MadAxe

Thanks for the replies - much appreciated. The regulator was not hooked up at the time I started getting air hungry, I was breathing through the valve at the front of the mask. I was able to move air, just not enough of it to feel comfortable once I was all taped up and fully closed in - felt like I was breathing through a straw

In defence of the exercise co-ordinator, the tenders (also new to Hazmat) were a little over-eager in getting me fully suited up before the air tanks were ready to go. Also, I figure I'm at least partly to blame in that I probably should have spoken up before hand that the equipment wasn't really fitting me properly.

Thanks again.

Got an SCBA question for the firefighter/medics here that I hope someone can answer for me. I'm a complete newbie to SCBA but recently had the opportunity to get suited up in a B Level Hazmat suit with SCBA as part of a mock chem spill exercise. Both the suit and the mask were too small to fit me properly (they were the only ones available) but since it was just a training exercise we went ahead and got me and another responder suited up anyways.

The tenders had just finished taping the last of the seams around the hood and the mask, but hadn't hooked me up to the air supply yet. I had felt fine up to that point, but within about 90 seconds of being fully taped up (but with no air running) I started feeling really air hungry. My understanding was that one can breathe through the port on a mask without the air supply hooked up without any problems, so I chalked it up to nerves/excitement and made an effort to relax and breathe normally. That did nothing to help, and I started getting -extremely- air hungry. I could feel myself beginning to panic, so I signalled to the tenders that I wanted the hood off. As soon as I got the hood off I pulled the mask away from my face a bit, got a good breath of air, and felt fine again.

The incident got me wondering - should I have been able to breathe normally through the mask without the air supply running? For how long? I'm a big guy (powerlifter) and have a tidal volume way above average. I've had my lung capacity measured with a spirometer at just over 9L, which is about 1.5x the average, if that matters.

I've never had an anxiety attack or incident of claustrophobia in my life, but having treated other people going through them I'm wondering if that might not be the explanation for what I felt. All I know is that I was extremely uncomfortable, but would like to know why, and if it is going to be a potential problem for me in the future.

Apologies for the long-winded question (no pun intended).

In order to survive, the system must first collapse

EMS Magazine Monthly Insider

Insider for June '07

By Scot Phelps, JD, MPH, EMT-P, CEM, CBCP, MEP

The concept of an EMS system has failed. After 40 years, it is time to admit defeat. The concept of an EMS system has failed. While the idea of providing an organized system of advanced out-of-hospital care was a good one, internal and external forces have led to the imminent failure of the EMS system in America. I, for one, am glad, because the system as it is currently structured cannot work.

This collapse was about 20 years in coming. When I started EMS in the 1980s, there was a lot of hope for the industry. I grew up in an era when BLS ambulances were nearly 100% volunteer outside of large cities, when first aiders were transitioning into EMTs, and when statewide paramedic coverage was an almost-realized dream in New Jersey. It was also an era of mobile intensive care nurses (holy cow! a decently paid career track with options), a strong tradition of volunteer crew chiefs with a decade of experience mentoring new cadets, and a billing system that let paramedics bill enough to cover the costs of operating the paramedic system. It was far from perfect, but it seemed to be moving ahead.

Twenty-three years later, when I talk to colleagues from my era about their experiences, I hear a common refrain:

"I thought being a paramedic was going to be a real job." Instead, we have regressed into an EMS system that is only interested in cost, not quality; that equates certification with competency, with no field training and supervision; EMS providers (both career and volunteer) who work an endless series of 60-hour work weeks; no upward career mobility; and McJobs (no pension, no benefits) instead of careers. How did things go so wrong? I have a few ideas:

The Public Has Never Understood What We Do.

Until we jettison the acronyms that mean nothing to the public (EMT, BLS, etc.) and focus on using the term "medic" for all ambulance providers, we will never have a consistent public image. A SWAT police officer is still called "officer." We also need to be the ones who talk to the press about accidents involving injuries and fatalities. The police are not the ones who cared for the patients--we are.

We Let Medicare Pay for Calls, But Not the EMS System.

When Medicare changed its payment rules seven years ago, we let them fundamentally change from paying for patients' pro rata share of system costs to paying for the actual cost of the transport, stranding a huge percentage of overhead costs if your agency has a normal level of utilization. We did not make it clear to our elected officials that they would need to pay the rest. We also accepted mandatory coverage from Medicare, which meant that systems had no reason to compete on quality, only cost, since their payment remained fixed.

We Let Other Disciplines Do Our Jobs.

