# Austin Travis County EMS hiring Paramedics and paying them as Basics



## ExpatMedic0 (Nov 1, 2012)

Anyone notice that the famous Austin Travis county EMS took a turn for the worse a while back? I use to think this looked like a great municipal agency to consider working for, then a few months ago they stopped paying for double paramedic ambulances. Ok fair enough... but... now there in a budget crises...

Now on there recruitment website there hiring Paramedics (even TX licensed medics with college degree's) to work for EMT-B pay until a position becomes available to be "promoted" to Paramedic, although you are in all actuality a certified or licensed paramedic from the start.

I wrote to the recruitment and PR people twice about this, never got a reply.

This seems like a shady business practice to save money. Any thoughts? 
How about some of you from Texas? Did I get the story right or can you fill us in ?


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## DesertMedic66 (Nov 1, 2012)

Common practice. When a medic position opens up they will be moved into it and given medic pay.


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## ExpatMedic0 (Nov 1, 2012)

firefite said:


> Common practice.



So maybe RN's should work as CNA's "until a spot becomes available" for an RN or Doctors should work as orderly's until the hospital has the money to "promote" them to what level they already are? Seems absurd to me


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## DesertMedic66 (Nov 1, 2012)

schulz said:


> So maybe RN's should work as CNA's "until a spot becomes available" for an RN or Doctors should work as orderly's until the hospital has the money to "promote" them to what level they already are? Seems absurd to me



Medic wants a job with company A. Company A only has spots open for EMT. Medic wants a job to make money. Medic accepts EMT job so that it gets him/her some money and a guaranteed medic position when one opens up. Company A is happy and in the end the medic gets a medic job.


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## medicsb (Nov 1, 2012)

I don't think this is a bad idea, really.  Its probably a pretty good idea.  The medic as an EMT gains familiarity with the system and the medics, gets observed for their work, they will likely have to keep up on their knowledge in order to compete for a position, and transitioning to medic will likely be much smoother than hiring a new medic (and cheaper from a financial standpoint).


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## Veneficus (Nov 1, 2012)

medicsb said:


> I don't think this is a bad idea, really.  Its probably a pretty good idea.  The medic as an EMT gains familiarity with the system and the medics, gets observed for their work, they will likely have to keep up on their knowledge in order to compete for a position, and transitioning to medic will likely be much smoother than hiring a new medic (and cheaper from a financial standpoint).



I am not sure I like the idea.

If you are not usng your knowledge, then you are losing it.

Also some places I have seen do this have had to pay EMTs very close to medic salaries. But when being a medic earns only $1 or $2 over an EMT, the question becomes why accept the responsibility. 

I also think that it promotes insular practices and I know of no agency that retains any level of quality once it becomes a good old boys club. 

I am not so sure ATC is being shady, it looks more like desperation to me.


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## fast65 (Nov 1, 2012)

It's not really that uncommon of a practice, I know a few companies around here have been thinking of doing something like that, or already have.

 When you have a budget crisis, but have the benefit of being in a hiring market saturated with paramedics who are desperate for a job, why not pay them EMT wages? Sure, I don't personally like the practice, but it's a smart move in my opinion. You get a higher level provider for a lower cost, smart move on the employers side of things.

  The way I see it, this has the potential to increase employee performance, at least in theory. You have a paramedic who performs at a satisfactory level, and is content with that, but then you add in a large pool of paramedics who are working for EMT wages with the promise of getting the next open medic spot. Soon that medic will realize that those medics below them want their spot, and they're going to be working hard to get it, so what's that do to the other medic? It might make him perform just a little bit better to ensure he keeps his spot.


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## STXmedic (Nov 1, 2012)

It's been known down here that they are doing that. Right or wrong, that's how they're doing it. If you don't like it, don't apply. Odds are a paramedic spot will open up pretty quick anyway; ATC has a considerably high turn-over.

Besides, their basics still get paid better than most medics.


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## medic417 (Nov 1, 2012)

They hire you at basic wages and you only practice as a basic even though certified as a Paramedic.  Would be aggravating to know more than the guy that is being paid to be the Paramedic.


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## STXmedic (Nov 1, 2012)

I agree, it would be quite frustrating. I'd probably end up getting called in to the medical directors office a couple times... :unsure:


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## medicsb (Nov 1, 2012)

Veneficus said:


> I am not sure I like the idea.
> 
> If you are not usng your knowledge, then you are losing it.



This would certainly be a huge con.  I think it would depend more on how long it takes to transition into a medic position.  If you're working with a medic, you'll be seeing the same calls and just because you're not riding in the few ALS patients you see, doesn't mean you're not using your knowledge.  You will certainly get rusty skill-wise (I'd say most medics in all-ALS systems are inherently rusty, though), but that can be ameliorated if there is some additional hands-on training and review during the transition to the higher position.  A medic should get to know their partner and the extent of their knowledge and if their EMT partner is medic trained, then the medic should consider the EMT to be a potential resource when making decisions.


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## VFlutter (Nov 1, 2012)

schulz said:


> So maybe RN's should work as CNA's "until a spot becomes available" for an RN or Doctors should work as orderly's until the hospital has the money to "promote" them to what level they already are? Seems absurd to me



Some new graduate RNs will work as techs for a few months before a RN job opens up on the floor they want. Or some people get tech jobs in ICUs, even though they have an RN license, with the hope that they will be offered a job as a nurse when available. 

I do not see a problem with it. It is the person's choice to take that lower paid job with the expectation of moving up. If you do not like it then get a job at another company. But I am guessing the places doing this are good companies with a lot of applicants applying. 

Personally, if a good ICU offered me a job but required me to work as a tech for 6 months I would still probably take it. It all comes down to how bad you want the job and if it is worth the wait.


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## Tigger (Nov 1, 2012)

There are more than a few paramedics working as basics at Boston EMS, who does not hire paramedics. They hire basics, and then put them through a medic program. I can't imagine being a medic and being kept at the basic level, yes your assessment skills would be superior but working on a straight BLS ambulance there is not a lot to do with the results.


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## ExpatMedic0 (Nov 1, 2012)

Seattle medic 1 makes all outside paramedics retake there paramedic program with medic 1. However you are paid quite well while doing, not 15 bucks an hour at ATC as a licensed degree baring paramedic


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## Medic Tim (Nov 1, 2012)

Tigger said:


> There are more than a few paramedics working as basics at Boston EMS, who does not hire paramedics. They hire basics, and then put them through a medic program. I can't imagine being a medic and being kept at the basic level, yes your assessment skills would be superior but working on a straight BLS ambulance there is not a lot to do with the results.



their basics make more than most medics. From what I hear they are very selective


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## STXmedic (Nov 1, 2012)

schulz said:


> Seattle medic 1 makes all outside paramedics retake there paramedic program with medic 1. However you are paid quite well while doing, not 15 bucks an hour at ATC as a licensed degree baring paramedic



Where are you getting your pay information on ATC at...

And licensed paramedic makes no difference on pay. Some companies pay extra for having a degree, but that's not related to whether or not they're a licensed paramedic vs certified.


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## ExpatMedic0 (Nov 1, 2012)

http://atcems.org/home/index.php?option=com_content&view=section&layout=blog&id=14&Itemid=27
_
"you can be certified at the EMT-Basic, EMT-Intermediate, EMT-Paramedic, or the Licensed Paramedic level and will have the opportunity to promote within the department to EMS Medic II and beyond. Working alongside an EMS Medic II, you will have the opportunity to perform both basic and a limited number of advanced procedures such as; King LTD airway placement, nebulized medication administration, Continuous Positive Airway Pressure (CPAP) and 12 Lead ECG acquisitions. Pay rate is $15.35 an hour and you will be on a 48 hour workweek. " _
It seems to me this is a good way to get a paramedic with a college degree (licensed paramedic in TX) and pay him/her as someone with a few weeks of training(EMT-B) for as long the agency needs to save money.Who knows how long this will be. ATC recruitment and PR wont answer my emails. Your from TX so maybe you can shed some light on this?


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## STXmedic (Nov 1, 2012)

Ah, you were referring to the basic level's pay on the box. That's about the standard pay rate (or slightly higher) for a medic at most private companies around here. So for a medic, you'll be paid about average. If you're a basic, you'll be paid much higher than any basic around.

I fail to see how any of that correlates to ATC bringing on more licensed, college educated paramedic than standard paramedics, or any other level for that matter.

ATC tried this a year or two ago and it failed because the city didn't officially clear it. This time they have city backing. They are also about to go to collective bargaining through the city. So if they want to keep upping their pay and benefits, I doubt the city will decide to go back to dual medics. Especially if they can sell that these advanced basics are more than enough to support a paramedic partner.


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## Tigger (Nov 1, 2012)

Medic Tim said:


> their basics make more than most medics. From what I hear they are very selective



Yes to both, IIRC starting pay for basics while in the academy is 45k plus, and then it goes up significantly once you start working on a truck.


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## ExpatMedic0 (Nov 1, 2012)

I made over $15.00 an hour as an EMT in Oregon... 

I guess where I am getting at is this. ATC use to have 2 Paramedics making good Paramedic wages on each ambulance. According to what I have read they are having a budget crisis and cut each ambulance to have 1 Paramedic and 1 EMT. They claim this was not done to save money, yet there way over there budget right from what I have read in the Austin news paper and JEMS. NOW There accepting "anyone" to fill the 2nd non Paramedic on each ambulance. 

I would imagine if I was a hiring manager and some EMT-B's, EMT-I's, EMT-P's and EMT-P's with college degrees applied I would choose the EMT-P's with college degree's. Your getting " a lot more for your money" and when your in a budget crises it would make a lot of sense. So now tell me this, since this is not just a probational thing its now your official job title... how long does a Paramedic have to work for this? Is it even possible any longer to be hired directly as a Paramedic?

I am not sure but I think I see this as a way to save money at the cost of the employee.


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## ExpatMedic0 (Nov 1, 2012)

it states right on the website 15 bucks an hour as you can see from my above quote. That comes out to around $29,000 a year before taxes.... and as I stated who do you think they will choose to fill the slot for that pay?

I guess it would just suck if your a paramedic in Austin who chose to get your college degree so you get the fancy gold patch and be licensed  I guess it wont do much for you there


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## STXmedic (Nov 1, 2012)

schulz said:


> I made over $15.00 an hour as an EMT in Oregon...
> 
> I guess where I am getting at is this. ATC use to have 2 Paramedics making Paramedic wages on each ambulance. According to what I have read they are having a budget crisis and cut each ambulance to have 1 Paramedic and 1 EMT. They claim this was not done to save money, yet there way over there budget right from what I have read in the Austin news paper and JEMS. NOW There accepting "anyone" to fill the 2nd non Paramedic on each ambulance.
> 
> ...



Yeah, basics don't get paid that much here. $11/hr is about average.

I agree that a medic would have a leg up on a basic or intermediate in the hiring process. They wouldn't have to pay for the lower levels to go through P school, so it would be cheaper in the long run. The licensed paramedic over the certified: maybe, maybe not. If ATC does pay extra for a college degree that a Licensed Paramedic would have, why would they hunt for somebody that try would have to pay more to; especially when there is no difference in capabilities between the two. As for a LP being better educated, most LPs I know have degrees in fields completely unrelated from a past career (Geology, English, Liberal Arts, etc). 

I agree that it's most certainly a way to save money. But none of their current employees are effected by it, and everyone that is hired as an EMS Medic 1 knows that's the position they are bing hired for. So I dot necessarily think its at the cost of the employee. To the medics, it may have been better with the previous system. If you come in as a basic though, you're getting higher pay, a job you couldn't have gotten previously, and potentially your medic school paid for. 

To my knowledge, there's nothing that's shown that a dual medic service is superior to a P/B service. So if you can maintain your standard of care, and can do it with a P/B for cheaper, and you don't screw any of your current employees, then why not?

And no, I don't believe they will be hiring paramedics any longer as an EMS Medic 2.


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## ExpatMedic0 (Nov 1, 2012)

I have just been following ATC the past few years and it was a future agency I was interested in at least considering... I guess I am just worried there going downhill and I was interested to hear your guys feedback and if you think this is just a backdoor way to hire the highest level paramedics in the state and work them for less pay?


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## STXmedic (Nov 1, 2012)

schulz said:


> I have just been following ATC the past few years and it was a future agency I was interested in at least considering... I guess I am just worried there going downhill and I was interested to hear your guys feedback and if you think this is just a backdoor way to hire the highest level paramedics in the state and work them for less pay?



If you want to get burnt out quick, ATC is the place for you. If you want a system with ATC's reputation but actually deserves it, with the same great pay, even better protocols, and in the same area, forget ATC and go to WilCo.


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## ExpatMedic0 (Nov 1, 2012)

well the city of Austin appeals to me also ;-)


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## STXmedic (Nov 1, 2012)

schulz said:


> well the city of Austin appeals to me also ;-)



And still right down the street from wilco 

I agree; I'll probably be moving there in 2-3 years. Well worth the hour to hour and a half commute.


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## marshmallow22 (Nov 13, 2012)

I love coming on to these forums and seeing all the speculation regarding a certain department, ususally by someone who has no idea what they're talking about.  True ATCEMS is hiring for "medic 1" positions.  Whether you're an EMT or Paramedic does not matter.  Reasoning behind it has nothing to do with budget problems.  In the ATCEMS system approximately 80% are BLS.  Therefore, ALS skills are rarely used.  Secondly, ATCEMS's plan is a 60/40 split, not EVERY truck.  Thirdly, the $15 an hr comes to quite a bit more than 29k per year with built in overtime, and also the ability to pick up a TON of extra shifts.  There are not too many EMS only departments in the country that have the depth that ATCEMS has in regards to what you can do in the department.  There's Spec. Ops, Tactical, Motorcycles, Bike Medics, Gators, etc.  Also, even AS a paramedic working in another state (I.E. California), you're stuck on a private with poor conditions, low pay, no respect, and playing politics to the fire department.  Personally, I'd rather take an EMT position with a top rated department making more than most medics in other states, earning city benefits including a pension (similar to CALPERS), and now civil service with the opportunity to promote.  Yes, you'll be busy, but that's what you signed up for when you work for the now 14th largest city in the country.  So before you spout off with a bunch of nonsense, do some research and get your facts straight!


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## jgmedic (Nov 13, 2012)

I'd heard it was due to the fact that most medics could not pass their hiring process, so this way they can train them to their standards while hiring more than 2-3 people per process.


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## Fish (Nov 13, 2012)

marshmallow22 said:


> I love coming on to these forums and seeing all the speculation regarding a certain department, ususally by someone who has no idea what they're talking about.  True ATCEMS is hiring for "medic 1" positions.  Whether you're an EMT or Paramedic does not matter.  Reasoning behind it has nothing to do with budget problems.  In the ATCEMS system approximately 80% are BLS.  Therefore, ALS skills are rarely used.  Secondly, ATCEMS's plan is a 60/40 split, not EVERY truck.  Thirdly, the $15 an hr comes to quite a bit more than 29k per year with built in overtime, and also the ability to pick up a TON of extra shifts.  There are not too many EMS only departments in the country that have the depth that ATCEMS has in regards to what you can do in the department.  There's Spec. Ops, Tactical, Motorcycles, Bike Medics, Gators, etc.  Also, even AS a paramedic working in another state (I.E. California), you're stuck on a private with poor conditions, low pay, no respect, and playing politics to the fire department.  Personally, I'd rather take an EMT position with a top rated department making more than most medics in other states, earning city benefits including a pension (similar to CALPERS), and now civil service with the opportunity to promote.  Yes, you'll be busy, but that's what you signed up for when you work for the now 14th largest city in the country.  So before you spout off with a bunch of nonsense, do some research and get your facts straight!



Came off as a bit rude there, had a chance to answer some questions about your system and educate people who do not know any better, but chose another route I guess huh? Austin is large, and even most Medics within the ATCEMS system cannot agree on why the change came about, so of course your going to have a lot of speculation by the outisde world.


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## 46Young (Nov 13, 2012)

ChaseZ33 said:


> Some new graduate RNs will work as techs for a few months before a RN job opens up on the floor they want. Or some people get tech jobs in ICUs, even though they have an RN license, with the hope that they will be offered a job as a nurse when available.
> 
> I do not see a problem with it. It is the person's choice to take that lower paid job with the expectation of moving up. If you do not like it then get a job at another company. But I am guessing the places doing this are good companies with a lot of applicants applying.
> 
> Personally, if a good ICU offered me a job but required me to work as a tech for 6 months I would still probably take it. It all comes down to how bad you want the job and if it is worth the wait.



"If you do not like it then get a job at another company" is fine, but then we can't complain when more and more people marginalize the field as a stepping stone job. If companies are going to nickle and dime me like that, I'm going to have no remorse in using them for my needs until something better comes up. Hence the transient nature of the EMS workforce.


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## 46Young (Nov 13, 2012)

fast65 said:


> It's not really that uncommon of a practice, I know a few companies around here have been thinking of doing something like that, or already have.
> 
> When you have a budget crisis, but have the benefit of being in a hiring market saturated with paramedics who are desperate for a job, why not pay them EMT wages? Sure, I don't personally like the practice, but it's a smart move in my opinion. You get a higher level provider for a lower cost, smart move on the employers side of things.
> 
> The way I see it, this has the potential to increase employee performance, at least in theory. You have a paramedic who performs at a satisfactory level, and is content with that, but then you add in a large pool of paramedics who are working for EMT wages with the promise of getting the next open medic spot. Soon that medic will realize that those medics below them want their spot, and they're going to be working hard to get it, so what's that do to the other medic? It might make him perform just a little bit better to ensure he keeps his spot.



This is why the EMS labor force is so transient, and EMS cannot progress in education and pay due to lack of organization. The companies are doing everything they can to get labor on the cheap, and then the existing medics have to worry about job security since they might get bumped by a newer employee? This actually happens in quite a few places - the tenured, more expensive employee gets pushed out for the newer, cheaper employee. No wonder so many people use EMS as a temporary position until they can start an actual career.


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## 46Young (Nov 13, 2012)

PoeticInjustice said:


> It's been known down here that they are doing that. Right or wrong, that's how they're doing it. If you don't like it, don't apply. Odds are a paramedic spot will open up pretty quick anyway; ATC has a considerably high turn-over.
> 
> Besides, their basics still get paid better than most medics.



J/C, why does ATC-EMS have high turnover?


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## Veneficus (Nov 13, 2012)

marshmallow22 said:


> I love coming on to these forums and seeing all the speculation regarding a certain department, ususally by someone who has no idea what they're talking about.  True ATCEMS is hiring for "medic 1" positions.  Whether you're an EMT or Paramedic does not matter.  Reasoning behind it has nothing to do with budget problems.  In the ATCEMS system approximately 80% are BLS.  Therefore, ALS skills are rarely used.  Secondly, ATCEMS's plan is a 60/40 split, not EVERY truck.  Thirdly, the $15 an hr comes to quite a bit more than 29k per year with built in overtime, and also the ability to pick up a TON of extra shifts.  There are not too many EMS only departments in the country that have the depth that ATCEMS has in regards to what you can do in the department.  There's Spec. Ops, Tactical, Motorcycles, Bike Medics, Gators, etc.  Also, even AS a paramedic working in another state (I.E. California), you're stuck on a private with poor conditions, low pay, no respect, and playing politics to the fire department.  Personally, I'd rather take an EMT position with a top rated department making more than most medics in other states, earning city benefits including a pension (similar to CALPERS), and now civil service with the opportunity to promote.  Yes, you'll be busy, but that's what you signed up for when you work for the now 14th largest city in the country.  So before you spout off with a bunch of nonsense, do some research and get your facts straight!



Not agency specific but I would like to point out...

In any industry, built in OT and the ability to pick up extra shifts means your pay sucks.

It doesn't matter if it is an extra shift at your primary agency or a second or third job at another. If you are working extra for reason other than personal enjoyment, then you do not have a viable job.

In my younger days I thought I was the selfless defender of society, respected, looked up to etc. 

Forget that crap, it doesn't put food on the table or pay for a family. Either show me the money or keep your extra duties and "hardcore" mentality.

(for the record, I work a lot because I want to, not because I need to, the fact I get paid for it is a bonus)


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## 46Young (Nov 14, 2012)

marshmallow22 said:


> I love coming on to these forums and seeing all the speculation regarding a certain department, ususally by someone who has no idea what they're talking about.  True ATCEMS is hiring for "medic 1" positions.  Whether you're an EMT or Paramedic does not matter.  Reasoning behind it has nothing to do with budget problems.  In the ATCEMS system approximately 80% are BLS.  Therefore, ALS skills are rarely used.  Secondly, ATCEMS's plan is a 60/40 split, not EVERY truck.  Thirdly, the $15 an hr comes to quite a bit more than 29k per year with built in overtime, and also the ability to pick up a TON of extra shifts.  There are not too many EMS only departments in the country that have the depth that ATCEMS has in regards to what you can do in the department.  There's Spec. Ops, Tactical, Motorcycles, Bike Medics, Gators, etc.  Also, even AS a paramedic working in another state (I.E. California), you're stuck on a private with poor conditions, low pay, no respect, and playing politics to the fire department.  Personally, I'd rather take an EMT position with a top rated department making more than most medics in other states, earning city benefits including a pension (similar to CALPERS), and now civil service with the opportunity to promote.  Yes, you'll be busy, but that's what you signed up for when you work for the now 14th largest city in the country.  So before you spout off with a bunch of nonsense, do some research and get your facts straight!



So, from what you say, they actually are paying new medics an EMT's salary, and they are dropping a number of their double medic units to medic/EMT. Doesn't sound like speculation to me.

Now, does that built in OT come as part of the regular schedule? If so, how much, so we can get a true total compensation picture? If it's a 48 hour workweek, that's $40,560/yr. If it's a 56 hour workweek, it's $49,920/yr. This is how employers get over on you. $50k/yr sounds real good, but it comes in the form of a 56 hour workweek, which is 40% more hours worked than a 40 hour employee, which actually works out to be a third of your life while employed there. For every five 56 hour employees, the system saves the cost of hiring two FT employees, if the workweek was actually 40 hours like most of the country. 56 x 5 = 40 x 7. They don't have to pay for benefits, hiring, training, or retirement, but they still want to pay you $15/hr. Quite the racket. Buy five (employees) get one free with the 48 hour workweek, the concept's the same. In a pension system, the benefits and retirement alone can approach 100% of the employee's salary. 

This crap flies in the fire service as well; the worst is the federal FF jobs - 48/72's, or perpetual 24 on, 24 off. 

Also, if there's a ton of OT, then there's also either a ton of mandatory holdovers, or they're putting units out-of-service. The mandatory holdovers burn out the employees, and so does OOS units, since that makes everyone that much busier. Nothing like getting railed for 24 hours and then being told that you're stuck for 12-24 more, especially on a consistent basis.


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## 46Young (Nov 14, 2012)

Veneficus said:


> Not agency specific but I would like to point out...
> 
> In any industry, built in OT and the ability to pick up extra shifts means your pay sucks.



Right. See my above post. 56 hours = buy five, get two free, and a 48 hour workweek = buy 5, get one free. These employers aren't stupid. 

An employee's benefits including retirement can range from 50% to 100% of an employees salary as a cost to the employer. Up to a point, it's cheaper to provide OT shifts and also to do mandatory holdover, since it's cheaper than hiring a new employee and having to pay for benefits. They're certainly not passing this savings onto their employees in the form of increased base pay.


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## xrsm002 (Nov 14, 2012)

I used to work for a company in Texas that to keep up with the oil boom is paying EMT 15/hr Intermediates 17 and medics 19/hr. however their trucks are crappy but you could work 8,10,12,or 24 shift


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## Veneficus (Nov 14, 2012)

xrsm002 said:


> I used to work for a company in Texas that to keep up with the oil boom is paying EMT 15/hr Intermediates 17 and medics 19/hr. however their trucks are crappy but you could work 8,10,12,or 24 shift



I would not accept making $19 an hour if I were still a medic. 

Anything under $20 I would not even consider. $25 would get consideration if it came with a 32-36 hour work week and full benefits.

Because you can get that or more as an ER tech or teaching AHA classes full time, not breaking your back on the street.

I know medics who only teach AHA classes 9-4 (if by some miracle it doesn't start at 9:20 because of late students) monday through friday no holidays or weekends that net 4-6K a month doing it.

Sit through an ACLS class and see how little work teaching one is. 

You might strain your typing finger pressing "play" on the DVD, but it is definately not hard work, and you spend more time doing what you want outside of work.


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## STXmedic (Nov 14, 2012)

46Young said:


> J/C, why does ATC-EMS have high turnover?



Mostly call volume. Medics running 20-30 runs consistently on a 24hr shift. One of the medics I know that works there has been there for about 8 years; out of of his hiring class of 20, he and one other guy are the only ones left. Everyone I know that works there agrees that there's a reason they're hiring nearly 40 people a year, and it's not from replacing retirees. My partner (former ATC medic) also has a lot of complaints about management and supervisors there. I'm sure marshmallow will disagree, though... :unsure:


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## marshmallow22 (Nov 14, 2012)

Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.


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## STXmedic (Nov 14, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



:rofl: Oh, believe me, I am by no means bitter and I also have a job that I get paid extremely well for. I'm sorry, you only have 30 people quit per year, not 40. You have hundreds of medics applying, because there are hundreds of medics looking for jobs and y'all pay better than a private company. Sorry, I just like to know both sides of the coin and not just coat everything with sprinkles and marshmallows.


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## Fish (Nov 14, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



If bitter is in reference to me, then you would be wrong. I have a great Medic job, with great pay and benefits and it is with an excellent EMS system. I was just stating that when you come on here and talk about ATCEMS as a member of the team like you did, you give it a bad image. Recruiter or not. I believe you are one of the only Austin Medics who write on here, so for all of these people YOU ARE Austin EMS.

I have many friends who work for Austin, and most likely I know you. My friends like working for Austin, but they have a lot of complaints, and I don't have one friend who works for Austin that likes the EMT/Paramedic idea. Austin is a good system. But so is Williamson County, MCHD, and Fort Bend County. All about the same pay and benefits. And they all have difficult hiring processes.


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## rescue1 (Nov 14, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



Hundreds of medics apply for every job. Hell, a hundred EMTs applied for my job, and its some dinky little station in the burbs without any of the pizzazz that ACTEMS has. It doesn't mean the job is great, it means unemployment is high and people need money.

I'm interested in why there is so much turnover, though. I always thought ACTEMS was supposed to be a squared away EMS agency with a lot of career potential.

EDIT: Wow, totally missed PoeticInjustice's reply. 30 calls a shift? That's crazy. That's moving towards Philly or Baltimore crazy.


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## 46Young (Nov 14, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



Most decent sized municipal employers will have hundreds of applicants. People want the benefits and pension. Remember, the pay in EMS is low because there is too much supply. Your department is certainly not unique in it's number of applicants.

The bitterness is not from the inability to get hired by ATC-EMS. The bitterness is directed at EMS in general, with all it's undesireable features, some of which were highlighted in this discussion.

I used to work for Charleston County EMS in SC. Due to my ignorance, I thought I was getting hired into a 48 hour workweek with a $38k/yr salary, to be raised to $45k/yr after 6 months. I didn't know that 56 hour shifts existed; I thought that 24's meant two 24 hour shifts a week or less. 

The 56 hour workweek screws you guys because your hourly rate is much lower than it should be to achieve a $50k/yr figure, which is $15/hr with a 56 hour work schedule. By the same token, your OT is also at a much lower rate. Now, if you were paying EMT's or new medics $50k/yr on a 40 hour workweek, it's $22.32/hr. OT on that would be $33.48. That happens to be almost exactly what I earned as an EMT in NYC in 2005. As it stands, the OT on $15/hr is only $22.50. Do you see how you get screwed? To make $50k, you have to do 56 hours, which means all of your additional OT is at what should be your straight time rate. This is quite clever. The system makes out by getting "five and two free," and their "OT" is really what should be the straight time rate, so they're really not paying OT to cover vacant shifts. 

Think about it, $22.50/hr x 12 hours (OT  shift) is $270. $33.48 x 12 hours is $401.76. That's a $131.76 difference *every time you do 12 hours of OT!* What's more, you could have worked those extra 16 hours for additional OT, not as part of your regular schedule. So, you're really losing $535.68/week, since those hours should have been additional OT based on a $22.32 base rate. All of the above is how employers that have regular schedules of 48 hours, 56 hours, or more are exploiting you.

Tell me again how $15/hr is generous for a new medic. It's certainly much better than Charleston, but it's still $15/hr. Bus drivers, secretaries, and maitenance workers can make that much or more.


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## 46Young (Nov 14, 2012)

PoeticInjustice said:


> Mostly call volume. Medics running 20-30 runs consistently on a 24hr shift. One of the medics I know that works there has been there for about 8 years; out of of his hiring class of 20, he and one other guy are the only ones left. Everyone I know that works there agrees that there's a reason they're hiring nearly 40 people a year, and it's not from replacing retirees. My partner (former ATC medic) also has a lot of complaints about management and supervisors there. I'm sure marshmallow will disagree, though... :unsure:



That should be illegal! It certainly is in NYC with the 16 hour rule. Some places have a formula where if a 24 hour unit consistently goes over a certain percentage of net utilization (CCEMS was 60% IIRC), the unit gets split into two 12 hour shifts. 

We have to stop eating our young in this business.


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## Veneficus (Nov 14, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.



Could I just ask what it says?

I think this could be interpreted 2 ways. That either it is an extremely great service or that there is a reason  people are leaving.

I would point out that I have seen many services, both first and third hand whos pride and propaganda did not live up to what the  agency was really about.

Pride and propaganda are often used as a way to deflect attention from pressing internal problems. 

Not suggesting that is the case, but it is something to think about.

I have to admit though, when you are looking for ways to save money and you are hiring 30 people a year in an agency that is not experiencing significant expansion, it paints a bad picture.

It is easy to say not everyone can handle it, but it is always uncertain ground when your position is "not everyone is as good as me."

Just because somebody will not accept the abuse you will does not make them incapable or "less tough." 

I have walked in those shoes and in my hindsight encourage people not to put up with BS like I did thinking you will get something later or had more to be proud of than I did.



marshmallow22 said:


> Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



I don't see it that way at all. I see a lot of experienced people who I have come to know and respect on this forum who not only stand up for themselves but also for EMS as a whole. 

I believe it pains them to see providers taken advantage of or degraded. 

Whether I work in a hospital, a clinic, an academic department, as a teacher, or merit badge course instructor, I am paid for my highest credentials. Not because I am special, but because that is how reputable employers treat professionals.

Hiring a medic to work in an EMT spot, for EMT pay is not honorable, reputable, or demonstrates the value of paramedics.

It is a disservice to helping EMS become a profession. It is taking advantage of the labor force. 

Do not be fooled by all the titles and special unit badges in the world. 

"A soldier will fight long and hard for a bit of colored ribbon."

It doesn't mean their leaders value their sacrifices any.


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## xrsm002 (Nov 14, 2012)

Veneficus said:


> I would not accept making $19 an hour if I were still a medic.
> 
> Anything under $20 I would not even consider. $25 would get consideration if it came with a 32-36 hour work week and full benefits.
> 
> ...



This particular company is just now paying this due to the oil boom in west texas where people in the oil field doing hard physical labor are making 20-30/hr I was making 11.00/hr when I was there. I don't know of anywhere in Texas paying 20/hr most tech jobs I've seen are 15-18/hr.


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## Tigger (Nov 14, 2012)

Veneficus said:


> I would not accept making $19 an hour if I were still a medic.
> 
> Anything under $20 I would not even consider. $25 would get consideration if it came with a 32-36 hour work week and full benefits.



Do you consider cost of living at all for this? Many in EMS are willing to move around and deal with lower wages than they are used because they are livable in that area. Try and move again and you might be screwed. 20/hr is livable pretty much anywhere.

At this point in my life, I make less than 10 dollars an hour here in Colorado, meaning that will pretty much be impossible for me to move back to Massachusetts with any sort of savings. Therefore, I do not intend to move back.


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## Veneficus (Nov 14, 2012)

For an EMT-B salary, under 10 is about the average from what I understand. 

But for people who are willing to move or get into "nontraditional" roles, like ER tech, etc. You can get much better pay with a medic cert.

I would also like to refer to 46young's post about the cost of living illusion.


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## WTEngel (Nov 15, 2012)

People deserve to get paid what they are worth.

Until EMS gets its act together and lobbies as well as nursing has, the perception will be that EMS professionals are worth $10-15 an hour in both terms of academic achievement and professionalism.

I am with Vene on this one. I have scoffed at any offer less that $20.00/hr in the past 2-3 years.

Ultimately, when any segment of a professional population begins to take jobs from employers who are offering less than what is typically considered average for the market, it drives the wages for the entire profession in that region down. It is happening with nurses currently. Hospitals are starting "nurse intern" or "nurse resident" programs where they pay nurses a laughable wage for 6 months to a year under the guise of grooming them for a specific department or allowing them to "try out" as they rotate through the different units.

When employers begin selling employees on "built in" overtime, and "plenty of opportunity for extra work" it is code for "our base compensation sucks, but you can make ends meet by working more than you see your family."

The problem is there are so many new grads willing to work for whatever wage is offered simply to get that first 911 job. 

This fits perfectly with the narrative of the best and brightest in EMS leaving for greener pastures. Yet another example of why EMS can not retain many high quality candidates for the duration of their career, as they all end up going into nursing, fire, PA, medicine, etc. It is rare to see a highly qualified individual remain solely in EMS for their entire career without getting burnt out. If they do, they are a glutton for punishment...


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## marshmallow22 (Nov 15, 2012)

First off, everyone knows you do not get into EMS, Fire, or Police to become rich.  However, an EMS career for the city of Austin not only can provide you a comfortable lifestyle, but ample opportunity for advancement.  As far as "built in overtime", I would rather work the two 24's a week, or two 12's and a 24 a week to total 48 hrs, thus AUTOMATICALLY giving you 8 hrs a week in OT or 16 hrs a pay period, all for working just 2 or 3 days a week.  This leaves you 4 to five other days during the week to enjoy life, go to school, or pick up extra shifts to buy a few toys.  It's a well known fact that the big salaries we read about of ANY public safety provider was made in OT and not their base pay.  And as far as when a department tells you there is ample OT doesn't necessarily mean that they are dysfunctional.  Many of your larger departments (IE FDNY, LA City, LA County, DC Fire/EMS, Frisco just to name a few) including Austin will have the OT available due to vacation and sick time being utilized.  And when you have a department with 400-1000 employees there are bound to be quite a few holes everyday, not to mention any vacancies that may already exist.  I apologize if I came off aggressive or offensice, but I do not feel it's productive or helpful to bash, speculate, complain, or or spread misinformation about a department for which someone has no real 1st hand knowledge about.  A healthier way to open the forum regarding the hiring practices and/or pay regarding a specific department would be to simply ask for clarification, or just ask the questions pertaining to those topics.  Too often I read statements of "my friend works there and he told me this" or "I hear they're doing this."  Statements such as these lead to false information getting out and misinterpretations of the facts.


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## WTEngel (Nov 15, 2012)

The fact that most public safety professionals are selfless enough to go into this career without money in mind is what's makes it so easy for cities and companies to take advantage of the profession as a whole.

The EMS profession needs to stop making excuses for practices like this and begin to take action, both internally, and externally, if we expect to make the leap from vocational workers to true respected professionals.

This business of "years of tradition unimpeded by progress" only serves to push these goals farther behind.

I'm not directing this at anyone in particular, just saying in general.


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## ExpatMedic0 (Nov 15, 2012)

marshmallow22 said:


> Say what you want, but the fact that we have hundreds of applicants a year testing for our department (for ony about 30 spots) says something.  Secondly, I'm not recruiting... I have my medic job for which I get paid extremely well, I'm just setting the record straight.  Sounds like a lot of bitterness out there from guys who either can't get hired due to their "entitlement" attitude as a new medic, or just don't have what it takes.



Why would a new medic have this attitude? This system is forcing paramedics who want to work for ATC to first be hired as EMT-B's, this will only bring you new medics. Why would a good, well paid, Paramedic with 10 years of experience, possibly a family and financial obligations, come to this system to work as an EMT-B for far less salary. Especially for unknown period of time? Can you please tell me that? This is now what we call "a good ol boy system"

 I am the person who started this thread and you can see next to my name that I have been posting on this EMS forum for over 7 years. In actuality I have been in EMS for close to 10 years, a Paramedic for a good portion of that, and now completing my undergraduate degree in Paramedicine. 

I have never applied to ATC and I started with this thread to discuss the speculation surrounding the recent events. I even stated on the first post I was not sure if I have the story correct and invited people from ATC or anywhere in Texas to shine light on the matter for the rest of us. 


So to reiterate, I will summarize things below and your welcome to make any corrections.
Its all over the news for the public and all of us to read. ATC is in a huge budget crises, coincidentally during this same time ATC makes the decision to start staffing an EMT with a Paramedic  on every ambulance instead of the old system which was double Paramedic. Now they are hiring Paramedics and working them as EMT-Basics for an unknown period of time which is not a probation until they are promoted within ATC laterally to the Paramedic level, which in fact they are already licensed or certified as a provider? As a result nothing has changed, there still doing double Paramedic ambulances but due to the budget crisis now paying much less for the second Paramedic. There way of doing this is by not promoting him/her to paramedic or paramedic pay wage until a slot becomes available

PS: No offense to you buddy but I would never consider bragging about working for 15 bucks an hour when your forced to work overtime to make a good wage.You could pull that kind of cash at McDonalds as an assistant manager who is also working overtime.


