How to Become an EMT in New Jersey
Learning how to become an EMT in New Jersey, or an Emergency Medical Technician to be specific, is not an overnight accomplishment. Not only are you training to be a Garden State EMT, you are studying to become Nationally Registered, which is a relatively new requirement for the state.
Being Nationally Registered requires over 190 hours of coursework, which is equivalent to two college classes. Besides going over the basic lifesaving skill of Cardiopulmonary Resuscitation, or CPR, you will learn the legal side of medicine, such as HIPAA, and emergencies that bring not only the end, but a new start, to life.
Each state has their own challenges, as well as guidelines and laws, to practicing as an EMT, although with the National Registry becoming the norm, EMS will soon have similar protocols throughout the nation.
Brief History of EMS in New Jersey
New Jersey has seen Emergency Medical Services since the 1920’s, and was one of the first states to have this volunteer service. In fact, in 1927, the town of Belmar was one of the the first established volunteer ambulance services in the nation.
It wasn’t until the 1970’s that EMT’s became certified, and by 1973, the modern day EMS system was established across the country. Before this motion was passed to make the standard to have at least one EMT on a truck, there were no set rules as to what training you needed to ride on an ambulance; Rather, most agencies took anybody that was willing.
With the introduction of Emergency Medical Technicians in 1971, the standard of care greatly increased; Instead of being focused on getting the patient to the hospital as fast as possible, pre-hospital care was introduced. The number of patients suffering harm from calling an ambulance greatly decreased, as did the number of fatalities.
EMR vs. EMT vs. MICP vs. MICN
There are four different levels of medical first responders in New Jersey: EMRs, EMTs, MICPs, and MICNs.
EMRs, or Emergency Medical Responders, know the basics of emergency medical care; They are trained in basic First Aid and CPR, and are taught proper body mechanics when lifting and moving patients. They cannot administer any type of medication, and aren’t usually working on an ambulance; rather, some EMRs are police officers, firefighters, and safety officers for larger corporations.
Their goal is not to treat the person, it is to prevent further illness or injury in the patient until a higher level of care arrives, such as the EMTs. EMRs are covered under the Good Samaritan Law, which basically states that as long as you are acting in good faith, you will not be held legally accountable for a mistake made.
EMTs, or Emergency Medical Technicians, are certified to do what EMRs are capable of, and then some. The EMT scope of practice includes, but is not limited to, bleeding control, oxygen administration, delivering children, and cervical spine immobilization.
You will be the first on scene, in most cases, take the primary assessment, and begin treating the patient to the range of your ability, until a higher level of care arrives, such as a MICP or MICN. As an EMT, you will be held legally accountable to keep a patient’s medical history private, in accordance to HIPAA, or The Health Insurance Portability and Accountability Act.
Many times, those who take an EMT class have been EMRs beforehand, which gives them valuable insight about what to expect after the courses are over, and the street knowledge takes over.
MICPs, or Mobile Intensive Care Paramedics, are a step above EMTs; They are covered under the same laws as an EMT, but have more responsibilities. MICP scope of practice includes not only the scope of the EMT, but include procedures such as intubations, intravenous medications (or IV’s), and electrocardiogram monitoring (or EKG’s).
Paramedics in New Jersey work under their agency’s medical director; The paramedic has communication with the attending physician, who then dictates which medications, procedures, and treatments the patient receives. These orders must be documented, as the rule of thumb is “If it’s not written, it didn’t happen.”
MICNs, or Mobile Intensive Care Nurses, are Registered Nurses who work in the mobile intensive care field; They work alongside EMRs, EMTs, and MICPs to provide a higher level of care to their patients. MICNs must be Registered Nurses prior to becoming a MICN, and are basically ER nurses in the ambulance.
They have the largest scope of practice, which not only includes the scopes of EMTs and MICPs, but can do any duties they have done in the hospital; However, these duties are done going 60 MPH down the Turnpike.
Although the four levels of medical first responders differ, there are also many similarities, and without one level, the emergency medical service system would collapse; In order to provide the best care for your patients, you must be willing and able to work as a team, and know when to transfer to a higher level of care.
EMT Courses In New Jersey
Becoming a Garden State EMT is not for the faint of heart; It’s for those of us who are the self-proclaimed “Trauma Queens,” “Adrenaline Junkies,” and “Puzzle Solvers.” It’s for those who run towards the accident, not away from it; It’s for those who have been through it, and want to help people the same way somebody helped them.
There are a few different EMT courses in New Jersey, all of which use the same curriculum; No matter which class you enroll in, you will learn the laws, techniques, and skills to work on an ambulance.
