# Ems laws?



## Scubamedic (Oct 2, 2007)

Hello,

I am a newly certified and licensed paramedic in the state of Florida. I am trying to familiarize myself with the Florida medical practices act and how it pertains to paramedics. Unfortunatly I am unable to find any helpful information on the subject. Is there a website or
listing where I can find the definitve laws pertaining to EMS?

One of the many questions I am trying to answer is what exactly is the
laws regurading " duty to act"? My understanding of them is that a EMS responder has a duty to act and respond to calls durring their scheduled shift hours.   

I ask this because I work for a ambulance service that does a high volume of non-emergency bls transport to and from hospitals, ALF's ect. Call stacking is normal here. It is not uncommon to recieve a page durring the day reading *" Due to volume of holding calls all shift end times are cancelled". *

I am well aware of vaction and off days being cancelled due to MCI or natural disasters. But I have never worked in a company that will cancel the end of your shift. Is this legal?

I work 24 hr shifts in the ambulance and since we do non-emergency transport...No bunk room and No down time. My days are spent running calls from start to finish. You can imagine how disheartening reading that page could be at your 23rd hour. lol. At that point, no ammount of coffee and jogging circles around the truck will make me really happy about life. Only the dreams of a shower and 12hr of sleep keep me going. 


Example: 

So If I am scheduled to work a shift from 0800-0800 and in the
course of this shift I recieve a call that runs late. For arguments
sake lets say that the late call take me to 9:45am. Now while enroute
back to the station after finishing the call, dispatch notifies us that they have another non-emergency transport that has been holding for sometime and I am to take it. Would refusing to run this call be reguarded as "breech of
duty" or " failure to act? At what time or point does my duty to act end?

I am a hardworker and love caring for Pt's, but I have to acknowlage that after 26 straight hrs of running call, pt care is affected. 
I am more than slight worried about providing poor Pt care due to exhaustion and it comming back to bite me.



Any infomation you might have would be appriciated. B)


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## ditchdr911 (Oct 2, 2007)

Scuba-

I've been in a similar situation. But, I made a choice to quit after another ridiculously busy 26 hour shift. On my way home I fell asleep driving, flipped my car, and was ejected. I was picked up by (another service's) ambulance w/ LBB, c-collar and all. They were professional, patient, & considerate, despite the uniform I was wearing. I work for them now and it's guaranteed I go home at the end of my shift. 
Point being - not all services are like yours. Start looking around, talk to medics from other companies and see how they like working there. It isn't worth risking your livelihood for a company that puts profit before your well-being.
Anyway, I found three websites for you. The national dept of labor's website, Florida statutes for EMS, and an overview of general Fl labor laws. Good luck! 

http://www.dol.gov/dol/audience/aud-workers.htm

http://www.leg.state.fl.us/statutes...Year=2007&Title=->2007->Chapter 401->Part III

http://www.megalaw.com/fl/top/fllabor.php


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## reaper (Oct 2, 2007)

Scuba,

 I am not sure what area of the state you live in, but there is plenty of work for medics out there. You work for private service, their job is to make money, not worry about pt care. Most of these services could care less about your well being. Bottom dollar is all that matters to them.

They can not force you into any more then 36hrs, with no sleep. Florida does not have a "duty to act" law. If you refuse to take a transport, they can fire you! But, until you take the call, you have no obligation to that pt.

Do your self a favor and find a new job, in a 911 service. You will get burned out and disgruntled dong private transports all the time.


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## MedicPrincess (Oct 2, 2007)

Scuba-

As reaper said, there is not a duty to act law in Florida.  However, there is exceptions to that.  If you are at work, and you are DISPATCHED to an emergency call, you then have a duty to act.  A non-emergent transfer does not qualify as an emergency call.  The repercussions for not taking that call would be loosing your job.

Do you enjoy working primarily bls transfers? Both services I work for need medics....especially the county service, they are particularly hurting...and not under a hiring freeze d/t the upcoming tax cuts.


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## Scubamedic (Oct 2, 2007)

Thanks for the links ditchdr, hope that you havent any long term affects from that MVA. 

The first 24hr shift that I found out that my partner, who is my best friend    (did medic school together) was unable to drive the truck. Aparently someone didnt put her on the company insurence before the shift, So I was stuck driving the day. At the 22nd hr while transporting a dialysis pt, the exhaustion of running all night caught up to me and I had to exit the highway and take the sidestreets to the facility. Once done with the call I land-lined my dispatch and told him that we were out of service. I explained to him why and his response was " But we've got calls holding". I quickly descided to rephrase my explaintion, knowing that all call into dispatch are recorded, by saying " *OK...Dispatch...This is medic 06. I am calling to advise you that I am no longer able to drive this ambulance in a safe manner and am now a danger to myself and others. Do you still want me to run another call knowing that I can no longer drive safely? *

grumpily he replied " bring it in" 

I hate to admit that the bottom line is money, but its true.

