Another Florida EMS goes Fire

[ResTech]

I agree some are great at both and have a heart in both.... but I think a large majority would drop EMS from their job description in a heartbeat if given the chance.

 

[EMTinNEPA]

That is on top of a very decent FF income plus benefits including retirement.

And why not that as part of a decent paramedic income plus benefits including retirement? Why do you have to be a firefighter as well?

 

[EMTinNEPA]

Would you rather have something like EMTinNEPA described with a mish mash of responders who are EMTs with limited skills and equipment?

I don't always agree with running as many pieces of equipment to one scene as some systems do but there are far worst EMS systems out there that don't believe in providing Paramedics or even a paid employee for some consistency.

Who said anything about a mish mash of responders who are EMTs? Every single call in this county could be provided a paramedic. The only reason they aren't is because of the county's dispatch protocols. You act like a 911 call in my system is a death sentence and there is no paramedic or even paid EMT in sight. I have to ask, did you hurt your back setting up such a gigantic strawman? Yes, we have two paid ALS third services... but with a population of less than 65000 and some of that area being covered by out-of-county units, do you really need more than that? Between the two paid services, we average maybe 25 calls in a 24 hour period.

 

[Sasha]

And why not that as part of a decent paramedic income plus benefits including retirement? Why do you have to be a firefighter as well?

Because FF have their crap together and Paramedics don't.

 

[VentMedic]

And why not that as part of a decent paramedic income plus benefits including retirement? Why do you have to be a firefighter as well?

Nobody said you had to live in Florida.

There are areas where you can find jobs as a Paramedic in a service with good benefits and pay.

Like any other healthcare profession, including nursing, there may be things required that weren't in their idea of a dream job or the pay in an area is horrible. Nurses may leave FL to go to another state like CA where they can make 3 - 4x more money and take 3 - 4 times less patients. And, they don't have to do the job of an Environmental Tech as well as patient care.

There have been quite a few on the EMS forums that suppport a volunteer system such as the one in NJ. What does being a computer programmer by day and an EMT by night have in common?

I know education is a tired subject but until the entry level requirements of education for the EMT and the Paramedic are raised, many agencies will continue to view both as "techs" with just some additional skils to offer. If a two year degree was the standard for Paramedic, some FDs, ambulance companies and those holding the reimbursement strings in Washington, D.C. might view it a little differently.

 

[EMTinNEPA]

Because FF have their crap together and Paramedics don't.

Could you be any more vague?

 

[VentMedic]

Who said anything about a mish mash of responders who are EMTs?

You did a few pages back:

There are some great EMTs running with the FD-based BLS service, but only because they work, or at one time worked, for one of the paid ALS third services. The ones that haven't are disgustingly apparent. Here you have FF/EMTs who will hold onto a patient's wrist for two seconds and declare that their pulse is thirty. You have FF/EMTs who bring cardiac arrest patients down the stairs in a stairchair, and block their airway with an OPA in the process because they can't grasp the concept of gravity. You have FF/EMTs who will wait on scene for the medics to get there.

 

[EMTinNEPA]

Nobody said you had to live in Florida.

There are areas where you can find jobs as a Paramedic in a service with good benefits and pay.

Like any other healthcare profession, including nursing, there may be things required that weren't in their idea of a dream job or the pay in an area is horrible. Nurses may leave FL to go to another state like CA where they can make 3 - 4x more money and take 3 - 4 times less patients. And, they don't have to do the job of an Environmental Tech as well as patient care.

There have been quite a few on the EMS forums that suppport a volunteer system such as the one in NJ. What does being a computer programmer by day and an EMT by night have in common?

I know education is a tired subject but until the entry level requirements of education for the EMT and the Paramedic are raised, many agencies will continue to view both as "techs" with just some additional skils to offer. If a two year degree was the standard for Paramedic, some FDs, ambulance companies and those holding the reimbursement strings in Washington, D.C. might view it a little differently.

I will never live in Florida. I couldn't stand to live somewhere without seasons.

What if everybody who wanted to be an architect had to be a janitor? What if everybody who wanted to be an astronaut had to be the dude on the back of the garbage truck? These jobs have nothing to do with one another. The only thing EMS and Fire Suppression have in common are the lights and sirens. It's just another ploy by the Fire Department to make money because they educated the public to the point that they're driving themselves out of existence. And if by "environmental technician" you mean the handling of certain biological wastes, that's part of patient care. Keeping the room and the patient clean? Also part of patient care. We clean our rigs after every call, DON'T we?

As I have stated on this forum several times, I am VERY anti-volunteer. If it were up to me, every department in the United States would be a paid 24/7 third service, and the employees could have fun running into burning buildings on their time off.