In order to become an EMT in New Jersey, most courses require you to have a few different things; You need to be at least 16 years old on the first day of class, and must have a basic CPR certification. However, if you are under 18, you will be considered a provisional EMT until your 18th birthday, which means you must ride with an EMT over the age of 18.
You must complete the course to state standards, and must pass the written NREMT exams. Following the passing of the exams, you must pass the practical examination, or a skill assessment. These practical assessments have four different skills that are assessed, and the skills are assigned by the proctors. However, there is a fee to become a Nationally Registered EMT, which is around $100 to register.
Some First Aid Squads and Fire Departments offer a training fund. This is a fund that departments have that act as a waiver for the cost of an EMT course. As of October 2020, the list of eligible First Aid Squads can be found on the New Jersey State website.
This training fund can waive the entire $1,500 that it takes to enroll in any EMT course in the state; However, not all departments are eligible, and some departments will only pay for the course, while others will pay for the course and whatever equipment and textbooks are necessary.
EMT Training in New Jersey
In order to become a New Jersey State EMT, as previously discussed, you have to go through an EMT course. This, however, is not an easy feat. Sure, the classwork comes from a book, and if you take notes, and learn terminology, you should be good, right?
Not exactly.
EMT training in New Jersey is not a walk in the park, as passing the written exam with a perfect score is just the beginning. You must also pass your practical examinations, which can include things like HARE traction splints, manual airway management, or proper CPR and AED (Automated External Defibrillator) use.
In order to stay up to date, you must take something called a CEU, or Continuing Education Unit. In New Jersey, you need to complete 24 CEUs in the time your certification expires in order to recertify, as well as EMT-B Refresher A, B, and C courses. This will equal 48 total CEUs in a three (3) year period if you are recertifying.
The first EMT card you will receive will be active for five (5) years, and every card after that will expire in three (3). However, if you are a NREMT, you must recertify every two (2) years.
EMT Certification in New Jersey
Becoming a New Jersey EMT is an accomplishment you should be proud of, but what happens after you pass the class, and the practicals, and have your shiny new EMT card in your hand?
After you get it laminated (I’m kidding, of course!), the next step is not jump on a rig and start calling the shots. Whether you passed with a 99 average, or a 72, you should look at your first day as simply that: Your first day. You won’t know it all, you won’t see it all, and you will make mistakes. The key to being a great EMT is to learn from those mistakes, and listen to those who came before you.
No amount of schooling can prepare you for your first DOA, no amount of studying can teach you how to show compassion to families, friends, and loved ones, as you tell them their father, sister, son, is never going to survive.
Those who have been on an ambulance for the past 20 years are a vault of information-listen to their stories, their triumphs, and their failures. Not only will they help you become a better EMT, but they will teach you valuable tips to surviving the crazy world of EMS.
EMT School Tips
Passing EMT class is not an easy thing to do, especially when going through it alone. Going through EMT class with your fellow first aid squad members can be a lifesaver, but if you’re flying solo, there are some tips that you can use to make class a little bit easier.
First things first: Read. The. Book.
The EMT class book in New Jersey may seem daunting, but the information in it can, and will, save somebody’s life. Not only will it save lives, but you will learn every bit of information that is on every test. Don’t stop at reading the book, take notes, highlight, and fill out the workbooks if one is provided to you. If one isn’t provided, pull up the human skeleton on Google, and fill out the anatomy. Do every bit of work you can to make the information stick.
Make friends with your classmates, and ask your instructors any questions you have. Remember: No question is a dumb question, so ask away! Get a small study group together with your classmates; This serves as a study guide not only for you, but as a learning experience for those who are having a hard time with the material.
Use of acronyms was my saving grace, and they stuck with me to this day; My favorite EMS acronym is for the KED, or Kendrick Extrication Device. This device is mainly used to extract patients sitting upright that have been in Motor Vehicle Collisions, or MVC’s.
The acronym is as follows: My Baby Looks Hot Tonight. This stands for the order of the straps; Middle torso strap, Bottom torso strap, Leg straps, Head strap, Top torso strap. Although this is rarely used in today’s EMS world, I remember the acronym to this day.
Lastly, take time to focus on you. Yes, EMT class will feel like it’s taking over your life, but you can’t save others, if you can’t save yourself. Take an hour out of your day to do what you want to do. Forget the stress, the overwhelming feelings, and the headache of EMT class, if only for an hour.
New Jersey EMT Protocols
New Jersey’s EMT Protocols are constantly changing; This is due to the world of EMS constantly advancing. When I first became an EMT, every trauma patient got a backboard. Recent studies, however, show that back-boarding patients leads to an increase in agitation, discomfort, and has the possibility of airway compromise.