Where I worked, I constantly heard the EMT crews complaining about the career fire department, yet on the scene, they always let the firefighter/EMTs carry the patient. I will say it in no uncertain terms: Do your own job. Fire takes care of fire and rescue, police take care of law enforcement. If it involves injury prevention, safety or health, it is EMS' job. Carrying patients, teaching injury-prevention programs in schools, installing child car seats and decontamination are all patient safety-related issues and clearly the role of EMS.

We Never Asserted Control Over Emergency Medical Care.

It is great that your community firefighters and police are EMTs and respond quickly, but providing care is our profession and we have a right to regulate it. Generally, communities should have sufficient EMS resources to be able to respond anywhere in the community within minutes. But where EMS permits fire or police to provide emergency medical care, it should be only under our direct control for care, oversight and quality assurance.

We Never Stood Up and Said "No More McJobs."

In the Northeast, the volunteer EMS ethic is that "this job is so important, I'll do it for free," yet inexplicably, when they begin to transition to a career system, they do not think that EMS is important enough to pay career staff a fair living wage (with benefits and pension) to do it. To be fair, this is also prevalent in the private ambulance sector, but at least they can point to a profit motive. The reason paramedics have to work a 60-hour week is that you need 60 hours to pay your rent, and nobody in EMS thinks that's crazy. If we all quit our per-diem jobs tomorrow, salaries would correct themselves within six months.

We Need to Admit That Paramedics and EMTs Are Not the Same.

EMTs are technicians with less than five weeks of full-time training (significantly less than the police or fire academy) who treat symptoms. Paramedics are professionals with at least 50 weeks of full-time training who treat a diagnosis. With the new curriculum, there is no longer even a continuum of education from EMT to paramedic. This is important for one key reason: It artificially depresses paramedic wages, because there are so many more EMTs in any bargaining group. This undermines a graduated pay scale that would pay paramedics significantly more and pay for their experience. Without it, how can we ever expect to retain good paramedics when their long-term wages are depressed by EMTs? The primary reason we lose so many great EMTs, who choose not to become paramedics, is because the money just isn't there in the long-term.

We Abandoned the Concept of the Mobile Intensive Care Nurse.

I've never understood why we created paramedics in the first place in an era that also saw the development of specialized critical-care nursing. In New Jersey, and in many states across the country, almost every paramedic program had nurse preceptors for years. Nurses specializing in out-of-hospital care were quite common until the early 1990s. I never actually saw a paramedic work in the field until I began my clinical rotations. If we shifted to a three-year community college MICN program, we could ensure both a decent wage scale and true career path for medics (and it would solve #6).

Volunteers Are Fine, But the Year-to-Year Mind-Set Is Not.

EMS is a complex business, with eight-minute response times within your community, a stock that is both critical and time- and temperature-based, burdensome regulatory requirements and continuing education for your staff. Who the hell told you that you can manage all this without a business plan? Without short- and long-term multi-year goals? Without strong management support for a volunteer labor force? Volunteer EMS organizations, even more than career organizations, need career managers with a multi-year business plan mind-set or your organization is going to fail. Even the Red Cross has career people who manage volunteer staff.

Regardless of Our Employer, When We Do 9-1-1 Response, We Have Not Said That We Are Public Safety.

After 9/11, I had the privilege of working with George Contreras and Richard Fox to try to secure federal line-of-duty Public Safety Officer Benefits for all of the municipal, hospital, private and volunteer paramedics and EMTs who died during that event. That experience really opened my eyes to the inequality faced by medics across the country. We are not public safety because of who our employer is; we are public safety because we respond to the public's calls to a public emergency number. That is a critically important distinction.

Summary

In summary, the problem is us. While we have become very good at blaming everybody else for our troubles, in our hearts, we must think that EMS is not all that important. If we did, we would be fighting like hell, working together and pounding our fists on the table.

As it stands now, most of the talented paramedics I started with 20 years ago are no longer paramedics. Some got hurt, some died, some burned out, and many of the rest work part time, because they love EMS, but need careers to make livings for their families. It is painful for me to say that EMS is not a career, but it is not. It is also painful to see the EMS system, which I do value and once had great hope for, collapse, but it is. While many of the problems I have identified have fixes that could be implemented now, I understand that most will only be implemented when the system collapses. And that can't happen too soon for me.

Scot Phelps, JD, MPH, EMT-P, CEM, CBCP, MEP, is an associate professor for the Emergency and Disaster Management MPA in the School of Public Affairs and Administration at Metropolitan College of New York. He has served as assistant commissioner for Emergency Management at the NYC Department of Health and Mental Hygiene, as a hospital emergency manager and as a professor of emergency medicine at George Washington University School of Medicine.

