Capman

Rich', I suppose that there is no ruling out that possibility, but it seems pretty shallow to bust someones b'lls simply because someone he works with has done (at worst) something questionable. One of the problems with this planet is that we live in a paranoid society with too many people poking their noses in other peoples business. There are too many creative and mature ways to handle these people who attempt to associate you with something they believe is wrong. The initial poster should not worry about this.

Well, this one will spawn mixed feelings in any crowd. There is no easy way to offer answers or opinions that really matter on such a taboo topic. For the records, I take no stance on the matter one way or the other. Though, while Dust' and I haven't been seeing eye to eye lately on another topic, I have to agree with him on this one. The best advice is to keep out of it and don't lose sleep over it, as it shouldn't be your problem. I don't believe that you'll be judged for someone elses actions irregardless of right or wrong.

Approximately 4,000 calls a year with 4 bases of operation and 9 ambulances. This area is still considered super rural. About 400 - 600 of these are long distance ground or Air transfers. Some days the service does 5 runs and some days it does 20 runs. When events such as concerts or fairs come to town, we have done as many as 30 runs a day, though numbers like that only come around once or twice a year. It's a comfortable number for me and from the employers view, it's enough to generate funds worthy of making the service feasible to them.

My employer gives us internet access for the posting of electronic run forms and work related research such as monitoring CEH/CEU's and downloading pdf's and other documents from the Maine EMS website. EMTcity.com is not a blocked website. Discussing EMS protocols equipment and other related material on this site (as long as the usage is not extreme and does not interfere with duties) is not really frowned upon. It's one of the Pro's of working at this particular organization. The use of the internet for playing around with "myspace" and websites like that is forbidden and is sure to generate a reprimand when the computer geeks downstairs report back to our director.

Interesting point! You may want to keep this topic about funny situations around the ambulance base and such. Patient specific humor is a dangerous area, and to post these occurences on the forum is even worse. A clear and obvious HIPPA violation! It is also safe to add that not just EMS workers visit the forum. How would you feel if you read a post where the EMS workers who came to your house were laughing about your situation? Sure some calls are plaqued with humor, but you can't post them online man!

First of all Dustdevil, thank you for the insults which are by no means any less of a true reflection of "your" character. Second, while I appreciate the time you took for "your" extremely opinionated post, it is nothing more than just that. Third, if you had taken the time to not let "your" characteristic behavior get in the way of your attention span, you would have noticed my initial statement (complete with typo') was meant to be humorous. You should really try to lighten up just a bit and refrain from using words such as "stupid" and "spellcheck". It would make the forum that much more of a pleasant place.

Ha! Pointless banter. We all know that any patient well enough to b!tch about a non offensive tatoo didn't really need an ambulance in the first place. Isn't this what half of you would truly like to say? OK... Seriously... There are about 50,000 reasons a patient can complain or pass judgment about me, so if they want to complain about a tattoo of an eagle on my forearm that's fine. If they complain about my care, that's when I will be concerned. Should the eagle on my forearm ever become a problem, then I guess it's long sleeve shirts in my future. Not much of a problem either... I live in Maine. BTW... Don't attempt to feed me that little old lady line either. I have recieved many compliments on the tat' from little old ladies. But then again it's an eagle not a demon or some of those earlier examples.

Thank you for the replies. That was the information I was looking for. Great link Jake'. That blue rig is HUGE!!! Is that a class C license?

This rig would be used in the rural EMS setting. It's key function will be highway use for interfacility/long distance tranports. The only traffic congestion will be in the cities we usually transport to. For example, Portland; Maine.

Interesting topic! It's relatively simple to make a shallow statement such as, "The service I work for is terrible". You take the pros and cons and weigh the balance. Do the pros outweigh the cons, and visa versa? That being said, I would have to say in my case that the cons do outweigh the pros. For the most part, most of my co-workers are competent top notch parmedics and EMTs. I don't care where you go, for every 10 EMS workers, at least one is a knuckle head for various reasons. This can tarnish a service somewhat, but does not make it a bad service. Usually, there are others who recognize such problems and pick up the slack because they know by hanging a particular knuckle head out to dry can have a negative impact on a service. Those who truly care will want to avoid this. One of the positive features of this facility is an incredible amount of overtime is available at your ability or choice to work it. This however, is not viewed as a gift or a generous gesture on their part. The bottom line is that they do not have a choice, and we have the option to capitalize on that factor. Besides, the overtime I perform generates them more revenue than they actually pay out for this overtime. So where do the problems truly originate? Problems originate in this case at the executive levels, where the brass of a large "Not for Profit" health care facility are more focused at securing their high paid positions by any means necessary. This means sacrificing quality to cut costs at the lowest level of health care at thier orginization, which in this case is the ambulance service. Examples of this practice include, overworked employees who pick up the slack of a major understaffing as a result of poor wages. In short, increasing call volume and higer expectations with less staffing and failing resources. Failing resources include ambulances; some of which are reaching 200,000+ miles, and a "don't fix it until it's broke" mentality. On two separate occasions wheels have literally fallen off while driving down the road despite multiple work orders stating that there was a concern due to vibrations. BTW, the work orders vanished which generated memos that scolded the staff for poor reporting procedures. No one was injured in these incidents due to low speeds as the failures occured, but this obviously could have been disatrous. Incidents not as significant as this happen regularly. It is also pertinent to add that none of our ambulances receive any routine maintenance... EVER. Most signifcant of all, is the fact that 99% of our employees feel (due to recent negotiation practices on behalf of the employer and a multitude of other incidents) an ounce of respect is given to them from the employing health care facility or the executives who run it. We are in essence, the Black Sheep of their orginization. So, my fellow EMTCity associates... You do the math. Thanks for reading.

