WANTYNU

This is a complex issue, licensing vs. certifications, vs. qualified degree program asks the question, what level of education, and who should control the standards? As I stated earlier, in NYS almost all others in the groups mentioned above are licensed by the department of education, EMT’s and Paramedic’s are certified by the Department of Health. One run by a well established system of advisors and representatives from academic intuitions (education), the other by a bureaucratic appointee (DOH). This impedes the standards required for education, in addition comparing to the therapists working inside the hospital environment and are therefore closely observed in a clinical setting, when you have a doctor fighting for the necessity of the services delivered, (to be read i.e. billable services), it is easier to support the argument for all the above requirements. I find it interesting but not surprising that Phlebotomists and Patient Care Technicians are rising in the ranks (soon to pass prehospital care providers?). In spite of the fact, that our systems allows us to do more as practitioners independently every day. To further complicate the issue, we are still not viewed by most communities as a required necessity because people are still willing to provide this service for free. Where we are a necessity because there are not enough service providers to go around, the standards for entry are lowered, to get more into the system (see my first sentence). The FDNY fire suppression union is fighting this by not allowing their members to volunteer even if the corps is outside NYC jurisdiction. We are up against a two level value proposition, one, the communities we serve don’t really value our service, and two, we don’t / can’t recognize our own value. The measuring contests grow out living at the bottom of the ladder, there is no one left to pick on but our selves. As soon as we realize that putting down fellow responders devalues all of us, the sooner we can learn to stop this destructive behavior, the sooner we can start to climb the ladder. Bringing this group together is possible, but we need to stop fighting among ourselves about who is better. Look no further then the variety of EMS organizations and internet boards, there is no communication between them, there is no collaboration, all are all fighting to be king of the hill, yet no one is willing to step back, so one can take the lead. (We can finesse the results later, once we have structure as a group). The day we stop stepping on each other’s heads, in these petty disputes, is the day we take the first step to professional recognition. Best to all, WANTYNU

OH yes, also, I agree, lithium batteries are the only way to go! WANTYNU

A little clarification, on this subject; The metal O2 keys on the market (commonly the Hudson RCI or Western) today are not Aluminum they are made from Zinc, sometimes called white metal, or pot metal (meaning any low temperature melting metal that’s thrown into the pot to pour), and they weigh almost 4 ounces. In comparison mine are strengthened aircraft grade Aluminum alloy, (Aluminum, Magnesium, Copper mix), weigh about 1 oz and are about 50 times stronger than Zinc. Using titanium would be stronger still, but getting a machine shop to cut you one, would in my estimate cost you at minimum around $100 (2 hours at $50 per hour / a pretty standard rate). Depending on the design, could be slightly stronger and lighter then aluminum (about 10 – 15% in both categories). You would need to decide if the cost and the hassle are worth it. I can’t get into any more detail on the wrench I make in this thread, but it’s easy enough to find more info on, if you wish to. But at least on that Item you can be an informed consumer. Also personally although I do sacrifice some brightness, I like the dual purpose light, as it does both the job of a pen light, and a regular flashlight (just make sure what setting your on before you check someone’s pupils). Hope this helps as well. Good Luck, WANTYNU

HuH? Did I miss something, Why is blood flowing, wasn't this about buff belts? WANTYNU

Maybe we're not so different from lawyers after all...

I never thought of this, but maybe I should ask: "How many jobs do you do a shift", but then is it fair to compare 8 hours to 12, or 24? And I don't want to imply anything of the the folks that don't do that many jobs a shift, as a job is a job, and just as important to the person / people calling for our help. The idea of this thread was to get to the question; are you over worked? Any ideas, opinions?

So, a sensible conclusion would be? a) If you wear a duty belt your a N.E.-Whacker-Buff-overstuffed-who-doesn't-really-need-the-stuff-they-carry-just-want-to-look-cool-newbie. or If you don't wear a duty belt your a : I-can-do-anything-with-nothing-at-all-x-ray-vision-eyes-that-light-up-and-electrodes-for-fingers-SW-supermedic? Please pick only one (1 or 2) because it is so obviously black and white that there is only one correct answer.... :wink: Hey! can this get nominated for longest sentence?

Hey Spenac, I still like you, besides you've got noting to apologize for. I think this post underlines a bigger problem with EMS in general. NO NOT DUTY BELTS (before some one here starts) How we as a group handle little things. If this is how we do it, how are supposed to unite across the country, and gain respect from the public? Too serious?? Maybe I should have just kept this post light...

