checkersfire

i'm just wondering if there is a law in most states against 911 abuse?? if not THERE SHOULD BE. that way in these cases the p.d. could be notified and citations issued. i know it's different for some private services, it they think they'll make a buck they will haul anyone AMR/ABBOTT etc.

Although we've have had some do things close to this, I would almost transport just thinking he was a nut because of calling the rig for this! I would have to assume something is not right with this person. But ultimately, I would contact medical controll. My company would want me to transport (dont' want to lose the revenue). The other concern is if you leave and he walks out into traffic or drops dead on the sidewalk after you leave THERE MAY JUST BE A LIABLITY ISSUE THERE I have had them waiting at the curb with their suitcase waiting on us to transport them to hospital as direct admit cause medicaid won't pay for a cab

i've seen it, never got to use one, the medic that has it loves it. i think there is two of them, one for adults and one for peds. i do know their somewhat expensive though.

nobody is trying to make you their whipping boy, ryder is stating facts. i have my share disagreements with some nursing staff memebers at certain er's and snf's. i am licensed and it's my ass in a sling. like he said your under their wing right now. you may not think so, but you come across here as if you have an attitude, maybe you don't mean to, maybe your expressing yourself the wrong way? i help adjunct medic students in the classroom and for some reason, alot of students especially in the 1st tier or semester seem to have an attitude problem, they have a "know it all" attitude, i've had some that would interfere with my pt care when i was doing my medic runs and the were the emt on the truck and the preceptor had to put them in their place. please take my advise, be humble, do it their way, when you graduate, you can take a chance and do what you want. when your on your own out there, it's another world and it's real humbling when your on your own the first time in the truck and don't have a preceptor there holding your hand. enjoy the experience while you can.

i have been told that the "bevel down" idea works for going thru valves. i have also had an older medic tell me the he has sprayed a shot of nitro on the preferred site and that will make some harder veins appear. i would be careful when and where i tried this technique, i don't think your preceptors would like it very much. as far as your clinical sites. your going to run into alot of asshole rn's, lpn's and md's along the way. you just have to bite your tongue and deal with it until you get your license. once there, you can put them in their place, but make sure your RIGHT 100% or you will completely lose respect and have a hard time almost everywere you go. it seems like everyone knows everybody in this field. your not going to get every iv, intubation in the field. so don't expect to, and ANYBODY on here who says they do is a DAMN LIAR!!!! most medics get an iv around 80-85% of the time and it seems to come in spurts, some weeks you can't miss and other weeks you won't hit even the biggest vein.

No, the starting base pay for emt for example is 8.90 an hour, if you achieve "b" rate its 9.90 and "a" rates is 10.90. If you and your partner are dual licensed (illinois and missouri) you get an extra 65 cents an hour. Only if your on the Illinois side though, the Missouri employees don't have that option. The reason I'm complaining is the fact that they start you out at "a" rate automatically then if you mess up it feels like your being punished, when in reality they should start you at the lower rate and you earn your "a" rate and maybe it would seem different, I don't know. I figure it won't change anytime soon. My main reason for posting on here was to let the other amr employees across the country know what they are trying to implement all over!

They are not technically "withholding pay" they say your base pay is actually $2 dollars less an hour, so its considered a "bonus" if you do everything right.

