# IFT BLS EMT



## AfxEMT (Aug 17, 2015)

Hello everyone. I'm an emt-b & I work for a private ambulance, we primarily do IFT. This is my first ems job & I've been doing it for three months now. However I feel like doing BLS IFT gets no respect from other health care professionals, like one time we were about to take a pt to a snf so I was asking the nurse for a report & allergies & such & she told me "I don't understand why you need all of this, you're just transport."
Is it just me or this is BLS IFT life?? Private taxi. Barely get to do anything besides vitals & continue O2 therapy.


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## medichopeful (Aug 17, 2015)

AfxEMT said:


> Hello everyone. I'm an emt-b & I work for a private ambulance, we primarily do IFT. This is my first ems job & I've been doing it for three months now. However I feel like doing BLS IFT gets no respect from other health care professionals, like one time we were about to take a pt to a snf so I was asking the nurse for a report & allergies & such & she told me "I don't understand why you need all of this, you're just transport."
> Is it just me or this is BLS IFT life?? Private taxi. Barely get to do anything besides vitals & continue O2 therapy.



BLS IFT is, for the most part, just a private taxi.  However, it's an EXCELLENT learning experience for you.  You'll get practice with patient assessment and customer service.  In addition, you'll be able to learn medications, diseases, etc.  Show those on both ends of the transfer (as well as the patient) that you're learning these things, and are competent, and hopefully the attitude changes.  Keep in mind, though, that there will always be people who are just jerks.  

Look at going to a service that provides emergency response or critical care transport after you get some experience.  Also look at going to medic school if you're interested in continuing in this field.  Good luck!


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## EMT11KDL (Aug 17, 2015)

That is the attitude of SNF, at least that has been my experience.  Both on BLS and ALS IFT also with 911 calls.   When I was working part time on an IFT ALS Truck we would do BLS Transfers because our BLS Truck was busy.  And while my EMT was getting report, sometimes I would over hear something that would trigger me to ask a question and I would get a similar attitude from the staff.  We were transporting a patient because he was altered after a ground level fall and the nurse said that he had dementia.  So I asked what is his normal baseline mentation that is causing you to say he is altered now, and she could not understand why I was asking the question.  Found out later after speaking to other staff members that he actually wasn't altered at all.  

I will say learned a ton while working IFT.

You just have to take everything with a grain of salt, EMS is still new to the medical field and we do not have a lot of respect yet from other professionals.  (But this is another argument for another thread, and I know we have many threads already started on this topic)


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## BillThompson (Aug 19, 2015)

To be honest, it depends on how you handle yourself. I work on a one-on-one BLS/ALS rig, and when it's my call I'm the one in charge. I'll ask the nurses questions, and if they don't want to answer I keep asking until they do answer. I'll never fall in line with the private taxi mentality, because we're still medical professionals providing medical care. Some won't respect you, but it's up to you to push through that, remain professional, and get all the information you need.


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## NPO (Aug 24, 2015)

This feeling will never end. I work for a reputable company that exclusively (911/IFT) 90% of our county. Even when we go on a transfer we occasionally get the nurse who doesn't understand. They ask why I have questions and why I need a report. Their excuses range from "He's already been accepted over there." To "I called report to the nurse already," to "you're just BLS"

My response is usually "what if we don't make it to XYZ." 

Most often these responses are from inexperienced and incompetent nurses. The good ones understand.


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## BeansCO (Sep 3, 2015)

I worked private for 3 years. Most of the calls were IFT. Misunderstanding about our scope is rampant.
The worst was when a nurse became angry with me for opening and going through the patients packet (facesheet, DNR, allergies, meds, past medical history). She claimed I couldn't look at it due to HIPAA regulations. I don't think she understood what continuity of care means. 
Have had a few nurses accompany us when we transported patients to appointments. If they weren't already aware, they were surprised by what our scope covers. 

My recommendation is to remain polite and get the information you need to do your job, even if you have to ask another nurse. You can always vent about the experience later.


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## Ewok Jerky (Sep 3, 2015)

Or tell them you're in nursing school.


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## Honeybadger (Sep 4, 2015)

Ift is a great way to get some exposure to a few things. You learn a lot of medications that fieldwork doesnt teach. You get to learn a lot about definitive care. You learn about end of life care. But most of all, you will learn how sad it is when the body has outlasted the mind (dementia) and you will get to do a lot more suctioning in my experience. You learn a lot about how to talk to your patients and very importantly, you learn the inner layouts of the hospitals (of which there are 17 in the Seattle area) and you also learn where all the snf facilities are, which does speed your response times when you're 911.

