Do "High-Performance" Employers Actually Want Experience?

RocketMedic

RocketMedic

Californian, Lost in Texas
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Title asks the question. Many "high-performance" EMS systems exist, generally with isolated and insular hiring practices designed to build employees their way. What is your opinion of these agencies in terms of their desire for outside experience?
 
I'm not sure what you mean by high performance? Like higher level of care as in Mobile ICUs?
 
"High performance" meaning high-volume EMS systems, regardless of level of care. Examples would be EMSA, ATCEMS, Las Vegas, Seattle, etc. Basically anywhere that boasts of a high volume of calls.
 
I does provide uniform care. Seattle for example can say that all their employees are trained to the same standards. They also run a decent system. No where near ideal but if I got offered a spot with I would not mind working two set days a week for how much they make.

Do I like that some systems make you start as a basic then promote to medic? Not really, I went to medic school for a reason.

Protocol wise usually larger departments need stricter protocols to cover the lowest common denominator. Smaller departments can have better over site. Is that a hard and fast rule, not by any means.

For me, I have a few dream places to work. None are a unicorn, but all will allow me to live well, provide decent patient care, and most importantly spend time with my family. I will deal with some crap as long I I get the above.
 
FireWA1 said:
I does provide uniform care. Seattle for example can say that all their employees are trained to the same standards. They also run a decent system. No where near ideal but if I got offered a spot with I would not mind working two set days a week for how much they make.

Do I like that some systems make you start as a basic then promote to medic? Not really, I went to medic school for a reason.

Protocol wise usually larger departments need stricter protocols to cover the lowest common denominator. Smaller departments can have better over site. Is that a hard and fast rule, not by any means.

For me, I have a few dream places to work. None are a unicorn, but all will allow me to live well, provide decent patient care, and most importantly spend time with my family. I will deal with some crap as long I I get the above.
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Yes, but that's not the question posed. The question is do high-performance systems actually want outside experience in the first place.
 
Yes. I can speak solely for skcmo, and only from what I have been told, but they do want paramedics to apply. They know they are getting someone who has a good foundation and knows the material. Yes the student is going to get all that information again but at that point it is review and the zoo can teach higher level material instead of covering the basics. Now they do have basics in the class as well so they have a steeper hill to climb but not impossible.

Now I don't like what atcems does but they obviously get enough candidates that it is not a problem for them.
 
KCM1 wants experience, but not necessarily paramedic experience... They want to know you are aware of what the job entails and that you can stay with a service as a full time employee for a while.

If I were still in WA, would I work at KCM1? Yeah. The money and benefits are great. Would I be unhappy there? Yep. Having worked BLS in South King I know it's not my kind of place. But, that's not to say it's not a great service and not an excellent place to work. Drinking the KCM1 KoolAid is a bad thing, enjoying what you do and making a comfortable living wage is not.
 
RocketMedic said:
Title asks the question. Many "high-performance" EMS systems exist, generally with isolated and insular hiring practices designed to build employees their way. What is your opinion of these agencies in terms of their desire for outside experience?
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It's probably case-by-case. But, for me, I don't really care. So many variables of "experience" - one medic with 20 years experience is not the same as another with 20 years. Depending where one has worked and average hours worked per week, it is totally possible that medic with 5 years fulltime work in a busy system is going to be more experienced than someone with 20 years experience as a volunteer or even fulltime in a low volume system. If a service wants to build paramedics from the ground up then more power to them. The paramedic curriculum may be similar from place to place, but the experience obtained by paramedic students can vary greatly. Attracting "experienced" paramedics or EMTs is a double edged sword. It doesn't mean they have "good" experience, and for certain there is plenty of opportunity to import crappy practices and attitudes from "experienced" people.

Sorry your hide is so chapped by these "isolated and insular" services. Hopefully you one day find a place where you fit in.
 
Right or wrong, staffing is a big issue in these big, busy EMS systems. Recruiting, training, and retaining staff can be a major and very expensive challenge. So finding (or molding) people to fit the culture and expectations becomes an important part of the business strategy.

Lets be honest.....paramedicine is not rocket science by any stretch. It's probably a bigger deal finding employees who are reliable and are willing to stick around a while than it is to find those who are solid paramedics. A decent paramedic is not hard to find.....but finding a few hundred of them who aren't total dipsticks and are going to hang around a while is a challenge. So that becomes the focus.

