46Young

As some of you may already be aware, BC Ambulance Service paramedics have just had a contract rammed down our throats via provincial government legislation. This legislation extends the current agreement, and all addendums made to it, until the end of March 2010. Included in the legislation is a 3% wage increase payable only on "working" hours retroactive to April 1, 2009.

This is an unprecedented move on the BC government's part as CUPE 873 was in the process of voting on BCAS' "final offer". This legislation is a clear attack on the paramedic profession and in direct violation of the Canadian Charter of Rights and Freedoms. It does not have a hope in hell of standing up in court which unfortunately is a moot point as the Olympic Games will be over before a court challenge can be mounted.

BC paramedics repeated requests for the appointment of an independent arbitrator to settle the dispute have fallen on deaf ears. Having volunteered to submit to binding arbitration, the BC paramedics have completely run out of bargaining room. For the interim decals will stay on the ambulances and regular uniform will stay in the closet (with the exception of Remembrance day when everyone will be in full uniform out of respect for veterans and their families). The BC Federation of Labour conference will be held later this month (November 2009) where CUPE 873 paramedics are sure to be the hot topic of the year. I expect to see further action as a result of said legislation following the BCFED convention. What form it will take I don't know and will not speculate at this time.

Ed

B.C.'s striking paramedics ordered back to work

Paramedics blame VANOC for strike bill

B.C. paramedics legislated back to work after all-night session

Okay, so striking isn't an option. Have you tried a slowdown? You know, take an hour and a half to write your report at the ER each and every time? Decon your unit for an hour after each and every call. You're technically not striking, but you'll cripple the system nonetheless. Of course, if something seriou(which is maybe 10% of calls in reality) comes across, go available to run the call. If you do IFT, take in excess of an hour on the floor and do the same at every drop off, assuming it's a routine transfer. Since you're frequently held over, make it standard practice throughout the service to bang in sick the next shift after each mandated holdover, each and every time, to cost them in OT what they ought to be spending in higher salaries and hiring.

Does your union have no political connections? My union uses Firepac $$'s, which is only 5 bucks out of each check (voluntary) to assist with lobbying, campaign contributions for politicians that are sympathetic to our needs, PSA's and such. We also participate in numerous charities, both because we generally want to, as well as the great PR that we receive. It works exceddingly well here.

Well damn. I thought about applying to Charleston County when I move to SC next year (hopefully). Now though, I think I'll stick with Horry County or Florence County. Since I'm going to be in Conway SC, I could do with either or work for Brunswick County in NC. Decisions, decisions. Charleston County doesn't sound like anything I'd be interested in.

http://www.emtlife.c...unty+ems&page=3 post # 28

http://www.emtlife.com/showthread.php?t=14118&highlight=charleston+county+ems this thread as well

If it were me, I would always put things into terms such as "Staff advises the pt was found on the couch and observed to be twitching." I'll always paraphrase pt/staff/bystander accounts using that language unless a direct quote is necessary. Staff "advises" vs staff "said" makes a world of difference, especially in court. Don't quote verbatim unless absolutely necessary to validate treatment.

What, exactly, is QA/QI's official problem with your statement? It doesn't seem like much of a big deal to me. Was there a pt care error with this call or something?

Pro-Transport-1 is a very bad EMS company to work for. I strongly feel that EMS is a family, and because I work for Pro-Transport-1 I feel I need to protect my EMS family members. I know that when you read the nice job EMT or Paramedic job descriptions from Pro-Transport-1 it sounds like Pro-Transport is a good company.

Let me give you some true facts:

Pro-Transport-1 401K DOES NOT match at 15% as someone here stated it's 2% after 2 years of being a Pro-Transport employee. Before 2 years of service its 0%, Pro-Transport doesn't match for those employee's at all.

Pro-Transport-1 EMT's care very much. The problem is with Pro-Transport management, and ownership.

Medical Benefits: Medical Benefits at Pro-Transport-1 only covers 50% of the employee and 0% of Pro-Transport employee family members. This is for Kaiser Only.

Yes Pro-Transport offers other medical plans then Kaiser but the company pay's 0% into them EVEN FOR THE EMPLOYEE. Pro-Transport employee's pay 100%. Co-Pays are high with both. A Kaiser ER visit will cost you $250!

Starting pay is $9.50 per hr. which is a true statement. Yes you do get call bonuses. The call volume is low as others have stated about Pro-Transport. 4 BLS Calls on a good day. That does very depending on what station within Pro-Transport you work at. Many employee's have complained that the calls are not counted correctly. I personally haven't had any problem, but have seen many who have. Some have been shorted more then $25.

The ambulances are often missing equipment again management is aware and routinely sends you out on calls. Often the rig's are down and at Ford. Sometimes there are no ambulances to drive. Your call and your $5 gets routed away. O another thing dispatch does not dispatch evenly. So 1 crew may have 5 or 6 calls, and another crew may have only 2 calls. Even if the crew with 2 calls came on shift before the crew with 5 or 6. Pro-Transport management is aware and says their working on the problem.

Let me just close by saying, I just feel strongly that these items needs to be made aware to EMS personnel who are thinking of applying. Yes, it's a place to get your foot in the door with EMS. If you're a new EMT come to Pro-Transport, but get in and get out. You will find that all I am saying about Pro-Transport-1 is very true. Honestly there is much more I could say about Pro-Transport but I think you get my point.

I strongly believe that those wishing to get some initial experience in EMS, where private based IFT is the only feasible option, should ONLY DO IT ER DIEM. Working at Wal-Mart, Costco, Staples, Applebees, TGIF, or something similar FT will likely pay better, and provide superior medical benefits. That would be a good strategy while waiting for an ER tech spot, a position in third service EMS, hospital based EMS, or while completing a degree.