Also a little information on HIV transmission via saliva. Hopefully it will help ease some of the stress while you wait. http://www.thebody.com/content/art40621.html Dr. Jeffrey Laurence explained that studies have shown that a reliable laboratory can isolate HIV in the saliva samples of about 25% of HIV-positive people. The same labs can isolate HIV in 100% of blood samples from the same people. In those saliva samples in which virus can be found, the concentration of virus is much lower than in blood, semen, or the already low concentrations found in vaginal or cervical secretions. The low concentration of virus in saliva may mean that saliva is less likely to cause infection than blood or other body fluids. This is certainly supported by test tube and animal studies of infectivity. Why is saliva less infectious than other fluids? It is believed that there is a substance in saliva that inhibits HIV. The inhibition observed may be due to large sugar-protein molecules in the saliva called glycoproteins. These glycoproteins apparently cause HIV to form giant clumps which are not capable of causing infection. Animal studies also suggest that saliva is an unlikely source of HIV transmission. In studies, concentrated SIV (simian immunodeficiency virus; a virus similar to HIV) was rubbed on the vagina, rectums, and gums of monkeys. Infection occurred in monkeys that had been exposed via the rectum or vagina, but not those exposed via the gums. In a test tube study, chimp saliva blocked the ability of HIV to infect T4 cells. Experiments with human saliva showed that it was less effective than chimp saliva at inhibiting the virus but still quite effective. In one study, 10-60% of the saliva samples could inhibit the virus, not completely, but by a fair amount. (Patricia Fultz, et al., CDC). At least ten studies have shown that saliva can inhibit HIV. HIV is present in ejaculate, pre-ejaculatory fluid, vaginal secretions, and cells in cervical fluid. None of these fluids contain the glycoproteins that inhibit HIV in saliva and all are more infectious than saliva. Again best of luck WANTYNU

From the NYS DOH Website: Under what circumstances can HIV-related information be disclosed without an approved HIV release form? For medical treatment: • Medical professionals working on the treatment team with the person’s existing provider may discuss a patient’s HIV-related information with each other or with their supervisors, but only to give necessary care. A general release is needed to disclose medical information to a provider who is not affiliated with the person’s current medical provider. • With a general release, a hospital or health care provider may share HIV-related information with a patient’s insurance company if the information is needed to pay for medical care. • Medical personnel and certain other supervisory staff may have access to HIV-related information to provide or monitor services if the person is in jail or prison or is on parole. • Disclosure may occur without consent in certain cases of on-thejob exposure to HIV when all criteria for exposure have been met. • Parents or guardians of a minor or individuals who are legally authorized to provide consent can be given HIV-related information about the person if it is necessary to provide timely care, unless it would not be in the person’s best interests to disclose the information.

Not clear cut at all, yet another point about working EMS. First as many on this on this board have said, get your management involved ASAP. Second, if this is a Federal VA job, the nurse might be correct {see the previous posts, links}), but you may still have rights. Third, she bit you which I know for sure is battery, aka a CRIME, I would look into pressing charges, being on drugs is no excuse under the law for committing a crime. IF chargeable this would change her rights and allow for testing. In the mean time, as much as you may not want to, consider starting the AZT prophylactically, as she is a in a high risk behavior group. You can allways DC if she's found Neg. I seem to remember reading a news story that our rights nationwide have changed with suspected exposure, worth investigating. (If I can find it, I'll post). Sorry to hear about his, a friend is on AZT 2nd to a needle stick through a confirmed HIV pt, it’s no picnic. Best of luck WANTYNU

