# How are EMT-Basics treated in your region?



## nymedic9999 (Oct 19, 2013)

Out of curiosity I want to hear from people how the treatment of EMT-Basics varies from region to region.  For example do you come from a region that has faith in there Basic techs or a region with an abundance of ALS techs and little faith in its EMT-Basics.


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## chaz90 (Oct 20, 2013)

Quite well in this area. BLS protocols aren't the most aggressive, but they don't need to be. They have full discretion to cancel ALS response after they arrive on scene, frequently transport 911 calls alone as BLS, and are able to request ALS on anything they want. Pay is darn good for BLS in the area with 911 calls only, stations with no posting, and low call volume in areas for those that want it. IFT EMT life in southern DE is a different story, but what else is new?


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## emt11 (Oct 20, 2013)

Until about 6 months ago(when more and more EMT students were doing 3rd rides and getting out there on the street), heads would start rolling and the sky's would darken when someone said they were a Basic. Now that the state is (unfortunately) making new EMT students take NREMT for Basic then finishing class for the AEMT and then taking the AEMT registry(it's stupid, I know, and yes they really are making people take registry twice). Also note, unless your in very rural area's, you won't find work in this state as a Basic. I'85 and AEMT is the minimum for nearly every service and at that level you are considered BLS. Only a Paramedic is classified as ALS in GA.


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## Mariemt (Oct 20, 2013)

Very well. It is almost unheard of to have a paramedic on a squad at all unfortunately. We are rural Iowa and mostly volunteers. I have a much larger squad and we are lucky enough to have 4 medics. 

The basics are treated with respect and kindness. The doctors love us as do nurses. 
Our scope has been expanded a bit to allow a few things by MD.


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## Bullets (Oct 20, 2013)

chaz90 said:


> Quite well in this area. BLS protocols aren't the most aggressive, but they don't need to be. They have full discretion to cancel ALS response after they arrive on scene, frequently transport 911 calls alone as BLS, and are able to request ALS on anything they want. Pay is darn good for BLS in the area with 911 calls only, stations with no posting, and low call volume in areas for those that want it. IFT EMT life in southern DE is a different story, but what else is new?



Pretty much this, our protocols are standard NREMT but we have just changed the SMR protocol in my town to reduce its use.


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## medichopeful (Oct 20, 2013)

We're treated well!


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## unleashedfury (Oct 20, 2013)

EMTs here are treated fairly well. 

ALS is for the most part abundant however as a intercept for BLS Most paramedics treat the EMT's with respect and if you show your confident in your skills and provide great detail of your assessment you'll do fine. 

If you prove to be a sub par EMT rely solely on ALS to get all your assessment completed including vitals or just lazy. You'll be treated fairly poorly


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## Tigger (Oct 21, 2013)

Depends on the agency and area really. P/B is the predominant 911 staffing model in Colorado. Well regarded and progressive ALS services generally expect a lot out of their EMTs. Getting certified and then hired by such an agency is the first step. I have six-months two a year to get through well over 100 checkoffs, from basic EKG interpretation to med administration, to mapping. EMTs are also expected to play an active role in assessments and are trained accordingly. My agency wants its EMTs to be able to both take care of basic calls and be a good assistant to the paramedic.  

At the same time we cover five volunteer fire districts with first response EMTs. Very few of them have any interest in going above and beyond, and there is little in the way of oversight or QI. As such, they are treated far differently. It's not a volunteer vs. paid thing, it's a quality of care thing. Some of our volunteer providers are excellent and are treated as such but they are sadly in the minority.


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## yowzer (Oct 21, 2013)

Depends on who you work for. Private ambulance? You're scum. FF/EMT? Walk on water, get to take part in all the cool studies, etc.


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## TheLocalMedic (Oct 21, 2013)

Well, EMTs are a dime a dozen around here, and they get treated accordingly.  Often not a whole lot of respect, and if you work for an IFT company you are generally the laughingstock of the county and are expected to be able to fake a blood pressure and not much more.  

A lot of this disrespect stems from the low standards EMTs are held to in this area, and the fact that the EMT puppy mills churn out thousands of young, exuberant but inexperienced students every year.  The IFT companies prey on new EMTs, hiring 18-22 year olds with no experience and then crushing their souls within a year so they leave EMS feeling burnt out.  Unless they are in the 911 system, EMTs generally never stick around long enough to gain much experience, which contributes to the general culture of inexperience and drooping standards of care.


