# Low wages chase away EMTs



## MMiz (Nov 26, 2008)

*Low wages chase away EMTs*

BROWNSVILLE — Chris Goodrich decided to become a paramedic for the sheer thrill of it — of trying to administer CPR in the back of a fast-moving ambulance, of opening someone’s airway so the person can breathe, of helping to save a life

[...]

Basic EMTs in the south central U.S. make a median of about $23,000 a year, and paramedics, $34,000, according to a national survey on EMT and paramedic pay that appears in the October issue of the Journal of Emergency Medical Services. 

*Read more!*


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## VentMedic (Nov 26, 2008)

MMiz said:


> *Low wages chase away EMTs*
> BROWNSVILLE — Chris Goodrich decided to become a paramedic for the *sheer thrill of it* — of trying to administer CPR in the back of *a fast-moving ambulance*, of opening someone’s airway so the person can breathe, of helping to save a life


 
Great example of a quality medical professional! I would say whatever they are paying him, it is too much. 

Maybe it is more than the wages that chase people on to other medical careers. Some may be mature adults who want to work in a chosen field of medicine for the patient care aspect but end up getting partnered with someone who is just wants a thrill ride.



> Because of low pay and numerous opportunities to work as a basic emergencymedical technician, the Rio Grande Valley is graduating fewer paramedics and some local emergency services are seeing a shortage as a result.


 
It takes 140 hours to be an EMT in Texas and they can do a few additional advanced "skills" as determined by their medical director. Hence, they can do some of the exciting stuff like ETI but not really have the full responsibility of a Paramedic. Pretty cool! What incentive is there to be a Paramedic if the EMT can already do so much with so little?

If EMTs are already remaining as EMTs and not going on with another few months of "training" to make more money, raising their wages is only going to encourage them to stay at this level. 

It takes 634 hours to be a Paramedic in Texas with maybe an additional 160 hours if you add EMT-I. For all THREE levels that is less then 1000 hours of training. 



> Nurses, Respiratory Therapists and other health professions make more than EMTs and paramedics


 
The other health professions do over 1000 hours for just clinicals and REQUIRE a college degree which is more than 2x the education REQUIRED of a Paramedic for entry into the profession. How much more than an EMT is that? 

Notice that they did not mention *CNA* which is closer to the equivalent hours of training for the *EMT*?

*EMT*: 140 hours - $23K 
*CNA* for that area: $8 - 10/hr or $21K

*Paramedic*: $34K for just under 1000 hours of training.

*LVN*: $37K - 1 year certificate and very difficult to find a decent job since many employers now demand/require the higher educated RN especially for working in the hospitals. Like many other health professions (including RT) they found 1 year is just not long enough and often a 2 year degree is too short.

*RN*: $57K That may be overstated for many midwest and southern states but when compared to their responsibility and education, that would be a decent expectation. $40K - $45K is a more realistic expectation in many parts of the country. 

Texas at least has an additional patch and title for someone who has obtained a 2 year degree as a Paramedic, but it is not mandatory. So at this time it would be difficult, especially if there are unions involved, to offer more pay for the exact same job description and no stated MANDATORY education requirement except for a Paramedic cert.


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## BLSBoy (Nov 26, 2008)

It all comes down to recruitment/retention, and the lowest common denominator. 

The vollies don't want any more training, since they have "real jobs" and just want to play EMT when its convenient for them, and the fire depts (note, not firemen, but more so the buffoons who run them) want any and everybody to become Paramedics, and they want them yesterday. 

Until EMS is it's own *profession*, we will continue to see this occur. 

Sounding like a broken record yet?<_<


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## RailFan77 (Nov 28, 2008)

BLSBoy said:


> The vollies don't want any more training, since they have "real jobs" and just want to play EMT when its convenient for them, and the fire depts (note, not firemen, but more so the buffoons who run them) want any and everybody to become Paramedics, and they want them yesterday.
> 
> Until EMS is it's own *profession*, we will continue to see this occur.
> 
> Sounding like a broken record yet?<_<



Not sounding like a broken record....just one of those typical "pompus" medics that we have to deal with here in Jersey.  Last i checked the "vollie" EMT's do play a vital role in some communities...especially where the paid companies won't go because they can't make a buck.  I just hope that when you have a sick person in your family one day...maybe a mother, father, child, whatever....they will still feel it "convenient" to come help them especially after reading your post.