I did ift for two years and I am at the point where ive seen it all (airlifts taught me a lot too) and am happy with 911 response now. But I feel like I am a much better EMT than many of my peers who have only ever done 911 who don't know what a lot of cardiac, blood thinning, psych, or narcotic medications are. Out here, the majority of our ift transports really should be wheelchair or stretcher van, which pisses me off, as it kust means AMR is deliberately trying to milk the patients, and cabulance services are so anemic that hospitals would rather make up some phony baloney physician certification statement (pcs form) and force us to polish a turd, so to speak, in trying to justify why this patient needs an ambulance ride, without lying, in our narratives.

Bls ift transport is one of the biggest scams in healthcare right now. Almost nobody needs it.


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## CSchlesinger908 (Nov 8, 2015)

AfxEMT said:


> Hello everyone. I'm an emt-b & I work for a private ambulance, we primarily do IFT. This is my first ems job & I've been doing it for three months now. However I feel like doing BLS IFT gets no respect from other health care professionals, like one time we were about to take a pt to a snf so I was asking the nurse for a report & allergies & such & she told me "I don't understand why you need all of this, you're just transport."
> Is it just me or this is BLS IFT life?? Private taxi. Barely get to do anything besides vitals & continue O2 therapy.


I know the feels, I work for one here in Shreveport, LA. We do IFT but we also do some "911" to nursing homes and such. I get that same speal about "your just Transport". I feel like EMT school was a waste working here.


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## TransportJockey (Nov 9, 2015)

CSchlesinger908 said:


> I know the feels, I work for one here in Shreveport, LA. We do IFT but we also do some "911" to nursing homes and such. I get that same speal about "your just Transport". I feel like EMT school was a waste working here.


Honestly, most IFT patients do not need what little education EMT-Bs DO get. The truly sick IFT patient's usually go ALS or CCT or get  flown from a-to-b


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## Chewy20 (Nov 9, 2015)

Anything an EMT does on an IFT truck can be taught to anyone walking the street in ten minutes. Use IFT as a stepping stone, and don't be the guy just going through the motions (though easy to get sucked into, as I did.) Look at your patients history and then study up on that disease process and the drugs used to help it.


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## CSchlesinger908 (Nov 9, 2015)

Chewy20 said:


> Anything an EMT does on an IFT truck can be taught to anyone walking the street in ten minutes. Use IFT as a stepping stone, and don't be the guy just going through the motions (though easy to get sucked into, as I did.) Look at your patients history and then study up on that disease process and the drugs used to help it.



That's definitely what I'm doing. Whenever I go to these clinics I always grab one of every pamphlet I see. I look up meds I don't know. It's definitely a good place to get my feet wet, of course.


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## Akulahawk (Nov 9, 2015)

NPO said:


> This feeling will never end. I work for a reputable company that exclusively (911/IFT) 90% of our county. Even when we go on a transfer we occasionally get the nurse who doesn't understand. *They ask why I have questions and why I need a report*. Their excuses range from "He's already been accepted over there." To "I called report to the nurse already," to "you're just BLS"
> 
> My response is usually "what if we don't make it to XYZ."
> 
> Most often these responses are from inexperienced and incompetent nurses. The good ones understand.


If they give you excuses, you can provide a better reply by stating simply, "Would you accept care of a patient without getting report from anyone?" That puts things into a perspective that nurses understand, even if they don't understand what you do or what your scope is.


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## NPO (Nov 9, 2015)

And that's exactly what I do.


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## Akulahawk (Nov 9, 2015)

BeansCO said:


> I worked private for 3 years. Most of the calls were IFT.* Misunderstanding about our scope is rampant.*
> The worst was when a nurse became angry with me for opening and going through the patients packet (facesheet, DNR, allergies, meds, past medical history). She claimed I couldn't look at it due to HIPAA regulations. I don't think she understood what continuity of care means.
> Have had a few nurses accompany us when we transported patients to appointments. If they weren't already aware, they were surprised by what our scope covers.
> 
> My recommendation is to remain polite and get the information you need to do your job, even if you have to ask another nurse. You can always vent about the experience later.


One of the reasons why there's a "misunderstanding" about the scope of EMS practice is that in nursing school, nor after it, nurses aren't educated at all about the scope of practice that EMS personnel have. They aren't taught the differences between EMT, AEMT, and Paramedic scopes of practice. 

As to the nurse getting angry about you going through a packet, sometimes it's better to just wait until you're outside the facility and out of the nurse's view before you resume mining for info. Right then isn't the time to give an ignorant nurse an education about HIPAA because that'll just evolve into a shouting match and you'll lose because the nurse will report to their supervisor that you were rude and that can cost a transport contract.


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## Akulahawk (Nov 9, 2015)

NPO said:


> And that's exactly what I do.