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## DitchDoctor77 (Oct 22, 2013)

I have to say these threads referring to the negativity regarding Non-Emergency EMT providers is really disheartening.  I've been an EMT and in EMS for 25 years.  My time has been spent in 911, Hospital ER, Non-Emergency, as well as Management.  Now I'm far from naive and yes several private for profit EMS companies in my state and area have been busted by the Feds and many are pretty shady and cut corners.  I also know this, in my company I have a diverse group.  Several 911, several non-EMTs, and several less experienced EMTs.  Our trucks are licensed by the state and inspected every 3 years just like 911 services.  My providers do assessments and vitals (cause I know if anything happened to a patient in my teams care and they have to go to the ER the first thing the nurse or doctors going to ask is "What happened just prior? And "What were they're vitals?") on every Patient and complete state EPCRs just like 911 services.  In our area the amount of "True emergencies" equals maybe 5%. This mean 50% are lights and siren to scene and out of that 50% 10% is a  lights  and siren to a medic rendezvous.  Then out of the 10 of those maybe 2% are lights and siren to the hospital.  The other 45% are no lights no siren to scene and to the hospital.  ISNT THAT THE SAME AS A NON-EMERGENCY TRANSPORT?  The only real difference is we know when are calls are.  We also do events that can have serious injuries such as auto racing, equine events, football games and other events.  Our company welcomes new EMTs... Why? So they can learn and hone their skills taking vital signs, patient assessments, communication skills... In a non rushed, non critical time so when they have to rush they know what they're doing.  EMTs who call us losers, not real EMTs, or scum need to realize we took the same test, work on the same licensed BLS units, follow the same protocols, use the same EPCR programs, and are there for the same reason...  THAT PERSON WHO NEEDS CARE!!!!  At least that's why I get up every day and that what I teach my team members....  Thank you for listening...  Sorry to vent.


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## toxik153 (Nov 12, 2013)

Well, depends on the region for me. I have noticed in region 1 (for ex.) nurses and hospital staff are 65-70% disrespectful or just treat us like ambulance drivers instead of EMT's (trained medical professionals) and the other % as EMT's speaking to us about the patients hx and dx, any tx's they received and the patient status. 

In region 2 its the opposite, about 80-90% of the nurses and hospital staff are very helpful and respect us as EMT's, not that we're medical gods but, you catch my drift. Almost all patients like us, they see us a lot and really do appreciate what we do.

I work with an IFT company and sadly some FF guys look down on us, even though we all took the same damn test and have the same damn license...we aren't up to par, supposedly.


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## JETKONI (Nov 13, 2013)

TheLocalMedic said:


> A lot of this disrespect stems from the low standards EMTs are held to in this area.



I come from a Law Enforcement background and experience, took EMT to challenge myself by cross training. In my observation is lack of self inner personal confidence, and once again, based in my opinion, it is how one carries himself, with respect and knowing how to wear the integrity of any badge.  The camaraderie in the field of EMS, lacks. And what I hate the most is when one wears the uniform like a slob (w/ ketchup stain on his badge)  I have meet EMTs that are top notch and they know how to handle themselves professionally, and takes pride of the badge that they wear. (This is based in Santa Clara County)

The standard is there.. It is the individual that ruins it for everybody.


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## TheLocalMedic (Nov 14, 2013)

JETKONI said:


> I come from a Law Enforcement background and experience, took EMT to challenge myself by cross training. In my observation is lack of self inner personal confidence, and once again, based in my opinion, it is how one carries himself, with respect and knowing how to wear the integrity of any badge.  The camaraderie in the field of EMS, lacks. And what I hate the most is when one wears the uniform like a slob (w/ ketchup stain on his badge)  I have meet EMTs that are top notch and they know how to handle themselves professionally, and takes pride of the badge that they wear. (This is based in Santa Clara County)
> 
> The standard is there.. It is the individual that ruins it for everybody.



How true.  There really is something to be said about having a professional demeanor and appearance.  And looking the part is half the battle. 