When you're hired as a brand new EMT for a private based IFT company, I strongly suggest getting shifts exclusively with medics. You'll see more acutely ill pts, you won't have to worry about any liability/negligence from working with an incompetent or inexperiences BLS provider. It's likely that you'll learn more when working with a medic, anyway.

That's exactly what I did. After getting my EMT, I kept my FT job in beverage sales, did a stint as an EMS vollie for MVVAC (NYC), and worked per diem for seven months at Hunter Ambulance-Ambulette Inc. in Inwood NY. When the NSLIJ HS CEMS hired me, it was for FT employment, and I was set. At Hunter, it quickly became evident that I was working with inexperienced, clinically ignorant personnel on the whole. When I had exactly two weeks on, I had a partner that was brand new to the field. It was at that point that I chose to work exclusively with medics. One crew brought a pt with rigor into the ED in a stair chair with an NRB attatched. I've heard of a Metrocare (now Transcare) crew doing something similar. I've also witnessed a crew "bagging" an arrest pt through the NRB resevoir. I took pity and threw them a BVM so they wouldn't get jammed up. You don't want to get mixed up in a negative pt care issue at all, let alone that early in your career.

Looks like you are hitting all the EMS forums today with your message. I guess I'll repeat myself on this forum.

In all fairness why don't you post a comparison of other transport services in your area to see if benefits, wages and bonuses are similar?

Even in the SF Bay area, it is difficult for an EMT to demand much for wages. Realistically, 3 months of training and "BLS" care for 4 or 5 patients per day doesn't bring in the big money. With the short time for training and the many tech schools mass producing EMTs every 3 months or less, there is an abundance of EMT-Bs in the area just waiting for a job that at least offers a paycheck and/or health insurance.

Many laid off and well educated people from Silicon Valley are now working as EMTs after a quick course just to keep their families insured and bring in some money. Some are just trying something different while inbetween employment contracts. Of course they will probably return to their other careers and lifestyle once the economy in that area picks up.

If you don't like your job you can try to go elsewhere but as an EMT-B you might be limited.

True. Many have been laid off, with bills to pay and mouths to feed. When you need work, and need it yesterday, you're going to look for the quickest, easiset option. Enter EMS. A GED, 600-700 bucks and 120 hours of your time will make you eligable for hire. You and everyone else who seek a quick and easy route to employment. As such, EMT's are a dime a dozen, and are compensated as such. the most desireable agencies can afford to be selective, and also require prior experience, to at least see some form of work history in the field. Continue your education to seperate yourself from the pack. And contribute to your 401k regardless of the employer's willingness to pay.

Recommended reading - The Truth About Money, The Lies About Money, and Rescue Your Money (read this first), all by Ric Edelman.

Add paramedic fly cars (chase cars, QRV's, whatever you want to call it) during business hours, when vollie participation is at it's least.

The North Shore LIJ Health System CEMS is currently providing medic fly cars to several communities in Suffolk Co LI at no cost to the public. This was negotiated with the County, as NSLIJ bought a number of hospitals in the area, giving the health system considerable market share in the area. The fly car program was a give back to the area. The contract is set to expire, though, to the liking of the health system.

The town of Rockville Centre contracted out EMS coverage to NSLIJ. The CEMS is a combo NYC 911/IFT agency. The CEMS provides 24/7 ALS coverage with an EMT/medic crew. The CEMS provides all equipment including the bus. The town guarantees a certain amount of revenue for the year. I think it's around $500,000 or so. The town keeps any additional revenue from billing. Worth mentioning, this is an area with a high cost of living and tax rate, with a proportionally high number of privtely insures residents, and few uncompensated cases.

Perhaps the vollies in your area can put out some paid fly cars during the day. Perhaps an area hospital can provide a staffed txp unit for a certain amount of guaranteed compensation. To get the hosp to agree to a lower rate of compensation, perhaps the community could persuade local NH's, clinics, urgent care's and hospitals to let any IFT contracts with the privates expire, and let the hospital have exclusive rights to the IFT business in the area. The community gets professional coverage, and the hospital gets the IFT windfall. Win-win.

That is a concern - here in Florida as well as in New York. I always thought that healthcare was the safe fallback career, you can always get a healthcare job - ha. I am sure there are more jobs in healthcare than there are in a lot of other fields - but also a lot more people competing for each job these days, as EVERYBODY floods into healthcare.

What about nursing? Does the job market seem better for that in NYC?

This is the way I see it - some areas of the US are populated primarily by the working class, with a lower proportion of the elderly. With less elderly come less NH's, and less of a need for hospitals and clinics in general. Charleston SC is a good example. 4 out of 5 people I've spoken to that live there are in their mid 20-s to mid 40's, and have relocated from other areas. I didn't see a whole lot of NH's, or elderly in general for that matter. The eldery that I did see were generally in much better health, on average, than the elderly in NY. In NYC, there are upwards of 8 million living there. There is a huge population of elderly, who are in pooper health, on average, than other areas of the US. There are an ungodly amount of NH's there. There are plenty of hospitals in the greater NY area as well.

Remember that the population expands exponentially, and the proportion of elderly vs others will steadily rise, if not explode upward. The baby boomers will reach retirement sooner or later. Who's going to take care of all these elderly? In NYC, all 8 million+ will amplify any population shifts regarding age, more so than any other region in the US. Now THAT'S job security!

I hear ya. The reason we'd move to New York is to get the in state tuition. Other than that, I'm fine with having her go to college wherever she wants. She's been obsessed with going to college in NYC for years, and I'm fine with that. Once I moved there' I'd assess things, and after she got her one year of residency, I'd decide if I wanted to work and live in NY forever or if the high rents eat up too much of the higher salary. (Florida salaries are really low but rent is cheap.)