I was asked recently at an interview for medic school why I like and dislike certain medics.  That "I'm better than you" pompus attitude that you are showing there is one thing I said I can't stand that some (not all) medics have.  Hope I don't sound like you one day...or it will be a really sad day.


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## JPINFV (Nov 28, 2008)

^
Hopefully when his family gets sick he'll have an ambulance crew whose profession is prehospital medical care and not someone whose hobby is prehospital medical care.


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## Ridryder911 (Nov 28, 2008)

RailFan77 said:


> Not sounding like a broken record....just one of those typical "pompus" medics that we have to deal with here in Jersey.  Last i checked the "vollie" EMT's do play a vital role in some communities...especially where the paid companies won't go because they can't make a buck.  I just hope that when you have a sick person in your family one day...maybe a mother, father, child, whatever....they will still feel it "convenient" to come help them especially after reading your post.
> 
> I was asked recently at an interview for medic school why I like and dislike certain medics.  That "I'm better than you" pompus attitude that you are showing there is one thing I said I can't stand that some (not all) medics have.  Hope I don't sound like you one day...or it will be a really sad day.



Can you really back up what you say? Or is it just the usual B.S. I hear from New Jersey. Seriously, in the year of nearly two thousand and nine the one and only state that still endorses first aid over medical care. Can I take anything seriously from that state in regards to emergency care? 

Vollies only play a role where it is the only  option available and although I have never visited nor would I ever plan to (due to the potential dangers of EMS or lack of) I really doubt that the state has the lack of population or area where professional EMS could not be provided. If that is the case, then I stand corrected or endorse the  volunteerism in those specific areas. With that statement, just because one is a volunteer they should be equal or greater trained. 

It is a documented fact that vollies has been detrimental to the growth of EMS and the education related to patient needs. Such as the Montana studies, and rural studies of the early 90's and the reevaluation of the EMT curriculum in which the material was "dumbed" down. Medical terminology was almost totally eliminated, emphasis of being friendly and that everyone should pass was placed into institutions. As well it was the associations of such as those in New Jersey that protested increasing medical knowledge and training. Thus in realility reducing the care and needed treatment to the sick and ill... feel proud of yourselves now? 

In the real world of medicine, not hobbies, looking cool, or even feeling good about oneself with self centered ego's; people need competent and advanced medical care. There is little that placing band-aids, slapping some oxygen or kissing boo-boo's does for the truly ill and severely injured patient. I ask what is the outcome of your patient that has vomited and now aspirated, ever heard of chemical aspiration and do you know the outcomes? How many brain cells died as you were awaiting an advanced life support to give IV glucose? Was the Cath lab or receiving hospital awaiting and prepared for the right sided myocardial infarction? How did the mother fair that was having eclamptic seizures and the meconium stained neonate? 

Still like to argue the need of having someone do it for fun or "for the good of the community" or one that has dedicated their life to studying and performing it?  What is *shameful * is I have been providing ALS care to poor communities as a EMS paid professional for over thirty one years, so I know it can be done. I don't care to hear excuses for that is what it is! If those that are so "concerned" was really and truly concerned they would be finding funding, legislate to fund advanced and professional services, instead of volunteering as an EMT. Otherwise they are doing it for their own ego's. 

Your community supports law enforcement, dog catcher? Then it can support an EMS. Has your community thought of district EMS and conjunction with other EMS so everyone can prosper or is it alike so many others that "want their own" or nothing at all? 

Again, it is *NOT* all volunteers, alike it is *NOT* all firefighters that give their groups a bad name, unfortunately it is the majority and usually those that attempt to acclaim to represent their groups. 

R/r 911


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## Foxbat (Nov 28, 2008)

You seem to equate "volunteer" with "unstaffed" and "BLS", which is not always correct. In my area, there are volunteer and combination ALS services staffed 24/7. And for BLS services, an ALS backup (often as a medic fly-car) is dispatched.
The service I am curently volunteering for is a combination service with a paid ALS crew 24/7; volunteers (usually EMT-Bs) are used either as a third person, to staff trucks in case of multiple calls at the same time (or MCIs), as additional personnel to help with bariatric pts., to supplement a crew when paid personnel is not available (sick etc.), and for stand-bys (sports games, etc.). I do not think that us - or our neighbours, all-volunteer services - hold EMS back; volunteers can be successfully incorporated into the system (ex. Israel, Germany, Spain) and these systems may actually provide higher level of care then American ALS systems, having a physician on scene as a primary caregiver.