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## xrsm002 (Nov 15, 2012)

According to their website you can be certified at any level except ECA:

Austin-Travis County EMS

Position:
Contact:
Email:
Phone:
Address:
City:
State:
Website:
Closingdays)

EMT-Basic
EMS Recruiting
emsrecruiting@austintexas.gov
512.974.1098    Fax: 512.974.1099
P.O. Box 1088
Austin
Texas
http://www.atcems.org
15

EMS Medic I - Field

About the Job:

The City of Austin/Travis County EMS is currently recruiting for EMS Medic I - Field positions. This position provides pre-hospital and/or out-of-hospital emergency medical care and rescue in emergent conditions & environments for the City of Austin,Texas Emergency Medical Services Department. 

Duties and Responsibilities:

Provides patient advocacy and interagency teamwork. Assesses patients and perform skills and procedures as defined by the Medical Director. Assists in all active patient rescue activities. Completes appropriate patient care documentation and other reports. Ensures that the vehicle and all items of equipment are stocked, clean, and ready for use. Operates an emergency vehicle including responding to emergency scenes and transporting patients to medical facilities. Attends meetings, seminars, and training sessions. Maintains a strong safety focus and follows safety standards and practices. 

Minimum Requirements: 

Must be able to write and read English.

Must be 18 years of age or older.

Must have a High School Diploma or GED.

Must complete application for employment and all steps in the hiring process

Licenses or Certifications:

At the time of the application deadline, which is July 16, 2012, you must have one of the following certifications: 

•A current Texas Department of State Health Services Certification as an Emergency Medical Technician, Emergency Medical Technician-Intermediate, Emergency Medical Technician-Paramedic, or Licensed Paramedic, or be eligible for Texas Department of State Health Services out of state reciprocity at one of the four listed certification/license levels.

Additional license:

•Texas Class "C" Driver's License or equivalent license


Physical Requirements:

Ability to don and effectively wear required Department issued personal protective equipment; including but not limited to respirators, protective eyewear, goggles, facemasks, boots, helmet, bunker coat and pants, ballistic vest, protective jackets and gloves. This includes complying with the Department facial hair requirements. 
Unimpaired mobility: Must be able to quickly respond to ambulance, must be able to access patients in difficult terrain, must be able to climb stairs, must be able to work in close and dangerous environments such as damaged vehicles, must be able with partner to carry equipment and patients weighing up to 180 pounds.

Physical Abilities: Must be able to perform strenuous physical requirements such as CPR, lifting and moving of equipment and patients in a variety of environmental conditions. Must be able to swim at the basic survival level.

Motor Skills: Must be able to perform required medical skills and techniques, such as bandaging, splinting, basic airway management techniques, defibrillation.

Vision: Must have correctable vision acceptable for day and night operation of emergency vehicles, must have color acuity adequate for determination of skin and blood color, must be able to read medication dosages on drug labels and syringes.

Hearing: Must be able to hear and understand information provided by patients, family or bystanders; must be able to hear breath sounds and accurately determine auscultated blood pressures; must be able to differentiate separate conversations in active, distracting environments; must be able to hear and understand radio traffic when responding with lights and sirens.

Speech: Must be able to speak and enunciate clearly and at a level audible to others in loud conditions, must be able to speak clearly in stressful situations, must be able to verbally communicate with patients, families and other emergency personnel.

Application Instructions:

For information on application procedures please visit: http://www.austincityjobs.organd use Requisition Number 069762. For detailed information regarding the EMS Medic I – Field Hiring Process please visit the Austin-Travis County EMS website at http://www.atcems.org/>


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## ExpatMedic0 (Nov 15, 2012)

Yes but its already been stated that any new paramedic must start as this. I believe it not possible to start as "EMS Medic 2" until you have been promoted from EMS Medic I.

Also as previously discussed who would you hire as the hiring manager in a budget crises? An EMT with a few weeks of training, or a Paramedic? Keep in mind you pay them exactly the same..... Its also worth noting TX also has a level called "licensed Paramedic" which only Paramedics with college degree's hold. The most bang for your buck is deff the paramedic, especially the licensed one.


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## 46Young (Nov 15, 2012)

schulz said:


> Why would a new medic have this attitude? This system is forcing paramedics who want to work for ATC to first be hired as EMT-B's, this will only bring you new medics. Why would a good, well paid, Paramedic with 10 years of experience, possibly a family and financial obligations, come to this system to work as an EMT-B for far less salary. Especially for unknown period of time? Can you please tell me that? This is now what we call "a good ol boy system"
> 
> I am the person who started this thread and you can see next to my name that I have been posting on this EMS forum for over 7 years. In actuality I have been in EMS for close to 10 years, a Paramedic for a good portion of that, and now completing my undergraduate degree in Paramedicine.
> 
> ...



+1 on all the above.

It sounds like we have about the same amount of time on the job. I've got 10+ in, 7+ as a medic myself. 5 years NYC 911, just shy of six months Third Service municipal, and the rest fire based.

Also, take notice of the copy of the ATC-EMS job posting below - I see no mention of any requirement, hiring preference, or additional pay for a degree, the "Licensed Paramedic" I believe. This is what I mean when I say that it's not just fire based systems that benefit from less educated EMS providers. I would qualify for this job with nothing more than a GED, an EMT-B card, or a 4-6 month EMT-I or medic mill cert.


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## 46Young (Nov 15, 2012)

schulz said:


> Yes but its already been stated that any new paramedic must start as this. I believe it not possible to start as "EMS Medic 2" until you have been promoted from EMS Medic I.
> 
> Also as previously discussed who would you hire as the hiring manager in a budget crises? An EMT with a few weeks of training, or a Paramedic? Keep in mind you pay them exactly the same..... Its also worth noting TX also has a level called "licensed Paramedic" which only Paramedics with college degree's hold. The most bang for your buck is deff the paramedic, especially the licensed one.



Perhaps an ATC-EMS employee could confirm or deny this, that an EMS Medic II position would be a seperate job posting. I know my former hospital employer did it this way, as does Charleston County EMS. They usually have a paramedic job posting, and very occasionally a medic crew chief opening.


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## ExpatMedic0 (Nov 15, 2012)

46Young said:


> Perhaps an ATC-EMS employee could confirm or deny this, that an EMS Medic II position would be a seperate job posting. I know my former hospital employer did it this way, as does Charleston County EMS. They usually have a paramedic job posting, and very occasionally a medic crew chief opening.



I agree, and I can not prove with out doubt everything I said is true. Its merly speculation. I hope through discussion someone will shed further light on this matter. I would love to hear from an ATC  medic regarding this.


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## 46Young (Nov 15, 2012)

marshmallow22 said:


> First off, everyone knows you do not get into EMS, Fire, or Police to become rich.  However, an EMS career for the city of Austin not only can provide you a comfortable lifestyle, but ample opportunity for advancement.  As far as "built in overtime", I would rather work the two 24's a week, or two 12's and a 24 a week to total 48 hrs, thus AUTOMATICALLY giving you 8 hrs a week in OT or 16 hrs a pay period, all for working just 2 or 3 days a week.  This leaves you 4 to five other days during the week to enjoy life, go to school, or pick up extra shifts to buy a few toys.  It's a well known fact that the big salaries we read about of ANY public safety provider was made in OT and not their base pay.  And as far as when a department tells you there is ample OT doesn't necessarily mean that they are dysfunctional.  Many of your larger departments (IE FDNY, LA City, LA County, DC Fire/EMS, Frisco just to name a few) including Austin will have the OT available due to vacation and sick time being utilized.  And when you have a department with 400-1000 employees there are bound to be quite a few holes everyday, not to mention any vacancies that may already exist.  I apologize if I came off aggressive or offensice, but I do not feel it's productive or helpful to bash, speculate, complain, or or spread misinformation about a department for which someone has no real 1st hand knowledge about.  A healthier way to open the forum regarding the hiring practices and/or pay regarding a specific department would be to simply ask for clarification, or just ask the questions pertaining to those topics.  Too often I read statements of "my friend works there and he told me this" or "I hear they're doing this."  Statements such as these lead to false information getting out and misinterpretations of the facts.



So, in effect you're saying that you need 16 hours of OT a pay period in order for your pay to be comfortable. Based on a 48 hour/week average schedule, the newly hired medic on a basic's wage makes $40,560/yr. That's actually not too bad when compared to most other EMS systems in this country, but you still have to work eight extra hours to make that wage. If your EMS system had a 40 hour workweek, and posted $40,560/yr as starting pay, your base rate would be $19.50/hr. The OT that you're mandated to work as part of your regular schedule would actually be extra money, which would be $19.50 x 8 or $156. Over 52 weeks/yr, that's an extra $8112. So, by having built in OT to make a "comfortable wage," you're losing an extra $8112/yr and 416 hours a year, or 10.4 "free" workweeks.

In other words, your pay scheme isn't as good as you think it is.

If you had a 42 hour workweek like Alexandria Fire and EMS single role medics, or D.C. Fire (24/48/24/96, and 24/72 respectivelly), you would have a stronger case. They work 24's just like we do, but their schedule is almost a 40 hour workweek, not 48 or 56 scam like most EMS agencies.

I also work a 56 hour workweek, but there's a two differences:

-My hourly rate is based on the quoted yearly salary. I'm fire based, so 53 out of 56 hours are straight time per FLSA laws. So, there's 1.5 hours of built in OT per week, on average.Sounds like a scam, but realize that the hourly rate is higher than it would be if the quoted yearly salary was given as 16 hours straight time and 16 hours of OT. This also means that my OT rate will be much higher than if we were 40/16 employees.

-Due to FLSA laws, in a 28 day cycle OT is paid on all hours past 212. If we do OT earlier in the pay cycle, we get paid 1.5x right on the spot, and also another half hour's pay on each OT hour worked in the back end. If I do 24 hours OT early on, I basically get that time and a half and then another 12 hours of FLSA pay, which equals another 12 hours of straight pay. Double dipping's cool.

FD salaries are so high because there is a lot of OT worked, but when you're starting off at $50k, $60k, or $80k plus, it's much easier to break six figures than when you're starting in the 30's as is typical in EMS.


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## Veneficus (Nov 15, 2012)

46Young said:


> So, in effect you're saying that you need 16 hours of OT a pay period in order for your pay to be comfortable. Based on a 48 hour/week average schedule, the newly hired medic on a basic's wage makes $40,560/yr. That's actually not too bad when compared to most other EMS systems in this country, but you still have to work eight extra hours to make that wage. If your EMS system had a 40 hour workweek, and posted $40,560/yr as starting pay, your base rate would be $19.50/hr. The OT that you're mandated to work as part of your regular schedule would actually be extra money, which would be $19.50 x 8 or $156. Over 52 weeks/yr, that's an extra $8112. So, by having built in OT to make a "comfortable wage," you're losing an extra $8112/yr and 416 hours a year, or 10.4 "free" workweeks.
> 
> In other words, your pay scheme isn't as good as you think it is.
> 
> ...



I have to ask, are you a union steward? You are awefully fast and good at figuring this stuff out.


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## 46Young (Nov 15, 2012)

schulz said:


> I agree, and I can not prove with out doubt everything I said is true. Its merly speculation. I hope through discussion someone will shed further light on this matter. I would love to hear from an ATC  medic regarding this.



If the information and inferences in this thread are accurate, then that's sad. There aren't too many EMS agencies around that are desireable. If I had known about ATC-EMS back in 2006, I probably would have applied and worked there instead of going to Charleston before the FD, and who knows, I might have still been there today. It sounds like things are going in the wrong direction at ATC from what I'm reading and seeing here. Disappointing.


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## TransportJockey (Nov 15, 2012)

marshmallow22 said:


> First off, everyone knows you do not get into EMS, Fire, or Police to become rich.  However, an EMS career for the city of Austin not only can provide you a comfortable lifestyle, but ample opportunity for advancement.  As far as "built in overtime", I would rather work the two 24's a week, or two 12's and a 24 a week to total 48 hrs, thus AUTOMATICALLY giving you 8 hrs a week in OT or 16 hrs a pay period, all for working just 2 or 3 days a week.  This leaves you 4 to five other days during the week to enjoy life, go to school, or pick up extra shifts to buy a few toys.  It's a well known fact that the big salaries we read about of ANY public safety provider was made in OT and not their base pay.  And as far as when a department tells you there is ample OT doesn't necessarily mean that they are dysfunctional.  Many of your larger departments (IE FDNY, LA City, LA County, DC Fire/EMS, Frisco just to name a few) including Austin will have the OT available due to vacation and sick time being utilized.  And when you have a department with 400-1000 employees there are bound to be quite a few holes everyday, not to mention any vacancies that may already exist.  I apologize if I came off aggressive or offensice, but I do not feel it's productive or helpful to bash, speculate, complain, or or spread misinformation about a department for which someone has no real 1st hand knowledge about.  A healthier way to open the forum regarding the hiring practices and/or pay regarding a specific department would be to simply ask for clarification, or just ask the questions pertaining to those topics.  Too often I read statements of "my friend works there and he told me this" or "I hear they're doing this."  Statements such as these lead to false information getting out and misinterpretations of the facts.


Just saying, using DC FEMS as an example of a system that has ample OT but is NOT dysfunctional makes me wonder if you know what you are talkign about. DC FEMS is one of the worst run agencies in the country right now, as evidenced by their shortage of medics and now the idea of taking all medic ambulances off the roads between certain hours of the morning. They can't even cover their own calls.


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## 46Young (Nov 15, 2012)

Veneficus said:


> I have to ask, are you a union steward? You are awefully fast and good at figuring this stuff out.



I was in Baruch College in NYC for accounting back in the 90's before I dropped out due to lack of interest. Still good with figures. I've done much studying on personal finance and investing. I've worked here with a few financial and retirement gurus that have shown me how to maximize the financial benefits of working here, and that has allowed me to effectively analyze my former places of employment, as well as figure out what a department is really offering based on quoted salary, schedule, retirment years ofservice and multiplier, etc. Charleston Third Service EMS was a negative learning experience for me in several regards in the financial sense.


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## Veneficus (Nov 15, 2012)

46Young said:


> I was in Baruch College in NYC for accounting back in the 90's before I dropped out due to lack of interest. Still good with figures. I've done much studying on personal finance and investing. I've worked here with a few financial and retirement gurus that have shown me how to maximize the financial benefits of working here, and that has allowed me to effectively analyze my former places of employment, as well as figure out what a department is really offering based on quoted salary, schedule, retirment years ofservice and multiplier, etc. Charleston Third Service EMS was a negative learning experience for me in several regards in the financial sense.



Next time I get an offer can I send it to you to analyze?


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## 46Young (Nov 15, 2012)

TransportJockey said:


> Just saying, using DC FEMS as an example of a system that has ample OT but is NOT dysfunctional makes me wonder if you know what you are talkign about. DC FEMS is one of the worst run agencies in the country right now, as evidenced by their shortage of medics and now the idea of taking all medic ambulances off the roads between certain hours of the morning. They can't even cover their own calls.



Yes, and FDNY EMS also has had OT problems. NYMedic 828 could tell you better, but they had what's called the "KVO" program (Known Vacancy Opening). IIRC, if you sign up for three OT shifts, you can't be mandated to work any additional shifts that month. That program would get suspended on an off due to staffing shortfalls, though. Good luck trying to go to classes when you're held over all the time.


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## 46Young (Nov 15, 2012)

Veneficus said:


> Next time I get an offer can I send it to you to analyze?



Sure. Or at least we can discuss what questions to ask, but something tells me that you could teach me a thing or two instead


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## Veneficus (Nov 15, 2012)

46Young said:


> Sure. Or at least we can discuss what questions to ask, but something tells me that you could teach me a thing or two instead



Probably not, numbers are not my strong suit.

But I can analyze the :censored::censored::censored::censored: out of systems and operations.


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## 46Young (Nov 15, 2012)

marshmallow22 said:


> And as far as when a department tells you there is ample OT doesn't necessarily mean that they are dysfunctional.  Many of your larger departments (IE FDNY, LA City, LA County, DC Fire/EMS, Frisco just to name a few) including Austin will have the OT available due to vacation and sick time being utilized.  And when you have a department with 400-1000 employees there are bound to be quite a few holes everyday, not to mention any vacancies that may already exist.
> 
> 
> 
> ...


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## 46Young (Nov 15, 2012)

Veneficus said:


> Probably not, numbers are not my strong suit.
> 
> But I can analyze the :censored::censored::censored::censored: out of systems and operations.



"The Truth About Money" by Ric Edelman (whatever the latest edition is, not the 2003 version) is a good place to start for personal finance


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## NYMedic828 (Nov 15, 2012)

46Young said:


> Yes, and FDNY EMS also has had OT problems. NYMedic 828 could tell you better, but they had what's called the "KVO" program (Known Vacancy Opening). IIRC, if you sign up for three OT shifts, you can't be mandated to work any additional shifts that month. That program would get suspended on an off due to staffing shortfalls, though. Good luck trying to go to classes when you're held over all the time.



In 4 years I think I have been mandated less than 6 times. (two of them were in major storms/blizzard conditions so I wouldn't of driven home anyway)

If you have class, you just log on and say "ehhh, im not feeling so good put me out sick." And go home...

KVOs are not so much anymore for avoiding mandation as they are for securing overtime in order to feed your family on low EMS wages.

I almost never work overtime. I work a second job here in a flycar that no one bothers me at. I hate most of my coworkers, I hate almost all of my bosses (because they are almost all sleezy scum once they make boss) and I get pissed if I have to stay for even a minute past my scheduled end time.


The second I make firefighter I will not set foot on an NYC ambulance ever again. (Unless they implement firefighter/paramedics which will never happen in NYC because that would be a practical idea...)




In relation to the thread, paying a medic to work as an EMT is common practice here. Why am I going to pay you medic salary when insurance pays me for a BLS transport?


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## 46Young (Nov 15, 2012)

NYMedic828 said:


> In 4 years I think I have been mandated less than 6 times. (two of them were in major storms/blizzard conditions so I wouldn't of driven home anyway)
> 
> If you have class, you just log on and say "ehhh, im not feeling so good put me out sick." And go home...
> 
> ...



Do you mean medics working for medic pay on a BLS bus? The thread is about ATC-EMS downgrading a portion of their doble medic buses to medic-basic, and paying new medics the same as BLS or an EMT-I until a medic II spot opens up. What we've inferred thus far is that even though they've downgraded to medic/EMT, they can still have some of those units be double medic without paying the second medic their rightful medic pay.

Basically, it looks like the non medic II spot can be whatever, but it will pay at the EMT rate regardles.  

Good luck at the Rock! I got tired of sitting on street corners too. After getting out of our fire academy, my formerly single role EMS classmates have all said the same thing - theat they would never go back to that type of work environment.


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## NYMedic828 (Nov 15, 2012)

46Young said:


> Do you mean medics working for medic pay on a BLS bus? The thread is about ATC-EMS downgrading a portion of their doble medic buses to medic-basic, and paying new medics the same as BLS or an EMT-I until a medic II spot opens up. What we've inferred thus far is that even though they've downgraded to medic/EMT, they can still have some of those units be double medic without paying the second medic their rightful medic pay.
> 
> Basically, it looks like the non medic II spot can be whatever, but it will pay at the EMT rate regardles.
> 
> Good luck at the Rock! I got tired of sitting on street corners too. After getting out of our fire academy, my formerly single role EMS classmates have all said the same thing - theat they would never go back to that type of work environment.



Ah I didn't fully read the threat.

FDNY wise, many EMTs take an outside medic program and may have to wait up to 6 months after completion of their course to be promoted to paramedic. In that time they work as an EMT and they do not have any medic privileges.

I was referring more to outside agencies though such as hospital units that will gladly hire you as an EMT but that is with your agreeing that your title is EMT and they will pay you as such. If a medic spot opens up, they will rightfully promote you if you desire.



And thanks, 2 months to go hopefully can't wait. Have to go finish up my investigation tomorrow morning.


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## ExpatMedic0 (Nov 15, 2012)

46Young said:


> If the information and inferences in this thread are accurate, then that's sad. There aren't too many EMS agencies around that are desireable. If I had known about ATC-EMS back in 2006, I probably would have applied and worked there instead of going to Charleston before the FD, and who knows, I might have still been there today. It sounds like things are going in the wrong direction at ATC from what I'm reading and seeing here. Disappointing.


+1 could not agree more, I hope I am wrong...


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## 46Young (Nov 15, 2012)

NYMedic828 said:


> Ah I didn't fully read the threat.
> 
> FDNY wise, many EMTs take an outside medic program and may have to wait up to 6 months after completion of their course to be promoted to paramedic. In that time they work as an EMT and they do not have any medic privileges.
> 
> ...



It's different if you're hired as an EMT-B, agree to that, but are restricted to BLS. It's when you're hired into and paid for an EMT spot but they want you to do ALS that this becomes shady.

I was lucky that I graduated medic class in 9/2005, and was in the medic upgrade class maybe two weeks later. North Shore-LIJ took a different, more appropriate approach than ATC-EMS IMO:

-Medic II if six months FT paid ALS 911 experience, or five years volunteer ALS 911, who can ride lead on a 911 bus, and do any non CCT IFT call, or

-Medic I if not qualified for Medic II, needs to ride with Medic II in 911, only basic IFT calls such as single drips, no vent jobs, no STEMI or Stroke Calls, that sort of thing. Can be 2nd ALS provider on a CCT with a Medic III (CCT).

Back in 2005, EMT pay was around $15/hr up to $20/hr after a year. Medic I was $22/hr up to $25 after six months. Medic II was $26-something up to $30/hr after six months, and Medic III's got $33/hr, but were IFT only. This was a 40 hour workweek, and 10% night differential applied.


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## 46Young (Nov 15, 2012)

schulz said:


> +1 could not agree more, I hope I am wrong...



If the budget is the issue, at least be honest about it, and I caould understand the staffing and deployment changes, but I still can't agree with paying someone basic pay but ask them to provide ALS.

Even employees that assume an acting status for a higher grade position typically get 5-10% acting pay, just sayin'


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## marshmallow22 (Nov 15, 2012)

I'll clear some skepticisms...

Whether you're a paramedic or EMT you'll be hired as a medic 1 at the medic 1 pay rate regardless of any prior experience.  Yes, I agree this may limit the # of experienced applicants we get, but experience does not always mean a good candidate.  Once hired, they will attend the academy lasting aprroximately 8 weeks, ride 3rd man then eventually 2nd man for a few months, and then test for credentialing at the BLS level only.  They may be wearing a paramedic patch, but are ONLY able to practice at the credentialed level ID badge which will be BLS regardless if they're a paramedic or not.  So the notion that the department is hiring paramedics and paying them EMT wages to perform paramedic work is 100% false.  I'll be more than happy to clear up any other falsehoods/rumors and answer any other questions.  Thanks.


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## 18G (Nov 15, 2012)

marshmallow22 said:


> I'll clear some skepticisms...
> 
> Whether you're a paramedic or EMT you'll be hired as a medic 1 at the medic 1 pay rate regardless of any prior experience.  Yes, I agree this may limit the # of experienced applicants we get, but experience does not always mean a good candidate.  Once hired, they will attend the academy lasting aprroximately 8 weeks, ride 3rd man then eventually 2nd man for a few months, and then test for credentialing at the BLS level only.  They may be wearing a paramedic patch, but are ONLY able to practice at the credentialed level ID badge which will be BLS regardless if they're a paramedic or not.  So the notion that the department is hiring paramedics and paying them EMT wages to perform paramedic work is 100% false.  I'll be more than happy to clear up any other falsehoods/rumors and answer any other questions.  Thanks.



So I would have to go through 8 weeks of an academy, ride as a 3rd person, then as a 2nd person, and then after all of that take a BLS test!?!? HOW STUPID IS THAT! Why is a Paramedic taking a credentialing exam at a BLS level???

And further more, why would an EMS provider being permitted to only provide a BLS level of care be misrepresenting their level of care delivery by wearing a patch that says Paramedic??? What happens if the EMT who is actually a Paramedic is needed to provide ALS interventions? Are they allowed to do so?

This is a really convoluted and idiotic process.


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## marshmallow22 (Nov 15, 2012)

Yes, that's correct... academy, field training, then credentialing testing as a BLS provider only.  In our system you are recognized to provide the level of care at which your ID badge that you wear identifies you at, regardless of your patch.  There are a few firefighters on AFD that are licensed paramedics in Texas who are not allowed to perform ALS skills because they are not CREDENTIALED by the medical director in the sysytem at the ALS level.  AFD is strictly a BLS provider regardless what the patch says.  I agree it would be frustrating to be a licensed medic and not be able to perform the skills you went to school for.  As for now though it is what it is whether we or anybody else likes it or not.


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## 46Young (Nov 15, 2012)

marshmallow22 said:


> Yes, that's correct... academy, field training, then credentialing testing as a BLS provider only.  In our system you are recognized to provide the level of care at which your ID badge that you wear identifies you at, regardless of your patch.  There are a few firefighters on AFD that are licensed paramedics in Texas who are not allowed to perform ALS skills because they are not CREDENTIALED by the medical director in the sysytem at the ALS level.  AFD is strictly a BLS provider regardless what the patch says.  I agree it would be frustrating to be a licensed medic and not be able to perform the skills you went to school for.  As for now though it is what it is whether we or anybody else likes it or not.



So, why didn't you just say what you did over the last two posts seven pages ago instead of complaining about us speculating?

We took educated guesses because the things we described are common throughout EMS.


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## medicsb (Nov 15, 2012)

NYMedic828 said:


> (Unless they implement firefighter/paramedics which will never happen in NYC because that would be a *practical* idea...)



:rofl:
:wacko:
:rofl:
:wacko:
:rofl:
:wacko:

(Couldn't resist.)


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## DrParasite (Nov 15, 2012)

46Young said:


> Back in 2005, EMT pay was around $15/hr up to $20/hr after a year. Medic I was $22/hr up to $25 after six months. Medic II was $26-something up to $30/hr after six months, and Medic III's got $33/hr, but were IFT only. This was a 40 hour workweek, and 10% night differential applied.


ugh, 33 an hour for your most experienced medics, but you only do IFTs? I would kill myself, esp if I was considered the highest level of training at my agency.  Unstable IFTs are one thing (STEMI, Strokes, etc, anything where there is a life threat from a very recent illness or injury), but a very stable IFT?  where the patient needs a monitor for a procedure tomorrow morning?  I couldn't do it, and I know quite a few medics (actually a whole lot) who would die or boredom.  Just a personal opinion, your opinion may be different.  

And yes, I do know quite a few RNs who do CCTs, and they are often partnered with a paramedic (so they can do ALS 911 calls when not on a CCT).  They have similar opinions about CCTs, especially the prescheduled ones.





NYMedic828 said:


> KVOs are not so much anymore for avoiding mandation as they are for securing overtime in order to feed your family on low EMS wages.


and why do they pay low wages?  because people will work for such low wages.  Then again, I'd rather work OT on my schedule than being forced, or a side job, since usually OT pays more





NYMedic828 said:


> I almost never work overtime. I work a second job here in a flycar that no one bothers me at. I hate most of my coworkers, I hate almost all of my bosses (because they are almost all sleezy scum once they make boss) and I get pissed if I have to stay for even a minute past my scheduled end time.


not for nothing, but you must be a joy to work with.  I'm curious what your coworkers think of you.  

Than again, from the FDNY firefighter who started out in EMS, while they are happier on the engine than on the ambulance, they either 1) took the open competitive test instead of the promotion or 2) didn't have as miserable of an attitude as you seem to have.  Again, I don't know you personally, but based on your opinion of your coworkers.


NYMedic828 said:


> The second I make firefighter I will not set foot on an NYC ambulance ever again. (Unless they implement firefighter/paramedics which will never happen in NYC because that would be a practical idea...)


yeah, because FF/PM in NYC makes absolutely 0 sense.  most places FF/PM is a waste of money, and NYC would be no exception.  paying their EMS crews better and having more ambulances to handle the call volume is a much better idea than wasting a paramedic on a fire truck.


NYMedic828 said:


> In relation to the thread, paying a medic to work as an EMT is common practice here. Why am I going to pay you medic salary when insurance pays me for a BLS transport?


Boston does it too (which was already mentioned).  If you want your foot in the door, starting BLS is often the easiest way to get into a medic spot.  I know a couple places that will hire paramedics, and let them work as EMTs for an EMT rate.  One place will actually pay new medics who were hired as EMTs medic salaries until a full time medic spot opens up.

BTW, NJ has some paramedics who are volunteers in EMS.  They are only able to act as EMTs, as the agency is only a BLS level agency.  I'm pretty sure it's the same for Paramedics whose job description is as a BLS provider.


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## 46Young (Nov 15, 2012)

DrParasite said:


> ugh, 33 an hour for your most experienced medics, but you only do IFTs? I would kill myself, esp if I was considered the highest level of training at my agency.  Unstable IFTs are one thing (STEMI, Strokes, etc, anything where there is a life threat from a very recent illness or injury), but a very stable IFT?  where the patient needs a monitor for a procedure tomorrow morning?  I couldn't do it, and I know quite a few medics (actually a whole lot) who would die or boredom.  Just a personal opinion, your opinion may be different.
> 
> And yes, I do know quite a few RNs who do CCTs, and they are often partnered with a paramedic (so they can do ALS 911 calls when not on a CCT).  They have similar opinions about CCTs, especially the prescheduled ones.
> 
> and why do they pay low wages?  because people will work for such low wages.  Then again, I'd rather work OT on my schedule than being forced, or a side job, since usually OT pays morenot for nothing.



The CC medics that only do IFT like doing only IFT. Not everyone in the system wants to do NYC 911. The CCM only gets high acuity calls, not NH discharges, routine IVL/monitor/O2, etc. That system gets a fair amount of CC calls, so it's not too bad. They can spend the down time taking classes and such.

As far as FDNY EMS, everyone in NY knows that you work at the hospitals for the money, schedule, and working conditions, and you work FDNY for the benefits. It's good money if you're just off the street or stocking shelves somewhere I suppose. The pay used to actually be worse, believe it or not, before they got uniform status and actually got a new contract. Their top pay is actually closer to the hospitals than what it was before. If you're committed to living in NY for life, and are committed to doing EMS for the long term, then it's the best choice to work for FDNY EMS since you get decent medical, a pension that includes OT in the calculation, and is way more stable than the hospitals, which seem to be falling like dominoes lately.

Of course, a medic can do better financially and also with working conditions out of state, particularly fire based, but most in the business back in NY are maybe vaguely aware of EMS systems elsewhere, but hear that they pay crap. So, the FDNY EMS pay seems to be not too awful for a 110 hr EMT course or a 13 month medic class for those with little ambition in life.


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## Fish (Nov 15, 2012)

I love the saying nobody joins EMS to get rich


I usually hear that from EMTs who make $8 an hour and are trying to convince themselves that they don't mind.

That being said

Austin pays well, their Medics live comfortable life styles and are typically not living paycheck to paycheck. What they are willing to pay an EMT basic with no experience right out of school is the best around.


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## ThirdCareerMedic (Nov 15, 2012)

PoeticInjustice said:


> I agree, it would be quite frustrating. I'd probably end up getting called in to the medical directors office a couple times... :unsure:



So, if you are working as an "overfill" in an EMT position when you are licensed as a paramedic, do you only practice to the level of an EMT, using EMT level protocols, etc.?  Or, are you by law/license expected to practice to the level of paramedic regardless of whether your position is that of an EMT or not? 
All the responsibility of a paramedic but not the pay?


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## 46Young (Nov 16, 2012)

ThirdCareerMedic said:


> So, if you are working as an "overfill" in an EMT position when you are licensed as a paramedic, do you only practice to the level of an EMT, using EMT level protocols, etc.?  Or, are you by law/license expected to practice to the level of paramedic regardless of whether your position is that of an EMT or not?
> All the responsibility of a paramedic but not the pay?



Refer to post #77. They're hired into an EMT spot, so their patch says EMT, even though they're credentialed to a higher level by the state.


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## ThirdCareerMedic (Nov 16, 2012)

46Young said:


> Refer to post #77. They're hired into an EMT spot, so their patch says EMT, even though they're credentialed to a higher level by the state.



Thanks for that.  Just so I am clear, so if one wears a patch saying EMT, then one has no ethical or legal responsibility to provide care at the ALS level in spite of credentialing or licensing at that level?


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## shfd739 (Nov 16, 2012)

ThirdCareerMedic said:


> Thanks for that.  Just so I am clear, so if one wears a patch saying EMT, then one has no ethical or legal responsibility to provide care at the ALS level in spite of credentialing or licensing at that level?



As I understand this they wear the patch that the are certed at by the state(Basic w/ Basic patch, Paramedic w/ Paramedic patch). They are system limited to a Basic level. On the job they cant function past whatever the system's BLS protocols are. 

We've done this to a handful of paramedics that weren't capable enough to function as paramedics. They worked at a BLS level within our system while being remediated. 

Maybe I missed it..Is there a possibility in the future that ATC will hire in current paramedics to function at that level? Or is the only way now to hire in as a paramedic and play as a basic till a paramedic spot opens (a la Boston)?


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## firecoins (Nov 16, 2012)

If your a medic working as an EMT, you have no obligation to provide ALS care and you wont have the equipment available to provide ALS care anyway.   Your expected to do the BLS as best can be done.


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## marshmallow22 (Nov 16, 2012)

Just to clarify again, you will be hired at the EMT level whether you are a paramedic or not, and whether you have any experience or not.  Once cleared you will be working on a truck with a paramedic partner, but regardless of your state license you are only allowed to practice at the BLS level.  In our system you wear an ID badge, and that ID badge has a specific color and status as to what level you may practice at, even though the patch on your shoulder may indicate you're a paramedic. I know it sounds a bit confusing, but that's the way it is.  I agree that for an EMT I don't think you'll find many places that will pay as high as us working in an all 911 only system with great benefits.  As a paramedic there may be better options as far as the pay goes, at least until you promote to a paramedic spot.


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## shfd739 (Nov 16, 2012)

marshmallow22 said:


> Just to clarify again, you will be hired at the EMT level whether you are a paramedic or not, and whether you have any experience or not.  Once cleared you will be working on a truck with a paramedic partner, but regardless of your state license you are only allowed to practice at the BLS level.  In our system you wear an ID badge, and that ID badge has a specific color and status as to what level you may practice at, even though the patch on your shoulder may indicate you're a paramedic. I know it sounds a bit confusing, but that's the way it is.  I agree that for an EMT I don't think you'll find many places that will pay as high as us working in an all 911 only system with great benefits.  As a paramedic there may be better options as far as the pay goes, at least until you promote to a paramedic spot.



So for a current paramedic is this the only way in? Or will ATC hire in paramedics in the future to function at that level without the Medic 1 crap?


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## ExpatMedic0 (Nov 16, 2012)

sounds like an EMT's dream come true and a paramedics bad dream.


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## TransportJockey (Nov 16, 2012)

I guess ATC just got taken off the list of places I really wanna work... There's still Williamson though


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## medic417 (Nov 16, 2012)

TransportJockey said:


> I guess ATC just got taken off the list of places I really wanna work... There's still Williamson though



You can definitely find better pay and protocols away from ATC. They are no longer even close to being one of the best.


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## marshmallow22 (Nov 16, 2012)

Not sure how long this will go on for, but we are being told that the medical director wants a 60/40 ratio of dual medic vs medic/EMT trucks.  Also, in regards to Williamson County, they do a 24 on and 48 off rotating schedule, and their pay starts at 16.30/hr regardless of experience. Just FYI.  And opinions may vary, but as far as EMS agencies go, we are still one of the most respected and one of the higher paying departments in the nation (at least for the medics who came in before the current hiring practices).


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## marshmallow22 (Nov 16, 2012)

Agencies are not measured to be the best by their protocols or pay.  Those things are what is desireable to potential applicants.  To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center.  There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate.  A good paramedic is basically a social worker 90% of the time.  You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.


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## medic417 (Nov 16, 2012)

marshmallow22 said:


> Agencies are not measured to be the best by their protocols or pay.  Those things are what is desireable to potential applicants.  To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center.  There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate.  A good paramedic is basically a social worker 90% of the time.  You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.



But when your patient needs them you sure want to be working for a progressive system where you can do what the patient needs.  

I do agree with the social worker statement in fact it is actually closer to 99% than 90%.


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## Veneficus (Nov 16, 2012)

marshmallow22 said:


> Agencies are not measured to be the best by their protocols or pay.  Those things are what is desireable to potential applicants.  To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates,



Cardiac arrest survival rate is nowhere near a measure of a good EMS system. 

There are far too many confounding factors and you are measuring how well you are bringing people back from the dead.

To say nothing of the fact that bystander CPR is going to be the biggest indicator of success.