As far as enjoying non-emergency bls tranport as being the bulk of my day...no, i dont enjoy it. But this comapny was the one the called me back and since its my first paramedic position, I feel that I should really give it a shot in order to get a good employment background. I worked for a 911 based ambulance service in daytona beach for about a year and a half as a emt-b and loved it. Unfortunately they were not hiring when I need a job. So here I am. We do a small amount of emergeny response and although alot of our calls come in as non-emergency, I usually have to advise dispatch to up-grade us...I don't go to a SOB call non-emergency. I know that the copany is not where I want to stay too long, but it does give me oppertunity to due Pt care as a medic untill something else opens up. Im in the miami area, so if you have any links to EMS thats hiring right now I would love to take a look at them. 

thanks to all of you for your help and info.


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## VentMedic (Oct 2, 2007)

Sounds like the Miami privates haven't changed much in 30 years.

This past week another report on FF and EMS Sleep Deprivation was published and posted on Florida EMS's Listserv. 

Here's a link where you don't need a password. 

http://www.iafc.org/displaycommon.cfm?an=1&subarticlenbr=559

Current EMS updates from FL EMS can be found at:
http://ww7.doh.state.fl.us/mailman/listinfo/flemscomm

Florida has case precedents for sleepy drivers. However, FL EMS still has deep roots in the FD and that has also set a precedence in the field.  

If you read through some of the past threads on this forum and others, you'll find there are many people that are willing to risk life and limb to keep 24 hour shifts. Of course, many of them may run only 3 -4 calls/shift and still consider themselves over worked.  Employers are afraid to switch to 12 hr in fear of staffing issues.  


The early days of EMS, we fought hard for labor law exemptions.  Now, some of this may be coming back to haunt us.  I worked for a busy FL company in the 70s and 80s where 24 calls in 24 hours was a very slow shift. 24 calls was a breakeven point for most private companies. Some of the trucks were franchised to private individuals like taxis. They had to pull closer to 30 with county money for runs to stay running. Dialysis and NH patients were considered to be gold during those days.   They were also a welcome break then from the 911 calls, but not for the reasons one would think. 

I also remember when the Teamsters wanted to organize our drivers (non-credentialed) and EMTs, something unheard of in Florida at that time. Everybody was signing up. Then, the hours thing was mentioned by the union reps. The union wanted to impose some of the "trucker" standards for continuous road hours. They actually go the door slammed in their face by the EMS workers because there was money to be made doing 24 - 72 hours stretches.  And yes, I have requested my driver on more than one occasion to be brought in for rest.   The paramedics and EMTs would then search the yard for a fresh driver to get back on the street.

Be safe, get your experience and move to better working conditions. 

Depending on what part of Miami you are in, you could try Monroe or Collier County EMS.  You won't be too over worked in Monroe. The money isn't great though. 
http://monroecofl.virtualtownhall.net/Pages/MonroeCoFL_Personnel/employment


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## Scubamedic (Apr 14, 2010)

*Thank you to all*

Hey everyone, Scubamedic is back. 

First I wanted to thank you for all the advice and help. After some hard thought I did reach a desicion and left the private ems commpany that I was working for. I concluded that it was not it my best interest to stay and that their way of playing lose and fast with both Pt care and my employment was going to end badly and most likely in the loss of my licence to practice as an EMT-P. Since I have been involved with EMS starting and a volunteer with my home county Fire service starting in 1999, I was not going to waste 8 years of climbing the ropes to lose it due to the poor practices of one commpany. 

I believe in professionalism and doing the job right. I love real EMS and was wasting my skill and dulling my mind there. Right now I back home in daytona beach and there is scant work in the field. I am keeping up with my cert's and am looking for work. Unfortunatly, There is little open even in the tri county area, since most of the Ems is being done by the FD, even transport. 

I'll be searching the employment area of the forum and keeping an eye out in the paper. I just wanted to thank all those that replied to my post. If it wasn't for you frank and honest assement of the situation, I might have just lapsed into compacency and might not have my EMT-P Patch. I just hope to find a 911 ambulance service soon. I have been checking down in orlando and the economy is really in shambles since there seems to be so few jobs open and so many people with many more years of expirence in line before me. 

I recertify this year and that will bring me in touch with many people in the field, perhaps I will, with luck, get some info or catch a break. 