Ok, WOW, I go away and all hell breaks loose, I guess I’ll join in the fray as it seems everyone else has. Dust, You’re a really smart guy, Your post on the pay thread stopped me in my tracks, and that other RT Medic, outstanding points, delivered with insight and perspective, then you go say the thing against NY’RS and it just blows apart your creditability. Hey I’m from NYC and you managed to raise my ire some . You carry a sharp sword in that head of yours, try using it a little more judiciously (is the middle east justice system influencing you a bit?!?) . You have a very acid wit no doubt; maybe a little less heat in your posts, might provoke a little less resentment, and get people to listen more. Hey, just a little advice, use it if you want to, its’ worth every penny you paid for it… (and I'll still read your posts, I don't really think dislike New Yorker's as much as you come off appearing too in your posts.) So back to this post. Not everyone here in the Big Apple is a whacker, and as has been pointed out, most do carry duty belts; so maybe, just maybe there’s something to that. I have followed this thread from the beginning, and although I don’t feel NTG has behaved that entirely well, I think we can agree he got bashed a bit. I wear a duty belt, I find it handy and very convenient, remember up here we sit in the bus ALL SHIFT, so it’s nice to take it off, and relax, and all you need for a job is a quick snap and you’re good to go. I also don’t carry a TON of stuff but I do carry the following: My domestic leash oh, I mean my cell phone, Hazmat pager, Key ring holder and keys, Benchmade Rescue Hook which has a nice flat belt holder and weighs nothing (I just don’t like how quick it gets dull), great for donor cycle leathers. A nylon radio holder with attached side pocket in which I keep” A mini drug reference / protocol quick reference, from EMS-Safety.com Shears, (hate anything in the small of my back) Plastic umbilical clamp (good for holding an IV bag on a carry down), Streamlight duel LED/REG flashlight ($25 on Amazon), Small bright and light. Shove knife (the only tool for opening simple doors real easy), (1 oz) Black sharpie marker, And a great (if I do say so myself), O2 Wrench {yes OK one of mine!} (All this fits nicely in the radio holder), A NYLON glove pouch, A word on that, a couple of people forgo glove pouches for pockets, that’s a mistake, the gloves we wear are for our protection, (MRSA is out there folks) not the patients, they’re made of thin rubber (or nitrile), think about something else made from thin rubber, would you stick one of those in your pocket (unwrapped) and then use it later? (not unless you wanted to be called mommy or daddy…) Utility gloves with Kevlar palms in back pocket, A spiderco spiderwrench multi tool which clips to the inside of my front pocket, no case needed. A pen in my shirt pocket. I hate putting stuff in thigh pockets, so I don’t use them. This sounds like a lot, but it really doesn’t weight that much (maybe 3 lbs with radio?) I find this covers all my needs and I even switched to lithium batteries (thanks for the tip) to lighten up a little more. AND yes I HAVE HONESTLY used everything I carry at one time or another. Notice, No window punch, they belong in a machine shop not on an ambulance, as Spenac so aptly pointed out, breaking a window is not rocket science. Well there is my two cents worth. Best to all WANTYNU OH and PS please don’t joke about terrorism, I hope it NEVER comes to your city, or for that matter this country again.

Very interesting input, theory, and history. I have a lot of homework to do now (I was not aware of the RT history, and never even considered looking at PT). I do know that in NY Doctors and Nurses are LICENSED by the Department of Education, where as Paramedic’s and EMT’s are CERTIFIED by the Department of Health. (talk about control) I’m sure there is a difference how they are viewed under the law, but I will need to do some research to better understand what it is. How are RT’s and PT’s empowered to practice (Licensed or Certified)? I agree we waste time and effort comparing ourselves to nurses, but the response is a logical one, as we tend to work closest with them in the hospital setting, and it has long been considered the (unofficial) next step for medics. I have over 6 partners currently in nursing programs. Great thread. WANTYNU

yup, was lazy and got lucky, my bad (even though the departing crew said everything was good). Three biggest lies: I love you, The check is in the mail, The bus is good, you don't need to check it... breaking a window is Not rocket Science?!? Now you tell me! You mean I don't need a minicomputer to calculate mass / velocity of the rock anymore, Great one less thing to carry…

Dustdevil, Why the post? What was the constructive purpose? You have stated I have shown intelligence in my posts, so do you doubt I could be as cutting in my comments as you? Do you notice that I choose not to be? Have I ever put you down, even once? Smart-aleck comments devalue us all, contribute to this forum, don’t devalue it. You have a great position, and are a prolific poster, please consider using those attributes for the betterment of the entire site. I don’t even want to know what you have against NY (or NJ), but I don’t think people are laughing. Btw, there’s a TON of stuff about NY on the Web, but I’ll underline just a few. We’re the busiest EMS in the country (not saying the best, but we all have our faults now don’t we.) We were THE ONLY CITY IN THE COUNTRY TO BE ATTACKED BY TERRORISM THREE (3) TIMES, for those keeping count that’s TWO more than any other city. Stop being so damn negative. Together we stand, divided we fall. Not laughing. WANTYNU