Rates as per the current (under review) collective agreement between the Union and the City of Edmonton. EMT-Ambulance, 36M Salary Grade: 001, $19.31 - $25.543(Hourly). EMT-Paramedic, 36M Salary Grade: 002, $22.988 - $30.125 (Hourly)

Doesn't the top ACP rate in the GTA range from between $33-$38/hour? Who the hell's going to take a $15k-$20k pay cut just to move to Edmonton? I know the housing prices in Toronto are outrageous, but come on...

I think plenty of Ontario-based services would be happy to host an international observer. Most are run directly by the local municipal government. Your best bet would be to track down a few and send them an email asking if you'd be able to ride out. If your home service can offer them a similar option, I can't see a lot of them who'd say no.

EVERY single professional firefighter in the State of California is at least certified EMT. A VERY large percentage of them are Paramedics. And a VERY large percentage of those wannabes who are trying to be firefighters are also EMTs and Paramedics. Not to mention that a couple of hundred schools are cranking out several hundred new ones every four months. Not to mention the "Boot Camp" there that cranks out EMT-Bs in 14 days. And have you not noticed how many Californians come to this website desperate for a job? You're crazy if you think anybody is going to have any problem staffing a service there without drawing on AMR and others.

Again, if it were as easy as you're suggesting, why on earth would this company have caved? Why capitulate and offer a massive raise if they didn't have to? Why not just fire them all and hire on these droves of unemployed EMT-B's? Why is any EMS agency paying its staff anything more than minimum wage, if there are 'a billion' of EMT-B's just salivating for jobs, as you claim. Why?

The answer is that it would be fantastically expensive, and a huge beaurocratic hassle for any agency to just unload all its staff and try to re-hire new ones. That's where skill in demand setting comes in - make yourself the cheaper of all options while still getting the best offer you can. This isn't rocket science - every labour market on the planet does this. Why are you so convinced that EMS is any different? If anything, EMS has it better than most industries- our jobs can't be outsourced to India for $0.25 a day. A diesel engine manufacturer can shut down for two weeks to re-tool if they want to. An EMS service can't do that. That's the leverage we use to bargain with, and sometimes that might have to go as far as threatening to strike, depending on the conditions on the ground.

Even in California, unions are fast losing their foothold. The governor himself is going against unions. Many US states are non-union and will never be union....Canadians don't have to worry about private industries stepping in and taking over a government function.

Anti-union political sentiment and the actual labour laws written on the books are two very different things. Don't confuse them. Unions are a fact of life for the corportate world and will remain so. Look at the airlines. Look at all the major car manufacturers. Look at the movie industry - all heavily unionized. As for Canada, you obviously know even less than I know about California - government handover to private corporations is everywhere. Even our sacred cow of health care is slowly being privatized. EMS in Canada is one of the few exceptions, largely because we've got a strong labour movement within Canadian EMS services. And other than Ontario, none of the provinces have 2-year BLS programs.

This definition of "political" from the American Heritage Dictionary says it all: Based on or motivated by partisan or self-serving objectives. Sounds exactly like your "solidarity" and "labour issues" to me.

I'm trying to motivate and educate anybody and everybody who works for a living in this field to stand up and better their working conditions. Including you, assuming you do in fact do this kind of work. The pressures of government, budgetary, and corporate issues will form a natural opposition, and a fair solution for everybodywill be found in the middle.

That's it. I don't want to see the public endangered, I don't want to see anybody's business go under - but I'm also unwilling to be stepped on so somebody can reap a greater profit off my back. I want a fair wage for the work I do. I want a level playing field for all parties, and on the worker side that means organized labour, until something better comes along.

In the Perfect World of DustDevil, exactly how would things work? No unions? We take whatever companies offer without dissent? You've got a lot of hyperbole to offer, but that's about all I've seen from you so far. What exactly is it you think these people should have done? What do you think any service should do that's going into contract negotiations. I've got a plan - what's yours?

Hey... you say screw the companies and the communities and the scabs. I say screw the wankers. What's the difference? We're both screwing somebody. What makes your point of screw so much more valid than mine?

Well, for one thing the word 'wanker' never appears in anything I've written - I think that says a lot about the difference between me and you. I'm trying to inform and encourage every person reading this who is facing or will face this kind of situation in the future. I'm trying to provide cogent arguments and actual data to support my position. You're engaging in name calling and reactionary rhetoric. You've yet to coherantly respond to all but a fraction of the challenges I've posited to you.

And if they had listened to YOU, they would have been unemployed by now. Good thing they listened to neither of us, right

I said stick to their position and they Powers that Be would cave, and they'd get what they wanted. Whether that took a strike, or just the threat of one. Well, they stuck to their position, threatened to strike right down to the 11th hour - and the Powers caved and they got what they wanted. They all still have jobs, and they all got a raise. Is this somehow confusing for you?

