Should EMS wages be call based?

[mobey]

I was recently having a debate with another member about wages.

I won't get into the local details, but here in Alberta, the city wages are nearly frozen while the rural wages are skyrocketing. This is a result of the entire province unionizing.

Previously, the City's were great paying jobs, and the rural staff barely scraped by. So we are really just equalizing wages at this time, which is really upsetting the City medics.

So the opinion that I have found quite common coming from the city medics, is that us rural workers do not do enough calls to warrant wage parody with the city workers.

My opinion is: we should be paid based on education and job title, NOT call volume.

We do entirely different jobs. eg: A city worker may do 2 ETOH, a code, and a chest pain in 1 - 12 hr shift, then go home and shut the radio off for the night.

Last tour I did a 7hr old female with increased ICP that had to be rescusitated, then managed for the 3.5hr transport, then go home and remain "on call" for the next 48hrs straight.

True enough, that may be the only call I do, but why should my annual income be any different than a city workers? We do totally different jobs.

Edited October 22, 2011 by mobey

[nypamedic43]

The service I work for pays by the hour. Everyone has a set schedule. I work 5 9 hour days. There are some guys that work 57 hours weekly and some that work 66 or 72. Each hour over 40 pays time and a half.

There is a service just north of us that pays per call. I have heard that the pay is pretty good. However both areas are more city than country. I wish I could give you some kind of comparison of wages but in talking to people that work for the other service, they like the pay per call wages.

[flamingemt2011]

Salary should be based on supply and demand alone, busy/slow, rural/urban, white shirt/blue shirt shouldnt matter. If the rural service has a harder time attracting medics it should pay more, if urban services have a harder time attracting medics, they should pay more.

[JakeEMTP]

I think all the Alberta medics should be paid the same. Sure the City medics may run more calls, but they do not have pt. care for as long as the rural medics. It is a wash in my opinion. You are all educated to the same level, therefore should be paid the same.

If the City medics are bitching, ask them to complain to their union. I would think they would want their union brethren to make the same. All for one, one for all stuff. Either that or apply for a rural job.

[RaceMedic]

hmmmm call based pay is to unpredictable to really count on for income, especially in a rural service. You may go days with out a call. hard to make a living with out money.

Supply and demand ... well i don't think that will work cause as a medic i want to work. If the rural service is paying more but still has no volume how do you keep skills? The busier city job is still more attractive do to actually getting to treat patients. Besides who is going to provide the money for a rural service to pay the medics ? In most cases where i am the really rural services are completely volly with an annual operating budget less than my "not so rural" services fuel budget. there county population is somewhere in the neighborhood of 10,000-15,000 people compared to my county of aprox. 60,000 people.

Economics suck ass, but it is simple to see that the tax base that a county of 15,000 can not pay as much as a tax base of 60,000 ... and we are only 45 miles apart .Not to mention that very rural service may run in a busy year 200 calls as opposed to my services call volume of 3500 calls a yr ....

can't pay with whats not there ... Damn wish the feds could figure that out ....

Race

*edit*

The only union shop i worked in was in the metro area as soon as the union was voted out the pay and benefits increased exponentially. Im not a pro union worker...

Edited October 22, 2011 by RaceMedic

[mobey]

The service I work for pays by the hour. Everyone has a set schedule. I work 5 9 hour days. There are some guys that work 57 hours weekly and some that work 66 or 72. Each hour over 40 pays time and a half.

There is a service just north of us that pays per call. I have heard that the pay is pretty good. However both areas are more city than country. I wish I could give you some kind of comparison of wages but in talking to people that work for the other service, they like the pay per call wages.

The spirit of the thread is not "What does your service pay?"

I would like to hear your opinion/rationale on paid per call, or paid per education.

RaceMedic:

If the rural service is paying more but still has no volume how do you keep skills?

Just to clarify, I am talking about wage parody. Both make the same. A Paramedic is a Paramedic no matter the setting.

Ahh yes... skills.... This is another infamous argument made by the urban fans. The problem of skills in the rural setting is a real one. I would love a thread where we discuss the upkeep of skills, and how each service does so. But in keeping with the direction of this thread, I will turn your question around to ask: If a few rural services do not take steps to ensure competence of thier providers, should we hack the wages of all rural employees and label them as having weak skills as justification for taking pay away?

RaceMedic:

The busier city job is still more attractive do to actually getting to treat patients.

Maybe to some, I RSI'd an overdose a couple weeks ago, then transfered her into the city with Dopamine running, pushing bicarb, and continuous sedation/paralytic. The transfer was just over 2 1/2hrs.

Don't get to do that in the city. To be fair.... that is all I did in 3 days though

Oh, BTW: On the topic of skills..... are we certain that a "inner city" medic has the skills to run critical care transports for hrs on end?