About the best you could do to turn this in your favor is community CPR instruction and public access AEDs.



marshmallow22 said:


> on scene trauma times



This doesn't matter either. Most trauma is ortho in nature. The only life threatening ortho injury is compartment syndrome. 

Sprains, strains, and most fractures are time dependant in hours or days.



marshmallow22 said:


> There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill..



Are you saying that advanced training and skills is not something that attracts and retains quality providers?



marshmallow22 said:


> A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate.  A good paramedic is basically a social worker 90% of the time.  You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.



I think this contradicts your earlier statement. If this is a measure of a good paramedic, would not advanced skill training and knowledge, or special education in social issues and alternative transport decisions from the ED be the mark of a good system.

You basically used a 1980s set of measurements of a good system and then went on to give modern examples of a good paramedic. 

???


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## marshmallow22 (Nov 16, 2012)

The ways to measure a good EMS system ARE the ways in which I stated you do that. Why? Because that is raw data... objective data.  Everything else is just opinion and subjective argument.  Again, opinions may vary, but what I can tell you is that our stats don't lie.  I'm proud of my department and our protocols work just fine for our system. I believe we are still one of the best systems in the country.


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## RocketMedic (Nov 16, 2012)

marshmallow22 said:


> Agencies are not measured to be the best by their protocols or pay.  Those things are what is desireable to potential applicants.  To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center.  There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate.  A good paramedic is basically a social worker 90% of the time.  You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.




*Intubation

I agree with the sentiments of your post, but emphasis on statistics is also flawed.


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## medicsb (Nov 16, 2012)

There is a funny thing that happens on EMTLIFE, which is demonstrable in this thread.  A service that is relatively transparent, which actually dedicates time to PR, etc. seems to get plenty of bad-mouthing by others.  There is always a citation of "better" services outside of whatever one is being talked about, yet rarely are these services ever mentioned, and when they are, I look them up and I am consistently underwhelmed.  

There is nothing seemingly that special about Williamson County EMS from what I can tell.  They run around 30,000 calls with 15-16 double medic trucks.  They use RSI and have a STEMI and stroke system.  Ho Hum.  (Most services with RSI probably shouldn't be doing it, including almost every service in TX, so that is in no way a indicator of a good system.)  They do not appear to make any data public - they're just like most of other EMS'.  (Though, they claim to be data-driven and claim to publish data, yet I can't find a thing.)   Probably good, not too bad... whatever.  Unlike most places, one can actually look up data from ATCEMS system as they make quite a bit public.  If nothing else, they deserve credit for that.  And, well, actually looking at the data published, they're not a bad service and probably are better than the majority in the US.  

Really, ATCEMS may not be the best.  There probably are others just as good, if not better (maybe WilCo), but shame on those others for not promoting themselves better.


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## Veneficus (Nov 16, 2012)

marshmallow22 said:


> The ways to measure a good EMS system ARE the ways in which I stated you do that. Why? Because that is raw data... objective data.  Everything else is just opinion and subjective argument.  Again, opinions may vary, but what I can tell you is that our stats don't lie.  I'm proud of my department and our protocols work just fine for our system. I believe we are still one of the best systems in the country.



Raw data that means nothing has no value.


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## marshmallow22 (Nov 16, 2012)

Well put medicsb!!  And let me just say, out of all of my posts I have never degraded or taken away from any other EMS department.  Each department has their pros and cons... just as mine does.


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## TransportJockey (Nov 16, 2012)

marshmallow22 said:


> Well put medicsb!!  And let me just say, out of all of my posts I have never degraded or taken away from any other EMS department.  Each department has their pros and cons... just as mine does.



The only agency i have spoken disparagingly about is DC FEMS (yes i feel the acronym is fitting considering how they perform). It has been shown several times what type of system they are. 
As for Austin/Travis, i just have a personal issue with being a medic but not being allowed to perform up to my full training and knowledge. I have been gravitating to working for agencies that employ the double medic truck model, and i would love to go back to Texas to do it. It is my personal opinion that i do not like the way they work their system now, and hence i will most likely not consider employment with that agency. I have others, including several with community health or advanced practice and critical care scopes (which interests me much more than an all 911 truck does anyways), that i was considering which will move up in consideration. Including a maroon company in a large metro area in Texas.


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## marshmallow22 (Nov 16, 2012)

When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency.   We get plenty of apps. and we'll operate just fine without you so that's okay if you don't apply with us.  I think you're going to find it won't be as easy as you think it is to get hired with the agency of your choice, but good luck to you anyways.


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## Fish (Nov 16, 2012)

marshmallow22 said:


> Not sure how long this will go on for, but we are being told that the medical director wants a 60/40 ratio of dual medic vs medic/EMT trucks.  Also, in regards to Williamson County, they do a 24 on and 48 off rotating schedule, and their pay starts at 16.30/hr regardless of experience. Just FYI.  And opinions may vary, but as far as EMS agencies go, we are still one of the most respected and one of the higher paying departments in the nation (at least for the medics who came in before the current hiring practices).



Austin no longer pays for experience


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## DrParasite (Nov 16, 2012)

marshmallow22 said:


> When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency.


I'm curious: if 100% of applicants have their paramedic card, and are educated to the paramedic level, how do 80% of them get rejected during the hiring process?  what seems to be the biggest eliminating factor?


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## Fish (Nov 16, 2012)

medicsb said:


> There is a funny thing that happens on EMTLIFE, which is demonstrable in this thread.  A service that is relatively transparent, which actually dedicates time to PR, etc. seems to get plenty of bad-mouthing by others.  There is always a citation of "better" services outside of whatever one is being talked about, yet rarely are these services ever mentioned, and when they are, I look them up and I am consistently underwhelmed.
> 
> There is nothing seemingly that special about Williamson County EMS from what I can tell.  They run around 30,000 calls with 15-16 double medic trucks.  They use RSI and have a STEMI and stroke system.  Ho Hum.  (Most services with RSI probably shouldn't be doing it, including almost every service in TX, so that is in no way a indicator of a good system.)  They do not appear to make any data public - they're just like most of other EMS'.  (Though, they claim to be data-driven and claim to publish data, yet I can't find a thing.)   Probably good, not too bad... whatever.  Unlike most places, one can actually look up data from ATCEMS system as they make quite a bit public.  If nothing else, they deserve credit for that.  And, well, actually looking at the data published, they're not a bad service and probably are better than the majority in the US.
> 
> Really, ATCEMS may not be the best.  There probably are others just as good, if not better (maybe WilCo), but shame on those others for not promoting themselves better.



One thing is for sure, Austin has a PIO and a large Clinical department. And large budget. Allowing for them to make stats as available as they do.

I would not say "shame on others..." not all departments have the same amount of resources.


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## TransportJockey (Nov 16, 2012)

marshmallow22 said:


> When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency.   We get plenty of apps. and we'll operate just fine without you so that's okay if you don't apply with us.  I think you're going to find it won't be as easy as you think it is to get hired with the agency of your choice, but good luck to you anyways.



I know for a fact it won't be easy. That's why I am doing as much as possible to stand above people I know I will be applying against. It's why I am finishing a class to prepare me to sit for my FP-C, and why I'm looking at my AAS in EMS, along with a BS-EMS specializing in community paramedicine. Thank you for hte luck, I know I will still need it no matter what. I have no doubt that your agency will do just fine, as I said, it's my personal opinion. And to me, applying for agencies out of NM, that's all that matters. 
Either way, stay safe.


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## marshmallow22 (Nov 16, 2012)

Historically if you passed the written and skills then you made it through all 3 days of the:excl: process which include the physical agility, a psych written, a psych interview, and a panel interview.  Those that made it through the process and did not get hired were not hired for a number of reasons. Some of those include having a poor interview, a poor psych interview, and failing our background process.


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## medicsb (Nov 16, 2012)

Fish said:


> One thing is for sure, Austin has a PIO and a large Clinical department. And large budget. Allowing for them to make stats as available as they do.
> 
> I would not say "shame on others..." not all departments have the same amount of resources.



Nah.  I disagree.  Most EMS' have websites.  It doesn't take much effort to make a page for "quality" metrics.  Any service that does any sort of QA/QI should be able to track certain things from response times to ETI success to STEMIs ID'd to use of CPAP.   It may take some effort to gather the data, but the effort is worth it.  I remember back when I was first a medic and was helping out with QA/QI, it took me only a couple of hours to compile ETI stats over the past few years since we did electronic charting (man were those bad).


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## medicsb (Nov 16, 2012)

Veneficus said:


> Cardiac arrest survival rate is nowhere near a measure of a good EMS system.
> 
> There are far too many confounding factors and you are measuring how well you are bringing people back from the dead.
> 
> ...



Wut?  No where near a good measure?  C'mon.  We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs.  Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system.  For something we consider to be so easy to manage, many seem to not do it well.  Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems.  If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.    

It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.  

It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.


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## Fish (Nov 16, 2012)

medicsb said:


> Nah.  I disagree.  Most EMS' have websites.  It doesn't take much effort to make a page for "quality" metrics.  Any service that does any sort of QA/QI should be able to track certain things from response times to ETI success to STEMIs ID'd to use of CPAP.   It may take some effort to gather the data, but the effort is worth it.  I remember back when I was first a medic and was helping out with QA/QI, it took me only a couple of hours to compile ETI stats over the past few years since we did electronic charting (man were those bad).



True, and I would add. Most EMS services already have this data, they have just not got around to placing it online. For whatever reason.


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## Veneficus (Nov 17, 2012)

medicsb said:


> Wut?  No where near a good measure?  C'mon.  We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs.  Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system.  For something we consider to be so easy to manage, many seem to not do it well.  Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems.  If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.
> 
> It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.
> 
> It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.



Easily measurable yes. But I stand by my statement it is a poor measurement of a system.

I could probably write a book on the utstein criteria and its shortcomings.

So how do you rate EMS systems with poor cardiac arrest survival in populations predisposed to poor outcomes?

Take for example Medic-1 stats, they have a reasonably healthy and educated populous, compared to say greater DC or Philly. What about Detroit? States with high incidence of obesity and comorbidities of it?

Does a low arrest "save" rate reflect poorly on those systems?

How does it compare with what was done by the hospital?

I agree it is easy data to collect. It is easy to sell to the public. But as far as measure for a system, too many confounding variables.

Edit: I would also point out that areas which have good outcomes using Utstein generally advocate for it and places with poor statistics don't use it at all.


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## ExpatMedic0 (Nov 17, 2012)

So as some one else mentioned,  ATC is also no longer paying for years of experience?


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## marshmallow22 (Nov 17, 2012)

That's correct. It does not matter on your experience anymore.  I know that may limit the # of apps of people we get that have experience, but also experience doesn't necessarily mean a good candidate. We also do not want someone with bad habits.  With our new recent adoption of civil service voted in by the residents this past election many things may change in regards to our hiring practices in the future.


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## usalsfyre (Nov 17, 2012)

marshmallow22 said:


> That's correct. It does not matter on your experience anymore.  I know that may limit the # of apps of people we get that have experience, but also experience doesn't necessarily mean a good candidate. We also do not want someone with bad habits.  With our new recent adoption of civil service voted in by the residents this past election many things may change in regards to our hiring practices in the future.



So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".


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## 46Young (Nov 17, 2012)

usalsfyre said:


> So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".



I was thinking the same thing. Only employing the inexperienced, which is what is happening by proxy with ATC's current hiring practices, just assures that the new hires only think along company lines, with no forward thinking of their own. Places that only want inexperienced people clearly do not value forward thinkers with different perspectives and ways to improve their service.

Right after I left NS-LIJ CEMS they did the same thing - they only wanted new people that did things the company way and would not question any current practices for the purpose of improving their operations and working conditions. Also, if you've never worked anywhere else, a system could be seriously flawed, but the probie would never know it.


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## marshmallow22 (Nov 17, 2012)

We're not only going to hire inexperienced people. We actually have some experienced paramedics that got hired in the medic 1 position with the last hiring process.  All are welcome to apply, and we will hire the best candidate for the position. Once again, someone with experience does not always make the best candidate, especially if they're a problem child somewhere else, or have an untrainable attitude.


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## Veneficus (Nov 18, 2012)

usalsfyre said:


> So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".



Well said.

I have even come across places that wanted to hire outsiders specifically for an unbiased outside view of the company. 

That is a mark of a highly progressive and respectable employer.



46Young said:


> I was thinking the same thing. Only employing the inexperienced, which is what is happening by proxy with ATC's current hiring practices, just assures that the new hires only think along company lines, with no forward thinking of their own. Places that only want inexperienced people clearly do not value forward thinkers with different perspectives and ways to improve their service.



This is becomming more and more common in all industries as I see it.

Those with nothing to fear have nothing to hide.

But when you get promoted by seniority instead of ability, hiring a highly capable, established, and tested candidate is a very scary prospect.



marshmallow22 said:


> We're not only going to hire inexperienced people. We actually have some experienced paramedics that got hired in the medic 1 position with the last hiring process.  All are welcome to apply, and we will hire the best candidate for the position. Once again, someone with experience does not always make the best candidate, especially if they're a problem child somewhere else, or have an untrainable attitude.



I doubt that.

One of my former partners, an extremely capable and singularly gifted medic, applied there many years ago. I was listed as one of her references and ATC called me.

The questions they asked me about her were largely non-professional. When I pointed out their questions had nothing to do with the job and were basically things they were not legally permitted to ask a reference or at an interview, the caller tried to pull the "we're both medics and nobody will ever know, be a friend..." line.

Again I stated I would not answer questions not relevant to the position and her out of work hobbies and "preferences" was the word he used.   
He then asked me in the same call, based on my credentials, if I wanted to interview for a postion as well.

I declined. 

I don't need anybody calling my former coworkers and friends asking about my "preferences" out of work to see if I am a good candidate for a job.

I will also point out, a "problem child" is a very subjective description. I have been labeled a "problem child" by some of my past employers. For things like "not driving fast enough in the fog" or " not sounding panicked enough on the radio." I was even a "problem child" for pointing out that the billing practices at one agency might actually be medicare fraud. (only a few years after I left they "settled" the matter out of court)  

In other agencies, I continue to be acclaimed as an extremely desirable employee. 

I guess it is all a matter of your "preferences."


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## RocketMedic (Nov 18, 2012)

Kool-aid Kool-aid!

There's a fantastic Army cadence about just that. 

Personally, I think one of the markers of a truly superior employer is when there is no Kool-Aid, simply a desire to work there (along with a gourmet coffeepot). 

I'd take coffee over Kool-Aid any day of the week.


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## NomadicMedic (Nov 18, 2012)

Rocketmedic40 said:


> Kool-aid Kool-aid!
> 
> There's a fantastic Army cadence about just that.
> 
> ...



We have a Keurig at every station.


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## RocketMedic (Nov 18, 2012)

n7lxi said:


> We have a Keurig at every station.



Glorious.


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## DrParasite (Nov 18, 2012)

Veneficus said:


> I will also point out, a "problem child" is a very subjective description. I have been labeled a "problem child" by some of my past employers. For things like "not driving fast enough in the fog" or " not sounding panicked enough on the radio." I was even a "problem child" for pointing out that the billing practices at one agency might actually be medicare fraud. (only a few years after I left they "settled" the matter out of court)


Ever interviewed for a supervisory position?  I did several years ago, and told how I wanted our company to be better and gave specific examples, and I didn't get the job.  I was later told that they wanted someone who had their head in the sand, thought the agency was the best ever and people were lucky to be working there, and management's policies were perfect.  Suffice it to say, I didn't get the job there.

a problem child is someone who speaks up when something is wrong, tries to makes a situation better, gets educated outside of their agency and tries to bring it back to raise standards, points out potential legal issues that management might not see (or might not want to see), and anyone who interrupts the status quo, or who doesn't drink the koolaid and thinks that the bosses are imperfect and will point out when they are wrong.  personally, I consider it to be a good thing, as when everyone says the same thing there is no chance for progress in an organization.


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## RocketMedic (Nov 18, 2012)

However, many agencies have low "problem children" tolerances and accept mediocrity as the standard- something I'm running into.


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## NomadicMedic (Nov 18, 2012)

And many EMS agencies have supervisory staff with no management experience or training... And people who may just be ENTP are deemed "trouble children".


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## Veneficus (Nov 18, 2012)

Rocketmedic40 said:


> However, many agencies have low "problem children" tolerances and accept mediocrity as the standard- something I'm running into.



There is nothing that the incapable and mediocre resent more than a champion.

It is everything they will never be.


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## 46Young (Nov 18, 2012)

To be fair, $15/hr on a 48 hour/week work schedule is actually decent money for a medic in most places outside of expensive population centers such as LA and NY. This is compared to most other EMS systems, which typically pay from $30k/yr to $35k/yr for medics, and it's a 56 hour/week schedule, not 48. ATC-EMS is basically offering $40k/yr @ $15/hr. Not great, but better than a lot of places, particularly in the Southeastern U.S. 

Many places do not pay for experience, but experience may give a hiring preference. In CCEMS (SC), they offered $38k/yr to start, up to $45k/yr after making Crew Chief, with a top of $68k/yr after ten years or so, for medics. That was basically $11.50/hr base, on a 56 hour schedule. I mis-understood the person interviewing me in that they had 12's and 24's, and a 48 hour schedule was mentioned. I thought it was a 48 hour schedule regardless if 12 hour or 24 hour shift, but I was wrong. I was naive in that the only systems I've worked previously were 40 hour places. I didn't know this was a 24/48 with no Kelly's type of place. I was burnt out in only three months with the 12-24 hour holdovers and busy call volume.

If CCEMS paid their medics $15/hr to start, I would have been making $50k/yr instead of $38k/yr. The sad thing is that they were the best paying third service municipal EMS provider in the region, so $15/yr at ATC-EMS doesn't seem so bad in comparison. I just hope that they have regular step increases, so that they're not stuck at $15/hr for more than a year if they can't promote.


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## 46Young (Nov 18, 2012)

Some questions about ATC-EMS out of curiosity:

What is the service requirement (how many years) for the defined benefits retirement? For example, is it 25/55? Does there have to be an addition of age to years of service?

What is the percentage multiplier for the pension benefit? For example, CCEMs only offered 1.8% @ 28 years of service, which only gives you a 50% yearly benefit.

Is your medical premium paid by the employer after your retirement, or do you have to pay the premium 100%? Is your medical insurance portable?

What are the bottom and top salaries for each position, and how many years does it take to reach that top pay?

Do you have a DROP (TERI in SC)? I've heard Houston fire has a ten year drop @ 20 years of service.

How much do you pay in bi-weekly medical premiums, and are there deductibles?

How many light duty positions are available for the injured and pregnant? 

How many different positions are there for non -supervisory employees that do not involve field EMS transport?

How many supervisor positions are there in your organization, and what is your total headcount for the organization?

What criteria are used to fufill or deny leave requests? 

What is your policy on mandatory recall and holdover? Also, if the employee has travel plans on their days off (plane tickets, hotel reservations, etc), can they be held or recalled?

Are CEU's given on duty, are they given off duty but mandated and compensated for, or are your employees on their own?

Are units automatically placed in-service as soon as they arrive at the hospital, or are they permitted to finish their report before having to go back in-service?

Is there a policy in place that lets an employee use their leave to go home during the overnight hours of their shift (or the next day if held over) if they feel they are too tired to drive or give pt care?


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## 46Young (Nov 18, 2012)

Hey, do you know what I just realized? If you work a 48 hour schedule (two 24's/week), you'll work 30 forty-hour work "years" after 25 calendar years.

If you work a 56 hour schedule (like I do, a 24/24/24/24/24/96, or a 24/48), you'll work 35 forty-hour work years.

This is why I would never work a 56 hour schedule for much less money than I currently do. Sure, technically you get to sleep at night, exercise for an hour or two a day and take classes online of you want, but you're still away from home for 1/3 of your work-life


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## ExpatMedic0 (Nov 19, 2012)

AMR starts brand new paramedics with out experience at about $40,000 a year in Portland with no OT. I know guys in that system who do work a good amount of OT and pull 80,000.
So no, the ATC 15 bucks an hour wage for a paramedic is not so great. Portland's cost of living is not very high and I made 15 an hour an EMT there before I was even  a Paramedic. 
if you google McDonalds assistant manager, they make 15 bucks an hour in most places, which comes out to around 29k with no OT


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## Veneficus (Nov 19, 2012)

I think something that needs to be remembered is EMS is still a vocation.

Some municipalities pay a rate considerably inflated compared to the private sector. (Excellent for employees, don't get me wrong, but it is still like hitting the job lottery to get that)

If you look at the lateral and upward advancement of other vocational jobs, it is basically nothing. 

Afterall, what is the lateral transfer for a welder or carpenter?

What is the promotion? Site manager? Forman?

Many of these vocations do have a higher salary compared to EMS. Look at waste disposal. 

Looking back, I would have taken that job over EMT anyday. Would have earned 2-3 times the salary even before benefits. 

Unless you get hired in a stellar position like 46young, there simply is no future in EMS other than poverty. The self sacrifice maybe altruistic, but it certainly isn't going to give you much more than self satisfaction or a disability claim.


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## 46Young (Nov 19, 2012)

schulz said:


> AMR starts brand new paramedics with out experience at about $40,000 a year in Portland with no OT. I know guys in that system who do work a good amount of OT and pull 80,000.
> So no, the ATC 15 bucks an hour wage for a paramedic is not so great. Portland's cost of living is not very high and I made 15 an hour an EMT there before I was even  a Paramedic.
> if you google McDonalds assistant manager, they make 15 bucks an hour in most places, which comes out to around 29k with no OT



You might be right. I did some calculations:

Let's say that ATC was a 40 hour/week employer. The same goes for Portland AMR. ATC pays $15/hr, or $31,200. AMR pays $20/hr, or $41,600. Assume that ATC pays a 50% pension @ 25 years of service, a benefit of $15,600/yr. AMR has a 401k, but for the sake of argument, we'll assume that there's no employer match. We'll also assume that ATC does not require an employee contribution to the pension fund. 

The difference in yearly salary is $10,400. If the AMR employee invests this sum every year, starting at year two have to earn the money first), they would need to amass $313k over the 25 years, that will give 5% interest, to match the pension benefit without touching the principal. To achieve this, the AMR employee simply needs to earn an annualized return of 1.8% over that term! 

Now, the true yearly salary for ATC @ $15/hr on a 48 hour schedule is $40,560/yr. 50% of that as a pension is $20,280. The AMR employee needs to build up $406,000 over the same 25 years. The annual return needs to be only 3.66%, still easily doable. 

So, $20/hr at a 40 hour employer with only a 401k without employer match easily trumps $15/hr plus 8 hours of built in OT assuming 50% @ 25 years. 

I guess $15/hr isn't so great after all.

Another important lesson her is if you have the choice of a pension employer, and a non-pension employer that pays 33% more, you'll be able to build a much better retirement, given that you invest the entire difference in pay with deferred comp. Even 25% more should be sufficient, I think.


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## RocketMedic (Nov 19, 2012)

Veneficus said:


> There is nothing that the incapable and mediocre resent more than a champion.
> 
> It is everything they will never be.



This pretty much sums up today.

"Why are we responding code-3 to a known stable patient?"

"RESPONSE TIMES! EVERY CALL IS AN EMERGENCY AND DESERVES AN EMERGENT RESPONSE!"

"But you can literally get there in less than five minutes by following the normal flow of traffic."

"THEY ARE AN EMERGENCY! WE HAVE TO RESPOND EMERGENT!"

-Later-

"What emergent calls wouldn't you run hot to?"

"Lots of things- everything triaged as an Alpha-level call, falls for lift assists..."

"WE HAVE TO RUN HOT TO ALL OF THOSE! THEY'RE LIFE-THREATENING EMERGENCIES!"

Luckily, this isn't from a veteran medic, but it still underscores the point.

Yep. That sort of day.


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## Fish (Nov 20, 2012)

medicsb said:


> (Most services with RSI probably shouldn't be doing it, including almost every service in TX.



Why do you not think services with RSI should be doing it?


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## usalsfyre (Nov 21, 2012)

I could make broad, sweeping statements about medical students, but don't. Agree there are a lot if places that don't need to do RSI. Singling out one state that you haven't seen success rates on is a pretty clown move.


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## Veneficus (Nov 21, 2012)

usalsfyre said:


> I could make broad, sweeping statements about medical students



and you would probably be right.

(I am not entering the RSI debate)


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## medicsb (Nov 21, 2012)

Fish said:


> Why do you not think services with RSI should be doing it?




I tend to think that paramedicine (and medicine, in general) requires education (didactic), training (hands on, overseen by an "expert"), and frequent experience to be proficient.  Usually, in EMS, one (or 2) of those is deficient.  Considering that most EMS systems with RSI do not restrict its practice to a small number of intubators, I am not confident that paramedics, even with great education and training, are able to become experienced enough to be proficient at the skill of intubation.  I can only think of 2 studies where RSI was shown to be not harmful.  One was a weak retrospective study and the other was a strong RCT that showed benefit by the skin of their teeth.  Both of the paramedic populations/EMS systems studied were not in any way representative of the typical medic or EMS system in the US, particularly since one was performed in Australia.  

Basically the potential for harm is greater than the potential for benefit given how the majority of EMS systems are set up in the US.  I'd say this applies to ETI in general and not RSI, specifically.

Nothing I have read shows Texas services to be any different than the typical EMS service in the US (other than geography), despite what anyone from TX would like to say.  Don't get me wrong, I'm totally open to the possibility of some of these services being as good as some would like to think.  And, I do think there are some services that seem pretty good from what I have read.

Also, usalsfyre, pretty please show me the data.  I've already checked pubmed, and there's nothing there.  I'll accept abstracts for unpublished studies and yearly reports or ppt presentation by a representative of a service.  I might even accept something on a website.

PS: I'd agree that broad, sweeping statements about medical students are probably true.


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## usalsfyre (Nov 21, 2012)

Medicsb, I'm actually going to retract my earlier statement and say after thinking...your right. Part of the problem in the US is it's thought of as a "system skill" when in reality it needs to be an individual skill. I still disagree that it's useless in field (EBM hasn't ever looked at it outside of urban/suburban areas to my knowledge) but will agree it's overdone.

That said, you've still not offered a convincing reason for singling out Texas.


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## medicsb (Nov 23, 2012)

usalsfyre said:


> I still disagree that it's useless in field (EBM hasn't ever looked at it outside of urban/suburban areas to my knowledge) but will agree it's overdone.
> 
> That said, you've still not offered a convincing reason for singling out Texas.



I don't think it is without potential use, I think that the average medic does not intubate enough for the benefits to outweigh the risks.  The only systems that showed benefit from the procedure were systems with a small number of intubators, thus much much more frequent experience.  Any system that is all-ALS should not allow RSI for every medic (as was done for the San Diego RSI study).  Anyhow, we may have to agree to disagree or make another thread.

Anyhow, about my Texas remark...
What I said was in response to the criticisms of ATCEMS and the citation of another service (WilCO) as being better and more progressive, which seems to occur with any discussion of any well-known EMS system in TX ...

My remark was pointing out that RSI probably shouldn't be done anywhere in the US, even including these vaguely great, "progressive" services in TX since this discussion was mostly in regards to TX.


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## Fish (Nov 23, 2012)

medicsb said:


> I don't think it is without potential use, I think that the average medic does not intubate enough for the benefits to outweigh the risks.  The only systems that showed benefit from the procedure were systems with a small number of intubators, thus much much more frequent experience.  Any system that is all-ALS should not allow RSI for every medic (as was done for the San Diego RSI study).  Anyhow, we may have to agree to disagree or make another thread.
> 
> Anyhow, about my Texas remark...
> What I said was in response to the criticisms of ATCEMS and the citation of another service (WilCO) as being better and more progressive, which seems to occur with any discussion of any well-known EMS system in TX ...
> ...



You think that because Wilco is an all ALS system they are causing more harm than good with RSI and should not be performing it? Just want to be sure what harm over good you are referring to, I know that in the San Diego study the system showed a large amount of time without ventilation and left their patient's hypoxic for a lengthy time.


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## marshmallow22 (Nov 23, 2012)

46Young said:


> You might be right. I did some calculations:
> 
> Let's say that ATC was a 40 hour/week employer. The same goes for Portland AMR. ATC pays $15/hr, or $31,200. AMR pays $20/hr, or $41,600. Assume that ATC pays a 50% pension @ 25 years of service, a benefit of $15,600/yr. AMR has a 401k, but for the sake of argument, we'll assume that there's no employer match. We'll also assume that ATC does not require an employee contribution to the pension fund.
> 
> ...



Thanks for ALL of your assumptions about a system that you do not even work for.  I had a good laugh.  I can't believe that you would actually compare a metropolitan city, civil service, 3rd service provider to a private ambulance.  Say what you want, but ATCEMS is here to stay, and not only that, but will continue to get bigger.  Oh, and we also have medics making 100k +.  How many times has AMR changed hands over the years, lost contracts to the fire department, or have even sold out their own employees to cut a deal with fire departments?  Yeah, rather have the $15/hr job and not have to worry about private ambulance antics.


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## RocketMedic (Nov 23, 2012)

I'd rather go with the cold, hard numbers myself. I'm rapidly finding that institutional Kool-Aid doesn't beat a Keurig in the station.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> Thanks for ALL of your assumptions about a system that you do not even work for.  I had a good laugh.  I can't believe that you would actually compare a metropolitan city, civil service, 3rd service provider to a private ambulance.  Say what you want, but ATCEMS is here to stay, and not only that, but will continue to get bigger.  Oh, and we also have medics making 100k +.  How many times has AMR changed hands over the years, lost contracts to the fire department, or have even sold out their own employees to cut a deal with fire departments?  Yeah, rather have the $15/hr job and not have to worry about private ambulance antics.



I worked for AMR prior to the third service I work at now, lets just say. I could not afford the 401k, benefits or the wage at AMR.

Where I am now, I make 25k more a year than I used to, have a very good retirement and have good medical/dental insurance. 

If I was an employee at Austin, I would feel very secure(job security) and well taken care. I would also feel beat into the ground after every shift haha, but financially happy non the less.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> Thanks for ALL of your assumptions about a system that you do not even work for.  I had a good laugh.  I can't believe that you would actually compare a metropolitan city, civil service, 3rd service provider to a private ambulance.  Say what you want, but ATCEMS is here to stay, and not only that, but will continue to get bigger.  Oh, and we also have medics making 100k +.  How many times has AMR changed hands over the years, lost contracts to the fire department, or have even sold out their own employees to cut a deal with fire departments?  Yeah, rather have the $15/hr job and not have to worry about private ambulance antics.



No one at Austin has the title of Field Medic and has a base salary over 100k do they? You are referring to officers correct?


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## Fish (Nov 23, 2012)

marshmallow22 said:


> Thanks for ALL of your assumptions about a system that you do not even work for.  I had a good laugh.  I can't believe that you would actually compare a metropolitan city, civil service, 3rd service provider to a private ambulance.  Say what you want, but ATCEMS is here to stay, and not only that, but will continue to get bigger.  Oh, and we also have medics making 100k +.  How many times has AMR changed hands over the years, lost contracts to the fire department, or have even sold out their own employees to cut a deal with fire departments?  Yeah, rather have the $15/hr job and not have to worry about private ambulance antics.



He was not being offensive, just crunching rough numbers. He never claimed his numbers were accurate.


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## RocketMedic (Nov 23, 2012)

Fish said:


> I worked for AMR prior to the third service I work at now, lets just say. I could not afford the 401k, benefits or the wage at AMR.
> 
> Where I am now, I make 25k more a year than I used to, have a very good retirement and have good medical/dental insurance.
> 
> If I was an employee at Austin, I would feel very secure(job security) and well taken care. I would also feel beat into the ground after every shift haha, but financially happy non the less.



Honestly...I would go back to AMR if they'd have me back. I'm already tired of the Kool-Aid.


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## marshmallow22 (Nov 23, 2012)

Fish said:


> No one at Austin has the title of Field Medic and has a base salary over 100k do they? You are referring to officers correct?



Base salary, no, but tenure field medics and Captains with a good amount of OT can hit that mark.


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## marshmallow22 (Nov 23, 2012)

Fish said:


> He was not being offensive, just crunching rough numbers. He never claimed his numbers were accurate.




How can you crunch #'s when you don't even know what the #'s are?


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## RocketMedic (Nov 23, 2012)

marshmallow22 said:


> How can you crunch #'s when you don't even know what the #'s are?



Because, Marshmallow, he can take _good assumptions_ based on quoted pay and hours and extrapolate that raw data into salaries, percentages, and the like.


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## Fish (Nov 23, 2012)

Rocketmedic40 said:


> Honestly...I would go back to AMR if they'd have me back. I'm already tired of the Kool-Aid.



I would move before I worked for another Private, is there some good out there? I am sure there is, but I have worked for two and my opinion is such that I do not want to give it another shot.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> How can you crunch #'s when you don't even know what the #'s are?



It was a rough assumption based off of guestimates, it was an educated answer that he gave.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> Base salary, no, but tenure field medics and Captains with a good amount of OT can hit that mark.



Gotcha, that is how it is at most third service EMS agencies and FD's also.


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## marshmallow22 (Nov 23, 2012)

Rocketmedic40 said:


> Because, Marshmallow, he can take _good assumptions_ based on quoted pay and hours and extrapolate that raw data into salaries, percentages, and the like.



Pretty difficult to predict 401k's in this volatile market.  Again, how many "layers of paint" does AMR have on their trucks?


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## TRSpeed (Nov 23, 2012)

marshmallow22 said:


> Base salary, no, but tenure field medics and Captains with a good amount of OT can hit that mark.



Of coarse OT. We have medics here at AMR Socal making over 100k a year.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> Pretty difficult to predict 401k's in this volatile market.  Again, how many "layers of paint" does AMR have on their trucks?



Curious,

How long have you worked at Austin?


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## VFlutter (Nov 23, 2012)

I don't get the EMS concept of working crazy amounts of OT and then claiming that is a good paying service because you make $X a year.


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## Fish (Nov 23, 2012)

ChaseZ33 said:


> I don't get the EMS concept of working crazy amounts of OT and then claiming that is a good paying service because you make $X a year.



We love to be sitting in ambulance for over a third of our lives


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## DrParasite (Nov 23, 2012)

ChaseZ33 said:


> I don't get the EMS concept of working crazy amounts of OT and then claiming that is a good paying service because you make $X a year.


you know, I was going to say the same thing but deleted my post......

and Fish, if you work a 40 hour week, you still spend 1/4 of your life at work (including commute time)


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## Fish (Nov 23, 2012)

DrParasite said:


> you know, I was going to say the same thing but deleted my post......
> 
> and Fish, if you work a 40 hour week, you still spend 1/4 of your life at work (including commute time)



Right, but I work a 24/48. Always over a third with OT, sometimes I feel like it is half


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## VFlutter (Nov 23, 2012)

DrParasite said:


> you know, I was going to say the same thing but deleted my post......
> 
> and Fish, if you work a 40 hour week, you still spend 1/4 of your life at work (including commute time)



I only work 36 hours a week


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## ExpatMedic0 (Nov 23, 2012)

ChaseZ33 said:


> I only work 36 hours a week



your also a student


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## VFlutter (Nov 23, 2012)

schulz said:


> your also a student



I worked 24 a week as a student. Full time RNs work 36 a week (3 12s). I have been working 36 the past few months since I only have class one day a week.


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## marshmallow22 (Nov 23, 2012)

:glare:





ChaseZ33 said:


> I don't get the EMS concept of working crazy amounts of OT and then claiming that is a good paying service because you make $X a year.



Because this job is not only fun, but it's the easiest job in the world.  There are so many other professions and jobs that you have to work much harder at to make that kind of money... not to mention the fat cat pension I'll be getting when I retire.


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## Fish (Nov 23, 2012)

marshmallow22 said:


> :glare:
> 
> Because this job is not only fun, but it's the easiest job in the world.  There are so many other professions and jobs that you have to work much harder at to make that kind of money... not to mention the fat cat pension I'll be getting when I retire.



I too am happy that I have a pension....... But you are waaaayyyy to confident that it will be there when you retire(I am gonna guess you still have over 20yrs). You have to contribute to a seperate retirement account if you want to insure you will live like a "fat cat"....... The age of Pension reform is here, Texas pensions have been under attack the past few years, they have already been overhauled in CA and NV. If Texas retirements do not stay modest, then we will be next. The only way to insure a retirement....... Is to literally go out and make it happen. 

Easiest job in the world?


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## RocketMedic (Nov 23, 2012)

Fish said:


> I would move before I worked for another Private, is there some good out there? I am sure there is, but I have worked for two and my opinion is such that I do not want to give it another shot.



I didn't mind it. They didn't force-feed Koolaid, at the very least.


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## DrParasite (Nov 23, 2012)

Hey marshmallow22[YOUTUBE]ggXmKPMaHMo[/YOUTUBE]


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## NomadicMedic (Nov 23, 2012)

I love what I do, and I certainly appreciate my pension plan, but I wouldn't call it the "easiest job in the world."

Fat cat pensions are going by the wayside. It's my goal to work toward keeping what I've got. And yes, I invest on the side. Gotta hedge those bets.


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## Fish (Nov 23, 2012)

Rocketmedic40 said:


> I didn't mind it. They didn't force-feed Koolaid, at the very least.