Sorry, I should have done a search before the post, I know him and George, and the article so I thought it germane to the subject… Next time I’ll do a search and a reference link. But still a lot of good ideas. I’ am pretty sure I wouldn’t support a “scorched earth” policy (hey green house gasses and all that), but an aggressive rebuild is absolutely in order. However as the article points out WE are part of the problem, as long as we continue to sabotage ourselves, we will never take one step forward. A part of the problem is we’re too mixed in with other services. In addition, I think EMS solutions mentioned the idea that as long as we work for free and peanuts, they’ll (the communities we serve) will pay us in legumes.

In the realm of professional posts, this has taken a turn down the wrong path, I read through this thread and we’ve had every suggestion from the plausible to the ridiculous (use the light on the bus it work fine) . Can we possibly agree since we work in different systems our equipment need WILL be different? Don’t call people names because they carry a duty belt, that would be like telling a cop to leave his gun in his car and run back if he found he needed it. I'm sorry but they built the elevators in the projects a little too small to fit my bus in, (and a lot of time my stretcher as well), so in order to treat the patient, you ACTUALLY need stuff… I know this may surprise a few here, but (and I will only speak for myself), but in NYC you could easily find yourself twenty flights up, with a single elevator working, and a hundred people that think their business is more important then you trying to save someone’s life, so every button (in spite of your protests ) gets pushed between you and your patients floor. Now honestly, do you really want to run back down to your bus to get a piece of equipment you might need? Is that fair to the patient. Calling someone a whacker because they wear an equipment belt is narrow minded and a little ignorant. Not everyone has complete access to their bus. We don’t live in a perfect world, stuff breaks, most urban system have a spare bus in case the one you’re in breaks down, it’s usually an old POS thats on its last legs, if you had the choice of making a quick repair on your own and not switching out of the bus you normally use or taking the time to move all your equipment into something that was a temporary Band-Aid, what would you do? Call fleet services that’s funny, how responsive is your own mechanic when you need your personal car fixed? Now you want to call a person who is even more over worked and under paid then you to change a strobe light, or fix a fuse? Good Luck My point is there is no such thing as a “WHACKER” , there are well prepared EMS personal who know their environment and like to be prepared for the unexpected on the 20th floor. If you tried to work in NYC without carrying a variety of personal equipment on each and every job, not only would have an extremely short career , you'd be toast by your third call. WANTYNU. BTW, If you carry a belt, and want to lighten your load by a couple of ounces, I know a place that makes a really good O2 wrench…

So how do you get to practice your skills?

