# Williamson County EMS is Hiring



## aquabear (Dec 26, 2017)

In case you missed it, Wilco EMS is hiring! Applications close on 1/5 for a testing process that will take place in mid-January. If you have any questions, feel free to ask!

http://www.wilco.org/Departments/EMS/Work-for-WCEMS


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## RocketMedic (Dec 26, 2017)

Looks amazing, but 24/48s?


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## aquabear (Dec 26, 2017)

RocketMedic said:


> Looks amazing, but 24/48s?


Our busiest truck averages 9 calls a shift, so 24/48s are doable and admin looks at moving/adding resources once a unit gets close to 10 calls a shift.

We also have three demand trucks, two work 12hr shifts and one works 10.5hrs x four times a week.


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## DrParasite (Dec 26, 2017)

all ambulances are 2 paramedics only?  any EMT positions?  

what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?


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## TransportJockey (Dec 26, 2017)

DrParasite said:


> all ambulances are 2 paramedics only?  any EMT positions?
> 
> what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?


I know it's an all paramedic agency, with no EMT positions in the field

Hmmm.. One of Cyn's relatives told her that she needs to move to Round Rock, and we both like the Hill country area... Hmmm....


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## RocketMedic (Dec 26, 2017)

aquabear said:


> Our busiest truck averages 9 calls a shift, so 24/48s are doable and admin looks at moving/adding resources once a unit gets close to 10 calls a shift.
> 
> We also have three demand trucks, two work 12hr shifts and one works 10.5hrs x four times a week.



It's not the UHUs as much as it is the thought of going back to 33% of your life at work from ~25% for the same pay, same job. I _like_ 24/72 for slower/rural agencies, and I _*really really really really*_ like the 12-hour peak truck write-my-own-schedule thing I've got going on here. It literally took a disaster to make me work overnight lol.


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## Tigger (Dec 26, 2017)

RocketMedic said:


> It's not the UHUs as much as it is the thought of going back to 33% of your life at work from ~25% for the same pay, same job. I _like_ 24/72 for slower/rural agencies, and I _*really really really really*_ like the 12-hour peak truck write-my-own-schedule thing I've got going on here. It literally took a disaster to make me work overnight lol.


If only 24/72 didn't require four shifts of people to make it work.


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## DrParasite (Dec 26, 2017)

What that is true, 24/72 use the same level of manpower an 12 hour shifts covering the same schedule.  

One of the biggest drawbacks to 24/48 (from what I hear, I have never worked them) is you always feel like you are either recovering from work or getting ready for work; you don't get that extra do to be completely off.


TransportJockey said:


> I know it's an all paramedic agency, with no EMT positions in the field


so doesn't that mean the medics end up treating a whole lot of non-ALS needing patients?  leading to the issue of skills degradation, because they just don't get to see enough sick patients to maintain the high levels of competency?  Wasn't this one of the documented issues with an all ALS system?


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## aquabear (Dec 27, 2017)

DrParasite said:


> all ambulances are 2 paramedics only?  any EMT positions?
> 
> what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?



Every truck is dual paramedic, and almost all of our Admin and Clinical Practices staff are credentialed paramedics too. That level of care allows us to have a great scope of care because we have a minimum of two highly trained providers on every scene. We don’t need permission from a supervisor or contact OLMC to do things like DSI/RSI, surgical cric, pericardiocentesis, hang pressors etc.

I don’t really keep track of a “BLS vs ALS” ratio to be honest. The “ratio” does change from truck to truck, but everyone still gets sick patients.



DrParasite said:


> so doesn't that mean the medics end up treating a whole lot of non-ALS needing patients?  leading to the issue of skills degradation, because they just don't get to see enough sick patients to maintain the high levels of competency?  Wasn't this one of the documented issues with an all ALS system?



The first step we do to make sure we maintain high levels of competency is to hire the right people. Once they pass our rigerous hiring process, they have to pass our academy and credentialing process, which can take up to a year.

Our medics stay sharp with daily peer to peer chart reviews, Senior Medical Officer KPI chart reviews and Station Lieutenant operational chart reviews. These chart reviews allow us to quickly identify problems (individual and system wide) and work toward resolving them.

We also have quarterly mandatory CE classes, monthly mandatory Medic-CE courses, paid card classes and regular SMO station visits where they update field medics with patient care trends, SOC updates/clarifications and airway management skills verification. Our Clinical Practices staff also publish monthly statistics for the clinical metrics we track.