What kool-aid do you keep talking about?


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## RocketMedic (Nov 23, 2012)

Fish said:


> What kool-aid do you keep talking about?



An agency's loud and omnipresent claims of superiority and the culture surrounding it. I really do wish I'd done more research before I moved up here, I honestly was happier at my old job.


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## DrParasite (Nov 23, 2012)

Fish said:


> What kool-aid do you keep talking about?


this link will explain the phrase http://bit.ly/SjBZzi


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## Fish (Nov 23, 2012)

DrParasite said:


> this link will explain the phrase http://bit.ly/SjBZzi



I know the phrase, just wondered what kool-aid he kept referring to


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## marshmallow22 (Nov 23, 2012)

Fish said:


> I too am happy that I have a pension....... But you are waaaayyyy to confident that it will be there when you retire(I am gonna guess you still have over 20yrs). You have to contribute to a seperate retirement account if you want to insure you will live like a "fat cat"....... The age of Pension reform is here, Texas pensions have been under attack the past few years, they have already been overhauled in CA and NV. If Texas retirements do not stay modest, then we will be next. The only way to insure a retirement....... Is to literally go out and make it happen.
> 
> Easiest job in the world?



Yeah, I realize that pensions are under attack, however CA and NV based a lot of theirs on the housing market with mortgage backed securities and the tax revenue generated from those highly inflated home values.  The bubble burst and so did CA and NV's pension system.  Texas has one of the strongest economy's in the nation and did not have a fraction of "the bubble" that CA and NV did.  And yes, I also contribute to my 457b plan.  Yes, compared to other jobs that I've had in the past, this by far is the easiest, and most fun.  So I do not mind putting extra hours, especially if I want to enjoy some of the nicer material things now and then.


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## Fish (Nov 23, 2012)

Rocketmedic40 said:


> An agency's loud and omnipresent claims of superiority and the culture surrounding it. I really do wish I'd done more research before I moved up here, I honestly was happier at my old job.



Where are you working now? Why'd you move there?


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## 46Young (Nov 23, 2012)

marshmallow22 said:


> Thanks for ALL of your assumptions about a system that you do not even work for.  I had a good laugh.  I can't believe that you would actually compare a metropolitan city, civil service, 3rd service provider to a private ambulance.  Say what you want, but ATCEMS is here to stay, and not only that, but will continue to get bigger.  Oh, and we also have medics making 100k +.  How many times has AMR changed hands over the years, lost contracts to the fire department, or have even sold out their own employees to cut a deal with fire departments?  Yeah, rather have the $15/hr job and not have to worry about private ambulance antics.



I don't understand you. Throughout this thread you've been intentionally vague for the most part, and then you complain that everyone's speculating, this post being the latest example.

Need I remind you that I've asked you specific questions about your department? Post # 127 on this thread to be exact. It's cute that you've conveniently ignored that post, but then you say you "had a good laugh" about my assumptions. 

Regarding my comparison of the pension job with a 48 hour schedule @ $15/hr and the private job w/ 401k @ $20/hr, explain to me how my numbers are inaccurate.

Anyway, here's my questions about your department, again:



Some questions about ATC-EMS out of curiosity:

What is the service requirement (how many years) for the defined benefits retirement? For example, is it 25/55? Does there have to be an addition of age to years of service?

What is the percentage multiplier for the pension benefit? For example, CCEMS only offered 1.8% @ 28 years of service, which only gives you a 50% yearly benefit.

Is your medical premium paid by the employer after your retirement, or do you have to pay the premium 100%? Is your medical insurance portable?

What are the bottom and top salaries for each position, and how many years does it take to reach that top pay?

Do you have a DROP (TERI in SC)? I've heard Houston fire has a ten year drop @ 20 years of service.

How much do you pay in bi-weekly medical premiums, and are there deductibles?

How many light duty positions are available for the injured and pregnant? 

How many different positions are there for non -supervisory employees that do not involve field EMS transport?

How many supervisor positions are there in your organization, and what is your total headcount for the organization?

What criteria are used to fufill or deny leave requests? 

What is your policy on mandatory recall and holdover? Also, if the employee has travel plans on their days off (plane tickets, hotel reservations, etc), can they be held or recalled?

Are CEU's given on duty, are they given off duty but mandated and compensated for, or are your employees on their own?

Are units automatically placed in-service as soon as they arrive at the hospital, or are they permitted to finish their report before having to go back in-service?

Is there a policy in place that lets an employee use their leave to go home during the overnight hours of their shift (or the next day if held over) if they feel they are too tired to drive or give pt care?


Maybe we can have more accurate information and not have to make assumptions if you would answer these questions, thanks


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## 46Young (Nov 23, 2012)

marshmallow22 said:


> How can you crunch #'s when you don't even know what the #'s are?



This was quite simple. ATC-EMS starts ay $15/hr, AMR, $20. I simply showed how a $5/hr difference in pay invested 100% over 25 years can easily trump a 50% pension @ 25 years with a very modest annualized return, which was less than you would get from a relatively stable bond fund, such as the Vanguard intermediate-Term Bond Index, for example. Don't take my word for it, just look up that fund (I generally go with ETF's, but the regular fund will show the necessary price history) and see for yourself. It's the same where I work. We pay 7% of our base pay into the retirement fund, and the county pays 33%. If I could keep the 40% and invest it, I'd have way more than what my pension will pay, and it's about 75% @ 25 years, and around $100% @ 30 years of service. Having the three year DROP mitigates this to an extent, but I'd still rather have 40% of my base pay to invest every year instead of 75% @ 25/55. Explain to me how any of this is innacurate given what little information I've been given.

Oh, did I forget to mention that the 401k employee in our $15/hr vs. $20/hr example will also have their principal in their posession in addition to the income that their investment yields? You don't get that with defined benefits. 

If you would be so kind as to show us your company's grade and step incease information, perhaps I can give a more accurate analysis, thanks


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## 46Young (Nov 23, 2012)

marshmallow22 said:


> Pretty difficult to predict 401k's in this volatile market.  Again, how many "layers of paint" does AMR have on their trucks?



Layers of paint are irrelevant; the 401k is portable. 100% of my 403b money from my previous hospital based employer, plus their contributions was rolled into my 457 where I currently work.

Volatility is irrelevant for the long term, which is why you and your advisor need to decide how to allocate your capital over the various asset classes, and then perform percentage based portfolio rebalancing. It's that simple. Market timing never works out in the long run.


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## marshmallow22 (Nov 23, 2012)

46Young said:


> I don't understand you. Throughout this thread you've been intentionally vague for the most part, and then you complain that everyone's speculating, this post being the latest example.
> 
> Need I remind you that I've asked you specific questions about your department? Post # 127 on this thread to be exact. It's cute that you've conveniently ignored that post, but then you say you "had a good laugh" about my assumptions.
> 
> ...



In reply to the main financials:

23 years of service x 3% per year.

Employee contributes 8% per check mandatory pre tax

5 year drop @ 23 yrs

Buy back allowance is 5 yrs

Employee health premiums for employee paid by the city, add employee + family, around $240 per check.

Other random ?'s:

No one has ever been denied light duty due to injury or pregnancy

Multiple command positions,  division chiefs, assistant chief, and chief.

At hospital autmatically granted 20 min to complete report before placed available.  30 min + granted to finish report for code 3 return to hospital (most don't even need the 20 min though).

Extremely rare but yes, you can go home in the middle of shift for ill

On call list made with every bid so you know your days 7 months in advance (aprroximately 5 "on call" days in 7 months)

We utilize the telestaff system of staffing so if you are familiar with that system then there is no need to explain how vacation, sick time, etc is requested.  We allow 12 slots of vacation and find your own coverage per day.


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## 46Young (Nov 23, 2012)

marshmallow22 said:


> Base salary, no, but tenure field medics and Captains with a good amount of OT can hit that mark.



"With a good amount of OT?" How about not being intentionally vague and telling us what a field medic starts at and tops out at, and the same for the officers? You tell me that, and I can give you a good estimate on how much OT they need to break $100k.

My base is $84k/yr which includes medic riding pay for the ambulance and engine, $3/hr and $2/hr, respectively. Night differential is worth around $2,500/yr. We get 10% of a basic FF's pay as our ALS stipend as well. Our regular schedule is a 56 hour workweek, and FLSA kicks in @ 212 hrs/four week cycle, so on the average we get 53 straight and 3 @ 1.5x. I haven't counted all the county holidays, where we get 11.2hrs extra straight pay for holidays on a scheduled off day, and 16 hrs extra pay for a holiday worked. In addition, when we do OT, it counts as 1.5x right off the bat, but it also counts towards our 212 hour FLSA threshold. So, if I do Ot in the first three weeks, I get an additional 6 hours of straight time for 12 hours worked, and 12 hours additional pay on every 24 hours worked.

If my base is $84k/yr (next step coming soon, another 3k+), then I need another $16k to make $100k. That's $ 616/ pay period, or $1334/month in OT. My base hourly in the field is $23-something/hr, so my OT is $34.50/hr + at least $2/hr in ALS riding pay, so $36.50/hr as a rough estimate. 616/36.5 = 16.9 hours a pay period, or 37 hours/month, or 440 hours/yr, or 8.5 hrs/week, on the average. But, with FLSA, this figure will actually be much lower. 

Your turn. What are the $100k tenured medics and Capt's hourly pay rates, what are their bonuses, work hours, etc? Just how much is "a good amount of OT" like you say?


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## marshmallow22 (Nov 23, 2012)

Some of our tenured and captain medics make high $20 to low $30 per hour. So OT rate is $45/hr. Our pay is just a straight time and a half after 80 hrs in a pay period and a standard check is 96 hrs from either 4 twenty four hour shifts or 4 twelves and 2 twenty four hour shifts. So automatically with just working the 96 hrs in those two weeks we get 16 hrs of OT.  A few checks ago I had a total 164 hours... 80 regular and 84 at overtime rate.  Pretty simple math.  I'm not saying that's the standard but even making 80k per year goes pretty far here in Austin.


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## Medic Tim (Nov 23, 2012)

I am happy making my 75k a year on 150 hours a month. (37.5 a week) I like my time off. With the occasional ot shift I do quite well without working myself to death. It is no wonder so many medics burn out. I would hate my job putting in 60-70+ hours a week.


The new job I am looking to get (fingers crossed) has a base of 110-145k depending on the sched. I would be a very happy medic if I was somehow able to get it.


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## Fish (Nov 24, 2012)

marshmallow22 said:


> Yeah, I realize that pensions are under attack, however CA and NV based a lot of theirs on the housing market with mortgage backed securities and the tax revenue generated from those highly inflated home values.  The bubble burst and so did CA and NV's pension system.  Texas has one of the strongest economy's in the nation and did not have a fraction of "the bubble" that CA and NV did.  And yes, I also contribute to my 457b plan.  Yes, compared to other jobs that I've had in the past, this by far is the easiest, and most fun.  So I do not mind putting extra hours, especially if I want to enjoy some of the nicer material things now and then.



Yes, but another factor was the extremely generous and unsustainable retirements that those states had in certain municipalities. I see some Larger Texas cities starting to head this way, although our housing market has not crashed. Who knows what will happen in 20yrs. With the more the retirements grow, the harder they will be to sustain in hard times. And hard times WILL come, they always do.


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## RocketMedic (Nov 24, 2012)

Fish said:


> Yes, but another factor was the extremely generous and unsustainable retirements that those states had in certain municipalities. I see some Larger Texas cities starting to head this way, although our housing market has not crashed. Who knows what will happen in 20yrs. With the more the retirements grow, the harder they will be to sustain in hard times. And hard times WILL come, they always do.



Texas is a state that has historically weathered depressions by virtue of its energy and transportation sectors. 
Resurgences in the national economy generally mean economic downturns in the Midwest.


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## Shishkabob (Nov 24, 2012)

$86k base?
$75k (even if it is paid in Canadian donuts?!)



Man, I was happy with my base pay, especially considering my age, but now I hate you both.  And your coworkers.


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## ExpatMedic0 (Nov 24, 2012)

:rofl:



Linuss said:


> $86k base?
> $75k (even if it is paid in Canadian donuts?!)
> 
> 
> ...


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## NomadicMedic (Nov 24, 2012)

Linuss said:


> $86k base?
> $75k (even if it is paid in Canadian donuts?!)
> 
> 
> ...



I'd be stoked to get *$75 *in Canadian Tire money.


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## Medic Tim (Nov 24, 2012)

Lol that's awesome


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## medicsb (Nov 24, 2012)

Fish said:


> You think that because Wilco is an all ALS system they are causing more harm than good with RSI and should not be performing it? Just want to be sure what harm over good you are referring to, I know that in the San Diego study the system showed a large amount of time without ventilation and left their patient's hypoxic for a lengthy time.



By harm, I mean anything that causes an increase in morbidity and/or mortality.  The few studies that have shown good outcomes (PMIDs: 21107105 and 15824647) were performed in systems where paramedics are good at intubation, and those systems also have a relatively small number of paramedics (how else will medics intubate frequently without going to the OR). There have been studies showing that medics who intubate more often are more likely to be successful (PMID: 14585451), and another showed that medics who intubate more frequently have better outcomes versus those who do it infrequently (PMID: 20138400).

So, all-ALS is going to be associated with decreased ETI frequency, which is associated with poorer outcomes.  I might go so far to say that without OR time every year, it might be impossible for "all ALS" system to become proficient enough at ETI for RSI to even be considered.  I think an "all-ALS" system could circumvent the skill dilution by limiting who can do the procedure.  

[FYI, if you put those PMIDs into the pubmed.com search, you can see the abstracts.]


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## Fish (Nov 24, 2012)

medicsb said:


> By harm, I mean anything that causes an increase in morbidity and/or mortality.  The few studies that have shown good outcomes (PMIDs: 21107105 and 15824647) were performed in systems where paramedics are good at intubation, and those systems also have a relatively small number of paramedics (how else will medics intubate frequently without going to the OR). There have been studies showing that medics who intubate more often are more likely to be successful (PMID: 14585451), and another showed that medics who intubate more frequently have better outcomes versus those who do it infrequently (PMID: 20138400).
> 
> So, all-ALS is going to be associated with decreased ETI frequency, which is associated with poorer outcomes.  I might go so far to say that without OR time every year, it might be impossible for "all ALS" system to become proficient enough at ETI for RSI to even be considered.  I think an "all-ALS" system could circumvent the skill dilution by limiting who can do the procedure.
> 
> [FYI, if you put those PMIDs into the pubmed.com search, you can see the abstracts.]



I will PM you as to not hijack this thread


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## 46Young (Nov 24, 2012)

marshmallow22 said:


> In reply to the main financials:
> 
> 23 years of service x 3% per year.
> 
> ...



The above sounds pretty good, definitely better than you'll do most other places.

 69% @ 23 years with a 5 year DROP is great. 

We have 30 leave slots for non-officers daily on telestaff, and 15 for officers. Liberal exchange of shift, but we cannot have someone work OT for us to get off.


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## 46Young (Nov 24, 2012)

marshmallow22 said:


> Some of our tenured and captain medics make high $20 to low $30 per hour. So OT rate is $45/hr. Our pay is just a straight time and a half after 80 hrs in a pay period and a standard check is 96 hrs from either 4 twenty four hour shifts or 4 twelves and 2 twenty four hour shifts. So automatically with just working the 96 hrs in those two weeks we get 16 hrs of OT.  A few checks ago I had a total 164 hours... 80 regular and 84 at overtime rate.  Pretty simple math.  I'm not saying that's the standard but even making 80k per year goes pretty far here in Austin.



We'll use $30/hr since virtually none of us are or will be officers in EMS. Our basic FF/EMT's top out at $81k, or $27.88/hr, plus the incentives for medics that I've mentioned previously. techs $85k @ $29.21/hr, Master techs $89k @ 30.67/hr, Lt $97k @ $33.60/hr, and Capt I $113k @ $38.81/hr. for each of these positions that are 56 hours and not 40 hour day work, add 1.5 hrs x 52 weeks (the 3 hours OT per FLSA). For example, the FF gets an extra $2,174, and the Capt I gets an additional $3,027.

So, you haven't mentioned any additional pay, only $30/hr (a happy medium between field medics and Capt's) for 40 hrs and 8 hours @ $45/hr . That's $82,920/yr, for a $57,214.80/yr pension, plus $286,074 in the five year DROP assuming no COLA's. Pretty stellar for EMS. That's pretty good for a fire department as well. Charleston County EMS had a paltry 1.8% multiplier @ 28 years with a three year TERI (DROP), which they're apparently doing away with, and their top-out pay is under $70k, for comparison's sake. 

$30/hr was just shy of what I was making in hospital based NYC EMS in 2007 (403b), and that was considered decent, so $30/hr in Austin with eight hours/week built in OT should make you quite comfortable. I'm honestly a little suprised, since most Third Service EMS employers offer starting pay of only $30-$35k tops, with a final step being only $50k give or take. That's like $10 or $11/hr to start, maybe $16-$17/hr after many years OTJ.

Going on $30/hr, the tenured medic would have to do only 7.2 additional hours of OT beyond their regular schedule each week to hit $100k. a 24 once a month and an occasional 12 would do it.

Edit: to the base, add around $16k or more to each top salary if they're a medic. Average $2k/yr in night diff, $5k in ALS cert pay, $7k in hourly riding pay as an engine medic or if they ride the box, and the built in FLSA @ 3 hours/week, the equivalent of 1.5 hour's pay per week, from $2,100-$3,000/yr. So, the basic FF/m gets $97k, the Capt I/medic gets $130k.


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## 46Young (Nov 24, 2012)

Linuss said:


> $86k base?
> $75k (even if it is paid in Canadian donuts?!)
> 
> 
> ...



I've been in the department for a minute. Brand new FF/medics get around $71k with all incentives, FLSA, night diff, etc. once they clear off of ALS internship.

A ff/medic that never promotes has a top-out of $81k, but with all differentials and ALS bonuses, is closer to $97k.


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## marshmallow22 (Nov 25, 2012)

Before the medic1 hiring process, our starting medic pay with no experience was mid $17/hr putting that around 44k per year. Wilco's starting pay is closer to 50k per year right now, but their schedule is 24 on 48 off.  Comaparitively speaking due to a lower cost of living, ATCEMS and Wico are two of the higher paid 3rd services in the country where you do not have to be a firefighter.  However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.


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## Veneficus (Nov 25, 2012)

marshmallow22 said:


> However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.



Sounds like doom is at hand. 

After all look at how well mergers went every place else.


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## Fish (Nov 25, 2012)

marshmallow22 said:


> Before the medic1 hiring process, our starting medic pay with no experience was mid $17/hr putting that around 44k per year. Wilco's starting pay is closer to 50k per year right now, but their schedule is 24 on 48 off.  Comaparitively speaking due to a lower cost of living, ATCEMS and Wico are two of the higher paid 3rd services in the country where you do not have to be a firefighter.  However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.



Wilco's starting is around 55k

Do you like your schedule at Austin? I have some friends who do, and some who don't. The ones who don't were used to a 24/48 at other services and enjoyed there 2days off after every shift. The ones who do, came from busy urban EMS services that ran 12s.

I really do hope there is not a merge for you guys, one only has to look a couple hundred miles in each direction of your city to see why fire based EMS would be a step in the wrong direction for you.

Recently, Kansas City, Cleveland, and many other large cities have merged with epic failures.

What would ATCEMS gain by merging? 

I am not stating you are for a merge, most Medics in Austin are very against it.


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## ExpatMedic0 (Nov 25, 2012)

double post, sorry


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## ExpatMedic0 (Nov 25, 2012)

marshmallow22 said:


> However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.


Man.... To each there own I suppose.
However in my opinion as a 3rd party observer the fact ATCEMS is in a huge budget crises(public information in multiple news sources) considering a merger with the fire department, no longer paying for experience and hiring/paying all paramedics as EMT-B's for extended periods of time(not probation), and everything else that has been discussed, it looks like things aren't looking so good. If ACTSEMS continues down this road they will virtually eliminate all outside professionals in EMS with experience and higher education. 

I use to think that sounded like a great agency in a great area. Lots of special teams and promotional opportunity's, 3rd party municipal EMS not affiliated with the fire or police, 
but now it seems like only a place for 21 year old paramedics who want to work as EMT-B's, with no experience, no nothing of EMS, who can pass a round robin exam while being judged by "good ol boys" in the good ol boy system, which I am %100 confident will become exacerbated greatly if you merge with the fire department. That is one possibility anyway....
It is only a theory but I think its a pretty strong one, don't you?


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## ExpatMedic0 (Nov 25, 2012)

Veneficus said:


> Sounds like doom is at hand.
> 
> After all look at how well mergers went every place else.



agreed. Many end up as a red headed step child.


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## STXmedic (Nov 25, 2012)

marshmallow22 said:


> Before the medic1 hiring process, our starting medic pay with no experience was mid $17/hr putting that around 44k per year. Wilco's starting pay is closer to 50k per year right now, but their schedule is 24 on 48 off.  Comaparitively speaking due to a lower cost of living, ATCEMS and Wico are two of the higher paid...


 LoL! Lower cost of living?! Compared to LA maybe  I guess if you're willing to commute a little you can get a little better... 





> However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.


So they're finally going to get their way, huh? Y'all have been fighting tooth and nail to prevent that for years.


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## shfd739 (Nov 25, 2012)

schulz said:


> Man.... To each there own I suppose.
> However in my opinion as a 3rd party observer the fact ATCEMS is in a huge budget crises(public information in multiple news sources) considering a merger with the fire department, no longer paying for experience and hiring/paying all paramedics as EMT-B's for extended periods of time(not probation), and everything else that has been discussed, it looks like things aren't looking so good. If ACTSEMS continues down this road they will virtually eliminate all outside professionals in EMS with experience and higher education.
> 
> I use to think that sounded like a great agency in a great area. Lots of special teams and promotional opportunity's, 3rd party municipal EMS not affiliated with the fire or police,
> ...



Nearly the same conversation my wife and I had yesterday. 

At one point we both wanted to work there. Not anymore.


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## RocketMedic (Nov 25, 2012)

That rather definitively crosses ATCEMS from a lot of people's radars.


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## marshmallow22 (Nov 25, 2012)

schulz said:


> Man.... To each there own I suppose.
> However in my opinion as a 3rd party observer the fact ATCEMS is in a huge budget crises(public information in multiple news sources) considering a merger with the fire department, no longer paying for experience and hiring/paying all paramedics as EMT-B's for extended periods of time(not probation), and everything else that has been discussed, it looks like things aren't looking so good. If ACTSEMS continues down this road they will virtually eliminate all outside professionals in EMS with experience and higher education.
> 
> I use to think that sounded like a great agency in a great area. Lots of special teams and promotional opportunity's, 3rd party municipal EMS not affiliated with the fire or police,
> ...



We're still a great department with many opportunites like Spec Ops, Tactical, bikes, Motorcycles, etc, and plenty of promotional opportunity.  At this point though, new providers will just have to take 1 extra step due to the new hiring practices.  Yes, there are and will always be budget concerns when it comes to public safety in ANY city since public safety is a large part of any large city's budget.  However, as I stated before, we are in much better shape than many departments budget wise.  We just had another stand alone state of the art EMS station built and are due to add 2 more trucks.  We just received a fleet of brand new F450 extended cab trucks that recently went into service to replace some of our Internationals and Freightliners.  As far as a merger goes, that could be good or bad, but in any case we are still a long way from that happening if it happens at all.  On a side note you seem to display a degree of hostility on the subject of ATCEMS. What's your deal?


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## 46Young (Nov 25, 2012)

marshmallow22 said:


> Before the medic1 hiring process, our starting medic pay with no experience was mid $17/hr putting that around 44k per year. Wilco's starting pay is closer to 50k per year right now, but their schedule is 24 on 48 off.  Comaparitively speaking due to a lower cost of living, ATCEMS and Wico are two of the higher paid 3rd services in the country where you do not have to be a firefighter.  However, as far as ATCEMS goes their may be some big changes to come since we are now civil service, including the possibility of merging AFD and EMS.



Sounds like the writing is on the wall. Hopefully the merger doesn't happen. The EMS side almost invariably loses it's identity and share of resources. Just ask any FDNY EMS employees who were OTJ before the 1996 FD merger. I have two cousins that left there a few years after that debacle. 

Here's one disgruntled member's blog on FDNY EMS:

http://fdnyemswebsite.com/


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## 46Young (Nov 25, 2012)

Veneficus said:


> Sounds like doom is at hand.
> 
> After all look at how well mergers went every place else.



Resistance is futile. Jean Luc Picard will not be there to save you.


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## 46Young (Nov 25, 2012)

Fish said:


> Wilco's starting is around 55k
> 
> Do you like your schedule at Austin? I have some friends who do, and some who don't. The ones who don't were used to a 24/48 at other services and enjoyed there 2days off after every shift. The ones who do, came from busy urban EMS services that ran 12s.
> 
> ...



From experience, I can tell you that a 24/48 is not a desireable schedule, unless you're sleeping throughout the night most of the time. You're spending the first day recovering, and the next day you have to prepare to go back to work. If you take a day off, you only have a five day break. If you like to do OT, you never have more than one day off between shifts. Same if you work a place that has mandatory holdover/mandatory recall. You have to use five days just to get two weeks off. At least our schedule is arranged a little differently, so four days leave gets us 15 consecutive days off, and one day off gets us six days in a row. It's still a 56 hour schedule, arranged as 24on/24off/24on/24off/24on/96off. I would much rather a 42 hour schedule like FDNY, DC, Alexandria Fire and EMS, though. This industry standard of a 56 hour regular workweek is bullcrap. With a 56, you're spending an extra two 8 hour workdays as part of your regular schedule. I would never do this schedule if it weren't for the fact that it pays so well. 

I couldn't do a 24/48 for $40k/yr (lucky to get that in EMS). Been there, done that. There's not much time left to bump up that salary when you're hung over the next day from being up all night, unless you're okay with not having a life outside of work.


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## Veneficus (Nov 25, 2012)

46Young said:


> unless you're okay with not having a life outside of work.



What is this "life outside of work" you speak of?

:rofl:


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## NYMedic828 (Nov 25, 2012)

Apparently I got a yearly raise this month.

Soon il be above minimum wage!


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## 46Young (Nov 25, 2012)

The abundant OT you're talkng about (Marshmallow), 80 hours or so on a paycheck when OT is typically slow (Oct-Nov), suggests to me a few possibilities:

There is high turnover, which results in lots of vacancies

There is frequent sick leave abuse, which may be due to burnout, or inability to use vacation leave

ATC-EMS does not staff positions with full timers for the purposes of vacation/sick relief (referred to as pad personnel), but just has enough full timers to staff what they run on a daily basis

ATC-EMS would prefer to pay OT up to a point rather than hire additional employees (or hire less than they otherwise would), as this saves them money

For example, a new FF/EMT costs my employer as much in benefits as it does to pay their salary. Off the bat, there's the county'ss 33% contribution to the pension fund, their 75% of the medical insurance premium, vacation/sick days, paid county holidays, hiring, training, and uniforms. So long as the county doesn't pay $100k in OT to staff a FF position ($50k in salary + $50k in benefits), they make out. That's also one less pension to pay.

Which brings me to another point - this isn't directed at ATC-EMS, but just a general observation:

Employers may use a generous salary, particularly a generous starting salary to attract qualified employees, and also to divert attention away from undesireable features of the organization. Employers may like high turnover, since it greatly reduces their future pension burden. If the average employee stays only a few years, the employer's off the hook for the pension. The high pay keeps the application pool filled so that they don't miss a beat. 

Take notice when an employer spends little to no resources on your orientation. For example, CCEMS gave us a one day orientation, then it was just me and my FTO on the bus (I was minimal staffing, no riding third)starting day #2. NS-LIJ CEMS in NYC had a two week in-class orientation, and then a few weeks riding as a third. My current hospital based IFT second job had a few days of orientation, and then as many ride-alongs (3rd person) as the trainee needs to be comfortable. My FD has a 24 week fire academy, and a four month ALS internship, Two months of which is riding as a third, and four hour class sessions weekly for the entire four months. 

If a place throws you out on the street as minimum staffing as quick as possible, then they obviously choose not to invest money in orientation, since they expect the employee to not last too long. It's cheaper to hire someone else and put them through a one day orientation than try hard to keep the employee, and have to pay them a pension, and also their salary increases over the years.


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## 46Young (Nov 25, 2012)

Veneficus said:


> What is this "life outside of work" you speak of?
> 
> :rofl:



Someting I vaguely remember from my childhood.


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## 46Young (Nov 25, 2012)

NYMedic828 said:


> Apparently I got a yearly raise this month.
> 
> Soon il be above minimum wage!



I love NY! $60k/yr in pay and OT wasn't enough to support my wife and child as an EMT, so that was a huge factor in choosing medic school over nursing school back in the day.

Congrats on the raise! Did you catch up with the FDNY FF's entry salary yet? (I can break your chops because you're escaping FDNY EMS in less than two months)


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## Veneficus (Nov 25, 2012)

46Young said:


> There is frequent sick leave abuse, which may be due to burnout, or inability to use vacation leave



I must respectfully disagree with "sick leave abuse"

Sick leave is calculated into your salary. 

Not using sick leave means you are working extra days you should have off.

It is an outdated concept which is why many reputable employers have "no fault" sick policies or calculate a single PTO bank.


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## Fish (Nov 25, 2012)

46Young said:


> From experience, I can tell you that a 24/48 is not a desireable schedule, unless you're sleeping throughout the night most of the time. You're spending the first day recovering, and the next day you have to prepare to go back to work. If you take a day off, you only have a five day break. If you like to do OT, you never have more than one day off between shifts. Same if you work a place that has mandatory holdover/mandatory recall. You have to use five days just to get two weeks off. At least our schedule is arranged a little differently, so four days leave gets us 15 consecutive days off, and one day off gets us six days in a row. It's still a 56 hour schedule, arranged as 24on/24off/24on/24off/24on/96off. I would much rather a 42 hour schedule like FDNY, DC, Alexandria Fire and EMS, though. This industry standard of a 56 hour regular workweek is bullcrap. With a 56, you're spending an extra two 8 hour workdays as part of your regular schedule. I would never do this schedule if it weren't for the fact that it pays so well.
> 
> I couldn't do a 24/48 for $40k/yr (lucky to get that in EMS). Been there, done that. There's not much time left to bump up that salary when you're hung over the next day from being up all night, unless you're okay with not having a life outside of work.



Usually we sleep most of the night


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## NYMedic828 (Nov 25, 2012)

46Young said:


> I love NY! $60k/yr in pay and OT wasn't enough to support my wife and child as an EMT, so that was a huge factor in choosing medic school over nursing school back in the day.
> 
> Congrats on the raise! Did you catch up with the FDNY FF's entry salary yet? (I can break your chops because you're escaping FDNY EMS in less than two months)



Lol I'm year 2 medic that puts me at $48,127 base pay. About $25/h I believe...

Firefighter starting is $39,000 in the academy and 41,000 at a year. The firemen are sneaky though they hide their real pay under the "fringe" benefits half. That 41,000 is really 49,000 and at top pay in total they come in around 100k. From year 4 to 5 as a fireman you get a $30,000 raise... 

Most of my top pay firefighter pals made 100-160,000 last year while the chief of EMS makes 100,000.

Also on EMS and fire after like 7 years you collect longevity pay.


Fire payscale
http://www.nyc.gov/html/fdny/html/community/ff_salary_benefits_080106.shtml

EMS payscale
http://www.nyc.gov/html/fdny/html/community/ems_salary_benefits_042607.shtml


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## marshmallow22 (Nov 25, 2012)

Regarding the amount of OT at Austin we allow 12 people off per day, and that's before sick call.  Not to mention the vacancies we already have for varoius reasons.  As far as sick call goes we are a very busy system (probably could use another 10 trucks on the streets) so I won't deny that there's "mental days" being taken, otherwise known as burnout.  We do have a variation of schedules which some people like and others do not.  It's pretty difficult to please everyone in a department this size.  As far as merging with Fire, that is still years away if it happens at all.  There are no details regarding that topic as it was just barely mentioned so I won't even touch that topic regarding pros/cons. I am aware however of some of the difficulties and benefits other departments have had with mergers.


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## Veneficus (Nov 25, 2012)

marshmallow22 said:


> streets) so I won't deny that there's "mental days" being taken,



Isn't that a good thing though?

Mental health is still health.


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## Shishkabob (Nov 25, 2012)

46Young said:


> Take notice when an employer spends little to no resources on your orientation.



My agency does a week of basic HR, a couple weeks of basic things such as basic protocols, map reading, ePCR training etc, a couple weeks of drivers training, and then the medics come back for another few weeks of higher protocols and card type classes, followed by a a few weeks of FTO, more if they're going to run their own truck.

About 3-4 months for the average medic to get released, and that's not even to run their own truck.


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## NomadicMedic (Nov 25, 2012)

It's between 4 and 6 months before a new hire at Sussex is cleared to work without an FTO.


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## Fish (Nov 25, 2012)

6-8months with us


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## ExpatMedic0 (Nov 26, 2012)

marshmallow22 said:


> On a side note you seem to display a degree of hostility on the subject of ATCEMS. What's your deal?



Hostility? Well in my opinion I do not agree with there new business ethics. I think they built a great reputation for themselves and I now its disheartening to see the direction there going. I do not think I am being hostel as I have no personal connection or involvement with Texas or ACT. This was a topic of discussion in light of recent events to a big well known EMS agency.


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## VFlutter (Nov 26, 2012)

NYMedic828 said:


> Lol I'm year 2 medic that puts me at $48,127 base pay. About $25/h



That's what I will make as a new grad :wacko: why did I got to school for 4 years? :glare:


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## NYMedic828 (Nov 26, 2012)

ChaseZ33 said:


> That's what I will make as a new grad :wacko: why did I got to school for 4 years? :glare:



You aren't in NY.

My friend just graduated with a BSN and his starting pay here is $68,000 while in training at the hospital. Nurses here top around 90-100k I think.

Firefighters make more than a nurse and college is not a requirement. But there is the whole risking your life thing.


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## Wayne (Jan 6, 2013)

Sorry to bump an older thread, but google just led me here.  I'm in the current hiring process for Austin/Travis County, and from what I've seen, it looks like they're mostly hiring a lot of basics, and paying them better than most basics.  Also, a huge number of the paramedics that applied weren't able to pass the basic level skills exams and written exams.  I guess experience doesn't count for everything.

It seems like they're working on fixing their high turnover.  My experience in the process has led me to believe they're looking for younger basics/medics that want to train here and spend their careers in Austin.  Whether it will work or not remains to be seen.

Oh, and someone mentioned the good ol' boy system -they've done a pretty good job of making the process mostly objective and anonymous.

The new-hire list should be posted this week, they're looking for 30 this process, I wonder how many they took.


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## Fish (Jan 6, 2013)

Wayne said:


> I guess experience doesn't count for everything.



No it does not, you have to keep up with the tides of EMS. You can't come in to test and think you've got it made when you have 10years of Experience, not when you spent those ten years not doing anything to retain, gain, and garnish your knowledge and skills.


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## usalsfyre (Jan 6, 2013)

Wayne said:


> Also, a huge number of the paramedics that applied weren't able to pass the basic level skills exams and written exams.  I guess experience doesn't count for everything.



If a paramedic can't pass a basic level examination either A)the test was flawed or B)they were crappy medics. A paramedic should be able to perform "BLS" skills as well or better than a basic.


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## Wayne (Jan 6, 2013)

usalsfyre said:


> If a paramedic can't pass a basic level examination either A)the test was flawed or B)they were crappy medics. A paramedic should be able to perform "BLS" skills as well or better than a basic.



There were plenty of basics, several with no actual work experience, who passed. *shrug*


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## medic417 (Jan 6, 2013)

usalsfyre said:


> If a paramedic can't pass a basic level examination either A)the test was flawed or B)they were crappy medics. A paramedic should be able to perform "BLS" skills as well or better than a basic.





Wayne said:


> There were plenty of basics, several with no actual work experience, who passed. *shrug*



I'm starting to lean towards flawed exam.


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## shfd739 (Jan 6, 2013)

medic417 said:


> I'm starting to lean towards flawed exam.



I've always thought that about their testing process


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## usalsfyre (Jan 6, 2013)

Wayne said:


> There were plenty of basics, several with no actual work experience, who passed. *shrug*


Then I agree with the other two posters above me, the exam is flawed (which I kind of suspected in the first place). I likely couldn't pass the NREMT-B exam...I just don't think at that level. To penalize someone for being able to think at a better than 8th grade level means you're knocking A LOT of good candidates out.

Anyone else notice a lot of A/TCo defenders around? Similar to a well known northwestern agency perhaps.....h34r:


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## medicsb (Jan 6, 2013)

usalsfyre said:


> Anyone else notice a lot of A/TCo defenders around? Similar to a well known northwestern agency perhaps.....h34r:



Watch out, conspiracies abound!