And I am very pro-education. However, it's the volunteers (like the ones that run with my local FIRE DEPARTMENTS) and FD medic mills across the country that lobby to keep the educational standards low. I don't care if Florida and Seattle are exceptions that prove the rule. Are two exceptions worth hundreds of cases of "same old song and dance"?

 

[EMTinNEPA]

You did a few pages back:

Hardly a mish-mash. Seems like either volunteer Firefighters or FF/EMTs who don't know their anus from a hole in the ground, or a paid crew (paramedic included) that actually knows what's going on. Most of the calls (imo should be all of the calls, but that's county's fault, not ours), there is a paid crew there to slap the volunteers, call them morons, and do the job right. The volunteers exist only as a relic of yesteryear. The paid services in this county could handle the call volume on their own. And things work quite well on the paid ALS side of things.

 

[VentMedic]

I will never live in Florida. I couldn't stand to live somewhere without seasons.

What if everybody who wanted to be an architect had to be a janitor? What if everybody who wanted to be an astronaut had to be the dude on the back of the garbage truck? These jobs have nothing to do with one another. The only thing EMS and Fire Suppression have in common are the lights and sirens. It's just another ploy by the Fire Department to make money because they educated the public to the point that they're driving themselves out of existence. And if by "environmental technician" you mean the handling of certain biological wastes, that's part of patient care. Keeping the room and the patient clean? Also part of patient care. We clean our rigs after every call, DON'T we?

As I have stated on this forum several times, I am VERY anti-volunteer. If it were up to me, every department in the United States would be a paid 24/7 third service, and the employees could have fun running into burning buildings on their time off.

And I am very pro-education. However, it's the volunteers (like the ones that run with my local FIRE DEPARTMENTS) and FD medic mills across the country that lobby to keep the educational standards low. I don't care if Florida and Seattle are exceptions that prove the rule. Are two exceptions worth hundreds of cases of "same old song and dance"?

There are just as many if not more ambulance companies that have their own mills.

I can see you don't like FFs so it is of little use to continue an argument with you. You also have not worked in very many professional systems to know all the advantages and disadvantages. And, you are not in Paramedic school yet.

Cleaning the patient care area of a truck and cleaning an entire patient room, including bathroom, which may take over an hour is a little different and takes other professionals away from their other patients. You don't have another patient in the truck when you are cleaning it so there is no comparison.

Hardly a mish-mash. Seems like either volunteer Firefighters or FF/EMTs who don't know their anus from a hole in the ground, or a paid crew (paramedic included) that actually knows what's going on. Most of the calls (imo should be all of the calls, but that's county's fault, not ours), there is a paid crew there to slap the volunteers, call them morons, and do the job right. The volunteers exist only as a relic of yesteryear. The paid services in this county could handle the call volume on their own. And things work quite well on the paid ALS side of things.

So whre are the paid ALS? Why are patients subject to the type of care you mentioned and for what length of time?

 

[EMTinNEPA]

I have no problem with FFs. If my house is burning down, I want a firefighter, who focuses all his time and all his training on BEING A FIREFIGHTER. If I'm having a heart attack, I want a paramedic who focuses all his time and all his training on BEING A PARAMEDIC. I want a master of the trade at hand, not a jack of all, master of none. It's just like using the right tool for the job. Sure, a pair of pliers may allow you to tighten the nut, but would it do the job like a perfectly-fitting wrench?

You do this all the time, address half my points, resort to NUMEROUS logical fallacies (usually strawmen, appeals to ridicule, or ad hominems), then declare that I am not worth having an argument with.

And since we've reduced the discussion to claims of bias, I have to ask, what is your problem with private third service medics? The fact that they view healthcare as a business and treat it as such? The fact that if they handled all the EMS, the Fire Department would have to cut significant numbers and resources?

 

[EMTinNEPA]

There are just as many if not more ambulance companies that have their own mills.

I can see you don't like FFs so it is of little use to continue an argument with you. You also have not worked in very many professional systems to know all the advantages and disadvantages. And, you are not in Paramedic school yet.

Cleaning the patient care area of a truck and cleaning an entire patient room, including bathroom, which may take over an hour is a little different and takes other professionals away from their other patients. You don't have another patient in the truck when you are cleaning it so there is no comparison.

So whre are the paid ALS? Why are patients subject to the type of care you mentioned and for what length of time?

So just because some of the bigger ambulance companies in this country have mills, that makes it ok for FDs to?

Cleaning is cleaning. Sorry, I thought being clean was part of being a medical professional.

And how do you know what services I have worked in? I currently work for a private/hospital based service. In the past I have worked for private not-for-profit, pure for-profit, and fire-based services. And I would take private ANY DAY OF THE WEEK. I don't need to be a paramedic to recognize obvious bullcrap when I see it.