There has been much debate about whether it's more beneficial to earn less with less overhead, or earn more in an expensive area. I know one thing to be true - when comparing two different areas, assuming that the cost of living is proportional to compensation from each job, it's more beneficial financially to live in the more expensive region. What's more, saving 10% of a 50k/yr salary, or 10% of an 80k/yr salary? which pension is worth more, 75% of 50k, or 75% of 80k? With a 401k/403b, which is higher, a 6% match of 50k, or a 6 percent match of 80k? Make sense? Of course, if you're miserable where you live, all of the above is irrelevant.

There is a lot of good information here, but to add my 2 cents ... I have 4 friends who have recently graduated Medic school with me, all with NYC 9-1-1 experience who haven't even been able to get a job doing BLS IFT ... They are some of the best new medics, and best EMT's I know, the job market is tough out here right now, apply around before committing ...

Why are medic school graduates looking for BLS work in the privates? BLS are a dime a dozen in NY, as well as anywhere, though. Anyone with a GED and free evenings can get their mcert.

A shortage of medic jobs in NYC doesn't suprise me, with NY Methodist running three classes at once, Stonybrook, St. Vincent's and LaGuardia barfing out hundreds of medics every year.

Thanks so much for your answers!!! Yes, I already do look at pictures just about every day to condition myself....ever since I was kid I've always been fascinated with trauma! Its nice to know that pictures do seem to condition yourself. I'm feeling fairly confident because I can look at those pictures without my stomach turning and looking away! My best pal is an emt and she said the same thing about the smells! She said the only time she almost threw up was because she was in the back of an ambulance and took some guys shoes off and the smell almost knocked her over backwards! Your answers really helped calm some anxiety I have thanks!

Vomit = bad. Trench foot/decomposing body = worse. Perfed colostomy = worse still. Odor from a crispy critter = worst.

Check this out, it's a video of an electrocution fatality. NSFW. 6-05-09, Electrical Guide Wire = bad It's pretty graphic. See how you react to it.

http://www.fridaypage.com/

Which section(s) of the Rockaways? Far Rockaway? Bayswater? Seagirt? Edgemere? Arverne? Hammels? Rockaway Beach? Rockaway Park? Belle Harbor? Neponsit? Roxbury? Rockaway Point? Point Breeze?

Roxbury, Rockaway Point and Point Breeze are gated, co-op communities, with their own security force, so if you say those are high crime areas, the locals will definitely have words with you.

And, as a point of information, I live in the Belle Harbor/Neponsit area, and work basically in Far Rockaway,

You do realize that the fool stupid actions of a few locals regrettably end up with entire neighborhoods being "painted with the same brush". I've actually met really decent people in what are considered some of the worst Public Housing Projects in the city, and some really nasty folks in the "rich" neighborhoods.

Think about it, if you're moving to NY on a CNA/EMT salary, how are you going to be able to afford rent in a gated community? Sure, Belle Harbor and points west are nice to live in, but how do you expect one to buy property making 10-20/hr? When I said stay away from Rockaway, I took into account that the more affluent and safe areas would be out of reach financially speaking. Anyway, if these areas are so safe, then why is a security force necessary? Also, If one wants to move into a decent part of Far Rockaway, don't they need to be Jewish?

There are decent people as well as nasty ones anywhere you go. What important though, what matters is your surroundings. I've been redeployed plenty of times to the Rock, typically near PenGen, on 53I, 53D, and 54Y. I know what goes on. I worked for Hunter Ambulance as well, and drove around when not on a job. Going east of 116th, you can't tell me that anything in that direction beats living in Middle Village or similar areas. Sorry. And, if you're commuting by car, you need to pay a toll to get into Queens the quick way, and the train takes forever.

Speaking of 116th st, I've been going to the beach there as long as I can remember, up to around 1995 or so. I have plenty of pictures in the family photo album from there. I've seen it slowly change for the worse over the years. Now I wouldn't be caught dead there at night. Smart move restricting street parking west of 116th during the summer. It keeps the rest of Rockaway segregated, as well as beachgoers from Queens and Brooklyn. Really, when you get to Belle Harbor, it's like night and day compared to Far Rock, Arverne, Rockaway Beach/Park, and anything else in the area. Long Beach, Jones Beach and Robert Moses are much better choices. Riis park is okay, but there are much better places to go.

Anyway, for Floridastudent, I have a simple solution. when considering a neighborhood to live in, drive around the neighborhood around 1900 hrs, and again at around 2300 hrs or so. Observe who lives there and what goes on. I'm referring to criminal activity, loitering, police activity, not demographics per se. Are there thugs IFO every bodega at midnight, watching you intensely as you drive past? Check for an abundance of graffiti, the condition of buildings (well maintained or in a state of disrepair?), and how clean or dirty people keep their property. Do the math, so to speak, and decide what environment you're willing to live in.

That is certainly a possibility! I guess I could use my mother's address here in Florida.

I am cutting and pasting all this great information! Thank you!

Middle Village looks very promising, and even relatively affordable.

So is there much EMT work available out in the boroughs or would I most likely need to commute in?

Plenty of work in Queens, Brooklyn and the Bronx. Some privates off the top of my head are transcare (IFT/911), Citywide, Hunter Ambulance, Midwood, North shore Ambulance (not affiliated with the hospital) and AMR (IFT/911). Hospital based EMS in the outer boroughs include NSLIJ CEMS, NY Prebyterian (Cornell), NYHQ (Booth)and Jamaica/Flushing/Brookdale. St. Johns on QB and Mary Immaculate went bankrupt and closed due to a scourge of uncompensated cases. Pulse and a patch are good for privates, the hospitals take more work or a hook. Your best bet for getting hired and breaking into NYC 911 would be Transcare or Northe shore LIJ.