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## firecoins (Nov 28, 2008)

VentMedic said:


> Great example of a quality medical professional! I would say whatever they are paying him, it is too much.


Don't blame bad journalism with bad EMS.  What you quoted on fast moving ambulances has alot more to do with the writer. 

Even if the medic said stuff about codes in fast ambulances, he may have oversimplifing EMS for the usually uniformed journalist.  Publicists make a career of dealing with the press. Paramedics do not. 




BLSBoy said:


> Until EMS is it's own *profession*, we will continue to see this occur. <


EMS is its own profession last I checked. 



Ridryder911 said:


> Can you really back up what you say? Or is it just the usual B.S. I hear from New Jersey.
> R/r 911


You "hear" alot stuff about New Jersey.  I have my doubts you know the "usual" B.S. about NJ when you live and work in the Midwest. Internet forums are the place to be judging the Northeast.  Certain locations in NJ promote a first aid squad over medical care.  Its not the whole state.  Please stop with the over generalizations.


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## Ridryder911 (Nov 28, 2008)

firecoins said:


> EMS is its own profession last I checked.
> 
> 
> You "hear" alot stuff about New Jersey.  I have my doubts you know the "usual" B.S. about NJ when you live and work in the Midwest. Internet forums are the place to be judging the Northeast.  Certain locations in NJ promote a first aid squad over medical care.  Its not the whole state.  Please stop with the over generalizations.



Actually EMS is NOT a profession rather a vocation as a profession requires a degree entry level. 

Sorry, I am not generalizing New Jersey. I realize it is not the whole state but still the state representation in general. I have read reports and legislation from their First Aid Squads and volunteer lobbying organizations. Again, any state that promotes first aid in lieu of professional ALS care is bad. Period. Yes, if that is they want it so be it. 

Amazing it is only the Eastern states that has "fly cars". I wonder how they justify the costs? It is not that expensive to place a Paramedic on each responding unit. Instead of paying or having three personal only two. If actual EMS managers knew how to budget and bill appropriately. Again if smaller and lower reimbursed areas can do it, surely those with higher call volume and higher paying ratios can do it as well. 

R/r 911


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## Desert Ranger (Nov 28, 2008)

Paid or volunteer, does it really matter as long as the care giver has proper training and operates within and does not exceed their scope of practice?


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## JPINFV (Nov 28, 2008)

Desert Ranger said:


> Paid or volunteer, does it really matter as long as the care giver has proper training and operates within and does not exceed their scope of practice?



It matters when one of the sides is complaining that they can't undergo additional training because it would interfere with their real job. Here's a question for the volunteers, would you still be volunteering if the EMT-B level required a year of college courses (chem, A/P, psych, etc) before being able to enter an EMT-B course?


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## RailFan77 (Nov 28, 2008)

The question could also be posed...Would anyone who is an EMT-B remain as one if college coursework was required?  I believe most people would opt to become EMT-P.

Listen...I am not saying the system is perfect here.  My whole rant was more for the blanket statement that was thrown out there.


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## Ridryder911 (Nov 28, 2008)

RailFan77 said:


> The question could also be posed...Would anyone who is an EMT-B remain as one if college coursework was required?  I believe most people would opt to become EMT-P.
> 
> Listen...I am not saying the system is perfect here.  My whole rant was more for the blanket statement that was thrown out there.



Very good points. Hence the reason you do not see volunteer (primary role) physicians, nurses, etc. Also, we will see what will occur in about three years as many states will require accreditation for Paramedic institutions (albeit they do not have to be collegiate) they do require a degree to teach a Paramedic course. 

