# How are vollys viewed by paid EMT's?



## crashh (Jun 2, 2012)

A few ppl i know where talking and we got into the volly vs. paid thing. Thoughts?  :huh:


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## TatuICU (Jun 2, 2012)

crashh said:


> A few ppl i know where talking and we got into the volly vs. paid thing. Thoughts?  :huh:



I appreciate them.  Some I've run into are a little overbearing/Ricky Rescuish, but so are a lot of paid people I've worked with. Again, appreciate them responding and so should the people they're responding to.  I think the biggest thing people complain about is their inexperience and their "I would've done it like this" attitude after all is said and done but you have to put that in the proper context.


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## crashh (Jun 2, 2012)

but does the fact they're volunteer necessarily make them inexperienced?   I mean, it's according to how many calls, and the extent of the injuries they've had to deal with I would think?  

I'm new to this, so just wondering!    I have been driving ambulance for 6 or 8 months now and just got done w/my EMT exams.  I will continue to be volunteer until I move out of this town, which will hopefully be in about 3 years, after para school, and then nursing school.


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## DesertMedic66 (Jun 2, 2012)

Mostly (from what I've heard) they are viewed as the Ricky rescues. If you look on YouTube they are the ones with strobe lights on their vehicles and personal response kits (they may be required to carry them, I have no clue). 

We don't have any volunteer fire departments or volunteer ambulance services anywhere in my area so I don't have a personal opinion.


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## NYMedic828 (Jun 2, 2012)

TatuICU said:


> I appreciate them.  Some I've run into are a little overbearing/Ricky Rescuish, but so are a lot of paid people I've worked with. Again, appreciate them responding and so should the people they're responding to.  I think the biggest thing people complain about is their inexperience and their "I would've done it like this" attitude after all is said and done but you have to put that in the proper context.



Hit the nail on the head.


In NYC, there are VERY few volunteer 911 ambulances aside from certain religious based services.

I volunteer back home on my free time, and honestly inexperience is widespread. The problem is that people think they are in fact experienced and therefore are far less open to learning. 

I finished paramedic class thinking I was all set for the big leagues but after a week on a busy ambulance I realized how much I truly do not know.

The great thing about the medical field is there is ALWAYS something you can learn. 99.9% of it is above your scope as an EMS provider but regardless, knowledge is power.

People who intubate once every 3 years on a human being if they are "lucky" are very common. Many have and will never intubate a real human being. (At that point, the skill should honestly be removed from the region it is not beneficial.)

I do my best to take what knowledge I can collect and give back what I can to my co-vollies but often times I will have 6 people in the classroom from a department with 50 EMS providers and another 50 firefighters that ride the ambulance.

On the upside, people do realize those who are truly experienced and will listen to them at scenes. (Granted the state requires them to listen to a medic...)


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## TatuICU (Jun 2, 2012)

crashh said:


> but does the fact they're volunteer necessarily make them inexperienced?



In MY experience the answer would be yes.  Typically volunteer services HERE only exist in areas with ridiculously low call volumes (5-10 a month maybe?) and if you figure a typical EMT-B/I/P (mostly EMT-Bs) only responds to 75% of those calls........

Now, on the other hand we've had some people who I've worked with at paid services that have graciously donated their time at volunteer services but again, in MY experience that generally doesn't last long as these people are usually more or less forced into authoritative positions at the volly due to their experience, and end up throwin the dueces because what started as them just helping out here and there has turned into a second job.

And with the inexperience comes a different attitude as NYMedic stated.  It's kind of like that old saying, "The older i get the more I realize that I don't know ****."
My first 6 months as a basic EMT, I realized that I was woefully out of my depth.  I thought I was very smart and well prepared, but again the more I saw and did, the less I realized I truly understood.  Same in an ICU setting.  Experience and making mistakes are the best teachers and unfortunately there's only one way to get experience and learn from mistakes, lol.


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## TatuICU (Jun 2, 2012)

firefite said:


> Mostly (from what I've heard) they are viewed as the Ricky rescues. If you look on YouTube they are the ones with strobe lights on their vehicles and personal response kits (they may be required to carry them, I have no clue).



Yeah, that has been an issue here as well.  Leave the lights at home and obey traffic laws if in your POV.


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## NYMedic828 (Jun 2, 2012)

There are a good few states that allow volunteer personnel to have a full response vehicle with lights and sirens.

Other states, such as my own allow you a flashing blue light that does not permit the breaking of any traffic laws. It is a courtesy if the driver ahead of you feels like yielding.

There are far too many Ricky Rescues around here.

My department does around 650 EMS and 350 fire calls a year. Members are only required to make 20% of those calls if they are off probation. You do not have to make the ambulance to get call credit. 90 calls lets say for the average person PER YEAR, is not enough to gain any credible experience.


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## Achilles (Jun 2, 2012)

TatuICU said:


> In MY experience the answer would be yes.  Typically volunteer services HERE only exist in areas with ridiculously low call volumes (5-10 a month maybe?) and if you figure a typical EMT-B/I/P (mostly EMT-Bs) only responds to 75% of those calls........ * Our department is volunteer and we're doing 1-2 calls per day, give me a minute......
> 
> 
> Ok that comes out to 30-60 per month*
> ...



 I'm not going to tell you what I think about you saying the volunteers are less expirenced than Paid. We also have all new equipment except for our Gruman which is an 86, but still runs like a champ. We have a dive team, along with an 15' alluminum boat and a 12' zodiac. We also have an airboat and a hovercraft. Along with that we have our dive truck and the 25' trailer which follows close behind it (almost like magic). We get about 400 fires a year. With 34 guys firefighters, All emts. We also do mutual aid for the surrounding cities. Some of our POV's have lights on them, not all of them. A buddy of mine was POC in a city of 55,000. Just because your are paid doesn't mean your smarter than everyone else.


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## Achilles (Jun 2, 2012)

TatuICU said:


> Yeah, that has been an issue here as well.  Leave the lights at home and obey traffic laws if in your POV.



And delay response time even more. Without stating that responding priority one causes more accidents. Please explain your logic on what you've just said.


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## STXmedic (Jun 2, 2012)

There are quite a few volly systems around here. One of these is very good. They train heavily, are very professional, and good at what they do. I live rolling up and seeing these guys on scene.

However, that is not the majority of systems down here. Most (down here) are young kids that are very "Ricky rescue" woowoo types, poorly trained, want nothing to do with medical runs, don't do crap on calls other than get in the way, and think they are gods gift to firefighting. I usually groan when I see there units in scene.

I would assume this is very regional dependent though, so take my opinion with a fine grain of salt.


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## TatuICU (Jun 2, 2012)

Achilles said:


> And delay response time even more. Without stating that responding priority one causes more accidents. Please explain your logic on what you've just said.



You want me to explain the logic behind why its dangerous to have some goober in his personal vehicle putting lights on it and putting th public at risk by disobeying traffic laws? Serious? Well never mind, i guess everyone with a basic license and a Honda accord should light em up and head to that fall call.


1-2 calls a day is still a very low call volume and if there are no medics on those units then you have no frame of reference so I'm not sure what point you're trying to make.  I'm not sure a basic's scope requires the same amount of experience as higher level's to gain an maintain proficiency.  Sound a little defensive.  Did someone call you Ricky rescue today?


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## STXmedic (Jun 2, 2012)

Achilles said:


> I'm not going to tell you what I think about you saying the volunteers are less expirenced than Paid. We also have all new equipment except for our Gruman which is an 86, but still runs like a champ. We have a dive team, along with an 15' alluminum boat and a 12' zodiac. We also have an airboat and a hovercraft. Along with that we have our dive truck and the 25' trailer which follows close behind it (almost like magic). We get about 400 fires a year. With 34 guys firefighters, All emts. We also do mutual aid for the surrounding cities. Some of our POV's have lights on them, not all of them. A buddy of mine was POC in a city of 55,000. Just because your are paid doesn't mean your smarter than everyone else.



Also be aware that your system is in the minority. Obviously there are going to be some great, stand-out services, which it sounds like yours is. I wish there were more services like this. No need to get butt-hurt over an opinion on the Internet


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## TatuICU (Jun 2, 2012)

Achilles said:


> And delay response time even more. Without stating that responding priority one causes more accidents. Please explain your logic on what you've just said.



Im also curious as to what percentage of calls you think benefit from a code 3 response in general


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## STXmedic (Jun 2, 2012)

TatuICU said:


> Im also curious as to what percentage of calls you think benefit from a code 3 response in general



All of them! I mean, you never know! What if the patient who called for a minor laceration has an arterial bleed?! :rofl:


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## abckidsmom (Jun 2, 2012)

Our county is staffed 24/7 with 3 medic units.  We need about 5 ambulances to have it fully covered with a cushion.

There are 35 career staff, and over 400 volunteers.  The volunteers mark up from 1800-2400, 1900-2300, 2200-2400.  Random shifts, during the slow hours, without coordinating the coverage to be spread out.

One agency will mark up 2 units and a medic fly car for 5 hours on friday and saturday nights.

What we think of volunteers is that they do whatever they want, spend whatever money they want to, and benefit the system only marginally.  Even though they are free labor, they are a colossal waste of money in our system, with upkeep on 5 buildings, uniforms for hundreds of people, continuing education, radios, boots, incentives....all that for 6 hours here and there of a BLS ambulance that doesn't really want to do calls anyway.

Many of them are extremely competent, many are very friendly, some of them care more about patient care than anything else.

Too many of them are in it for the empire building, the control, and the flashing lights.


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## Achilles (Jun 2, 2012)

TatuICU said:


> You want me to explain the logic behind why its dangerous to have some goober in his personal vehicle putting lights on it and putting th public at risk by disobeying traffic laws? Serious? Well never mind, i guess everyone with a basic license and a Honda accord should light em up and head to that fall call.
> *Actually around here you have to have at least Fire 1 to get on a department plus 18-24 months of probation before you can respond priority 1. *
> 
> 1-2 calls a day is still a very low call volume and if there are no medics on those units then you have no frame of reference so I'm not sure what point you're trying to make.  I'm not sure a basic's scope requires the same amount of experience as higher level's to gain an maintain proficiency.  Sound a little defensive.  Did someone call you Ricky rescue today?*I didn't say they weren't any medics on those rigs, but a majority of our department is specialist and basic, we're LALS. As for me being defensive; no i don't believe I have ever been called "Ricky rescue." Being defensive-honestly, I'm not being defensive, this is a topic that is brought up all the time- 70 percent of firefighters in the United States are volunteers. *



..............


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## jemt (Jun 2, 2012)

IMO they are horrible.

Here in NJ its not uncommon to have a volunteer squad go 3rd or 4th page before signing on to respond.

Also in New Jersey alot of ALS units use "fly cars" and there have been times when the ALS unit is on scene with a pt. for 15+ minutes waiting for the local BLS volunteer squad to get a ambulance out to transport.

I also know of instances personally where one EMT in the back and a police officer driving while working a code.

EDIT: I'm awaiting Veneficus post to this thread.


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## Achilles (Jun 2, 2012)

TatuICU said:


> Im also curious as to what percentage of calls you think benefit from a code 3 response in general



I'd have to run numbers to give you an exact percentage or even a close number, I will tell you a majority of our calls are medical as opposed to trauma, on the contrary we still get trauma calls. If the call is not Life threatening we won't run lights and sirens.


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## DrParasite (Jun 2, 2012)

jemt said:


> IMO they are horrible.


I could be mistaken, but aren't you a newbie EMT who used to volunteer?  If I am wrong, I apologize in advance for my error.





jemt said:


> Here in NJ its not uncommon to have a volunteer squad go 3rd or 4th page before signing on to respond.


yeah, and many paid EMS agencies have calls stacked, so the caller might end up waiting 20-40 minutes for an ambulance.  Not only that, but a paid agency might only have one ambulance, so any second call is an automatic request for mutual aid, while the volunteer squad can have 3 ambulances, and if the primary crew is on a job, they are paging out for another crew before requesting mutual aid.  and if a volunteer squad needs mutual aid it's a sign the volunteers can't do their job, but paid agencies do it all the time.  it's a HUGE double standard.





jemt said:


> Also in New Jersey alot of ALS units use "fly cars" and there have been times when the ALS unit is on scene with a pt. for 15+ minutes waiting for the local BLS volunteer squad to get a ambulance out to transport.


and there are many many many times when ALS doesn't even respond when requested, or never makes it to the scene, or takes the long route so they get cancelled by the BLS.  If ALS doesn't make it to the scene, oh well, BLS can just transport, but if BLS doesn't make it to the scene, well, the volunteer BLS has failed.  or when a city like Plainfield has 2 ALS flycars in town, and only one BLS ambulance, so when 2 ALS emergencies occur, guess what happens?  It's a double standard.

The truth is that the only difference between a full time paid EMT and a volunteer EMT is experience.  a volunteer EMT might work 12 hours a week on an ambulance, while a paid EMT does 36 or 40.  I know quite a few volunteer EMTs who could run circles around paid EMTs, and quite a few paid EMTs that I wouldn't let treat my worst enemy.  Training is often identical, as both paid and volunteer EMTs take the same exact course.  

The other secret is the majority of paid EMTs started our as volunteers.  More often than not, they started a volunteers, got a paid job, and decided they were better than volunteers.  I know of several EMTs who were volunteers in town, and then were offered paid jobs in the same town, and now they think they are better than the volunteer EMTs.  I'm like "weren't you volunteers just 3 months ago???"  And that doesn't even account for the paid EMTs who are still volunteers, sometimes even officers in their volunteer agencies.

Many paid EMTs look down on volunteers because "it's the cool thing to do."  Everyone else does it, so i'm gonna jump on the bandwagon.  They all drink the kool aid, spread the propoganda, and think that all volunteers are idiots, when the truth is many of their own personnel are just as bad.  Yes, there are stupid volunteers, but there are some outstanding volunteer EMS professionals, some who run as many calls than their paid counterparts.  And that's not even including the twohatters (and we won't even mention those FT paid EMTs who can't stand volunteers EMTs, but are active and proud volunteer firefighters).  and then their are the full time paid EMTs who work for transport companies, don't know how to do an assessment, can't backboard someone, but they are paid EMTs, and as such, better than those horrible volunteers.

For full disclosure, I am a career EMS professional assigned to communications in an urban EMS agency, and am not a volunteer.  Prior to going into communications I worked on the ambulance for several years.  I started out as a volunteer, and I never forgot where I came from.  If my local squad wasn't run by a bunch of dinosaurs who think it's the 1970s and there is no reason to act professionals or keep up with modern standards, I would still be with them.  and my hometown got 5000 EMS calls a year, which is more than some paid services, which I was a proud member of before I moved out of the area.


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## Bullets (Jun 2, 2012)

DrParasite said:


> The truth is that the only difference between a full time paid EMT and a volunteer EMT is experience.  a volunteer EMT might work 12 hours a week on an ambulance, while a paid EMT does 36 or 40.  I know quite a few volunteer EMTs who could run circles around paid EMTs, and quite a few paid EMTs that I wouldn't let treat my worst enemy.  Training is often identical, as both paid and volunteer EMTs take the same exact course.


Id disagree, im sure you know some volunteer squads who cover big areas, busy areas and run jobs pretty steadily. Woodbridge, Ironbound, Edison, and some squads that have a hybrid system of volunteer and paid where they work together. Other paid systems call for mutual aid pretty regularly. And it can be volunteer agencies going into paid areas. 

But seriously, how many paid v volley threads is the forum going to have


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## Tigger (Jun 2, 2012)

Rest assured that I am by no means trying to attack you by multiquoting, I'm just trying to make some observations.



Achilles said:


> I'm not going to tell you what I think about you saying the volunteers are less expirenced than Paid. We also have all new equipment except for our Gruman which is an 86, but still runs like a champ. We have a dive team, along with an 15' alluminum boat and a 12' zodiac. We also have an airboat and a hovercraft. Along with that we have our dive truck and the 25' trailer which follows close behind it (almost like magic). We get about 400 fires a year. With 34 guys firefighters, All emts. We also do mutual aid for the surrounding cities. Some of our POV's have lights on them, not all of them. A buddy of mine was POC in a city of 55,000. Just because your are paid doesn't mean your smarter than everyone else.



Just curious, but how does any of this show that your agency provides a quality EMS service? You very well might, but having all new equipment and dive team and boats does not automatically make for a good fire or EMS agency. There are plenty of places that run a fine service with older but serviceable equipment just as there are many places that have all shiny trucks but hide behind their toys when it comes to serving their citizens in the best way possible. I am not saying that you're agency does that, I am saying that the above is not a solid argument and is often employed by those less than stellar agencies who are in denial about the service they provide.


Achilles said:


> And delay response time even more. Without stating that responding priority one causes more accidents. Please explain your logic on what you've just said.


For whatever reason it seems that many around here that drive their POVs code three do so in a far more reckless manner than when they are operating actual apparatus. I have a hunch that this centers around fire trucks and ambulances being much larger and that they are relatively unfamiliar to drive compared to a POV. Regardless, the volunteer agencies that have figured out how to minimize response time have usually done it through in station or very nearby duty crews. It seems a tad ridiculous to have to have the ambulance crew respond ten minutes to the station to get the ambulance and then 10 minutes back to the call, doesn't it? Obviously the citizens are getting what they paid for, but if an agency wants to excel, they're having their people very near the ambulance when on-call.



Achilles said:


> I'd have to run numbers to give you an exact percentage or even a close number, I will tell you a majority of our calls are medical as opposed to trauma, on the contrary we still get trauma calls. If the call is not Life threatening we won't run lights and sirens.


Worry not, you don't have to run numbers to realize that running L&S makes a very small difference on the vast majority of calls, and that the time saved, especially in more rural areas, can be fairly minimal.


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## Tigger (Jun 2, 2012)

As for my own views, my hat is off to those that choose to volunteer and I happily would if the opportunity existed for me at the present. The town I live in has a POC ambulance that is fairly well run with good response times and a general lack of knuckle heads associated with it. This probably stems from most of the community being older and therefore most EMTs have another significant career to attend to. We are also surrounded by full time ALS fire departments and have a three-town AMR medic flycar based in town so getting ALS is a quick affair.