If the private provider implodes, the local government can and will provide service for their citizens without them. That is fact.

In the short term, they'll only be able to do so if a company like AMR is able to convince its staff to come in and work on OT, like the example already given above. If the staff in question were to show some solidarity and refuse to do so, that local government is in big trouble. As I've been saying all along, stick together and we all stand to benefit.

A fire service, even one that already provides EMS coverage, is going to be very hard pressed to upscale to meet the new level of demand without a significant infusion of personnel and resources. It's cheaper to employ an independant EMS agency to do that than to try and fund Fire to do it.

Those facts give workers, even those with an '80-hour EMT patch' that you so denigrate, some leverage in the bargaining process that they should be willing to use. If the rest of us will stand with them, they'll be successful.

I'd like to add that my wife was an NREMT-I for four years before we got married and moved up here. I'm well aware of the differences between Canadian and American pre-hospital care, and the issues facing American EMT's and Paramedics. The legislation is different all over the continent, but the basic principles of organized labour in the workforce are universal.

Unlike yourself, I am not here with an agenda to spout my political views.

Again with the 'agenda' accusations. WTF does that have to do with politics? This is a labour issue that directly affects every single one of us who does this for a living. What are you here with? Helpful comments like this?

Screw them. If the wankers spent less money on electronic cardiology stethoscopes, star of life tattoos, and useless crap from Galls, they could afford a $30 dollar co-pay for $300 dollars worth of medical care. Don't like that co-pay? Move to Canada and wait three months for your "free" doctors visit that cost you ten percent of your salary. Rolling Eyes

I am merely pointing out the obvious for the intelligent consideration of those in such a situation.

And if they had listened to you, they would have gotten nothing.

Ah, now I understand where the confusion comes from. You are quoting me out of context, and I still have to wonder if you are not doing so intentionally to suit your agenda.

Let me try one more time to get it through your head...

I said IF THEY STRIKE... then the fire department would step in. They did not strike, so you can neither prove nor disprove my statement.

DustDevil, your entire post is quoted above, and the words 'if they strike' aren't in it. And basic logic is clear in that a negative can't be disproved - hardly a victory for you.

I'm quoting you in full, but let's proceed from the notion that you did in fact mean 'if they strike Fire will step in'. Okay... so why didn't they? According to you the Fire Dept's in California are ready to go with their contingency in the Chief's desk drawer, presumably with little or no need for additional resources from the local governments. Why did the politicians let it get down to 10 hours to the strike deadline without mobilizing Fire to ensure a seamless transition? Do they enjoy living on the edge?

As for my passion clouding my judgement and 'having an agenda', you're the one typing in big angry letters and who started making insulting comments. Sounds like you're a lot more passionate about this than I. And my 'agenda' is to have EMS workers stand together and fight for improved wages and working conditions. Are you taking a stand against that idea? Are you arguing that we should all be poor and living in fear of our managers?

All I predicted was that if the medics stood together, they'd prevail. And I was right. Are you so intolerant of anyone disagreeing with you that you can't accept any viewpoint other than yours having some validity?

none of us were on forced overtime. what we did was work on our off days....It made a really nice paycheck and it paid for a trip to Australia so I did it without hesitation.

Okay, fair enough. It's not for me to judge what people choose to do on their days off. And if you chose to take on another job to help pay some bills thats your business.

But the reality is that from an organized labour standpoint, your actions helped to keep the former employees from getting any sort of concessions, or managing to get their old jobs back with any sort of improvements. You and everybody else in your situation could have declined those extra hours and extra pay, and helped out some fellow workers to improve their lot. That's not an entirely selfless action, either - somewhere down the road you and your colleagues might have been prepared to walk out. How would you have felt if those employees also refused to move in and do your jobs on OT?

Again, it all comes down to sticking together for mutual benefit.

All the more reason to strike, and put pressure on all the stakeholders to come up with a fair and reasonable solution. If AMR has a union, then their workers aught to show some solidarity with their colleagues and refuse to work in that area. Watch how fast the local politicians will jump if the prospect of no EMS coverage becomes a real possibility.

I predicted the politicians would jump if a strike became a real possibility, not if a strike actually occured. Well, it came down to the 11th hour, and they jumped all right. Into their budget and came out with the money to pay for a raise.

My words.

Been reading long?