EMS I agree, And to stir the pot once more.... A GREAT article from Scott Phelps written for EMS Magazine. It is very forward thinking and controversial, "Turn the whole thing on it's head thinking", but Scott's a very Smart guy, so his opinion is at least worth listening to and giving some consideration. The slant may be more urban in nature, however, there are seeds of wisdom we all may prosper from... here's the article. >>>>>>>>>>>>>>>>>>>>>>>>>>>> http://www.emsresponder.com/print/Emergenc...E-of-EMS/1$5494 >>>>>>>>>>>>>>>>>>>>>>>>>>>>>> "The FAILURE of EMSIn order to survive, the system must first collapse By Scot Phelps, JD, MPH, EMT-P, CEM, CBCP, MEP The concept of an EMS system has failed. After 40 years, it is time to admit defeat. The concept of an EMS system has failed. After 40 years, it is time to admit defeat. While the idea of providing an organized system of advanced out-of-hospital care was a good one, internal and external forces have led to the imminent failure of the EMS system in America. I, for one, am glad, because the system as it is currently structured cannot work. This collapse was about 20 years in coming. When I started EMS in the 1980s, there was a lot of hope for the industry. I grew up in an era when BLS ambulances were nearly 100% volunteer outside of large cities, when first aiders were transitioning into EMTs, and when statewide paramedic coverage was an almost-realized dream in New Jersey. It was also an era of mobile intensive care nurses (holy cow! a decently paid career track with options), a strong tradition of volunteer crew chiefs with a decade of experience mentoring new cadets, and a billing system that let paramedics bill enough to cover the costs of operating the paramedic system. It was far from perfect, but it seemed to be moving ahead. Twenty-three years later, when I talk to colleagues from my era about their experiences, I hear a common refrain: "I thought being a paramedic was going to be a real job." Instead, we have regressed into an EMS system that is only interested in cost, not quality; that equates certification with competency, with no field training and supervision; EMS providers (both career and volunteer) who work an endless series of 60-hour work weeks; no upward career mobility; and McJobs (no pension, no benefits) instead of careers. How did things go so wrong? I have a few ideas: 1) The Public Has Never Understood What We Do. Until we jettison the acronyms that mean nothing to the public (EMT, BLS, etc.) and focus on using the term "medic" for all ambulance providers, we will never have a consistent public image. A SWAT police officer is still called "officer." We also need to be the ones who talk to the press about accidents involving injuries and fatalities. The police are not the ones who cared for the patients--we are. 2) We Let Medicare Pay for Calls, But Not the EMS System. When Medicare changed its payment rules seven years ago, we let them fundamentally change from paying for patients' pro rata share of system costs to paying for the actual cost of the transport, stranding a huge percentage of overhead costs if your agency has a normal level of utilization. We did not make it clear to our elected officials that they would need to pay the rest. We also accepted mandatory coverage from Medicare, which meant that systems had no reason to compete on quality, only cost, since their payment remained fixed. 3) We Let Other Disciplines Do Our Jobs. Where I worked, I constantly heard the EMT crews complaining about the career fire department, yet on the scene, they always let the firefighter/EMTs carry the patient. I will say it in no uncertain terms: Do your own job. Fire takes care of fire and rescue, police take care of law enforcement. If it involves injury prevention, safety or health, it is EMS' job. Carrying patients, teaching injury-prevention programs in schools, installing child car seats and decontamination are all patient safety-related issues and clearly the role of EMS. 4) We Never Asserted Control Over Emergency Medical Care. It is great that your community firefighters and police are EMTs and respond quickly, but providing care is our profession and we have a right to regulate it. Generally, communities should have sufficient EMS resources to be able to respond anywhere in the community within minutes. But where EMS permits fire or police to provide emergency medical care, it should be only under our direct control for care, oversight and quality assurance. 5) We Never Stood Up and Said "No More McJobs." In the Northeast, the volunteer EMS ethic is that "this job is so important, I'll do it for free," yet inexplicably, when they begin to transition to a career system, they do not think that EMS is important enough to pay career staff a fair living wage (with benefits and pension) to do it. To be fair, this is also prevalent in the private ambulance sector, but at least they can point to a profit motive. The reason paramedics have to work a 60-hour week is that you need 60 hours to pay your rent, and nobody in EMS thinks that's crazy. If we all quit our per-diem jobs tomorrow, salaries would correct themselves within six months. 6) We Need to Admit That Paramedics and EMTs Are Not the Same. EMTs are technicians with less than five weeks of full-time training (significantly less than the police or fire academy) who treat symptoms. Paramedics are professionals with at least 50 weeks of full-time training who treat a diagnosis. With the new curriculum, there is no longer even a continuum of education from EMT to paramedic. This is important for one key reason: It artificially depresses paramedic wages, because there are so many more EMTs in any bargaining group. This undermines a graduated pay scale that would pay paramedics significantly more and pay for their experience. Without it, how can we ever expect to retain good paramedics when their long-term wages are depressed by EMTs? The primary reason we lose so many great EMTs, who choose not to become paramedics, is because the money just isn't there in the long-term. 7) We Abandoned the Concept of the Mobile Intensive Care Nurse. I've never understood why we created paramedics in the first place in an era that also saw the development of specialized critical-care nursing. In New Jersey, and in many states across the country, almost every paramedic program had nurse preceptors for years. Nurses specializing in out-of-hospital care were quite common until the early 1990s. I never actually saw a paramedic work in the field until I began my clinical rotations. If we shifted to a three-year community college MICN program, we could ensure both a decent wage scale and true career path for medics (and it would solve #6). 8.) Volunteers Are Fine, But the Year-to-Year Mind-Set Is Not. EMS is a complex business, with eight-minute response times within your community, a stock that is both critical and time- and temperature-based, burdensome regulatory requirements and continuing education for your staff. Who the hell told you that you can manage all this without a business plan? Without short- and long-term multi-year goals? Without strong management support for a volunteer labor force? Volunteer EMS rganizations, even more than career organizations, need career managers with a multi-year business plan mind-set or your organization is going to fail. Even the Red Cross has career people who manage volunteer staff. 9.) Regardless of Our Employer, When We Do 9-1-1 Response, We Have Not Said That We Are Public Safety. After 9/11, I had the privilege of working with George Contreras and Richard Fox to try to secure federal line-of-duty Public Safety Officer Benefits for all of the municipal, hospital, private and volunteer paramedics and EMTs who died during that event. That experience really opened my eyes to the inequality faced by medics across the country. We are not public safety because of who our employer is; we are public safety because we respond to the public's calls to a public emergency number. That is a critically important distinction. Summary In summary, the problem is us. While we have become very good at blaming everybody else for our troubles, in our hearts, we must think that EMS is not all that important. If we did, we would be fighting like hell, working together and pounding our fists on the table. As it stands now, most of the talented paramedics I started with 20 years ago are no longer paramedics. Some got hurt, some died, some burned out, and many of the rest work part time, because they love EMS, but need careers to make livings for their families. It is painful for me to say that EMS is not a career, but it is not. It is also painful to see the EMS system, which I do value and once had great hope for, collapse, but it is. While many of the problems I have identified have fixes that could be implemented now, I understand that most will only be implemented when the system collapses. And that can't happen too soon for me."