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## medicsb (Jun 2, 2012)

As a former NJ medic, some volunteers squads were great and others were horrible. Some EMTs were great and some were horrible.   Same with the paid crews.  I tended to see more vollies not dressed for the job and they tended to be more likely to show up with a clipboard and no stretcher.  Skill-wise, there wasn't a huge difference, but the paid services that were good were also consistent, while with good vollie squads, there seemed to be greater variation among crews.  In reality, BLS in general needed a kick in a butt.  (And ALS, too, in some places.)


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## Achilles (Jun 2, 2012)

Tigger said:


> Rest assured that I am by no means trying to attack you by multiquoting, I'm just trying to make some observations.
> 
> 
> 
> ...



I don't get offended over someone sitting behind a computer 
Regards,


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## Tigger (Jun 2, 2012)

Achilles said:


> You're right, having all the new equipment doesn't show training. But what we do, shows the amount of training our department has.



But we're talking about EMS here. Having a department that has many specialties does not mean jack when it comes to quality of their EMS service. Your department may have loads of training with water rescue and rescue diving and the whole nine yards, but my point here is that this all has no effect on EMS.


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## Achilles (Jun 2, 2012)

Tigger said:


> But we're talking about EMS here. Having a department that has many specialties does not mean jack when it comes to quality of their EMS service. Your department may have loads of training with water rescue and rescue diving and the whole nine yards, but my point here is that this all has no effect on EMS.



Every Thursday our department does training, usually in the winter it's Rescue and then in the summer it'll be fire, etc... Also, we have many members that started out as Volunteer, went to career and went back to Volunteer. And, we've took the same schooling as paid EMS. We also get the same BS calls as a paid department does.


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## shannonlovesth (Jun 2, 2012)

Training don't mean jack if you don't get out on the street use it. 
I am a volunteer and have a lot of respect for the paid people in my department (I belong to a half and half department). They deal with a lot of good calls but also have to deal with a lot of B.S. during the day like we do at night. 

On another note though and I don't feel like anyone should feel they have to be intimidated and disrespected by another just based off of experience or paid vs. unpaid excuse. (Goes for both Volley and Paid).


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## Achilles (Jun 2, 2012)

shannonlovesth said:


> training don't mean jack if you don't get out on the street use it.
> *not only that but your ambulance won't run unless you have fuel in it*


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## lightsandsirens5 (Jun 2, 2012)

medicsb said:


> As a former NJ medic, some volunteers squads were great and others were horrible. Some EMTs were great and some were horrible.   Same with the paid crews.  I tended to see more vollies not dressed for the job and they tended to be more likely to show up with a clipboard and no stretcher.  Skill-wise, there wasn't a huge difference, but the paid services that were good were also consistent, while with good vollie squads, there seemed to be greater variation among crews.  In reality, BLS in general needed a kick in a butt.  (And ALS, too, in some places.)



EMS in general needs a kick in the butt......That is my opinion.

So...here is my take OP. There are good and bad services, there are good and bad employees, and there are paid and volunteer EMS systems. 

Take all six variables and you come up with a number of combinations. As a whole, you CANNOT apply the BAD brand to volunteer services and the GOOD to career ones. I have worked with two volunteer services and have worked with or closely with two paid services. Four services. Of the volunteer ones, one was amazing, the other sucked. As for the paid services, one was great, the other....not so. Just because you pay someone to do their job does not make them good as it. (Take the federal government for example....)

I have worked with Paid medics that SUCK and volunteer medics that are amazing, literally the best in the business. And the other way around.

I think that it all comes down to heart. Where is it at? If the heart is not in it to be more educated, the improve your skills and knowledge base, to hone your patient interaction mannerisms, to stay current with new research and studies, to better yourself as a clinician in general, you will suck be ye paid or unpaid. On the other hand, if you want to be good, if you study, if you stay abreast of current discoveries, if you try to keep yourself on the bleeding edge of technology and knowledge, then if you are paid, or volunteer, you will be a good medic. 

Now, all THAT being said (take it or leave it by the way....), simply because you are paid most assuredly does NOT mean this all happens by default, and likewise, simply because you are volunteer does not mean that it will not happen. Whatever your "pay grade" you will NEED....yes, need to work on it on your own. Find classes, pay out of YOUR pocket to attend them. Search for and study new research. Stay abreast of developments and discoveries. Dow you own research!

Which leads me to my conclusion...well, almost. But: I truly believe that being paid or being volunteer has little (yes maybe SOME) bearing on your level of "goodness" as a medic. Possibly the only advantage a paid medic has over a volunteer is an (in general) increased call volume. (I do suppose that beings in another variable for our previous six variables....there are paid services WAY slower than many volunteer services of which I know). 

Anyhow....I'll shut up now after I say that I am finally and firmly on the "Medics are SORELY undereducated" bandwagon. 

Apply yourself to the job (not the job description, but rather what is reuired (stupid Q key) to be a good clinician, and you will do well, paid or unpaid.


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## Aidey (Jun 3, 2012)

Disclaimer: I started paid on-call, went volly, and am now full time private. 

I think it depends on the department. Some vollys have poor training and response standards, and others are quite demanding. I agree that the equipment a department has is not necessarily a reflection of the quality of the members of that the department. This goes for both paid and volly services. Having lots of shiny new toys says more about the tax base and person in charge of applying for grant money than it does the quality of the responders. 

Physical appearance makes a big difference to me. It drives me bonkers when we get on scene and have 8 vehicles in the driveway and 10 people, 1/2 of whom aren't wearing any department clothing. I can never tell who is a responder and who is family. 

Volly departments are in a tough spot. They have to find a balance between having high standards and chasing people off. I have found the highest quality volunteers in my area are at the mixed paid/volly departments. Many of the outlying FDs here have one or more paid staff on at all times and then fill the rest of the spots with volunteers. Once you get into the all volly departments things tend to get a bit more questionable. 

I do think it is generally accurate to say that vollys who do not also  work in EMS somewhere else have less experience. Volunteer departments  tend to be smaller departments with lower run volumes, meaning less  chance to get experience. Generally volunteers can not spend as much  time on EMS as someone who is paid full time to be there because they  have their "real" job to worry about. 

I agree with the person above that there seems to be a resistance to learning new/different things that is beyond what we normally run into in EMS. A couple years ago our county medical director came out with a very stern memo telling people to get a room air SpO2 before putting the pt on oxygen, unless they were in obvious respiratory distress. On a run with an all volly department I asked if they had a room air sat, before putting the pt on the NRB. They said no, and when I asked if they had seen the memo they said that they didn't see the point of getting a room SpO2 because they were going to put the patient on oxygen anyway. *facepalm* 

I personally have a hard time addressing those types of issues. The explanations on why something should be done differently tend to be long, and over the head of the first responder I'm talking to, who is usually the same age as my father. Plus is it disheartening to break the news to someone that something they've been doing for the last 20 years, and are convinced helps people, is totally unnecessary. 

Now, when all of that is said and done, I can't hate vollys (usually). I was the first medic on scene of a nasty fatality car crash. There were about at least 10 vollys there from 2 departments on scene. I had to get pretty close to the car to treat the fatality, and I asked if the car was secure. They assured me it was, and one of the guys offered me his helmet anyway. That would _*NEVER *_happen with one of the guys from the career departments around here.


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## shannonlovesth (Jun 3, 2012)

Disclaimer: I have been EMS for only 3 years. I can only give an opinion based on my short experience as a volunteer. 
As a volunteer I can't stand ones that use "its okay we are only volunteers" as an excuse to not do a job correctly. I will admit in my little experience this is a problem I have seen a lot (even with the more experienced volunteers). Right now i'm a very do it by the book/protocol to the best I can person and I do but heads with a lot of other volunteers because of it.


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## medicsb (Jun 3, 2012)

Now that I have a little more time and have already commented on NJ vollunteers... 

I am *almost* completely against the existence of volunteer medics. I would only accept them in rural areas as long as the medic works full-time as a medic elsewhere OR if they're working along side another FT medic.  Experience does matter for paramedics and in most places, in my opinion, even full-time medics do not see enough sick patients to support their current skill-set.    

As far as BLS, I'd be okay with volunteer organizations as long as they have a crew IN STATION 24/7 available to respond in an ambulance upon dispatch commiserate with the call volume.   They should also be in a uniform (yes, pajamas or flip-flops do not count) and held to the same standards as paid organizations.  And policies/regs/etc. (at state or national level) shall never be made to appease volunteers.  

I say this as a former volunteer of 2 years and as someone who is considering volunteering again.


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## shannonlovesth (Jun 3, 2012)

You guys keep mentioning an issue with a uniforms and volunteers and them not being in it. I know at my station you don't get near the truck unless you have boots, ems pants, and proper shirt. Same goes many times for 3rd rig jobs/all calls. Is it really bad in some areas? If so is it okay if I ask what is the worse you guys have seen?


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## Handsome Robb (Jun 3, 2012)

Like everyone said, it's department dependent. 

Some are excellent, others, not so much. 

I know vollies who I'd take of certain shifts out of certain paid stations any day of the week, hands down. I've also been talking to family on a scene and heard a volly guy say "we should get him a blanket, he's shivering" and turned around to find the pt in a full tonic-clonic seizure.

I'll say it again, some are great some are not so great. We have quite a few medics and intermediates that live in outlying areas and volunteer on the limited number of volly units we have if they are around and a call drops. It's always nice to show up on scene and see a coworker running the show.


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## rwik123 (Jun 3, 2012)

I'm a member of a volly student run squad and I definitely feel as though we are looked down upon by paid fire of other towns we respond into. Especially because we are all students we put an extra emphasis on training and standards of care, even more since we operate at the ALS level. We operate at the same ability or even higher than many paid departments around us, and i believe its our pride and commitment to our service that drives us. Its also a great privilege that we have the 911 contracts we have and don't take it for granted. Compared to many other student squads and even a great deal of squads around the country we have it made...so we don't slack.


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## RocketMedic (Jun 3, 2012)

I personally really appreciate my area's volunteers- Sierra County, NM has some great people, and we have a good level of cooperation between our hospital, our hospital-based EMS, and our volunteers, to the point of an integrated supply system, common monitors, etc. With some of our communities literally two or three hours from the interstate (to say nothing of the hospital!) those volunteers are quite needed. 

Well-trained volunteers on a well-organized department are vital and give a lot of our rural areas depth- for instance, we rely on our volunteers for MCI and/or fourth-call transportation. It's also not unheard of for an off-duty or third-out FT medic to respond POV to a scene and transport in with a volunteer unit.


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## frdude1000 (Jun 3, 2012)

My Point of View


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## DrParasite (Jun 3, 2012)

shannonlovesth said:


> You guys keep mentioning an issue with a uniforms and volunteers and them not being in it. I know at my station you don't get near the truck unless you have boots, ems pants, and proper shirt. Same goes many times for 3rd rig jobs/all calls. Is it really bad in some areas? If so is it okay if I ask what is the worse you guys have seen?


honest answer?  two days ago, around 8am, I was in Bergen county for a meeting with a non-EMS coworker of mine, at his office.  Surprisingly, I saw the local ambulance parked across the street, lights on, and with 2 PD units. Apparently there was an emergency occurring next door.

of the 3 person crew, a girl was wearing shorts and flip flops, a guy was wearing khaki shorts, and the 3rd was wearing jeans.  no uniform shirts, no polo shirts, I don't think they were even had any identifying attire.  if they hadn't been running in and out of the ambulance, i wouldn't have even known they were EMTs.  As an EMT, I was embarrassed.  Although i will say, I have seen paid EMTs in the hospital looking just as bad, and once the person was so poorly dressed (wacker ems t-shirt, emt badge on chain around neck, etc), I filed a complaint with their supervisor.

Before someone accuses me of being a uniform nazi, I will stipulate that if you don't plan on being on a rig, you shouldn't be held to the same standard.  So if you are at the station, or on assigned duty crew, you should be wearing uniform pants, a uniform shirt, and boots, and whatever else your agency has designated as your riding uniform.  

If you are answering a scramble/3rd call, you should be wearing long pants, sneakers or (preferably) boots, and a shirt that identifies you as a member of the EMS agency, or jumpsuit/coveralls and proper footwear.  I don't agree with delaying a response so a scramble crew can get changed into a proper uniform, especially with already having the inherent delay of having to respond to the station.  it doesn't hurt to have a T-shirt/jobshirt/polo/uniform shirt in your locker, esp if you might be responding for that 3rd call.

BTW, shannon are you with Florence or westhampton fire/ems by any chance?


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## medicsb (Jun 3, 2012)

shannonlovesth said:


> You guys keep mentioning an issue with a uniforms and volunteers and them not being in it. I know at my station you don't get near the truck unless you have boots, ems pants, and proper shirt. Same goes many times for 3rd rig jobs/all calls. Is it really bad in some areas? If so is it okay if I ask what is the worse you guys have seen?



I mainly worked day shift, so what I usually saw was a squad shirt thrown on with just jeans or shorts and sneakers.  Often, the shirts weren't tucked in.  Generally, they looked like slobs.  (To be sure, I saw a number of paid crews that'd do the untucked, boots untied thing; actually my local EMS service that is an all paid FD has some medics and EMTs that like to go with their shirts unbuttoned and untucked.)  Anyhow, the night shift medics would see some vollies coming out in pajamas.  Once or twice I did see an EMT show up to a vehicle rescue in shorts and flip flops.


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## rwik123 (Jun 3, 2012)

DrParasite said:


> honest answer?  two days ago, around 8am, I was in Bergen county for a meeting with a non-EMS coworker of mine, at his office.  Surprisingly, I saw the local ambulance parked across the street, lights on, and with 2 PD units. Apparently there was an emergency occurring next door.
> 
> of the 3 person crew, a girl was wearing shorts and flip flops, a guy was wearing khaki shorts, and the 3rd was wearing jeans.  no uniform shirts, no polo shirts, I don't think they were even had any identifying attire.  if they hadn't been running in and out of the ambulance, i wouldn't have even known they were EMTs.  As an EMT, I was embarrassed.  Although i will say, I have seen paid EMTs in the hospital looking just as bad, and once the person was so poorly dressed (wacker ems t-shirt, emt badge on chain around neck, etc), I filed a complaint with their supervisor.
> 
> ...



Jumpsuits pretty much eliminate this problem even though there not the most stylish. They can be thrown on over anything.


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## Tigger (Jun 3, 2012)

DrParasite said:


> Before someone accuses me of being a uniform nazi, I will stipulate that if you don't plan on being on a rig, you shouldn't be held to the same standard.  So if you are at the station, or on assigned duty crew, you should be wearing uniform pants, a uniform shirt, and boots, and whatever else your agency has designated as your riding uniform.
> 
> If you are answering a scramble/3rd call, you should be wearing long pants, sneakers or (preferably) boots, and a shirt that identifies you as a member of the EMS agency, or jumpsuit/coveralls and proper footwear.  I don't agree with delaying a response so a scramble crew can get changed into a proper uniform, especially with already having the inherent delay of having to respond to the station.  it doesn't hurt to have a T-shirt/jobshirt/polo/uniform shirt in your locker, esp if you might be responding for that 3rd call.
> 
> BTW, shannon are you with Florence or westhampton fire/ems by any chance?



That's not being a uniform nazi at all. Part of being a professional is looking the part, and I cannot stand when someone says "I'm volunteer, the fact that I am here is good enough." No it is not, we're all doing the same job and regardless of whether you are getting paid or not does not somehow make it acceptable to wear flip flops and shorts to a call. You work on ambulance, look the part. Where I live, the ambulance crew wears a town EMS shirt, navy pants, and black shoes or boots. Sure, there is a little more variation than a full time service, but point is that the crew is easily identifiable and looks professional. EMS uniforms, especially t-shirts, are not that uncomfortable and there is no reason why you cannot just wear it while you're on call.


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## Craig Alan Evans (Jun 3, 2012)

In Virginia the majority of the state is volunteer and the career personnel mostly started as volunteer to receive their training.  I think as a career paramedic the best attitude toward volunteers is one of mentoring and education.  We were all there once thinking we knew everything we needed to know and we were actually clueless.  At the time I started as a volunteer I would have really appreciated a career paramedic with 25 years experience with that attitude.


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## jemt (Jun 3, 2012)

DrParasite said:


> I could be mistaken, but aren't you a newbie EMT who used to volunteer?  If I am wrong, I apologize in advance for my error.yeah, and many paid EMS agencies have calls stacked, so the caller might end up waiting 20-40 minutes for an ambulance.  Not only that, but a paid agency might only have one ambulance, so any second call is an automatic request for mutual aid, while the volunteer squad can have 3 ambulances, and if the primary crew is on a job, they are paging out for another crew before requesting mutual aid.  and if a volunteer squad needs mutual aid it's a sign the volunteers can't do their job, but paid agencies do it all the time.  it's a HUGE double standard.and there are many many many times when ALS doesn't even respond when requested, or never makes it to the scene, or takes the long route so they get cancelled by the BLS.  If ALS doesn't make it to the scene, oh well, BLS can just transport, but if BLS doesn't make it to the scene, well, the volunteer BLS has failed.  or when a city like Plainfield has 2 ALS flycars in town, and only one BLS ambulance, so when 2 ALS emergencies occur, guess what happens?  It's a double standard.
> 
> The truth is that the only difference between a full time paid EMT and a volunteer EMT is experience.  a volunteer EMT might work 12 hours a week on an ambulance, while a paid EMT does 36 or 40.  I know quite a few volunteer EMTs who could run circles around paid EMTs, and quite a few paid EMTs that I wouldn't let treat my worst enemy.  Training is often identical, as both paid and volunteer EMTs take the same exact course.
> 
> ...




I never was a vollie but I am fairly new to EMS, I see you refer to Plainfield which makes me think your North Jersey? I'm not familiar with up there, so maybe I don't see the same things you do.


I don't understand your point about going mutual aid, I have saw it needed as well as given at my squad and it worked out fine. It's EMS, making call volume unpredictable so its going to happen.

You say everyone jumps on the bandwagon hating volunteers, yet you go and talk down on paid transport EMT's.


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## mycrofft (Jun 3, 2012)

I skipped the posts above.
My experience: most volly agencies become little political machines and tend to accrete a cohort of people who are willing to keep showing up no matter what, or who need their own little kingdom to rule. Each has its own culture, whether of excellence or not, or some degree in between. Paid ppeople may also not have a good personal knowledge of each volunteer group, so negative rumors will abound.
So, the answer is, "It depends".