My advice, get an ER tech position, maybe go per diem at a private, and try to get into EMS at a hosp. if that's what you want to do. NSUH Manhasset was paying ER techs 22/hr back in 2007. Look there, and try for NSUH EMS if you want.Otherwise, go ER tech>RN>challenge medic. It's easier to get into RN school and also get work as one than it is elsewher in the country. Only go FDNY EMS if you plan to stay in NY for life, and value a so-so pension and decent medical over hourly compensation. Otherwise, it's not worth it. Now that I think about it, the state gives pensions. A friend of mine left NSLIJ to work as an RN at Stonybrook hosp out on the island. 65k to start, 25 and out pension. If I had planned on staying in NY, I would have gone that route myself.

About your car, is it possible to keep it registered in FL? Much cheaper. Everyone else in NY does it. Go down any street, particularly in poorer areas, look down the block, and you'll see PA, NY, PA, PA, NC, NY, PA, FL, GA. I'm sure that Bed Stuy isn't exactly a prime destination for tourists. Long Island in general has cheaper insurance rates, and reasonable rates in the New Hyde Park area. Something else to consider.

Staten Island is too isolated. The city is either too expensive or too rough, depending on the area. No middle ground there.

I've lived in Bushwick Brooklyn. I don't recommend it. Greenpoint is relatively safe, Bay Ridge is OK. So is Park Slope, but it's expensive. I wouldn't recommend any other neighborhoods.

I've also lived in Ridgewood and Middle Village Queens. Both areas have buses and the M train. Ridgewood was getting a little ghetto, but the Eastern Europeans have bought up a lot of property there, and maintain it well. Glendale is OK. Bayside, Whitestone, Flushing, Fresh Meadows and Glen Oaks are good to live, but are expensive and lack much mass transit (except for Flushing). Best bang for your buck while being in a safe area would be Middle Village, Glendale, or Ridgewood from Fresh Pond Rd down to about Onderdonk or Seneca Ave. Stay away from Myrtle Avenue unless you're above Seneca. Metropolitan Ave from Forest Ave up through union Tpke is safe. Stay out of LIC, Astoria, Corona, Jackson Hts, Woodside, Sunnyside, East Elmhurst, and most of the Eastern/Southern part of Queens to include the Rockaways, and anything down Woodhaven. I've either lived, worked EMS or both in all of the areas I've mentioned so far. When you work nights, you see what really goes on. stay away from any areas along the J or A lines.

I don't know much about the Bronx. Many parts of the Bronx are rough.

Middle Village has no alternate side of the street parking, so you could easily keep your car there. Crime is relatively low there. My in-laws live there.

To make any appreciable amount of money, you'll need to work in NYC. BLS pays around 10/hr for privates, maybe 15-22 for 911 participating hospitals. ER techs can make 15-20/hr as well. Working conditions are poor in the privates, but are decent at the hospitals. It's easy to get hired by a private, but difficult to get hired by a hosp. (except North Shore LIJ CEMS) without any prior 911 experience, or an "in". CNA's make anywhere from 10-15/hr, check openings at the hospitals. 1 BR in a decent area runs 1000-1200/month. 2BR maybe 1500-1900. Car insurance is oppresively high.

Also, I would focus my energy on an ER tech or CNA position at the hospital. If you want to break into 911, apply to a hospital system that has an EMS agency, such as NSLIJ or NY Presbyterian, so you can focus on getting hired from the inside. Working conditions in the hospital will trump that of the street, and is way more school friendly. If you want to go RN (challenge the medic afterwards) there are many schools available, and plenty of employment available post graduation, unlike elsewhere in the country. The city did have a program that gave aid for those wishing to pursue LPN school. you can look into that, also.

Medics make around 20-22 in the privates, and 22-32 in the hospitals.

It's typically been easy to get hired with FDNY EMS. The working conditions are horrible, though.

http://nyc.gov/html/...ts_042607.shtml

When you park your car, lock your steering wheel with the club lock facing the dash. This makes it way more difficult for the perp to pick the lock.

Unfortunately, we live in the age of entitlement. The vast majority of minors nowadays are raised in an extremely lax environment. Is it due to the single parent not spending enough time at home, and therefore feels guilty to give discipline? Are both parents working so much that someone else (or the streets) are raising their kids? Do the kids threaten to call the cops when corporal punishment is attempted? Are the parents just soft? Are the parents too afraid that their children won't love them if they don't buy them everything they want, and do everything for them at home? Who knows.

I believe that children that are made to work a PT $hit job during the summer or a couple days a week while in school to pay for clothes, dates, a beater car, etc will build character, teach the value of a dollar - to include saving and investing, and also to appreciate a real job, a career quality job when they earn that right after much sacrifice.

Entry into EMS is all to easy. Many that I've come across don't take the job particularly seriously, like they're doing the place a favor by showing up, as they're destined for bigger and better things, and the job is already beneath them. It shows in pt care, driving, appearance, timeliness, badmouthing the company (they don't pay me enough to do this the way they want), language, and disrespect for authority. Many who get their EMT and then go to work right away don't take the job that seriously. They are most likely single, living at home, with no overhead other than car insurance and clothing bills. If they get fired, it's no big deal.

Professional pride should be an innate quality, or at least a function of a proper upbringing. However, this is the real world we're talking about. Generally speaking, the level of professional pride appears to be dependant on several factors - difficulty in getting hired, compensation/benefits, treatment by management, and proximity/availability of similar places of employment.