Anyways, again thank you for all your support.

scubamedic


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## reaper (Apr 14, 2010)

If you don't care where you live, Head to the north part of the state or the panhandle. The economy is better and there is work there. Most services are County run EMS. Not big on FD up there.


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## junno328 (Apr 14, 2010)

well, I think you can answer your own question my friend.....

ever seen a cop decline a call because he was working overtime??  you may be als certified, but declining a call is a big no no.  ever driven past an accident and not stop?  probably not.  any call that is up on the board 911/non emergency is a call.  it has to be run.


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## reaper (Apr 14, 2010)

junno328 said:


> well, I think you can answer your own question my friend.....
> 
> ever seen a cop decline a call because he was working overtime??  you may be als certified, but declining a call is a big no no.  ever driven past an accident and not stop?  probably not.  any call that is up on the board 911/non emergency is a call.  it has to be run.



Please don't offer bad advice. You have no duty or obligation to run any call, 911 or non emergency, in an unsafe condition. There is no breach of duty or abandonment issues, till you actually accept the call or make pt contact.

This is the thinking that gets Pt's and providers killed!


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## EMSLaw (Apr 14, 2010)

I agree with Reaper on this one. Much like the mentality of a "one on one battle with death", the idea that EMS providers are somehow supermen who can go for 36 hours with no rest and survive on rusty nails and stale coffee is crazy.

After so long without sleep, you're an accident looking for a place to happen.  Whether that happens in the back of the truck or behind the wheel, it's no favor to the public or to patients.  

As for what the law says... I would strongly suspect that anyone operating an emergency vehicle on no sleep would find that, in the event of a crash, they were held severely to account, along with their employer.  It's one thing if you run 9-1-1, and get some sleep with the occasional long night.  If you have no down time, you're just dangerous.  The body needs sleep.


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## Scubamedic (Apr 14, 2010)

*Agreed*

Juno-_well, I think you can answer your own question my friend.....

ever seen a cop decline a call because he was working overtime?? you may be als certified, but declining a call is a big no no. ever driven past an accident and not stop? probably not. any call that is up on the board 911/non emergency is a call. it has to be run. _






reaper said:


> Please don't offer bad advice. You have no duty or obligation to run any call, 911 or non emergency, in an unsafe condition. There is no breach of duty or abandonment issues, till you actually accept the call or make pt contact.
> 
> This is the thinking that gets Pt's and providers killed!





I have to agree with reaper here. You have NO DUTY TO STOP AND HELP WHEN NOT ON DUTY. I have researched this adnausum and in my state...*unless you are on duty, answer the radio call acknowlaging the call to respond and then Do Not respond*... You are not in breech of duty.

You have no obligation to stop and help a TC/ MVA while off duty , although I hope we all at least call it in. 

Now I am not talking about people trying to duck calls or trying to leave early, besides, in any good ambulance service, you arrive 30 min before shift change and so does your relief.

What I was discussing was driving and treating pt's for 25.5 straight hrs and when I had reached then end of my ability to operate a ambulance or render Pt care safely, my dispatch telling me that they were to busy with non-emergent intra-facility calls, the commpany's bread and butter...and that I had to continue to work dispite the fact that I was 1.5 hours over due and my relief was sleep in their cars back at the station. 

I have received enough information from this and just wanted to thank all the people involved. I have been in EMS since 1999 and a paramedic for 5 years. Right now my principal source of income is tutoring EMT and Paramedic students, which mean I am about as up to date with EMS as One can be, since I have to in order to be a effective tutor. 


*36 hours with no rest and survive on rusty nails and stale coffee *LOL, I loved that EMSLAW. RARRRRRRR!

So again thank you to all....


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## Scubamedic (Apr 14, 2010)

Juno-_well, I think you can answer your own question my friend.....

ever seen a cop decline a call because he was working overtime?? you may be als certified, but declining a call is a big no no. ever driven past an accident and not stop? probably not. any call that is up on the board 911/non emergency is a call. it has to be run. _






reaper said:


> Please don't offer bad advice. You have no duty or obligation to run any call, 911 or non emergency, in an unsafe condition. There is no breach of duty or abandonment issues, till you actually accept the call or make pt contact.
> 
> This is the thinking that gets Pt's and providers killed!


________________________________________________________________




I have to agree with reaper here.