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## Veneficus (Jun 3, 2012)

shannonlovesth said:


> You guys keep mentioning an issue with a uniforms and volunteers and them not being in it. I know at my station you don't get near the truck unless you have boots, ems pants, and proper shirt. Same goes many times for 3rd rig jobs/all calls. Is it really bad in some areas? If so is it okay if I ask what is the worse you guys have seen?



The worst I have seen?

Volunteer firefighter on the scene of a working structure fire with a wife-beater, shorts, and no shoes doing everythig from shuttling equipment to holding the nozzle of an exterior line.

Right up untill we took him to the hospital.


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## Level1pedstech (Jun 3, 2012)

Veneficus said:


> The worst I have seen?
> 
> Volunteer firefighter on the scene of a working structure fire with a wife-beater, shorts, and no shoes doing everythig from shuttling equipment to holding the nozzle of an exterior line.
> 
> Right up untill we took him to the hospital.



Best post of the thread. Having been a volunteer for ten years in a very rural area in WA state I have my share of stories but that beats them all. One question I have to ask is what was the reason for transport?


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## Veneficus (Jun 3, 2012)

Level1pedstech said:


> Best post of the thread. Having been a volunteer for ten years in a very rural area in WA state I have my share of stories but that beats them all. One question I have to ask is what was the reason for transport?



crushed his foot when the 10lbs of adapters and crap stuffed in the 5 lb engineer's compartment fell on it while he was trying to dig something out of the back.


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## Level1pedstech (Jun 3, 2012)

Having had FF/EMT positions with two very different agencies over a ten year period let me give my thoughts on the subject.

Agency number one was your stereotypical rural agency. Members were all volunteer except for the chief, the mix was 75% fire and 25% medical. Minimum certification for medical personnel was first responder but most were basics,there were two EMT-I's and two medics. Majority of personnel responded to the closest station the remainder went POV.

Drills were held four times a month,the training for medical people was designed to make sure all members compleated the CE's required to recertify at their respective level. For fire people the training was designed to make sure skills were maintained at the level of IFSTA FF 1. One drill each month was a mixed drill which allowed fire and medical to cross train and learn how to work togeather. Members were welcome and encouraged to attend every drill but were only required to attend one a month. ALS care and transport was provided by a seperate agency. 

Agency number two was a small combination municipal department consisting  of full time,part time and volunteer personnel. Minimum certification for all was EMT-B and IFSTA FF 1.  The staffing on our ALS assesment engines running 24/7/365 out of four stations was 1 paid Capt FF/Medic,1 paid or part time engineer,1 volunteer and 1 intern. Of course this mix could be different depending on staffing levels and engines sometimes would have to run BLS. We had two ALS transport units staffed with a medic provided by AMR and a part time EMT-IV Tech that was provided by the department. AMR also would respond  if the medic unit was out of the area.

Training was designed to keep everyones skills at peak level and everyone was encouraged to advance as far as they could. If you were a volunteer on an engine you were expected to maintain your skills at the same level as your paid counterparts. I liked this concept because it tended to seperate out the Ricky Rescues and those that were only in it for the shirt.

Bottom line is that both agencies got the job done and were there when the call came in. The paid/volunteer rivalry will always be an issue but I believe most of those that offer thier time as volunteers have their act togeather and are able to get the job done.


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## Level1pedstech (Jun 3, 2012)

Veneficus said:


> crushed his foot when the 10lbs of adapters and crap stuffed in the 5 lb engineer's compartment fell on it while he was trying to dig something out of the back.



Nice.


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## Veneficus (Jun 3, 2012)

Level1pedstech said:


> Nice.



sorry it wasn't more exciting.


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## Level1pedstech (Jun 3, 2012)

Veneficus said:


> sorry it wasn't more exciting.



Would have made great you tube viewing. I just needed the whole story so I could get a good mental picture.


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## Chimpie (Jun 3, 2012)

*The thread has been cleaned up and off topic posts have been removed.  Keep it on topic and polite please.*


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## DrParasite (Jun 4, 2012)

jemt said:


> I never was a vollie but I am fairly new to EMS, I see you refer to Plainfield which makes me think your North Jersey? I'm not familiar with up there, so maybe I don't see the same things you do.


I started my paid EMS experience in Plainfield.  boy was it an eye opener.  Since then, I have worked in both central and north Jersey for more than 10 years.





jemt said:


> I don't understand your point about going mutual aid, I have saw it needed as well as given at my squad and it worked out fine. It's EMS, making call volume unpredictable so its going to happen.


you are the one who said volunteers always go 3rd and 4th request before getting a truck out.  i just mentioned that paid agencies request m/a immediately, while if a volunteer agency did that, the paid agencies would consider that a failure to do their job.


jemt said:


> You say everyone jumps on the bandwagon hating volunteers, yet you go and talk down on paid transport EMT's.


Absolutely I do.  I have yet to meet any good transport EMTs.  No, wait, that's not true.  The only good transport EMTs have 911 experience, and currently spend time on a 911 ambulance.  I know a lot of great people who work doing transport EMS.  great friends, great drinking buddies, and a lot of fun outside of work.  But they typically have horrible EMT skills.  Most of the good ones are working on getting a 911 job, or work FT in 911 jobs and do transport just for extra money.  I'm not jumping on the bandwagon, I'm at the front leading the group.

Just because you are a volunteer, doesn't mean you can't be professional.   And as Veneficus said, there can be some extremely embarrassing volunteers, but I would hope that an embarrassing extreme few do not represent the vast majority.


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## crashh (Jun 4, 2012)

I see it a little better now, thanks guys!

as far as lights...here we are allowed to run with flashing blue, but it does NOT give us a right to disobey any traffic laws. They highly discourage this in our company, we are to run by the laws, and the light is used as a courtesy permission only.


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## Irish42 (Jun 4, 2012)

Last I checked, my polo says EMS on it, not paid or volunteer.
Last I checked, being professional depends on the indivuals additude, not the bases of your employment.
Last I checked, pataint care is the number 1 priority, not whether I get paid or not.

Everything else is bull:censored::censored::censored::censored:, bad leadership or politics.


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## jemt (Jun 4, 2012)

DrParasite said:


> I started my paid EMS experience in Plainfield.  boy was it an eye opener.  Since then, I have worked in both central and north Jersey for more than 10 years.you are the one who said volunteers always go 3rd and 4th request before getting a truck out.  i just mentioned that paid agencies request m/a immediately, while if a volunteer agency did that, the paid agencies would consider that a failure to do their job.
> Absolutely I do.  I have yet to meet any good transport EMTs.  No, wait, that's not true.  The only good transport EMTs have 911 experience, and currently spend time on a 911 ambulance.  I know a lot of great people who work doing transport EMS.  great friends, great drinking buddies, and a lot of fun outside of work.  But they typically have horrible EMT skills.  Most of the good ones are working on getting a 911 job, or work FT in 911 jobs and do transport just for extra money.  I'm not jumping on the bandwagon, I'm at the front leading the group.
> 
> Just because you are a volunteer, doesn't mean you can't be professional.   And as Veneficus said, there can be some extremely embarrassing volunteers, but I would hope that an embarrassing extreme few do not represent the vast majority.




I would actually view it more professional if a vollie agency went mutual aid after second tones, not a failure.

On transport EMT's, I can agree alot are terrible at doing "EMS" but also alot work both 911 and transport, considering most jobs are within transport since that is where the money is running BLS.

Also just this weekend I was listening to a call unfold, a ALS box ambulance was on scene with a pt. waiting for the vollie agency to get out when the ALS unit requested permission to transport and was denied and told to wait for the BLS unit to arrive. At this point the vollie agency was at 4th tones.:wacko:

If I had it my way, all vollie agencies would have to go mutual aid after second tones.


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## crashh (Jun 4, 2012)

we are lucky to have 4 ALS in our dept, so usually we are always running with at least one at all times


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## rescue1 (Jun 4, 2012)

From my experience at 3 volley stations, volunteers are as good or bad as the system in place around them. 

The main issue is staffing and the sticky issues of retention. I've been at a station where the EMTs were all very competent and many were paid or worked in a hospital, but the ambulance had about a 50% failure rate, and another where the EMTs ranged from good to barely able to handle a BLS sick person, but took 8 minutes or so to respond. 

I think the main issue confronting volunteer EMS is that while you can fire or discipline a paid EMT, knowing you can hire another, you cannot do the same with a volunteer. With many volley agencies struggling to staff trucks or make calls, when you terminate or suspend a volunteer, you may lose a crucial responder. In the same way, you can make your paid staff attend training, wear uniforms, and clean the bathrooms, but enforcing the same on volunteers could result in a loss of membership thanks to the "I'm just a volunteer, you can't expect me to do that" excuse. This lack of discipline means that while you can have well motivated, competent responders, you can also have responders that want to play with flashing lights and don't want to know more then "apply O2, drive fast".

I've also found morale is much higher in staffed stations. Nothing is more disheartening then having a station that routinely fails to respond.


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## crashh (Jun 4, 2012)

wow, some of these volunteer organizations sound horrible!  From the sounds of it, we run a pretty good service.  Take it seriously, safely, and training of all types are encouraged, and paid for.  Our CC's take the time to teach us, both in and out of the field.  We drill once a week.   We rarely have a 2nd tone, but it does happen from time to time.  when both our ambulances are out, we have a mutual aide on standby.always.


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## TransportJockey (Jun 4, 2012)

I've never volunteered... and swore I never would (until the rural county next door told me I could play as a medic and they'd pay for my AAS and BS in EMS along w/ TEMS and whatever other classes I want for 24 hrs/month minimum.), but generally I hold judgement until I see the dept work. Around here in NM, for hte most part, I'm not too thrilled w/ what I've seen. I work for a private 911 service that does transport in a rural area. Most of the time we are the only providers on scene, as we can't get any vollies to get out of bed for anything other than a structure going up. Generally even on codes, I'll be the lone unit on scene. Which sucks. 
Volunteers in certain areas seems to be phasing out... can't say I'm to sad by that.


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## RocketMedic (Jun 4, 2012)

Sierra County's volunteers are pretty motivated, TJ. I like them quite a lot.


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## TransportJockey (Jun 4, 2012)

Rocketmedic40 said:


> Sierra County's volunteers are pretty motivated, TJ. I like them quite a lot.



That they are. I know Kevin (another classmate, and a friend of Keith and Javi) tells me they actually do a good job. I was mainly referring to large parts of ValCo.


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## RocketMedic (Jun 4, 2012)

There's population there?


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## Chief Complaint (Jun 5, 2012)

Most of them are looked down upon by the career staff here.  Not all, but i would say that the majority of them are.

They dont have the same training as us, and arent held to the same fitness standards.  That leads to a lot of tension between the two sides.


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## rescue1 (Jun 5, 2012)

I think any system where the volunteers and career men are held to different standards will breed tension. If the professional staff have to clean the station, stock the rigs, and attend mandatory training while the volunteers can lay about the station watching HBO, there will be grumbling in the ranks. 
This is also true if the paid men are trained to a much higher level and have to "babysit" volunteers on calls.
Also note this could go both ways, paid guys can be lazy too. But it tends to be the way I described, for the simple reason that when you pay someone, you have far more leeway on telling him what to do with his time.


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## crashh (Jun 6, 2012)

how is the training different?


We don't have any paid in our dept. we  are all volunteer


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## rescue1 (Jun 6, 2012)

Continuing education, drills, attending seminars on various medical issues, that kind of thing. You can't just take EMT-B and then decide you don't ever need to know anything else about medicine.

Or if you do fire and EMS, have paid men with much more certifications. Also, in many of the Maryland academies I've seen, the paid firefighter's courses will simply be longer. In (volunteer) firefighter 1, we spent like...2 days on roof ladders. In the paid academy held there they spent over a week on roof ladders. That kind of thing.


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## HawkMedic (Jun 6, 2012)

Volunteering is exactly what it entails; You will get a broad spectrum of providers from the lazy to the very best. I know several individuals that you would look at and say they are the very best providers and they deserve the compliment, however the flip side is you also get the providers that don't take it seriously. Regardless of their job describtion (paid/volunteer) its the same, and it needs to be taken seriously with dedication to training, and riding calls frequently. I think the question should be about how you feel about lazy people who don't want to better themselves


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## crashh (Jun 6, 2012)

rescue1 said:


> Continuing education, drills, attending seminars on various medical issues, that kind of thing. You can't just take EMT-B and then decide you don't ever need to know anything else about medicine.
> 
> Or if you do fire and EMS, have paid men with much more certifications. Also, in many of the Maryland academies I've seen, the paid firefighter's courses will simply be longer. In (volunteer) firefighter 1, we spent like...2 days on roof ladders. In the paid academy held there they spent over a week on roof ladders. That kind of thing.



we drill every week....we are encouraged and it is paid for us to go to seminars, talks, conventions etc.  Continuing education is encouraged, and in some cases, paid for by the dept.  I am looking into getting my paramedic training paid for at this time.  We just went to high band finally!

Most of our firefighters, myself included have many certifications, and are also FF2 qualified.  Our dept pays for us to go to different training for certification programs, including the state Fire Academy in Montour Falls.


I guess I'm just saying that not all volly units are like the ones you are used to dealing with.  I'm not saying we know everything (even paid personnel can't say that..you never know everything), but we work hard at making sure we are up to date on training and equipment etc.


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## rescue1 (Jun 6, 2012)

I'm not disagreeing with you about volunteers. My current department is primarily volunteer and they are (for the most part) very squared away with training and professionalism. 
Like I said earlier, a volunteer station is as good or bad as the people in it and the framework system surrounding it. The main difference between a volunteer and a paid staff is that a volunteer organization, and therefore the people in it, must be self motivated and not settle for the minimum, as unfortunately many do.
A paid organization also must not settle, but when a company or municipality begins to invest money in things they have higher expectations and demands, and more leverage to make it happen.


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## TransportJockey (Jun 6, 2012)

Rocketmedic40 said:


> There's population there?



LOL Not so much. But I'm gona be vollying in Torrance, where there's even less population lol


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## Chief Complaint (Jun 6, 2012)

crashh said:


> how is the training different?
> 
> 
> We don't have any paid in our dept. we  are all volunteer



Our paid staff go through a grueling 6 month academy which works out to a little more than 50 hours/week of solid training.  Im not knocking the volunteers for not going through the academy because its not an option for them, but the bottom line is that it is an entirely different level of training for the career staff.


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## crashh (Jun 7, 2012)

sounds crazy!  no worries, i'm not offended at all by any of these posts fyi...just fairly new to this & trying to get some info 

i like your name Chief Complaint :lol:


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## Level1pedstech (Jun 7, 2012)

Chief Complaint said:


> Our paid staff go through a grueling 6 month academy which works out to a little more than 50 hours/week of solid training.  Im not knocking the volunteers for not going through the academy because its not an option for them, but the bottom line is that it is an entirely different level of training for the career staff.



Why not hold the volunteers up to the same standards of training and testing. Earlier in the thread I used my former department as an example of how combination departments can be successful. 

We also moved staff up from within which saved the city money and time when full time paid spots opened up. The path started at shift volunteer then you would test into the part time pool,all full time positions were filled from the part time pool. Another benefit was that the new full timers had alredy been on the floor for at least a couple of years so the move over to full time did not require an academy or supervised probie time.


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## Veneficus (Jun 7, 2012)

*Just asking*



Level1pedstech said:


> Why not hold the volunteers up to the same standards of training and testing. Earlier in the thread I used my former department as an example of how combination departments can be successful.
> 
> We also moved staff up from within which saved the city money and time when full time paid spots opened up. The path started at shift volunteer then you would test into the part time pool,all full time positions were filled from the part time pool. Another benefit was that the new full timers had alredy been on the floor for at least a couple of years so the move over to full time did not require an academy or supervised probie time.



So how do you stop it from being a good old boy club or an organization that is not receptive to innovation?


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## Level1pedstech (Jun 7, 2012)

TransportJockey said:


> I've never volunteered... and swore I never would (until the rural county next door told me I could play as a medic and they'd pay for my AAS and BS in EMS along w/ TEMS and whatever other classes I want for 24 hrs/month minimum.), but generally I hold judgement until I see the dept work. Around here in NM, for hte most part, I'm not too thrilled w/ what I've seen. I work for a private 911 service that does transport in a rural area. Most of the time we are the only providers on scene, as we can't get any vollies to get out of bed for anything other than a structure going up. Generally even on codes, I'll be the lone unit on scene. Which sucks.
> Volunteers in certain areas seems to be phasing out... can't say I'm to sad by that.



Seems to me you are being compensated,with money from the county for your education. Not sure how you figure your a volunteer at least not the kind of volunteer being discussed in this thread.

As far as coming out and "playing" as a medic,most of us know what you mean. To the new people however you are making the case for those that are convinced volunteers will never be equal to their paid counterparts. Guess your getting the best of both worlds.


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## Level1pedstech (Jun 7, 2012)

Veneficus said:


> So how do you stop it from being a good old boy club or an organization that is not receptive to innovation?



Everybody from the mayor on down the line needs to be involved and on board to keep the department focused. In our case most major issues had to be brought before the board of commissioners for approval which removed the "good old boy factor" at least in comparison to my other department.

As far as being receptive to innovation you know as well as me that you have to have the right command staff. From the chief to his asisstant to the battalion chiefs and on down to the captains on the floor there has to be a commitment to continue the forward movement of the department. Having the IAFF on board was a big help for us as well as our involvement with the larger nearby agencies.

The real way to look at it if you wanted to take an agency in this direction is to look at what it offers the tax payers. Forget the paid/volunteer arguement and who is better fit to serve and focus on the fact that with this model your getting service and coverage for roughly half the cost of the all paid agency.

This is not a template for every agency but if given the right conditions I think its one that could be implemented in areas where they have outgrown the all volunteer agency but are not fiscally sound enough for an all paid agency. 

Of course the commitment of the volunteers has to be above the level that most are now accustomed to. Knowing that full time paid spots are filled from within is a huge motivating factor and should serve as incentive for the volunteer staff to work even harder than the full timers. This incentive also makes the volunteer recruitment process more competitive and draws in people from outside the community.


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## rescue1 (Jun 7, 2012)

The above model is used fairly effectively by EMS squads in the Philly suburbs. I'm not a member of any, so I really can't talk about them with any expertise, but it's my understanding that everyone is held to identical standards, paid and volunteer, both for scheduling and training. Volunteers also have hiring preference. I hear its pretty effective.