First please don’t misread into my statements, if you looked, I do recognize it takes a 4 year undergrad degree, but there are many in EMS who have a 4 year degree, and more, however they don’t get paid any more because they have one though.. For the second part of your post, that’s EXACTLY my point, we’re looking at the wrong things. We need to look outside our field to understand VALUE, which is a composition of Education, Risk, Demand, Difficulty, and finally PUBLIC PERCEPTION, are we ambulance drivers or technicians? Anyone remember the “Pet Rock” it was all about marketing, but the joke was the guy who did it, made millions, selling an ordinary rock in a box with a fancy name to the public… My point is not to compare us to lawyers or any one else for that matter, my point was to open a discussion on value. Lawyers themselves argue $1000 per hour is ridiculous, but they get it because they have set the public’s perception that they’re worth it. What can we do as a group to set public perception that we’re worth more?

Dust your talking theoretically right? Because we both know that the standards around the country vary but are not even close to what you propose. (I know how you feel about NY, but even so… I’m an NREMT-P which I hope we can agree is a stick in the sand as for program difficultly benchmarks). From what I understand New York is somewhere near the more difficult end, I took both the NY State and National written tests and IMHO they weren’t that different, and I took only one skills practical for both. Granted, the course I was in prepared us for both but still it wasn’t easy. Including home study time, easily past 2500 hours worth of work (working a fulltime job while doing it as well, just added to the misery… ) And yes while $1000 / hr is news, $500 – 700 (the standard) is not, which is still 20 – 30 TIMES a medics salary. Is being a lawyer 20 -30 times more difficult than being a medic or even a nurse medic to that end? And don’t get me started about CEO’s… Pacman, I can see your point as well, but EMT’s as hard as they work, are at a different education level then Medics, so they can’t really be compared here when referring to education but still are they worth the money they get? And yes, the standards for medic’s is not as high as it should be, but keep in mind, we are expected to evaluate / diagnose /and then TREAT life threatening conditions in the field in a few minutes, something that can take a lot longer in the ER (and if you’ve ever seen a CODE run in an ER verses the field, you tell me which one goes smother?) Not everyone can do it, and few can do it well. Again, You’re right EMS for most is a dead end CAREER, and I even work in a system that does some advanced critical care procedures as well, Balloon pump, neonate transport etc. So I have to ask why is that only worth 1/50 (or so) of these other professions? Why do we get paid what we do, when doing what cannot be called, by any standard, trivial work. No one here has argued the point we are undervalued. But again I ask why? Where does the value point get defined, is it us? or the public?

Ya, your right of course, but keep in mind a LOT of EMS folks do have a 4 year degree, that’s where I was going with the two years. Of course if you wish to compare the top of the medical food chain, then you have at least 7 years before you can start your specialty and 2 to 4 years after that before you can “practice” (or around ten years before you start to make any "real" money. On a side note here in NY you have to be an EMT first (aprox 200 hrs training) then to become a medic takes a year, with about 1600 - 1800 hours of class and clinical time combined. for a total of almost 2000 hours (1 working year). Why is that only worth 1/50 (or 2 cents for every dollar) of these other professions? Where I was going with this post, is how little we get paid and how low we are on the ladder, doing what cannot be called trivial work. We are undervalued, I don't think anyone would argue that point, But why? Where does the value point get defined, is it us? or the public? Just stirring the pot some on this as we should be thinking about why we must work two to three jobs to get by....