Additionally, every medic must take an annual skills, written, med math and 12 lead interpretation exam in order to remain credentialed.


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## RocketMedic (Dec 28, 2017)

The medicine is pretty advanced indeed. Do y'all have peak trucks?


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## Bullets (Dec 28, 2017)

aquabear said:


> surgical cric, pericardiocentesis


How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?


RSI i dont think of as fancy, everyone around me does it. You still hang pressors? Around here its all push dose


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## aquabear (Dec 28, 2017)

RocketMedic said:


> The medicine is pretty advanced indeed. Do y'all have peak trucks?


We run two 0700-1900 trucks and have one truck that runs 0800-1830 MTuThF.


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## aquabear (Dec 28, 2017)

Bullets said:


> How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?
> 
> 
> RSI i dont think of as fancy, everyone around me does it. You still hang pressors? Around here its all push dose


System wide I couldn’t give you exact stats on the two (pericardiocentesis and cric). I’ve personally performed a pericardiocentesis once this year. They are two tools in our tool box that I am glad to have.

We’re using push dose pressors in addition to hanging levophed, again all as standing orders.


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## RocketMedic (Dec 28, 2017)

How many days a week are these peak trucks, and do they get fought over?


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## Tigger (Dec 29, 2017)

Bullets said:


> How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?
> 
> 
> RSI i dont think of as fancy, everyone around me does it.* You still hang pressors? Around here its all push dose*


Push dose pressors are designed to be a bridge. A bridge to hanging real vasopressor infusions. Continuing to bolus vasoactive medications for extended time periods is not good for patients. Use 10mcgs of Epi or dirty epi drips to get your patient through tough times, but they aren't and were never intended to be anything besides super short term measures. If your transport times are short it might not matter I guess.


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## Bullets (Dec 29, 2017)

Tigger said:


> Push dose pressors are designed to be a bridge. A bridge to hanging real vasopressor infusions. Continuing to bolus vasoactive medications for extended time periods is not good for patients. Use 10mcgs of Epi or dirty epi drips to get your patient through tough times, but they aren't and were never intended to be anything besides super short term measures. If your transport times are short it might not matter I guess.



NJ, so yeah, transport times are like 5-15 minutes in my area. Only time we would have something long would be an offshore rescue which basically never get ALS until they hit land.


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## Tigger (Dec 29, 2017)

Bullets said:


> NJ, so yeah, transport times are like 5-15 minutes in my area. Only time we would have something long would be an offshore rescue which basically never get ALS until they hit land.


Not to mention the time on scene. It's a little unfortunate that actually mixing infusions is no longer emphasized.


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## RocketMedic (Dec 30, 2017)

I made one this week...

Back on-topic, if I had to be sick or injured, I would _way_ rather do it in WilCo than anywhere around there. For a lot of people, myself included, they're a very desirable operation. My only qualm with them is their schedule, and that's just because I'm all sorts of snowflake about 'work-life balance' and I really want to use my fancy book learning in more ways than to be the Ash Ketchum of EMS.


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## RocketMedic (Dec 30, 2017)

I'm only half-expert, but a lot of y'all from places like CA or NY or wherever with high taxes would find yourselves very pleasantly surprised by what an equivalent paycheck in Central Texas can get you. Austin's pricey, but there's a lot of nice places to live in the Central TX area that are both cultured and affordable.


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## Bullets (Dec 30, 2017)

RocketMedic said:


> I'm only half-expert, but a lot of y'all from places like CA or NY or wherever with high taxes would find yourselves very pleasantly surprised by what an equivalent paycheck in Central Texas can get you. Austin's pricey, but there's a lot of nice places to live in the Central TX area that are both cultured and affordable.


So whats a street medic making in Wilco


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## RocketMedic (Dec 30, 2017)

I think it's like $52k ish pretax.


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## TXmed (Dec 30, 2017)

RocketMedic said:


> I made one this week...
> 
> I really want to use my fancy book learning in more ways than to be the Ash Ketchum of EMS.



haha im gonna have to steal this one.


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## aquabear (Jan 1, 2018)

RocketMedic said:


> How many days a week are these peak trucks, and do they get fought over?


The schedule is a little confusing because of when our pay week starts, but the cliff notes version is you get a 3 day weekend every other weekend. So for our two week pay period starting on a Friday it’s 3 on, 2 off, 2 on, 3 off, 2 on, 2 off.

Vacancies are hit and miss, for the first 2 years there was no movement, and in our most recent staffing there were 3 shifts open.