Don't think BLS, Think interfacility/Long distance (150+ miles). Majority of these transports are not BLS.

Hello, It would be greatly appreciated if there is anyone that could offer information and experience pertaining to the Navistar 4700LP. http://www.lifestarrescue.com/LSR313/LSR313_Hyper.htm It would be even better if this information could be comparable to the E350/450 Chassis. This Navistar 4700LP would be used as a long distance, Interfacility Transport Unit; offering care ranging from BLS to Paramedic Specialty Care (PIFT-CCEMTP). Is it... 1) ... a comfortable ride for patients, as the patients currently riding in the E350 complain about the comfort level and feeling every bump in the road. 2) ... easy to handle? I have no major complaints about the E350 chassis. I would expect that this Navistar 4700LP chassis would handle equally well, or better. Is this true? 3) ... fuel efficient? Is the DT466 Diesel a decent powerplant for this rig, or is it underpowered, leading to poor fuel efficiency? Any other information that could be offered would be appreciated as well. Thanks a lot.

Sorry I can't help with California figures, but my info may still help to formulate a national average. Also, Info such as this can be obtained from JEMS a popular EMS publication. In Maine, for the hospital based service I work for, Basics make $7.04 an hour, while only several towns away the EMT basics at a munipal based service make $9.23 an hour. The first thing you should know about EMS wages, is that there are variables. While the $9.23 an hour sounds better, our hospital based basics working for $7.04 an hour take home more. Most of the seasoned EMT's and Medics will support my explanation as to why. The Municipal service only offers 12's at 36 hours a week. The hospital based service Offers 24 hour shift schedules which puts an employee at 16 hours of overtime per pay period right off the start. Not to mention, (due to high call volume, and control over all of the interfacility and local transfers) over time is given away like water. The trade off of course is less time at home, but the option for a good take home check is there. Whether you take that option is up to you. There are pros and there are cons. You, unfortunately; have to choose your battles. If you really want to pursue a career in EMS and earn a modest but decent living, you should consider becoming a paramedic. Hope this helps Matt

"More importantly perhaps, what took the state of Maine until 2003 to start doing checks?" They did do background checks prior to 2003, but only on a need to investigate basis. Seems weird to me too, but I don't make the rules. As for the NCIC, as far as I know it; it may only be used under certain circumstances. I don't believe that employment with a fire department is one of them. http://www10.informe.org/PCR/faq.html I could be wrong though, all I know is that I have to mail them a $15 check at every re-licensure. They used to do it for free.

Hunter', let me re-iterate that the confusion was my fault. I realized that when when the responses pertaining to med control came in. Rid', sorry for the confusion. Carry on.

"Not to be crude, but do you guy's still call in for orders as well?.... " I'm not trying to be crude either but, have you ever heard of protocols or are you simply a bunch of renegades that do as you wish? As far as the transporting via flight. I believe partially due to my explanation, you have me confused. The flights I'm referring to that doctors call the shots on are interfacility transports. For example, The Aroostook Medical Center does not have the panel of specialized surgeons and doctors that Eastern Maine Medical Center has. So after we bring them into the ER and they have been stabilized but still need to go to the larger, more equipped facility, the ER doctor will dictate how and where they will go for this 180+ mile trip. As for an ALS emergency flight service that takes a patient from the scene to the hospital... We have no such service in our area. Sorry for the confusion.

Excellent point!!! Then it's no new revelation that the recognition of medics as medical professionals is still quite a ways off. That is at least; in the eyes of the medical community. I guess I had better get used to those annual 2% raises and non recognition, because the attrition of ill educated medics could take decades.

