The Private Ambulance Service Thread

[GulDukat]

I myself work for a private ambulance company and have seen what they do and don't do.

More so what they "don't" do. It is such a hassel to get anything done at all. Its all about the money.Forget your employee's that actually make the money for you!

They don't want to pay for proper equipment and training for newbies. They are always so concerned with what other companies think of them they forget about patient care.

The pay sucks,the "insurance" sucks, and you can never find a supervisor around when you need one :x

Not to mention all the ED's and City workers think we are the scum of the universe because we don't have a fire logo on our vehicles! :evil:

I have a few....issues. Can you tell?

Sorry for going off like that! :oops:

Do NOT be sorry for going off like that. That is exactly what I want in this thread, honest thoughts and opinions.

Yours are even more important because you are there and doing this for a living.

Let's deal with two things from your post, if you don't mind.

1. What kind of equipment are they not spending their money on that you feel like you are missing? Also what kind of training are you referring to?

2. Why do you suppose that the E.D.'s feel the way they do about you? I understand why the F.D. services feel the way they do, but do you feel angry that the E.D.'s who put the patients care in your hands for their transfers and releases or whatever else doesn't have any respect for you or your co-workers?

BTW, none of these are trick questions and I am not trying to be condescending to you at all. I just would really like to know how you feel and why you feel the way you do.

Also, if the company you worked for paid better and had better benefits would you consider a career in that company or no matter what would you prefer to move on?

[JPINFV]

[align=left]I work for a private service and yes we are part of the ems systems. we take all 911 calls in this county. Im not thrilled with the owners. they like to cut corners and cost but thats cuz they are private and don't get the funding. I do like working here and like the people i work with. it would be nice to have good up to date equipment but that doesn't always happen. in ems we are taught to work with what we have and compensate

Apparently they don't teach nor expect a moderate ability to write either. As said countless times before, but since you're new still needs to be repeated, you will be judged on your grammar ability. This isn't to say that we expect college term paper quality work, but for the love of all that is good and holy, please use complex sentences, commas, and apostrophes. There's no sense in wasting time posting a message if your ideas get lost in a terrible signal to noise ratio.

[JPINFV]

I'll bite, so to speak.

1. What kind of equipment are they not spending their money on that you feel like you are missing? Also what kind of training are you referring to?

Equipment that I think we should have:

AEDs

good map books [some of my [soon to be ex] company's map books date back to 2005. These are maps that are on units run 12 hours a day, 7 days a week. They get abused and are, in some cases numerous, missing pages.

Jump bags

Training:

more than 1 formal CE event every 6 months [normally it's an "EVO" course and a MCI drill] on rotating days [i.e. not ALWAYS on Saturday]

professional EVOC course [i.e. not having an FTO teaching people how to use the siren when he doesn't have any idea how it works and having another FTO drive a car though a simulated intersection that ends up with the ambulance and car going in circles around each other].

Actual drills with our WMD suits that were supplied by the county [basically they're escape suits, nothing special, but the people trying them on took about 10 minutes to put the entire thing on.]

Other:

Maintaining and repairing units. When a unit hasn't had a working AM/FM radio in 2 years, there's a problem. When the primary/secondary emergency light switch is backwards [intersection lights don't come on when put to primary], there's a problem. When the communications radio DOESN'T work at all, there's a problem, yet these units still go out.

2. Why do you suppose that the E.D.'s feel the way they do about you? I understand why the F.D. services feel the way they do, but do you feel angry that the E.D.'s who put the patients care in your hands for their transfers and releases or whatever else doesn't have any respect for you or your co-workers?

The "hire anyone with a pulse and a cert, pulse optional" choice with FTOs that don't really do any training, and sprinkled with crew chiefs who's attitudes are "do what ever causes the least amount of trouble with the nursing homes" then the company WILL get a bad rep. You, as an employee, are a representative of that company, and people will use they're previous dealings with the company's employees to prejudge you.

Also, if the company you worked for paid better and had better benefits would you consider a career in that company or no matter what would you prefer to move on?

1. I would probably move on because where I want to be [at least regionally], doesn't involve working with any single company, but with the EMS system as a whole. The EMS system in California is controlled by each county individually [i.e. one protocol/level/scope for the entire county, regardless of the company].

2. The abuse and indignity [yes, working in a POS unit that's normally understocked and dirty for a company that doesn't care about it's employees past their ability to make money] is simply not worth it. I think it speaks volumes when the waterpark I work at seasonally takes better care of its employees and guests than the ambulance company does of its employees and patients.

[zebra_emt]

I work for one of the largest ambulance services in the country and we are private. We run well over 60,000 calls every year. This is mainly because we are the premier service in the county, thus making many of the small, volunteer ones "obsolete". People subscribe to our service and the volunteer services never make it out of the gate.

My thoughts on the private service are fairly positive. We offer acceptable membership fees that allow patients to get quality care w/o a large bill. Our system has a very respectable on-scene time. Also, we train all our own EMT and Medics. However, we do have a few negative aspects. One is we run many transfers and do not utilize our BLS crews properly. Another aspect is poor pay of the employees. We have approximately 200 EMTs and 100 Medics. The pay difference between the two is minimal.