The introduction of Narcan via intranasal administration was a game changer for those agencies in areas where opiates ran rampant. Before BLS, or Basic Life Support, was able to administer Narcan, agencies would have to wait for a MICP unit to arrive on scene to administer the lifesaving medication.
Although protocols differ from state to state, local and agency protocols may vary as well. For example, many paid ambulance companies require two (2) EMTs or higher on an ambulance at all times, while other volunteer organizations only require one (1).
What To Do After Class
So you’ve passed your EMT class, got your certification, and you’re ready to join the ranks of the paid EMT world. You have a few different ways to go about it: You can work for a hospital doing paid 911, you can work for a transport company doing IFT’s, or inter-facility transfers, or you can work for the big cities like Camden and Trenton.
All of these are great options, and it all depends on your preference. Hospitals and cities pay anywhere from $15 to $19 an hour, depending on location and call volume, while transport companies pay from $13 to $16 an hour. Factoring in the high cost of living in New Jersey, most EMTs are able to live comfortably working full time, but many companies offer overtime opportunities for those looking for extra money.
Diagnosis: Do or Don’t?
Many times, when called to a scene, we can use our deduction skills to figure out exactly what is going on with a patient. For instance, you get dispatched to the local nursing home for a resident “not acting right.” Upon arrival, you note patient has right sided facial drooping, slurred speech, and a noticeable arm drift. The patient seems confused, and the staff at the nursing home states that “they were fine when I checked on them ten minutes ago.”
You ask the patient to repeat the phrase “the sky is blue in Cincinnati,” and you get a jumbled mess of words in response.
Using our knowledge, we can easily guess that this patient is having a Cerebrovascular Accident, otherwise known as a CVA or a stroke. However, EMTs are unable to give a diagnosis, as we are only able to see what’s presented to us. As EMTs, our job is to treat the patient, not diagnose them, and diagnosing them may do more harm than good in the long run.
What To Expect In EMS
Becoming an EMT is just the beginning for many people; Often, we seek higher education, and become Paramedics, Nurses, or even Doctors. EMS isn’t just sitting at the station, however.
It’s hours spent with your partner, on the road, in strangers’ homes. It’s missed meals, birthdays, and holidays. It’s vomit, feces, and blood stained clothing. It’s pumping on the chest of your elderly neighbor. It’s watching life start, and trying to stop life from ending.
My First Call
I became an EMT when I was sixteen. My first call was a CPR in progress. Upon arrival to the scene, I was greeted with two police officers doing CPR on a young, 20-something year old. They had overdosed, and this was before the widespread use of Narcan.
When I was a freshman in high school, this kid -that’s what they were, a kid- was a senior. I stepped foot in the motel room, and froze. I didn’t know what to do, it was like I was shell-shocked. I knew this kid, and now they’re dead. I went in to my first call thinking I was on top of the world, and I left it with a cold body covered by a sheet. EMT class could have never prepared me for this, but I learned from it.
I learned that the human body is like a car. Sometimes, you need to get an oil change, or fix your brakes, or change your spark plugs. Sometimes, you need to take medicine, or get surgery, or mend a broken bone. But sometimes, our engines go, and those can’t be replaced as easy. Sometimes, a car is just too far gone, and so is the human body.
I remember my lieutenant pulling me aside, and telling me this, and to be honest, at the time, it didn’t make me feel any better. I was an EMT. I was supposed to look death in the face, and stop it. How could I be so naive, so clueless?
EMS isn’t about saving everybody. EMS is about saving those who can be, and preserving the dignity of those who can’t. It’s about compassion, care, and above all else, it’s about being the change in the world those people need on their worst days.
Conclusion
Learning how to become an EMT in New Jersey is not a walk in the park, but for those of us who have a knack for helping those who need it, the time, sweat, and tears are definitely worth it.
In order to be a NJ EMT, you must pass both a state test, and the National Registry. EMT class is by far one of the most challenging things I have done to date, but knowing I’m making a difference in the lives of others made all the stress worth it.
If you are going through EMT class, remember a few key rules: Read your book (and actually study it!), remember your acronyms, make friends with those in your class, and make time for yourself! Study your protocols, you should know them like the back of your hand.
Make sure you do your CEUs in a timely fashion, and apply for refresher courses as soon as you are eligible too; There’s nothing worse than stressing about finding a refresher a month before your card expires!
If you take anything from this article, take the fact that you are training to be an EMT, not training to save the world. You can’t, and won’t, save everyone, but that’s okay.
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