I can tell you how they stay at "a" rate, they cheat their times!!! They will call en route then sit on scene another 10 minutes or drop the pt off at the er and have their partner go outside and put them "back in service" so their times stop. Like I said, I don't have so much of a problem with the paperwork portion, we can control that. Like mshow stated above, there are some substandard people here where we are that never get in any kind of trouble. I can't understand why? they seem to have the worst bedside manner, are the rudest to the staff at er's and snf's. They shuffle pt's in and out like cattle to keep their times good, to me that's not good pt care at all. Unfortunately, when these ass clowns do this, it makes us ALL look bad and incompetent. I have known people who have done some pretty stupid, I mean REALLY stupid things and still have a job and are at "a" rate and still have their job. I guarantee if I went in tomorrow and even mentioned I might call a union to talk to them, I would be gone by Thursday, and that's no joke, and I have a very clean record except for some absences for when I had skin cancer and missed 2 months last year. The plan looks good on paper, and may sound good to those on the outside, but when you really look into it, the way it's set up here, it stinks. I was asked a couple years ago what I would do different if I were mgt, my reply was do away with the performance plan, and if someone can't maintain an acceptable performance then they would be going bye bye lol. The paperwork issue is just an add on to the total plan, if you can't figure out the paperwork in a couple days, the you really shouldn't be touching a patient they have changed some things, used to, 911 (code 3) calls counted on your times, so if your on-scene at a mvc and waiting 35 or 40 minutes for the fire dept do exticate, your times counted. Now, at least if your call is dispatched code 3, your times don't count. If your called to a snf or mutual aid with a fire dept, it's considered "prior care on scene" which is a code 2 call (lights and sirens) but your times count, even though your doing the same treatment. Also, wait and returns to the dr's office used to count on your times, or if you were waiting for another crew to help you lift a pt, your times counted. At least they changed it so, code 3, wait and returns and lift assists don't count anymore so that's one positive.

I agree, but I would rather lose the instance program in trade for the "times" I also, can fix my times sometimes. But I refuse to be fraudenlant about it, and sometimes that would be the only way to stay at "a" rate. I also agree that they don't get rid of the "dead weight" they need to. I don't understand why, but its' been that way for years. It seems the worse you are, the easier it is to keep your job?

Let Let me tell you something junior, I've been here ALOT longer than you have!! I have seen alot of bs at Abbott/AMR and have heard from people on the Missouri side that have worked for AMR in other regions. They loved it, there was no pp plan, they had excellent equipment etc. The person trying to implement this plan at other places is our own executives from here that have been promoted to the region level! How do you figure a union would bring more trouble? What, with better benefits, higher wages, no more pp plan? I don't even care about the pay raise, IF, they did away with the pay for performance plan and left us at "a" rate. Actually, I don't mind if they left it there for the paperwork, we can control our paperwork, we CAN'T control our times, unless you want to do like the Missouri crews and cheat your times one way or another. I refuse to cheat, I also refuse to give substandard care to meet a time quota! Like I've said here before, when I get tired of it I will leave, then you'll be even more short handed and you can run even more! lol

How far are you from Seattle? I have an old boss/friend that is a cop there and I have been considering coming up that way.

I don't know either. The rumor going around here is that it is over whether to sign 3 yr contract or 4 yr. I believe it has to be more than that. Who sponsors your union? Here the only ambulance private service that is union is Gateway and that is backed by the teamsters. They do have it pretty good. Their previous owners almost lost the company by some misconduct, but they were just bought out and making a come back. Their emt's start out at $14 an hour and medics at either $19 or $20 an hour. Thats why amr is losing alot of people here to them!

My apologies to the snf nurses on here. If your a snf nurse that was prior ems then I wasn't referring to you at all. The snf nurses with prior ems experience and er nurses are the ones that will give you the decent pt care report when picking up a pt and will listen when you are dropping off a pt. You can always tell the difference. I'm not joking when I say though that around here there are some idiot nurses in our snf's in the st louis area, I don't know if its that way in the rest of the country? I know we have some morons in this field also. I get disgusted when I go to pick a pt up on a serious call (they have advised dispatch that its non-urgent) when it clearly should have been an "emergency" call, then when you arrive, they are at the desk and the pt needs to be intubated (I had that actually happen recently) the nurse was at the desk, handed me the paperwork and says "the pt is in room 108 and ready to go" I get there and they are breathing 40 times a minute and labored. I wasn't a happy camper, but you can't say anything to them, they complain and then you get in trouble for pissing off a customer. Again, my apologies to the "good" nurses on here I may have offended.