R/r 911


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## Desert Ranger (Nov 28, 2008)

BLSBoy said:


> It all comes down to recruitment/retention, and the lowest common denominator.
> 
> The vollies don't want any more training, since they have "real jobs" and just want to play EMT when its convenient for them, and the fire depts (note, not firemen, but more so the buffoons who run them) want any and everybody to become Paramedics, and they want them yesterday.
> 
> ...


huh? So are you saying people with quals like mine are not professionals? I am not a volunteer but I have other duties besides EMS


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## Ridryder911 (Nov 28, 2008)

Desert Ranger said:


> huh? So are you saying people with quals like mine are not professionals? I am not a volunteer but I have other duties besides EMS



You are a professional but your primary job is that of a Ranger with duties of providing emergency care when and as if needed. Your are not considered a professional EMS provider even though it is part of your profession. This does not lower your intent nor ability, just classification. The same as those of us in EMS may have a special sector to perform does not make a professional ________. 

I do not classify EMT's that are Deputies Reserve as professional LEO's. ... See where I am getting at? 

R/r 911


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## Desert Ranger (Nov 28, 2008)

Ridryder911 said:


> You are a professional but your primary job is that of a Ranger with duties of providing emergency care when and as if needed. Your are not considered a professional EMS provider even though it is part of your profession. This does not lower your intent nor ability, just classification. The same as those of us in EMS may have a special sector to perform does not make a professional ________.
> 
> I do not classify EMT's that are Deputies Reserve as professional LEO's. ... See where I am getting at?
> 
> R/r 911



That is being hyper picky about "professional" status. Like the "mine is bigger" arguments.


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## Foxbat (Nov 28, 2008)

JPINFV said:


> Here's a question for the volunteers, would you still be volunteering if the EMT-B level required a year of college courses (chem, A/P, psych, etc) before being able to enter an EMT-B course?


I have some of these courses (chem, math, etc.) and planning to take A&P before graduation, although my degree is not EMS related (unless I decide to go for a minor in bioengineering... still undecided on that). What is your point?


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## firecoins (Nov 28, 2008)

I do not support First Aid squads but many NJ areas have a fine EMS system.  The state level problems are political.  And yes i have read the same study you did.  

I support fly car systems.  It allows medics to arrive on scene first and do an ALS assesment on all patients. If the call requires him to go on the transport unit, he does. If it doesn't, he remains available to respond other emergencies.


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## Ridryder911 (Nov 28, 2008)

Desert Ranger said:


> That is being hyper picky about "professional" status. Like the "mine is bigger" arguments.



Not really. Professionals are picky who can acclaim to be in their profession or not. That is part of what being a professional is all about their inclusive. Not everyone nor should everyone be allowed. Sorry, one can act and present themselves as a professional but to really be a professional within a certain profession itself, one must be at the top and proficient and truly educated and dedicated within it. 




Foxbat said:


> I have some of these courses (chem, math, etc.) and planning to take A&P before graduation, although my degree is not EMS related (unless I decide to go for a minor in bioengineering... still undecided on that). What is your point?



Part of the problems in EMS is taking the shortest and easiest route. Don't believe me, look at the requirements of being an instructor of EMS. Majority of those that do volunteer do it out the kindness of their hearts, or let's be blunt : Whistles, lights, sirens. There is very little interest past the minimal amount required. That's understandable. It's not in the best interest for the patient though. 

Heck, when new curriculum's come out; lobbying and protesting immediately starts when it involves more hours and tougher reading requirements. What do you think if we were to require Basic EMT to be at least one year in length and to mandate college level science courses to accompany such courses, what would the attribution rate be of volunteers? 
Again, lets look up North. 

R/r 911


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## reaper (Nov 28, 2008)

Desert Ranger said:


> Paid or volunteer, does it really matter as long as the care giver has proper training and operates within and does not exceed their scope of practice?




So how will you feel if 20 people show up to volunteer as park rangers? I mean come on, it can't be that hard a job, I could learn it in a few days!

How long do you think it would take your bosses to start cutting people? They could have 1 or 2 paid rangers over see all the volleys. Save a lot of tax payer money!


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## Foxbat (Nov 28, 2008)

Again, it's not like EMT-Bs can either be utilized as a primary caregiver or not utilized at all. I am all for medic (or, preferrably, physician) at least assessing each patient, but why not have a free extra pair of hands? I already gave examples of European systems that use lower level providers to supplement ALS providers.
I have described our organization earlier; how would our patient care improve if we stop doing stand-bys, have one person on the back of the truck instead of two, not having additional trucks respond to MCIs, etc.?