You're kidding, right? You can't be serious. Use your head. You're in CALIFORNIA! The birthplace of fire-based EMS! The only place that the local politicians are going to "jump" is to their fire chief. Then you won't have to worry about your "low paying job." In fact, you will have no job to worry about at all. And you will have only yourself to blame.

So - you said the only place the politicians would jump to is their fire chief, and suggested that the employees would then be laid off from their 'low paying job.'

Well, the politicians didn't do that. You were wrong. In the end they caved and came up with the money to grant the Piner's employees a good healthy raise.

Your words.

I was involved in a situation where the mom and pop went under, the county they covered cancelled their license to run in the city. AMR came in, didn't hire any of their people, brought in all their own people with lots of overtime, heck I worked 4 24 hour shifts in a row(12 on 12 sleeping) and we covered it fine.

But this service was so unliked in the community and their medics/emt's were so anti AMR that neither AMR nor the previous services employees wanted to have them work there.

So the big guys AMR And the like can pull from their current resources if they need to until they conduct some sort of hiring process.

That sounds like a really crappy deal for all involved. What strikes me about your story is that AMR covered the shifts with their own staff on overtime. I take it you were an AMR employee, since you state that the Mom and Pop medics weren't re-hired. How long were those shifts covered with staff on OT?

Overtime is expensive - and not just when it comes to the wages. Inury rates go up, health care claims go up. AMR must have been banking on only a short period of time passing before they were awarded the contract themselves. Who did they then hire to staff the trucks?

From a Monday-morning quarterback perspective, there are several things that could have been done there. The labour laws in the U.S. are pretty similar to those up here - forced overtime is illegal in all but the most extreme emergency situations. So all the AMR employees brought in to cover could have refused to work any OT to show solidarity with the Mom and Pop employees laid off. The local government would then have been forced to look for other options. Just about anything they come up with is going to be at least as expensive as just conceding to whatever demands caused Mom and Pop to go under in the first place.

And yes, I am a really pro-labour guy. I wasn't until I got into this job and saw first hand the BS that politicians and manager will try and pull, if they're allowed to get away with it. All I want is a level playing field for all participants. Management makes their case, labour makes their case, and a fair solution is found somewhere in the middle.

I do not agree that management will cave every time though. I've seen it too many times where they didn't cave. But I do agree that solidarity on the labor front is a tremendous asset to have and more often than not with even the remotest threat of losing their jobs labor will cave first and continue to work in the crappy conditions.

Our service tried to unionize and it was basically quashed by management but then again, we did not have union support behind us.

In the event that management decides to hang tough, it will become a matter of public pressure. Every EMS manager governs at the pleasure of their political masters. They are ultimately responsible to the elected officials for providing the service for which they've been contracted. If they fail to do so (because their employees have legally walked off the job) then their necks are on the chopping block. They'll cave.

But let's say a manager isn't just being obstinate, and they really can't afford to offer a raise. Okay, fine. They're still going to have to go to the politicians and explain why their ambulances are sitting empty. If they can make their case that they simply can't afford to pay their staff enough to keep them on the job, you can bet the politicians will come up with a solution. Either by funding that manager themselves, or bringing in another agency to do the job. As I've stated above, another agency is likely going to have to hire those very same workers themselves.

From a worker's standpoint, they'll ultimately get what they want, if they stick together.

EMS isn't alone in having difficulty unionizing. Look at the nightmare WalMart employees have been going through. It's not always easy. WalMart was willing to close an entire store - a multimillion dollar loss for their bottom line, just to keep a union from getting their foot in the door.

But the difference between us and WalMart is that no government will ever be able to do without EMS. They can't just shut an agency down - not without opening the door to another agency. In this relationship, its the EMS workers themselves who have the power, so long as we open our eyes to that fact.

Like any other business, EMS management hates organized labour, because it forces them onto a level playing field with its workers. They'll try every tactic they can, legal and illegal, to intimidate their employees into abandoning the union process. They stand to reap far greater profits off your back if they can do so.

Yes they will go out of business hence the Fire services and big conglomerate services such as AMR and MEdTrans and others to come in and pick up the pieces at a rock bottom price. So yes they will go out of business but not quickly.

Okay, so let's surmise that Mom and Pop's Ambulance service goes under because it can't afford to pay it's staff a wage that's competitive with other agencies. So what happens then? The area just does without EMS coverage? Of course not. Other arrangements will be made. The public will demand it, and the politicians will make it happen.

So let's say Fire wants to take it over. Okay, great. They'll need enhancements to their staff and budgets at least as large as the service that just folded. They can't simply pull personnel off an engine company or rescue squad, because that then leaves them short-staffed on the fire suppression side. Since their fire-suppression numbers contribute to a municipalities ISO data and insurance premiums, that will not be tolerated. No matter how you slice it, they're going to have to hire more staff.