When I started my EMS journey at hunter Ambulance-Ambulette, a fine pulse and a patch IFT operation (per diem, can't live on 9.50/hr), there were plenty of bottom feeders, including one medic who would routinely spend an hour on the floor (no exaggeration), and an hour at the drop-off, citing poor pay. NSLIJ CEMS was at once THE place to go, and still ranks high as an attractive employer. That place was run militant, very busy IFT, mandated L/L updates when greater than 20 mins onscene or at destination, strict uniform/grooming policy, shoe buffer in the hall, etc. It takes time to get hired there, and many are turned away. The pay is competitive for the area. You can also work 911 or IFT depending on the shift. The employees are expected to up their game as such, and for the most part do so. However, things like overbearing management, rearrangement of schedules every 9 months, lack of OT have resulted in turnover and disgruntled employees as of late. Charleston County EMS was also run quite strict, as they are the highest paying 911 EMS agency in the region. They eat their young with a ferocity not seen in other agencies. the employees there are forced to behave, but look to leave at the earliest opportunity. The hiring process for the Fairfax Co FRD is lengthy, including a polygraph. The pay is stellar, as well as working conditions and benefits. Completing a lengthy academy is required prior to going out into the field. Many regard it as a career, and therefore come correct. I know the last example is fire based, but you can use any quality "go to" third service agency to serve the same example.

The higher the caliber of employer, the more selective they can be in hiring, and the more demanding they can be of their employees, to include education, so long as the employees are treated well regarding working conditions, schedule, forced OT, leave policy. If you're a slacker, they'll drop you like a hot pop tart.

I've also noticed that those with a military background generally have a higher percentage of those who take pride in their job and do it well, even if it's a crappy stepping stone agency.

My concern here, & this is the 3rd time I have said it, is that if they are too excited to do anything other that jump in the car & go then how slap happy are they with their treatment, drug doses & thought processes.

We cannot teach common sense, it is inconceivable that you would write a SOP for the most stupid things, but we have to get to the lowest common denominator.

How many calls would it make a diffenence for a physical check to be made in the addition of say 20 seconds to the response? Yes in the case of an MI minutes mean muscle, but really, what difference will it make?

None.

They have shown they have a lack of understanding of reality & just wanna get out their & show off with their lights & sirens.That is what we do not need in EMS. Lets make the example of them & fire their asses.

Fire asses, huh? Funny that you haven't said jack about the AMR crew that "didn't notice" that traffic had stopped in front of them, then turned into the oncoming lane, and then hit that guy's car, killing them. Running over the homeless man was negligent sure, but it wasn't intentional, in that they didn't see him and then purposefully run him over. The AMR crew failed to scan the road ahead of them, which suggests in strong likelihood that the driver was distracted, perhaps talking/texting on the phone, maybe eating or drinking, or playing with the radio. The driver killed that man. The driver was also criminally charged as well. I don't see you jumping all over THAT story, calling for their jobs, their heads, whatever. Give it up already you hypocrite.

http://www.emtcity.com/index.php/topic/16667-news-feed-man-dies-in-collision-with-florida-ambulance-jemscom/

I know you've seen this, as it's been on the main page when you've been online, don't feign ignorance by saying that you haven't seen this thread.

Hey NickD, I understand the importance of presenting yourself as a valuable potential asset to the company during the interview. However, prior to hire, matters such as salary, work schedule, benefits, leave policy, paid time off, selection procedures for promotions, deferred comp with match, etc. etc. need to be discussed. Several weeks or months into the job isn't the time to be learning these things, as they ought to be in writing prior to hire. So, if not at the interview, when and where should one address these concerns?

All too often certain things are promised to the new employee (verbally, not in writing), and not delivered. "We've had a recent change in policy". "We never said that." "Where did you hear that we were giving (XYZ) benefits?"

The guy did not jump out in front of a moving fire truck. He didn't have a phone to tell the FFs to run over him. There's a seriously busy highway nearby with fast moving traffic that he could have walked out on. Instead, the guy was at a big building known to house people who could provide some first aid. Regardless of his intent or his chosen lifestyle, the FFs failed to look. This could have been an elderly person just as easily who passed out while trying to get medical help. Just because the patient has alcohol on board does not make him any less in need of help than the suited businessman who could also pass out while having a heart attack at that door.

Next time you see a person wanting to jump from a building or bridge, just push them if they don't meet your idea of worthiness for care or a reason to approach with caution. You could then use the same arguments of defense that they asked for it.

No, the guy didn't jump out IFO the truck. He did lay down IFO the medic unit's bay, however, when he could have opted stand up and be seen. If he was only trying to get their attention, why would he reduce his profile so as to be less likely to actually be noticed, increasing the danger of being run over? An elderly person passing out at the bay is quite different than someone deliberately walking over to and then laying down at the same place. The call location would have actually been IFO their bay (or at least station) and not one down the block. Same thing for the businessman. The medics hold blame for not looking, no argument there. I'm assuming that there are no dept SOP's in regards to checking IFO the rig before responding, or these FF/medics would likely be out of a job or at least suspended or something. Actually, your post #22 provides an article that states that there wasn't an existing SOP to that end. Blame the dept for that one. Many SOP's, GOP's and operating manuals are devised to prevent recurrences of prior accidents and fatalities. This seems to be one such case. In the case of the businessman or the elderly person, they wouldn't be deserving of their fate. The victim in the article had an active role in the incident. He suffered the consequences of his actions. That preplanned course of action is what alters the assignment of blame in this case, apparently enough to absolve the crew.

As far as the jumper up, if they end up a jumper down it was their decision. It doesn't mean that I won't try my best to dissuade them, but if they jump, it's out of my hands, and whatever injuries they incur was their own doing.