In the long run though it comes down to quality patient care. I can say for certain that our staff is trained well (though some do not exhibit it) and we receive few complaints from patients, families, or healthcare providers in hospitals.

Just my observations!

dxu

[mindenmedic]

i work for a private comp that services 911 to 6 parishes(counties outside louisiana),, 2 to 4 trucks per parish .

The plus sides: a new truck every 3 yrs. i got my brand new e350 type I 2months ago.

lp12, equipment in good condition, good benifits w/ retirement, family owned environment (they will do anything for you. training is good. we are rural with some response times have to be 30 min because of tiny communities in the middle of no where but because of this our company helicopter will launch at the same time we get enroute to bad calls like rollovers or MIs and if we get there and don't need them just turn them around. sometimes they beat us there. the company owner doesn't mind burning gas. my station is 20 miles from a small hospital and 50 from level one trauma so i fly out all cva's and MIs as well as trauma. i love it. we rely on the volunteers in some middle of nowhere places. its cool because on mva i will show up and they are packaged and ready to go. very liberal protocals, no call needed for morphine on chest pains or trauma w/o abd injury

negatives: "you call we haul". nursing home to dr office wait and returns. supplies can sometimes get low. management is sometimes the good ol boy system. we only have 1 drug that is not state mandated, glucagon. only have 2 narcs valium and MS

all in all i'm not leaving until i get RN

[cloe911]

I work for a BLS company in an area where Privates cover most of the inter-facilities and nursing facility BLS ER calls. There are roughly 15 companies in the are with some running only one rig on up to 30 rigs. These Privates do play a major role in the EMS system: they relieve the mundane tasks off the 911 crews who are able to handle the truely life threatening calls. They are a place to work and gain experience and knowledge you will never get in EMT school (which is a joke in this state, but that's a whole 'nother posting!). They provide a flexible schedule while you are in Paramedic or RN school. They can "weed out" those persons who should never be on the business end of a defibrilator or a syringe.

But........I can make more money working at In N' Out Burger, gain more respect at Starbucks, and get better benefits at Walmart. But in the tradition of "paying your dues" it's something 99% of EMTs go through on the road to the 911 career.

My company pays just enough to afford a 300sq. ft studio with mac-n-cheese for dinner, but I also get use a power-cot all day and save my back for the medic life.

Every company has it's evils and it's upsides.

[JPINFV]

^

Since you just mentioned the absolute BEST hamburger join ever, where in California do you work?

[99% of In-N-Out locations are in California because the ingredients are shipped fresh daily from their processing plant. Another aside is that In-N-Out is supposed to be near the top of the fast food pay scale anyways]

[whit72]

Does it really matter what uniform your wearing? If your private, civil or whatever your care should reflect competent professionalism.

I have met fantastic providers in every type of system, and everybody's got meatheads.

In the private system I worked in the company had no control over you. You were controlled totally by the fire dept. Dispatched and so on. If you had equipment failure or scheduling issue a transfer truck was downed immediately to put you back in service.

They usually have unlimited resources also so you not scraping and stressing other nearby areas to satisfy your call volume.

Your also not locked into the same area forever, they usually hold multiple contracts so transferring to different areas is possible. You can work in busy systems or quieter, urban or rural. You can get a variety if you so choose

Their downfalls are many, but mostly on the transfer side. Not so much if your in a 911 system. The pay was pretty good and the benefits were better then some of the municipalities. 401k vs pension and so on.

So I guess they all have the positives and negatives. Its what you make of it.

[Gerry314]

Private ambulance services are the "transfer" jockies of EMS. They cannot be considered part of the EMS system because the employer cares little about Emergency Medical Services. The goal with private services [at least where the boss is concerned] is taking transfers exclusively. Obviously the road crews feel different, but they don't make the rules.

I have seen "emergencies" take a back seat to transfers too many times to kid myself about private ambulance services and what they represent. That's why the turnover rate is so high in private services. No EMT or Paramedic feels good about making transfers their primary focus, thus many hate what they do and where they are at. Those of us who have over 20 years remember the days when medics and EMTs were all proud medical providers, now a chimp can do what private EMS does primarily. Sure "that's where the money is" [transfers] but it isn't and never will be where my heart is in feeling like part of the EMS system. I feel like a cab driver with skills.

[JPINFV]

^

From the inside, I agree that IFT isn't really a part of EMS.

That said, there are two major reasons that I see IFT companies as a part of EMS.

1. Private emergency calls/direct admits: There are plenty of BLS transports from nursing homes and assisted living facilities where the patient needs to be at an ER for care or needs to go to the hospital for a procedure (direct admit patients). Without an alternative to the 911 system, these patients would BE 911 calls due to a simple lack of options.

2. Hospital discharges/hospital to hospital transfers/CCT calls: One of the problems with ER backlogs isn't space in the ER, but space on the floors to get the patient OUT of the ER. Every discharge and hospital to hospital transfer means that one more patient can be moved out of the ER which means that one more bed is open in the ER which means that 911 units are waiting LESS for a bed.