I think this system is great, but the issue is that it requires you have be a combination system to start. For an all or almost all volunteer system (which is where a lot of the complaints arise about volunteers) this system obviously won't work, since you have no (or almost no) paid positions for the volunteers to "promote into".
The only other issue is if you can't keep volunteer recruitment high. So while some areas (very populated ones) will have no trouble with a constant stream of people volunteering for a few years to get a paid position, a more rural department may end up hiring all the volunteers and transform into a paid department.


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## Veneficus (Jun 7, 2012)

rescue1 said:


> The above model is used fairly effectively by EMS squads in the Philly suburbs. I'm not a member of any, so I really can't talk about them with any expertise, but it's my understanding that everyone is held to identical standards, paid and volunteer, both for scheduling and training. Volunteers also have hiring preference. I hear its pretty effective.
> 
> I think this system is great, but the issue is that it requires you have be a combination system to start. For an all or almost all volunteer system (which is where a lot of the complaints arise about volunteers) this system obviously won't work, since you have no (or almost no) paid positions for the volunteers to "promote into".
> The only other issue is if you can't keep volunteer recruitment high. So while some areas (very populated ones) will have no trouble with a constant stream of people volunteering for a few years to get a paid position, a more rural department may end up hiring all the volunteers and transform into a paid department.



Do you think this system will advance pay, opportunity, or profesional status of EMS in the area?


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## rescue1 (Jun 7, 2012)

Well, the unfortunate truth is that any job that someone will A) do for free or B) do for personal satisfaction rather then pay will never advance in salary or opportunity with any speed, if at all.

If people were willing to do software consulting for free, and there were long lines of people wishing to do software consulting just for their own enjoyment, then software consultants wouldn't be making 6 figures. 
But at the same time, especially today with municipal budgets in the crapper, the transformation into a progressive paid system may not be a financial possibility.

So I'd say while this may not be the ideal system to rule all other EMS systems, I think it is an improvement over an all volunteer system for advancing EMS as a whole.


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## Level1pedstech (Jun 7, 2012)

rescue1 said:


> The above model is used fairly effectively by EMS squads in the Philly suburbs. I'm not a member of any, so I really can't talk about them with any expertise, but it's my understanding that everyone is held to identical standards, paid and volunteer, both for scheduling and training. Volunteers also have hiring preference. I hear its pretty effective.
> 
> I think this system is great, but the issue is that it requires you have be a combination system to start. For an all or almost all volunteer system (which is where a lot of the complaints arise about volunteers) this system obviously won't work, since you have no (or almost no) paid positions for the volunteers to "promote into".
> The only other issue is if you can't keep volunteer recruitment high. So while some areas (very populated ones) will have no trouble with a constant stream of people volunteering for a few years to get a paid position, a more rural department may end up hiring all the volunteers and transform into a paid department.



The transition point from all volunteer to combination would be when the commitment is made and the funding is in place. There has to be some level of funding however there is no minimum requirement as to the number of paid staff you need to start with. A nearby department I know of started with a paid chief then added one paid FF/EMT at a time until they were able to staff two first out BLS engine companies with a full time Capt and a part time engineer. The other seats were filled with volunteers and interns from the local fire science programs.

Offering an intern program for the local fire science students is a great option if you have sufficent call volume. Also as I mentioned the recruitment process is easier and becomes more competitive once you start filling in the paid spots with those that have put in thier volunteer time. Residency requirements need to be wavied to allow people to come in from outer areas for shift time. The benefit for the department is this allows for less reliance on POV response because you have crews in quarters. Benefit for the volunteers is that while on 12 and 24 hour shifts the crews drill togeather and share all the house duties (cleaning,cooking) which helped build mutual respect.


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## crashh (Jun 7, 2012)

I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes?  Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.

our company is 100% volly.  But we're different than others around us in that we are more of a corporation i think.  We are in a contract with our town...and get paid a certain amount from the 2 colleges that reside here. So, we don't have to do fundraising...we have a fund to work with.  We do get donations and such of course as well


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## rescue1 (Jun 7, 2012)

crashh said:


> I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes?  Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.



For the same reason anyone volunteers, I guess, because you enjoy it. And because most of these systems do not have the staffing to crew all the apparatus in the house with paid men, so the volunteers still play a key role in the system.

For example, I belong to a fire company that has 2 ambulances, 2 engines, and a combination rescue/ladder. During the day there are 4 career personal on duty, 2 FF/EMTS and 2 FF/Medics. At night it drops to 2 personal, with at least one medic.

Obviously, there are not enough paid guys to staff more then one or two apparatus at a time, so the volunteers respond in or staff the station to provide most of the manpower. 
For EMS, this means if I'm at the station I could ask the paid EMT if he wanted a break if we got a call, and I'd replace him on the ambulance. At night, a second ambulance call requires a volunteer response since there is only staffing for one ambulance in house. Or for a fire call, the volunteers may provide the crew to an engine that is driven by a paid staffer.

As to why you'd CHOOSE to volunteer, it's because either a) You have another job and don't want to be a career firefighter or EMT or because b) There is a huge demand for each paid position...we have 8 full time career staff and like 40 volunteers. And we don't hire our volunteers either. So it's not like you can just waltz in and get a paid job.


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## rescue1 (Jun 7, 2012)

Level1pedstech said:


> The transition point from all volunteer to combination would be when the commitment is made and the funding is in place. There has to be some level of funding however there is no minimum requirement as to the number of paid staff you need to start with. A nearby department I know of started with a paid chief then added one paid FF/EMT at a time until they were able to staff two first out BLS engine companies with a full time Capt and a part time engineer. The other seats were filled with volunteers and interns from the local fire science programs.
> 
> Offering an intern program for the local fire science students is a great option if you have sufficent call volume. Also as I mentioned the recruitment process is easier and becomes more competitive once you start filling in the paid spots with those that have put in thier volunteer time. Residency requirements need to be wavied to allow people to come in from outer areas for shift time. The benefit for the department is this allows for less reliance on POV response because you have crews in quarters. Benefit for the volunteers is that while on 12 and 24 hour shifts the crews drill togeather and share all the house duties (cleaning,cooking) which helped build mutual respect.



I agree, I think this system is a good middle ground for areas that cannot justify or afford an all or mostly paid system. I've always found volunteer morale to be higher in systems where stations are staffed and response times are quick...nothing sucks more then belonging to a station where there is doubt as to whether you can respond on each call.

That being said, the issue is keeping staffing in station if you only run, say, six or seven hundred calls a year between fire and ambulance. When you can go a whole day without a single call, it can be tough to keep volunteers in the station 24/7.


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## Level1pedstech (Jun 7, 2012)

Veneficus said:


> Do you think this system will advance pay, opportunity, or profesional status of EMS in the area?



Pay would be equal to other agencies in the area for full timers,part timers would make less but they are gaining experience. 

Additional opportunities would depend on funding just like they do now. This model acts to consolidate current resources and man power into a more manageable system. The positions are there already,some have funding and some dont. 

I think the public liked seeing our guys in uniform and looking professional when we responded to calls but also if we were in doing our shopping for chow. There were no barefoot wife beater wearing responders on scene and no POV responders racing to calls. The surrounding agencies looked upon us with high regard which I guess would qualify as having profesional status. Honestly I was more concearned with how I was viewed by the public you know the one who pay the bills.


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## Level1pedstech (Jun 7, 2012)

rescue1 said:


> I agree, I think this system is a good middle ground for areas that cannot justify or afford an all or mostly paid system. I've always found volunteer morale to be higher in systems where stations are staffed and response times are quick...nothing sucks more then belonging to a station where there is doubt as to whether you can respond on each call.
> 
> That being said, the issue is keeping staffing in station if you only run, say, six or seven hundred calls a year between fire and ambulance. When you can go a whole day without a single call, it can be tough to keep volunteers in the station 24/7.



Roger that,I remember having many 24's with out a call. The days were filled with drilling,drilling and more drilling. Then of course there was painting,yard work, toilet scrubing,cooking,dishwashing,PT and maybe depending on the Capt a little more drilling before bed. But I can say in two years I only sat in a recliner and watched TV once or twice so we were always doing something.


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## Level1pedstech (Jun 7, 2012)

crashh said:


> I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes?  Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.
> 
> our company is 100% volly.  But we're different than others around us in that we are more of a corporation i think.  We are in a contract with our town...and get paid a certain amount from the 2 colleges that reside here. So, we don't have to do fundraising...we have a fund to work with.  We do get donations and such of course as well



You would volunteer for the experience. There were only so many full and part time paid positions which were earned by putting in your time. There was no option to go in and shift as a volunteer or shift as a paid guy. Hope that makes it a little clearer.


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## jemt (Jun 7, 2012)

FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.


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## Level1pedstech (Jun 7, 2012)

jemt said:


> FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.



Really,what makes you think so. Its such a simple idea but let me ask who would cover the work now being covered by volunteer agencies assuming there is no funding currently available for paid staff? The common simple answer to this question is money would have to be found somewhere. In which I reply have you looked at the economy and the budget deficits and the large number of agencies big and small that are closing stations and laying off people.


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## jemt (Jun 7, 2012)

Level1pedstech said:


> Really,what makes you think so. Its such a simple idea but let me ask who would cover the work now being covered by volunteer agencies assuming there is no funding currently available for paid staff? The common simple answer to this question is money would have to be found somewhere. In which I reply have you looked at the economy and the budget deficits and the large number of agencies big and small that are closing stations and laying off people.



Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up. 


I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour


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## rescue1 (Jun 7, 2012)

jemt said:


> FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.



I'm not so sure. A big draw of people working in EMS is the fact that they love, or think they will love, doing EMS. Therefore, they will accept lower wages, regardless of whether or not the towns ten miles away have a paid system or a volunteer system.

The over-reliance on volunteers has certainly slowed the growth of EMS in some respects (educationally, mainly), but I don't know if it directly would impact wages.


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## Level1pedstech (Jun 7, 2012)

jemt said:


> Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up.
> 
> 
> I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour



Forced by who? Once again you need a revenue source,this is not a supply and demand issue. The number of EMT's and the lousy pay they are offered is an example of supply and demand.


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## ffemt8978 (Jun 7, 2012)

jemt said:


> Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up.
> 
> 
> I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour



Wow....just, wow.

No, if every city/town was forced to have paid EMS, they would not have any EMS.  They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model.  Neither of those options would ensure adequate response times or staff availability.

You do realize that your "couple of emts" at $15/hours equates to over $130,000 per EMT position per year?  That provides one EMT to cover 24 hours per day, 365 days per year.  That does not include things like unemployment insurance, health insurance, retirement, ongoing training, uniform allowances or other such items like minimum equipment, maintenance, and supplies for the station.  So to have a minimum two person ambulance staffed 24 hours per day, every day, equates to over $260,000 per year in wages alone (leaving overtime out of the equation completely).

Considering my district's budget is less than that amount every year, where do you propose we obtain this money from?  The taxpayers that fund us certainly don't want an increase in their taxes, and it's been brought to them on repeated occasions.


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## Level1pedstech (Jun 7, 2012)

ffemt8978 said:


> Wow....just, wow.
> 
> No, if every city/town was forced to have paid EMS, they would not have any EMS.  They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model.  Neither of those options would ensure adequate response times or staff availability.
> 
> ...



Thats a great break down and does a great job of showing the hidden costs behind those "15.00 P/Hr EMT's". I dont think many people realize the tremendous battle that  these smaller agencies wage every day trying to provide help when the call comes in. Much of that work both in the field and in the office is done by volunteers,I just dont think people get the big picture.


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## Level1pedstech (Jun 7, 2012)

ffemt8978 said:


> Wow....just, wow.
> 
> No, if every city/town was forced to have paid EMS, they would not have any EMS.  They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model.  Neither of those options would ensure adequate response times or staff availability.
> 
> ...



For many years my all volunteer local department was really luck to have our levys approved by the tax payers. These days people are tax tired and who can blame them. Sadly it hurts the smaller agencies the worst and they are the ones most likely to spend the money the way it was intended.


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## Veneficus (Jun 7, 2012)

ffemt8978 said:


> Neither of those options would ensure adequate response times or staff availability.



I think it would really help all forms of EMS agencies a lot to get away from using response time as a measure of how desirable or effective a system is.

The 8:59 response time was an arbitrary number developed by the firs service because that was the average response times of paid departments around the nation. It was based on a time that would allow the possibility of a save of a structure that was on fire and reported early. 

Building construction played a major role in that.

If we think about applying that time to EMS, which many places list as desirable, just from a logical point of view it is not realistic or beneficial.

Consider a major urban city with high call volume. How many rigs would you need on the road at any given time to maintain that?

What percentage of your call volume would actually benefit?

How much would it cost?

Apply that same logic to suburban and rural environments. It rapidly becomes cost prohibitive. So you are actually harming your agency by using that standard.

From a medical point of view, would 9 minutes, not including call to dispatch and chute time make a difference in cardiac arrest? an airway obstruction? Class III hemorrhage?

What about the time from initial call to actual intervention on the patient? 10 minutes? 12 minutes? 15 minutes?

Now look at more time dependant reasonably treatable conditions where EMS may effect some level of treatment. MI, Stroke, class II hemorrhage. 15 minutes, 20 minutes, even 30 may not be unrealistic. Possibly more in the case of ischemic stroke, which is 90% of them.

Non acute may wait indefinately. 

Now seperate the issue of response vs. transport. 

If you put a medic in a KIA (or other cheap car) You need only 1 staffer, not 2. You don't need a $90K+ transport ambulance.

At which point time extending intervention would be available much cheaper. With trasport capability available if/when needed. It may also make it reasonably possible to drive this person nonemergent. 

While some may argue there woul be no reimbursement in place already for that, and certainly that is true, how much are you collecting compared to call volume now?

At what point would you actually save money not responding a transport unit to every call every 9 minutes?


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## Veneficus (Jun 7, 2012)

Level1pedstech said:


> For many years my all volunteer local department was really luck to have our levys approved by the tax payers. These days people are tax tired and who can blame them. Sadly it hurts the smaller agencies the worst and they are the ones most likely to spend the money the way it was intended.



I have no sympathy for a population that pays on average 20% less in taxes than every other modern nation and then complains it has no money to fund services like fire, police, and EMS.

That is not even counting people who after deduction and refund pay no or almost no tax at all.


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## Level1pedstech (Jun 7, 2012)

Veneficus said:


> I have no sympathy for a population that pays on average 20% less in taxes than every other modern nation and then complains it has no money to fund services like fire, police, and EMS.
> 
> That is not even counting people who after deduction and refund pay no or almost no tax at all.



As a person who when its all added up sees right about 40% of my income go to taxes of some sort I get you point.


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## jemt (Jun 7, 2012)

ffemt8978 said:


> Wow....just, wow.
> 
> No, if every city/town was forced to have paid EMS, they would not have any EMS.  They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model.  Neither of those options would ensure adequate response times or staff availability.
> 
> ...




I apologize I should have clarified my point. I wasn't insinuating  that every city/town should have their own EMS system, I just making the point that if every city/town had paid EMS (be it municipal,third party, private entity etc etc.) pay and advancement would go up for EMS providers.

Many communities are already serviced by third party providers who offer zero dollar contracts to cities/towns in exchange to be able to bill their residences for services rendered. 

As long as vollie services are around, pay and advancement in EMS will continue to grow at the turtle pace it is now.


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## rescue1 (Jun 7, 2012)

ffemt8978 said:


> Wow....just, wow.
> 
> No, if every city/town was forced to have paid EMS, they would not have any EMS.  They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model.  Neither of those options would ensure adequate response times or staff availability.



This isn't always true. I know for a fact a municipality I vollyed for could have affored 24/7 BLS transport coverage (ALS chase was separate). This would have cut about five minutes from response times, dropped the number of ALS runs (which only were ALS because the volunteers could not always be trusted with a patient), and could have been done for probably under $100,000 a year.

But to be fair, there are other areas that could not afford that and could not justify it.


As for taxes, Level1pedstech, the lowest tax brackets in the USA are the poor, and the very wealthy. So while you may see 40% go to taxes, a millionaire who carefully manages manages his wealth and assets can end up paying maybe 10%. And that 30% lost tax revenue is a decent chunk of cash.


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## STXmedic (Jun 7, 2012)

Volly department.


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## Chief Complaint (Jun 7, 2012)

Level1pedstech said:


> *Why not hold the volunteers up to the same standards of training and testing.* Earlier in the thread I used my former department as an example of how combination departments can be successful.
> 
> We also moved staff up from within which saved the city money and time when full time paid spots opened up. The path started at shift volunteer then you would test into the part time pool,all full time positions were filled from the part time pool. Another benefit was that the new full timers had alredy been on the floor for at least a couple of years so the move over to full time did not require an academy or supervised probie time.



In a perfect world, sure.  But it would be impossible to find a group of people, willing to work for free and quit their day jobs, who could go through the academy.

Plus they would have to pay a full time staff (plus overtime) to train them.

Its just impossible.


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## DrParasite (Jun 7, 2012)

jemt said:


> I apologize I should have clarified my point. I wasn't insinuating  that every city/town should have their own EMS system, I just making the point that if every city/town had paid EMS (be it municipal,third party, private entity etc etc.) pay and advancement would go up for EMS providers.


yeah, maybe in dreamland... or if you drink the cool aid that private employers keep using to keep wages low.





jemt said:


> Many communities are already serviced by third party providers who offer zero dollar contracts to cities/towns in exchange to be able to bill their residences for services rendered.


by private companies, who are paying $9 an hour (if they are lucky), where turnover is high, and employers pay their employees crap, because if they leave, they will just replace them with another new grade, who will accept $9 an hour.





jemt said:


> As long as vollie services are around, pay and advancement in EMS will continue to grow at the turtle pace it is now.


That's a lie that spreads around paid EMS circles, usually spread by managers who don't want to pay their staff much money, and then by employees who just parrot what they are told without even thinking it through.  And if you think about it, instead of drinking the koolaid, you will realize it makes 0 sense.

volunteers have 0 to do with paid salaries, except in areas where paid and volunteers work for the same agency (combination agencies or paid and volunteer agencies covering the same primary areas).

