utilized by the college are on a contractual basis. All contracts contain an agreement that college personnel and Health Sciences students will conform to the rules and regulation of the agencies. Central Community College personnel or students failing or refusing to abide by these policies will not be permitted to care for patients and may be dismissed under the provisions for noncompliance of rules and regulations of any of the affiliating agencies. Students who are dismissed from clinical experiences may jeopardize their ability to satisfactorily complete the course requirements, and will be dropped from the program.

*NOTE: The clinical sites reserve the right to deny access to their facilities for any reason. Denial of access to a clinical facility can include but are not limited to:

• willfully and knowingly violating the clinical facilities policies and procedures,
• willfully and knowingly violating Central Community College’s policies and procedures,
• violating any criminal or civil law,
• reporting to duty impaired by alcohol, medication, or illegal drugs,
• failure to acquire all of the required immunizations
• currently ill with any infectious disease that may place clients or staff at risk for exposure to a contagious disease.

Denial of access to any clinical facility for the above reasons may result in such consequences as unsuccessful completion for the Paramedicine Program, immediate and permanent expulsion from the program and the denial of the ability to sit for the National Registry of EMT's certification exam. Any student dismissed from the clinical setting, for administrative reasons, will receive a grade of "F" for the clinical course and will be dismissed from the program. There are no exceptions to this rule.

Length of Shifts

• Length of shifts will be determined by the facility.

Training Area

• The student is to remain in their assigned area unless given permission by their preceptor to leave the area.
• Students may assist in moving patients or follow them to their destination if approved by the preceptor.
• Students may not enter other patient care areas without permission.

Electronic Device Usage Guidelines

• No student is permitted to use a personal electronic device during the scheduled shift.
• If a student needs to make a personal call with the facilities phone, this has to be approved by the preceptor or shift supervisor.
• If a student is not following these policies the instructor and Program Director needs to be contacted.

Visitors

• Students are not allowed to have visitors during their clinical experience for any reason. If a student does have a visitor, please complete an Incident Report Form and return the form with the student’s evaluation form.

Meals and Breaks

• A preceptor may grant the student a meal or break when they feel it is appropriate. Students are allowed on 30 minute meal break for every 8 hour shift.
• Students are responsible for their own meals.
• Breaks are at the discretion of the preceptor.

Dress Code

• Students are required to maintain a professional appearance.
• Paramedic students will be issued a green polo shirt with the Central Community College logo. They will be required to wear this shirt and the CCC issued Paramedicine photo ID during the shift.
• All students are required to wear either dark pants or EMS pants, no jeans or shorts are allowed.
• The student will be required to wear clean rubber soled shoes or duty boots.
• Every Paramedic student will be issued a Central Community College Student name badge with picture. This badge must be turned in once they have completed their clinical times. If a student does not have a name badge, the facility must ask the student to leave and contact the college about this student’s conduct.
• Inappropriate jewelry needs to be removed before each shift. (ex., piercings, large ear rings, or dangling necklaces.) If host facility guidelines are more restrictive, then they will be followed
• Students should avoid wearing perfume, cologne, body spray or aftershave; these scents may become distracting to the patient.
• If the preceptor feels that the student is not dressed per these guidelines, please document this on the student’s evaluation form. The preceptor has the right to send the student home for this behavior.

Clinical Time with Employer

• Paramedic students will be allowed to schedule clinical time at their place of employment through their instructor. A student will be allowed to pursue patient contacts at their place of employment. Only 50% of hours may be counted towards the required time within the category that involves their area of employment (ex. ICU nurse can only count 50% of ICU time at their employer’s ICU). Patient contacts will not be limited within their place of employment.

As Paramedic students, you will be privy to personal information of the patients you are caring for. Since you will obtain this information, you are required to follow the laws set forth within the Health Insurance Portability and Accountability Act. Each facility and ambulance squad may have different requirements of the student before they are allowed to be active with patients.

What is HIPAA?

The Health Insurance Portability & Accountability Act of 1996 (HIPAA), Public Law was passed by Congress:

• To improve portability and continuity of health insurance coverage in the group and individual markets
• To combat waste, fraud, and abuse in health insurance and health care delivery
• To reduce costs and the administrative burdens of health care by improving efficiency and effectiveness of the health care system by standardizing the interchange of electronic data for specified administrative and financial transactions
• To ensure protecting the privacy of Americans’ personal health records by protecting the security and confidentiality of health care information

If at any time during your experience you are unsure of what qualifies under HIPAA, ask your preceptor or instructor. 