But experience is what builds the confident demeanor of EMTs, and where I'm at the BLS IFT EMTs are categorically inexperienced, young and undereducated.  Paramedics, once they have gone through their didactic and internship, must still go through a "ten call" process when they are hired where they must prove to an FTO that they can appropriately handle and treat at least 10 ALS patients.  EMTs, on the other hand, only have to pass a didactic period of training.  Why don't EMTs have a field training portion where they must "intern" with a 911 provider to show that they can act appropriately as an ALS adjunct?  I believe that EMTs would benefit greatly from a pseudo-internship.


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## Tigger (Nov 15, 2013)

TheLocalMedic said:


> How true.  There really is something to be said about having a professional demeanor and appearance.  And looking the part is half the battle.
> 
> But experience is what builds the confident demeanor of EMTs, and where I'm at the BLS IFT EMTs are categorically inexperienced, young and undereducated.  Paramedics, once they have gone through their didactic and internship, must still go through a "ten call" process when they are hired where they must prove to an FTO that they can appropriately handle and treat at least 10 ALS patients.  EMTs, on the other hand, only have to pass a didactic period of training.  Why don't EMTs have a field training portion where they must "intern" with a 911 provider to show that they can act appropriately as an ALS adjunct?  I believe that EMTs would benefit greatly from a pseudo-internship.



My AMR operation has a month long fulltime academy followed by a two to three months of internship. It's out there. 

Even the six shifts I got at my current place as an "internship" with the binder of check offs to complete was beneficial.


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## PFDEMT (Nov 15, 2013)

yowzer said:


> Depends on who you work for. Private ambulance? You're scum. FF/EMT? Walk on water, get to take part in all the cool studies, etc.





SOOO funny.
i work sno/king and if your not medic one then your a trashy piece, unless your with a dept that sponsors m1.


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## O2andDogs (Nov 17, 2013)

It's been a while since I have been active on this board, but this topic caught my interest as it is extremely relevant to my current situation. 

I was trained as a basic in Western Washington State. In that area (King County Particularly), the protocols and the attitude are very pro-medic. In the urban areas, there is not even really an option for intermediate training. Basics are either firefighters or run private ambulance. The protocols basically boil down to O2 and vitals. You will never use a lot of what you learn in class, and they tell you that.

I have since moved to rural Virginia, and I now run with a volunteer squad. Basics are treated with respect (provided they are deserving of it, of course). Training here is free, all the way up to paramedic, and good squads encourage their members to get higher certifications. Protocols are very aggressive, and allow basics to perform some skills that would normally be considered pretty intermediate. The community attitude is "Can you help me? Awesome, I like you!" Generally, someone in trouble doesn't care what letters are after your name.


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## alexandermpd (Dec 4, 2013)

Sometimes we have the super hero medics that decide to treat basics like they don't deserve to be on an ambulance


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## Handsome Robb (Dec 4, 2013)

My county requires a minimum of I/P staffing. So we don't use basics except for special events.


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## CentralCalEMT (Dec 4, 2013)

My county, for 911 units, uses exclusively B/P staffing with the rare exception that two medics end up on a shift together. BLS units, which are exceedingly rare to begin with (only 1-2 for the entire county) run transfers only. Nobody except for several medics with a paragod complex seem to look down at EMTs. I always try and treat my EMT well. Most of the EMTs at my company ask lots of questions and try and further their knowledge base on a daily basis. There is absolutely NO reason to look down on an EMT who is trying to do their job well.

Now, if I see an EMT who clearly doesn't respect himself or herself such as a dirty wrinkled uniform not tucked in, unzipped boots, unshaven, rude demeanor, or otherwise generally sloppy, I am not going to respect them. It is not because they are an EMT, it is because they are not holding themself to the high standard that EMS should hold itself to. I would feel the same way about another paramedic, a firefighter, a cop, etc who does not have self respect. Respect is earned, not given, and most of the EMTs I work with have earned my respect, and I would trust them to have my back on even the most serious calls.


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## NPO (Dec 8, 2013)

At my company (mgmt, other EMTs and medics): Well. Everyone gets along, no medics treat EMTs like their slaves. Its not tolerated here, but also, the EMTs know their place.

By Fire Depts: Depends on the Dept. Some we get along great with, some will literally push you aside in the ER.