I work in a city, making a decent living.  if I were to volunteer 20 miles away, that wouldn't affect my salary at all.  and if my boss tried to tell me that my volunteering would affect my work salary, all I would tell him is "one thing has nothing to do with the other."  Lots of paid firefighters who make a lot of money, and there are still a lot of volunteer firefighter.  

towns already don't want to pay for EMS.  forcing them to create a well funded and well staffed system is expensive, and all too often towns choose to outsource to a :censored::censored::censored::censored:ty private company that will hire newbies at $9 an hour.  and if they complain, they just fire them and replace them with another $9 an hour employee.

low wages will continue as long as people in EMS are willing to accept low wages.


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## Aidey (Jun 7, 2012)

DrParasite said:


> low wages will continue as long as people in EMS are willing to accept low wages.



And there is no wage lower than $0.


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## bigbaldguy (Jun 7, 2012)

There is one direct way that volunteers can effect pay in an agency that has both paid and volly's. Where I work, uncovered shifts are sometimes picked up by volly's. This reduces the number of shifts available for paid folks to pick up for overtime. It doesn't seem to really make a huge difference but it is possible that paid folks are missing out on some overtime because of volly's. 

Other than this there is really is no rationale for trying to say volly's effect the pay of paid employees that really makes much sense. You just don't get volly's who are willing to work the same way paid folks are. Apples and oranges.


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## ffemt8978 (Jun 7, 2012)

Aidey said:


> And there is no wage lower than $0.



And yet some vollies are paid per call or per shift, they just don't make their living at it.


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## Level1pedstech (Jun 7, 2012)

Chief Complaint said:


> In a perfect world, sure.  But it would be impossible to find a group of people, willing to work for free and quit their day jobs, who could go through the academy.
> 
> Plus they would have to pay a full time staff (plus overtime) to train them.
> 
> Its just impossible.



We would hold a volunteer academy once a year for new recruits,classes were tuesday and thursday evenings for four hours and all day on saturdays for four months. After completion of the academy another six months to a year is spent working on task books under the supervision of a captain. During your probie year there is an expectation of 48 hours of shift time and attendance at weekly drills. After a year you complete more written and skills testing then are free to shift department wide and can also participate in part timer testing. Lateral applicants could bypass the academy if they had documentation showing training and education equal to or greater than our academy.

Everyone from the chief on down to the part time staff had a job during the academy either as instructirs or asistants. The goal was to have everyone trained and certified to the level of FF2 with either an EMT-B or IV Tech cert. 

It is possible but there has to be 100% commitment from the whole dpartment to make it a reality. It not something that is implemented over night but I think in the future it may be the way to go for many departments. As far as the quality of volunteers you would notice after a very short time that guys would be coming from all over to jump into such a great oportunity. In fact I guarantee that you would have much better applicants if they new it was a true combination department where all are equal and advancement to paid full timer is only possible from the inside


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## Aidey (Jun 7, 2012)

ffemt8978 said:


> And yet some vollies are paid per call or per shift, they just don't make their living at it.



He still undermined his entire point with that statement. If people willing to accept low wages mean that wages stay low, what affect do volunteers have?


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## bigbaldguy (Jun 7, 2012)

Aidey said:


> He still undermined his entire point with that statement. If people willing to accept low wages mean that wages stay low, what affect do volunteers have?



I would argue that if a volly receives pay even if it's just 5 dollars a call as I've seen some around here do then they aren't technically a volly. That said these pseudo vollys still aren't able to replace a paid employee, they simply won't in most cases be held to the same standards. Still apples and oranges. 

EMS gets paid very little because they don't pull together and demand better, both of their employers, of each other and most importantly of themselves. Do vollys erode wages for EMS, I doubt it but even if they do the damage they do is so minimal in comparison to the damage we do to ourselves that I think it's a non issue. 

If you are reading this then please know you most likely aren't who I'm talking about. The fact that you are on EMTLIFE makes you the type of person who should step up and be part of the solution. The whole point of this site is to facilitate exactly these kinds of conversations so that they can be brought out where we can see them.


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## Aidey (Jun 7, 2012)

I don't think it is apples to oranges in a lot of places. It is pretty terifying to hear a dead serious debate about downgrading a career department to a mixed paid/volly department, because after all, if people are willing to do it for free, WTF are we paying them for? One of the city council members who supported the idea subsequently was elected mayor.


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## firemedic0227 (Jun 7, 2012)

I am a new Firefighter EMT-B on a Part-time (I work 14 12 hour shifts during a 28 day period) which I might add, adds up to a regular full time job. This was my first job as an EMT or a firefighter even though I am a military Firefighter as well. I know many VERY good EMT-B and EMT-P that are also on this department that started out as a Volunteer for this same now part-time fire department. I would trust any one of these people with a family member of mine or even my life. A lot of other EMT-B and EMT-P volunteer in their home areas as well. I also want to add that I have also went through Paramedic School and I have learned more in the short time I have been on this Part-time department than I ever knew even through medic school. Just because you train a lot doesn't mean you are good at things out in the field.

I have a great appreciation for volunteers as my dad was one in the small town I grew up in for many many years. My grandpa is a retired fire chief for that same volunteer department, some EMT's are pointless and do it for the lights and sirens but many very good EMT's do great things even with small call volumes. It just depends on how well you translate your training to the field! So I guess what I am trying to get at is that I am impartial to either way like many of you here on this thread.


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## Level1pedstech (Jun 7, 2012)

Aidey said:


> I don't think it is apples to oranges in a lot of places. It is pretty terifying to hear a dead serious debate about downgrading a career department to a mixed paid/volly department, because after all, if people are willing to do it for free, WTF are we paying them for? One of the city council !members who supported the idea subsequently was elected mayor.



I dont think anyone is talking about downgrading anything. Its clear that many departments could benefit from a true combination department. Pooling the resources available to help move a department forward is what Im talking about.

 You seem hung up on the money issue,you know for some of us it has never been about the money. Even if I had been offered a full time position I would have not been able to take it,the 50% percent cut in pay to start would have been a killer.


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## Aidey (Jun 8, 2012)

I'm not hung up on the money. I commented on a statement someone made at the end of a lengthy post claiming that volly services have no impact on wages, which I think is false. The example I gave is a true story of how the public advocated for downgrading the department to a mixed department because they didn't want to pay wages for the evil union firemen. People argued that if the smaller outlying departments operated with volunteers then the city department could too. Given the current economic climate that city can not be the only one discussing downgrading their department.


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## DrParasite (Jun 8, 2012)

Aidey said:


> He still undermined his entire point with that statement. If people willing to accept low wages mean that wages stay low, what affect do volunteers have?


No, I didn't, and you missed the entire point of the statement.

Let me try again: You work in town A.  I volunteer in town A.  Me being a volunteer will help keep your wage low, because they can replace you with me for less money (this was the only example where that argument holds some validity) 

You work in town A.  I volunteer in town B.  we cover different towns, and do NOT interact at all, except on the very rare MCI.  me being a volunteer has no impact on your salary.  Its not even apples and oranges, it's apples and water buffalo.

and the statement that has you confused: You work in town A, been there for 5 years, and make $20 an hour.  I just got out of school, and am looking for a job, and your boss (in town A) offers me a job paying $10 an hour to do the exact same job you are doing, which I gladly accept.  So why should your boss (town A) pay you $20, when I can do the same job you are doing for half the price?  I am going to still volunteer in town B, where I live, 20 miles away, but my volunteering has no impact on my accepting a paid job in town A for $10 an hour.


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## Tigger (Jun 8, 2012)

DrParasite said:


> You work in town A.  I volunteer in town B.  we cover different towns, and do NOT interact at all, except on the very rare MCI.  me being a volunteer has no impact on your salary.  Its not even apples and oranges, it's apples and water buffalo.



Now let's suppose that town A and B are fairly similar in terms of demographics, size, and call volume. Town A's government is facing a shortfall, and notices that Town B provides EMS service through a volunteer service while Town A pays to have two EMTs in the station 24/7. Both towns are delivering the same service yet Town B doesn't have to pay much in the way of compensation to its EMS providers. Seeing this, Town A lays off its paid EMS employees and starts a volunteer service. Service delivery remains the same, and the town's budget is closer to being balanced. The only downside are the now unemployed EMS staff.

So yes, volunteers aren't keeping salaries low, they could just be a risk to the very existence of one's salary. But that's fine right?

I don't know if this has happened yet anywhere, I can't hope to perfectly informed on the dealings of every town in the nation. But I do know that more than a few city governments have called for paid fire and EMS departments to build a volunteer contingent so as to weather drastic cutbacks. Some especially aggressive mayors have called for entire paid fire departments to be disbanded and replaced by volunteers or POC staff. Given the shape of the economy, this is to be expected, and there are many, many services that staff a single truck in an area surrounded by volunteers that are at risk of being axed. 



> and the statement that has you confused: You work in town A, been there for 5 years, and make $20 an hour.  I just got out of school, and am looking for a job, and your boss (in town A) offers me a job paying $10 an hour to do the exact same job you are doing, which I gladly accept.  So why should your boss (town A) pay you $20, when I can do the same job you are doing for half the price?  I am going to still volunteer in town B, where I live, 20 miles away, but my volunteering has no impact on my accepting a paid job in town A for $10 an hour.



I don't get this argument at all. A company or government pays its longer tenured staff more so as to retain them. It's a lot cheaper to give someone a raise or pay OT than it is to hire someone brand new and train them, even if they are starting at a lower wage. This is a basic tenet of running any sort of organization, and its prevalent everywhere, and I don't see it relates at all.


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## DrParasite (Jun 8, 2012)

Tigger said:


> Service delivery remains the same, and the town's budget is closer to being balanced.


key phrase being Service delivery remains the same.  If the same job is done for less money, it's better for the tax payer.  But the reality is that it never happens that way.  I don't want anyone to lose their jobs, but the laws of business say if your job isn't needed (for whatever reason, replaced with machines, consolidated with another department or town, or it's just obsolete), than it's going to go away.  


Tigger said:


> So yes, volunteers aren't keeping salaries low, they could just be a risk to the very existence of one's salary. But that's fine right?


or the town can eliminate their jobs and bring in a private service.  or a cheaper private service.  or the FD/PD could start up their own service.  so will you be anti FD/PD/private agencies?  after all, they can "be a risk to the very existence of one's salary."  Its still not volunteers who are the enemy, it's the belief that the job can be done cheaper by someone else.  


Tigger said:


> I don't know if this has happened yet anywhere, I can't hope to perfectly informed on the dealings of every town in the nation.


Show me 1, just one, fully staffed EMS department, that went from 100% career staffing to 100% volunteer staffing, and maintained the sae levle of service, and I will buy your argument.  

The reality is, they don't.  Volunteer departments go from 100% volunteer to combination, to 100% paid.  They might even go from 100% paid to 100% paid with some volunteers supplementing, but rarely will a department lay off career staff and hope to replace them with volunteers.  Not saying it never has happened, but it's very rare.   More often than not it's a threat, much harder to actually implement it.


Tigger said:


> I don't get this argument at all. A company or government pays its longer tenured staff more so as to retain them. It's a lot cheaper to give someone a raise or pay OT than it is to hire someone brand new and train them, even if they are starting at a lower wage. This is a basic tenet of running any sort of organization, and its prevalent everywhere, and I don't see it relates at all.


it happens all the time, especially in the private EMS agency.  Employees are seen as expendable, and easily replaceable, and treated as such.


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## Tigger (Jun 8, 2012)

DrParasite said:


> key phrase being Service delivery remains the same.  If the same job is done for less money, it's better for the tax payer.
> But the reality is that it never happens that way.  I don't want anyone to lose their jobs, but the laws of business say if your job isn't needed (for whatever reason, replaced with machines, consolidated with another department or town, or it's just obsolete), than it's going to go away.


If the argument is purely about doing the citizen's right, then you're correct. I might also add though that many governments have no idea what successful EMS looks like. Town A might have been getting an ambulance to every call in less than five minutes while Town B took 12 but Town's A government did not bother to look deeper at the issue so they are misguided in thinking that service delivery remains unchanged.



> or the town can eliminate their jobs and bring in a private service.  or a cheaper private service.  or the FD/PD could start up their own service.  so will you be anti FD/PD/private agencies?  after all, they can "be a risk to the very existence of one's salary." Its still not volunteers who are the enemy, it's the belief that the job can be done cheaper by someone else.



Yes, I would consider my self to be anti "taking over agencies just to save the town or city a buck." I guess I'm just no fan of any service that comes in looking to take jobs, but that's an emotional not economic argument. Maybe I'm just a softy, but if a private company approached the city you dispatch for and said they'd provide the same service for half the price with their own employees, you'd also be pissed, right?



> Show me 1, just one, fully staffed EMS department, that went from 100% career staffing to 100% volunteer staffing, and maintained the sae levle of service, and I will buy your argument.
> 
> The reality is, they don't.  Volunteer departments go from 100% volunteer to combination, to 100% paid.  They might even go from 100% paid to 100% paid with some volunteers supplementing, but rarely will a department lay off career staff and hope to replace them with volunteers.  Not saying it never has happened, but it's very rare.   More often than not it's a threat, much harder to actually implement it.



I can't yet. My point is more that while it's only been threatened at this point, if the economy stays the way it is it may be only a matter of time before some government gets aggressive an actually does replace a properly staffed paid service with a combo or volunteer service. Only time will tell.


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## DrParasite (Jun 8, 2012)

Tigger said:


> Yes, I would consider my self to be anti "taking over agencies just to save the town or city a buck." I guess I'm just no fan of any service that comes in looking to take jobs, but that's an emotional not economic argument. Maybe I'm just a softy, but if a private company approached the city you dispatch for and said they'd provide the same service for half the price with their own employees, you'd also be pissed, right?


Cencom Dispatch center closes, services moved to MONOC and CENCOM's parent company's press release and MONOC gets contract for Hudson county EMS 911 calls and JCEMS's response.  It can (and does happen) all too often, even with dispatch centers.  All comes down to the lowest bidder, and yes, people were laid off in the CENCOM deal, and JC lost dispatchers (but I think they weren't laid off, just relocated to other divisions).  and in my person opinion, services have absolutely suffered, but the contract does go by lowest bidder.  But no volunteers took those jobs, just a private company that pays it's people poorly and has a history of zero-bidding the competition, and then failing to follow through on what they promised or biting off more than they can chew (and paying their staff less than the going rate, but they are a monopoly in 2 counties).

but if MONOC's employees wouldn't accept such a low wage, MONOC would have to pay more.  like I said, as long as people accept low wages, this will continue to happen.  and it still has nothing to do with volunteers affecting wages.


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## Tigger (Jun 8, 2012)

DrParasite said:


> Cencom Dispatch center closes, services moved to MONOC and CENCOM's parent company's press release and MONOC gets contract for Hudson county EMS 911 calls and JCEMS's response.  It can (and does happen) all too often, even with dispatch centers.  All comes down to the lowest bidder, and yes, people were laid off in the CENCOM deal, and JC lost dispatchers (but I think they weren't laid off, just relocated to other divisions).  and in my person opinion, services have absolutely suffered, but the contract does go by lowest bidder.  But no volunteers took those jobs, just a private company that pays it's people poorly and has a history of zero-bidding the competition, and then failing to follow through on what they promised or biting off more than they can chew (and paying their staff less than the going rate, but they are a monopoly in 2 counties).
> 
> but if MONOC's employees wouldn't accept such a low wage, MONOC would have to pay more.  like I said, as long as people accept low wages, this will continue to happen.  and it still has nothing to do with volunteers affecting wages.



You asked me if I was anti FD/PD/private agencies, so I responded with that example. I think you're missing my point here though.

I'm not saying that volunteers presently pose a threat to paid EMS providers jobs. All I am saying is that many governments have threatened to lay off staff and use volunteer or POC staff instead. If the economy continues to suffer and municipalities cannot balance their budgets, it is not far-fetched to think that some hard-line mayor will actually follow through with such threats. As with the example you posted, governments are looking to cut costs, and they'll privatize public services if it costs can be brought down. Costs go way down when you don't have to pay wages so if a government can get EMS service for even cheaper by using volunteers, what's to say they won't? That will lead to layoffs and regardless if its better for the taxpayer I have hard time supporting laying off employees during a recession.

Perhaps this will only remain the talk of zealot mayors, I certainly hope so. However I could easily see it being used as pressure for paid staff to take pay cuts, "take the cuts or we'll lay you off and replace you with volunteers." I can't imagine many people want to call the city's bluff with their job on the line.


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## starbucks4511 (Jun 8, 2012)

I really don't think volunteer=inexpierence. Where I live we have quite a few volunteer companies, mine being one of them and we are the biggest and best for a big area! We also have paid positions, though many people do volunteer. So it really depends on your location, we have many volunteers that are very smart, expierenced, and know a lot for being volunteer. So in my area volunteer fire comapnies are common. We answer about an average of 500-700 calls a month, EMS alone.


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## rescue1 (Jun 8, 2012)

starbucks4511 said:


> I really don't think volunteer=inexpierence. Where I live we have quite a few volunteer companies, mine being one of them and we are the biggest and best for a big area! We also have paid positions, though many people do volunteer. So it really depends on your location, we have many volunteers that are very smart, expierenced, and know a lot for being volunteer. So in my area volunteer fire comapnies are common. We answer about an average of 500-700 calls a month, EMS alone.



Where in PA are you? Are you in the Philly area, by any chance?


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## starbucks4511 (Jun 8, 2012)

I live in Williamsport, i dont think thats very close to philly. Lol


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## rescue1 (Jun 8, 2012)

Yeah, not so much...


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## Level1pedstech (Jun 8, 2012)

Aidey said:


> I'm not hung up on the money. I commented on a statement someone made at the end of a lengthy post claiming that volly services have no impact on wages, which I think is false. The example I gave is a true story of how the public advocated for downgrading the department to a mixed department because they didn't want to pay wages for the evil union firemen. People argued that if the smaller outlying departments operated with volunteers then the city department could too. Given the current economic climate that city can not be the only one discussing downgrading their department.



As a seventeen year union member I can tell you that the IAFF as well as many other unions are under tremendous pressure. We have all been asked to give a little,some a little more than others. The "evil union firemen" as well as the evil union teachers and the evil union truckdrivers will in the future be giving bigger and bigger concessions. Does the devasting loss for the unions in Wisconsin (twice) ring a bell,it should because its going to spread like wildfire. The storm clouds are gathering and there are very dark days to come for all union members but this not the union/non union forum so lets not any further.

As far as downgrading to a combination department I pointed out that no one on this site mentioned downgrading anything. You have first hand knowledge of a department that has downgraded thats great but no one here has mentioned it until now.