To be fair, you did say "My response is usually "what if we don't make it to XYZ" and not what I suggested. Those are two very different statements, that, to us, mean essentially the same thing: "I need to get report on that patient." To the nurse, the first statement you gave doesn't change a line of thinking because if the transport destination is changed they figure they can just call report to the new destination. The other response puts things into the perspective of the nurse's own practice. The nurse may be ignorant about your scope or what you do, but won't be ignorant about their own scope or practices. 

You might not ever go into nursing, but if you know enough about their normal processes about accepting care of a patient, you can go a long way into getting your point across without letting things devolve.


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## escapedcaliFF (Nov 22, 2015)

IFT is where ambulance companies make their money. Most PTs pay via insurance vs. 911 where only 60 percent end up paying.


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## escapedcaliFF (Nov 22, 2015)

Ive had nurses give me crap about looking through PT treatment records while waiting on some doctor to check them out one last time. I normally just ignore them for the most part. Ive gone to charge nurses to get a PT history and status cause some nurse thought she didnt have to tell me anything. Normally going to the charge nurse changes the nurses tone pretty fast. Ive refused to transport PTs until a nurse has given me the low down on a PT. That normally ends up being funny when they complain to my supervisor and I explain it to them. If you do your job right your supervisor should have no problem backing you up.


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## StCEMT (Nov 22, 2015)

AfxEMT said:


> "I don't understand why you need all of this, you're just transport."
> Is it just me or this is BLS IFT life?? Private taxi. Barely get to do anything besides vitals & continue O2 therapy.



I have yet to have any nurses give me trouble, they're usually good about making sure I have all I need before I leave. The latter half kind of rings true for my limited time though, O2 is a rare occurrence for me.  It has been helpful in learning good communication skills with patients and developing my own system of organization.


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## olaf1988 (Nov 25, 2015)

Chewy20 said:


> Anything an EMT does on an IFT truck can be taught to anyone walking the street in ten minutes. Use IFT as a stepping stone, and don't be the guy just going through the motions (though easy to get sucked into, as I did.) Look at your patients history and then study up on that disease process and the drugs used to help it.




I agree that even on an IFT unit you should still do your own assessment, take your own vitals. I've caught things that were never mentioned in the "report" from the sending nurse that completely changed the treatment plan for a patient. IFT is what you make of it, as many have said, use it to your advantage. Hone your patient assessment and vital skills and build good rapport with your patients and the hospital staff (if possible).

Depending on your system you might be able to run CCT which can give you some insight into more complex medical issues. When I worked CCT I worked with a RN who was a paramedic as well. I would always listen in on the reports he got and gave and then ask him about anything I didn't understand. It was a great learning environment.


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## squirrel15 (Nov 27, 2015)

escapedcaliFF said:


> Ive had nurses give me crap about looking through PT treatment records while waiting on some doctor to check them out one last time. I normally just ignore them for the most part. Ive gone to charge nurses to get a PT history and status cause some nurse thought she didnt have to tell me anything. Normally going to the charge nurse changes the nurses tone pretty fast. Ive refused to transport PTs until a nurse has given me the low down on a PT. That normally ends up being funny when they complain to my supervisor and I explain it to them. If you do your job right your supervisor should have no problem backing you up.


That sounds like an attitude issue on your end, I've never had a nurse be unwilling to give me a quick history on discharges. Are you trying to get a life story for a discharge patient? And how is the charge nurse going to tell you anything about a patient they haven't seen, read you the pts chart?


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## johnrsemt (Dec 1, 2015)

If you work somewhere that 60% of 911 patients pay for their transports (either by insurance or private pay) you are in great shape.     I doubt if the national average is higher than 35-40%.   I know in Indy where I used to work (till 2008) the private service I worked for had about 25% of 911 runs paid for, and the fire departments in the area probably had about the same. 
Suburbs are higher percentage than urban;  and rural is higher still,   but rural doesn't have the BS runs that the cities do.


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## Kevswens (Dec 4, 2015)

I work for a private ambulance company that mostly does IFTs. I have never came across a nurse that refused to give report or allow me to look through the patient's information. However, if nurses are in a bad mood for whatever reason, I always carry company pens with me to handout to nurses. Nurses love pens and it usually cheers them up.


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## ZombieEMT (Dec 28, 2015)

I have personally learned more doing IFT than I ever learned in a 911 setting. IFT gives you the opportunity to practice assessment and learn. You can talk to your patients. Learn the diseases. Learn medications. Build people skills. Sometimes if doing CCT transports, patients are more severe than in 911. IFT, is however, what you make of it. Some people just look at paperwork and fill boxes because they are suppose to. Some people do not take advantage of it.

There will always be resistance with facilities, whether hospitals, offices or SNFs. When it comes down to it, sometimes, all we are is transport. I know doing BLS IFT, some patients only go by BLS because they cant go in a wheelchair. The patient is bed confined, and therefore needs stretcher. Many of the facilities are not actually looking for any level of care, just transport. Most of the patient's do not need any additional care. They go by stretcher on technicality. We do the same for psych transfers to psych facilities, minor inter hosp transfers. 