By other EMS providers: We generally work well when it when it involves patient care. There is some animosity and "my team is better" when just chit chatting, but no real hostility for the most part.

By Health Care Facilities (Incl. Hospitals): This too varies. Most nursing homes dont care, unless you are there for a legit reason, not just dialysis. Hospitals are usually pretty good, but some more than others. There are a few bad apples though.

Occasionally, we run into a nurse who is SUPER nice, and really makes sure everything is taken care of for us and that we have everything we need. Usually, we find out these nurses started as EMTs.


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## KyleC41 (Dec 9, 2013)

I work for a private service in southwest Ohio. I'm a basic and in my company I get treated really well. I run with a paramedic partner and we switch off and on for who gets to drive and who gets to be with the pt. there is never looking down at the basic or get out of the way attitude scum of the earth kinda deal. Now at the hospitals the nurse sometimes treat us both as scum so I haven't noticed the difference yet for treatment of basics vs paramedics.


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## emsdave (May 31, 2015)

I agree with alot of comments so far. I have been through many hospitals ems districts and most of the emts are highly respected some not so much. Do you push yourself to learn? Push yourself to get out there and help? Learn your EMD staff and show them you know your stuff. You are a professional not mediocre untrained uneducated "ambulance driver" you do so much more. I thought that emts are treated like crap in emt school but when you show your medic you are there to do a job and do it well you will gain that respect. Speaking of IFT companies well do they do vitals correctly? Do they asses what is needed and uses correct wording on pcr? Then if I am a MD or an charge rn then my opinion is going to think ugh stupid emt no I will treat you as a professional. All in all you carry yourself as a professional that is what you will be treated as. Talk and look and act like an idiot well you will be treated as such!


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## phideux (Jun 2, 2015)

I know with the last 2 Basic partners I had, I felt like I had hit the Paramedic lottery. A great Basic partner is invaluable to a Medic.


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## Knightinwhitesatin (Jun 2, 2015)

EMTs are a dime a dozen..... Empty My Trash.... It's sad really. I treat my partner well as a good EMT can make a medic look good.....We run an B/P area not usually are two medics together but honestly I really like to be double medic.


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## BillThompson (Jun 2, 2015)

CentralCalEMT said:


> Now, if I see an EMT who clearly doesn't respect himself or herself such as a dirty wrinkled uniform not tucked in, unzipped boots, unshaven, rude demeanor, or otherwise generally sloppy, I am not going to respect them. It is not because they are an EMT, it is because they are not holding themself to the high standard that EMS should hold itself to. I would feel the same way about another paramedic, a firefighter, a cop, etc who does not have self respect. Respect is earned, not given, and most of the EMTs I work with have earned my respect, and I would trust them to have my back on even the most serious calls.



Someone not shaving is no way a sign that they don't respect themself, nor should it be considered a sign of sloppiness or laziness. The idea that one must be clean shaven to be professional is preposterous, and has no basis in reality.

Both my 911 and my Private run Basic/Paramedic, with the Private having a handful of BLS only trucks in our area. In general your rank doesn't matter when it comes to respect from hospital staff and patients. If you wear the uniform of a Private you will automatically get less respect than if you are wearing the uniform of a municipality. In my experience what is expected from the Basic depends on the Paramedic and how much the Basic is willing to assert his/herself. I'm not a driver, I provide patient care to the utmost of my ability. In some ways I guess I demand respect through my actions and the fact that I want to make sure I help my Paramedic to take care of the patient in the most efficient and beneficial manner possible. There are those who are more comfortable just being driver's, but that's not why I got into this field and I believe that is a limited view of our role in the EMS system.


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## Noncreative (Jun 2, 2015)

Not sure where you are getting trained as an EMT-B, NREMS phased it out completely last year.


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## Noncreative (Jul 2, 2015)

Depends on how long the medics have been in the field, back when most of them started a EMT-B was little more than a EMR, and they never even noticed that EMT-B isn't even a rank anymore.  Honestly a bunch of EMT's only contribute to the problem with poor presentation.