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## Wayne (Jan 6, 2013)

usalsfyre said:


> Then I agree with the other two posters above me, the exam is flawed (which I kind of suspected in the first place). I likely couldn't pass the NREMT-B exam...I just don't think at that level. To penalize someone for being able to think at a better than 8th grade level means you're knocking A LOT of good candidates out.
> 
> Anyone else notice a lot of A/TCo defenders around? Similar to a well known northwestern agency perhaps.....h34r:



Not being a paramedic, I don't exactly understand.  Can you give me a example of a BLS question where a paramedic would answer differently than an EMT?

I'm not saying their process isn't flawed- it definitely is.  But I don't understand why it's difficult for a paramedic to pass NREMT based written, and two skills (which are known to them, nothing random), especially in a process where you have time to prepare.


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## RocketMedic (Jan 6, 2013)

usalsfyre said:


> Then I agree with the other two posters above me, the exam is flawed (which I kind of suspected in the first place). I likely couldn't pass the NREMT-B exam...I just don't think at that level. To penalize someone for being able to think at a better than 8th grade level means you're knocking A LOT of good candidates out.
> 
> Anyone else notice a lot of A/TCo defenders around? Similar to a well known northwestern agency perhaps.....h34r:




EMSA's got the same disease. What have I done moving to Oklahoma?


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## ExpatMedic0 (Jan 6, 2013)

Wayne said:


> Sorry to bump an older thread, but google just led me here.  I'm in the current hiring process for Austin/Travis County, and from what I've seen, it looks like they're mostly hiring a lot of basics, and paying them better than most basics.



Well I'll be damned, looks like my hypothesis as OP was correct.:blush:


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## Fish (Jan 6, 2013)

30 Positions is a lot!


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## usalsfyre (Jan 6, 2013)

Wayne said:


> Not being a paramedic, I don't exactly understand.  Can you give me a example of a BLS question where a paramedic would answer differently than an EMT?
> 
> I'm not saying their process isn't flawed- it definitely is.  But I don't understand why it's difficult for a paramedic to pass NREMT based written, and two skills (which are known to them, nothing random), especially in a process where you have time to prepare.


As a medic, my thought process does not revolve around "high flow O2 and transport rapidly".


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## RocketMedic (Jan 6, 2013)

But Kyle, they're high-speed! BLS before ALS! "Paramedics save lives, EMTs save paramedics!!!1" and all that.


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## Fish (Jan 6, 2013)

usalsfyre said:


> As a medic, my thought process does not revolve around "high flow O2 and transport rapidly".



I can dig that, however....... This is a Basic level test, the options don't get much more advanced than that, so a Paramedic should be able to choice the right answer from the options given.


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## Wayne (Jan 6, 2013)

Fish said:


> I can dig that, however....... This is a Basic level test, the options don't get much more advanced than that, so a Paramedic should be able to choice the right answer from the options given.



That's my thought. There are only a handful of answers that could be right for any question they ask.


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## Bullets (Jan 6, 2013)

usalsfyre said:


> As a medic, my thought process does not revolve around "high flow O2 and transport rapidly".



technically no BLS agency should think that way any more


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## STXmedic (Jan 6, 2013)

Bullets said:


> technically no BLS agency should think that way any more



:rofl: That doesn't stop the vast majority of them!


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## ExpatMedic0 (Jan 7, 2013)

Rocketmedic40 said:


> But Kyle, they're high-speed! BLS before ALS! "Paramedics save lives, EMTs save paramedics!!!1" and all that.


Fighting the reaper! Doing the same same stuff as a Doctor but at 90MPH!


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## Fox800 (Jan 7, 2013)

PoeticInjustice said:


> Mostly call volume. Medics running 20-30 runs consistently on a 24hr shift.



Um...no. Call volume is high, but nothing like that. On my busiest shifts I'd do just under 1 call per hour, on a 12-hour shift. The busiest 24-hour shifts would do 15 or 16.


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## Fox800 (Jan 7, 2013)

rescue1 said:


> I'm interested in why there is so much turnover, though. I always thought ACTEMS was supposed to be a squared away EMS agency with a lot of career potential.
> 
> EDIT: Wow, totally missed PoeticInjustice's reply. 30 calls a shift? That's crazy. That's moving towards Philly or Baltimore crazy<_<.



It is a squared-away place to work, if you can handle the high call volume and management who place a higher emphasis on customer service/satisfaction than the delivery of medicine.

And 30 calls a shift is absolutely false. The most I saw on a busy 24-hour shift was 15 or 16 transports.


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## Fox800 (Jan 7, 2013)

18G said:


> So I would have to go through 8 weeks of an academy, ride as a 3rd person, then as a 2nd person, and then after all of that take a BLS test!?!? HOW STUPID IS THAT! Why is a Paramedic taking a credentialing exam at a BLS level???
> 
> And further more, why would an EMS provider being permitted to only provide a BLS level of care be misrepresenting their level of care delivery by wearing a patch that says Paramedic??? What happens if the EMT who is actually a Paramedic is needed to provide ALS interventions? Are they allowed to do so?
> 
> This is a really convoluted and idiotic process.



Amazingly, we would have paramedics applying for BLS positions fail BLS scenarios/skills tests. Why? They haven't done them in forever or can't think that way. So yes, it's reasonable to have someone take a crendentialing examination for the level of clearance they've been working towards. 

Texas is a delegated practice state when it comes to EMS. That means your medical director can credential you to do whatever he wants to, regardless of your state certification. As an EMT-B, I was credentialed to start IV's because my medical director authorized it (this was at another department, not A/TCEMS). They can credential you to any level they want to. A/TCEMS's chief is a paramedic but he is only system credential at the EMT level, because he's an administrator and doesn't run calls. And it's not misrepresentation, it's the medical director's decision. You are state certified or licensed as a paramedic, which means you can wear that patch. However, the medical director determines what level you function at and what you can or cannot do.


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## STXmedic (Jan 7, 2013)

How long have you been there, Fox? If it's only 15 or 16 transports at the busiest, then I'd be curious as to why there's such a high turnover at ATC. Our guys consistently run that or more, and we never lose anybody. 30+ new-hires per hiring is crazy considering its not from retirees. What's driving everybody out, then? Management?


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## Fox800 (Jan 7, 2013)

shfd739 said:


> As I understand this they wear the patch that the are certed at by the state(Basic w/ Basic patch, Paramedic w/ Paramedic patch). They are system limited to a Basic level. On the job they cant function past whatever the system's BLS protocols are.
> 
> We've done this to a handful of paramedics that weren't capable enough to function as paramedics. They worked at a BLS level within our system while being remediated.





marshmallow22 said:


> Just to clarify again, you will be hired at the EMT level whether you are a paramedic or not, and whether you have any experience or not.  Once cleared you will be working on a truck with a paramedic partner, but regardless of your state license you are only allowed to practice at the BLS level.  In our system you wear an ID badge, and that ID badge has a specific color and status as to what level you may practice at, even though the patch on your shoulder may indicate you're a paramedic. I know it sounds a bit confusing, but that's the way it is.



That is correct.


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## Fox800 (Jan 7, 2013)

PoeticInjustice said:


> How long have you been there, Fox? If it's only 15 or 16 transports at the busiest, then I'd be curious as to why there's such a high turnover at ATC. Our guys consistently run that or more, and we never lose anybody. 30+ new-hires per hiring is crazy considering its not from retirees. What's driving everybody out, then? Management?



I was there for 4 years (2008-2012) up until six months ago when I went back to school. We would occasionally run more than one call per hour but that includes cancellations before you reach the scene, no patient found, stuff like that. I maybe, MAYBE once or twice (in four years) ran 13 transports in a 12 hour shift. That was working on the busiest ambulance in the system on an exceptionally busy day (Austin City Limits, South by Southwest, ROT Rally, Halloween, New Year's Eve, etc.) But no, you're not running >1 transport per hour (average).

Turnover is caused by a variety of factors...just off the top of my head:
-High call volumes compared to other services or compared to what people were used to at prior jobs. Coming to A/TCEMS from a slower system with single digit call volumes per shift would be a rude awakening. A lot of people think they can take it and get worn down after a while. It's not the kind of place where you can come to work and play video games or finish a project on shift. Yes, we have a few stations like that but they are the minority...those are like 5-6 stations out of 30+ ambulances, you won't be working there exclusively.
-Politics. The department places a huge emphasis on looking good for the media, pleasing city council, and customer satisfaction surveys...more so than listening to reason from field staff. Admin was more concerned about how something "looked" regardless of whether or not it was the right decision concerning patient care, delivery of treatment, operational issues, etc.
-Lack of communication between administration and field staff. Major decisions would be made regarding treatment guidelines, personnel policies, vacation/sick time usage, staffing configurations, etc. with little or no communication before they went into effect. This was incredibly frustrating and from what I hear from coworkers it's just as bad/getting worse.
-Understaffing. The department committed to staffing the Formula 1 track which was a major commitment, to the tune of 6-8 ambulances, supervisory staff, first responders, etc. This was while we already had 20-30 vacancies for our 911 operations.

Despite all of this, I think that A/TCEMS is still a pretty good system compared to most metropolitan areas. All other major cities in Texas (Dallas, Houston, San Antonio) have fire-based EMS, and we hear horror stories about that. Fort Worth is the only exception, and after doing some ride-outs with MedStar, A/TCEMS definitely has a better system (in my opinion)

Those are a few of the big issues. I've been gone for a few months but I was there when this Medic 1 program was being implemented and I took part in some of the hiring processes. If you have any other questions, let me know.


----------



## Fox800 (Jan 7, 2013)

medicsb said:


> There is nothing seemingly that special about Williamson County EMS from what I can tell.  They run around 30,000 calls with 15-16 double medic trucks.  They use RSI and have a STEMI and stroke system.  Ho Hum.  (Most services with RSI probably shouldn't be doing it, including almost every service in TX, so that is in no way a indicator of a good system.)  They do not appear to make any data public - they're just like most of other EMS'.  (Though, they claim to be data-driven and claim to publish data, yet I can't find a thing.)   Probably good, not too bad... whatever.  Unlike most places, one can actually look up data from ATCEMS system as they make quite a bit public.  If nothing else, they deserve credit for that.  And, well, actually looking at the data published, they're not a bad service and probably are better than the majority in the US.
> 
> Really, ATCEMS may not be the best.  There probably are others just as good, if not better (maybe WilCo), but shame on those others for not promoting themselves better.



Also interesting that I had a few coworkers that left Williamson for A/TC, but never the other way around. Of course, that's purely anecdotal. Williamson seemed like a fine place to work and I considered it for a while. However, I laugh when I hear my friends that work there complain about a "busy" day running 5-6 transports on a 24 hour shift in Round Rock. Such a tough life.

From what I heard, it's almost too laid-back, it's a lot harder to get in trouble for things. I heard they'd have four ambulances at the same restaurant eating breakfast in the morning. That kind of stuff would never fly at any of the other places I've worked. They really didn't ever want two ambulances in the same area if they could avoid it.


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## Fox800 (Jan 7, 2013)

DrParasite said:


> I'm curious: if 100% of applicants have their paramedic card, and are educated to the paramedic level, how do 80% of them get rejected during the hiring process?  what seems to be the biggest eliminating factor?



For a while, hardly anyone could pass the entrance examination. It was written based on national standards. I remember one process had 35-ish people took it, and only 3 passed. They ended up hiring no one, the 3 that passed all failed out for other reasons (scenarios, interviews, background investigation, references, whatever).

On the BLS level examinations, paramedic-certified applicants were failing for things like verbalizing ALS interventions and neglecting BLS interventions, not requesting ALS assistance, or just not being prepared. A lot of it is ego. People wouldn't study or even review NREMT skills sheets. I always did that to make sure I didn't forget something stupid. When was the last time you took a national standard skills exam and had to verbalize every little thing?


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## Fish (Jan 7, 2013)

Fox800 said:


> Also interesting that I had a few coworkers that left Williamson for A/TC, but never the other way around. Of course, that's purely anecdotal. Williamson seemed like a fine place to work and I considered it for a while. However, I laugh when I hear my friends that work there complain about a "busy" day running 5-6 transports on a 24 hour shift in Round Rock. Such a tough life.
> 
> From what I heard, it's almost too laid-back, it's a lot harder to get in trouble for things. I heard they'd have four ambulances at the same restaurant eating breakfast in the morning. That kind of stuff would never fly at any of the other places I've worked. They really didn't ever want two ambulances in the same area if they could avoid it.



Wilco has 10+ Medics working for them currently, that came from Austin. While I have worked for Wilco 1 Medic has left for Austin, and he came right back within a year. And Wilco has a Policy against more than 2 ambulances at 1 resturant, and has for years.

No Wilco vs Austin stuff, our two systems work closely together and do not view eachother as competitors" rather we view them as "sister systems"


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## Fox800 (Jan 7, 2013)

Fish said:


> Wilco has 10+ Medics working for them currently, that came from Austin. While I have worked for Wilco 1 Medic has left for Austin, and he came right back within a year. And Wilco has a Policy against more than 2 ambulances at 1 resturant, and has for years.
> 
> No Wilco vs Austin stuff, our two systems work closely together and do not view eachother as competitors" rather we view them as "sister systems"



Well then I stand corrected, and I think I know who you were talking about, met him while he was a cadet. As far as the four ambulances at a restaurant at once, that came from one of my friends who worked there for 8-9 years before she left for A/TC, so I imagine it was quite a while ago.

Like I said, I think Wilco has a fine system and would have worked there in a second. It just seems to be much more laid-back than A/TC in some regards. At least, that's what I hear. I've never worked there and never done a ride-out, just heard that from current/former employees.


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## Fish (Jan 7, 2013)

Fox800 said:


> Well then I stand corrected, and I think I know who you were talking about, met him while he was a cadet. As far as the four ambulances at a restaurant at once, that came from one of my friends who worked there for 8-9 years before she left for A/TC, so I imagine it was quite a while ago.
> 
> Like I said, I think Wilco has a fine system and would have worked there in a second. It just seems to be much more laid-back than A/TC in some regards. At least, that's what I hear. I've never worked there and never done a ride-out, just heard that from current/former employees.



I am sure years ago it did happen, and most likely that is why the policy is in place. Don't quote me on this, but I believe the policy is over 7yrs old. Wilco is a laid back system, we view our managment more as Leaders and Resources and not so much disciplinarians. The system highly promotes self supervision and doing the right thing. And I would say it works, never have I worked with such professional and dedicated people who hold themselves accountable and strive for a high level.

Best of luck to you in school, is it in the Medical field?


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## mycrofft (Jan 7, 2013)

Bet you a nickel the que awaiting "promotion" gets jumped. A lot. Especially managerial and supervisor positions.

Bet they still pay for landscaping City Hall, right?<_<


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## RocketMedic (Jan 7, 2013)

Fox800 said:


> I was there for 4 years (2008-2012) up until six months ago when I went back to school. We would occasionally run more than one call per hour but that includes cancellations before you reach the scene, no patient found, stuff like that. I maybe, MAYBE once or twice (in four years) ran 13 transports in a 12 hour shift. That was working on the busiest ambulance in the system on an exceptionally busy day (Austin City Limits, South by Southwest, ROT Rally, Halloween, New Year's Eve, etc.) But no, you're not running >1 transport per hour (average).
> 
> Turnover is caused by a variety of factors...just off the top of my head:
> -High call volumes compared to other services or compared to what people were used to at prior jobs. Coming to A/TCEMS from a slower system with single digit call volumes per shift would be a rude awakening. A lot of people think they can take it and get worn down after a while. It's not the kind of place where you can come to work and play video games or finish a project on shift. Yes, we have a few stations like that but they are the minority...those are like 5-6 stations out of 30+ ambulances, you won't be working there exclusively.
> ...




You could switch EMSA for A/TCEMS and this would be absolutely identical.


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## Fox800 (Jan 7, 2013)

mycrofft said:


> Bet you a nickel the que awaiting "promotion" gets jumped. A lot. Especially managerial and supervisor positions.
> 
> Bet they still pay for landscaping City Hall, right?<_<



Who knows. Oh yes, reminds me of the year the employees voluntarily gave up their raises so the department could "stay afloat" because money was so tight. After we did that, the top brass got raises and brand new take-home cars. Apparently their 5 year old vehicles weren't nice enough. We were in such a financial bind, right? Gotta love it.


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## Fox800 (Jan 7, 2013)

Fish said:


> I am sure years ago it did happen, and most likely that is why the policy is in place. Don't quote me on this, but I believe the policy is over 7yrs old. Wilco is a laid back system, we view our managment more as Leaders and Resources and not so much disciplinarians. The system highly promotes self supervision and doing the right thing. And I would say it works, never have I worked with such professional and dedicated people who hold themselves accountable and strive for a high level.
> 
> Best of luck to you in school, is it in the Medical field?



Thanks buddy. I'm in my first year of medical school. I miss the truck now and then, hence why I'm messing around on here instead of studying for my upcoming gastrointestinal exam.


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## Fish (Jan 7, 2013)

Fox800 said:


> Who knows. Oh yes, reminds me of the year the employees voluntarily gave up their raises so the department could "stay afloat" because money was so tight. After we did that, the top brass got raises and brand new take-home cars. Apparently their 5 year old vehicles weren't nice enough. We were in such a financial bind, right? Gotta love it.



My 5 year old Vehicles still sparkle and what not! 200k Miles here I come! 

Forget to mention I bought used, came with 50k


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## Fish (Jan 8, 2013)

Medic Friend of mine who works for Austin, posted this on his Facebook page this morning

http://www.statesman.com/news/news/...ustin-travis-county-ems-should-face-au/nTpyB/


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## Fox800 (Jan 8, 2013)

Fish said:


> Medic Friend of mine who works for Austin, posted this on his Facebook page this morning
> 
> http://www.statesman.com/news/news/...ustin-travis-county-ems-should-face-au/nTpyB/



Interesting. I sincerely hope that they don't merge with AFD, it would be a shame to see a system like A/TC be ruined like other mergers around the country.

Guess I picked a great time to leave.


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## Fish (Jan 8, 2013)

Fox800 said:


> Interesting. I sincerely hope that they don't merge with AFD



Me too

Most of the Medics at ATCEMS do not want a merger either, however some of the Medics want it, so they can get off of the Ambulance and also get a pay raise.


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## Fox800 (Jan 8, 2013)

Fish said:


> Me too
> 
> Most of the Medics at ATCEMS do not want a merger either, however some of the Medics want it, so they can get off of the Ambulance and also get a pay raise.



Selfish reasons, honestly. No reason at all to run another EMS system into the ground to pad run numbers for a fire department to justify a larger budget.


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## medic417 (Jan 8, 2013)

Fox800 said:


> Selfish reasons, honestly. No reason at all to run another EMS system into the ground to pad run numbers for a fire department to justify a larger budget.



Sadly they set this up by all the crap they have done the past few years.  They are not near the department they used to be.


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## Fish (Jan 8, 2013)

Found this in the Comments section in the article.......

"Hello Im a firefighter here in the austin area. I have the most experience in saving lives then any of the EMTs that work in austin. I have 10 documented saves in the last 2 months alone so hear me out. .... What we need to to is merge the fire department and EMS. The EMS EMTs are there to just drive the patient to the hospital. The driving part really isnt that hard to do. We as firefighters usually recommend to them which drugs to use for the patient and a lot of times they are confused as to which hospital they should take the patient to so we advise them of that also. 
As a matter of fact whenever they have a critical call we as firefighters usually have to ride in the back of the ambulance with the patient to the hospital running code 3. The Austin EMS EMTs need us in the back to manage patient care. When the call is done they just drive us back to our station and call us back on the next call. It would be easier for us to just have them just drive it would save the taxpayers a lot of money. As a matter of fact if its a difficult call (such as CPR, chokings etc) the Austin EMS EMTs will call me in the station because they do not know what to do. I will advise them of the cpr/mouth resuscitation ratio rate. They are always very apperciative of the information I provide. They are a great crew very nice..so merging would be the best option...."




Poor attempt at Humor! Some people are going to take this seriously


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## ExpatMedic0 (Jan 9, 2013)

AHAHAHAHA :rofl: Troll level=master



Fish said:


> Found this in the Comments section in the article.......
> 
> "Hello Im a firefighter here in the austin area. I have the most experience in saving lives then any of the EMTs that work in austin. I have 10 documented saves in the last 2 months alone so hear me out. .... What we need to to is merge the fire department and EMS. The EMS EMTs are there to just drive the patient to the hospital. The driving part really isnt that hard to do. We as firefighters usually recommend to them which drugs to use for the patient and a lot of times they are confused as to which hospital they should take the patient to so we advise them of that also.
> As a matter of fact whenever they have a critical call we as firefighters usually have to ride in the back of the ambulance with the patient to the hospital running code 3. The Austin EMS EMTs need us in the back to manage patient care. When the call is done they just drive us back to our station and call us back on the next call. It would be easier for us to just have them just drive it would save the taxpayers a lot of money. As a matter of fact if its a difficult call (such as CPR, chokings etc) the Austin EMS EMTs will call me in the station because they do not know what to do. I will advise them of the cpr/mouth resuscitation ratio rate. They are always very apperciative of the information I provide. They are a great crew very nice..so merging would be the best option...."
> ...


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## Bullets (Jan 9, 2013)

I am just trying to wrap my head around this issue.

ATC is posting openigns for Medic-1 which is a BLS position? And there are ALS cetified providers applying for and being hired for the BLS position? And once hired they are paired with an ALS partner and expected to do ALS skills?

Or they are expected to do BLS Skills?

In my and the two other main Police EMS agencies in my area, we have a bunch of Medics who work for us. We are all BLS agencies and every employee only provides at the BLS level regardless of their level of certification. In all cases, these police department based agencies pay better then the ALS they regularly interface with. Many of the medics who work for the local ALS also work for PDEMS. Its generally a better position, less calls, better equipment and trucks, better stations, more involvement with the state agency (Which means OT doing "cool" Stuff)

And they all wear their medic state patch, even while on the BLS truck


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## Fox800 (Jan 9, 2013)

The Medic 1 position is for a BLS level provider. Even if you're certified as a paramedic, if you get hired into the Medic 1 position you are a BLS provider in the A/TCEMS system and are limited to functioning at that level. They wear their paramedic patch because that's their state certification. However, Texas does not have statewide or regional protocols. Each agency's medical director writes protocols for that agency and can credential EMS personnel to do (or not do) whatever they want.

For instance, you could be hired as a paramedic and be limited to functioning at the EMT or even first responder level. Vice-versa, providers be credentialed to perform skills outside of their normal scope of practice. You could have a paramedic functioning as an EMT or an EMT starting IV's and administering medications usually limited to paramedics. It's the medical director's call.


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## iftmedic (May 22, 2014)

marshmallow22 said:


> I love coming on to these forums and seeing all the speculation regarding a certain department, ususally by someone who has no idea what they're talking about.  True ATCEMS is hiring for "medic 1" positions.  Whether you're an EMT or Paramedic does not matter.  Reasoning behind it has nothing to do with budget problems.  In the ATCEMS system approximately 80% are BLS.  Therefore, ALS skills are rarely used.  Secondly, ATCEMS's plan is a 60/40 split, not EVERY truck.  Thirdly, the $15 an hr comes to quite a bit more than 29k per year with built in overtime, and also the ability to pick up a TON of extra shifts.  There are not too many EMS only departments in the country that have the depth that ATCEMS has in regards to what you can do in the department.  There's Spec. Ops, Tactical, Motorcycles, Bike Medics, Gators, etc.  Also, even AS a paramedic working in another state (I.E. California), you're stuck on a private with poor conditions, low pay, no respect, and playing politics to the fire department.  Personally, I'd rather take an EMT position with a top rated department making more than most medics in other states, earning city benefits including a pension (similar to CALPERS), and now civil service with the opportunity to promote.  Yes, you'll be busy, but that's what you signed up for when you work for the now 14th largest city in the country.  So before you spout off with a bunch of nonsense, do some research and get your facts straight!



Marshmallow...your description of the Ca conditions and experience for private medics is 100% accurate.. I'm really considering Austin Travis EMS..do you work out there? You made a good point ATCEMS sounds very appealing I just dropped my App


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## Bullets (May 22, 2014)

iftmedic said:


> Marshmallow...your description of the Ca conditions and experience for private medics is 100% accurate.. I'm really considering Austin Travis EMS..do you work out there? You made a good point ATCEMS sounds very appealing I just dropped my App



*(Moderator snip)*


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## ExpatMedic0 (May 22, 2014)

An Oldie but a goodie. You know whats funny? When I started this thread, this article (and many others) had not yet come out 
http://www.jems.com/article/administration-and-leadership/austin-travis-county-ems-responds-jems-a


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## Handsome Robb (May 22, 2014)

All I will say is I worked too long and too hard to go back to working as an EMT for 2+ years. 

If it were a shorter period of time I'd absolutely consider it, ATCEMS was one of the places I really wanted to work until they changed to B/P trucks and started the medic I/II deal.


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## ExpatMedic0 (May 22, 2014)

Robb said:


> All I will say is I worked too long and too hard to go back to working as an EMT for 2+ years.
> 
> If it were a shorter period of time I'd absolutely consider it, ATCEMS was one of the places I really wanted to work until they changed to B/P trucks and started the medic I/II deal.



I %100 agree and feel(felt) the same way


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## TransportJockey (May 22, 2014)

ExpatMedic0 said:


> I %100 agree and feel(felt) the same way



And im another that does as well. I'm still looking in the area, but not with austin


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## Handsome Robb (May 22, 2014)

WilCo has been on my radar for a while now after speaking at length with one of their recruiters.

Then I realize there's no snow in or around ATX and it's been the deal breaker thus far.


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## WTEngel (May 22, 2014)

I feel like I've been a paramedic too long to go back to being a medic sometimes. You know what I'm talking about Expat....


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## TransportJockey (May 22, 2014)

WTEngel said:


> I feel like I've been a paramedic too long to go back to being a medic sometimes. You know what I'm talking about Expat....



I don't know if I can take a step back into such less progressive and aggressive protocols


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## TRSpeed (May 22, 2014)

TransportJockey said:


> I don't know if I can take a step back into such less progressive and aggressive protocols



This guy haha


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## STXmedic (May 22, 2014)

TransportJockey said:


> I don't know if I can take a step back into such less progressive and aggressive protocols



Not all of us can perform prehospital PCIs...


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## RocketMedic (May 22, 2014)

I don't think that I could go to being an EMT for years on end. Quite frankly, I know my job and don't need to be retarded to EMT-B to do it.


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## Handsome Robb (May 23, 2014)

TransportJockey said:


> I don't know if I can take a step back into such less progressive and aggressive protocols




Mines bigger than yours! 

Oh wait...


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## xrsm002 (May 23, 2014)

Robb said:


> WilCo has been on my radar for a while now after speaking at length with one of their recruiters.
> 
> Then I realize there's no snow in or around ATX and it's been the deal breaker thus far.



If you want snow go to Amarillo or Lubbock. Lol.


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## TransportJockey (May 23, 2014)

Robb said:


> WilCo has been on my radar for a while now after speaking at length with one of their recruiters.
> 
> Then I realize there's no snow in or around ATX and it's been the deal breaker thus far.



Come live in ABQ and work where I do lol. I'll gladly carpool with you


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## iftmedic (May 23, 2014)

TransportJockey said:


> Come live in ABQ and work where I do lol. I'll gladly carpool with you



What is ABQ???


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## TransportJockey (May 23, 2014)

iftmedic said:


> What is ABQ???



Albuquerque, NM


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## usalsfyre (May 24, 2014)

Three thoughts.

1. A/TC is a better agency than most

2. A/TC is very intent on telling you they're a better agency than most

3. A/TC's protocols seem to be built more around an urban perspective and it's expected if you're out in the boonies (there's still small parts of Travis County that are) you'll call StarFlight for both transport time and expanded level of care.

As for hiring medics as basics, it's a civil service thing. My SWAG is when they restructured they did it with a civil service board in mind and felt they had to stratify levels somehow, even if it was highly arbitrary.


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## iftmedic (May 24, 2014)

usalsfyre said:


> Three thoughts.
> 
> 1. A/TC is a better agency than most
> 
> ...



Once they hire you...how long is Orientation before you hit the field as Medic1


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## STXmedic (May 24, 2014)

Orientation used to be 13wks I think. I'm not sure if they cut that down since you're only working at an EMT level, now.


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## Handsome Robb (May 25, 2014)

I don't think they did. Maybe a little but there's a pretty solid academy to their hiring process from what I'm told. Up to and including swimming for part of it if I remember correctly. Seems harmless to me but I grew up in the water, not everyone has water confidence.


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## iftmedic (May 25, 2014)

Robb said:


> I don't think they did. Maybe a little but there's a pretty solid academy to their hiring process from what I'm told. Up to and including swimming for part of it if I remember correctly. Seems harmless to me but I grew up in the water, not everyone has water confidence.



How much money can you expect to make during academy... Any OT??


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## OnceAnEMT (May 25, 2014)

When I was talking to some higher-ups at ATCEMS I was told that, realistically, I would need to take off a semester of college in order to complete the Academy and orientation process. Not sure if this is described on their website, but do note that their is an "Academy" and an "Orientation", where you have a preceptor and such. This lasts a good half a year if not longer. The Academy, as yall said, is a few months. Intensive enough, however, to prevent a full-time semester.


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## iftmedic (May 25, 2014)

Grimes said:


> When I was talking to some higher-ups at ATCEMS I was told that, realistically, I would need to take off a semester of college in order to complete the Academy and orientation process. Not sure if this is described on their website, but do note that their is an "Academy" and an "Orientation", where you have a preceptor and such. This lasts a good half a year if not longer. The Academy, as yall said, is a few months. Intensive enough, however, to prevent a full-time semester.



I'm assuming no OT at this point huh? I'm just trying to figure out if I could even afford it... Otherwise I'm better off staying in LA area


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## Angel (May 25, 2014)

and whats the pay after the orientation? I have a hard time even considering working for a place that would put me through a second internship. new or not, i didn't do all that for nothing and find it almost insulting. IMO it shouldnt take 3 months to figure out if you can do the job or not


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## TransportJockey (May 25, 2014)

Angel said:


> and whats the pay after the orientation? I have a hard time even considering working for a place that would put me through a second internship. new or not, i didn't do all that for nothing and find it almost insulting. IMO it shouldnt take 3 months to figure out if you can do the job or not



If you're a medic it's more like a year or more before yiy promote to ALS


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## iftmedic (May 25, 2014)

TransportJockey said:


> If you're a medic it's more like a year or more before yiy promote to ALS



I just want to be able to make ends meet on the pay


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## Chewy20 (May 25, 2014)

it says right on their site starting pay is $15.35 and you will work a 48 hour work week. Not sure how much the pay is once you are promoted as a medic. 

This cycle of applications is due on the 6th I believe, and the process goes throughout the summer with an academy start date in August if I am not mistaken. (to lazy to look around site right now.)


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## iftmedic (May 25, 2014)

Chewy20 said:


> it says right on their site starting pay is $15.35 and you will work a 48 hour work week. Not sure how much the pay is once you are promoted as a medic.
> 
> This cycle of applications is due on the 6th I believe, and the process goes throughout the summer with an academy start date in August if I am not mistaken. (to lazy to look around site right now.)



Yeah I saw the rate but not sure if the schedule would allow to make more money. If u work 48 hour shift not bad or 2 24s ...but if you show up 4-5 times a week that's junk  ...I'm trying to see if its even worth my time I have wife kids dogs....and my decision would impact everyone's life ....I'm also looking at the Privates in the area.


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## STXmedic (May 25, 2014)

Unless things have changed, you're most likely to start off doing 4x12. Then as you gain seniority you can bid for their hybrid shifts (24 & 12x2, or 24x2). Typically new employees would start off on 12s, though.


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## TransportJockey (May 25, 2014)

And, again, another thing to remember is you won't be having state tax coming out if your paycheck in Texas


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## iftmedic (May 25, 2014)

Thank you all for your responses and feedback... I'm gonna drive in to Austin on the 14th for the hiring process... Get a feel for the city, maybe its meant to be and I'll  land a job with a legit Agency. Otherwise I'll go with plan B finish HVAC training buy a work truck and run a one man show, service and repair biz.... 12-15 years of spinning my wheels in the low paying EMS world is enough. Should have gone to college...


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## TRSpeed (May 25, 2014)

iftmedic said:


> Thank you all for your responses and feedback... I'm gonna drive in to Austin on the 14th for the hiring process... Get a feel for the city, maybe its meant to be and I'll  land a job with a legit Agency. Otherwise I'll go with plan B finish HVAC training buy a work truck and run a one man show, service and repair biz.... 12-15 years of spinning my wheels in the low paying EMS world is enough. Should have gone to college...



I pm'd you. We are all hear to help each other. Hopefully you don't have to move too far from family.


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## Handsome Robb (May 25, 2014)

iftmedic said:


> Yeah I saw the rate but not sure if the schedule would allow to make more money. If u work 48 hour shift not bad or 2 24s ...but if you show up 4-5 times a week that's junk  ...I'm trying to see if its even worth my time I have wife kids dogs....and my decision would impact everyone's life ....I'm also looking at the Privates in the area.



12s are definitely the most likely shift as a new employee. Even on 24s I'm pretty sure it still is a 48 hour work week, not the 56 like most FDs or EMS agencies that run 24s or 48s are. Also, if it does bump to a 56 hour week when you get to that point I wouldn't be surprised if your hourly dropped so you're making the same annual amount. Doesn't make any sense to pay the people working the less desirable shifts less than those working the more desirable ones. I very well could be wrong, just thinking with the whole Civil Service thing they try and keep it on an even playing field for everyone.


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## iftmedic (May 25, 2014)

Robb said:


> 12s are definitely the most likely shift as a new employee. Even on 24s I'm pretty sure it still is a 48 hour work week, not the 56 like most FDs or EMS agencies that run 24s or 48s are. Also, if it does bump to a 56 hour week when you get to that point I wouldn't be surprised if your hourly dropped so you're making the same annual amount. Doesn't make any sense to pay the people working the less desirable shifts less than those working the more desirable ones. I very well could be wrong, just thinking with the whole Civil Service thing they try and keep it on an even playing field for everyone.



Yeah I remember AMR would do that.. you jump on a 24 or 48 and work more hours but yet your expected to make the same so they would drop your hourly to keep it "Fair" ...


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## iftmedic (May 25, 2014)

iftmedic said:


> Yeah I remember AMR would do that.. you jump on a 24 or 48 and work more hours but yet your expected to make the same so they would drop your hourly to keep it "Fair" ...



I wonder how the OT is??


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## Handsome Robb (May 25, 2014)

iftmedic said:


> I wonder how the OT is??




From my friend that works there: "plentiful" 

As a Medic I they pulled down like 70k but that's with a lot of OT.


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## iftmedic (May 25, 2014)

Robb said:


> From my friend that works there: "plentiful"
> 
> As a Medic I they pulled down like 70k but that's with a lot of OT.



The good thing is that eventually you should get raises and promotions ...unlike privates were you sometimes never get a raise


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## OnceAnEMT (May 25, 2014)

iftmedic said:


> The good thing is that eventually you should get raises and promotions ...unlike privates were you sometimes never get a raise



I've seen a spreadsheet indicating pay levels based on years of experienced for each position, but I've never been able to find it again. Basically, your pay increases the longer you are on-board, and as you are promoted. Don't there are any "personal" raises though, as it is a government system.


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## iftmedic (May 25, 2014)

Grimes said:


> I've seen a spreadsheet indicating pay levels based on years of experienced for each position, but I've never been able to find it again. Basically, your pay increases the longer you are on-board, and as you are promoted. Don't there are any "personal" raises though, as it is a government system.



So experience meaning years in service with their agency. Not years experience you personally have as a  medic


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## OnceAnEMT (May 25, 2014)

iftmedic said:


> So experience meaning years in service with their agency. Not years experience you personally have as a  medic



Correct. As its been said, starting with ATCEMS is basically starting as a fresh EMT. Nothin'.


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## Handsome Robb (May 25, 2014)

iftmedic said:


> The good thing is that eventually you should get raises and promotions ...unlike privates were you sometimes never get a raise




I work for a private under a P.U.M. and we have an established pay raise structure. With differentials as an FTO and 5 years of service for us medics can pull around 70k base provided they consistently have a trainee.

We don't count years of experience from other agencies either.

I'd be interested to know what Medic I/IIs top out at. We're in the 23.5x/hr range at the top end before FTO, Preceptor or Community Health Paramedic differentials. Comes out to 63,xxx/year base plus benefits.


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## iftmedic (May 25, 2014)

Robb said:


> I work for a private under a P.U.M. and we have an established pay raise structure. With differentials as an FTO and 5 years of service for us medics can pull around 70k base provided they consistently have a trainee.
> 
> We don't count years of experience from other agencies either.
> 
> I'd be interested to know what Medic I/IIs top out at. We're in the 23.5x/hr range at the top end before FTO, Preceptor or Community Health Paramedic differentials. Comes out to 63,xxx/year base plus benefits.



Whats PUM?


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## NomadicMedic (May 25, 2014)

Interesting. Our range for starting medics,Paramedic 1, is 19.38 - 26.18. P2 tops out at 29.91, P3 at 31.76. FTO adds an additional 1.20/hour. (Not much, but lots of overtime.) Supervisors top end is 33.67. 