What is the National Registry of Emergency Medical Technicians?

The NREMT is a national non-profit corporation that provides a uniform process to assess the knowledge and skills required for competent practice by EMS professionals.

What is required from the student with NREMT?

To obtain a license to practice within the state of Nebraska the student is required to pass the NREMT cognitive and psychomotor exam. The psychomotor exam is held at many sites throughout the United States. There are exams held annually in Nebraska3 . The student may test at any location within the United States. The cognitive exam is proctored by Pearson Vue. The student must register for the exam through the NREMT website.

When can the student attempt to test?

The student has the ability to attempt the skills test after successful completion of the classroom courses.

When the student has successfully completed all the classes in the program in its entirety, the ability to attempt the cognitive test.

The Nebraska Health and Human Services EMS web page will provide the information on locations and dates of exam.

National Registry of Emergency Medical Technicians
6610 Busch Blvd.
P.O. Box 29233
Columbus, Ohio 43229
Phone: (614) 888-4484
Fax: (614) 888-8920
www.nremt.org

The NREMT Certification Eligibility, Discipline and Appeals Policy

Purpose of Certification/Registry

The National Registry of Emergency Medical Technicians (NREMT) is the National EMS Certification as outlined in the National EMS Education Agenda for the Future: A Systems Approach. National EMS Certification is utilized in the EMS licensure process in the United States. The NREMT conducts its activities in accordance with its mission to certify and register Emergency Medical Services (“EMS”) Professionals throughout their careers by a valid and uniform process which assesses the knowledge and skills for competent practice and by maintaining a database of registrants. Registry policies are established to assure the public, EMS licensing or authorizing agencies, employers and other healthcare providers that certified EMS professionals have demonstrated the required knowledge and skills to practice safely and effectively.

The National Registry does not issue a license or authorization to practice, and does not warrant job performance of EMS professionals.

Role of the NREMT

In its role as the National EMS certification, the NREMT:

• Establishes eligibility requirements for applicants for certification
• Develops examination requirements (cognitive and psychomotor)
• Establishes re-certification requirements
• Reviews applicants’ self-disclosed criminal convictions and actions taken against their healthcare related professional licenses
• Monitors certification status of registrants and takes appropriate action against the certification when apprised of adverse licensure actions and criminal convictions
• Provides to licensing or authorizing agencies obtained adverse licensure action and criminal conviction information regarding registered EMS professionals The NREMT does not :
• establish, accredit or approve education programs for certification or recertification
• Assess job performance
• Assess fitness for all aspects of job performance (physical, mental, criminal background clearance)
• Investigate complaints regarding EMS practice
• Establish scopes of practice or standards of care
• Establish job-related standards of professional behavior

Eligibility for Certification or Recertification

1. To be eligible to apply for certification or recertification, an individual must at all times be eligible for or hold a full and unrestricted license to practice as an EMS professional under the laws of the licensing or authorizing agency of the jurisdiction(s) in which he practices. The NREMT may deny an individual eligibility for certification or recertification because of the limitation, suspension or revocation of any of the individual’s licenses to practice as an EMS Provider or other healthcare professional by any licensing or authorizing agency or the surrender of such a license while under investigation and/or in lieu of disciplinary action against his license.
2. An individual is not rendered ineligible for certification if the individual is denied licensure solely by reason of seeking licensure in a jurisdiction which does not recognize NREMT certification as a basis for licensure as an EMS professional.
3. An individual is not rendered ineligible because of entry into and successful participation in a non-disciplinary rehabilitation or diversionary program for chemical dependency authorized by the applicable licensing or authorizing agency.
4. An individual may not be rendered ineligible solely on the basis of a limitation, suspension, termination or surrender of a license in any jurisdiction where the applicant does not practice and/or where the action of such jurisdiction is based upon and derivative of a prior disciplinary action taken by another jurisdiction where the applicant has a full and unrestricted license in the jurisdiction in which he practices, and provided further that the jurisdiction, in granting such licensure, was aware of the applicant’s outstanding disciplinary actions in other jurisdiction(s).
5. An individual must comply with all initial certification and recertification requirements, deadlines, rules and standards of the NREMT as set out in the Entry Requirements and Application Process provisions for the applicable level of EMS professional posted on the NREMT’s website and described in the NREMT’s Requirements brochures. The individual bears the burden of demonstrating and maintaining compliance at all times. The NREMT considers the individual to be solely responsible for his certification.