Some of you seem to be confusing the issue here, or at least not getting it!!!! Example: I explained about the times, 31 minutes bls and 42 als. If I am waiting at the p/u for 35 to 40 minutes for the facility to get the pt ready for me to transport (I'm talking about non-emergent calls), and I get to the destination and have to wait another 15-20 minutes for an rn to sign and take over pt care or just waiting on a bed, then my times are shot and I just lost a dollar an hour, or if my truck breaks down while your still on scene your times keep running (I know because it has happened to me before) I was considered to be on-scene90 minutes waiting on the tow truck. These things are BEYOND my control, has nothing to do with my skills as a medic, but I still lose just the same. I don't have a problem with them docking my pay for substandard paperwork nor anyone else's. Paperwork and pt care you CAN control, just not your times. They don't count your driving times because frankly if a crew was in an accident and told the court they would be punished for driving times, I think there would be a nice little lawsuit there? Many times we are dispatched to p/u at a snf or hosp when we are 5 minutes away, normally there is a 30 dispatch time. I can't justify taking 30 minutes to get to a location when I'm posted less than a mile from there. But when I call on scene, my times start rolling and if the pt isn't ready, there is nothing I can do about it. Now and then you will get a dispatcher who will tell you in advance a call is coming out at a certain time so you can time it right, but that's not the "norm". So I have heard people on here praising this plan, who doesn't really understand the whole idea!! Yes, there is a 60 day grace period as a new hire, and you stay at the higher rate of pay from the start until you mess up, so basically everyone expects it. The thing that really pisses me off (pardon the french) is that a couple yrs ago, I was in financial trouble, had to file bankruptcy. They called to verify income, they gave them my "a" rate of pay, not based on "c" rate. I filed the chapter 13 payback plan were your payments are based on your income. The company denied the different rates of pay when the lawyers questioned them during the bankruptcy. If your ashamed of your policy, then don't have it. If your not ashamed up then why are you denying it? Still havn't got a straight answer on that one and probably never will lol.

Thanks Dwayne, that's exactly what I was trying to say. The only thing is, they don't care so much about the pt care part of it. If you mishandle a pt, some misconduct etc, depending on who you are, you might get corrective counseling, a day or two suspension. If, you happen to be someone they want to get rid if, then you will be terminated for fairly minor offenses. I don't think the company sucks, just some of the mgt. I have been with them many years and have seen some good emt's and medics come and go. What I have been trying to tell people on here (mostly the amr folks) that may end up with this plan, because I hear that amr actually likes the idea, is that you may end up with the same plan and it stinks. Our morale is at an all time low and it's because of the "a", "b" and "c" rates. Another change was implemented, now if you can't have the pt sign the back of the form, you must get a proxy (which has always been the case) but now you have to document in the "objective" section why the pt can't sign the report, and if it isn't an rn proxy at the snf or er/destination, then you have to also put in their address and if you don't you drop in pay again. I just think our pt care should come FIRST and all this other crap second. I guess also what I'm trying to say is, it does affect the way our people do pt care. I have been at "b" rate because of my times, I refuse to lower my standards and like I've even told mgt, eventually, I will become tired of losing my pay and I will leave and go somewere else to work. I do know crews (both emt's and medics) who have/will give poor patient care to stay at the "a" or "a" plus rate, will commit fraud, forgery, cheat their times etc. We have an excellant Medical Director, he told me he didn't even realize this plan until a few weeks ago, no one had brought it to his attention. He knew their was a plan, but the way it was explained to him it wasn't punishment, but reward. Our employees have heard the last 8 months or so (since we were bought out by amr) that there was going to be a big change in April. My point is, I know of about 4 medics and 6 emt's that are leaving in a couple weeks if it doesn't change. We can't afford to lose anymore people, we are so short handed now, I could work my 16 hours a day x7 days if I wanted because of the staffing now. emt's aren't so in demand right now, but it only takes approx. 4 months to train them, it's a little longer to get a medic through. Maybe someday, someone in this company will wake up and change things for the better here and we can keep people.

are you with amr? at least your union there, the last time someone tried to bring the union here, they fired about 10 of them that were trying to organize (although that was before amr took over here). no i refuse to work here at "c" rate! our last "across the board" pay raise is contingent on you being at "a" rate. if you drop to b or c rate, you also lose the pay raise (which i think was 10 or 15%) not sure to be honest. i'm just curious if anyone else in amr has the same plan??