I never said that the victim in the article has less of a value as a human being than the next person, just that I can't feel sorry for someone who intentionally puts themself in harm's way for no good reason and then succeeds in actually getting injured. What did you think would happen? Life isn't a cartoon where you get run over and in the next frame you're good as new.

That makes it okay for the FFs to run over him and ignor safety? Are you saying that because he was where he was regardless of intent, he deserved what he got? Are you in agreement with all of the other "FFs" posting the comments at the end of the original article and that is why you are making this "he was sucidal argument?

What's with the double standard? FFs lecture the general public all the time about checking around their vehicles before pulling out of a driveway. That is part of their "public safety" message. Hell I've even seen them go to court to see someone gets a long prison sentence for doing essentially the same thing.

Are some FFs now just going through the motions of "public safety" and are only in the FDs for the benefits?

No, the FF/medics were guilty of some level of negligence for failing to see the victim, but the victim DID lay down at that exact spot (not standing up, but lying down out of sight), at that exact time, for a specific reason, as he expressed suicidal ideations as motivating him to do what he did. He's as much to blame as the FF/medics. Maybe more so, as the law cleared the crew of any wrongdoing based largely on the victim's own account of the event. He made a conscious decision to do what he did. Alcohol may have been a factor, sure. He also made the decision to drink the amount of alcohol that he did. Darwininsm, just like the former EMS employee that was crushed to death by the bay door.

Welfare checks, maybe but...

There is also nothing in the Paramedic curriculum that would prepare a Paramedic to do what RNs do in home care. When was the last time you staged a wound and applied treatment? What do you know about insulin and diabetes teaching? Nutrition? Tube feedings? Various vacuscular access devices for the long term? Chemo? Stoma care? Various ostomies? Evaluated BP medication effectiveness? Administered all the typical medications many, many times to be familiar with them? Did family education for all of the above procedures? To be effective, one should have enough knowledge and experience where all issues involving long term patient care should come easily for the practitioner.

For the CCEMT-P, some ambulance services hand out those letters after a two hour inservice. They may even call them that so the truck can be a CCT but due to protocol restrictions they may not have any more skills or knowledge than a regular 911 ALS truck. Some Paramedics, such as in FL, can have an expanded scope to do IABP and ventilators. However, again, the training/education will vary from 2 hours to 2 weeks. And yes, some doctors have refused to let some Paramedics take the patient unless a nurse went with them when they appeared clueless or overwhelmed by a critical patient. We have also had some very back adverse outcomes from Paramedics transporting patients that were way out of their expertise. Unfortunately the Paramedics didn't understand enough to ask questions or what even what questions to ask.

The UMBC CCEMTP is a very basic overview of a few critical care concepts. In two weeks it is very difficult to teach one to be a competent critical care clinician. Several RNs and RRTs have taken the program only to be disappointed in the material but most already had critical care experience and found it to be very basic knowledge. For the Paramedic, it is a decent program but should NOT be taken as an end all or even a good beginning for all there is to know about critical care medicine. Too many have come away from the UMBC class thinking they know everything there is to know and that leads to very bad things for the patient they are assigned the responsibility of.

There are only about 5 states that do recognize the CC-P/CICP/CCEMT-P credential in their list of levels. I believe Ohio has a decent setup for their CICP but less than 100 hours of training is required. That pales in comparison to the training other practitioners get for critical care even without the experience. If you look at the degree of the RT, it is essentially an introduction to critcal care medicine and even at that it barely scratches the surface for all one can experience working an ICU.

The Canadian Flight/Critical Care Parmedic program is very impressive. Their training is adequate enough to where nurses do not need to accompany them. But, it is built off of an already impressive education foundation.

U.S. Flight Paramedics can also have an expanded scope and often do get a decent amount of education and additional skills from their employer. However, the ideal candidate should have at the very least college level A&P. Pathophysiololgy and Pharmacology would also be a big plus. As it is now, an RN is usually paired with the Paramedic if they do CC IFT. It is even difficult for CCT and Flight RNs to keep up with all the advances in Critical Care medicine unless they are hospital based or continue to work in an ICU on their off days. Paramedics do not have that opportunity nor to they have the base education required to fully grasp all the critical care concepts if they graduated from a Paramedic program that just did the minimum "hours of training". Just learning a few "tech skills" to be a knobologist for the IV pumps and the ventilators are not sufficient to manage an intensive care patient. Unfortunately, those that have gotten a CCEMT-P patch from their employers with little training rely on speed to get from point A to point B if taking a nurse is not an option or they bluff enough to make people think they are well qualified.

There are of course exceptions. Rid has explained his program for CCT and it appears to be quality.

Regarding the first paragraph, a CCEMT-P with a bachelor's, such as EMTinEPA suggested earlier could have the sufficient knowledge base to do the home care thing. That's dependent on the course material, naturally. The CCEMT-P with a bachelor's ought to be able to perform well inn CC txp's, and perhaps NICU's and PICU's with specialty training. Ditto for flight.

As far as needing college to have any credibility as a pro education spokesperson, how about cutting me some slack. I already have A&P and pharm. After medic school I worked OT frequently as well as per diem jobs for two years, to get out of debt, and then to fund investments to provide my family with some measure of financial security. I then moved to Charleston for 6 months. Then it was a 9 month internship/recruit ordeal with Fairfax. The Fairfax career is proving way more lucrative than having an ASN or BSN. I now have the option of pursuing those goals, already being financially secure. Now I'm completing my rookie year. I spent those 9 months prior making only 53k without incentives, so I've spent my time post academy working OT and a side job, as before. We plan to buy a house soon. It's all about priorities, what's most important at the present. Did I not start the thread "RT vs RN" to ask for educational advice? Those wheels are in motion for the spring semester.