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## aquabear (Jan 1, 2018)

Bullets said:


> So whats a street medic making in Wilco


Starting pay is $56k with zero overtime shifts. When you include mandatory CEs and early and late punches for crew change, it’s gets closer to $60k.


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## RocketMedic (Jan 1, 2018)

Pretty much exactly what I'm at here. In just too lazy to go through yet another onboarding and NEOP/credentialing process for more of the same lol. Plus school and write-my-own schedule...


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## aquabear (Jan 1, 2018)

RocketMedic said:


> Pretty much exactly what I'm at here. In just too lazy to go through yet another onboarding and NEOP/credentialing process for more of the same lol. Plus school and write-my-own schedule...


I totally get that. I wouldn’t leave here unless you offered me a whole lot more cash with the same medical director and scope of care.

But we do get 250% matching on out TCDRS retirement plan...


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## NPO (Jan 24, 2018)

Their website says they serve 500,000 people and run 30,000 calls per year.

Coming from a system with 800,000 people and 110,000 annual calls, this sounds like a vacation!

Yes. That's one call for every 8 people. 
*sigh*


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## TransportJockey (Jan 24, 2018)

aquabear said:


> Starting pay is $56k with zero overtime shifts. When you include mandatory CEs and early and late punches for crew change, it’s gets closer to $60k.


As of now that's about where our in charges stand down here too. I'm in the same boat at @RocketMedic except i actually have tcdrs lol


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## AlexandraMay3155 (Feb 25, 2018)

aquabear said:


> In case you missed it, Wilco EMS is hiring! Applications close on 1/5 for a testing process that will take place in mid-January. If you have any questions, feel free to ask!]



Do you guys take paramedics for internships?


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## aquabear (Feb 26, 2018)

AlexandraMay3155 said:


> Do you guys take paramedics for internships?


We have contracts to take students from ACC, Temple College and EMTS. I’m not sure if we take interns from other schools, that would be something the school would need to contact the department about.


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## RocketMedic (Mar 13, 2018)

If it wasn't for the 24/48....I really like that area of Texas. Spent the afternoon and evening in Gruene/New Braunfels and I miss the nice part of Texas. Driving back to Houston was like going to Louisiana for no good reason. 

I'm not about that 24/48 though. Ain't about that life. Not my favorite.


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## FiremanMike (Mar 14, 2018)

RocketMedic said:


> If it wasn't for the 24/48....I really like that area of Texas. Spent the afternoon and evening in Gruene/New Braunfels and I miss the nice part of Texas. Driving back to Houston was like going to Louisiana for no good reason.
> 
> I'm not about that 24/48 though. Ain't about that life. Not my favorite.



I’m on m-f now and I miss 24/48 and the free time that comes with it..


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## Tigger (Mar 14, 2018)

FiremanMike said:


> I’m on m-f now and I miss 24/48 and the free time that comes with it..


Any schedule without a four day break is meh. We're on modified kelly (OXOXOXXXX) which is I think ok for 24s. I bet I could live with the 24/48 to work for such a great place though.


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## FNGperpetual (Dec 20, 2018)

How do ya'll feel about hiring new paramedics? 
( with basic or intermediate experience)

 How often do yall look for new workers?


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## aquabear (Dec 20, 2018)

FNGperpetual said:


> How do ya'll feel about hiring new paramedics?
> ( with basic or intermediate experience)
> 
> How often do yall look for new workers?


We are currently taking applications until January 4th at 1700hrs central time for a hiring process in mid January.

We do hire medics straight out of paramedic school (we only require you have your state license by the end of the academy), so lack of experience as a paramedic isn’t a disqualification.


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## aquabear (Jul 20, 2019)

Bumping this. Wilco EMS is hiring! Applications close at 1700 central time August 9th. The hiring process will be August 19-22 and you don't need your Texas DSHS license to apply, you just need to be eligible for reciprocity.

As always, I'm here if anyone has questions.


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## FNGperpetual (Jul 20, 2019)

Paramedic only??


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## StCEMT (Jul 20, 2019)

Texas is the temptation I have to avoid lol


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## NPO (Jul 20, 2019)

FNGperpetual said:


> Paramedic only??


Yes, they only employ Paramedics


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## Tsubasa (Apr 1, 2020)

Howdy!

Do you know when the next application process for Wilco is? Thank you in advance!


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## aquabear (Apr 1, 2020)

agnelson2 said:


> Howdy!
> 
> Do you know when the next application process for Wilco is? Thank you in advance!