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## Desert Ranger (Nov 28, 2008)

Elitist snobbery.


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## reaper (Nov 28, 2008)

Desert Ranger said:


> Elitist snobbery.



I see that you are well versed in the art of discussion


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## JPINFV (Nov 28, 2008)

Foxbat said:


> I have some of these courses (chem, math, etc.) and planning to take A&P before graduation, although my degree is not EMS related (unless I decide to go for a minor in bioengineering... still undecided on that). What is your point?



My point is that anyone who thinks that the EMT-B level provides or requires enough education has no clue what they're talking about. The science background for EMT-B is rivaled by high school science. We ("we" being "EMT-Bs) should have a working understanding of anatomy and physiology AND how our interventions and diagnostic tools work. Yes. we should know how, for example, action potentials are created. We should know how blood pressure is regulated in the body. Anyone who's in charge of patient care (of which EMT-Bs fall into this group) should know these. Anyone who thinks that anything but an extremely simplistic idea of anatomy and physiology can be taught in 2 hours (2 hours per NHTSA curriculum) has never taken an anatomy and physiology course. 

Now, if volunteers are complaining about the time commitment to become an EMT-P, I'm fairly certain that they are going to complain about being required to have a true science background before they are taught to practice prehospital medicine.



Foxbat said:


> Again, it's not like EMT-Bs can either be utilized as a primary caregiver or not utilized at all. I am all for medic (or, preferrably, physician) at least assessing each patient, but why not have a free extra pair of hands? I already gave examples of European systems that use lower level providers to supplement ALS providers.
> I have described our organization earlier; how would our patient care improve if we stop doing stand-bys, have one person on the back of the truck instead of two, not having additional trucks respond to MCIs, etc.?



Strange, I've never once had a paramedic show up before me on a call going to the emergency room. The vast majority of the patients I've transported have had me, an EMT-B (or my partner), as the primary care giver on the call. Of course if you require all ambulances to have EMT-Ps on board, then why have EMT-Bs to begin with except as a first responsers? We really are not required or given the education required to be making the decisions that we make day in and day out.


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## Foxbat (Nov 28, 2008)

JPINFV said:


> Of course if you require all ambulances to have EMT-Ps on board, then why have EMT-Bs to begin with except as a first responsers? We really are not required or given the education required to be making the decisions that we make day in and day out.


Why _not_ have an EMT-B as an extra pair of hands to assist medic? Let me ask again, how will our patient care improve if we have just a medic in the back of the truck, rather than medic and basic?


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## fortsmithman (Nov 29, 2008)

reaper said:


> So how will you feel if 20 people show up to volunteer as park rangers? I mean come on, it can't be that hard a job, I could learn it in a few days!


In my part of the world Park Rangers have more education than a EMT. The job of Park Ranger requires you to do law enforcement,  natural resource management,  fire fighting. Part of the problem is EMS training is too short.  EMT should be between 6 months and a year and paramedic should be a 4 yr degree program.


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## BLSBoy (Nov 29, 2008)

Desert Ranger said:


> huh? So are you saying people with quals like mine are not professionals? I am not a volunteer but I have other duties besides EMS



You are a Park Ranger, no?
You are a LEO, correct?

Few and far between is it that you will see combo depts like Fire/LEO, but how many areas is EMS the little red headed step child of Fire, where there are brand new fire apparatus, well trained, and highly paid FFs, LEOs have new cars, are well paid, and highly trained, but EMS is by a third service provider, the ambulances are decrepit and old, the personnel are burnt out, tired, and underpaid?

I absolutely love it when I am working, and there is a well trained LEO who had beat me on scene, has a good set of vitals, the proper airway for his training, a decent PmHx and med list ready for me. I think that all LEOs and FFs should be, at a minimum a MFR. 
But EMS personnel needs to have their training expanded, so that we understand more then what we do. 
When you can go to school for 120 hrs, and expect to be treated, and paid equal as a FF who has gone to the academy for 3 months every day, then has an extensive 6mo-1yr of on the job training, you are out of your mind.


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## BLSBoy (Nov 29, 2008)

Desert Ranger said:


> Elitist snobbery.



Elitist snobbery?

Please, do explain.


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## ffemt8978 (Nov 29, 2008)

No need to explain as this thread is now closed.

Play nice, people.


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