My contribution to the discussion was to show how it is possible to have a department that has paid staff and volunteer staff working together. This is not some idea Im floating out for approval from the "we need to change the system" folks. My former department has been useing this model for well over a decade and it has been well recieved by everyone including the IAFF. 

This is not the type of department where volunteers come out and hand out water at the rehab trailer then roll hose or do salvage after a large structure response. Then back at the station they head for the recliners until its time to go home. My example is a department where all staff is held to the same standards in all areas of the job. 

Now there is a case to be made that in the future there could be a place for this type of department. If it meant because of budget constraints that anytown USA 
might in a worst case scenario have to deep cut and eliminate 50% of its paid staff. Would it not be better to supplement with part time,reserve or volunteer staff? My thoughts are that the union would be faced with two big poblems to solve. Are the remaining staff expected to pick up the slack left by the cuts and is it safe to expect crews to provide service at pre cut levels with half the staff. It might take time but I bet the union would get on board,they may have no choice. 

The bigger problem is would it be possible to find volunteers that are qualified and physically able to step up and get the job done.


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## Veneficus (Jun 8, 2012)

Level1pedstech said:


> As a seventeen year union member I can tell you that the IAFF as well as many other unions are under tremendous pressure. We have all been asked to give a little,some a little more than others. The "evil union firemen" as well as the evil union teachers and the evil union truckdrivers will in the future be giving bigger and bigger concessions. Does the devasting loss for the unions in Wisconsin (twice) ring a bell,it should because its going to spread like wildfire. The storm clouds are gathering and there are very dark days to come for all union members but this not the union/non union forum so lets not any further..



I would like to point out that I think this is an accurate statement that will directly affect every EMS provider in the country and while there is controversy between pro-union and anti-union opinion, this is an important topic for discussion because no matter what your position, if you continue to work in EMS, the outcome of these elections and public perceptions and opinions will directly affect your future. 

If you recall after  Sept 11th, Fire, Police, and EMS were elevated in status. Those of us who were around prior remember being "a required drain on public resources" that politicians would rather not spend money on for any number of reasons. 

Providers of today and the very near future are going to see the exact same opinions and positions that we dealt with so long ago. For the post 9/11 providers, it will be a far cry from the status they are used to.

Hero or villian is really a matter of dates.



Level1pedstech said:


> As far as downgrading to a combination department I pointed out that no one on this site mentioned downgrading anything. You have first hand knowledge of a department that has downgraded thats great but no one here has mentioned it until now..



Last year, A councilman in Columbus, Ohio put forth a position that the fire department, in order to save money, should downgrade from ALS to BLS. His position was supported by studies done showing no benefit from ALS in short transport times and data showing no improvements in ALS patients. 

While not downgrading from paid to volunteer, I think this issue will be faught again in the very near future.


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## Tigger (Jun 8, 2012)

starbucks4511 said:


> I really don't think volunteer=inexpierence. Where I live we have quite a few volunteer companies, mine being one of them and we are the biggest and best for a big area! We also have paid positions, though many people do volunteer. So it really depends on your location, we have many volunteers that are very smart, expierenced, and know a lot for being volunteer. So in my area volunteer fire comapnies are common. We answer about an average of 500-700 calls a month, EMS alone.



Ya'll run over 16 EMS calls per DAY as a volunteer organization? How many stations is that out of, that works out to be 6,000 calls a year, which is about what the busiest engine companies in the country's bigger cities run total between fire and EMS runs.


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## DrParasite (Jun 8, 2012)

Tigger said:


> Perhaps this will only remain the talk of zealot mayors, I certainly hope so. However I could easily see it being used as pressure for paid staff to take pay cuts, "take the cuts or we'll lay you off and replace you with volunteers." I can't imagine many people want to call the city's bluff with their job on the line.


again, show me 1 city that did that.  just one.  I'll even settle for one that tried it, found it didn't work, and switched back.  but we both know you will never find one.  

it's a threat, it's a bad threat, but still that, just a threat.  No mayor in the world would actually do that.  In fact, if a union had any balls, they would say "do it.  and while you are recruiting, formal educating, background screening, internal educating, how many of your tax payers will due because now we don't have the resources to do the job right??"  You'd be surprised how quickly that idea goes out the window, especially when you spin it like that to the papers.

it's much more likely the current system will be outsource to a private agency, which already has the formal structure, education, and infrastructure in place, than laying off existing staff and replacing them with volunteers.

oh and Veneficus, are there any studies that would support that a 100% volunteer system is better than a 100% paid?  Easy to make an argument when you have some scientific backing behind you, much harder when it goes against current practices.


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## Tigger (Jun 8, 2012)

DrParasite said:


> again, show me 1 city that did that.  just one.  I'll even settle for one that tried it, found it didn't work, and switched back.  but we both know you will never find one.
> 
> it's a threat, it's a bad threat, but still that, just a threat.  No mayor in the world would actually do that.



Yes, it is just a threat. I don't know how many times I am going to have to write that. 

As I have said in all of my posts, *if the economy continues to remain in a recession, how long will it it be before a city government goes and cuts its EMS staff from paid to volunteer?* Heck, it doesn't even have to be all the staff, but if you're staffing three ambulances and then suddenly the city decides to staff two with volunteers and have one paid, people are going to lose their jobs. When a city is looking at shortfall bigger than its budget, drastic changes come.

A few cities in the Midwest have disbanded their entire fire departments (Allen Park and Pontiac Michigan since I know you'll ask) and entered into protection agreements with neighboring towns. A few mayors have called for similar tactics but _want to use volunteers _rather than mutual aid however I cannot find the town's name (possibly in Illinois) but I'd rather be more productive than wading through pages of firehouse.com crap to find the article.

For the last time, no city has replaced paid staff with volunteers, *yet*. I'm looking at _future_ implications of a poor economic climate here.



> In fact, if a union had any balls, they would say "do it.  and while you are recruiting, formal educating, background screening, internal educating, how many of your tax payers will due because now we don't have the resources to do the job right??"  You'd be surprised how quickly that idea goes out the window, especially when you spin it like that to the papers.


I'd be interested to read some of these articles, as usually its the public servants that get slammed at the expense of the government.


> it's much more likely the current system will be outsource to a private agency, which already has the formal structure, education, and infrastructure in place, than laying off existing staff and replacing them with volunteers.



Certainly this is the more likely course of action, especially since it happens already. I just wonder if a government will realize that they can get services even cheaper through volunteer and POC staffing arrangements than through private companies. I look at Maryland and Virgina that have hugely active volunteer fire and EMS service that is able to cover call volumes higher than many paid cities with seemingly little difficulty and fairly minimal paid staffing augmentation when compared to the massive volunteer core. If volunteers can meet the demand there, why can't they be used in other areas, or so a seriously cash-strapped city or county *may one day think*.

EDIT: Carbondale VA's last mayor called for disbanding the FD and replacing them with volunteers, http://www.thecarbondalenews.com/news/x1120191111/Mayor-stands-for-paid-fire-dept-in-defending-fee


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## Aidey (Jun 8, 2012)

Level1pedstech said:


> As far as downgrading to a combination department I pointed out that no one on this site mentioned downgrading anything. You have first hand knowledge of a department that has downgraded thats great but no one here has mentioned it until now.



Someone posted "low wages will continue as long as people in EMS are willing to accept low wages." To which I replied that there is no wage lower than $0, meaning that volunteers also impact wages. When someone is willing to do a job for no or very little pay that makes it easier for other people to argue that high wages or any wages are unneeded. To back up my point, I gave an example of a case were people seriously argued that their city department should be downgraded. 

A city going from a full career department to a mixed department, at a time that their run volume is increasing, is not a good idea. If the run volume/population was decreasing it could make sense. I am not against mixed departments. I think they can be an economical middle ground for some areas. I mentioned back on the first page that the best volunteers here are the ones at the mixed departments.

From the online debate over a SAFER grant. 


> Can we realy affort $100,000 a year rookie firemen? Why has the fire  department got total control over ambulance service? Some body is  getting black mailed here. Private ambulance services are all over the  country why not in Gotham? Just how much would we save if the fire  department was no longer in the ambulance business? There are also  cities much larger than Gotham that get along fine with Volunteer  fire departments, but I guess nothing is too good for the tax payers of Gotham


City population is ~35,000. Run volume of ~5000 a year, with 9 people per shift. 4 of those on the 2 ambs.


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## rescue1 (Jun 8, 2012)

Cities larger then 35,000 with an all volunteer fire department? I'd bet there are no more then a handful of those throughout the whole US. 

Besides, mayors or councilmen always call for downgrading to a volunteer fire department, because they have no idea how a volunteer vs career department works. Have there actually been cases of radical downgrades from paid to combo or to fully volunteer? I can't think of any that did anything that drastic.


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## DrParasite (Jun 8, 2012)

Tigger said:


> Yes, it is just a threat. I don't know how many times I am going to have to write that.


Heck, it doesn't even have to be all the staff, but if you're staffing three ambulances and then suddenly the city decides to staff two with volunteers and have one paid, people are going to lose their jobs. When a city is looking at shortfall bigger than its budget, drastic changes come.[/quote]omg, the sky is falling, the sky is falling!!!! lets keep worrying about something that won't happen.  We can worry about the sky falling all day, I'd rather worry about situations where the sky has fallen on many agencies (where they were gov't based and were outsources and/or replace with non-government agency).

But I will say, if they have enough volunteers to eliminate 2 paid crews 24/7, while maintaining the same level of service, that is impressive.  


Tigger said:


> A few cities in the Midwest have disbanded their entire fire departments (Allen Park and Pontiac Michigan since I know you'll ask) and entered into protection agreements with neighboring towns.


yep, eliminating your home department and contracting with your neighbor would be just as bad.  still not volunteers who are taking the paid guys jobs.


Tigger said:


> Certainly this is the more likely course of action, especially since it happens already. I just wonder if a government will realize that they can get services even cheaper through volunteer and POC staffing arrangements than through private companies. I look at Maryland and Virgina that have hugely active volunteer fire and EMS service that is able to cover call volumes higher than many paid cities with seemingly little difficulty and fairly minimal paid staffing augmentation when compared to the massive volunteer core. If volunteers can meet the demand there, why can't they be used in other areas, or so a seriously cash-strapped city or county *may one day think*.


all of those departments are combination departments, who used to be 100% volunteer, and when staffing levels dropped, they started putting paid staff on.  With very few exemptions, once you put paid staff on, you don't take them off.  and if you do, well, that's the risks of working for a combination department.


Tigger said:


> EDIT: Carbondale VA's last mayor called for disbanding the FD and replacing them with volunteers, http://www.thecarbondalenews.com/news/x1120191111/Mayor-stands-for-paid-fire-dept-in-defending-fee


that's a combination department (which I mentioned earlier), and it's the former mayor who wants to do it, not the current one.  If it goes through, it's not a good thing, but its one of the risks of working in a combination department.

disclaimer: I used to work for a combination department, where I knew having many volunteers could affect how many shifts I got.  I would not object to volunteering again in the future, but I would never be a volunteer in a combination department ever again, because I would never want to take money out of a coworkers pocket.


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## Tigger (Jun 8, 2012)

DrParasite said:


> Heck, it doesn't even have to be all the staff, but if you're staffing three ambulances and then suddenly the city decides to staff two with volunteers and have one paid, people are going to lose their jobs. When a city is looking at shortfall bigger than its budget, drastic changes come.
> 
> omg, the sky is falling, the sky is falling!!!! lets keep worrying about something that won't happen.  We can worry about the sky falling all day, I'd rather worry about situations where the sky has fallen on many agencies (where they were gov't based and were outsources and/or replace with non-government agency).
> 
> ...



There is no point in even having this argument if you cannot look towards the future. What's the point of having this discussion if your response is going to be "that will never happen?" I don't think anyone thought that entire paid fire departments would be disbanded, but that happened and I doubt any members were well prepared for that action. The fact of the matter is that none of us have any idea what city governments will do if they are faced with a massive shortfall. To not discuss what it is logically possible is just setting us up to be behind the eight-ball if that day ever comes. 

Also, a fully paid department becoming combination is not good for the paid employees. Lay offs are likely, and OT availability is like to decrease. How is that good for the employees? My position here is to save the jobs that already exist, there is no way a municipality does not lay off staff when transitioning to a combo department as where would the savings come from? And yes, the article I posted does have the old mayor calling for it, my point was that these threats have been made before.


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## zmedic (Jun 8, 2012)

I feel like the vast majority of places in the US volly v paid doesn't really matter because either the area is super busy and needs 24 hour in house coverage, or it's rural and they run 50 calls a year and there is no way to get enough money to be paid. I think it's a small (10%? 5%?) of total EMS calls that are run by places that are in that in between zone where it be covered by paid or volly. 

The reason why it's so hard to go from paid to volunteer, even if it's only a few ambulances, is that it takes a huge number of volunteers to cover once ambulance if they are going to be in house, 24 hours a day. Say you have a paid ambulance, 24 hour shifts. People work probably 10-12 shifts a month. So you need 2 EMTs per shift, so 6 per month. Now if you want that covered by volunteers, in house how many do you need? 

I'd say most vollys aren't going to do more than 5 or 6 twenty four hour shifts a month (assuming they are working etc). So now to cover that one ambulance you need 12 people. I'd say with people's different schedules you probably need 20-30 to really ensure you had enough. 2 ambulances, 40-60 people. 

There numbers are off the top of my head, but it is very hard for a department that has a few paid EMTs to say "we're going to go out and recruit and train 40 people." It's much easier to go from having 40 volunteers and say "we are looking for 6 people to go full time."


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## zmedic (Jun 8, 2012)

Tigger; said:
			
		

> Also, a fully paid department becoming combination is not good for the paid employees. Lay offs are likely, and OT availability is like to decrease. How is that good for the employees? My position here is to save the jobs that already exist, there is no way a municipality does not lay off staff when transitioning to a combo department as where would the savings come from? And yes, the article I posted does have the old mayor calling for it, my point was that these threats have been made before.



You could argue that having some volunteers actually protects some of the paid jobs, because you make having a department more affordible. If the city says "we can only pay for 3 full time people," you can't have a department so then it ends up being either all volunteer or it shuts down. But if those 3 paid people are augmented with vollys they you can keep it going. 

As long as the education requirement for EMT is kept low, salaries will stay low. If I was a city I'd say "why should I pay $60,000 a year to someone with 4 weeks of training." And people would demand more money if they said "I spent 3 years in school, you have to pay me for that or I won't work for you." So I don't think it's having volunteers that keeps salaries low.


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## DrParasite (Jun 8, 2012)

Tigger said:


> I don't think anyone thought that entire paid fire departments would be disbanded, but that happened and I doubt any members were well prepared for that action.


actually, it happens more often than you think.  the Pontiac Michigan example was a good one.  but lets give more information: Pontiac was closed, and was merged with the neighboring department.   The FFs were even offered jobs with the new department.  So it's not like they just closed the door and said get out, nor did they replace any paid staffing with volunteers.  and Allen Park FD was eliminated; but the normal staffing was 6, 2 of whom were on the ambulance.  2 guys on a ladder and 2 on a rescue (or maybe they have 4 on the engine, idk).  maybe the elimination of the small department allowed a more efficient operation?

Consolidating the little kingdoms is often a good idea.  that's what happened in maryland, all the small volunteer FDs were absorbed by the counties; they ceased to exist, and replaced with the county wide department.

but in both cases, no volunteers were used to replace any paid staff, so we are back to comparing apples to pineapple, and your argument, while logical, actually doesn't apply to the situation at hand.





Tigger said:


> To not discuss what it is logically possible is just setting us up to be behind the eight-ball if that day ever comes.


I'm all for planning for the future, but I would rather worry about what is realistically likely going to happens, instead of scenarios that will never happen based on past precedence.  Lets worry about history repeating itself, not a one in a million never before happened situation.


Tigger said:


> Also, a fully paid department becoming combination is not good for the paid employees. Lay offs are likely, and OT availability is like to decrease. How is that good for the employees? My position here is to save the jobs that already exist, there is no way a municipality does not lay off staff when transitioning to a combo department as where would the savings come from? And yes, the article I posted does have the old mayor calling for it, my point was that these threats have been made before.


I agree with you on your general idea.  What I don't agree with is your conclusion that layoffs will occur.... usually it's just open positions remain unfilled, because they are expected to be filled by volunteers.

as zmedic said, it's not 1 paid positions is replaced by 1 volunteer.  it's usually 6 or 8 volunteers to cover 1 paid position, and that gets expensive.


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## crashh (Jun 9, 2012)

ok i kinda lost track of this a few posts ago,,,,


BUT


what about areas where there is NO paid positions available?  our company runs completely on volleys.  if we don't respond, our locals don't get any help at all.  

this has all been a convo as if there was a choice.  we have no choice.  if we don't volly, ppl die.


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## crashh (Jun 9, 2012)

just sayin...


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## Veneficus (Jun 9, 2012)

zmedic said:


> I feel like the vast majority of places in the US volly v paid doesn't really matter because either the area is super busy and needs 24 hour in house coverage, or it's rural and they run 50 calls a year and there is no way to get enough money to be paid. I think it's a small (10%? 5%?) of total EMS calls that are run by places that are in that in between zone where it be covered by paid or volly.
> 
> The reason why it's so hard to go from paid to volunteer, even if it's only a few ambulances, is that it takes a huge number of volunteers to cover once ambulance if they are going to be in house, 24 hours a day. Say you have a paid ambulance, 24 hour shifts. People work probably 10-12 shifts a month. So you need 2 EMTs per shift, so 6 per month. Now if you want that covered by volunteers, in house how many do you need?
> 
> ...



That is very interesting.

I wonder what the costs of initial and ongoing training would be. Especially the time investment of instructors and presenters. 

At what point would it actually be cheaper to have a paid department?


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## Tigger (Jun 9, 2012)

crashh said:


> ok i kinda lost track of this a few posts ago,,,,
> 
> 
> BUT
> ...



No, people go back to the days before EMS and take one another to the hospital, just like a BLS ambulance does most of the time. It's not an attack on you or where you wotk, I do the same thing. But unless that AED, tourniquet, or EpiPen is arriving real quick, and it often is not in volunteer systems without the staff out of station, no survival rates are being increased. You get what you pay for, right?