We had an idea about when we would have our next hiring process and academy, but COVID jacked up all of our plans. Currently all CE classes, mandatory trainings and even out annual SOC updates/testing have all been indefinitely postponed due to social distancing policies in an effort to keep staff safe.

We should hire again this year, but honesty I don’t know when it will happen.

Sorry I can’t give a better answer right now, but as soon as I hear something, I’ll be sure to share it.

In the mean time, stay safe, be healthy, and study AMLS and 12 leads.


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## Tsubasa (Apr 2, 2020)

Thanks! I was wondering because the Williamson County EMS Facebook page made a comment that they are currently accepting applications, but I did not see it listed anywhere on their website. 

I definitely have a lot of studying ahead of me!


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## aquabear (Dec 16, 2020)

Bumping this thread since we are hiring again! Application closes on January 15th at 12PM CST.

Dual Paramedics on Every Medic Unit
Evidence Based Protocols
Up to date equipment: Stryker PowerPRO + Power-LOADs, LP15s with Technimounts, Ventilators on Every Truck
Competitive Pay
TCDRS retirement with 250% match (Wilco is 1 of 9 organizations that match at that rate)

I'll be happy to answer any questions via PM or you can check out the recruitment page -> Wilco EMS Recruitment


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## PotatoMedic (Dec 16, 2020)

aquabear said:


> Bumping this thread since we are hiring again! Application closes on January 15th at 12PM CST.
> 
> Dual Paramedics on Every Medic Unit
> Evidence Based Protocols
> ...


My wife says we can't move.  Wonder if I could commute...🤔


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## Tigger (Dec 16, 2020)

The HR folks or whomever made this add should be commended for putting the pay on the flyer!


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## aquabear (Dec 16, 2020)

Tigger said:


> The HR folks or whomever made this add should be commended for putting the pay on the flyer!


We're pretty open about it. Your checks are lower during the academy because you don't average 56 hrs/week like when you are on the truck, which does suck. However, that figure doesn't include mandatory CE, paid card class hours and built in over time completing shift change, so that number gets closer to $60k. While you can't work OT during the new hire process, it's abundant when you clear with existing vacancies and planned growth over the next fiscal year.


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## DrParasite (Dec 17, 2020)

aquabear said:


> Dual Paramedics on Every Medic Unit


Question about your system and call volumes: how many of your patient's meet the CMS standard of being an ALS1 or ALS2 patient?  Most systems I am familiar with are around 20-40% (using the definition of "Advanced life support, level 1 (ALS1) is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including the provision of an ALS assessment or at least one ALS intervention"), with the rest being BLS.  

Since you are a dual medic system, and making the assumption that you are similar to other EMS systems with a 60%+ BLS patient rate, how do you maintain skill competency on rarely used skills (ET tubes, chest decompression, surgical airways, to name a few), and spend more than half your time dealing with not-sick patients who do not require ALS interventions?


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## Tigger (Dec 18, 2020)

Wilco has one of the most involved medical directors in the country and a great clinical education department. They open source lots of their materials for others to make use of. I won’t speak to their specific processes but if there was ever a department’s internal training program to model off I think would choose them.

Also this idea that when paramedics also see non-sick patients makes them somehow less effective is a false paradigm. Other places have figured how to provide effective ALS besides just Delaware and New Jersey. It isn’t just volume that makes one a strong paramedic, nor is it arbitrary dispatch determinants.


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## VentMonkey (Dec 19, 2020)

Jeff Jarvis defines, and is the epitome of an EMS medical director all others should model themselves after. Hands down.


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## DrParasite (Dec 20, 2020)

Tigger said:


> Other places have figured how to provide effective ALS besides just Delaware and New Jersey.


yes, but most places do it by pairing an EMT with a paramedic.  if it's a BLS patient, the EMT treats, if it's an ALS patient, the paramedic treats.  with a dual medic system, you have a paramedic treating BLS patients.

And my question has nothing to do with dispatch criteria, but rather CMS criteria.  

your unwarranted hostility towards the NJ and DE ALS systems is unwarranted and irrelevant to my question.


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## jgmedic (May 6, 2021)

So I just made it through the skills test and have my interview next week. I'm curious from a field medic perspective, how is the working environment? Station life, etc, also, best places to show my wife we might be able to afford with 4 kids?


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## brandonb02 (Mar 13, 2022)

Do you guys run IFT transfers too or strictly 911? And is it still 24 hour shifts? I personally hate working anything shorter than 24. 48/96 is my favorite schedule but 24/48 is certainly an improvement from 12s.


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