It just so happens, as I've come to find out during a conversation with a colleague at the ED today, that NOVA CC's paramedic program is an accredited assosciates. Why is this important? It's important because the Fairfax County FRD sends selected employees that submit a letter of interest to the FRD to NOVA to earn their paramedic cert. Fairfax sends their employees to college for a paramedic assosciates. No fast track medic mill here. The dept also seeks to upgrade all their I's to P's when economically feasable. Fairfax no longer hires I's to function as ALS providers, to my knowledge.

Score one for the fire service. I knew that I came to the right place.

I did a quick google search and found this:

http://education-por...n_virginia.html

Look to the Annandale campus, not Tidewater, which is down near the Va Beach/Norfolk area.

Here's what I propose for the new levels...

Paramedic - Certified (PM-C)

Paramedic - Advanced Practice (PM-A)

Critical Care Paramedic (CC-P)

Eliminate "technician" from the job title, make PM-C equivalent to EMT-Basic in terms of skills, maybe give them a few extra tools, and make it a one year certification program. PM-A would be equivalent to the current EMT-Paramedic and would be a two year associate in applied science. CC-P would be a four-year bachelor's.

This is my perfect world. As long as we have "technician" in our name, we will continue to be treated like technicians and continue to earn a technician salary. Look what happened when RTs became Respiratory Therapy and upped their educational standards. Besides, everybody calls us paramedics already anyway.

That's not a bad idea, just that you'd need to convince employers to get onboard with that. Tell them that they could stop using RN's to do CC txp's, and instead bill for the CC medic at a higher rate. Perhaps CCEMT-P's could muscle in on the RN home visit sector. Another income stream for the agency.

I've asked several times on this forum and others as to how this positive change will come about. I only get vague answers claiming that education will force change, education plus organization will force change, but no concrete plan of action. I've suggested that EMS learn from the IAFF's success and employ a similar strategy. Or form unions to better their deal at their particular agency.

Just think, the union will demand higher wages, better retirement, working conditions, medical, so on and so forth. Management will scoff, of course. The union can come back with a suggestion that management meet them in the middle if they all up their education to a degree level in an agreed upon time frame, as a condition of continued employment. A higher quality provider deserving of this generous deal. Having successfully bargained for a better deal, other EMS professionals will seek employment there. They'll also need degrees to apply. Other agencies will lose their best employees to this one. Other employers will be forced to increase their salary, benefits, education requirements, etc. etc. to match. Just one possible scenario.

At the present, I don't see many in EMS going the degree route solely for a career in EMS. Not without a federal mandate or a livable wage and decent retirement to attract the more highly educated. EMS missed the boat on increasing education. Many use the field for a quick way to make some cash without spending years in school. Since most that enter the field are doing so to earn a living without having to go to school for several years or so in the first place, then it's quite a stretch to believe that individuals in the future that enter EMS for the same reasons would voluntarily go the degree route without an immediate lucrative payoff for their efforts. RN's, RT's and others went the education route first, citing pt benefit, then increased insurance reimbursement, then salary/benefit increase, but the EMS workforce is of a different mentality.

http://www.firerescue1.com/fire-news/597966-fla-firefighters-cleared-after-running-over-homeless-man/#

Thoughts?

Herbie,

I think you are a bit mislead about certain aspects. Despite the fact that the IAFF is resistant to change on the EMS perspective, many are starting to require at least some college education to get in there, and then usually a degree to advance through the rank. This is why you are seeing so many degree completion programs popping up on the internet and within the technical college system. The vast majority of police departments require at least two years of college and the more you have the better off you are. In this state, hiring for FD's and PD is done on a point system and things like college, veteran status, prior experience, etc help you gain more points in consideration during application. Also, almost any EMS service in the area requires a bachelors degree and 5 years EMS experience with prior supervisory experience to consider moving up into a directors roll.

A degree in EMS will make a huge difference as it did when nurses went from a technical education to degrees. Yes it took them a bit, and agreed it was painful - it weeded out those unwilling to move up to a higher level of education. And I believe that's exactly what would happen with EMS. I don't argue too much with leaving the basic at a technical level of education as a degree shouldn't be required for those who only solely want to volunteer and rarely make calls, or for PD and FD who are cross trained. Let a two year degree be the entrance which would be like an I-85/AMET level but at the same proposed skill set. Then a four year degree be a full paramedic, and post graduate be your critical care medics. I'm not concerned with whether the degree came from a technical college, a degree completion program, or a university. I'm not arguing it would be a bigger output of funds but I believe it would move EMS from the public safety sector to more the healthcare provider area such as hospitals, etc. If we want more skills and responsiblity and to move from the taxi mentality we must increase education. Though as previously stated, a piece of paper will be a start, but it's up to the individual person to learn the content. Just as there are people who slip through the cracks with other professions, there still will be, but much of that will be reduced. For those currently working, degree completion options should be offered.

I don't argue too much with leaving the basic at a technical level of education as a degree shouldn't be required for those who only solely want to volunteer and rarely make calls, or for PD and FD who are cross trained. However, basics complain of not being able to do very many skills beyond basic first aid (heads up guys, that's why it's called a BASIC). They're still useful for taxi rides to doctor's offices, dialysis runs, etc and there is still a market for them or solely as drivers. However, I do feel for any significant IFT's or 911 then you should be a paramedic to give your patient the best possible care. Nursing Assistants complain of being nothing more than a glorified butt wiper and they have comparable education essentially to the basic emt. They aren't entrusted with a large skill set because of that so why should we extend basic's skills for a similar education? I'm not knocking either one - the are important within the role they serve, but would you want a nursing assistant pushing medications without the education and knowledge? They aren't even allowed to distribute medications without additional training. This is the entry level though and a great majority of nursing schools require six months of working as a nursing assistant prior to application (which didn't use to be the case), so are we off to ask basics to do the same? I think basics have seriously over rated themselves in terms of knowledge and what their scope of practice should be.

