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Topic may be in the wrong thread, but I see this as a management problem, so I placed it here. As I was reading an old post, I was struck by someone who was asking whether or not they should hire a medic because he/she didnt make a great first impression. The poster was more or less saying, if we werent so desperate, I wouldnt even consider him/her.

That raises alot of questions, at all levels of EMS.

1. Do you work at a desperate service ? If so, how does hiring warm bodies effect the care your service delivers ? How do you like working with someone who is a below average employee ?

2. If you do not work at such a service, why is your service different ? What does your service do to attract and keep the "best" ? Is it money, benefits, equipment, schedule, call volume, management, none or all of these things ?

3. Does your service fire everyone that should be fired, or does it take an act of congress to get rid of the bad apples ? If so, is that because of the shortage ?

4. What does it feel like when you walk into your service, as an outsider ?

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Topic may be in the wrong thread, but I see this as a management problem, so I placed it here. As I was reading an old post, I was struck by someone who was asking whether or not they should hire a medic because he/she didnt make a great first impression. The poster was more or less saying, if we werent so desperate, I wouldnt even consider him/her.

That raises alot of questions, at all levels of EMS.

1. Do you work at a desperate service ? If so, how does hiring warm bodies effect the care your service delivers ? How do you like working with someone who is a below average employee ?

2. If you do not work at such a service, why is your service different ? What does your service do to attract and keep the "best" ? Is it money, benefits, equipment, schedule, call volume, management, none or all of these things ?

3. Does your service fire everyone that should be fired, or does it take an act of congress to get rid of the bad apples ? If so, is that because of the shortage ?

4. What does it feel like when you walk into your service, as an outsider ?

1. It feels like it. It's driving me nuts.

2. N/A

3. I wish they did. I have my list ready.

4. If you walk in as an outsider, and see me, I will be pleasant, friendly, yadda, yadda, yadda. I am an FTO for my company, so I will work with you to make you a productive employee. However, if you bring with you the IKE attitude, I will have you crying by the end of the shift.

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1. Yes, however they have started to utilize the grossly inadequate paramedic for a lead basic on a BLS transfer truck. Examples of grossly inadequate include mistaking a head bleed for an acute coronary crisis (and being reported by the ER doctor) and transporting a dead body reporting the vital signs to be "within normal limits." I'm fairly sure the reason they can't be paramedics is largely based on complaint by ER physicians and less about the crimes they committed against the patch. I only say that because they still have many paramedics running functioning that have IQ's hovering around 80 that consistently make mistakes that aren't reported on. It's become so common many emergency departments simply dismiss the mistakes and set about correcting the situation. The upside of this phenomena is being recognized as a competent provider pretty early on by the nurses and doctors. There are a few of us that can ask for any order and NEVER be turned down simply because we've proven ourselves, over and over. Sucks for the public we serve, rocks for the handful of us.

2. I once worked at the perfect service. It took me nearly three years to prove myself. It's hard to do that when everyone you work with is uber-smart and educated to a level barely seen in EMS. I mean requiring actual college A&P, actual college English and math courses, having an entry level exam to weed out those that are lucky to be walking upright. The pay wasn't great. It was a hospital based service and the EMS-ER relationship was fantastic. Most trucks were double medic. The turn-over was low, the arrogance high. I will say this, they earned the right to be arrogant. Those paramedics were incredible. If I'm going to be sick enough to need EMS, I want to there when I need them.

3. No, generally they promote them. My current service is built on "yes-men." Those that challenge the good old boy system are the ones that take the most flack. I don't take any crap from the fire department, which is a problem because my service worships them. Medical call, my scene, my patient, do what I want or leave. I rarely need lifting help, and I don't need a bunch of people standing around with their thumbs up their butts gawking at my patient. Subsequently, I'm actually banned from working in one part of the city because I don't play well in the sandbox with the fire department.

4. Pretty crappy. When I first came in I had come from an accredited paramedic program taught by one of the best instructors in the country (Bob Page). I had oodles of hours of clinical rotations in every part of the hospital, including ER physician shadowing. When I compared my clinical hours with the program given here, I had more than twice the hours and had completed time in more areas of the hospital. I also had my previous college background on top of everything. The program here is six months long with a short little online A&P class. Because I didn't go to their program I was told I could only work as an intermediate with another paramedic for an undetermined amount of time. Most of the paramedics were still fighting the 12-lead and use of capnography, whereas I was educated in both and found them to be invaluable assessment tools. They didn't look at where I was and what I had done, they looked at where I HADN'T went to school. I offered to help with education of 12-leads and capnography and have been turned down every single time.

I have to wonder if this type of company is a product of being in the south. I don't think I've ever worked for a place that is so close-minded and afraid of change. I've seen these people treat new people so badly that they've psychologically damaged them. I've seen one officer be so hard on a brand new EMT, the guy remarked that he felt near suicidal after his shifts. Having people that are supposed to be mentors acting like this, imagine how others act towards outsiders.

I'm really lucky, I'm only there once in a blue moon anymore. I channeled my energy into another job. I hated knowing that the reason I needed medication was because my job sucked. I love being a paramedic more than anything in the world and I'd love to be able to teach new EMTs and paramedics. Unfortunately, it looks like I'm going to have to wait until I move back north before I will once again be able to work as a paramedic on a full-time basis.

I've seen a lot of people have viewed this topic by next to no one has replied. I'm really interested in hearing how other services run. I hope some more people will honestly answer these questions.

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1. No

2. Money, benefits, training, equipment

3. Act of Congress, not because of desperation, but because of a very effective Union. (Cuts both ways)

4. Friendly, but not welcoming with open arms. You will be expected to continue to swim upstream and improve your game, otherwise you will be ostrascized. You will likely be cut during the hiring process if you are a complete boob.

Medics are all promoted from within the department, so there is no hiring of medics per se. All new hires are hired as BLS, with a requirement of completion of a 6 months training academy and another 6 months of probation. After that time, if you posess the credentials to work ALS and if there are posted openings a competitive written, practical and oral exam is given, those who pass are ranked, and the number of positions open go to the top of the list. Then you have another 4 months or so of clinicals, field internship and a final oral board. If you pass all that, another 6 month probationary period.

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