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## crashh (Jun 14, 2012)

i hear ya.  sometimes I am amazed that the reasons people call the ambulance :glare:

On the other hand, our ambulance service is free to the public!


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## fortsmithman (Jun 14, 2012)

TatuICU said:


> Yeah, that has been an issue here as well.  Leave the lights at home and obey traffic laws if in your POV.





Achilles said:


> And delay response time even more. Without stating that responding priority one causes more accidents. Please explain your logic on what you've just said.





PoeticInjustice said:


> There are quite a few volly systems around here. One of these is very good. They train heavily, are very professional, and good at what they do. I live rolling up and seeing these guys on scene.





TatuICU said:


> Im also curious as to what percentage of calls you think benefit from a code 3 response in general




My volly service used to issue red light for our POVs but took them back.  When we respond to the ambulance station in our POVs when we get toned out we are not authorized to violate any traffic laws.  My volly service we train on a regular basis.   As for how often we go priority 1 lights and sirens on the way to the scene we do but when we get there its not a life threatening call so we take the pt without lights and sirens.  In the 4 and a half years I've been on we have only taken the pt to hospital priority 1 maybe 20 times and our service has a call volume of roughly 250 calls per year.  That works out to a little over 1000 calls. in the 4 and a half years.  Most of our members do have our own jump bags.  Although mine sits at my home in the hall closet (I only bought it because another member was selling them and it was well stocked no drugs or O2 just dressings, bandaids, OPAs, BP cuff, and stethoscope). 


When I joined we were a part of the Community Comstable's ofice (equal to a town marshal) we were issued emergency lights because we were under that office.  Then we were moved to the department of public works we were tol by the director of public works not to use them.  We have since became indeppendant and now report directly to town council.


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## TransportJockey (Jun 15, 2012)

crashh said:


> ok i kinda lost track of this a few posts ago,,,,
> 
> 
> BUT
> ...



And when the vollies don't respond, and enough people die, maybe your system will consider becoming a real, professional, paid system.


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## rescue1 (Jun 15, 2012)

crashh said:


> what about areas where there is NO paid positions available?  our company runs completely on volleys.  if we don't respond, our locals don't get any help at all.
> 
> this has all been a convo as if there was a choice.  we have no choice.  if we don't volly, ppl die.



There's always a choice...a volunteer system simply means the community chooses not to pay the extra money for a paid EMS system. Yes, there are areas in the US that are too poor and have too few calls to have a paid ambulance, but my guess is that if push came to shove, most areas in the US could scrounge up the cash (and taxes) to pay for professional EMS. 

The fact remains, however, that there is no reason for them to do so when they can get an ambulance crew for free. For good or for ill.


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## Bullets (Jun 15, 2012)

TransportJockey said:


> And when the vollies don't respond, and enough people die, maybe your system will consider becoming a real, professional, paid system.



Just because a system is paid does not make it professional, nor does it make the volunteer "fake" or invalidate their effort. 

Volunteers can be a viable solution to providing EMS in some areas, poor, remote, or low call volume can make a paid staff unrealistic.


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## Level1pedstech (Jun 15, 2012)

TransportJockey said:


> And when the vollies don't respond, and enough people die, maybe your system will consider becoming a real, professional, paid system.



This has got to be the most insensitive thing I have seen posted on this site in a long while. Your bias towards "real,professional,paid sytems" is obvious as is your complete lack of professional courtesy. Your complete lack of compassion for those in need but without the resources to pay is astounding to say the least. Judging by your statement I can see you are without a doubt compleatly ignorant of the issues that contibute to the lack of "real,professional,paid" providers in rural areas. 

You people out there wonder why there is friction between paid/volunteer providers well meet the new poster boy. 

We have been down this path before but for the newer folks following along allow me to review a few things. First if there is no solid tax base there is no secure source of funding. Key word here is secure,if you can not provide the funding that is needed on a continuing basis you will not be able to recruit and retain "real,professional,paid" staff. You can fill the boot,flip hotcakes by the thousands and mooch off the feds till the cows come home but without a steady secure source of income your new sytstem will cease to exist. 

Of course there is the option to rely on the paid agency next door when someone is in need but the taxes paid by thier citizens should not be epected to fund services for the poor folks down the road. Then of course we have safer grants and other sources of funding from the feds,but why should the taxes being paid by Joe Blow in Iowa be sent out to fund a "real,professional,paid system" in Alabama? The funding for these services should be obtained from the city,county or state respectively not from the feds.

My friends and fellow volunteers as you can see the enemy is alive and well. We are what they fear because we offer a solution to the problem. Our commitment as it has always been is to provide help when the call comes in and to provide our services regardless of ones ability to pay. Most of us have never been about the money our satisfaction comes from making things better for those in need I salute each and everyone f you and thank you for your service.


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## rescue1 (Jun 15, 2012)

Level1pedstech said:


> My friends and fellow volunteers as you can see the enemy is alive and well. We are what they fear because we offer a solution to the problem. Our commitment as it has always been is to provide help when the call comes in and to provide our services regardless of ones ability to pay. Most of us have never been about the money our satisfaction comes from making things better for those in need I salute each and everyone f you and thank you for your service.



I think this may be a bit excessive. Regardless of how you feel on the paid/vollie issue, neither side is "the enemy". We are here for the same reasons and to do the same thing. Portraying the good and noble volunteers providing a service while the evil career staff try to drain the community for funds is not going to help the state of EMS, nor will portraying the volunteers as bumbling, incompetent fools.
The "enemy" here is systems with lack of education, training, or standards, regardless of whether their employees take home a paycheck.


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## STXmedic (Jun 15, 2012)

Level1pedstech said:


> My friends and fellow volunteers as you can see the enemy is alive and well. We are what they fear because we offer a solution to the problem. Our commitment as it has always been is to provide help when the call comes in and to provide our services regardless of ones ability to pay. Most of us have never been about the money our satisfaction comes from making things better for those in need I salute each and everyone f you and thank you for your service.


LMAO!!! :rofl::rofl::rofl:


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## Level1pedstech (Jun 15, 2012)

rescue1 said:


> I think this may be a bit excessive. Regardless of how you feel on the paid/vollie issue, neither side is "the enemy". We are here for the same reasons and to do the same thing. Portraying the good and noble volunteers providing a service while the evil career staff try to drain the community for funds is not going to help the state of EMS, nor will portraying the volunteers as bumbling, incompetent fools.
> The "enemy" here is systems with lack of education, training, or standards, regardless of whether their employees take home a paycheck.



Your are welcome to your opinion but I think the post I was replying to was excessive. I held back,man I held back. I have zero tolerance for anti volunteer blow hards.


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## Level1pedstech (Jun 15, 2012)

PoeticInjustice said:


> LMAO!!! :rofl::rofl::rofl:



Whats your solution to a problem that is only getting worse everyday?


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## rescue1 (Jun 15, 2012)

Level1pedstech said:


> Whats your solution to a problem that is only getting worse everyday?



What problem are we talking about here?


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## STXmedic (Jun 15, 2012)

Level1pedstech said:


> Whats your solution to a problem that is only getting worse everyday?



I don't remember saying I had one  The volunteer agency I come across most regularly is great and we've got a great relationship with. The "enemy"? Seriously? Somebody is being a little dramatic. If you're having that much trouble with all the paid agencies, something is seriously wrong with your area. And while no, being a paid department does not automatically make its employees more professional, I have seen a tremendously larger amount of unprofessional vollies. So before condemning the other side, try some introspection.


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## Chimpie (Jun 15, 2012)

I've encountered professional and unprofessional paid agencies/departments.  I've encountered professional and unprofessional volunteer agencies/departments.  

My guess is that one someone complains about either one of them, they are thinking of a particular agency or maybe even just a particular crew.  Painting either one of these with a broad stroke is wrong.


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## Level1pedstech (Jun 15, 2012)

Chimpie said:


> I've encountered professional and unprofessional paid agencies/departments.  I've encountered professional and unprofessional volunteer agencies/departments.
> 
> My guess is that one someone complains about either one of them, they are thinking of a particular agency or maybe even just a particular crew.  Painting either one of these with a broad stroke is wrong.



Agreed. However I was responding to what I considered a very insensitive statement. I have made several contributions to this thread that show from my past experiences how a department can function with combination staff.  The negative input from TJ adds nothing to what had been for the most part a positive discussion.

I do not view those that are vehemently anti volunteer as the enemy in the classis sense. Its more of a way to add bite to a discussion that like many others gets pulled off track. Anyone who entertains the idea that we should on some large scale eliminate or curtail the volunteer position is my enemy. It may not have come up in this thread but it has over the years.


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## Level1pedstech (Jun 15, 2012)

PoeticInjustice said:


> I don't remember saying I had one  The volunteer agency I come across most regularly is great and we've got a great relationship with. The "enemy"? Seriously? Somebody is being a little dramatic. If you're having that much trouble with all the paid agencies, something is seriously wrong with your area. And while no, being a paid department does not automatically make its employees more professional, I have seen a tremendously larger amount of unprofessional vollies. So before condemning the other side, try some introspection.



The enemy to me is not any particular paid agency its the group that advocates or invisions an all paid scenario. As far as introspection earlier I gave examples of two departments that I was associated with one where everyone was held to the same standards and the other a more classic all vollunteer department. My observations most likely coincide with yours.

I have tried on more than one occasion to show that it is possible to integrate volunteers into a department or agency that is having budget issues. If it comes down to half staffing engines or RA's with paid staff or implementing the combination model I know where I stand. Of course the best case scenario is an all paid IAFF represented department with the good wages,stellar benefits and killer retirement. Those of us that follow the issue know that type of department or agency is going to be the exception to the rule from here on out. Having combination staff that is equal in ability to thier paid counterparts is a solution that has been tried and proven to work. 

My input all along has been that there should be no rivalry between the two sides. For many departments its gone past the point of should we integrate volunteers and is now how do we make the change over to the combination model. 

The statement made by TJ was extremely insensitive but its his opinion I respect his right to express it but I sure dont have to accept it.


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## Level1pedstech (Jun 15, 2012)

rescue1 said:


> What problem are we talking about here?



 The problem as I see is how to continue to provide services in these budget challenged times. Some would like volunteers to go away but unless it starts raining money thats not going to happen. I see the opposite happening and think that the combination model will be the answer to many departments staffing problems. 

So paid,part time,volunteer or combination? In the case of combination should volunteers be held to the same levels of training and physical fitness as thier paid counter parts.


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## Tigger (Jun 15, 2012)

Level1pedstech said:
			
		

> The statement made by TJ was extremely insensitive but its his opinion I respect his right to express it but I sure dont have to accept it.



Get a hold of yourself and stop blowing things out of proportion. Insensitive? Really, that statement is insensitive?

Let's consider this for a second. The majority of volunteer and POC services do not staff a crew in quarters, so their service delivery is inherently inferior to that of a paid service, simply because it takes that much longer to get the ambulance out the door to the call. Let's also remember that the majority of volunteer and POC services are likely to provide only a BLS level of care. Most of the actually lifesaving BLS treatments are time dependent (AED/CP, EpiPen, bleeding control), yet these services are inherently delaying their arrival to life threatening calls. And that of course is if they respond at all, which in many areas is a significant problem. 

I have no dislike for volunteers or POC systems, and I'd happily volunteer my time if the opportunity existed. There are of course places where volunteers are the only answers as a result of the citizens' choice to not pay for EMS. Some EMS is better than no EMS, but TJ is right in principle, when you rely on people to do something for nothing, eventually things go wrong.

To me his statement is far from insensitive, it sounds more like the truth.


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## rescue1 (Jun 16, 2012)

Level1pedstech said:


> The problem as I see is how to continue to provide services in these budget challenged times. Some would like volunteers to go away but unless it starts raining money thats not going to happen. I see the opposite happening and think that the combination model will be the answer to many departments staffing problems.
> 
> So paid,part time,volunteer or combination? In the case of combination should volunteers be held to the same levels of training and physical fitness as thier paid counter parts.



See, I think your combination department is pretty sweet. It's a great way to blend volunteers and career personnel. However, I think the problem is that you're holding all volunteers to the standard that your combo department does. And the unfortunate fact is there are many areas that have an (all) volunteer agency that is subpar. And many of these areas (I've lived in two) could afford a fully paid or combination EMS service, but don't because the volunteers have always handled it and it saves the municipality money, or because the volunteers get upset at the idea of paid men upsetting the order of things.
And settling for a lesser service because of those reasons is just not OK


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## Level1pedstech (Jun 16, 2012)

Tigger said:


> Get a hold of yourself and stop blowing things out of proportion. Insensitive? Really, that statement is insensitive?
> 
> Let's consider this for a second. The majority of volunteer and POC services do not staff a crew in quarters, so their service delivery is inherently inferior to that of a paid service, simply because it takes that much longer to get the ambulance out the door to the call. Let's also remember that the majority of volunteer and POC services are likely to provide only a BLS level of care. Most of the actually lifesaving BLS treatments are time dependent (AED/CP, EpiPen, bleeding control), yet these services are inherently delaying their arrival to life threatening calls. And that of course is if they respond at all, which in many areas is a significant problem.
> 
> ...



For my benefit and those following along would it be possible to get a little insight into your level of experience dealing with rural agencies. More specifically have you ever been associated with an all volunteer agency in a capacity that allowed you insight into the operations aspect of that agency?

When you figure tht one out maybe you could let us who spoon fed you the "citizens choice not to pay" talking point. My guess is you have no idea what your talking about but feel you have enough inight to join a conversation that clearly is above your pay grade. Am I close?


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## rescue1 (Jun 16, 2012)

Level1pedstech said:


> For my benefit and those following along would it be possible to get a little insight into your level of experience dealing with rural agencies. More specifically have you ever been associated with an all volunteer agency in a capacity that allowed you insight into the operations aspect of that agency?
> 
> When you figure tht one out maybe you could let us who spoon fed you the "citizens choice not to pay" talking point. My guess is you have no idea what your talking about but feel you have enough inight to join a conversation that clearly is above your pay grade. Am I close?



I belonged to two rural agencies just like you described. The citizens in the one agency (in one county) made a conscious effort to pay for paid ALS ambulances. The other county (next to it) didn't. It shows in the level of service provided and in response times. 

Not all rural agencies are created equal.


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## Level1pedstech (Jun 16, 2012)

rescue1 said:


> See, I think your combination department is pretty sweet. It's a great way to blend volunteers and career personnel. However, I think the problem is that you're holding all volunteers to the standard that your combo department does. And the unfortunate fact is there are many areas that have an (all) volunteer agency that is subpar. And many of these areas (I've lived in two) could afford a fully paid or combination EMS service, but don't because the volunteers have always handled it and it saves the municipality money, or because the volunteers get upset at the idea of paid men upsetting the order of things.
> And settling for a lesser service because of those reasons is just not OK



Once again the success of a true combination department is dependant upon all staff being held to the same standard.  My experience has shown me that the combination model can be a option if everyone is onboard. My experience with the smaller all volunteer department has shown me that we will never be able to get every volunteer to meet the higher standards. Even thinking about having a national standard for volunteers like NREMT has for EMS in my opinion would be a wasted effort. Some people are just not that motivated and for many rural area its next to impossible to get people to volunteer that will strive to meet minimum standards.

The focus is mid to large size departments that are now mostly if not all paid. If these agencies are faced with the loss of career staff I think the combination model could be an option. 

My pro volunteer stance does not mean I am pro "whacker". We all want the best trained and the most highly skilled people providing this service. Im realistic and know that many rural agencies will never meet the standar,therefor I have chosen to be an advocate for the combination department.

This volunteer/paid discussion started with the question "how are volunteers viewed by paid EMT's". As usual things get pulled in different directions and we end up with good people making stupid statements. For the most part I think this thread has been constructive and I think the moderators have exercised restraint and allowed us to work past the rough spots.


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## Level1pedstech (Jun 16, 2012)

rescue1 said:


> I belonged to two rural agencies just like you described. The citizens in the one agency (in one county) made a conscious effort to pay for paid ALS ambulances. The other county (next to it) didn't. It shows in the level of service provided and in response times.
> 
> Not all rural agencies are created equal.



The paid ALS ambulance option is how my smaller department handeled EMS operations. All fire district personnel were capable of providing BLS,in most cases an EMT would be in district and provide care until our ALS service arrived to provide advanced care and or transport. With extended ETA's due to our very large district,response times ranged from 20 minutes on up to an our or more. Of course life flight was an option if we had a trauma that needed quick removal,weather permitting.

The third party option for ALS and transport works well if a rural community is not able to provide and staff a 24/7/365 ALS or BLS transport. I like the option because it eliminates the administrative nightmare and all operations are managed by the third party. In addition all of the education offered to department staff from BLS/CPR to EMT-B and IV tech was provided at minimal cost by the ALS service. Ongoing education and CE's for recertification was provided by our department.


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## rescue1 (Jun 16, 2012)

OK, I see what you're saying, and I agree. My main problem, as I sort of said above, is volunteer agencies that do not provide a reasonable service in an area that could support some form of improvement, whether from higher volunteer standards or from paid staffing.

I heard my EMS chief, when asked about the possibility of keeping a county paramedic in our station 24/7, ask if they and the driver would wait until other volunteers arrived so "they could have a chance to make the call". When the dumbfounded paramedic said no, the chief said he wouldn't do it.

So we had a station that turned down free paid staffing because it meant some people who lived far away couldn't make all the calls...and at the time, it would take (on average) about 8 minutes from dispatch for the ambulance to respond. Since then it's gotten worse, but still no increase in staffing.
That's the sort of thing that turns me off volunteer systems.


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## Chimpie (Jun 16, 2012)

rescue1 said:


> ...
> 
> I heard my EMS chief, when asked about the possibility of keeping a county paramedic in our station 24/7, ask if they and the driver would wait until other volunteers arrived so "they could have a chance to make the call". When the dumbfounded paramedic said no, the chief said he wouldn't do it.
> 
> ...



Can you explain these again, maybe in more detail?  I'm not understanding.


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## Level1pedstech (Jun 16, 2012)

rescue1 said:


> OK, I see what you're saying, and I agree. My main problem, as I sort of said above, is volunteer agencies that do not provide a reasonable service in an area that could support some form of improvement, whether from higher volunteer standards or from paid staffing.
> 
> I heard my EMS chief, when asked about the possibility of keeping a county paramedic in our station 24/7, ask if they and the driver would wait until other volunteers arrived so "they could have a chance to make the call". When the dumbfounded paramedic said no, the chief said he wouldn't do it.
> 
> ...