1._ ever seen a cop decline a call because he was working overtime?_ *  I am not talking about overtime. OT is scheduled Extra work, not your dispatch keeping you on the job for fear of losing your job/license*

2. _ever driven past an accident and not stop?_ * Yup. Got out the cell and called 911*
3. _any call that is up on the board 911/non emergency is a call. it has to be run. _

*Of course, But would you risk youself, your partner and your patient, Responding to a call that you could potentionally kill all three + more if you drifted off at the wheel. Or what If I draw up the wrong dose of meds becuase my brain is fried and injure or kill a pt. Do you want that person working on you, your mom, your wife, your kids....*


 I am not a "Supermedic" I do not let my ego run my ambulance. I know my limits and work smarter...not harder. You can't get lucky all the time, but you can be smart everyday.  Because at then end of the day...it is all my responsibity. All of it. And from the tone of your post, that is something I don't think you really understand. It's all on you. Everything about that call, even the fact that you took the call knowing you were too tired and unsafe.
Every part of that call, good or bad, is a result of my choices. And if I save a life by knowing what is right and not taking that call...even if it costs me my license...I can live with that better than knowing I killed someone because I was to tired to do my job.

I am not talking about sucking it up and doing the job after 9 calls and 14 hrs. I'm no wimp.  I am talking about complete mental exhaustion from 25.5 hrs of non stop running 35 calls and 20 reports left to write. 
I have work S.A.R. Ops and done my time in the weeds. 
Guts can only get you so far and luck always runs out. 

So again thank you to all....especially Juno, for reminding me, *To always to what it right, not what is easy. *


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## himynameismj (Apr 15, 2010)

I work for a transport company as well. Generally, your employer should have a required amount of time you must stay after in the contract. My employer can hold me up to two hours after my shift time ends by contract, so after two hours I can call them out and refuse.


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## reaper (Apr 15, 2010)

You sign contracts to work for an IFT company?


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## FLEMTP (Apr 15, 2010)

VentMedic said:


> Depending on what part of Miami you are in, you could try Monroe or Collier County EMS.



Collier County EMS is no longer.. they are now Collier County Fire/EMS and they do not hire single certification candidates anymore to my understanding in talking with the collier crews when we run into them.

Lee County EMS is a great third services EMS only agency... but right now Lee County EMS is not hiring, but keep an eye on the webpage, and when they do get ready to hire, I'll make a posting here

http://www.lee-ems.com

I work for Lee.. and we have several Medics that live in the miami/ft lauderdale area. They commute and/or carpool. A majority of our shifts are 24/48's on an ABC rotation. We do also have some 12 hour shifts on a D/E schedule rotation.

Scubamedic---If I can offer any advice about where to work in Florida please feel free to PM me, I have EMS contacts all over the state.

Also pertaining to the EMS laws in Florida, in addition to the chapter 401 of the Fl State Statutes, there is also the Florida Administrative codes, Chapter 64J, which pertains to Emergency Medical Operations... that might help answer some of your questions.


Anything else I can help you with please feel free to shoot me a PM!


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## Scubamedic (Apr 16, 2010)

*Is it just Fl...*

Is it just Florida or the whole country that is going the duel cert route?


 I want to drive a ambulance, I want pt care. I love FF's, but i have no wish to be one. Here is daytona beach we have Daytona beach shores, and 3 mile line of A1A and they are- EMT-P, P.D. and FD. ALL 3. They drive in QRV's and call out the engines or buses as needed.


Thank you for the links and the info, FLEMTP, Right now I am back up in the west side of volusia county. I am about to start getting all my recerts done and that will put me back in touch with all my old friends from EVAC and Daytona FD. So I wil pick their brains first, but if that dosent pan out I might be PMING you. lol.


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## MrBrown (Apr 16, 2010)

Could always come work with Brown in Kiwi.

You can be "dual role" as Mr Red and Mr White and drive lots like you know, all the time.

I fell asleep in the way to a job on Saturday, do you really want me driving? 

No I wasn't driving.


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## wolfwyndd (Apr 16, 2010)

Scubamedic said:


> Is it just Florida or the whole country that is going the duel cert route?


No, it's not the whole country.  But it seems to be leaning that way more and more.  

My FIRST ems job was back in Laurel, MD and they required you to have your volunteer FF cert BEFORE they'd send you to EMT class.  I then moved out to Dayton, OH and managed to find ONE service that had separate fire and ems.  However I ended up getting my 36 hour card just because I can almost guarantee that once I leave this exact department, I'll have to probably get FF level 1.


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## Scubamedic (Apr 16, 2010)

MrBrown said:


> Could always come work with Brown in Kiwi.
> 
> You can be "dual role" as Mr Red and Mr White and drive lots like you know, all the time.



I want to be Mr. Pink and Mr. Black and I want PT care too, I don't mind driving, actually I like it, But I like Pt care too.


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