If they hire 'firefighters' and simply put them onto the ambulance, they'll doubtless command significantly higher wages than the medics they've replaced, as they'll be trained to wear two hats. If they decide to form a secondary EMS division within the Fire Dept, and just hire medics... well, who do you think they'll hire? Out of towners? Ordinary Joe's off the street? No, it'll the medics who were just laid off by Mom and Pop's ambulance! So now they're working for a municipal agency, probably getting vastly improved wages and benefits. Sounds like a good deal to me.

Option number 2 - Another private company is contracted to provide service. Okay. So who is that company going to staff their trucks with? They certainly don't have a bunch of salaried employees on the payroll sitting around doing nothing - they're going to have to hire a bunch of new staff willing to work in the area in question. Once again, all the people just laid off by Mom and Pop's are going to be the best candidates.

Now of course, there is the risk of losing things like seniority, vacation and benefits, etc. when getting laid off and hired on with a totally new company. But that's where an organized approach comes in. A strong union will be able to negotiate with the incoming company to secure the benefits that stand to be lost in the transition. That's fairly standard business practice in other sectors. The incoming company will simply have to account for that in their bid for the contract with the local government. If they refuse to do so, then its up to the employees to stand together and refuse to join the new company. Said company will never be able to meet its service obligations without them, and so once again the politicians will step in to save the day, and their political careers.

This isn't anything revolutionary. This has been standard practice within the labour movement for decades. The problem is that EMS is such a new industry, and has been run by such Mickey Mouse outfits for so long that we're all unused to it. But it works, dammit! Just have faith in each other and we can all look forward to huge improvements in working conditions.

Been reading long?

Nobody said they would jump in and save the day. We said that if the medics went out on strike that the FD would jump in. The medics didn't strike. You're claiming victory for something that nobody ever predicted.

I suppose you predicted 9/11 and the Tsunami too? :roll:

Ahh, sarcasm. Tremendous! Let me try and respond to such cutting insight with my own humble observations.

You and several others in this thread bemoaned the 'foolishness' of these medics and made all sorts of predictions that they'd all lose their jobs, that the Big Red Machine would step in and take over, that the public wouldn't stand for it, etc. etc. All of you were wrong. All of you ignored the arguments presented in favor of your pre-established opinions, largely based on an ethical standpoint that it was wrong to 'endanger the public'.

What I said was that if the employees of Piners stood together, the Powers That Be would fold and concede to their demands (or at least agree to arbitration), rather than risk the cessation of services. I argued that Fire could not step in because they'd require such an infusion of cash and resources as to make it pointless - it would have been easier and cheaper to just give the medics what they were asking for.

My whole point was that there wouldn't even be a strike if the employees stood together, and got even a shred of solidarity from their colleagues, especially those at companies like AMR. The politicians of today will never risk it. They'll cave, every time. Which is exactly what ended up happening.

I predicted it because I have some knowledge about about labour relations and EMS. You obviously don't.

...you cannot get blood from a turnip and there are two hot button issues facing the working EMS staff members, pay and medical insurance. Pay can only go so high and comparing a large ems service with big revenue with a small service there is no way that that service can compare in resources yet many mom and pop ambulance services pay better that surrounding areas and then again some don't.

I've heard a lot of arguments from a lot of different people about the notion of 'pricing ourselves out of a job'. That's nonsense. The main factor controlling EMS wages is simple supply and demand. As demand for qualified staff goes up, the wages companies have to pay in order to recruit and retain staff goes up. This is no different for us than it is for any other segment of the workforce. And the demand is going up.

EMS is an essential service that the public will not tolerate doing without. But EMS is also cheap from a budgetary standpoint. Even up here in Canada, with fully socialized health care and next to zero monetary recovery by EMS agencies, the average cost to the property tax base for full ALS-level EMS coverage is miniscule in comparison to other costs.

For the City of Toronto (pop. 4.5 million or so) in 2006, with an average property tax bill of $2093.41, $503.61 went to police services, $204.59 went to fire services, and a measly $40.35 went to EMS. Toronto EMS is a world-class outfit with arguably the best training and equipment in the country, and a host of specialized units like Tactical EMS, Heavy Urban Search and Rescue, Riot Squad Medics, etc. etc. etc. And they do it for a crummy forty bucks a year per household. In Canadian dollars. See for yourself here.

The average salaries for BLS-level medics in Toronto is somewhere over $30.00/hour, though I'm sure the many Toronto EMS medics on here can more accurately comment on that than I can. Their salaries got to where they are because they've bargained hard when needed, and made the City of Toronto understand that they were a vital asset that needed to be paid according to their levels of expertise and responsibility.