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## Chewy20 (Jul 2, 2015)

Noncreative said:


> Depends on how long the medics have been in the field, back when most of them started a EMT-B was little more than a EMR, and they never even noticed that EMT-B isn't even a rank anymore.  Honestly a bunch of EMT's only contribute to the problem with poor presentation.


 
May I ask what problem basics contribute too? Because the only thing I see contributing to any problem is society calling 911 for everything under the sun. 99% of calls are BLS. Waiting to be entertained...

Also, for every crappy kept together basic I see, there is a crappy medic right next to him not holding his partner to a higher standard


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## arctic2 (Jul 3, 2015)

In my area its sort of a close knit community. Everyone knows someone who knows this guy and so on and so forth. I just recently started in this field and Ive noticed that the ALS medics treat the emts as there Right hand man. In other words they are treated just fine


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## itsgordon (Jul 4, 2015)

In NJ, 9-1-1 services, Staffing is dual basics and ALS hospital based Fly Cars. EMTs are treated pretty well, However it does depend on the area that you work at.


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## BigBadWolf (Jul 8, 2015)

Pretty good in my area.  We are a rural location that runs ALS on every call but the EMT is usually the one in charge of the scene for the most part.  The logic is that if the EMT is experienced on taking control of the easy calls, when a hard call comes in they will do everything out of habit and let the medic focus on what he can do.  My medic is also amazing at reading us so if we hit the wall he is there with a question for the patient or a comment that tips us in the right direction before anyone else notices that our mind went blank.  Our biggest critics locally are the fire fighters but that is a big political can of worms I wont go into.


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## Bullets (Jul 8, 2015)

BillThompson said:


> Someone not shaving is no way a sign that they don't respect themself, nor should it be considered a sign of sloppiness or laziness. The idea that one must be clean shaven to be professional is preposterous, and has no basis in reality


 If you aren't clean shaven then you can't get a good mask seal. If an EMT doesn't care about his own personal safety to the point that he sacrifices the ability to wear respiratory protection, then how can he be expected to care about a patient


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## BigBadWolf (Jul 8, 2015)

Bullets said:


> If you aren't clean shaven then you can't get a good mask seal. If an EMT doesn't care about his own personal safety to the point that he sacrifices the ability to wear respiratory protection, then how can he be expected to care about a patient



Having spent years on a hazmat team and passed every single one of my mask fit tests with a goa-t I can tell you that having well groomed facial hair works just fine with that equipment.


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## COtoWestAfricaMEDIC (Jul 9, 2015)




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## TransportJockey (Jul 9, 2015)

Bullets said:


> If you aren't clean shaven then you can't get a good mask seal. If an EMT doesn't care about his own personal safety to the point that he sacrifices the ability to wear respiratory protection, then how can he be expected to care about a patient


That actually is invalid. Most n95s will seal fine with a trimmed goatee, especially the duck bill type. I have passed multiple fit tests with a goatee


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## BillThompson (Jul 9, 2015)

Bullets said:


> If you aren't clean shaven then you can't get a good mask seal. If an EMT doesn't care about his own personal safety to the point that he sacrifices the ability to wear respiratory protection, then how can he be expected to care about a patient



Factually incorrect. I've passed a fit test and had a perfect mask seal with a mustache, goatee, even a small beard. In no way does an EMS worker being unshaven make a comment on someone's professionalism.


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## CentralCalEMT (Jul 15, 2015)

BillThompson said:


> Factually incorrect. I've passed a fit test and had a perfect mask seal with a mustache, goatee, even a small beard. In no way does an EMS worker being unshaven make a comment on someone's professionalism.



If your service allows facial hair then I agree 100% that facial hair has no reflection on someone's professionalism. One place I worked allowed beards and that was perfectly fine. However, if the service (my current one included) has a grooming policy that the employees have to follow then that is another story. When employees pick and choose what policies they want to follow, then that is an issue.


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## samsbgm (Jul 21, 2015)

nymedic9999 said:


> Out of curiosity I want to hear from people how the treatment of EMT-Basics varies from region to region.  For example do you come from a region that has faith in there Basic techs or a region with an abundance of ALS techs and little faith in its EMT-Basics.


I work in colorado and basics are treated very well. We have a skill set so we use it. Our protocols are very aggressive compared to most places. Most calls are bls so our medics appreciate us because they can go an entire shift just driving us around.


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