I know this post will be far from popular, but if we really want to see education progress these are the advances we are going to have to make, as painful as they may be. And to those of you that say well it doesnt make a difference to you - the changes would affect me as well in having to pursue additional education so I'm not exempt. But change and growth are painful and hard, but worth it in the end. EMS moved from nursing homes to the county/private/fire areas to advance, and now it's time to move again. We'll see better pay and a better respect and reputation.

At my dept the first promo to tech (EMS, Hazmat, Trot, Apparatus) gives 10% weight to education. For Lt's it's 20%. For Capt I and above, it's 25%. I'm suprised that more depts in this region don't require 2 years college. The FDNY dropped their requirement from 60 credits previously to now just one year or 6 months FT experience.

FD's, PD's and EMS agencies alike are requiring education nowadays for promos, and rightfully so. The problem is, there's way more opportunity for advancement in a FRD or PD when compared to EMS. We just promoted 31 new Lt's this quarter. This is done through oral boards and objective exams, afterward being placed on a list. In EMS, there seems to be way fewer opportunities for upward mobility in the system. Fewer supervisor positions available, fewer specialty niches to shoot for. Additionally, the promo system may not be a competitive list, but frequently based on favoritism and cronyism. Hospital based systems do offer more of an opportunity for advancement to other areas of the health system, but typically no pension to speak of.

So, take away the likelihood of your degree facilitating upward mobility, there's little motivation for many to go the degree route for the P-card, unless they want to parlay that into another healthcare related degree. But then, they're leaving the EMS field as their source of primary employment anyway. You'll need a large percentage of degreed paramedics to make effective any organization and lobbying. If the money's not there, many will go the path of least resistance, and the one's with degrees will look for a better deal before too long. Catch 22.

The EMS profession started out strong enough, but then stalled out. sure FD's had a large hand in that, but they weren't the sole offenders by far from a political standpoint. As far as the existing workforce, each and every EMT and medic currently employed and not holding a paramedic assosciates is to blame for holding back the profession, myself included, opting for easier alternatives. Start assigning blame there.

If only when leaving the apparatus bays, I'd suggest you look back to posting #6 of this string.

Other than that, does anybody have, on their ambulance, engine, or truck vehicles, one of those mirrors mounted on the front, that shows what is directly in the "blind spot" in front of that vehicle, as is required here in New York City, for Yellow School Buses? They became required after a school bus driver accidentally drove over a small student that had just gotten off her bus.

(Please note that I am calling a bus a "Bus", and not calling an ambulance a "Bus")

For those that don't know, most units in NYC are staged on street corners, the "89". Go watch any unit in the city, any time of day, FDNY EMS or NYC 911 participating hospital alike, and watch when they get a job. It's a safe bet that no one gets out of the bus and does a lap before they go 63. Even if it's at night and they were passed out before being awakened for the job. I know that I never did. Nor did anyone else I've known.

When I worked 46 Young T1 at the old 89 of National/Roosevelt, IFO the Walgreens there, there were quite a few drunks lurking about at all hours of the night. I've frequently observed them sleeping on a park bench, up against a building, on the corner, in the gutter, once on the double yellow in the middle of the street! I've gone 63 and noticed that someone fell off my back bumper. Twice. Some drunk decided to sleep on the back step. It's not a stretch to believe that one could go nite-nite IFO the front tire in the gutter. I've worked several "man under" jobs at a couple of 7 train elevated platforms. The drunk leanes over looking for the train, and falls in. Sometimes they're intact, sometimes we're searching down the block for body parts. Some people cross the street, slowly, in moving traffic, walking all hard and stuff, daring someone to hit them. Some teens think it's funny to jump out IFO our moving rig, saying to hit them so they could get rich and sue.

Darwinism. I don't wish anyone dead, I don't know the whole story as to why this individual laid down IFO the bay door. was he AMS with head trauma? Was he so drunk that he had no clue? Or was he just plain stupid? Don't know. Can't say at this time. What I can say is that I don't feel sorry for someone who injures/kills themselves due to pure stupidity. I do submit that drinking yourself into such a stupor that you have no clue where you are or what you're doing qualifies as pure stupidity, though. If you're at a house party or have sober friends to look after you it's one thing. If you're walking around the neighborhood three sheets to the wind is a whole other thing entirely. It's why I don't entertain refusals from drunks. Get them to a hosp where they're safe until they sober up. If you secure a refusal and they get smacked by a car, guess who's to blame?

46-50, for someone who does not even have a BA/BS, in this economy is pretty good in some places. Keep in mind a few factors:

1. All equipment and uniforms are porvided: Shoes, Boots, Gun/s, Cuffs, Shirts, Coats,etc.

All you really buy is underwear and socks...

wHILE THE BASE IS 50k, YOU GET:

25% EXTRA FOR SUNDAY, 10% extra, for nights after 1800, there is some OT for special events, court, etc.

The job is very self initated, and there are not a lot of calls for service.

Not to mention that NYPD, and many other depts, start at 10-15 K lower than wat we pay.

A county near us Anne Arundel County, MD, starts at 41K.....

That's what I'm getting at. Someone with either prior law enforcement experience or 60 college credits in whatever can blow past many professions that require a Bachelors or a Masters regarding salary, low stress, retirement, incentives, job security, etc. I'd jump on it myself if I wasn't already hooked up. I imagine this position is highly competitive. Otherwise, they wouldn't care about the 60 credit requirement.

Do you have a download for the step increase schedule? How are the higher positions compensated? Well over 100k as a top out I'm sure. Better than a PA or an attorney.