Can anyone seriously say that Mom and Pop Ambulance service in the U.S. are going to be run out of business if they're forced to pay their medics wages that are competetive with other services in their area? No government will allow that - it would be tantamount to political suicide to do so. It wouldn't require a particularly deep trip into the budgetary piggy bank to pay for some reasonable enhancements to wages and benefits. Look at the data for yourself.

If we as a group are afraid to apply the same techniques used by every other organized labour force out there, we're never going to be able to enjoy the same benefits they do. Whether that comes in the form of cost-of-living pay increases or improved health care coverage, we can kiss it all goodbye if we're not willing to present a united front when it comes to bargaining with management.

Every situation is different, and the same approach to labour relations isn't always going to be successful - or even necessary. But anyone and everyone involved in EMS should understand and appreciate that there is a sea change going on right now in this industry. Those changes are going to have enormous ramifications for the ways in which pre-hospital care is delivered, and the ways in which the human resources of EMT's and Paramedics are recruited and developed.

Both Canada and the U.S. are 'greying' - there is a demographic shift towards an older and older population. That means EMS is going to have higher and higher demands for service for the next thrity or forty years. WIth an across-the-board decline in volunteerism in EMS there is going to be a greater and greater demand for qualified personnel from the agencies that will provide EMS to those aging populations.

That means that we as EMT's and Paramedics are going to have greater and greater power when it comes to demand setting in negotiations, and a stronger and stronger position for those of us fortunate enough to have access to binding arbitration.

BUT! That's only going to be of any value if we all have the guts to stand up for ourselves and stick together. The people making small fortunes running private EMS companies would love nothing more than for all of us to adhere to the idea that 'we can't endanger the public - we should just take whatever they offer us and be thankful to have a job'. They're banking on that philosophy - literally.

It can be done, has been done and will be done, if we all show a little goddamm solidarity!

Haven't checked this board in a while - but good for Piners!!! =D> =D> =D>

It just goes to show that if a group of medics show some strength and solidarity, they'll come out on top every time. We have vastly more strength as a labour unit than we realize. Every EMS manager on this continent is all too aware that they'll lose in a PR battle over wages and working conditions. Nobody wants to see the public put at risk, but when push comes to shove, no EMS manager can afford to take the chance - they'll cave every time (so long as demands are within reason).

And just like I predicted - Fire didn't jump in at the last minute to save the day, the Piners medics didn't all lose their jobs. And yes, those of you who cried doom and gloom throughout this discussion deserve to have your noses rubbed in it. If they'd listened to you they'd have come out of this with jack s**t.

Take this as an example to stand tough and stick together, and we can win, dammit.

This is the kind of opportunity FD's love, private ambo's fail to meet coverage and fire swoops in and saves the day.....So like Dust said earlier it is suicide for these Medics to go on strike, in time it could cost them all their jobs

No Fire Service I've ever worked with could just step up and deliver ambulance service without a major influx of personnel and money. They might be able to shuffle resources as a very short-term option, but I think most firefighters (and their unions) would go berserk if significant resources were pulled from traditinonal FD duties to run EMS. No matter how you slice it, any FD is going to need much more money and personnel to deliver ambulance service.

You're advocating a defeatist mentality that's been prevalent in EMS for far too long. There is a long and well documented history of other labour movements that faced similar (often much more difficult) problems in their struggle to achieve fair working conditions. Look to their example. If anything, the prospects for EMS are even better than those of the general workforce, as EMS isn't a job that can be outsourced, and there will always be a need for medics in the community.

You're kidding, right? You can't be serious. Use your head. You're in CALIFORNIA! The birthplace of fire-based EMS! The only place that the local politicians are going to "jump" is to their fire chief. Then you won't have to worry about your "low paying job." In fact, you will have no job to worry about at all. And you will have only yourself to blame.

If it were that simple the municipal government would have shitcanned Piners when they were unable to meet their contractual obligations, and just handed the whole ambulance portfolio over to their FD's without a second thought. That won't happen because it would require massive funding increases to the FD, since Fire-based services always cost more to run than municipal and private companies - because of their higher wages.

Again, have the stones to fight for a fair wage and decent working conditions. WE DID IT UP HERE.

If you're not prepared to take action, then you're going to be stuck with substandard pay, substandard benefits, substandard everything. In Canada almost every service has had strong union representation for decades, and our working conditions and wages reflect that.

I don't want to see a member of the public come to harm because of a labour dispute. But I also have an obligation to my family to try and secure the best working conditions that I can. If the public (through their elected officials) is unwilling to meet me halfway, then they're the ones forcing the issue.