Plus, as medicsb explained, being "experienced" isn't always all it's cracked up to be.
 
Our agency hires a wide variety of experience levels and ages. In my academy class we had me (brand new EMT certificate, no EMS experience) and we had people who'd worked in other urban EMS systems. They hire on personality more than EMS experience. Attitude, personality and life experience are all taken into account in addition to EMS experience.

They hire medics and EMTs, but everyone starts as an EMT. If you're already a medic, you put your name on the promotion list, and you're promoted to medic as "operational need arises". The people in my class who were already medics only worked as an EMT for 4 months before being promoted. That's pretty common, the promotion happens fast if you're already a medic. It's worth it, I think, to work as an EMT for a few months and then get moved up.
 
Does it matter?

These systems know what they need to accomplish the goals set forth by their stakeholders and they deliver on them. Individual providers may not agree with said goals, but if the system works as designed and expected, does that also matter?
 
I'm just curious what "isolated and insular hiring practices" are being spoken of.

Check that...I'd only like a non-rabid answer, so I probably shouldn't ask that question.
 
Tigger said:
Does it matter?

These systems know what they need to accomplish the goals set forth by their stakeholders and they deliver on them. Individual providers may not agree with said goals, but if the system works as designed and expected, does that also matter?
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I think it does matter, because the stakeholders in many cases are not receiving the benefits possible from experienced personnel with outside views of what is possible. A perfect example would be Medic One or other tiered systems- by most accounts, they do not believe paramedics are appropriate care for most patients, and as such, they shift the responsibilities of ALS assessment and care to the hospitals as a cost-saving measure. To succeed or work in that environment, one must accept that concept- which means that they are already filtering out potential agitators. People like me don't get hired there because we are opinionated and favor something different.
 
triemal04 said:
I'm just curious what "isolated and insular hiring practices" are being spoken of.

Check that...I'd only like a non-rabid answer, so I probably shouldn't ask that question.
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Well, as arrogant as you sound, I'll still offer an explanation: isolated and insular hiring practices are those that force applicants to restart in an entry-level position and promote to their customary position within the agency, not within the industry. These practices are typically isolated to certain agencies and are luckily not an industry norm. They serve to insulate agencies from applicants who cannot or will not humble themselves by working at an entry-level position! while simultaneously making people who do promote feel they are more secure for passing those promotions. Since these arrogant, non-humble folks tend to be your less stable and more disruptive employees, they filter out the Rocketmedics.
 
Remi, I sense we hold different expectations of EMS.
 
You know what? I saw your posts in the thread about ATCEMS before they were removed. There are not words to describe you.

Done.
 
RocketMedic said:
I think it does matter, because the stakeholders in many cases are not receiving the benefits possible from experienced personnel with outside views of what is possible. A perfect example would be Medic One or other tiered systems- by most accounts, they do not believe paramedics are appropriate care for most patients, and as such, they shift the responsibilities of ALS assessment and care to the hospitals as a cost-saving measure. To succeed or work in that environment, one must accept that concept- which means that they are already filtering out potential agitators. People like me don't get hired there because we are opinionated and favor something different.
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Maybe, just maybe, they are not looking for those benefits. Which is their right, since again, that is what the stakeholders of the system have decided upon. As an outsider, you don't get to set those goals for them.
 
RocketMedic said:
Remi, I sense we hold different expectations of EMS.
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If by that you mean that I don't believe that the quality of a healthcare system is defined by "how much stuff they let us medics do to patients", or that I recognize the reality that most ALS care has failed to prove its worth where outcomes are concerned, or that I think the perspective of a street medic might be a little myopic when it comes to the design of a large EMS system, then you'd be correct.

I support the idea of a system that is focused on patient outcomes first and foremost, rather than on striving to have the "most advanced" protocols just to make the medics feel like rockstars.
 
Remi said:
If by that you mean that I don't believe that the quality of a healthcare system is defined by "how much stuff they let us medics do to patients", or that I recognize the reality that most ALS care has failed to prove its worth where outcomes are concerned, or that I think the perspective of a street medic might be a little myopic when it comes to the design of a large EMS system, then you'd be correct.

I support the idea of a system that is focused on patient outcomes first and foremost, rather than on striving to have the "most advanced" protocols just to make the medics feel like rockstars.
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The odd part is that those "advanced" protocols often actually help patients who need things like pain management.
 
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