How often do City Medics run transport vents for more that 15min? Nitro drips? Initiate blood transfusions? Use PEEP/CPAP for extended periods long enough they can actually do damage if used incorrectly?

Salary should be based on supply and demand alone, busy/slow, rural/urban, white shirt/blue shirt shouldnt matter. If the rural service has a harder time attracting medics it should pay more, if urban services have a harder time attracting medics, they should pay more.

Interesting.

Should the hiring process be different?

You are all educated to the same level, therefore should be paid the same.

Oh... You mean like a Profession?

[Siffaliss]

I was recently having a debate with another member about wages.

I won't get into the local details, but here in Alberta, the city wages are nearly frozen while the rural wages are skyrocketing. This is a result of the entire province unionizing.

Previously, the City's were great paying jobs, and the rural staff barely scraped by. So we are really just equalizing wages at this time, which is really upsetting the City medics.

So the opinion that I have found quite common coming from the city medics, is that us rural workers do not do enough calls to warrant wage parody with the city workers.

My opinion is: we should be paid based on education and job title, NOT call volume.

We do entirely different jobs. eg: A city worker may do 2 ETOH, a code, and a chest pain in 1 - 12 hr shift, then go home and shut the radio off for the night.

Last tour I did a 7hr old female with increased ICP that had to be rescusitated, then managed for the 3.5hr transport, then go home and remain "on call" for the next 48hrs straight.

True enough, that may be the only call I do, but why should my annual income be any different than a city workers? We do totally different jobs.

I find it interesting that you comment on how it is in a rural service when you've never worked in Calgary or Edmonton. Wages aren't NEARLY frozen, they ARE frozen for those in certain paysteps as both EMT's and paramedics. Certain staff have even had wages reduced.

How you've described a night in the city pretty incorrect. Firstly, there are very few 12 hour shifts, most nights are typically 14 hours. Secondly, due to the fact that we are understaffed for the volume of calls that are coming in, most 14 hour night shifts average at least 8 or 9 calls now. My record to date is 12. Edmonton for instance is now #1 in the country for murder, and several violent crimes don't even make it into the paper. I don't think it's appropriate for you to know or understand what goes on when you've never worked in a city of a million. There's also the coverage of surrounding areas, all the burbs. All this without having the number of staff to appropriately cover the city itself. Crews are run ragged and several are leaving for greener pastures because of this. So please, don't patronize by pretending to know what goes on.

Why didn't rural staff try and unionize before? Perhaps those of us who started small and still work small should have done that before. Then maybe we wouldn't have "scraped by". If 3 years ago you wanted to be paid more and realized it wasn't going to happen where you were, why didn't you make the move? And it's not that there's "equalization" going on. It's that they are preventing several from receiving raises until others catch up, which will likely take several years. How is this kind of "Robin Hood-ism" fair? We had what we had because we had a good union that fought for a lot longer than you or I have been in EMS, so that I could enjoy for a short while, the fruits of their years of hard work. Somehow the province made it legal for them as our employer to choose a union for us. Nobody got to vote on this.

My point is, that some made the choice to leave smaller areas for better paying jobs. People frequently do this in several industries, not just ours. Not saying people should get paid for each call like piece work as a mechanic. It's inappropriate that others have been forced to sacrifice and not given a choice in the matter, and wait years despite rising cost of living for financial gain, just so others who knew how pay initially differed from area to area when they entered into the field here. Things do have to be more fair, like a greater difference in pay between an EMT and a paramedic and better pay for everyone. But not like this.

And as for your post that was posted when I was posting my post ...

Most medics in the city are very well educated, some are paramedic instructors and some are STARS flight medics both past and present, some do critical flights and transports with other services. There are critical care transports that go on every day, difference is a shorter transport time. Some are also RN's and RT's, and are better at longer term critical care than you or I will ever be.

In fact, I've give you my next paycheque if you walk up to one of the STARS medics and tell them their critical care skills are shit. You appear to know it all so it shouldn't be an issue for you.

Edited October 22, 2011 by Siffaliss

[mobey]

I find it interesting that you comment on how it is in a rural service when you've never worked in Calgary or Edmonton.

Point taken, The largest city I have worked in was 25000 people, covered by 2 ambulances.

How you've described a night in the city pretty incorrect. Firstly, there are very few 12 hour shifts, most nights are typically 14 hours. Secondly, due to the fact that we are understaffed for the volume of calls that are coming in, most 14 hour night shifts average at least 8 or 9 calls now. My record to date is 12. Edmonton for instance is now #1 in the country for murder, and several violent crimes don't even make it into the paper.

Thank you for the clarification, my point made remains the same

I don't think it's appropriate for you to know or understand what goes on when you've never worked in a city of a million.