See why this is such a decent place to work? No sales tax, low cost of living. Decent money and a promotional ladder. 

We're not currently hiring, but applications are being accepted for the next round.


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## NomadicMedic (May 26, 2014)

iftmedic said:


> Whats PUM?




A public utility model. Private service contracted to a city to provide EMS.


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## Chewy20 (Aug 5, 2014)

Just wanted to clear a few minor things up.

-It is a 48 hour work week made up of 24s and 12s (any combination adding up to 48 hours). Once you are finished with the academy you will bid on available shifts (so probably a lot of 12s for new guys, though Travis County is huge so I am sure there are 24s available).

-You can view pay tables here http://austintexas.gov/hr/jobdesc/job_title_pay.cfm (type in "medic" in the search bar)

-The academy is now 6 weeks, Monday through Friday.



If anyone has general questions I can try to answer them. PM me or ask on here.


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## MonkeyArrow (Aug 5, 2014)

DEmedic said:


> Interesting. Our range for starting medics,Paramedic 1, is 19.38 - 26.18. P2 tops out at 29.91, P3 at 31.76. FTO adds an additional 1.20/hour. (Not much, but lots of overtime.) Supervisors top end is 33.67.
> 
> See why this is such a decent place to work? *No sales tax*, low cost of living. Decent money and a promotional ladder.
> 
> We're not currently hiring, but applications are being accepted for the next round.



Don't places without income taxes have higher sales taxes and luxury taxes? (i know that Texas does this, I think)


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## STXmedic (Aug 5, 2014)

Sales tax is typically 8.25% in Texas. What is it elsewhere?


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## DesertMedic66 (Aug 5, 2014)

STXmedic said:


> Sales tax is typically 8.25% in Texas. What is it elsewhere?



I believe 7.5% statewide but districts can add on some more.


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## MonkeyArrow (Aug 5, 2014)

STXmedic said:


> Sales tax is typically 8.25% in Texas. What is it elsewhere?



3% for food and 6% for everything else.


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## TransportJockey (Aug 5, 2014)

MonkeyArrow said:


> 3% for food and 6% for everything else.


Or zero percent for food in some places


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## STXmedic (Aug 5, 2014)

Isn't it zero for food here? Excluding restaurants that is.


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## Chewy20 (Aug 5, 2014)

MonkeyArrow said:


> Don't places without income taxes have higher sales taxes and luxury taxes? (i know that Texas does this, I think)



Usually, states get their money one way or another. It is still nicer to have a bigger paycheck at the end of the week though. Also with cost of living lower (once out of the city) than a lot of the country it works out pretty nice.


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## TransportJockey (Aug 5, 2014)

Chewy20 said:


> Usually, states get their money one way or another. It is still nicer to have a bigger paycheck at the end of the week though. Also with cost of living lower (once out of the city) than a lot of the country it works out pretty nice.


I have the best of both worlds. No state tax out of my paycheck and I buy stuff online or in NM where taxes are lower


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## TransportJockey (Aug 5, 2014)

Chewy20 said:


> Usually, states get their money one way or another. It is still nicer to have a bigger paycheck at the end of the week though. Also with cost of living lower (once out of the city) than a lot of the country it works out pretty nice.


Cost of living in the country can actually be bigger at times. My county housing is scarce with the oil boom, so apartments are more there than in Albuquerque


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## Handsome Robb (Aug 5, 2014)

DEmedic said:


> A public utility model. Private service contracted to a city to provide EMS.




Sort of, there's more to it than that. 

You drive a hard bargain about where you work sir.


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## Chewy20 (Aug 5, 2014)

TransportJockey said:


> Cost of living in the country can actually be bigger at times. My county housing is scarce with the oil boom, so apartments are more there than in Albuquerque



Yeah I guess that's true at times. If it came down to it though I would rather pay a little extra to live out in the country.


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## chriscemt (Aug 6, 2014)

MonkeyArrow said:


> Don't places without income taxes have higher sales taxes and luxury taxes? (i know that Texas does this, I think)



Not necessarily.  I don't have a link, but I think John Lott goes through this in one of his books, showing how removing property tax helps a state's revenues without raising sales tax.  Basically, by removing the property tax, your citizens have more money to spend on other things, and sales tax _revenues_ increase without increasing the sales tax _rate_.

It's up to how you lean politically to decide which model works best, I guess.


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## usalsfyre (Aug 6, 2014)

STXmedic said:


> Isn't it zero for food here? Excluding restaurants that is.



Zero for basic food stuffs, prepared foods will run more.


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## scotshy (Mar 26, 2015)

Chewy20 said:


> If anyone has general questions I can try to answer them. PM me or ask on here.



If someone is hired as a basic, what is the typical process in getting certified as a paramedic? Is there a particular local community college favored that they can go nights to complete the requirements? Is that common? How long does it take?


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## Chewy20 (Mar 26, 2015)

There is no program here that caters to working here. Austin Community College has a VERY good program, but it is 2 years at least and they don't care where you work. Also can no longer do your ride time with ATCEMS if you go to ACC and work here. There is also Temple college, and EMTSA which requires you to take the AEMT course prior. Other than that, you would have to travel to San Antonio pretty much.

Whatever route you choose it wont be easy, and you wont have much of a social life. I am weighing all those options at the moment against just taking degree classes.


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## STXmedic (Mar 26, 2015)

UTHSCSA... Just saying


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## scotshy (Mar 26, 2015)

Chewy20 said:


> There is no program here that caters to working here.



Sorry, are you saying you'd have to take a leave of absence from ATCEMS or just that there isn't a designated "ATCEMS program"? Do you have co-workers that are currently paramedic students?


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## Chewy20 (Mar 26, 2015)

STXmedic said:


> UTHSCSA... Just saying


 
Whats their schedule?


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## Chewy20 (Mar 26, 2015)

scotshy said:


> Sorry, are you saying you'd have to take a leave of absence from ATCEMS or just that there isn't a designated "ATCEMS program"? Do you have co-workers that are currently paramedic students?


 
You can not take a leave of absence from working here. Its civil service and full-time required. What I meant was ACC, especially, does not care you work for the city, they want to be your main focus and they always come first. Yes there are people in ACC and they all say its an awesome program that goes above and beyond, but there is a lot of hoops to jump threw, and they dont help you out. 5 semesters minimum.

Also know someone here taking an online program. (not sure what one)


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## STXmedic (Mar 26, 2015)

I can't tell you 100% yet what it will be next year (August), but it will likely be MWF class in the first semester, then TTh class second semester.


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## Chewy20 (Mar 27, 2015)

STXmedic said:


> I can't tell you 100% yet what it will be next year (August), but it will likely be MWF class in the first semester, then TTh class second semester.


 

Well that aint gonna work.


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## STXmedic (Mar 27, 2015)

I figured. It's not terribly conducive to full time employment, unfortunately. Guys make it work, but the first semester can be rough.


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## RocketMedic (Mar 27, 2015)

You could always drink from the TEEX firehose lol.


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## EMT Training Center (Mar 31, 2015)

Working in Austin, TX can be quite intense. Since bars drives the night life, expect many drunken encounters and cleaning up after the belligerent


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## EMT Training Center (Mar 31, 2015)

Still rewarding work albeit, but expect some interesting situations.  Your Trauma Training will really be useful


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## Chewy20 (Mar 31, 2015)

EMT Training Center said:


> Still rewarding work albeit, but expect some interesting situations.  Your Trauma Training will really be useful


 
uhhhhh k?


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## RocketMedic (Mar 31, 2015)

Lol Austin is where the textbook comes to life.


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## Tripletwo (May 13, 2015)

Chewy

Are employees treated well there?  Decent wages, advancement potential and benifets?  Basically are you happy there?  I am flying in from New England for the exam.  I am a paramedic in a busy urban system being busy doesn't bother me.  I'm Trying to find a place where I can do a career and be happy.  Any opinions you have would be greatly appreciated.


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## NomadicMedic (May 13, 2015)

http://www.austinchronicle.com/news/2015-05-08/high-stress-at-ems/


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## RocketMedic (May 13, 2015)

"Two years" by policy as a basic. 

ATCEMS's hiring policy appears to be designed to exclude the experienced, prideful and not-so-meek.


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## Chewy20 (May 13, 2015)

RocketMedic said:


> "Two years" by policy as a basic.
> 
> ATCEMS's hiring policy appears to be designed to exclude the experienced, prideful and not-so-meek.



Yeah we know @RocketMedic you say the same thing every time someone asks something, give it up.

@DEmedic That article is a good representation of what the field medics are going through. Theres a lot of good people here, but its becoming not worth it.


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## gotbeerz001 (May 13, 2015)

RocketMedic said:


> "Two years" by policy as a basic.
> 
> ATCEMS's hiring policy appears to be designed to exclude the experienced, prideful and not-so-meek.


... Otherwise known as cocky.

There is value to understanding, embracing and thriving in the role that you are given. The organization seems to understand this. Those who believe that they are better than their role maybe dont fit there.


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## Chewy20 (May 13, 2015)

Tripletwo said:


> Chewy
> 
> Are employees treated well there?  Decent wages, advancement potential and benifets?  Basically are you happy there?  I am flying in from New England for the exam.  I am a paramedic in a busy urban system being busy doesn't bother me.  I'm Trying to find a place where I can do a career and be happy.  Any opinions you have would be greatly appreciated.



For the most part yes we are treated well, I have not been around long enough to feel what other people do. Wages are good, advancement is there from Medic 1, 2, captain, commander, div chiefs, asst chief, chief. We have Rescue and Tactical to shoot for as well. People that work here say its crazy busy, some days are but it seems to be exaggerated in my mind most of the time. I am also from New England, and I love Austin. Am I happy here? Sure in some ways, it will get better, just a matter of time. Every place has its problems, but this is a good place to work regardless of the stuff going on. Fun city, and good partners for the most part. Huge variety of calls. Great benefits, and our retirement will be fixed soon.


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## NomadicMedic (May 13, 2015)

I thought it was an interesting read, maybe a bit biased.  I was hoping you'd offer an opinion.


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## Tripletwo (May 13, 2015)

Thanks for the honest answer Chewey.  people here are the same way, they exaggerate how busy we are and will forever find a reason to complain.  I dont mind starting as a basic even though I'm a paramedic.  To me it's worth it if it means having a career in a good system... And no more snow


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## Chewy20 (May 13, 2015)

DEmedic said:


> I thought it was an interesting read, maybe a bit biased.  I was hoping you'd offer an opinion.



Maybe if I get more time, probably not in open forum though haha.


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## RocketMedic (May 14, 2015)

Cocky is not a bad thing.


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## Carlos Danger (May 14, 2015)

RocketMedic said:


> Cocky is not a bad thing.



Cocky is ALWAYS a bad thing.


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## NomadicMedic (May 14, 2015)

Cocky and confident are NOT the same.


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## RocketMedic (May 14, 2015)

I tend more towards confident myself. ATCEMS's hiring policies present confident, assertive personnel with a challenge: bite our tongues for years while accepting the Kool-Aid in a system similar in all regards to every other "high-performance" EMS system, making lower-middle-class wages in an expensive area, and betting on better-than-average long-term benefits being enough to accept hard limits on our work and professional development.

Take me for instance. I have been a paramedic for six years now. I do not know it all, but I know quite a bit, and more importantly, I know I can handle myself and manage a call. I know the workflow, how to work with people, how to delegate and manage, and how to perform. I'm the man, the chief, the leader. Certainly I also know how to help, assist and advise, but I find myself wanting to lead and do and manage, because my place is (to me) that leader's role. I want things to be done the right way, my way, and I am not bashful or ashamed of it. When partnered or assisting likeminded folk, it is smooth and harmonious- work is being done by two well-trained, likeminded teammates- but those partnerships in places I work in are of my design, because I am the leader of the team and my way goes. I am the paramedic, and I like it that way. Certainly I can and do pick up information, knowledge, techniques and tricks from everyone, but I don't have revelations from peers or need to be precepted or mentored to be functional, competent and confident in any EMS system. Even crazy ones like Presidio would come fairly quickly to me, because I have the confidence and knowledge of how to work and learn already. Systems like ATCEMS, particularly ones with Lots Of Good Hospitals and Protocol Bibles and Limited Prehospital Care, are the kiddy pool of EMS and take about as much practice as learning to wade for me to be confortable, competent and excellent at. Put me in Houston, or Las Vegas at AMR or MedicWest, in Denver, in Albuquerque or Fort Worth or OKC or Austin or San Antonio (Fire EMS or Acadian) or Pafford or Hall or AMR or anywhere where English is spoken and I can hit the ground running. Tell me how I get paid, tell me the door and radio codes, tell me where your protocols are and what QI expects and I can work well. I know how to be a paramedic. 

That's confidence. You call it cocky, but that's because you associate that confidence with what you have always been told is "cocky", dangerous and unstable. It's anathma to the leadership at most "high-performance" systems, because that confidence leads to more than just clinical assertiveness- it leads to a desire to improve our lots in life the easy way, the aggressive way, the American way. It breeds questions, challenges and expectations that can never be met, so it is labeled as recklessness, cowboy, unstable, bad and undesIrable.

Austin-Travis County doesn't want that attitude. They'd rather take someone and train them by repetition until thet only know how to work the ATC way. That's not wrong, but their entire approach relies on deprogramming the habits and attitudes of the Rest of the World and replacing them with the sanctioned, approved thoughts of ATC. New guys who know little or nothing but ATC do well, because they are "the best" and they know it; they can master their systems and promote and perpetuate the myth, legend and mentality and measure themselves with their chosen yardstick to be the best- but they need more than just local new talent to staff and replace, so they reach out and target everyone else's new folks too, in the hopes of getting them before they are set in their ways. Sometimes it works, and they get Chewy20s and other new paramedics and EMTs, lured by the different locale, the promise of Texas-style bigger and better, the organizational structure and the retirement and the illusion of job security. It's tempting, and admittedly objectively better than a lot of other places offer. Me in 2012, fresh out of the Army, patch and pulse and eyes wide open, would have been perfect for ATC- but I went elsewhere. The ATC recruiters don't just get new people though. They get (and sometimes hire) people of all sorts of backgrounds, as they see fit. Sometimes they get experienced people who fit in, who can play the game and bite their tongues or just don't mind the Kool-Aid- but sometimes they get people with initiative, with drive and desire. People like me, who question and eventually get frustrated and stagnant. People like Ryan. 

The reason ATC has so many morale problems is because they are stagnating. In the early years of the millenium or the 90's, they might have been legitimately cutting-edge, but they really aren't any more. The rest of the world has caught up to ATC and surpassed it, so now ATC is just another high-performance urban EMS system.


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## RocketMedic (May 14, 2015)

I reckon a person like me would actually be happier at Hall or AMR or a nowheresville county service than at ATC. Sure, the protocols might leave something to be desired, but there's satisfaction immediately, not "years later".


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## Carlos Danger (May 15, 2015)

RocketMedic said:


> That's confidence. You call it cocky, but that's because you associate that confidence with what you have always been told is "cocky", dangerous and unstable.



No, I'm quite clear on the difference between confidence and cockiness. There's no confusion about that here. My reply was specifically directed towards your rather inexplicable statement that "cocky is not a bad thing".

Confidence is not a bad thing. In fact, it's essential IMO. 

Cockiness on the other hand is, at its best, unprofessional and unappealing. And at it's worst, it's downright dangerous.


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## Tigger (May 15, 2015)

There are many great providers who are both confident and cocky. They provide great care, but receive no support from their coworkers and cannot develop in the system. That attitude is not for me.


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## medicsb (May 15, 2015)

Isn't Austin a nice place to live? Don't most medics want to be busy and see a variety of calls?  It's a busy system, but it's not THAT busy.  They have a career ladder.  They do "community paramedicine".  Protocols seem on-point.  They track outcomes.  They have an involved medical director.  They are a true public service.  They have an academy that they put new hires through.  Seems like they do a lot of the right things that so many here want to see, but yet so many want to tear them down? 

Do they actually live up to the hype?  I don't know.  Probably not, but I doubt any place that many tout as "great" actually live up to the hype.  I recently read an abstract on intubation from one of the EMS' in TX that so many here seem to hold up as a "great" system and the results were abysmal.  Really it just seems that people rebel against any service with good PR, even if the service is ultimately better than most.


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## gotbeerz001 (May 15, 2015)

There is a very real difference between confidence and cockiness. Confident people rarely demand that they be recognized for the awesomeness that flows steadily from their pores. 

Confident people often understand how to weigh out the culture of a given agency, swallow their pride and find a way to fit in. 

Confident people also realize that you have to earn your voice at any new job and 2 years is not a long time to wait before you start trying to change things. 

Confident people can play their role without feeling like they are selling out. 

If you really are as good as you think you are, an agency will find a way to move you up to an appropriate level of service if there is an internal need.


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## RocketMedic (May 15, 2015)

....or you could just go to a place that actually respects you, your professionalism and opinion from the start.

Does a doctor who moves have to work two years as a PA to "earn his voice". An engineer? A plumber or mechanic or pilot or nurse?


If they can perform at a high level, how does retarding them develop them?


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## Tigger (May 15, 2015)

As the saying goes, respect is given and not earned.


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## RocketMedic (May 15, 2015)

Tigger said:


> As the saying goes, respect is given and not earned.



It's not necessarily respect, it, it is the job we were hired to do.


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## Chewy20 (May 15, 2015)

All I get from you @RocketMedic is that you think you are gods gift to pre-hospital care. We get it, you have a drive like no else on this planet. We get it, you would be much happier at some other company. We get it, ATC does not fit your unicorn standards. We get it, you can step foot in any system and hit the ground running. We get it, you believe the morale issues are due to being stagnant (dead wrong by the way). We get it, you do not like the way ATC hires. We get it, you think everyone here is a robot. We get it, you would never work for ATC.

Guess what, no one cares. The only reason I am writing back (this will be the last time I post in regard to anything you say) is because it seriously baffles me that you feel the need to write paragraphs about a place that you have never worked, when people are trying to figure out if they want to work here or not. Let me answer the questions eh? I will tell them like it is, if I have to PM them answers I will/have. Find a new hobby bud, continue on that ever long journey of finding the perfect job so you can finally find some inner peace. Holy crap.


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## Chewy20 (May 15, 2015)

medicsb said:


> Isn't Austin a nice place to live? Don't most medics want to be busy and see a variety of calls?  It's a busy system, but it's not THAT busy.  They have a career ladder.  They do "community paramedicine".  Protocols seem on-point.  They track outcomes.  They have an involved medical director.  They are a true public service.  They have an academy that they put new hires through.  Seems like they do a lot of the right things that so many here want to see, but yet so many want to tear them down?
> 
> Do they actually live up to the hype?  I don't know.  Probably not, but I doubt any place that many tout as "great" actually live up to the hype.  I recently read an abstract on intubation from one of the EMS' in TX that so many here seem to hold up as a "great" system and the results were abysmal.  Really it just seems that people rebel against any service with good PR, even if the service is ultimately better than most.



Yes, Austin is an awesome place to live, it does not get much better from what I have seen (besides the traffic...). No it is not THAT busy. Will you get slammed some days? Yeah, that's why you rotate to slower trucks. My last shift I had one call in 24 hours. Downtown trucks obviously are more busy. Its a city. If you are downtown for a 12hr shift, expect to run 10 calls.

I have plenty of money left over every month to do whatever I want. That coupled with 2-3 day work week, plus tons of vacation time, makes it easy to do the things you want. ATC has problems, just like any other company, ever. In the EMS world, there are a million worse places you could be.


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## gotbeerz001 (May 15, 2015)

RocketMedic said:


> If they can perform at a high level, how does retarding them develop them?


Most issues with employees have little to do with their actual production but rather their attitude. 

It sucks to hire a pain in the ***.... Especially if the only way to shut them up is to go along with their agenda.


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## RocketMedic (May 15, 2015)

Chewy20 said:


> All I get from you @RocketMedic is that you think you are gods gift to pre-hospital care. We get it, you have a drive like no else on this planet. We get it, you would be much happier at some other company. We get it, ATC does not fit your unicorn standards. We get it, you can step foot in any system and hit the ground running. We get it, you believe the morale issues are due to being stagnant (dead wrong by the way). We get it, you do not like the way ATC hires. We get it, you think everyone here is a robot. We get it, you would never work for ATC.
> 
> Guess what, no one cares. The only reason I am writing back (this will be the last time I post in regard to anything you say) is because it seriously baffles me that you feel the need to write paragraphs about a place that you have never worked, when people are trying to figure out if they want to work here or not. Let me answer the questions eh? I will tell them like it is, if I have to PM them answers I will/have. Find a new hobby bud, continue on that ever long journey of finding the perfect job so you can finally find some inner peace. Holy crap.



I tell people my opinions of places because they are completely legitimate impressions about certain agencies. No, I have never and will never work for ATC, but that does not diminish the value of my outsider's view observations. If they choose to consider my opinion, they will. If they choose to ignore it, they will. However (and I know this may be a shock to you) persons of intelligence often weigh multiple sources of information, and although valuable, a new EMT's firsthand insider's view is not definitive or even universally applicable to a paramedic moving to Austin, while another paramedic's outside opinion and advice could be useful.


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## RocketMedic (May 15, 2015)

gotshirtz001 said:


> Most issues with employees have little to do with their actual production but rather their attitude.
> 
> It sucks to hire a pain in the ***.... Especially if the only way to shut them up is to go along with their agenda.



It sucks worse to find yourself at a crappy employer.


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## gotbeerz001 (May 15, 2015)

A (subjectively) crappy employer affects the one...
A pain in the *** affects everyone. 

When I go to work, I am paid to meet the expectations of my employer. The employer is not obligated to accommodate my wishes. While we seem to be concerned about "the best" thing for the pt (also subjective to a degree), an employer is concerned with consistently providing a standard level of care while being able to make a profit. Satisfaction generally occurs when everybody is able to achieve a certain level of what they are looking for. 

It is my understanding that you, in particular, seem to have a difficult time finding that satisfaction while most people here at least operate at an agreeable level with our employers. Coincidence?


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## RocketMedic (May 15, 2015)

You completely miss the point that we are not obligated to settle and accept crappy employers.


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## triemal04 (May 15, 2015)

I don't get it...why would anyone want to listen to the opinion of someone who has never worked for a department, never tested with a department, never ridden along with the department, has no first or second hand knowledge of a department and apparently gets all their information from the news media and similar sources?

Someone who will explain their spotty track record with employers as a consequence of being a "new medic," yet at the same time feel like they are qualified to pass judgement on a department they know little, if anything, about?

Someone who constantly, without fail, goes from a "bad" department to a "good" department only to, within a matter of months, decide that the next department is also "bad?"

Everyone's opinion is legitimate to them; that's what an opinion is.  But that's a far cry from it being an objective, informed view.


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## RocketMedic (May 15, 2015)

triemal04 said:


> I don't get it...why would anyone want to listen to the opinion of someone who has never worked for a department, never tested with a department, never ridden along with the department, has no first or second hand knowledge of a department and apparently gets all their information from the news media and similar sources?
> 
> Someone who will explain their spotty track record with employers as a consequence of being a "new medic," yet at the same time feel like they are qualified to pass judgement on a department they know little, if anything, about?
> 
> ...



Nothing they do, or how they operate, or how they treat people is secret. Plus my concern for your opinion is absent.


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## RocketMedic (May 15, 2015)

And I happen to think it's better to take charge of your life and find a great job than it is to compromise on places that never will be what is necessary. I am entirely satisfied with my work and the course I have taken and don't particularly care for the judgements and opinions of people who only judge people in their bad times.


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## Handsome Robb (May 18, 2015)

So because you disagree with an agency that utilizes civil service and hires all at one level and requires time in the agency to promote you feel that you've the authority to tell people interested in the agency how "bad" said agency is because you, personally, don't agree with the way they hire? 

Yea that makes a lot of sense...


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## RocketMedic (May 18, 2015)

It makes more sense than idolizing them because of PR.


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## Tigger (May 19, 2015)

No one is idolizing them here.

Also, some people want to work at large, "high-performance" EMS systems. You don't. Great. Move forward.


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## Carlos Danger (May 19, 2015)

RocketMedic said:


> It makes more sense than idolizing them because of PR.



FWIW, I don't remember ever seeing anyone "idolize" ATCEMS on this forum. Maybe say positive things about them, but no idolatry that I've seen.

I think it is great that career satisfaction is so important to you. Most of us choose to balance other aspects of our lives with our job, or find satisfaction somewhere outside of our career entirely. Myself for instance......I know I could find jobs elsewhere that would pay considerably more _and_ probably be more enjoyable to me than where I work now. But family and other priorities keep me where I am for now, with a job that is not perfect by any means, but works quite well for me as far as balancing what it important in my life now. I actually count myself very fortunate to have found the position I have right out of school, even though there are probably some others somewhere who would look at where I work and find it completely unacceptable for some reason. Guess how much I care that my job might not be someone else's first choice?

What gives an individual satisfaction is entirely subjective, and many people don't even necessarily count on their jobs to bring them a sense of purpose or satisfaction or accomplishment. Telling those people, essentially, that they are lazy or brainwashed or some sort of a sell-out or that they could do much better if they only cared to look around because they "accept" a situation that you don't personally find ideal is pretty bold and pretty dumb, IMO. It's like telling someone they are wrong for preferring night shifts over day shifts, or even for liking green better than blue.


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## DrParasite (May 19, 2015)

Handsome Robb said:


> So because you disagree with an agency that utilizes civil service and hires all at one level and requires time in the agency to promote you feel that you've the authority to tell people interested in the agency how "bad" said agency is because you, personally, don't agree with the way they hire?


totally off topic, but doesn't Boston EMS do the same thing?


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## Tigger (May 19, 2015)

DrParasite said:


> totally off topic, but doesn't Boston EMS do the same thing?


Yes and no. Boston EMS only hires for EMTs, if you're a paramedic you are welcome to apply but it's not a huge application boost. Most of the new hires are EMTs, and the system is based on many BLS ambulances and a few ALS. So if you happen to be a medic working as an EMT it's not like you're working on a medic and can't function as such, you are on a BLS ambulance with only BLS equipment. When there is a paramedic vacancy they hold an internal paramedic program, I am not sure if you have to go through it if you are already a medic (ala Medic 1 in Seattle).


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## RocketMedic (May 19, 2015)

Boston EMS is another program buoyed by hype and low expectations.


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## gotbeerz001 (May 19, 2015)

RocketMedic said:


> Boston EMS is another program buoyed by hype and low expectations.


Naturally.

I'm surprised you even need to work… I kinda figured you **** gold bars.


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## gotbeerz001 (May 19, 2015)

RocketMedic said:


> Boston EMS is another program buoyed by hype and low expectations.


Have you given considered consulting… Seems strange that you would give away all this valuable  information for free.


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## Chewy20 (May 19, 2015)

He has all the inside scoop over at Boston EMS as well. With probably never stepping foot in MA at all. Listen to his words.

The more you read his posts, the more he sounds like a psych patient, no?


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## RocketMedic (May 19, 2015)

I like how none of you actually possess the faculties to do more than laugh. It really reinforces just how mediocre this industry and some of this forum's members are- stunted, "novel" BLS-heavy systems with good PR are idolized with little or no justification and critical analysis is written off as the rantings of a bitter hermit.

Chewy20, you're a Kool Aid drinking newbie who thinks your selection for a fairly exclusive service qualifies your opinion over all other ones. You literally do not have any experience of value to people smart enough to look around at the world.
Gotshirtz, you're a new California paramedic with a superiority complex becaise you haven't earned the emity of the Internet's legions of wannabes and newbs. Color me impressed by your depth of knowledge.

Remi, I have no idea who you are, but I really don't care. Yes, for me, finding a unicorn is important. I feel far too many of us settle for what we are told is good and justify it by playing up the good and denying the bad. I don't judge people by their employment decisions, but I do certainly feel that some of us brainwash ourselves into accepting a situation, and I think that's unfortunate.


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## RocketMedic (May 19, 2015)

Chewy20 said:


> He has all the inside scoop over at Boston EMS as well. With probably never stepping foot in MA at all. Listen to his words.
> 
> The more you read his posts, the more he sounds like a psych patient, no?



Boston EMS relies on generally short transport times, limited on-scene interventions and robust telephone triage to complete its mission. They do a good job, but are firmly on the "ambulance driver" side of the industry for most patients.


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## RocketMedic (May 19, 2015)

Heck, looking at BEMS protocols, they seem to be just as Mother-May-I as Southern California and very, very limited in what they can functionally do.

Check out that pain management protocol there, for example. Or the respiratory-distress. Or the focus on transporting, with or without ALS. Certainly, it's great service by numbers...but it seems poor for the patients served.


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## gotbeerz001 (May 20, 2015)

RocketMedic said:


> Gotshirtz, you're a new California paramedic with a superiority complex becaise you haven't earned the emity of the Internet's legions of wannabes and newbs. Color me impressed by your depth of knowledge.


I am a new CA paramedic. 
I am not new to working hard, finding satisfaction in my work while seeking out better opportunities. 
I am not new to getting along with coworkers. 

That said, it is only a matter of time before I am no longer a "new medic". The other traits seem to allude people for a lifetime.


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## ExpatMedic0 (May 20, 2015)

This thread had a recent revival. I started this thread in 2012 and my opinion still stands for a variety of reasons. I don't agree with the practice myself. In my opinion it seems to be the opposite of anything "high performance" as your weeding out some of the most knowledgeable and perhaps educated employee's and penalising them as applicants. In theory I suppose this is a heavy handed tactic of training everyone from the ground up the way you want them before there delicate blank canvases  are spoiled by the reality and knowledge of the outside world. I believe some tribes in the 3rd world have the same theory and tactic when it comes to the virginity of their women and various other human rights violations. However, before I stray to far off topic, ACTEMS was also in JEMS, EMS World, and local news papers at the time this article was started for major financial problems, system wide administrative failures, and other huge agency woes. As you may remember that is when this idea came into practice.


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## RocketMedic (May 20, 2015)

Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine. 

If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.

If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.


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## Tigger (May 20, 2015)

RocketMedic said:


> I like how none of you actually possess the faculties to do more than laugh. It really reinforces just how mediocre this industry and some of this forum's members are- stunted, "novel" BLS-heavy systems with good PR are idolized with little or no justification and critical analysis is written off as the rantings of a bitter hermit.
> 
> Chewy20, you're a Kool Aid drinking newbie who thinks your selection for a fairly exclusive service qualifies your opinion over all other ones. You literally do not have any experience of value to people smart enough to look around at the world.
> Gotshirtz, you're a new California paramedic with a superiority complex becaise you haven't earned the emity of the Internet's legions of wannabes and newbs. Color me impressed by your depth of knowledge.
> ...


You would also seem to lack any experience of value when it comes to your previous employers.

Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.

I'm surprised to see that you didn't know that.


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## RocketMedic (May 20, 2015)

Tigger said:


> You would also seem to lack any experience of value when it comes to your previous employers.
> 
> Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.
> 
> I'm surprised to see that you didn't know that.


So, the primarily-BLS service expanded more? Even if most or all of their ALS treatments were on standing order, they would still be blindingly average.


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## RocketMedic (May 20, 2015)

Tigger said:


> You would also seem to lack any experience of value when it comes to your previous employers.
> 
> Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.
> 
> I'm surprised to see that you didn't know that.


My previous employers had some value, but it wasn't beneficial for me to remain there. Even EMSA was, at best, a good place to learn.


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## Tigger (May 20, 2015)

SandpitMedic said:


> You're wrong!
> No, you're wrong!
> You're stupid!
> No, you're stupid!
> ...



I appreciate the sentiment, however we encourage discussion here. Which is precisely what is occurring here.

I don't think I am changing anyone's mind. But I think it's important that people reading this get both sides of the story.


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## Tigger (May 20, 2015)

RocketMedic said:


> So, the primarily-BLS service expanded more? Even if most or all of their ALS treatments were on standing order, they would still be blindingly average.


I don't know. I don't work anywhere near there anymore. Just pointing out that it's hard to get a good grasp of what a service provides solely based on the internet.


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## RocketMedic (May 20, 2015)

Tigger said:


> I don't know. I don't work anywhere near there anymore. Just pointing out that it's hard to get a good grasp of what a service provides solely based on the internet.



However, it's entirely possible to make reasonable evaluations based on their deployment model, general protocols and operational concepts.


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## Carlos Danger (May 20, 2015)

RocketMedic said:


> Remi, I have no idea who you are, but I really don't care. Yes, for me, finding a unicorn is important. I feel far too many of us settle for what we are told is good and justify it by playing up the good and denying the bad. I don't judge people by their employment decisions, but I do certainly feel that some of us brainwash ourselves into accepting a situation, and I think that's unfortunate.



I am a disinterested observer here. For years I worked in some pretty progressive HEMS programs, but EMS is simply a hobby to me now. I couldn't care less what you do with your career or how satisfied or dissatisfied you are. 

I'm just telling you, the constant berating of everyone else's career choices is wrong on several levels, and it really makes you come across as an arrogant prick. If you really want to help people find career satisfaction, there are ways to do it. If you just want to be a whiny know-it-all who no one takes seriously because your response is the same to every question, just keep doing what you are doing.


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## Chewy20 (May 20, 2015)

Smh.

Someone at least tell me where I get those patches he is talking about. Our shirts are only allowed to have the state and the department patches, and the other shirt only has department logo and personal name. I wanna be tacticool so bad.

Let the little ginger hobbit go back to his hole.

If someone has a question PM me, if you want. Now, back to being an ambulance driver.

@Tigger doubt it says anything about BLS being able to use Narcan etc. at our old service...but hey, he knows.


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## Burritomedic1127 (May 21, 2015)

RocketMedic said:


> Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine.
> 
> If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.
> 
> If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.



So putting 10 stickers on a patient and potentially starting an IV make you a clinician? The best tool any clinician can have is a killer physical assessment, whether basic, medic, RN, PA, whatever role. 

The assessment is the bread and butter and everything else after that is to help narrow findings off your assessment. 

To say that high volume and short transport BLS providers are just drivers, solidifies to me how unconfident you are as a provider, using cockiness to overcompensate. 

Wouldnt normally respond to something like this but being that i work in a high call volume area of one of the states where you dont know your *** from your elbow i had to chime in. Basics with strong assessments can be more helpful that dingleberry paragods who uses the monitors and drop huge IV lines brah.

Strip everything down company, trucks, pay, patches, level, ego, call volume, transport time, tools like monitors etc, all we should be doing is an good solid assessment. 

Giving you advice: dont be that guy


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## RocketMedic (May 21, 2015)

Burrito, you miss the point entirely.


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## Burritomedic1127 (May 21, 2015)

No i really dont though. Saying people shouldnt work at places in high call volume/short transport areas because it turns them into just a driver and not a clinician is ridiculous.


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## Burritomedic1127 (May 21, 2015)

Just saying man is that people dont want to hear someones opinions who hasnt worked in a area with a certain company. Its like a fart with the windows locked, a bunch of hot air. I could say x, y, and z ambulance company are terrible because of yadda yadda yadda but it doesnt hold any weight/validity because I never worked for x, y, and z. Everything else is just gossip, BS, and misinformed opinions. Unless you work or haved worked for the said companies, I wouldnt deter someone from working there and making their own opinions. Just looking out for people


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## RocketMedic (May 21, 2015)

Burritomedic1127 said:


> No i really dont though. Saying people shouldnt work at places in high call volume/short transport areas because it turns them into just a driver and not a clinician is ridiculous.



That's not what I am saying. I am pointing out that the model they maintain encourages minimal standards amd intervention.


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## Chewy20 (May 21, 2015)

RocketMedic said:


> That's not what I am saying. I am pointing out that the model they maintain encourages minimal standards amd intervention.



I am seriously the biggest idiot in here, because I try and not reply to you. Your last sentence is pretty far fetched though. The standards are pretty high here, and if you are talking about protocols, well then I do not know because I have not worked for another real 911 system. Ever since my first day our Medical Director has said, "You are expected to be a clinician, not a technician." A little cheesy? Sure, but I found it to be true, and I had to study my *** off in pathophysiology to meet his standards, or I would not have received my credentialing after FTO time. Which is a face-to-face interview with one of the MDs about medical. So to call me (or anyone really) a "little basic" makes you the person no one wants to work with. I promise you no one on here would want to work a shift with you (we know you do not care, I feel bad for you coworkers who have no choice though). My knowledge base has increased a ton from the date I started working here, because of here. Do I know everything? Nope, I am not you, so that would be impossible. Also, I do not "get excited" about much in EMS, nevermind narcan bud. Does that mean I will leave EMS? Who knows. About the interventions, if there is an intervention that NEEDS to be performed it is performed, whether it be critical, or for pain management. We have never rushed off scene once unless it called for it. Being new, I have tried to get the patient in the truck, only for my FTO to say, "Do you have at least 3 differentials yet? Is there anything more we can do?" We stay on scene until we no longer have anything more to go off of. So, that's all I will say about that narrow minded comment.



