Gerry314

It is common practice for AMR to re-hire workers after acquisition. It would be a process of re-applying for your job and an interview process. They have let people go during this process. However, they are good about permitting retention of years of service with your former employer for the purposes of seniority and longevity with AMR. Of course, AMR is infamous for inconsistency. Things might be different in your case because you are a Unionized shop. It sounds as though this is not as much an acquisition as it is a winning of contracted service with a municipality. In that instance AMR would be bound by the process of your Union CBA. There could be pink slips and eventual recall as work increases or licenses for ambulances increases. There are several possibilities. Familiarize yourself with your CBA and call on your stewards to enforce language dealing with change of work environment clauses, lack of work provisions, layoffs, terminations, and "effects bargaining" under NRLA.

What is suggested in the last paragraph I agree with. At least then when you work for transfer service there are no expectations of being a EMT or Paramedic. You said it yourself in attempting to prove me incorrect about the view of the public that the public is uneducated about EMS so they view as all the same. You made my case with your contribution. Do you think they would hold a transfer jockey in as high esteem as they do a crisis EMT or Paramedic if they were made aware? The one flaw in your example is there isn't any distinction drawn between the "granny tote cars" and ambulances that provide EMS. They are all one and the same. The problem I have is in the fact that the EMT's and Paramedics doing this job today don't have a choice in how they are utilized and it has evolved in commercial EMS that more and more of these ambulances are becoming the "granny tote cars". An ambulance that just completed a cardiac arrest, would immediately be dispatched to three or more transfers before seeing their next emergency call, and if the next emergency occurs after receiving a transfer the commercial EMS provider would be mandated to take the transfer over the emergency call under the threat of refusal to do a dispatched call. I have unwavering respect for the author of this rebuttal for his 30+ years. He is obviously my senior in service longevity so it would be inappropriate for me to discount his expert opinion. You are a credit to the field of EMS and I humbly accept your perspective.

I never said they "all" suck, I said that the dynamics of commercial EMS are such that they cannot be considered part of the EMS system as I define it or as it is viewed by the general public. When your primary occupation is transfers and they take precedence over emergency calls, that affects the legitimacy of that service as an EMS service. I am certain there are services with a more balanced transfer to emergency call valuation, but in my service...that isn't the case. Yes I have issues, and those issues stem from a misdirected focus. I spend many hours and a lot of money to maintain my credentials only to van patients from doctors appointments to home and every other manner of non-vital transportation. I didn't write what I wrote to be victimized by others on this board. Granted OWNERS of EMS services see their services differently than those who actually do the work. You can say what you want about me, but if you are honest about the facts that exist in commercial services then you understand what I am saying is factually sound. Calling my thoughts ignorant is either an attempt to ignore the facts and realities or it is a testament to the intelligence or depth of information available to the reader. I really hate getting involved in these discussions for this reason, you attack me for my perception of 23 years of EMS evolution as just disgruntled rantings instead of a truth that can effect EMS personnel who have longevity. Maybe you just don't recall the early EMS system and that leads you to criticize the comments of someone who has been there and what exists for you is percieved as the "Norm". Who knows, but I am done with this.

Very good questions. I will do the best I can to answer them. 1) I started EMS in 1985 as an EMT. I worked then as a Nurses Aide in a nursing home. I volunteered for a municipal ambulance service while I continued to work in the Nursing Home. Within two years I was pursuing my Paramedic. I was offered work by the chief of my volunteer service in 1987 as one of two paid personnel to cover days. I took that with a pay cut because I felt that EMS was so important and vital. In 1988 I was advised I would have to go commercial [private] to complete my Paramedic because of Medical Control matters so I went commercial. I graduated as a medic in late 1988, and my commercial ambulance association began. At that time medics were scarce and they were kept available for the serious calls and they were respected as providers of advanced care by all. 2) To be honest, there are so many it is tough. Not only where I am concerned but with other medics I am proud to call colleagues. I recall a child choking call that came in, in which my colleague Jim was right around the corner from as he was heading toward a transfer he had been given and he was denied diversion requests repeatedly followed by the all too familiar "are you refusing to do the call you were given" BS by the dispatcher, their attempt to catch him in an event of insubordination. He did the transfer. I specifically, was denied diversion to a seizure I was three minutes from in which it was reported that the patient was not breathing. Denied outright to transport a dialysis patient who was already ten minutes late to her appointment. 3) In many areas there are intercept Paramedics that are employees of my commercial service. These are closed shifts and given to the cronies of the managers. They are not subject to the shift bid process. We just lost a service area to a newly established municpal service whose genesis was on the grounds of what I am asserting, that we are not available for their emergencies or cannot meet the demand because of our primary focus on transfers. We are never available because of our companies disregard for the importance of being available for emergencies and their focus on the dollar generators. We serviced this area for 14 years. It didn't happen over night. The history was evident that we were not focused enough on the emergencies predominately for years and the municipality established its own service with that recognition and unchanging reality. 4) Yes, I have thought many, many times of changing my career, Nursing, P.A., Fire Fighter, but I was ignorant and lazy. I wasted time on hopeful vision. I am a long time smoker, started when I was 12. I kept convincing myself I couldn't make the fire department because of that. My longevity is related to a small amount of selfishness. The transition of commercial EMS, if it was a transition, was slow for medics. Medics were revered when I started. EMS may have had the same focus I see today that is disturbing to me, but I was exempt because I was a "medic". As time progressed, the lack of reverance became more and more pronounced as the ranks of medics grew. A slow growth, a slow progression of unimportance crept into my professional life. Soon I was nothing along with many of my colleagues with as many years. We were relegated to transfers as we lost our service areas to other services [commercials that publicly professed better service but we knew better in the rank and file] and to newly established fire based and municpal based services who were tired of hearing "no medic available". 5) Well you might have guessed that already. I was not satisfied working indoors after a while. When I began providing volunteer EMS service as an EMT I loved the "field" concept. The ability to float around and get outdoors. The pride that we felt in riding in our ambulance around the roads I grew up on appealed to me. The true, heartfelt senasation that we mattered. That we made a difference. The pursuit of EMS stemmed from a friend who worked with me in the Nursing Home and she urged me to join the EMT class with her and I agreed. She said I was great with patients and had something to offer so I joined. That was the very beginning. Well I have said way, way too much. I hope this answers your questions.

Private ambulance services are the "transfer" jockies of EMS. They cannot be considered part of the EMS system because the employer cares little about Emergency Medical Services. The goal with private services [at least where the boss is concerned] is taking transfers exclusively. Obviously the road crews feel different, but they don't make the rules. I have seen "emergencies" take a back seat to transfers too many times to kid myself about private ambulance services and what they represent. That's why the turnover rate is so high in private services. No EMT or Paramedic feels good about making transfers their primary focus, thus many hate what they do and where they are at. Those of us who have over 20 years remember the days when medics and EMTs were all proud medical providers, now a chimp can do what private EMS does primarily. Sure "that's where the money is" [transfers] but it isn't and never will be where my heart is in feeling like part of the EMS system. I feel like a cab driver with skills.