• • An individual must truthfully complete and submit an application in the form provided by the NREMT and shall provide all additional information as requested.
  • An individual must submit a complete recertification application on or before the expiration date (post-marked) for consideration of recertification.
    • An individual convicted of a felony or any other crime directly related to public health or the provision of emergency medical service will be reviewed for eligibility for certification and recertification under policies outlined in the NREMT's Criminal Conviction Policy.
    • The NREMT reserves the right to withhold or revoke certification or recertification in the event an applicant fails to make payment in full of all applicable fees. An applicant may not take a NREMT examination if the application fee has been stopped, cancelled or otherwise revoked, either by the applicant or a financial institution. An applicant will not be issued an authorization to take a NREMT examination until payment of the application fee in full has been made for all previous NREMT examinations for which such fee is due. NREMT also reserves the right to hold, cancel or revoke an applicant’s results on a NREMT examination for which payment in full has not been made.
    • The NREMT also may require an applicant to retake a certification examination if presented with sufficient evidence that the security or integrity of the examination has been compromised, notwithstanding the absence of any evidence of an applicant’s personal involvement in the security compromise.

Review of Applications

1. The NREMT requires submission of accurate and valid information demonstrating an applicant's fulfillment of NREMT requirements for certification and recertification. The NREMT has developed a secure web site to facilitate communication between a variety of individuals who are responsible for providing the necessary documentation to be submitted by applicants and EMS professionals.
2. Individuals using the NREMT web site are subject to and must comply with the web site Terms of Use Policy.

Terms of Certification

In applying for certification or recertification, and as a condition for the maintenance of certification, an applicant or registrant agrees that:

1. The NREMT's examinations, certificates, cards, logos, emblems, the name "National Registry of Emergency Medical Technicians," the copyrighted phrase “The NREMT is the National EMS Certification” and abbreviations relating thereto are all exclusive property of the NREMT and are protected by trademarks and copyrights. They may not be used for any purpose, other than accurately identifying an individual as a NREMT registrant or referencing the NREMT and its examinations, without express written consent.
2. The individual will immediately relinquish and refrain from using any NREMT certificate, card, logo, emblem, and the NREMT's name and related abbreviations in case of expiration, suspension, limitation, revocation or voluntary surrender of the individual's certification or as otherwise requested by the NREMT.
3. If the individual misappropriates any NREMT property or refuses immediately to relinquish, refrain from using and correct at their expense any misuse or misleading use of any of the above identified NREMT intellectual property when requested, the NREMT shall be entitled to obtain injunctive relief, damages, costs and attorney's fees incurred in obtaining any such or other relief.
4. The individual will notify the NREMT within thirty (30) days of the occurrence of any and all of the following: any change in address, e-mail address, telephone number, state of employment and licensure and any other facts bearing on eligibility or certification, including, but not limited to, the initiation of any disciplinary action by any state which has resulted in the suspension, revocation or restriction placed on the individual’s license, or right to practice or voluntary surrender of state registration of license while under investigation (or in lieu of disciplinary action) and any felony conviction.
5. The individual authorizes the NREMT and its agents to communicate all information relating to NREMT application, certification and review thereof, including the misrepresentation of material information on an application or of NREMT certification status and/or the outcome of disciplinary proceedings, to state and federal authorities.

Examination Irregular Behavior

Applicants should understand that engagement in any of the following activities may be sufficient cause to bar them from future examinations, to terminate their participation in an ongoing examination, to withhold, invalidate or revoke their results on an examination, to declare them ineligible for certification, to revoke their certifications or to take other appropriate action:

1. The giving or receiving of aid in the examination as evidenced either by
   • observation or by statistical analysis of answers of one or more participants in the examination, including:
   • Any transfer of information or signals between examinees during the examination. This prohibition includes any transfer of information between an examinee and any other person at any time during the testing period, including bathroom breaks.
   • Any appearance of looking at the answers of another examinee during the examination.
   • Allowing another examinee to view one's answers or otherwise assisting another examinee in the examination.
   • Taking or seeking to take an examination for another candidate or causing another individual to take or attempt to take an examination on the candidate’s behalf.
2. The unauthorized possession or reference to, books, notes, or other study, test or preparation materials at any time at the testing site, including bathroom breaks. Prohibited material includes written or electronically stored information or information transferred by electronic, acoustical, or other means and devices, including cell phones.
3. The making of threats to or engaging in unprofessional or abusive actions toward NREMT staff or agents.
4. The offering of any benefit to any agent of the NREMT or the testing service and/or a testing site administrator in return for any aid or assistance in taking an examination.
5. Creating a disturbance at the testing site, engaging in profane or abusive language directed at examinees or testing site administrators, tampering with the computer or otherwise not following the directions of a testing site administrator.
6. The unauthorized possession, disclosure, reproduction, dissemination or use of any examination content or materials or the solicitation of same. All examination materials are the property of the NREMT.