RocketMedic said:


> If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count



Lol where do I start here? Do certain people have more titles? Yes, they earned them, they are not noticeable anywhere except for telestaff except for you rank. Patches? We are not allowed to put patches on anything. Our white shirt has the state and department, that's it besides name and badge. Our blue shirt has only department logo and personal name. Does that solve that issue for you? Near living-wage? Like I have said before I live in the city and have plenty of money to do things out of work and go on vacations. Whats wrong with being on a bike, tactical, rescue or a community health team? They tried out for those and earned a spot. They are not just titles, our rescue and tactical always training and tactical is always on calls with SWAT. Rescues come unexpected obviously, but some are deployed to other parts of state due to the severe weather lately. Big rigs? You know everyone here absolutely hates being in our reserve trucks right (the "big rigs"), of course you did. Long hours, we work 48 hours a week. More than likely going to 42s for same pay. Pretty sure that's the norm.

You literally have zero to say about any department. You can have questions and opinions, that's it. 

How about this? I come to your department for a ride out, more specifically request one with you. I would love to see what a REAL paramedic does. More importantly I would love to see other peoples opinions of you. Hey who knows, maybe we can get through the day and you will blow my mind with your awesomeness and I will praise you and buy you a beer. Or throw my head through a wall. 50/50. 6 years of experience as a medic you have? It would be my honor.


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## RocketMedic (May 21, 2015)

Chewy20 said:


> I am seriously the biggest idiot in here, because I try and not reply to you. Your last sentence is pretty far fetched though. The standards are pretty high here, and if you are talking about protocols, well then I do not know because I have not worked for another real 911 system. Ever since my first day our Medical Director has said, "You are expected to be a clinician, not a technician." A little cheesy? Sure, but I found it to be true, and I had to study my *** off in pathophysiology to meet his standards, or I would not have received my credentialing after FTO time. Which is a face-to-face interview with one of the MDs about medical. So to call me (or anyone really) a "little basic" makes you the person no one wants to work with. I promise you no one on here would want to work a shift with you (we know you do not care, I feel bad for you coworkers who have no choice though). My knowledge base has increased a ton from the date I started working here, because of here. Do I know everything? Nope, I am not you, so that would be impossible. Also, I do not "get excited" about much in EMS, nevermind narcan bud. Does that mean I will leave EMS? Who knows. About the interventions, if there is an intervention that NEEDS to be performed it is performed, whether it be critical, or for pain management. We have never rushed off scene once unless it called for it. Being new, I have tried to get the patient in the truck, only for my FTO to say, "Do you have at least 3 differentials yet? Is there anything more we can do?" We stay on scene until we no longer have anything more to go off of. So, that's all I will say about that narrow minded comment.
> 
> 
> 
> ...



Oh, I used to believe that. This time a year ago, I would have said the same thing about EMSA. Then I found out what those buzzwords, metrics and all that jazz really meant and how it was treated, and it resulted in me ping-ponging around until I found a place that is finally better. You're more than welcome to come over for a rideout. We work very similarly to how you describe ATC, and I would enjoy the opportunity to change your mind and show you the world outside Travis County. 

Before you get all high-and-mighty though, do yourself a favor and try EMS in some other settings and contexts. Do a few shifts with Acadian or AMR. Explain to QI why it's not unreasonable or outside of protocol to medicate abdominal pain or avoid a spine board, or why you have the company's highest fentanyl administration rate, at 12% of your patients. Work with a good ole' boy EMT-B older than you that thinks it's acceptable to throw tantrums when you shoot down the plan to "take a nap" before you take a transfer. Work with coworkers who literally believe that sickle-cell is fake, that PID isn't a thing, that every trauma needs 14s and diesel alone. Work with an ******* who thinks a child's fear of needles overcomes both parental informed and implied consent and medical need. 

As for job-hopping- Go work a little outside of your insulated enclave and tell me why it's bad to jump through mediocre jobs in search of one that doesn't consume you. Go try and work for AMR at 35k a year, or Acadian at 37k, or even Washington County at 38k a year on a fixed 24/48. Go work for Acadian San Antonio and see if it's all you can do. If you enjoy that, feel free to belittle me- but if you want more, than you should probably shut up now.

Yes, I judge ATC by the lens of experience I have had in similar systems. Is it entirely fair or accurate? Probably not, but I feel the fundamentals are accurate. Frankly, Chewy, I look at your system and I see the setup for the exact same thing.


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## Tigger (May 22, 2015)

I have removed the comments that have nothing to with the discussion. I like the discussion, I do not like the tone. I am also guilty of snark here, but this is where it stops. Some us could use a lesson in tact now and again. 

Also, the report button. It's a thing.


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## Chimpie (May 22, 2015)

Thread has been cleaned up again. Keep it on topic (see original post or thread title) or it will be closed permanently and warnings/bans will be issued.


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## MedicSansBrains (Aug 28, 2015)

ExpatMedic0 said:


> Why would a new medic have this attitude? This system is forcing paramedics who want to work for ATC to first be hired as EMT-B's, this will only bring you new medics. Why would a good, well paid, Paramedic with 10 years of experience, possibly a family and financial obligations, come to this system to work as an EMT-B for far less salary. Especially for unknown period of time? Can you please tell me that? This is now what we call "a good ol boy system"
> 
> I am the person who started this thread and you can see next to my name that I have been posting on this EMS forum for over 7 years. In actuality I have been in EMS for close to 10 years, a Paramedic for a good portion of that, and now completing my undergraduate degree in Paramedicine.
> 
> ...


I do not work with ATCEMS yet but I'm in paramedic school in Austin (Austin Community College) where of course these details about ATCEMS are discussed. Many of my professors are ex-ATCEMS medics or current medics, FTO's, Captains, and even Commanders. 

1. Everyone, no matter your experience or certification (of course you have to be an EMT), is being hired as a Medic I with a BLS scope of practice. 

2. You are kept in this position for approximately 1-2 years or until you receive your EMT-P. 1-2 years is the answer you're looking for I believe. That's accurate and what I've learned talking to them, current medics, and higher ranks. 

3. The change from dual paramedic to EMT/Medic trucks was done by the medical director. The medical director has many reasons he says he did this but the important point is this. 

*It's being done to prepare the system for BLS ambos and ALS ambos, seperate. 
*
Whether or not that is still the case I'm unsure. However, that is the stated purpose for the move by the Medical Director and the Chief. The idea being that most calls in our system are BLS and there are many abusers and taxi rides because there is a very large homeless population in Austin which you'd have to live here to understand the dynamics. 

In the interim Paramedics who were being worked very hard to begin with have to do so now with only one set of ALS hands on board increasing their level of stress and responsibilities. From the medics I've talked to, on my rideouts etc., this is their main complaint of the current Medic/Basic trucks. 

That being said there are always going to be discrepancies and speculation as to the expressed purpose of policy and the real intention. Reading between the lines is a great skill but can lead to soothsaying and palm reading so I won't participate. 

There is recent talk among medics, which is gossip of course, of them changing the "probationary" 1-2 years for Medics back to being a true probationary/training period and practicing as an EMT-P from the get go. It is gossip to be sure and no one but the tops know of course. 

I also suspect there's a protectionist aspect to it all as well, speculation purely.

Austin is under so much pressure, not just in EMS, from the relentless growth from people moving here for music, money, culture etc. I'm an Austin native and when I tell people that they always tell me "wow you're rare" and it kinda pisses me off. Rant. 

This growth in demand has caused Austin EMS a lot of problems and the higher ups are trying to deal with it even if you might think it is hindering your ability to work or live here. Not being sassy just trying to let you in on some of the dynamics of Austin. I care very much about my city and it's people and now about its medics. Forgive my perceived xenophobia but if you were interested in moving here there's a complex endemic culture shock that is loosely connected to the subject at hand. 

If you would like to live in Austin and don't want to work as a basic in a very overworked system I would highly suggest working for WilCo or San Marcos/Hays Co. WilCo is the neighboring county to the north of Austin and San Marcos/Hays Co is to the south. They are both really considered Austin area and many of the people working there live in Austin. They are both very great systems, many of my profs and instuctors are from there, and I've done many rideouts with both. I will be applying to all three when I graduate because they all have their ups and downs and cultures but in the end are representative of systems striving to serve their communities and make a good name for the profession. 

If you have anymore questions specifically about Austin or the neighboring counties I can help with what I know and ask my professors and medics what the deal is.


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## MedicSansBrains (Aug 28, 2015)

medicsb said:


> Wut?  No where near a good measure?  C'mon.  We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs.  Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system.  For something we consider to be so easy to manage, many seem to not do it well.  Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems.  If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.
> 
> It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.
> 
> It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.


If you think Cardiac arrest survival rates are a good measure then ATCEMS is a great place especially considering they invented the pit crew method which has been the largest bump in survival rates since CPR was invented. Almost every system has adopted what was created my Austin medics. The only thing beyond this that has been shown to increase things further is bystander cpr and hypothermia.


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## MedicSansBrains (Aug 28, 2015)

marshmallow22 said:


> Yeah, I realize that pensions are under attack, however CA and NV based a lot of theirs on the housing market with mortgage backed securities and the tax revenue generated from those highly inflated home values.  The bubble burst and so did CA and NV's pension system.  Texas has one of the strongest economy's in the nation and did not have a fraction of "the bubble" that CA and NV did.  And yes, I also contribute to my 457b plan.  Yes, compared to other jobs that I've had in the past, this by far is the easiest, and most fun.  So I do not mind putting extra hours, especially if I want to enjoy some of the nicer material things now and then.


Also, Austin is one of the only housing markets that experienced growth in the "recession" of '08. Austin's economy is specifically unrelenting.


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## MedicSansBrains (Aug 28, 2015)

46Young said:


> We'll use $30/hr since virtually none of us are or will be officers in EMS. Our basic FF/EMT's top out at $81k, or $27.88/hr, plus the incentives for medics that I've mentioned previously. techs $85k @ $29.21/hr, Master techs $89k @ 30.67/hr, Lt $97k @ $33.60/hr, and Capt I $113k @ $38.81/hr. for each of these positions that are 56 hours and not 40 hour day work, add 1.5 hrs x 52 weeks (the 3 hours OT per FLSA). For example, the FF gets an extra $2,174, and the Capt I gets an additional $3,027.
> 
> So, you haven't mentioned any additional pay, only $30/hr (a happy medium between field medics and Capt's) for 40 hrs and 8 hours @ $45/hr . That's $82,920/yr, for a $57,214.80/yr pension, plus $286,074 in the five year DROP assuming no COLA's. Pretty stellar for EMS. That's pretty good for a fire department as well. Charleston County EMS had a paltry 1.8% multiplier @ 28 years with a three year TERI (DROP), which they're apparently doing away with, and their top-out pay is under $70k, for comparison's sake.
> 
> ...


Bro, it's on the web site for christs sake. Civil service pay scale. Quit beating him up http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf


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## MedicSansBrains (Aug 28, 2015)

46Young said:


> The abundant OT you're talkng about (Marshmallow), 80 hours or so on a paycheck when OT is typically slow (Oct-Nov), suggests to me a few possibilities:
> 
> There is high turnover, which results in lots of vacancies
> 
> ...


Austin FD has a 1 year academy... ATCEMS has an 8 week academy and 3 months of third person.


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## 46Young (Aug 29, 2015)

MedicSansBrains said:


> Bro, it's on the web site for christs sake. Civil service pay scale. Quit beating him up http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf



I was unable to find that doc. before making that post. Several pages of search + different keywords didn't reveal that doc.To use my region as a comparison, Alexandria Fire/EMS has single role medics that start at  around $50k/yr. To have the same standard of living in Austin, a medic would need to make $33,848, so the ATC-EMS starting pay of $39,621.60 (base + 2 hrs OT/wk) would be decent for a single role medic:

http://www.payscale.com/cost-of-liv...Emergency-Medical-Technician-(EMT)--Paramedic

$50k/yr isn't much for the greater D.C. area though. Our firemedics make low $50's in the academy, with a small bump for for months while on ALS internship, then they're making around $73k/yr. They would need to make $49,418 to have the same standard of living:

http://www.payscale.com/cost-of-liv...Emergency-Medical-Technician-(EMT)--Paramedic

Austin pays way better than EMS or fire/EMS in the Southeast (except CCEMS), that's for sure. Last I checked, Charleston County EMS (SC) started medics at $39k/yr, up to $46k/yr after six months and promoting to Crew Chief (can work with a basic). They abolished 24 hr shifts, and went to 12's, for a 42 hr workweek. Other places are holding on to the 24/48, and paying medics like $12-$14/hr if they're lucky.


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## 46Young (Aug 29, 2015)

RocketMedic said:


> Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine.
> 
> If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.
> 
> If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.



They seem to have some sort of career ladder, which is more than I can say for most places. The pay seems appropriate for the cost of living in Austin, which is also more than I can say for most places. Their pay is based on a 42hr workweek, which is refreshing, since most EMS employers can't manage to pay what ATC-EMS does, and they have 48 or 56 hour schedules! I made less than $12/hr at Charleston before I left. Before I went fire based EMS, and went to Charleston, I would have applied to ATC-EMS if I knew about them. 

Many EMS systems seem to favor EMT/Medic over a tiered system with dual medic units. For example, my department went to all 1&1 units recently. I don't like the medic/EMT setup, as I feel that the new medic's learning curve will be severely blunted due to running mostly BLS, but the all-ALS fleet saves $$$. 

Austin is a populous city, with low socio-economic system abusers just like any city, so EMS is going to be busy there. Since they have a 42 hr. workweek and not a 56 hr schedule, high call volume is appropriate. Also, being in an urban environment where the hospitals are typically less than ten minutes away, I wouldn't expect the protocols/guidelines to be as progressive as a department in a rural area with long txp times. 

With an urban system there's always a balance between load and go, and stay & play. Critical patients will typically get worked on-scene, a 12-lead will be obtained within 5 mins. of pt. contact when the 12 is indicated, but for the less than critical pts, I'll get an assessment/pertinent diagnostics, and begin interventions enroute . If some things don't get done, they don't get done. Calls are holding, and the pt. isn't going to have any change in outcome by going in the ambo, so if I don't get the line for the nurse because we had a 5 min. txp, then too bad. I'll stay and play for pain management, unless it's one of my known seekers, in which case I take my time setting up for a line, and finish it as we pull up a the ED. If the patient isn't in any acute distress, and I'm satisfied that they are stable, and clear for 12-lead and stroke assessment, I just want to get the call over as quickly as possible. The longer I take, the more times second due units will need to cover my response area. Urban, busy systems need to be efficient. We can't stay and play all of the time. We really are nothing more than transporters for many of our patients.

As far as looking to change the system your first month on the job, it takes time to develop your reputation before you have any sort of leverage to effect change. No one's going to pay much attention to the rookie. Being overly outspoken and negative about a new employer's way of doing business will get you on everyone's s*** list really quickly. A more realistic approach is to do your homework before taking the job. Forums like this can be helpful, but the best way to learn about the system, especially if you're flying in for an interview and assessment, would be to meet with employees, buy them lunch or dinner, possibly even schedule a ride-a-long, and learn how things work from actual employees, not random internet people. 

If you think the grass is greener and leave for another system, and find out that it's not to your liking, it's best to remain quiet and look for a new employer. Continue to follow the rules, and leave when the opportunity arises. I left NY for a better retirement and environment, found Charleston (in 2007, may be different now) to be undesirable to me, and just kept quiet until my present employer offered me a job. I just told CCEMS that I was moving back up north. They just assumed that I returned to NY, IDK. Basically, a rookie or two year guy isn't going to change the system; it's better to leave. Also realize that the same place may be another person's dream job.


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## Chewy20 (Aug 29, 2015)

46Young said:


> Their pay is based on a 42hr workweek



ATC is not based on a 42. ATC is based on a 48 hour week for field medics. There are a couple trucks that are on a 42 hour schedule as a trial right now. The new work week is in the talking and voting stages right now.

I am hoping to get on a 42 hour week due to not liking 24s. Plus the OT rate it higher.


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## MedicSansBrains (Aug 29, 2015)

46Young said:


> They seem to have some sort of career ladder, which is more than I can say for most places. The pay seems appropriate for the cost of living in Austin, which is also more than I can say for most places. Their pay is based on a 42hr workweek, which is refreshing, since most EMS employers can't manage to pay what ATC-EMS does, and they have 48 or 56 hour schedules! I made less than $12/hr at Charleston before I left. Before I went fire based EMS, and went to Charleston, I would have applied to ATC-EMS if I knew about them.
> 
> Many EMS systems seem to favor EMT/Medic over a tiered system with dual medic units. For example, my department went to all 1&1 units recently. I don't like the medic/EMT setup, as I feel that the new medic's learning curve will be severely blunted due to running mostly BLS, but the all-ALS fleet saves $$$.
> 
> ...


42 hour work week is for the Comms medics. Scroll down and you'll see it 48 in the field.


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## 46Young (Aug 29, 2015)

Chewy20 said:


> ATC is not based on a 42. ATC is based on a 48 hour week for field medics. There are a couple trucks that are on a 42 hour schedule as a trial right now. The new work week is in the talking and voting stages right now.
> 
> I am hoping to get on a 42 hour week due to not liking 24s. Plus the OT rate it higher.





MedicSansBrains said:


> 42 hour work week is for the Comms medics. Scroll down and you'll see it 48 in the field.



Even with a 48 hour workweek, the pay in Austin is still better than most places south of Northern Virginia down to Florida.

Who is voting for a 42 hr workweek? Is it the employees, is it supervision, or is it the local politicians? On the one hand, a 42hr workweek is shorter, and has a higher hourly rate (and a higher OT rate), but you'll be at work more often, and OT opportunities will be reduced. On the other hand, people who work 24's may like making less commutes to work, and may want to live further away from work. Alexandria Fire and EMS, for their EMS division, has a 42 hr workweek, but it's 24's. One on, two off, one on, four off. Some employees live 2-3 hrs away with that flexibility. 

That's one thing I had to get used to after leaving NYC, the longer scheduled workweeks. After working for Charleston, I learned to look at what the hourly pay was, rather than the yearly pay. $45k/yr (medic after six months at Charleston in 2007) sounded really good, until I saw that it worked out to less than $14/hr. I find it exploitative for employers to have 56 hour schedules, and even 48 hr schedules, unless the base pay before OT was decent, approaching $20/hr outside of the Northeast. Employers get around the low pay by using a schedule that has built-in OT, which saves them money, and distracts you from the low hourly pay.

For example, a new hire at ATC-EMS on a 48 hr schedule is making around $33k/yr, and works a mandatory 8 hrs of OT each week. It's still better than the Southeast, but it's still not much to live on, unless you're single and renting a studio, or splitting the rent with a few roommates. For comparison's sake, Austin cops graduate the academy making $57,530/yr, and top out at $93,402/yr:

https://www.austintexas.gov/page/benefits-and-salary

Fire does pretty well also. Are they 56hr people?

http://joinafd.com/benefits-summary

EMS typically comes in third when compared to fire and police in most places. I made more than fire and police in Charleston, but that is atypical


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## 46Young (Aug 30, 2015)

Question, what is "Comm" as part of the job title mean? Also, I understand EMS MEDIC I to be BLS, and MEDIC II to be a medic. What does an EMS Capt. do? Is it like a station commander, or is it a true supervisory position?

http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf


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## 46Young (Aug 30, 2015)

Also, just curious, how many employees are there overall, and how many Capt. and Commander positions are there? I'm just trying to get an idea of what the advancement opportunities are like. How does the promotional process work? Is there a test/oral interview, where you're scored and then put on a list that's ranked by score? Is this assessment and scoring performed by a third party, to avoid any favoritism? Or, do they just promote who they like best?

Edit: And discipline, how does it work? Is it progressive step discipline? If so, do employees receive the same punishment, and the same leniency as the case may be, as was given to previous employees? Or, is everyone treated differently even though it's a similar offense? These are things a prospective employee may want to know.


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## Chewy20 (Aug 30, 2015)

46Young said:


> Even with a 48 hour workweek, the pay in Austin is still better than most places south of Northern Virginia down to Florida.
> 
> Who is voting for a 42 hr workweek? Is it the employees, is it supervision, or is it the local politicians? On the one hand, a 42hr workweek is shorter, and has a higher hourly rate (and a higher OT rate), but you'll be at work more often, and OT opportunities will be reduced. On the other hand, people who work 24's may like making less commutes to work, and may want to live further away from work. Alexandria Fire and EMS, for their EMS division, has a 42 hr workweek, but it's 24's. One on, two off, one on, four off. Some employees live 2-3 hrs away with that flexibility.
> 
> ...



Mix of all voting for the schedule I believe. You'll have the option to work a 42 hour work week or 24s still when the new schedule is voted in, if ever. We start at 38k and bump up to 40k at your one year mark. Not bad for a basic. Also, I live alone in a non-studio apartment and have plenty of left over money to do as I please. Yes APD is paid a lot more. They hit 70k base rate after two years. They also have a massive budget. Yes I believe AFD is on 24-72s.


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## Chewy20 (Aug 30, 2015)

46Young said:


> Question, what is "Comm" as part of the job title mean? Also, I understand EMS MEDIC I to be BLS, and MEDIC II to be a medic. What does an EMS Capt. do? Is it like a station commander, or is it a true supervisory position?
> 
> http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf


 
Comm medics are strictly dispatch. Captains have their stations to look after, are also FTOs. They run calls just like everyone else unless they are in out-of-field gigs like the academy or CE. Our commanders are the field supervisors.


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## Chewy20 (Aug 30, 2015)

46Young said:


> Also, just curious, how many employees are there overall, and how many Capt. and Commander positions are there? I'm just trying to get an idea of what the advancement opportunities are like. How does the promotional process work? Is there a test/oral interview, where you're scored and then put on a list that's ranked by score? Is this assessment and scoring performed by a third party, to avoid any favoritism? Or, do they just promote who they like best?
> 
> Edit: And discipline, how does it work? Is it progressive step discipline? If so, do employees receive the same punishment, and the same leniency as the case may be, as was given to previous employees? Or, is everyone treated differently even though it's a similar offense? These are things a prospective employee may want to know.



I think we are between 400 and 500 sworn personnel. No idea how many captain positions there are. But there's a bunch. We have 5 district commanders on at a time. Not sure how many actually hold the rank, but again there are numerous different positions outside of the field as well. 

To promote you have a written and oral done by 3rd party for captain and up. It's based on scores. No favorites. 

To promote to medic 2 you have to be paramedic certified and be here for 3 years to be eligible. Although we have had to waiver the time in length due to shortages. You're looking at about a year as of now. My academy just missed the 1 year cutoff for sept so they will test in January. The test is written and then you go through a 16 week academy 1-2 days a week to promote to Medic 2. 

Things are really looked at on a case by case basis. Unless you do something agregious, you will be educated and told not to make the same mistake twice. We have a whole investigations department when it comes down to all that. Usually you are pulled off the truck until everything is sorted out, unless it was something minor and you will just get a write up.  Hope I answered most questions. I'm on my phone. So grammar may be in the woods.


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## MedicSansBrains (Aug 31, 2015)

Chewy20 said:


> I think we are between 400 and 500 sworn personnel. No idea how many captain positions there are. But there's a bunch. We have 5 district commanders on at a time. Not sure how many actually hold the rank, but again there are numerous different positions outside of the field as well.
> 
> To promote you have a written and oral done by 3rd party for captain and up. It's based on scores. No favorites.
> 
> ...


Wow I did not know the promotion period from I to II was three years technically. That's just on paper right? I understood it to be 1-2 years in practice. Correct?


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## Chewy20 (Aug 31, 2015)

MedicSansBrains said:


> Wow I did not know the promotion period from I to II was three years technically. That's just on paper right? I understood it to be 1-2 years in practice. Correct?



The civil service contract says 3 years. Like I said we are in need of people so they were able to waive the time period to a year. Not sure if that will be the new norm or just until they fill seats.


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## TransportJockey (Sep 1, 2015)

Supposedly the current academy class fills all empty ATCEMS slots... so it'll be interesting to see if they keep waivering that...


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## teedubbyaw (Sep 1, 2015)

http://www.dailytexanonline.com/2015/08/31/austin-travis-county-ems-faces-staff-shortages


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## TransportJockey (Sep 1, 2015)

They hit on why myself and quite a few experienced, or even new, medics will not apply to work there. Well that and the nearly 10k pay cut I would take to work there as Medic1


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## teedubbyaw (Sep 1, 2015)

As much expendable money that ATCEMS has, they sure could learn to use it differently.


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## 46Young (Sep 1, 2015)

Chewy20 said:


> I think we are between 400 and 500 sworn personnel. No idea how many captain positions there are. But there's a bunch. We have 5 district commanders on at a time. Not sure how many actually hold the rank, but again there are numerous different positions outside of the field as well.
> 
> To promote you have a written and oral done by 3rd party for captain and up. It's based on scores. No favorites.
> 
> ...



Answers a lot, thanks!


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## Chewy20 (Sep 1, 2015)

TransportJockey said:


> Supposedly the current academy class fills all empty ATCEMS slots... so it'll be interesting to see if they keep waivering that...



It may fill "seats" but they do nothing to help the medic 2s. If they don't change the 3 year plan for good, then they will need to start hiring paramedics as paramedics again. The majority of that academy is basics. Which is a huge change from previous academies.


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## 46Young (Sep 1, 2015)

teedubbyaw said:


> http://www.dailytexanonline.com/2015/08/31/austin-travis-county-ems-faces-staff-shortages





TransportJockey said:


> They hit on why myself and quite a few experienced, or even new, medics will not apply to work there. Well that and the nearly 10k pay cut I would take to work there as Medic1



The problems with ATC-EMS with the exception of mandatory EMT-B scope coming in, is similar to Charleston County EMS circa 2008. Charleston and ATC-EMS shared frequent forced OT, having to be on call twice per month (CCEMS was only for 12 hrs), with the forced OT being due to copious employee turnover. It's no fun being held for an additional 24 hrs after having worked a busy 24. Being mandated to be on-call without a stipend to compensate for the inconvenience of having to be available (can't travel or consume ETOH for example) is unreasonable.

Charleston had 24's and 12's 24's were 24/48 w/o Kellys, and the 12's were 3on/2off/2on/3off, twice on-call for 12 hrs. monthly, 48 hr limit on consecutive work hrs. Charleston has since gotten their act together, and now has a 42 hr work schedule with only 12 hr shifts for everyone, 16 hrs. cap. Read about it here:

http://www.postandcourier.com/article/20150307/PC16/150309543

For the ATC-EMS people, perhaps you could reference what Charleston County did, and use that to get ATC moving in the right direction. Talk to their people. Really, going to a 42 hr schedule should not be a problem for ATC. They already have fire on that schedule. They pay police and fire way more than EMS, so finances should not be a reason against the additional hiring needed to fill the new vacancies.

From working in Charleston, I can infer that ATC-EMS high turnover rates are due to the holdovers, recalls to duty, while making less than police and fire (how many do you lose to police and fire every year?), while working in a very busy system. Add to that being restricted to BLS, which also lowers their hourly rate until they can "promote" to medic. Single role EMS is always subject to high turnover, but it seems particularly dire in ATC. Is that accurate?


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## 46Young (Sep 1, 2015)

The medic 2's are probably taking the worst pounding since they can only fill medic vacancies.


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## Chewy20 (Sep 1, 2015)

46Young said:


> The medic 2's are probably taking the worst pounding since they can only fill medic vacancies.



We are on call once a month, and it is a couple days after your last shift. We are paid a certain amount of money while on call per hour, then if you get called in you immediately start receiving OT pay and you have two hours to get to the station. So travel as you like, but you need to be there in two hours.  Medic 2s can fill both medic 1 and 2 slots. Sure we may complain a bit when called in, but it does not bother me. We work 2-3 days a week. What's one more day a month. 

I haven't heard about anyone leaving here due to the hours. You can't work an OT shift once a month? People know the deal during academy. They don't like it they don't have to work here. Eventually the plan is to terminate the on call list but we are not in the position to do that right now. 

We need more trucks. Plane and simple. Supposedly we just asked city council for 8. Which would be awesome if approved. 

We have a budget of about $60 million, APD is around $283 million and AFD is around $138 million.


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## teedubbyaw (Sep 1, 2015)

Why would you want to work OT when you average 10-20 calls per shift?


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## Chewy20 (Sep 1, 2015)

teedubbyaw said:


> Why would you want to work OT when you average 10-20 calls per shift?



No one wants to be forced to work. But like I said we all knew this before we went out into the field. If you want to quit because of something you knew you were getting into, that's your own fault.


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## 46Young (Sep 1, 2015)

Chewy20 said:


> We are on call once a month, and it is a couple days after your last shift. We are paid a certain amount of money while on call per hour, then if you get called in you immediately start receiving OT pay and you have two hours to get to the station. So travel as you like, but you need to be there in two hours.  Medic 2s can fill both medic 1 and 2 slots. Sure we may complain a bit when called in, but it does not bother me. We work 2-3 days a week. What's one more day a month.
> 
> I haven't heard about anyone leaving here due to the hours. You can't work an OT shift once a month? People know the deal during academy. They don't like it they don't have to work here. Eventually the plan is to terminate the on call list but we are not in the position to do that right now.
> 
> ...



Again, thanks for the info. Is it possible that "The Daily Texan" misquoted Marquardt? You say that you're on call once a month, where he says it's twice a month, . You say "You can't work an OT shift once a month?" Marquardt says that in addition to regular work hours and the twice monthly on-call hours, "they are also being told to work additional hours without notice." How often is mandatory holdover/recall in addition to the on-call hours? When I worked in Charleston, without ever signing up for OT, I was forcibly working18 days per month or more on a 24/48 schedule.Marquardt makes it sound like forced OT is a regular and frequent occurrence, often enough to contribute to turnover and also discourage academy graduates from accepting a position at ATCEMS.

I worked for a prestigious hospital system in NYC, NS-LIJ CEMS, the kind of place that FDNY EMS people were trying to work instead of FDNY. Even there, people left for FDNY Suppression, NYPD, Nassau County PD EMS, Nassau or Suffolk Co. Police, or nursing/PA positions, or an office position by way of an Emergency Management degree. When people leave ATCEMS, do they conduct exit interviews to determine the reason for leaving? Do people typically quit to go to fire, police, or for an allied health position out of EMS? Is it just burnout, where they change professions frequently? Or, are there better paying/slower call volume/better working conditions in other regional EMS systems? High turnover is typically a HUGE red flag against seeking employment for a particular department. What are the reasons for the consistent personnel shortage.

Using the Medic 1 starting pay, having that 48 hour schedule means that you're losing $3.33/hr in OT pay, per hour, than if you were working on a 42 hr. schedule. If you only do 24 hrs/month of OT, that's a difference of $4,155.84, and also realize that you're also working 312 hrs/yr for free (48-42 = 6. 6x52 = 312. If you worked 312 hrs at a rate of $26.58/hr ($17.72 x 1.5, starting Medic 1 42 hr/wk base rate), you would also have an additional $8,292.96. In total, if you work a 48 hr. shift as a rookie, and get mandated to work an additional 24hrs/month, you're losing out on $12,448.80/yr. Now, if the call volume was low enough to allow sleep more nights than not, and you had the time to use the gym, cook, self-study, things like that, you could make a case for the 48hr schedule, but ATCEMS is busy, as a typical muni Third Service in a large city will be. I sincerely hope that you get the eight additional ambulance spots. What does the 48hr ATCEMS scheule look like? Is it a 24/48 with Kellys? Or is it something different?

Also, does anyone know the gist of this podcast? It's 22 mins. long, and features MD Paul Hinchey. Re: 24hr shifts

http://www.emsworld.com/podcast/10914635/ems-2020-podcast-ems-staffing-shift-schedules

There's also a really easy way to make everyone happy - go to a 24/72 shift, just like fire. EMS is busier than fire, so why should the employees work more hrs. for less pay? The people that want less commutes per week can have it, and the base hourly rate will go up. Regarding schedules, perhaps you should suggest to Marquardt to contact Alexandria Fire and EMS. Their single role EMS division works a derivative of a 24/72 (1on/2off/1on/4off), where they start at over $50k/yr, and every bus is double medic. They get mandatory OT as well, but when you are only working 7-8 days/month, a litlle forced OT isn't going to hurt. He should also contact CCEMS if he wants to go to 12's, and perhaps get a cap on consecutive work hrs at 16 straight.



teedubbyaw said:


> Why would you want to work OT when you average 10-20 calls per shift?





Chewy20 said:


> No one wants to be forced to work. But like I said we all knew this before we went out into the field. If you want to quit because of something you knew you were getting into, that's your own fault.



True that. The problem is, according to Marquardt, the paramedic graduates are choosing not to work for ATCEMS. Being restricted BLS for 2-3 years, and having frequent forced OT in the setting of a high call volume 24hr shift would turn me off as well, especially if other regional EMS systems can offer better working conditions. If not to ATCEMS, who are these graduates working for?

It seems that ATC-EMS is your typical muni Third Service EMS - Ok pay, but well behind the other uniformed public safety occupations, high call volume with not enough ambulances, regular work hours far in excess of the standard 40hr work week, forced OT, and high turnover.


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## 46Young (Sep 1, 2015)

I listened to the podcast. All of the detriments of working 24's were noted - disrupted circadian rhythms, errors due to sleep inertia, how the day following a busy 24 can be wasted, how being up for a long time is akin to being intox, the health risks, etc. The Doc. talked about changing staffing to 12's in the busy areas, limiting consecutive holdover hours, putting extra units in-service during peak hrs, things like that. What has changed since that podcast in April of 2013?

Edit: The question of how to hire and pay a fourth platoon (or 25% additional employees) to shorten the workweek was unanswered. It all comes back to cost. The more hours over 40 an employer can get away with, the more money they save on hiring and giving benefits to extra employees, which they would need to have if the workweek was 40 hrs. like it should be. It's easier to keep a shorter schedule from turning into a 48 or 56 hr shift (ask Alex Fire/EMS medics), than it is to shorten a schedule from a 48 or 56. The employer gets used to paying for less employees. That's less medical benefits, less paid time off, less pension burden on them.


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## teedubbyaw (Sep 1, 2015)

24's suck regardless of what system you work for.


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## 46Young (Sep 1, 2015)

teedubbyaw said:


> 24's suck regardless of what system you work for.



A 24/72 isn't bad at all - I can tough it out for one day if I know that I have basically a three day weekend after every shift. Even if I need to sleep in, or sleep half of the next day away to recover, I still have 2 1/2 quality days before my next shift. A 24/48 is the worst, because the first day off you're wasted, and the next day you have to prepare to go back to work. It's even worse when they hold you over for another 12-2 hrs. A 36/36 or a 48/24 is no fun. I've lived that lifestyle before.

I do miss my 16/12/12 shift that I had at my former employer, though. 40hr shift like it should be.


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## TransportJockey (Sep 1, 2015)

teedubbyaw said:


> 24's suck regardless of what system you work for.


Depends. I work a 24/48 Kelly (5 days off in a row every third week) and it's not too bad. But it helps that I'm not in a busy system.


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## teedubbyaw (Sep 1, 2015)

I work 10 days out of the month, and I'm currently at our rural station where on most shifts, I sleep through the night. 24's are not conducive to health. I'd still rather not work 4 days a week


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## triemal04 (Sep 2, 2015)

Chewy20 said:


> It may fill "seats" but they do nothing to help the medic 2s. If they don't change the 3 year plan for good, then they will need to start hiring paramedics as paramedics again. The majority of that academy is basics. Which is a huge change from previous academies.


Has ATCEMS ever officially said why they moved to making all paramedics start off as EMT's and waiting 3 years (officially at least) before moving up?  

I can see some benefits in a targeted ALS system (though a lot of those would be negated by a good and long academy, probationary period, and FTO time) but in a system where paramedics run on every call it makes less sense.  

Any insight?


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## Chewy20 (Sep 2, 2015)

triemal04 said:


> Has ATCEMS ever officially said why they moved to making all paramedics start off as EMT's and waiting 3 years (officially at least) before moving up?
> 
> I can see some benefits in a targeted ALS system (though a lot of those would be negated by a good and long academy, probationary period, and FTO time) but in a system where paramedics run on every call it makes less sense.
> 
> Any insight?



I think they have but I am unsure of the exact reason. Though I believe it mostly had to do with money. Not staffing a truck with two medics when most calls are BLS. Some medics would like to have another ALS provider as a partner when they get to a crappy call and need another hand for interventions. I get it, and sometimes feel bad and want to just hop over and start a line or something. But there is usually a commander at most of the true ALS calls to begin with, or you can request one. Another reason being "it sucks when there's a shift with all ALS and we are doing everything." Yes, it does but I won't let my partner run more calls than me. If I need to make it up next shift, I will. 

Where I'm seeing it be the biggest problem is when the Medic one doesn't know their *** from their elbow and leaves the medic 2 hanging. I refused to be that guy. Plenty of systems have P/B trucks, it's what you and your partner make of it. 

I have heard rumors of eventually going back to all ALS, as history shows. But that's all rumors. Or at least training medic 1s to start IVs etc. 

The medic 2s used to have an extensive credentialing process back in the hay day 5-10 years back.


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## TransportJockey (Sep 2, 2015)

A good credentialing process would help a lot with what they seem to want to do, and open up their candidate pool a bit more to medics who want to work for them but don't want to hire in as m1s


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## Chewy20 (Sep 2, 2015)

TransportJockey said:


> A good credentialing process would help a lot with what they seem to want to do, and open up their candidate pool a bit more to medics who want to work for them but don't want to hire in as m1s



In my opinion it's only a matter of time until they hire medics as medics.