Basically, you have to suck it up. Thats what IFT is like. As long as you know that you are doing what you are suppose to, then you are golden.


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## Kevinf (Dec 28, 2015)

There are opportunities to step outside the normal role as an EMT. I've had the privilege to be an active participant in minor surgical and various outpatient procedures after building a rapport with some of the doctors, facilities, and hospitals we frequent. It's very cool to be a part of something we normally aren't privy to while staffing an ambulance. There are quite a few doctors around that are eager to teach those that are eager to learn. One of my favorites was scrubbing in to assist with an IR fluoroscopy PICC placement. Watching the catheter feed through the chest vasculature to the heart in real-time was a treat.


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## jlw (Jan 1, 2016)

Learn what you can doing IFT, it'll help you in the long run, just don't get stagnate.


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## TheReallyCoolGuy (Feb 11, 2016)

That's disappointing to hear that. I work for a private IFT and I always chat with the nurses lol. Charisma helps. Some may just be having a bad day or some are just flat out rude. Don't take it to heart.


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## titmouse (Mar 23, 2016)

Dont let that mentality get to you. If the nurses are being richards, ask for the nursing supervisor. f they ask why do you need that info, tell that you want to know your patietns history for your report.


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## Gurby (Mar 23, 2016)

titmouse said:


> Dont let that mentality get to you. If the nurses are being richards, ask for the nursing supervisor. f they ask why do you need that info, tell that you want to know your patietns history for your report.



Eh, I don't know if that's a great idea.  If there is a consistent issue, I feel like it's a better idea to let your own supervisor know about it and let them handle it.


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## titmouse (Mar 23, 2016)

Gurby said:


> Eh, I don't know if that's a great idea.  If there is a consistent issue, I feel like it's a better idea to let your own supervisor know about it and let them handle it.


That is a good move as well specially when it comes to PCS forms LOL


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## ParamedicStudent (Apr 9, 2016)

Learn what you can. I worked IFT for three years and still am, and I can honesty say that I probably am a better EMT from being in months of medic school than three years of IFT. I'm also the type that'll learn from books and classroom time rather than being in the field 
But I did however learn how to take better vitals, talk to patients/family/nurses/staff, how not to be as awkward as I was before, how to use/operate a gurney, how to work in a moving vehicle. etc.


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## AfxEMT (Apr 13, 2016)

Hey everyone OP here. 
So I've been working more & more ALS now so it's not as mundane as just BLS IFT, I sometimes get to see some pretty cool medical calls & what not but recently I had a conversation with my partner who's been a paramedic since 86' (combat medic, lpn, flight medic, firefighter paramedic, etc) & I had asked if what we do is EMS & he said "no I don't think so, when was the last time you worked a car crash?"
If what we do isn't EMS then I'm not an EMT?
My Paramedics aren't Paramedics??
I understand where his coming from & I somewhat agree with him but I would like to hear you guys' thoughts. Thanks.


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## titmouse (Apr 13, 2016)

No, you are still an EMT and they are still Medics. You just work in an IFT company. Look into a company that run 911 calls


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## NomadicMedic (Apr 14, 2016)

This is why we need to break EMS off to a separate service classification, MTS. Medical Transport Service. Different training should be offered for a totally different set of problems.


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## titmouse (Apr 15, 2016)

DEmedic said:


> This is why we need to break EMS off to a separate service classification, MTS. Medical Transport Service. Different training should be offered for a totally different set of problems.


Didnt NREMT start an IFT EMT program in 2014?


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## Gurby (Apr 15, 2016)

IFT BLS trucks at my company have ended up on serious calls from time to time.  Go to pick up a patient for dialysis and find them unresponsive, only nearby truck for a seizure or cardiac arrest, etc.  I think you still need to be on the ball even if 95% of the time you're basically defrauding medicare just taking stable patients from point A to point B.  Maybe most IFT EMT's will never find themselves in that situation, but IMO you should still be mentally prepared for it so you don't fall on your face if you do.


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## AfxEMT (Apr 15, 2016)

"95% ofthe time you're basically defrauding medicarejusttaking stable patients from point A to pointB."

This. Morally & ethically I have a hard time accepting this but this job pays my rent & groceries. 
Sometimes I see it this way..
Burger King employee does BK stuff. 
Target employee does Target stuff. 
IFT =/= EMS(EMT/Paramedic)

I wanna become a Paramedic one day & get that cool patch but I don't think it'll be worth it unless I go to a place where fire & EMS is separate, or go become a firefighter or become a nurse.


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## TransportJockey (Apr 15, 2016)

@AfxEMT there's plenty of places where you have private services doing real EMS. Plus plenty of places where there's a third service EMS agency running a city or county.


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