Under the title of the more you know the more power you have, I present the following evidence: Perspective, it takes two years of school to get a JD (jurors doctorate) law degree... OK so how much is a lawyer worth? Fresh from the Wall Street Journal (WSJ). I direct your attention to the last sentence of the third paragraph. Lawyers Gear Up Grand New Fees Hourly Rates Increasingly Hit $1,000, Breaching a Level Once Seen as Taboo By NATHAN KOPPEL August 22, 2007; Page B1 The hourly rates of the country's top lawyers are increasingly coming with something new -- a comma. A few attorneys crossed into $1,000-per-hour billing before this year, but recent moves to the four-figure mark in New York, which sets trends for legal markets around the country, are seen as a significant turning point. On Sept. 1, New York's Simpson Thacher & Bartlett LLP will raise its top rate to more than $1,000 from $950. Firm partner Barry Ostrager, a litigator, says he will be one of the firm's thousand-dollar billers, along with private-equity specialist Richard Beattie and antitrust lawyer Kevin Arquit. The top biller at New York's Cadwalader, Wickersham & Taft LLP hit $1,000 per hour earlier this year. At Fried, Frank, Harris, Shriver & Jacobson LLP, also of New York, bankruptcy attorney Brad Scheler, now at $995 per hour, will likely soon charge $1,000. At large firms, billable rates have climbed steadily over the years, since 2000 rising an average of 6% to 7% annually, according to the law-firm group of Citi Private Bank, a unit of Citigroup Inc. But for some time, the highest-billing partners at top big-city firms have hovered in the mid-to-high $900 range, hesitant to cross the four-figure threshold. "We have viewed $1,000 an hour as a possible vomit point for clients," says a partner at a New York firm. [b]"Frankly, it's a little hard to think about anyone who doesn't save lives being worth this much money,"[/b] says David Boies, one of the nation's best-known trial lawyers, at the Armonk, N.Y., office of Boies, Schiller & Flexner LLP. A select group of attorneys began billing at that rate before this year, such as Stephen Susman, a founding partner of a Houston firm who has tried big-ticket cases around the country, and Benjamin Civiletti, a former U.S. Attorney General under President Carter and a senior partner at Washington, D.C-based Venable LLP. And in London, top attorneys bill at rates that, when converted, can hit almost $1,500 an hour. As a critical mass develops around fees of $1,000 an hour in New York, though, more firms may feel comfortable going to that level and beyond. "One-thousand dollars per hour has symbolic significance," says Robert Rosenberg, a Latham & Watkins LLP partner who bills $925 an hour. "But like the year 2000, it's just a number." Yet, many attorneys are still reluctant to charge $1,000 an hour. "There is a perception issue between $1,050 and $950," says Hugh Ray, a partner at Andrews Kurth LLP in Houston. "At some point, you look bad if you go too high." Mr. Boies says psychology in part has held him back from charging more than $880 per hour, noting, "When I started practicing law in 1966, my billing rate was considerably under $100." Law firms also derive comfort from running with the pack. "We prefer not to be market leaders when it comes to rates," says J. Gregory Milmoe, a bankruptcy attorney at Skadden, Arps, Slate, Meagher & Flom LLP in New York. Mr. Milmoe says in September his hourly rate will climb to $950. Firms' hesitation to breach the $1,000 mark shows that legal services aren't unlike other high-end products that sell at "just under" prices, like the $19,900 car, says Eric Anderson, a marketing professor at Northwestern University's Kellogg School of Management. "The sellers are worried that they will be perceived as extremely expensive." Some clients' reactions bear that out. Brackett Denniston III, the general counsel of General Electric Co., says the company has paid $1,000 per hour for "specialized" legal advice. Still, "that's a line we'd rather not see crossed," Mr. Denniston says. "A thousand dollars per hour is emblematic of the high cost of major law firms," he says. "More than rates, my greater concern is the overall inflation level" in legal costs. Thomas Sager, assistant general counsel of DuPont Co., says he recently balked when a New York lawyer cited $1,000 as his hourly rate. Instead, Mr. Sager says, he agreed to pay the attorney a flat monthly fee. "One-thousand dollars may be someone's choke point, but mine is actually a lot lower," he says. Still, some lawyers are confident they're worth $1,000 per hour, and that now's the time to break the barrier. "I haven't personally experienced resistance to my billing rates," Mr. Ostrager says. "The legal marketplace is very sophisticated." Law firms say the boosts aren't just about lining partners' pockets. They're partly a response to booming costs, which in recent years have included skyrocketing associate salaries -- first-year lawyers in many firms make $160,000 a year -- and expenses associated with geographic expansion. While it's hard to raise prices on standard legal work, for matters such as bet-the-company deals, intricate patent disputes, huge bankruptcies or complex antitrust litigation, firms often feel they can raise fees for name-brand partners without upsetting clients. Indeed, clients are often most cost-conscious about junior attorneys, believing they provide less value-per-dollar than senior counsel. Considering a major-league baseball player can make the equivalent of $15,000 per hour, "$1,000 for very seasoned lawyers who can solve complex problems doesn't seem to be inappropriate," says Mike Dillon, the general counsel of Sun Microsystems Inc. Hourly rates, of course, tell just part of the fee story. Firms occasionally discount their stated rates for top clients. And companies sometimes prefer to pay their lawyers a flat fee for each case or deal, believing it encourages more efficiency than billing by the hour. Plaintiffs trial lawyers often bill on a contingency-fee basis, earning a share of a settlement or verdict -- an amount that can dwarf top rates. "It represents an opportunity cost when I am working by the hour," says Mr. Susman, who last year raised his hourly fee to $1,100. He did it in part, he says, "to discourage anyone hiring me on that basis."