I agree in bonuses also, we used to have a bonus for perfect attendance, clean driving record after 2000 driving hours, they took those away. It's not about how good the pt care is, they are worried about the signatures so medicare will pay for the trip. I see you are from Canada, so you don't have to worry about those things up there. An example, someone that has chest pains, what would you put in your report for an assessment?? R/O chf, mi or something along those lines? They want us to put in the assessment block a reason the person has to go by ambulance. If I don't put what suits them, I can potentially lose a dollar an hour. These are the kinds of things I'm talking about in here, not being rewarded for doing a job that's above and beyond. It's not just here, paramedics and emt's across the u.s. aren't being paid what their worth. Not for the hours we put in (extra hours for ceu's etc) that we don't get paid for to maintain our licenses. I'm not trying to be a smart ass, but if your not with a company that has this sort of plan (like amr) here in missouri and illinois, then it's hard to understand exactly how it works. It's not just one or two little things to maintain, I couldn't possibly explain them all here. I'm just one of the many here that are unhappy with it, there is getting ready to be a major exodus from this company if they don't change things. I know a letter was written to the CEO about this and hopefully they will at least look into it.

Everybody here seems to be missing the point. It's not a matter of "doing a better job" you are being penalized for things that are out of your control! I think I do a wonderful job, thanks for the input anyway! I don't like dropping a dollar an hour my first week as a medic because I'm more worried about my patients and ended up 1 minute over the alloted time. I owe the company one year for helping with my education, so I'll be there for my obligation and then I probably will move on to something better. It doesn't matter how you look at it, whether your losing money or not getting the "bonus" either way your losing money!!!!!!! I can tell from some of the comments in this forum, alot of you must be in management. Management is the ONLY people who benefit from these kinds of plans.

hey, i'm not the one that started taking the shots!

you know who i am. i work on both sides. there is NO pay difference between il and mo unless you and your partner are dual lic. the only exception is the fact that if you don't have a mo lic, then you remain at the 'B" RATE. it's only a dollar difference between a and b and b and c rates! i have been here many years so i know all about the pay plans, we also used to have driver's bonuses, bonuses for perfect attendance etc. they took all that away. you are right that is was abbott that did it, amr just didn't change it. i know alot of people on both sides are just waiting to see what amr does, if they don't change things, alot of people emt's and medics will be flocking to gateway. i can make more as an emt at gateway that a paramedic at abbott/amr makes.

what are you, an english teacher? look john wayne wanna be. you must be one of those snf nurses, i don't know where you are from, you obviously havn't worked around any of the facilities here. you are right about this pay for perfomance plan casues alot of fraud in the field. unfortunately, the honest people and the hard working are the ones getting screwed by the system. the ones who commit the fraud always seem to be at the top rate, run the least amount of calls and sadly give the worst patient care and makes us all look bad, and for what, so amr can save a buck?? i have always said, get rid of the pay plan, and if crews can't maintain a minimum standard then they need to GO!!

yeah, i can sit outside and wait, if i want to LOSE a dollar or two an hour for a month! that's our whole complaint. i don't have an issue so much with the paperwork and losing a dollar if not done correctly, you can control that. you CAN'T control the times.

the problem i see with most classes, whether it be emt or medic is that most cover more in depth in the beginning, but then start focusing on taking the national registry exam after that, with the attitude that "you will learn most of your skiils in the street" i hear from alot of new emt's that their class was nothing more than a study session for the nremt written exam.