Medical Control should dictate. Up here in Maine, The ER doctor dictates whether or not someone flies. Our battle here is that Eastern Maine Healthcare who owns Lifeflight of Maine (http://www.lifeflightmaine.org/maineneedlifeflight.asp) Took over the Aroostook Medical Center who has always had a long standing contract and money invested with another flight service. (http://www.tamc.org/Service+List/Primary+Care/Crown+Ambulance/Transport+Services.htm) The doctors who are Pro EMHC and Lifeflight push that service while others push the local fixed wing service we have been using for years. As you can see, this could lead to quite a few problems... And it does! Any way, like I said. It really should be up to the doctors to dictate based on patient condition how they are to be transported.

There are variables. Let me direct you to the Maine EMS investigations committee minutes. Simply click on the year then scroll down to "investigations committee". You'll need a PDF reader. http://www.state.me.us/dps/ems/minutes/index.html 2004 - 2005 will probobly give the best results as they are after the criminal background check mandate. Start with this one... http://mainegov-images.informe.org/dps/ems...nvmin100604.pdf After reading, you'll see these variables that I am talking about. You will also see the phrase "public trust" come up quite frequently in these documents. How is public trust established? Reputation, years of service, quality of service, etc.... In 2003 Maine EMS mandated that everyone either licensing for the first time or re-licensing will go through a criminal background check by the State Beaureau of Investigations. What they found was that some people lied on their past applications about criminal history. (even people that were licensed for 10 years) The fraudulent claim of a clean background is a crime itself, yet you will find that in many cases the committee fined the applicant, issued letters of guidance and put them on a 3-5 year probationary period with stipulations. These crimes included robbery, theft, drug charges and various others. Most of the case they were many years ago when the applicant was young. Due to mitigating circumstances such as many years of clean, quality service and no other crimes during that time period, the applicant has once again re-gained public trust and therefore issued a license. Once you read these documents, you will have a better understanding of what I am talking about. You will also see the circumstances where a crime did disqualify an applicant. Such as sex crimes, extremely violent crimes, habitual behavior, and recent crimes. I hope this helps you out a bit. Matt B.

That is a good approach. Thanks again Dust' Matt B.

Perhaps you are right. Either way I like your thinking. Matt B.

"You can't teach common sense. Not in 6 months. Not in 2 years. Not in 4 years. Losers are losers, regardless of their sheepskin." I guess I couldn't have said that better myself. Excellent point! Now take that and remember back to when losers never had a chance to become a medic because years ago, in order to be a paramedic, you had to prove yourself as Basic for a period of time before getting into an intermediate program, then you had to prove yourself as an intermediate for a period of time before a service chief would either pay for or allow you into the program that was usually put on by the local service or fire department. Now a good reputation and proof that you are not a loser is no longer a prerequisite for enrollment into a college based paramedic program.

Exactly! I have seen it before. Employees make a demand and employer plants their feet. My approach will focus on the community health issues with a failing EMS system in Northern Maine. The problem up here is that the drawer is no longer full of applications as is once was. Let me explain the service up here. Our ambulance service covers 12 towns and has 9 rigs. This is done with four ambulance bases staffing 2-4 medics/emts in each. We have had the numbers on our roster drop significantly in the past few years as the older medics retire and others move on to nursing. The numbers that the college are putting out do not match the decline on the roster. This is to a point that the hospital has lowered standards by allowing First Responders to apply. Now instead of having two medics to a base, we now have a medic and a first responder (driver) in some of the bases. One of the bases is in a smaller town, and 10 times in the month of November this base was not manned due to either not being able to fill a call out from that base or not being able to fill a callout or shortage in another base leaving the service no other alternative but to pull the staff out of the smaller base to adequately staff the busier base. This significantly reflects a staffing issue. We are also looking at several EMT's and medics who are going to retire or are currently in the nursing program and will not be working for the service in the next year or two. The college at the time has no students in the Paramedic program this year due to a lack of interest. In other words, we have no EMS personel to fill the gaps we have now and the gaps that are going to be a factor within the next year or two. I see a significant community health issue arising here. We are looking at increased response times when an ambulance has to come from the next town over because bases aren't staffed appropriately. I truly don't know where these medics are going to come from. Next we are looking at dropping rigs that are licensed at the paramedic level to basic licensure rigs. All of this this is amidst higher call volumes as the health of the "baby boomers" we here so much about begins to fail them. This is going to be one of my sales pitches. After all, they are a community hospital. Isn't community health in their best of interest? :wink: Debate and input welcome... Matt B.

I will, and thanks a bunch for the advice, I'm expecting to get roughed up a bit. I mean what do I really have on my side when I'm fighting bussinessmen and lawyers? So I actually appreciate the debate about my approach. I don't want to get blindsided with questions I can't answer. So thanks again Dust' and Rid' for the great advice Matt B.