Denial or Revocation of Certification and Disciplinary Actions

The NREMT may, in its sole discretion, deny an individual’s eligibility for initial certification or recertification, deny, suspend or revoke an individual's certification or take any other appropriate disciplinary action with respect to an individual’s application, certification and/or recertification or deny authorization to use the NREMT’s website for any and all purposes, including submitting applicant training information in thecase of:

1. Ineligibility for NREMT certification.
2. Failure to comply with any policy or rule of the NREMT, including, but not limited to, NREMT’s website Terms of Use Policy.
3. Irregular behavior in connection with any NREMT examination.
4. The intentional and material misrepresentation, withholding of any material information or the failure to provide NREMT updated information on any application for certification or recertification or in any other representation or communication to the NREMT.
5. The intentional misrepresentation by a trainer of any applicant’s satisfaction of the training requirements for certification.
6. Misrepresentation of the individual's status as a registrant of the NREMT.
7. The conviction of, plea of guilty or plea of nolo contendre to, a felony or any criminal offense which is directly related to public health or the provision of emergency medical service in accordance with the NREMT’s Criminal Conviction Policy.
8. Limitation, suspension, revocation or other disciplinary action by a licensing or authorizing agency relating to practice, or the ability to practice safely and effectively, as an EMS professional or the voluntary surrender of a licensee in connection with or in lieu of any such disciplinary action. The NREMT reserves the right summarily to suspend an individual’s certification, prior to the exhaustion of any right of appeal, upon the revocation or summary or emergency suspension of the individual’s license by a licensing or authorizing agency based on the agency’s finding that the individual poses an imminent threat to the public and/or cannot practice safely and effectively.
9. Copying, reproducing, disclosing, disseminating or removing of examination-related materials from the test site, attempting to do same or solicit the same.

Appeals

1. Notice of Disciplinary Action: When the NREMT makes an unfavorable ruling regarding an individual's application for certification or recertification, request for an accommodation in the administration of an examination, cancellation or revocation of examination results or any disciplinary action, including, but not limited to, the revocation or suspension of certification (collectively “Adverse Decision”), the Executive Director shall send to that individual, by certified mail, return receipt requested, a statement setting forth: a. The action taken. b. The reason(s) for the action and, if applicable, a statement of facts constituting the alleged violation of any of the NREMT's rules or standards or the reasons for ineligibility. c. The time period in which the individual may appeal and provide any additional information.
2. Appeal Process: An applicant or registrant who is subject to an Adverse Decision of the Executive Director, excluding decisions with respect to the timeliness of applications or the scoring or reporting of the examinations, may appeal such decision by mailing a notice of appeal to the office of the NREMT within forty-five (45) days of the date that such decision was mailed (based on postmark). The request for appeal must contain the individual’s statement of the basis of his appeal, as well as any documents in support of the appeal. Materials not included in the request shall not be considered on appeal unless expressly requested in writing by the NREMT.
• Upon receipt of a notice of appeal, the Credentials Committee of the NREMT shall consider any additional information submitted by the individual in support of his or her appeal and make such further investigation as it deems appropriate.
• If the Credentials Committee grants the appeal, it shall so notify the individual in writing from the Executive Director.
• In the event the Credentials Committee denies the appeal, the Executive Director shall so notify the affected individual and inform that individual that: (i) He shall have forty-five (45) days from the date such decision was mailed to him to appeal the decision and provide any supporting statement and/or documentation for the appeal; (ii) if an appeal is made, a hearing on the appeal shall be held before an Appeals Committee; and (iii) the individual may appear at the hearing in person and produce evidence on his behalf, including submission of his written supporting statement and/or documents. The individual may be represented by legal counsel.
3. Hearing Process.: In the event of an appeal, the Chairman of the Board of Directors shall designate an Appeals Committee consisting of three (3) members of the Board of Directors who are not on the Credentials Committee.
• The Hearing Panel shall convene at a site designated by the NREMT.
• The Executive Director shall send the individual by certified mail, return receipt requested, a Notice of Hearing. The Notice of Hearing shall include a statement of the time and place of the hearing. The individual making the appeal must confirm in writing his attendance at the hearing no later than seven (7) days before the date and time of the scheduled hearing.
• The Appeals Committee shall determine all matters relating to the hearing by majority vote. A written record shall be made of the proceedings, and shall be available to the individual at a reasonable cost following the hearing.
4. Evidence: Formal rules of evidence shall not apply. All information related to the allegations shall be admissible at the hearing, whether or not such information would be admissible in a court of law. The purpose of the hearing is to assemble as much information as practical regarding all material aspects of the situation, and the Appeals Committee shall be entitled to take into account any such information of the type normally relied upon by individuals of reasonable prudence in the conduct of important personal matters. Disputed questions shall be determined by majority vote of the Appeals Committee.
5. Decision: The decision of the Appeals Committee shall be made by a majority of the Committee and shall be rendered in writing following the hearing. The decision shall contain the basis for the determination to uphold, modify or overrule the decision of the Credentials Committee and for any sanction(s) applied. It shall be transmitted to the individual by certified mail, return receipt requested. The decision of the Appeals Committee shall be final and binding.
6. Release of Information: The appeals procedure authorizes the NREMT and its agents to communicate all information relating to NREMT application, registration and review thereof, including outcome of disciplinary proceedings, to state and federal authorities.
7. Certification Status Pending Appeal: A registrant’s designation as certified on NREMT’s rolls shall not be changed pending the opportunity for the registrant to appeal to the Credentials Committee a decision of the Executive Director to suspend or revoke his certification. Upon the denial by the Credentials Committee of an appeal of the Executive Director’s decision to suspend or revoke a registrant’s certification, the registrant’s certification shall be designated on the NREMT’s rolls as suspended. A registrant shall not be removed from NREMT’s rolls as a registrant until the exhaustion of all appeals or the expiration of the time in which to appeal a decision denying recertification or revoking certification.