let me also add, for ten dollars an hour (the base pay for a medic) i could be flipping hamburgers at white castle. the sad part here is that amr is one of the better paying companies around here and that's why people are leaving this profession and utilizing their skills elsewere. these companies wonder why they can't keep decent people. alot of the younger medics leave here and go to municipalities on the fire dept's for me i'm just too damn old lol, so i'm sort of stuck. i'm not in it for the money, but don't dangle a steak in front of my face then throw me a hot dog.

here, you have a, b and c rates. your base pay is c rate officially. they hire you in and give you a 60 day grace period were you are at the "a" rate which is $2.00 an hour above "c" rate. to stay at a rate you have to be perfect on your paperwork, i.e. signatures, who signed etc. sometimes you CAN'T get all the info, either hospitals or even the individuals won't give it to you, they claim it's a hippa violation. second is the times. you take the time you get on scene until you go enroute- that block of time and then when you call on scene at your desitination until you go 10-8, that block of time. those two blocks added together can't go over an average of 32 minutes for bls and 42 minutes for als or you drop to b rate for a month, your also graded a month at a time also. the only exception is on code 3 calls (emergency) for us don't count towards your times. BUT, if you are sent to a snf code 1 (non-urgent) or code 2 (urgent but with care on scene) your times still count. anyone who works in this field knows that the snf nurses are idiots and shouldn't be counted as "prior care on scene" i could tell numerous stories of them sitting on their asses at the nurses station while i'm in the back working a code (they didn't even know the patient was coding) the snf or calling facility determines how we get dispatched! it's not so much the on scene time that's the problem, unless your doing a transfer and the pt isn't ready and you have to wait 30 minutes (and you wait while the timer is still ticking) they don't take you "off" the clock while your waiting. i do the same patient care whether it's dispatched as emergent or non, especially if the pt is going to the er for an acute problem. so if i have to wait at the hosp for 20 minutes to get a bed or give report to the rn on code 3 calls no problem, but for 1 and 2 calls it is. it happens ALOT around here, especially at your bigger facilities. i'll give you an example-the other day we were dispatched to a 148 which for us is a NON-URGENT CALL FOR A SEIZURE PT to a snf, this is a place that dr's, lawyers and business execs go (not the average or poor person). when we got there we waited 20 minutes for the security guard to escort us from the back door of the facility (they don't want ambulances pulling up out front) then the pt was eating breakfast so they insisted we wait until he was finished (even though he had been unresponsive according to them just 30 minutes prior) actually the seizure started, lasted 5 minutes then they said he was unresponsive for an hour, that's BEFORE they called us and by the time we got there he was fine. did he really seize? who knows, i think they were full of crap. anyway, when we got to the hospital we were taken straight in to the er but it was another 20-25 minutes for the rn to get around to signing our paperwork. it only takes a few calls like that and your at "b" rate for a month losing a dollar an hour. and if your times are really bad you could drop to c rate. and your paperwork is based on a percentage. 1 missed signature drops you automatically down (anything less than 100 percent). and if you had more then you drop to c rate and lose $2 an hour for a month. i will say with the times your graded over a 1 month period, so you can see were you are at and speed up if you need to. THE END RESULT, IT CAUSES SHITTY PATIENT CARE!!!!! CREWS ARE MORE WORRIED ABOUT THEIR TIMES AND PAPERWORK BEING PERFECT THAN THE PATIENT. i don't have a problem with bonuses based on performance every quarter or even every month, but it shouldn't affect our base pay. the base here for an emt is 8.90 an hour at c rate and medic is around 10 dollars an hour. there is a plan called A plus rate, where if you don't have any absences, tardiness or complaints you get a small percentage raise, you also have to be at "a" rate to get that also. if your at a rate, you also get that last raise percentage they gave us, but if you drop to b or c rate, you also lose the raise percentage. THAT'S WHAT EVERYONE HERE IS COMPLAINING ABOUT WITH US.