Point taken...... again. Thank you for reminding me 25000 is not a city

Why didn't rural staff try and unionize before? Perhaps those of us who started small and still work small should have done that before. Then maybe we wouldn't have "scraped by". If 3 years ago you wanted to be paid more and realized it wasn't going to happen where you were, why didn't you make the move?

Because I do not run from my problems, I progress the profession. I have unionized and negotiated 2 contracts at 2 different services. The last one i did I got us a 40% increase with retirement package and brought ALS to the community.

And it's not that there's "equalization" going on. It's that they are preventing several from receiving raises until others catch up,

Pretty sure that is the definition of equalization

In fact, I've give you my next paycheque if you walk up to one of the STARS medics and tell them their critical care skills are shit. You appear to know it all so it shouldn't be an issue for you.

Wow..... just Wow

[RaceMedic]

The spirit of the thread is not "What does your service pay?"

I would like to hear your opinion/rationale on paid per call, or paid per education.

RaceMedic:

If the rural service is paying more but still has no volume how do you keep skills?

Just to clarify, I am talking about wage parody. Both make the same. A Paramedic is a Paramedic no matter the setting.

Ahh yes... skills.... This is another infamous argument made by the urban fans. The problem of skills in the rural setting is a real one. I would love a thread where we discuss the upkeep of skills, and how each service does so. But in keeping with the direction of this thread, I will turn your question around to ask: If a few rural services do not take steps to ensure competence of thier providers, should we hack the wages of all rural employees and label them as having weak skills as justification for taking pay away?

To be totally honest most do nothing but basic continuing education, sometimes rotating through the ER or OR but not often. Here where i am none of the Very rural service pay well at all. as i said they are primarily volly BLS services that have full time jobs in other industries, primarily farming and agriculture. So the pay for them is irrelevant. they dont get paid. As for ALS transfers for them we have several fixed wing air ambulances in this region that fly in to the small hospitals and take over PT care. If the person is not that emergent then they arrange for ALS ground transport from a private service in the region. As far as pay between the paid service i work for and the metro i used to work for they are only separated by a few dollars an hour.

RaceMedic:

The busier city job is still more attractive do to actually getting to treat patients.

Maybe to some, I RSI'd an overdose a couple weeks ago, then transfered her into the city with Dopamine running, pushing bicarb, and continuous sedation/paralytic. The transfer was just over 2 1/2hrs.

Don't get to do that in the city. To be fair.... that is all I did in 3 days though

When i worked in the busier city, i averaged 15-18 calls per 24 hr shift worked. I RSI'd there ( not allowed where i am now) But your correct most city medics have no concept of transports lasting more than 20 minutes or not having a rotor to take them. It is truly different work as you have mentioned and many that have done both will attest each with their own unique challenges.

Oh, BTW: On the topic of skills..... are we certain that a "inner city" medic has the skills to run critical care transports for hrs on end?

How often do City Medics run transport vents for more that 15min? Nitro drips? Initiate blood transfusions? Use PEEP/CPAP for extended periods long enough they can actually do damage if used incorrectly?

Not near often enough.

Interesting.

Should the hiring process be different?

Oh... You mean like a Profession?

[Siffaliss]

I find it interesting that you comment on how it is in a rural service when you've never worked in Calgary or Edmonton.

Point taken, The largest city I have worked in was 25000 people, covered by 2 ambulances.

So less than 20 ambulances for 1 million+ including surrounding areas is good?

I don't think it's appropriate for you to know or understand what goes on when you've never worked in a city of a million.

Point taken...... again. Thank you for reminding me 25000 is not a city

We're talking major urban center here ...

Why didn't rural staff try and unionize before? Perhaps those of us who started small and still work small should have done that before. Then maybe we wouldn't have "scraped by". If 3 years ago you wanted to be paid more and realized it wasn't going to happen where you were, why didn't you make the move?

Because I do not run from my problems, I progress the profession. I have unionized and negotiated 2 contracts at 2 different services. The last one i did I got us a 40% increase with retirement package and brought ALS to the community.

Good for you. Why were you still complaining then? And some chose not to drive 200km for work as it wasn't necessary anymore.

And it's not that there's "equalization" going on. It's that they are preventing several from receiving raises until others catch up,

Pretty sure that is the definition of equalization

Sounds more like something Robin Hood would have done ... except people worked hard for what I and several others used to have. It wasn't just handed to them.

In fact, I've give you my next paycheque if you walk up to one of the STARS medics and tell them their critical care skills are shit. You appear to know it all so it shouldn't be an issue for you.

Wow..... just Wow

What's the issue? I thought no city medics could do critical care as good as you because you're in a small town and do LDT's for critical patients a couple times a month.

Edited October 22, 2011 by Siffaliss