Appealing Psychomotor (Practical skills) Examination

An examinee who believes that the psychomotor examination was administered in an inaccurate or unfair manner for any reason, including, but not limited to, an equipment malfunction, discrimination or bias of an examiner, must on the day of the examination immediately register a complaint and request for re-examination. The request shall be made to the NREMT Representative on the complaint form provided.

Upon a complaint being made, a Quality Assurance Committee, consisting of the Physician Medical Director, the Examination Coordinator, and the NREMT Representative shall be convened. When the NREMT Representative is also acting as the Examination Coordinator, a third uninvolved, unbiased person will be appointed to the Committee. The Committee may discuss the matter with the examinee and the involved skill station examiner(s), if necessary, and make such other investigation as they may deem appropriate. If a majority of the Committee determines that reasonable grounds exist for the examinee's complaint, the examinee shall be reexamined immediately by a different skill station examiner. The first examination will be disregarded and only the examinee’s performance on the re-examination shall be considered in determining his score on the examination.

The determination of the Quality Assurance Committee is final and binding upon the examinee. There shall be no further appeal from a failure on the practical examination.

Reconsideration of Eligibility and Reinstatement of Certification

An individual’s certification may be reinstated after revocation upon new application for certification only on the following basis:

1. The individual satisfies all eligibility requirements for certification in effect as of the request for reinstatement.
2. In the event of a felony conviction or conviction for a crime directly related to public health or the provision of emergency medical service, no earlier than one (1) year from the exhaustion of appeals, release from confinement or reinstatement of license, whichever is later.
3. In any other event, no earlier than one (1) year from the final decision of ineligibility for or revocation of certification.
4. In addition to other information required for application, an individual seeking reinstatement must fully set forth the circumstances of the decision denying eligibility or revoking certification as well as all facts and circumstances relevant to the application occurring after the decision. Where eligibility is denied because of felony conviction, the individual bears the burden of demonstrating by clear and convincing evidence that the individual has been rehabilitated and does not pose a danger to others.

Submission of Information to NREMT Concerning Possible Violation of NREMT Standards

Persons with information regarding a possible violation of NREMT policies should submit such information in writing addressed to the Executive Director. This information should identify the persons alleged to be involved and the facts concerning the alleged conduct in as much detail and specificity as possible, supplying all available supporting documentation. The statement should identify by name, address and telephone number the person making the information known to the NREMT and others who may have knowledge of the facts and circumstances concerning the alleged conduct. Supplemental information may be requested.

NREMT may forward reported information to the state. NREMT will not accept an anonymous letter or take action based upon an anonymous claim.