Where are the paid ALS? Most of the time on scene before the volunteers, if the volunteers ever even get out. On the rare occasions the vollies beat us, the patient is subject to the same level of care or sub-par care (depending on the individual on the vollie truck) for no more than 3-4 minutes, except in RARE extenuating circumstances.

 

[atropine]

No, we do not transport patients on engines or ladder trucks.
This is where some don't understand a Fire Based EMS system. Many do have ambulances and transport their own patients.

The system in L.A. is not the best model but that also has to do with their entire state system.

Do you live in LA, until you do don't bash. I work in southern Cali, and this is a great system, with lots of $$$ to be made.

 

[VentMedic]

And since we've reduced the discussion to claims of bias, I have to ask, what is your problem with private third service medics? The fact that they view healthcare as a business and treat it as such? The fact that if they handled all the EMS, the Fire Department would have to cut significant numbers and resources?

You are talking like you know everything about all services when you only have a little experience in the field.

The FDs in your area suck for medical care. I got that. That doesn't mean FDs are horrible everywhere. Some third service medics are very bad especially if they went to a 3 month wonder mill. Some are poorly run with little oversite and no adequate QA/QI in place. Some could care less about the safety of their employees.

So, don't judge all FDs based on the limited experience you have with the bad FDs in your area. I don't judge all ambulance services based on some of the very bad ones I have seen during my 30 years in this profession. I also spent more than a decade with a county EMS service (same Florida Retirement benefits) which had both very good Paramedics and some very bad ones.

It is the quality of the management and the attitude of the provider that makes for quality patient care.

 

[VentMedic]

Do you live in LA, until you do don't bash. I work in southern Cali, and this is a great system, with lots of $$$ to be made.

Are you one of those LA FFs that are now going to tell us all about the money you make and the hot babes you bed?

I think I have already read some of your posts on another forum as well your comment about women and no pants on this one.

Yes, you would be the one that gives professional FF/Paramedics a bad rep.

 

[EMTinNEPA]

You are talking like you know everything about all services when you only have a little experience in the field.

The FDs in your area suck for medical care. I got that. That doesn't mean FDs are horrible everywhere. Some third service medics are very bad especially if they went to a 3 month wonder mill. Some are poorly run with little oversite and no adequate QA/QI in place. Some could care less about the safety of their employees.

So, don't judge all FDs based on the limited experience you have with the bad FDs in your area. I don't judge all ambulance services based on some of the very bad ones I have seen during my 30 years in this profession. I also spent more than a decade with a county EMS service (same Florida Retirement benefits) which had both very good Paramedics and some very bad ones.

It is the quality of the management and the attitude of the provider that makes for quality patient care.

You will find no three-month wonder mill medics here... closest schools are all one year for a cert, two years for a degree, and over half of the medics have degrees. My PRIVATE service has a rigorous QA/QI process, and a safety committee who meet (on their own private time) several times a month simply to discuss how to make our service safer.

Florida and Seattle do it right... I gave you that. But there are too many systems like LA County, Washington DC, FDNY that focus on firefighting when the majority of their income is from EMS. Hell, FDNY went so far as to call firefighter a "promotion" from the paramedic level. All this does is cheapen our chosen profession.

The private services in your area suck. I get that. Know why they suck? Because they all wanted to work for the fire department, but the fire department didn't have any openings. How many of those private paramedics want to be firefighters?

 

[Sasha]

The private services in your area suck. I get that. Know why they suck? Because they all wanted to work for the fire department, but the fire department didn't have any openings. How many of those private paramedics want to be firefighters?

Wow, i didn't know you speak for all those privately employed EMTs/Medics in florida!

 

[EMTinNEPA]

Wow, i didn't know you speak for all those privately employed EMTs/Medics in florida!

And I didn't know that Rural/Metro represented every single private ambulance service in the United States, but you sure made that assumption in a hurry when it supported your argument.

 

[VentMedic]

The private services in your area suck. I get that. Know why they suck? Because they all wanted to work for the fire department, but the fire department didn't have any openings. How many of those private paramedics want to be firefighters?

I did not say the private services suck but yes there are many Paramedics working the BLS transport trucks until they get on with the FD.

The FD has been the culture here for over 40 years. If that is the primary service you grew up with, that is the norm. Many want to be FireMedics with a FD just like Johnny and Roy.

 

[EMTinNEPA]

I did not say the private services suck but yes there are many Paramedics working the BLS transport trucks until they get on with the FD.

The FD has been the culture here for over 40 years. If that is the primary service you grew up with, that is the norm. Many want to be FireMedics with a FD just like Johnny and Roy.

So if it was the norm in their culture, that makes it right? Do I really have to bring up numerous other embarrassing cultural norms from our species' storied past?

I idolize Johnny and Roy too. However, whenever they go on a fire call, I fall asleep in front of the TV.