A FIST suit is useful for overcoming inhibitions about full-power strikes and practicing at actual engagement ranges, but it doesn't really allow for the FUT (f**ked up tangle) that almost always occurs at some point in a fight. Also, it does nothing to condition someone for getting hit themselves. The first time most people eat a punch with little or no protection should be during training, not out on the street.

The key value in with MMA training isn't that it incorporates techniques that are somehow better than those in other systems - the core MMA techniques taught in most schools are in fact very basic. Its just that there is no substitute for the crucible effect that comes from full-out aggressive contact with an opponent who is actively trying to kick your ass.

Don't just take my word for it - look at the differences between these clips. In the first you have some traditional Aikido with some fancy-looking moves against an opponent who is not even trying to fight back. Next some some more nonsense practiced against guys who just stands there and take a beating.

Aikido demonstration

Karate self-defense

Next we have some MMA sparring at moderate intensity. Lastly, a real fight - fast, aggressive and ugly. Did it look anything like either of those first two clips?

MMA Sparring

Actual fight (Warning - violence)

Its not about trying to be the next Ultimate Fighter, and there is of course a world of difference between a sporting competition and an aggressive patient out in the field who is trying to hurt or kill you. But the reality is that MMA has conclusively shown that the vast majority of traditional martial arts and combatives techniques simply will not work against a determined attacker, at least not reliably.

What's the point of learning a technique that only work occasionally at best, or under ideal conditions? If you're going to spend time and money learning protect yourself, study something that's been shown to be successful through a Darwinian selection process. Then take those fundamental techniques and adapt them to the unique EMS environment.

If you're really serious about learning to defend yourself when it counts, train against someone who will punch you in the face or choke you into unconsciousness if you give him the chance. Your best bet to do that safely and effectively is to find a good gym in your area that offers MMA classes and get out there.

If not, then admit that you're not prepared to handle a violent confrontation and act accordingly.

All the more reason to strike, and put pressure on all the stakeholders to come up with a fair and reasonable solution. If AMR has a union, then their workers aught to show some solidarity with their colleagues and refuse to work in that area. Watch how fast the local politicians will jump if the prospect of no EMS coverage becomes a real possibility.

We're professionals deserving of a professional's wage. If it takes a threat of strike action to get that done, then so be it. As for the whole 'endangering the public/higher calling' argument, that's BS. Any worker deserves to be paid a salary commensurate with their skills, experience and responsibilities. In the end a well-paying service will attract and retain the best people, which will result in a higher quality service for the public.

If you're really serious about learning some defensive tactics that will actually in a full-on fight, find a school in your area that teaches MMA (mixed martial arts), and will allow you to spar against a non-compliant opponent with some intensity. Most such schools will have a jujitsu base.

I can tell you from first-hand experience that the sort of defensive tactics material advertised by most instructors is of very limited use in the real world. Techniques such as pain-compliance wrist-locks, hip-throws, standing arm-sweeps etc. etc. simply do not work against a determined attacker who is really trying to hurt you. At best they'll allow you to control a mildly intoxicated or confused patient, provided they don't become very aggressive.

Skip anything that doesn't offer a chance to practice hard against a non-compliant opponent who isn't following a script and will punch you in the face (with gloves on) as hard and fast as they can first chance they get, because that's what's going to happen in a real fight. Anything else is worse than useless, because you're going to get hurt trying to execute techniques that just won't work.

As a member of a unionized service, and as a union officer myself, I'm always interested in accounts of labour/management relations in EMS. From the limited information available about this situation, it looks like this company is pulling all of the classic moves to keep its employees scared, docile and poor. Just look at all the solidarity they're getting from members of this board. :roll:

I sincerely hope these employees exercise their right to strike and either force this employer to negotiate in good faith, or get the contract yanked and handed over to someone else. For those of you who condemn these medics for endangering the community - you're playing right into the hands of employers and civic officials who would like nothing more than to pay you minimum wage with zero benefits. You're the reason the salaries of EMT's/Paramedics across the U.S. are on average one-quarter to one-half of those in Canada. And that's with our insane income tax rates and weaker currency!

EMT's/Paramedics are workers like any other. They have the same rights to safe working conditions and fair wages as any other. Why should any special conditions apply just because they're serving the public? I agree that EMS is an essential service that should not be disrupted because of the labour process - thats's what binding arbitration if for. If the company or community officials refuse to negotiate or go to arbitration, than they've left the workers with no choice. A community that doesn't care about its emergency service workers enough to bargain fairly... well, they've earned a wakeup call in the form of a strike.