Your frustration is shared by all of us who want to see volunteer systems that fuction like paid systems. Like I said its not realistic to think all volunteer services could ever be held to the higher standards. Many of the small all volunteer services just dont have the call volume to justify change. In these rural areas if growth remains steady or even decreases they in all likelihood will continue to operate with what they have. Trying to bring about change in that setting could end up being a waste of time and resources. Focus should be on maintaining service levels for larger agencies that are forced to cut paid staff by implementing the combination model.

Depending on an agencies geographical area less than 8 minutes to get ALS on the road might not be so bad. If its 8 minutes plus another 15 enroute your right at my old departments average for ALS. However if its 8 then another 30 or more enroute your stretching. Of course factors like are there EMT's or other BLS providers on scene that can manage patient care should be considered.

No one in an area serviced by a volunteer agency is expecting or should expect service like you get in large metro areas. My combination departments expectation of service was 5 minutes for first ins and 9 for ALS which I believe is pretty standard.


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## rescue1 (Jun 16, 2012)

Chimpie said:


> Can you explain these again, maybe in more detail?  I'm not understanding.



Yeah, sure.

The volunteer station is an ambulance service that uses home response, with the exception of a paid driver/EMT on duty from 5a to 5p. ALS is provided by a county chase car coming from about 8 minutes away. The response area is fairly large, maybe 60 square miles, but 60%+ of the calls are in town, which is about 2 square miles. They run about 1,400 calls a year. 

Due to the nonavailability of members and distance from the station, the average time from dispatch to response (turnout time) is about 8-9 minutes, with 2-3 minutes of driving time for most in town calls.

There was discussion between a paramedic stopping by after a call and the chief of said department about the possibility of staffing a county paramedic in the station along with the driver to allow for an immediate ALS response. The chief was against this because it meant that the members living 7-8 minutes away would be unable to make the rig and respond. 

To me, this is a inexcusable reason to provide less effective patient care, especially since the tax base would easily allow for a staffed 24/7 ALS ambulance in that station.


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## Chimpie (Jun 16, 2012)

Thanks for the clarification.

So you have an EMT staffed at the station between 5-5, but still have to wait for the paramedic to get there before he/she can roll to the call?  Of does the medic go directly to the scene?

Does the medic get dispatched to every call or just ALS calls?

How many vehicles do you have at that station?
How many stations does this agency/department have?


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## Aidey (Jun 16, 2012)

rescue1 said:


> Yeah, sure.
> 
> The volunteer station is an ambulance service that uses home response, with the exception of a paid driver/EMT on duty from 5a to 5p. ALS is provided by a county chase car coming from about 8 minutes away. The response area is fairly large, maybe 60 square miles, but 60%+ of the calls are in town, which is about 2 square miles. They run about 1,400 calls a year.
> 
> ...



I've heard this argument too. If a secondary agency is able to respond faster than the primary agency, the primary agency won't respond as much.


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## rescue1 (Jun 16, 2012)

Chimpie said:


> Thanks for the clarification.
> 
> So you have an EMT staffed at the station between 5-5, but still have to wait for the paramedic to get there before he/she can roll to the call?  Of does the medic go directly to the scene?
> 
> ...



The paid EMT must wait until additional volunteers have arrived to fill out the crew. So, at a minimum, he needs one other person to respond. However, SOP states that the crew must hold in quarters until either 3 personnel have arrived or the 8 minute failure mark arrives (when the next due volly ambo will be alerted). The EMT is permitted to respond driver only at the 8 minute mark if no volunteers show (which happens with regularity). When the paid EMT leaves for the day, the same rules apply.
There is one station with 3 ambos and some boats/SUVs.

ALS is a separate entity entirely, dispatched on basically every call because of the high potential for driver-only response from the ambulance. The only calls without an ALS response are lift assist only calls. 
They will go directly to the scene in their chase car. They have a station 8 minutes away, and respond in single paramedic units.


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## rescue1 (Jun 16, 2012)

Aidey said:


> I've heard this argument too. If a secondary agency is able to respond faster than the primary agency, the primary agency won't respond as much.



I've heard it a lot, and it can be true. I left the agency I'm describing to go to one a county away. This county had paid ALS ambulances throughout the county, after a several high profile deaths where volunteer ambos failed to respond. Dispatch would therefore dispatch the county medic and the volly ambulance on all calls. Because of this, many volunteer ambulances would only respond on "good" calls like MVCs and arrests, because there was no need for them to respond otherwise with ALS transport responding as well.

Was that good? Maybe not, but I'd rather have the paid ambulances.


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## Tigger (Jun 16, 2012)

Level1pedstech said:


> For my benefit and those following along would it be possible to get a little insight into your level of experience dealing with rural agencies. More specifically have you ever been associated with an all volunteer agency in a capacity that allowed you insight into the operations aspect of that agency?
> 
> When you figure tht one out maybe you could let us who spoon fed you the "citizens choice not to pay" talking point. My guess is you have no idea what your talking about but feel you have enough inight to join a conversation that clearly is above your pay grade. Am I close?



Sure, but it has absolutely no effect on this discussion, especially considering that this discussion extends to areas that are not easily characterized as rural.

See here's the thing, I could care less if you think that this discussion is "above my pay grade." It does not bother me in the slightest that you have no respect for anyone's commentary that doesn't align with yours. I will likely not lose any sleep over being told that I don't know what I am talking about, and I laughed a bit at your poorly worded protestation that I should participate in this discussion which kind of defeats the point of this forum, no?

The ability to look at a problem logically without preexisting prejudices seems to have little merit to you as it seems that you'd rather just call out those who disagree with you with a flurry or emotional and not factually based reasoning. But I digress.

I live in a town with a massive tax base, one that has been proven by the town government to be able to support having paid 24 hour staffing of the town's ambulance or paying for a private company to staff their own ambulance in the town's building. Yet we still have a paid on call ambulance, one that averages an 11+ minute response time in a rural/suburban town of 15 square miles. It's a service that prides itself on town residents being able to give back to the town, and it's are well run with a professional appearance. Yet in several town meetings, the citizens have voted to not allow the funding of a paid EMS system. That's the beauty of town meeting government, you can directly see if a community wants something or not. In this case, the citizens are in fact choosing not to pay for anything besides paid-on-call EMS. It is of course their choice to say that they want an EMS service that has slower response times, delayed access to ALS, and comparatively less experienced providers, but that doesn't make it a good idea. 

I do of course understand that this not the case with many places. And as I have said over and over again, there are no doubt places where volunteers are the only answer, be it low call volume or lack of funding. I am not by any stretch of the imagination anti-volunteer, but rather pro-"best delivery of service possible given financial constraints."


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## ffemt8978 (Jun 17, 2012)

Play nice


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## DrParasite (Jun 17, 2012)

Tigger said:


> Yet in several town meetings, the citizens have voted to not allow the funding of a paid EMS system. That's the beauty of town meeting government, you can directly see if a community wants something or not. In this case, the citizens are in fact choosing not to pay for anything besides paid-on-call EMS. It is of course their choice to say that they want an EMS service that has slower response times, delayed access to ALS, and comparatively less experienced providers, but that doesn't make it a good idea.


And there in lies the truth.... despite having the money, the town still doesn't want to properly fund the EMS system.

That doesn't mean volunteers are failing to do the job, but rather the town doesn't want a paid staff.  the town is also willing to accept the downsides of having a volunteer ems agency and the financial savings as well.

btw, I know quite a few poor urban areas that have paid staffing 24/7.  typically they don't have the proper amount of units to handle the call volume, so they have extended wait times, but they are far from being wealthy communities.


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## fortsmithman (Jun 17, 2012)

Here in the NWT out of 20 or so communities only 7 have EMS and not 1 is ALS all BLS.  Of those 7 only 2 are full time our capital city which is fire based or as my trsining officer puts it an ambulance service that does the occassional fire call.  and our n2 largest community its a provate and he ****s around his emts so bad that they don't stay around long they end up at pour capital citys EMS.  The remaining communities are all volunteer based attached to their volunteer fire departments.  With the exception of my town which is a third service.  The only time we dont respond to a call is when its on the highway ouside of town when we only have enough memebrs for 1 crew as we cannot leave the town without EMS.  The only ALS is our air medevac service.


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## Level1pedstech (Jun 17, 2012)

Tigger said:


> Sure, but it has absolutely no effect on this discussion, especially considering that this discussion extends to areas that are not easily characterized as rural.
> 
> See here's the thing, I could care less if you think that this discussion is "above my pay grade." It does not bother me in the slightest that you have no respect for anyone's commentary that doesn't align with yours. I will likely not lose any sleep over being told that I don't know what I am talking about, and I laughed a bit at your poorly worded protestation that I should participate in this discussion which kind of defeats the point of this forum, no?
> 
> ...




The only disagreement I see is those that are ok with TJ's comment. Like I said he is welcome to his opinion and your welcome to support it. Time to move on and talk about whats important.

From the start of this dicussion I have offered first hand knowledge gained from my association with two very different agencies. No prejudices here,I could find things wrong with both types of agencies and providers. My opinions ond obsevations come from a combined twelve years of experience in fire/EMS,how about yours?

Your town is not the first to turn down a levy or other action that would bring in paid services. Not all communities have the options your town has,for many there simply are no resources available. These communities are the ones I think about when I read comments like TJ's. Once again if your okay with it then I support your right to have that opinion.

As far as how my posts are worded,maybe when your at the end of a six day 80 week your posts might be a little less than outstanding. Guess Im just never going to be a great fit with the "book throwers" and nerds in the group,but then again I always was more of a fire guy. Taking cheap shots is fine,step up to the line and have at it but remember the mods are watching. It might be nice to keep this thread open.


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## Veneficus (Jun 17, 2012)

Level1pedstech said:


> The enemy to me is not any particular paid agency its the group that advocates or invisions an all paid scenario.



I think this may be a little unfair. 

I think the only reasons there is not an all paid system, even in rural areas, is 1. Lack of effective system design
2. Greed. 

I will probably be called a socialist for this, but I remember an America where it was not only politically acceptable, but common to help your neighbors in need.

I think that there is a moral obligation to make sure the same consistant level of medical care is available to all. 

If that means paying taxes for poor Joe Shmoe down the street, across the state, or across the country, then that is what should be done. 

I didn't see people in Iowa or Wisconsin not giving money, goods, and volunteering service in NYC during Sept 11, Hurricane Katrina, or Various California Earthquakes.

Giving a few bucks a day to make sure somebody in Rural America gets effective and consistant EMS seems like a good use of money. 

Maybe it doesn't make people feel as good as donating during the big event. But it has been my experience the greatest help is behind the scenes, before a catastophe.


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## Shishkabob (Jun 17, 2012)

Lifting assistance.

People who won't get in my way when I have a job to do (unlike some paid fire departments)

People who I actually enjoy having on my scene as they are eager to help and to learn (unlike some paid fire departments)

People who think they have a more vested interest in the patient than you do simply because they live in the city, as opposed to me, the one who actually not only relies on the job, but on keeping my license.


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## crashh (Jun 17, 2012)

TransportJockey said:


> And when the vollies don't respond, and enough people die, maybe your system will consider becoming a real, professional, paid system.



ok, first of all, we ARE a "real" system.  We have 3 ALS in our company alone, most of our firefighters are also EMT's.  We answer to the same calls you probably do, with the little added funstuff that comes from living in a rural area (chainsaw accidents, etc.), and none EVER go unanswered.  We are treating our friends, family, co-workers etc.

Lack of pay does not equate to being unprofessional.  

I'm rather surprised at YOUR unprofessionalism.  just sayin...


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## TransportJockey (Jun 17, 2012)

crashh said:


> ok, first of all, we ARE a "real" system.  We have 3 ALS in our company alone, most of our firefighters are also EMT's.  We answer to the same calls you probably do, with the little added funstuff that comes from living in a rural area (chainsaw accidents, etc.), and none EVER go unanswered.  We are treating our friends, family, co-workers etc.
> 
> Lack of pay does not equate to being unprofessional.
> 
> I'm rather surprised at YOUR unprofessionalism.  just sayin...


First off I'll apologize for the way I said it, but not the message. I had just come off a long shift (almost 30 hours w/ 14 transports, each one being approx 2 hours from start to finish... imagine that, I work in a rural county) where I saw a volunteer rescue (or any volunteers at all) just once. So I was in a nasty mood, but I still think that volunteers that don't respond need to be replaced with a system that DOES respond. I don't care if that's the way it's always been done, or it's tradition. If you have a volunteer agency that doesn't respond, they are helping no one.

So... I actually know all about rural 911. I work for the county transport authority (a private 911 agency in central NM), and get to listen as time after time we have three or four districts called for mutual aid because volunteers decide tehy don't want to answer their calls. 
Just because you have a volunteer system that might actually work most of the time, doesn't mean that all of them are like that. More and more of the state of NM is like this, most volly depts I saw in TX were like this and wouldn't respond to anything short of a working structure. 

Oh, and I am a volunteer too, as of last week. I'm actually helping get the dept I joined back off the ground. But ya know what? I'm also helping them work out a proposal to get rid of volunteers altogether, since hte majority of them seem like all they want are a badge and a tshirt. I don't care at this point how EMS gets to the patient, (although my preference is paid, third service agencies everywhere, not associated w/ FD) just as long as it DOES get to the patient. 

When you have ambulances just sitting at the station because you can't convince any of your volunteers to run because it's not a 'cool call', that's a problem. One that needs to be fixed. Same with the education levels. If your volunteers can't hold themselves to the same standards for education and training that paid services hold their employees to, they don't need to be riding a rescue/bus/ambo/medic unit.


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## fortsmithman (Jun 17, 2012)

TransportJockey said:


> Oh, and I am a volunteer too, as of last week. I'm actually helping get the dept I joined back off the ground. But ya know what? I'm also helping them work out a proposal to get rid of volunteers altogether, since hte majority of them seem like all they want are a badge and a tshirt. I don't care at this point how EMS gets to the patient, (although my preference is paid, third service agencies everywhere, not associated w/ FD) just as long as it DOES get to the patient.
> 
> When you have ambulances just sitting at the station because you can't convince any of your volunteers to run because it's not a 'cool call', that's a problem. One that needs to be fixed. Same with the education levels. If your volunteers can't hold themselves to the same standards for education and training that paid services hold their employees to, they don't need to be riding a rescue/bus/ambo/medic unit.



My service is volunteer and we respond to every call withing the corporate limits of the town.  I have yet to be on a so called cool call.  Mostly it's IFT between hospital and nursing homes.  As well if the town did convert us to paid full time we would gladly go paid full time.  We have corrections officer who will be making less money and other who work in jobs that would pay them more to work EMS.  Currently my service has 20 members but with summer vacations and a few of our member who are firefighters with forest management and Parks Canada we are down to 7 members and when we have our weekly changeover and training meetings once a week basically any member who goes is on call  My service has 2 BLS units and in the main ambulance is crewed by a minimum of 3 members with 4 going out on average.    Our back up ambulance is crewed by 2 members with sometimes 3 going if the primary ambulance is out on a call.  
I agree with your statement that if a volly can't or won't commit to the same training levels required of the full time services.  When I first joined the main thing was free training.   It's the same with volly fire departments they should also train to the extent that paid services do.  Because fire and EMS is in the business of saving lives and property.  If our training is not up to par with full times services then people will not get the help they need.


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## JPINFV (Jun 17, 2012)

TransportJockey said:


> First off I'll apologize for the way I said it, but not the message. I had just come off a long shift (almost 30 hours w/ 14 transports, each one being approx 2 hours from start to finish... imagine that, I work in a rural county) where I saw a volunteer rescue (or any volunteers at all) just once. So I was in a nasty mood, but I still think that volunteers that don't respond need to be replaced with a system that DOES respond. I don't care if that's the way it's always been done, or it's tradition. If you have a volunteer agency that doesn't respond, they are helping no one.



I'd actually say that a volunteer agency that regularly has a response problem goes beyond not helping to hurting since it's diverting funding (be it tax or donation, money is money) that would to a service that will respond.


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## TransportJockey (Jun 18, 2012)

fortsmithman said:


> My service is volunteer and we respond to every call withing the corporate limits of the town.  I have yet to be on a so called cool call.  Mostly it's IFT between hospital and nursing homes.  As well if the town did convert us to paid full time we would gladly go paid full time.  We have corrections officer who will be making less money and other who work in jobs that would pay them more to work EMS.  Currently my service has 20 members but with summer vacations and a few of our member who are firefighters with forest management and Parks Canada we are down to 7 members and when we have our weekly changeover and training meetings once a week basically any member who goes is on call  My service has 2 BLS units and in the main ambulance is crewed by a minimum of 3 members with 4 going out on average.    Our back up ambulance is crewed by 2 members with sometimes 3 going if the primary ambulance is out on a call.
> I agree with your statement that if a volly can't or won't commit to the same training levels required of the full time services.  When I first joined the main thing was free training.   It's the same with volly fire departments they should also train to the extent that paid services do.  Because fire and EMS is in the business of saving lives and property.  If our training is not up to par with full times services then people will not get the help they need.



Training is also one of the reasons I joined the dept I did. They will pay for hosemonkey courses if I want it, but also CCT, TCCC, an AAS and BS in EMS, and anythign else fire or EMS (Like rope rescue) related certs I ask for.


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## Tigger (Jun 18, 2012)

DrParasite said:


> And there in lies the truth.... despite having the money, the town still doesn't want to properly fund the EMS system.
> 
> That doesn't mean volunteers are failing to do the job, but rather the town doesn't want a paid staff.  the town is also willing to accept the downsides of having a volunteer ems agency and the financial savings as well.
> 
> btw, I know quite a few poor urban areas that have paid staffing 24/7.  typically they don't have the proper amount of units to handle the call volume, so they have extended wait times, but they are far from being wealthy communities.



As for clarification, town government would like to see a paid EMS service operating in town. However given the nature of local government in Massachusetts where the citizens vote annually on any and all capital expenditures out of budget individually, it is the citizen's (that do not like to be educated in matters of public safety) that are choosing not to upgrade the EMS service. 

And for the record, I understand that there are lots of places where this is not an option and the only option is volunteers given the lack of a tax base in the region, really I do. I'm just pointing out there are many volunteer services operating in areas where they are not the only option at hand.


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