Shane, I truly appreciate your intentions I really do; However, I humbly request this be dropped. Our strength as a group is through knowledge and communication, sharing lessons we have learned and the sources we have gotten them from. Retribution is non productive, and no apologies for what was said are (were?) necessary. Mrmeaner, I’m very sorry for your friend, I have dug myself out of 5 figure debt twice, it’s no picnic and my wife says I’m now grinding my teeth at night over this new venture. (I never took offence at your rant, stuff happens). Everything I wrote came from a combination of experience, good advice I have received, lessons learned the hard way, and lots of reading about finance. No snake oil here, just notes from the school of hard knocks. Dustdevil , I think the editor of JEMS gave it the name tactical, but it may have been my friend in NYPD ESU (who is a tactical medic). Another friend that just got back from Iraq (Navy Medic) but stationed on the ground (air ambulance) I think that’s what he called it (he flew in a helicopter to retrieve wounded in hot zones under fire) Says tactical is as tactical does, it’s not in the name, it’s in the performance and use. I just set out to make the best tool possible for the job. I hope the idea works. One of the guys I work with brought it out to a firing range and it stood up to 45 cal rounds, it finally took a 50 cal rifle to take it out. He thinks Tactical is a fine description, and honestly who am I to argue? I really can’t get into why I think it’s the best for the job, because someone will accuse me of promoting it. If your definition of tactical is it has to kill something, or support that end, I guess it’s not, but if your definition is that it has to be built stronger then it’s intended purpose, so it can stand up to major abuse, I’d say it is. You be the judge, is that fair? Finally Ruff, (I think it was you that asked, I can’t find the thread, so if it wasn’t you my apologies) I do have a BA, with a Post Bacc in computer science, I was going for a dual major in Bio and Fine Art, a professional student if you will who finally had enough, and got out before I could qualify for the BS (the impatience of youth, I should have stayed and finished). My masters will be in disaster preparedness and planning, as soon as I get the time and money to finish it. For more years then I wish to think about I worked in Information systems as a business consultant, (Volly EMS on the side) I traveled so much I've actually had mail forwarded to my hotel room, the stewardess knew my first name and which client I was going to. I easily worked 80 – 100+ hours a week for a ridiculous amount of money, and when I finally got a local client so I didn’t have to travel as much I worked for a year in tower 1, we all know what happened next... Now I just work EMS, 40 – 70 hours a week with a small business on the side (an additional 30 – 40 hours) for a ridiculously small amount of money… There, I hope this finally answers everyone’s questions about me. Now if we can get back to the topic at hand that would be great! Thanks to all who stood up for me. All apologies accepted. Best to all WANTYNU