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## chaz90 (Sep 2, 2015)

What do you guys mean by "credentialing"? Is that just a process of becoming certified/licensed at a state or local level after previous national registration?


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## Carlos Danger (Sep 2, 2015)

chaz90 said:


> What do you guys mean by "credentialing"? Is that just a process of becoming certified/licensed at a state or local level after previous national registration?



In the hospital world, credentialing for a MD/DO, PA, or APN is a process where the group or hospital that employs you does a rather in-depth analysis of your education, certification, state licensure, misc credentials (ACLS, PALS, etc.), criminal background check, skills (how many central lines have you done in the past few years? are you really skilled at regional anesthesia?), references, malpractice history, etc. It can take weeks.

I've often wondered why more EMS agencies don't have similarly in-depth processes.


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## Chewy20 (Sep 3, 2015)

chaz90 said:


> What do you guys mean by "credentialing"? Is that just a process of becoming certified/licensed at a state or local level after previous national registration?



After the academy and FTO time we do a skill scenario in front of the academy captains, then we will sit in front of our medical director and he will interview us to see if we are where we need to be knowledge wise. Can be anything from the packet we received in the academy, from operations to patho-phys. If we pass both of those, we are a "credentialed" provider with no restrictions. Our packet was 300-400 questions of fair game for the interview. When paramedics were being hired as medics it was about 800 questions.

Without being credentialed you are not allowed to practice without a captain or FTO on the truck. You have 9 months from the day the academy starts to pass the interview or you'll be looking for another job.


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## NomadicMedic (Sep 3, 2015)

Sounds similar to the DE "out of state" certification process.


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## MedicSansBrains (Sep 7, 2015)

Austin Recently had their budget review. The chief was questioned on why the EMS staff has such a high suicide and turnover rate. He said his budget hasn't caught up to the growth of the city. 

The chief requested an extra 1.6 million dollars in the budget to move the system from a 48 hour work week to a 42 hour workweek. The request was granted so it seems that is the intention moving forward.


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## teedubbyaw (Sep 7, 2015)

Maybe if they'd stop spending their money on ********.


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## MedicSansBrains (Sep 7, 2015)

teedubbyaw said:


> Maybe if they'd stop spending their money on ********.


Like what?


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## teedubbyaw (Sep 7, 2015)

MedicSansBrains said:


> Like what?



Let's start with the overly long academy that spends more time worried about military style PE. 

Bunker gear for every new cadet? Bunker gear that they don't use. SCBA's for every new cadet...again, that they never use. Wet suits for every new cadet...that they never use because they don't do water rescues. 

Their extensive uniform list. Class A's so they can wear at graduation? 

List goes on.


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## Bullets (Sep 7, 2015)

teedubbyaw said:


> Let's start with the overly long academy that spends more time worried about military style PE.
> 
> Bunker gear for every new cadet? Bunker gear that they don't use. SCBA's for every new cadet...again, that they never use. Wet suits for every new cadet...that they never use because they don't do water rescues.
> 
> ...


I was under the impression that bunker gear is required by NFPA to be issued to the individual, so every new hire has to get measured and fitted to be compliant of the allow their employees to work in an IDLH or near an IDLH environment....so car accidents

I doubt they issue a new SCBA pack to every new hire, they probably just issue a mask, which i know is required un NFPA respiratory protection.SCBA masks are also a better choice for respiratory protection becuause they can be on air or with an adapter be on a P100 filter while providing integrated eye protection. Its a more secure method than glasses and a half face or N95.

Who does water rescues in that county?


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## teedubbyaw (Sep 7, 2015)

We don't carry bunker gear...because that's fire's job. 

And yes, they get the masks only, but that's still over $300 for something they don't use, and are the only service around here that has them that I know of. 

Fire does water rescue. ATCEMS has spec ops teams that do water rescue. So, they need wet suits why?


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> We don't carry bunker gear...because that's fire's job.
> 
> And yes, they get the masks only, but that's still over $300 for something they don't use, and are the only service around here that has them that I know of.
> 
> Fire does water rescue. ATCEMS has spec ops teams that do water rescue. So, they need wet suits why?



Another case of not knowing what the hell you're talking about, but it's ok. We are issued bunker gear yes. Not for fires, for pin ins with extended delays to pt care so we can go in the car. We get millennium masks, no SCBA. Which we all just had to turn in since we don't use them. We are not issued wet suites. We borrow them from a local dive shop FOR ONE DAY, while we do swift water training, then they are given back. Makes sense since Austin has major flooding and anyone can get caught up in it, if in the wrong situation. Yes we have rescue teams, so no regular medics are not dispatched to those calls unless standby. Extensive uniform list? Sorry we get more than one uniform a year like some people. Yes we have class A's. So doesn't every other public department. Do fire and PD wear there's all the time? No, but we all wear them at the same events. We did PT one hour a day, every morning, out of 8. Doesn't seem too focused on PT. Nor was it very military like. So in all, yes we have more tools than a private truck. Welcome to public safety. Are there things the department shouldn't be spending their money on? Sure, welcome to public safety. Know what you're talking about before you try and sound all knowing though. Have a good day.


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## teedubbyaw (Sep 7, 2015)

I'm well aware of what your bunker gear is for. Still a waste. 

I have two close friends that went through the academy at the beginning of this year. You're pretty much confirming everything I said, are you not?


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> I'm well aware of what your bunker gear is for. Still a waste.
> 
> I have two close friends that went through the academy at the beginning of this year. You're pretty much confirming everything I said, are you not?



If you are talking about the point where I said money could be spent better? Sure, if you understand that I am not talking about the money on things I listed above...If you understand what the gear bunker gear is for, then how is that fires job that are all BLS?


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## Tigger (Sep 7, 2015)

I don't really see how that is wasteful. It would be nice for the paramedic to have something more than their uniform to access the patient on TAs. Eventually I hope to get my agency a grant to get extrication gear for that reason. If you don't feel that's necessary, by all means. We, and many other places do. We also carry SCBA masks and cartridges to go along with our Ebola suits. I doubt they will be used, but something had to be done and they were in fact the cheapest option from public health.


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## teedubbyaw (Sep 7, 2015)

You're BLS, too. So what are you going to do that a firefighter can't?


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## Chewy20 (Sep 7, 2015)

Tigger said:


> I don't really see how that is wasteful. It would be nice for the paramedic to have something more than their uniform to access the patient on TAs. Eventually I hope to get my agency a grant to get extrication gear for that reason. If you don't feel that's necessary, by all means. We, and many other places do. We also carry SCBA masks and cartridges to go along with our Ebola suits. I doubt they will be used, but something had to be done and they were in fact the cheapest option from public health.



Wait, you mean you employer cares about your well being in the field, waste of money!


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## teedubbyaw (Sep 7, 2015)

Tigger said:


> I don't really see how that is wasteful. It would be nice for the paramedic to have something more than their uniform to access the patient on TAs. Eventually I hope to get my agency a grant to get extrication gear for that reason. If you don't feel that's necessary, by all means. We, and many other places do. We also carry SCBA masks and cartridges to go along with our Ebola suits. I doubt they will be used, but something had to be done and they were in fact the cheapest option from public health.



Do you have an agency with 500+ employees that all get issued scba's and do you think it's a good financial decision to buy that many people personal bunker gear?

Didn't think so.


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## teedubbyaw (Sep 7, 2015)

Chewy20 said:


> Wait, you mean you employer cares about your well being in the field, waste of money!



You stay safe by letting firefighters do their job and get the pt to you. Derp.


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## Chewy20 (Sep 7, 2015)

Did RocketMedic hack this account or something?


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## teedubbyaw (Sep 7, 2015)

Didn't think you'd be able to answer that question.


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> Didn't think you'd be able to answer that question.



About being BLS? We have a slightly larger scope than fire, but that means nothing in MVAs really, but the knowledge base difference is black and white. I have only used it once since being here, but it was needed. Let fire have more hands on doing THEIR job by getting the patient out, while we did OUR job by taking care of the patient. Quit being so hard headed bud.

Can guarantee you if your employer gave you extra equipment, you wouldn't whine about it...


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## teedubbyaw (Sep 7, 2015)

How many extrications have you worked? Being in the way is what we're good at. If fire can't handle ABC's then I don't know what to tell you. As a medic, there may be a slim chance extrication will be so prolonged that we will have to tube them, or needle decompression. But justifying bunker gear for every bls provider in a new company is not really an argument that can be backed.


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## teedubbyaw (Sep 7, 2015)

Oh, and we have brand new bunker gear on our rural units where it would most likely be used, thank you very much.


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> Oh, and we have brand new bunker gear on our rural units where it would most likely be used, thank you very much.



Lol ok, you have a splendid day sir.


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## teedubbyaw (Sep 7, 2015)

You don't have to be angry that I proved my point.


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## MedicSansBrains (Sep 7, 2015)

@teedubbyaw you are a proud troll sir.


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## teedubbyaw (Sep 7, 2015)

Opinions = trolling.

Facts = trolling.


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## triemal04 (Sep 7, 2015)

Hmmm...let's create a little scoreboard of opinions vesus facts.



teedubbyaw said:


> Let's start with the overly long academy that spends more time worried about military style PE.


Refuted by an actual employee of ATCEMS.  And "overly long" is definitely an opinion.



> Bunker gear for every new cadet? Bunker gear that they don't use.


Apparently true...except for the part about them not using it.  And the idea that they shouldn't have it...another opinion.  So let's call it 1 for each.



> SCBA's for every new cadet...again, that they never use.


Refuted by an actual employee of ATCEMS.



> Wet suits for every new cadet...that they never use because they don't do water rescues.


Refuted by an actual employee of ATCEMS.



> Their extensive uniform list.


Refuted by an actual employee of ATCEMS.  And apparently an opinion that having several uniforms is a bad thing.  Apparently someone never get's their uniform dirty...odd.



> Class A's so they can wear at graduation?


Pure opinion that having class A's is a bad thing.



> List goes on.



I'd ask that you go on with your list...buuuut...since by my count the scoreboard is now at 1 fact, 4 opinions and 4 falsehoods...well...you said it:


teedubbyaw said:


> Opinions = trolling.
> 
> Facts = trolling.


Uh-oh...


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## teedubbyaw (Sep 7, 2015)

Why are you here?


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## Tigger (Sep 7, 2015)

teedubbyaw said:


> Do you have an agency with 500+ employees that all get issued scba's and do you think it's a good financial decision to buy that many people personal bunker gear?
> 
> Didn't think so.


Didn't realize we allocate PPE based on agency size, that makes no sense. No we don't have 500 employees. Our budget is less than two million dollars for our 15 fulltime staff however. Really not far off based on percentages.


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## teedubbyaw (Sep 7, 2015)

Tigger said:


> Didn't realize we allocate PPE based on agency size, that makes no sense. No we don't have 500 employees. Our budget is less than two million dollars for our 15 fulltime staff however. Really not far off based on percentages.



So, again, what are you going to do as a basic with bunker gear?

And like I told triemal, who has no interest or information about ATCEMS, and is only here because I challenged him in the past, SCBA's were issued to cadets in the fall academy. Picking apart a post and saying "refuted by" and not adding any pertinent information is what he seems to be good at. And I stated that these were opinions and facts. When we're talking about an agency that is paid for by tax dollars, including mine, I can give my damn opinions all I want. You don't need a 2 thousand dollar uniform budget for a new cadet.


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> So, again, what are you going to do as a basic with bunker gear?
> 
> And like I told triemal, who has no interest or information about ATCEMS, and is only here because I challenged him in the past, SCBA's were issued to cadets in the fall academy. Picking apart a post and saying "refuted by" and not adding any pertinent information is what he seems to be good at. And I stated that these were opinions and facts. When we're talking about an agency that is paid for by tax dollars, including mine, I can give my damn opinions all I want. You don't need a 2 thousand dollar uniform budget for a new cadet.



I have already answered your question about basics with bunker gear, move on.

SCBAs were not issued in any academy. Can guarantee you that, so who ever your friend is, does not know what an SCBA is, or its not the truth. We were issued masks with container filters. There is a $60 million dollar budget, why not outfit your employees when you can? Its not like if we quit we get to keep the gear. It was an investment by the department.

Its amazing how people on this site are so opinionated about somewhere when they have never been employed. Worrying about the place YOU work seems to make more sense.


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## Tigger (Sep 7, 2015)

teedubbyaw said:


> So, again, what are you going to do as a basic with bunker gear?


Access the vehicle with my partner? Less than 20% of out district is covered by a paid fire. Sometimes it takes the volunteers a while to show up. Also I don't wish for us to get structural gear, since wildfire is more of a concern and we have a wildland fire program. We are not alone in having this, I have no idea if Texas agencies do, I would imagine. Makes for good cold weather gear as well, especially with snow drifts. That's what we want to do. What ATCEMS wishes to do may be different.


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## teedubbyaw (Sep 7, 2015)

I had 3 friends go through that academy, but ok. 

And you guys are asking for a budget increase. That's why. The expenditures are outrageous. You guys are blowing money out the *** on people who are with the company for, what, 6mo-yr? There's no investment there. Fix the other problems, including the high turn over rate, and I wouldn't really care if basics had bunker gear at the least of things. The focus has been misdirected for so long with ATCEMS.


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## teedubbyaw (Sep 7, 2015)

Tigger said:


> Access the vehicle with my partner? Less than 20% of out district is covered by a paid fire. Sometimes it takes the volunteers a while to show up. Also I don't wish for us to get structural gear, since wildfire is more of a concern and we have a wildland fire program. We are not alone in having this, I have no idea if Texas agencies do, I would imagine. Makes for good cold weather gear as well, especially with snow drifts. That's what we want to do. What ATCEMS wishes to do may be different.



Right. Rural is different. ATCEMS is not rural. Their most rural unit is a spec ops truck that is equipped with all of that. And you know the size of Austin fire department?

And we're not talking about your agency or bunker gear, really. We're talking about money. If you were a tax payer in Travis county, you may have different opinions.


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## Chewy20 (Sep 7, 2015)

teedubbyaw said:


> I had 3 friends go through that academy, but ok.
> 
> And you guys are asking for a budget increase. That's why. The expenditures are outrageous. You guys are blowing money out the *** on people who are with the company for, what, 6mo-yr? There's no investment there. Fix the other problems, including the high turn over rate, and I wouldn't really care if basics had bunker gear at the least of things. The focus has been misdirected for so long with ATCEMS.



My apologies, 3 friends that don't know what an SCBA is...Don't like the ways we spend money? Join the department, become in a position of power, or join city council. Until then, your opinion and strewed facts mean nothing. Keep being you and making your department thrive which apparently has nothing wrong with it.


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## teedubbyaw (Sep 7, 2015)

I forget how sensitive you get about ATCEMS. 

Every news article and publishing in the last few months about the troubles of ATCEMS speaks for itself. When a large cooperation can't get their **** together, well, I need not say anymore.


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## Tigger (Sep 7, 2015)

teedubbyaw said:


> Right. Rural is different. ATCEMS is not rural. Their most rural unit is a spec ops truck that is equipped with all of that. And you know the size of Austin fire department?
> 
> And we're not talking about your agency or bunker gear, really. We're talking about money. If you were a tax payer in Travis county, you may have different opinions.


You asked what I would do with bunker as a basic. I answered you. What else do you want?


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## 46Young (Sep 9, 2015)

teedubbyaw said:


> How many extrications have you worked? Being in the way is what we're good at. If fire can't handle ABC's then I don't know what to tell you. As a medic, there may be a slim chance extrication will be so prolonged that we will have to tube them, or needle decompression. But justifying bunker gear for every bls provider in a new company is not really an argument that can be backed.



There should be an engine company on-scene both to block (the Heavy Rescue needs to position next to the wreck), and to deploy a hoseline to protect the crew working. The Heavy Rescue crew will all be occupied with tasks, not involved in pt. care. If the engine company has four people, the fourth will be available to do pt. care inside the car. The other bucket person will staff the hoseline. The driver pumps, and the officer has incident command.

If there are less than four on the engine (many departments run with 2 or 3), someone from the EMS crew will need to get inside the car. If the ambulance gets on-scene before suppression crews, they will need to get inside the car. Pretty much EMS needs PPE.


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## 46Young (Sep 9, 2015)

MedicSansBrains said:


> Austin Recently had their budget review. The chief was questioned on why the EMS staff has such a high suicide and turnover rate. He said his budget hasn't caught up to the growth of the city.
> 
> The chief requested an extra 1.6 million dollars in the budget to move the system from a 48 hour work week to a 42 hour workweek. The request was granted so it seems that is the intention moving forward.



Suicide rate? ATCEMS employees are killing themselves? I don't understand.


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## 46Young (Sep 9, 2015)

teedubbyaw said:


> Do you have an agency with 500+ employees that all get issued scba's and do you think it's a good financial decision to buy that many people personal bunker gear?
> 
> Didn't think so.



No one clued me in to this until a few years ago, but with grants and other budget allocations, if you don't spend the money, you lose it. You and your friends may not be fully informed. Bunkers for EMS may have very well come from a grant. Same for the SCBA's or whatever they use for respiratory protection.

Where I work, we were able to fund a fourth position (a medic) on 8 of our ladder trucks due to a grant. We get new Hazmat meters and RAD pagers from grants. Every front-line unit has iPads from a grant. We're required, for three years, every Mon. and Tues. to use it for MCI training, to record each txp. We built a new fire station, but couldn't staff it for over a year because the funds were set aside several years earlier, and it needed to be used, or it would be lost forever. These are just a few examples. Some purchases may be puzzling, but it may very well be a use it or lose it scenario.


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## MedicSansBrains (Sep 9, 2015)

46Young said:


> Suicide rate? ATCEMS employees are killing themselves? I don't understand.


http://www.austinchronicle.com/news/2015-05-08/high-stress-at-ems/


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## 46Young (Sep 9, 2015)

MedicSansBrains said:


> http://www.austinchronicle.com/news/2015-05-08/high-stress-at-ems/



That's horrible! I've seen mental breakdowns by co-workers more than a few times, severe alcoholism that cost them their jobs and marriages, and depression/anger management issues, but never suicide. I read Trish McAuliffe's account of her son (in the comments), and how he had changed for the worse, before taking his life.

How accurate is the article about all of the issues with ATCEMS? It sounds like things could be fixed if they went to the 42 hr schedule, better protection/job security by not being able to be decertified and fired so easily, if there were paramedic initiated refusals and referrals to places other than an ED, and returning to a ALS/BLS tiered system. Maybe bump the pay some to achieve some measure of parity with fire and police, and employee retention should improve. The calls are going to be what they are, but the employees will be better able to weather the storm if there are better working conditions including a drastic reduction of forced OT, and doing away with having to be on call. I'm willing to bet that forced OT is worse than it should be because people that would sign up for OT wont do it because they get more than enough hours from being forced to work extra hours.

Can an employee claim the forced OT hours as comp time instead of pay? I would just use the OT to build my comp bank at 1.5x time, and then take all of the vacation days that I could, and also bang in sick occasionally for a mental health day.

The article says that ATCEMS has 37 ambulances, some of which are not 24/7, to handle a yearly call volume of 138,000, over 990 square miles, with a population of 1.15 million. For comparison, my department serves an area of 406 square miles, with a population of 1.118 million. We have 91,000 calls, maybe 75%  are EMS, so the yearly EMS call volume is about 68,250. That is handled by 42 ALS ambulances, each of which are 24/7/365, with occasional extra ambulances from the volunteers. The call volume here isn't super slow, but it isn't really busy either. The average unit runs 4.45 calls in a 24 hr period based on those figures, where a few run 1-2, and few run 10-11 at the most. I would say that ATCEMS people are being severely overworked. If ATCEMS has a call volume that's double of what our ambulances are doing, and I was being forced to do holdover or recall OT frequently, I would certainly burn out if I worked there. If ATCEMS units were all 24/7/365, the average call volume would be 9.94/24 hrs. I had a similar situation in Charleston County back in 2007-2008, where I didn't even make six months OTJ before leaving for my current employer. I was OTJ for two months when I was called with the job offer, and just prior to that call I was already set up to drop to per diem at Charleston, and work for MUSC Hospital, where they work 3 12's per week, with an hourly rate much higher than CCEMS. I suspect that people at ATCEMS explore similar options, working for other systems, or escaping to police or fire. Having the constant uncertainty of whether or not you're going to be stuck at work on your day off, and never being able to make concrete plans,

https://en.wikipedia.org/wiki/Fairfax_County_Fire_and_Rescue_Department

https://en.wikipedia.org/wiki/Fairfax_County,_Virginia

Edit: correction, 37 ambulances per the article


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## MedicSansBrains (Sep 9, 2015)

46Young said:


> That's horrible! I've seen mental breakdowns by co-workers more than a few times, severe alcoholism that cost them their jobs and marriages, and depression/anger management issues, but never suicide. I read Trish McAuliffe's account of her son (in the comments), and how he had changed for the worse, before taking his life.
> 
> How accurate is the article about all of the issues with ATCEMS? It sounds like things could be fixed if they went to the 42 hr schedule, better protection/job security by not being able to be decertified and fired so easily, if there were paramedic initiated refusals and referrals to places other than an ED, and returning to a ALS/BLS tiered system. Maybe bump the pay some to achieve some measure of parity with fire and police, and employee retention should improve. The calls are going to be what they are, but the employees will be better able to weather the storm if there are better working conditions including a drastic reduction of forced OT, and doing away with having to be on call. I'm willing to bet that forced OT is worse than it should be because people that would sign up for OT wont do it because they get more than enough hours from being forced to work extra hours.
> 
> ...


Yeah it's not good. ATCEMS is a county system too so there are quite a few square miles. Most of the time you'll be working shifts in the busy stations getting 9 calls in a 12 hour shift, not 24. 

I'm still in medic school in Austin so I don't work there. But I have done quite a few clinicals with them. Of course I pick busy stations for the experience so my view might be skewed but for the most part I think I'm right on the fact that they are constantly running all shift. 

Also, I think there's a policy problem that is possibly delineated when contrasting your numbers with ATCEMS. Your population is similar, but less square miles, however your call volume is a lot lower. I've brought up before that Austin's homeless population has a lot to do with that but I didn't bring up another possible contributing factor as. 

Austin's EMS policy is that private ambulances can't run emergency calls or upgrade facility to facility transfers. The emergency part is pretty common I'm sure but the facility transfers I'm not sure. 

For example, I ran with a station that happened to be around a lot of nursing homes. We ran something like 6-8 nursing home to hospital transfers in 12 hours along with other stuff. It was an amazing waste of a 911 service I thought. 

Even if a private ambulance is servicing a downgrade (hospital to nursing home) if they run into problems en route and the person codes etc. then they have to call 911 and transfer care in the middle of the street or whatever. 

I'm not sure how much this unnecessarily amplifies the call volume of ATCEMS but I bet it's one of the factors. maybe @Chewy20 can answer this. 

Pure conjecture but I bet this has its roots in reimbursement. Please correct me if I'm wrong but an upgraded facility to facility transfer is well documented enough that medicare will pay for it consistently right? So maybe ATCEMS is trying to get as much reimbursement to increase billables. Correct me if I'm wrong. I'm just trying to reason why this policy exists. 

There should be a serious reconsideration of things both in ATCEMS and in the profession as a whole. It is pretty disheartening to read about all of the problems in a profession that I'm excited to get into. It kinda makes me... not excited. That poor guy was excited when he moved to Austin and was "happy go lucky". Then he killed himself. Jeez. 

I hope the profession/industry changes and starts adding things like community paramedicine and community education and involvement. As a society we should evolve more in that direction. Having a much larger focus on health and bringing it to the population and helping them live healthier happier lives. 

Rather we get crap budgets (ATCEMS was 77 million, Fire was 180 million, APD was almost 400 million..) and have to parse it out to meet "minimum requirements" and F*(*(&ing response times. 

rambling on, rambling on, rambling on.


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## 46Young (Sep 10, 2015)

MedicSansBrains said:


> Yeah it's not good. ATCEMS is a county system too so there are quite a few square miles. Most of the time you'll be working shifts in the busy stations getting 9 calls in a 12 hour shift, not 24.
> 
> I'm still in medic school in Austin so I don't work there. But I have done quite a few clinicals with them. Of course I pick busy stations for the experience so my view might be skewed but for the most part I think I'm right on the fact that they are constantly running all shift.
> 
> ...



Don't get too disheartened, it sounds like they're trying to change things for the better. Even though ATCEMS has it's share of problems, if you can overlook the forced OT and the mandatory BLS entry point, it's probably a lot better deal than many other single role EMS employers. They're Civil Service with a pension, and it sounds like they provide the equipment and protocols to let you do your job as a medic. Other employers can pay medics $12/hr, and have crappy equipment/protocols/rigs. The Southeast sucks for pay, for example. You could also be working for a private like RM or AMR, where your job is in jeopardy each time the contract needs to be renewed, or if the current situation becomes unprofitable for the company. You could be stuck doing transfers in-between 911 calls. Your system could be SSM/PUM, which is absolutely miserable. ATCEMS should still be better than a lot of places. Your getting into paramedicine at a time where things seem to be changing for the better, so don't psyche yourself out just yet. I went to the fire service, and have over seven years on, so I'm staying put, but I wouldn't be opposed to doing some single role per diem 911 work in TX, SC, or FL after retirement, just to keep a little busy. 

In my particular case, I was getting a little burnt from single role EMS six years in when I joined the fire service, and I'm a little more burnt now. The significant calls don't bother me too much. I look at it like what's going to happen to someone is going to happen someone, and I'm just trying to use my training to mitigate it to the best of my ability. If a child dies in my care, or if I cant resuscitate the 38 y/o guy that dropped dead five minutes after I made contact, I'm okay with it, so long as my team and I did the best that we could to prevent it. Some patients are just too far gone for us to help out. What burns me out, besides lack of sleep, is all of the non-acute calls. The job actually becomes quite boring and mundane, and you can get a little resentful when you get awakened three times a night for trivial issues, and are useless for much of the day following your shift, assuming that you're not held over for forced OT. I only do real paramedicine very occasionally, so the joy of working txp is not there. I like medicine, and some hand-holding and comfort care is okay, but I'm not okay with trivial calls making up the majority of calls. Having a tiered ALS/BLS system will reverse that somewhat. Hopefully ATCEMS does that.



Where I work we have a similar policy where IFT units cannot run emergent NH/Urgent Care/doctor's office calls - that's for 911 only. We run Urgent Care stuff all the time, and we also have an Assisted Living/NH metropolis called Greenspring Village which calls 4 times a day or more. Plenty of Kaiser Permanente calls throughout the county. We also do an IFT out of the ED very occasionally, maybe 1-2 a week if that, if the IFT company has a long ETA. It would seem that my county also likes the guaranteed income from NH and clinic calls. We have to balance out the undomiciled and undocumented with no insurance. It's not as big of a problem as Austin I'm sure, but we still get our share of drunks, homeless, and the uninsured that use the ED as their PCP.


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## Aprz (Oct 7, 2015)

Got this in the mail today and thought of this thread.












I also got an e-mail.






I did go to their website awhile ago and filled out something to receive notifications about job openings. I'm not sure if I am willing to move until I try my options out here in California. I also would prefer not to get hired on as an EMT and have to wait to be promoted paramedic.


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## PotatoMedic (Oct 7, 2015)

Yup got the same thing in the mail.  Same reservations and I'm not sure my wife would be willing to move either.


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## kev54 (Oct 28, 2015)

Out of curiosity if you get hired as a medic 1 is it even possible to find time to go to Paramedic school while working? Or are some of the new hires just getting promoted when they already had their Paramedic and the medic 1 just may not have the time to go to Paramedic school because of what has been mentioned above?


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## Chewy20 (Oct 28, 2015)

kev54 said:


> Out of curiosity if you get hired as a medic 1 is it even possible to find time to go to Paramedic school while working? Or are some of the new hires just getting promoted when they already had their Paramedic and the medic 1 just may not have the time to go to Paramedic school because of what has been mentioned above?



Most were already certified paramedics. Yes you can still go to school. Though the community college in Austin makes it extremely hard on ATCEMS employees. They don't let you do rideouts with ATC if you work there. Their schedule and clinical time is not ideal and it's over two years. 

You would be better off driving to either San Antonio or better yet temple/Hutto for their courses. 

Paramedic school will put a strain on your life no matter what your job is. If you can suck it up like everyone else has. It will end eventually.


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## 46Young (Oct 28, 2015)

Chewy20 said:


> Most were already certified paramedics. Yes you can still go to school. Though the community college in Austin makes it extremely hard on ATCEMS employees. They don't let you do rideouts with ATC if you work there. Their schedule and clinical time is not ideal and it's over two years.
> 
> You would be better off driving to either San Antonio or better yet temple/Hutto for their courses.
> 
> Paramedic school will put a strain on your life no matter what your job is. If you can suck it up like everyone else has. It will end eventually.



I think Kev54 means that the ACTEMS employee going to medic school is likely going to get screwed with mandatory holdover or recall OT, which will conflict with class and clinicals. Even if there is no conflict, I'm sure that running busy 24's with little to no sleep, and then being held over will run them into the ground, causing them to fail the class. I did 40 hrs/wk on an ambulance with an occasional voluntary 12 of OT, and that was a lot with 16 hours of class per week with another 32+ hours of clinicals for most of the 13 months of the program. That was almost too much. I can't even begin to imagine the torture of being held over on a regular basis and trying to get through medic school.


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## Chewy20 (Oct 28, 2015)

46Young said:


> I think Kev54 means that the ACTEMS employee going to medic school is likely going to get screwed with mandatory holdover or recall OT, which will conflict with class and clinicals. Even if there is no conflict, I'm sure that running busy 24's with little to no sleep, and then being held over will run them into the ground, causing them to fail the class. I did 40 hrs/wk on an ambulance with an occasional voluntary 12 of OT, and that was a lot with 16 hours of class per week with another 32+ hours of clinicals for most of the 13 months of the program. That was almost too much. I can't even begin to imagine the torture of being held over on a regular basis and trying to get through medic school.



We are on "OCP" (on-call), one day a month...Its not that much to handle haha. Also, I am RARELY held over on a 24 due to a late call. Sure it happens once in a while, but that's EMS. People are doing the whole school thing right now, so you cant really have too many excuses. Word is ATC is TRYING to get an in-house program, but who knows how long that will take.

People go to college full-time, while working full-time, while taking care of a family.


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## 46Young (Oct 29, 2015)

From what I've read, it sounded like mandatory holdovers were a frequent thing, not just on-call once a month with a rare holdover due to no relief. Are you saying that besides the once per month on-call, it's rare to be held over for for an additional 12-24 hrs after your regular shift due to no relief or someone banging out sick? Are you saying that these schedule holes typically get covered with voluntary OT?

We rarely get late calls where I work, but that's simply because it's customary to relieve your person an hour prior to the start of shift. Getting stuck for an extra 12-24 hrs is a totally different matter.

Edit: @Chewy20's last post


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## kev54 (Oct 29, 2015)

More along those lines of what 46Young said. If it's doable that's good. I'm surprised they wouldn't just implement a work study so people could go to class at ACC and work part time hours but maybe it's not feasible? That seems easier than trying to start a in house medic program and deal with accreditation and all the hoops you have to jump through. Thank you for the information Chewy20 greatly appreciated.


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## Chewy20 (Oct 29, 2015)

46Young said:


> From what I've read, it sounded like mandatory holdovers were a frequent thing, not just on-call once a month with a rare holdover due to no relief. Are you saying that besides the once per month on-call, it's rare to be held over for for an additional 12-24 hrs after your regular shift due to no relief or someone banging out sick? Are you saying that these schedule holes typically get covered with voluntary OT?
> 
> We rarely get late calls where I work, but that's simply because it's customary to relieve your person an hour prior to the start of shift. Getting stuck for an extra 12-24 hrs is a totally different matter.
> 
> Edit: @Chewy20's last post



Oh that's what you meant? You will NEVER be held over for anything other than a late call. There's the OCP list, if that gets exhausted then they will use the accumulative list. Accumulative list is not often used as the people on OCP usually cover all the open spots.

More often then not, open slots are taken by volunteers looking for overtime. The past 2 out of 3 times I have been on-call. I never had to go in.


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## Chewy20 (Oct 29, 2015)

kev54 said:


> More along those lines of what 46Young said. If it's doable that's good. I'm surprised they wouldn't just implement a work study so people could go to class at ACC and work part time hours but maybe it's not feasible? That seems easier than trying to start a in house medic program and deal with accreditation and all the hoops you have to jump through. Thank you for the information Chewy20 greatly appreciated.



Part-time is a no go here. So that's out the window. Would just create more open seats in the system.


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## kev54 (Oct 29, 2015)

makes sense unless you found a way to fill them.


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## 46Young (Oct 29, 2015)

Chewy20 said:


> Oh that's what you meant? You will NEVER be held over for anything other than a late call. There's the OCP list, if that gets exhausted then they will use the accumulative list. Accumulative list is not often used as the people on OCP usually cover all the open spots.
> 
> More often then not, open slots are taken by volunteers looking for overtime. The past 2 out of 3 times I have been on-call. I never had to go in.



This story, and what you are saying are 180 degrees apart:

http://www.kvue.com/story/news/local/2015/01/14/atcems-medics-ask-for-change-support/21788485/


_TRAVIS COUNTY, Texas -- Austin-Travis County EMS paramedics are grieving after on of their fellow medics committed suicide earlier this week.

EMS staff tells KVUE another fellow medic committed suicide in 2014. While they may never know exactly what led their co-workers to that point, they said something needs to change to get them the help they need on the job.

"It's the profession we've chosen. You see tragedy and you want to help and you want to make a difference and you can't help but have that affect you," said ATCEMS Association President Tony Marquardt.

Marquardt has worked as a medic for 20 years.

"We don't mind being called in for a plane crash or a multi-car accident," he said.
_
*But, he said they're understaffed and overtime seems to be all the time.*
_
*"Being called in on accumulative overtime is happening with regularity as if it were a normal way of running a schedule," said Marquardt*.

He said the tragic loss of a fellow medic this week has created even more conversation, especially online where many coworkers are changing their profile pictures to a badge and speaking out about the need for more support in the workplace.

*"People are reaching out on social media because they're, frankly, over worked,*" Marquardt said.

"They love the system. They love taking care of patients. But they don't like being taken for granted," said Public Safety Commissioner Mike Levy.

Levy said turnover in paramedics is high -- around five or six a month. He worries it will ultimately hurt the patient as well.

"If they're fatigued and the morale is low, there's going to be lesser patient care in terms of quality," he said.

As they grieve for one of their own this week, they're also asking to be heard.

"There are definitely things that are out there that need to be changed and need to be addressed and I think acknowledging that is the first step," Marquardt said.

A spokesperson for Austin Travis County EMS tells us they do have a psychologist on staff who is there whenever employees need help.

During the month of December alone EMS responded to more than 10,000 calls in Austin and Travis County.
_

Are you saying that Marquardt is making up these claims of frequent pulls from the accumulative list, that it's a normal way of running the schedule? We have over 1,500 people on our department, and we lose maybe 1-3 people per month, and that's mostly due to retirement. Losing 5-6/month seems to be a real problem.


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## Chewy20 (Oct 29, 2015)

46Young said:


> This story, and what you are saying are 180 degrees apart:
> 
> http://www.kvue.com/story/news/local/2015/01/14/atcems-medics-ask-for-change-support/21788485/
> 
> ...




He is the head of the Employee association, and its media...Not once in my time of over a year working here, have I been called in off the accumulative list. All there really is to say.

The department is understaffed. There is no denying that. I would go ahead and say the hours worked are the last reason people are quitting. The OCP/Accumulative list are trying to be done away with. We will see what the future holds when we switch to 42 hour work weeks along with 24/72s in January.

Also, "Getting called in for a multi-car accident"? lol.

To clarify...The lists contain people who are not scheduled for that day and when it will not conflict within 8 hours of another shift. OCP days are on your schedule when you bid (so you will know what days to expect to go in, 10 months ahead.)


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## triemal04 (Oct 30, 2015)

_*"Being called in on accumulative overtime is happening with regularity as if it were a normal way of running a schedule," said Marquardt*_

The problem is, what does that actually mean?  Does that mean that every employee is being called in with regularity?  Are there multiple spots each shift that are filled that way?  One spot per day?  Several per week?  While a great soundbite, and from the labor perspective a great way to make their case, it's really a pretty nebulous comment that needs further explanation.  (and believe me, I'm fully on the side of labor)  

Where I work we also (like almost every department) have mandatory overtime.  At a guess I'd say that over the course of the year 75% or so of the department will get held over on mandatory overtime ONCE.  So, you could also say about my department that it is happening "with regularity as if it were a normal way of running a schedule," and be completely accurate...although the reality is that it is so infrequent on a personal level that it's benign.


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## 46Young (Oct 31, 2015)

triemal04 said:


> _*"Being called in on accumulative overtime is happening with regularity as if it were a normal way of running a schedule," said Marquardt*_
> 
> The problem is, what does that actually mean?  Does that mean that every employee is being called in with regularity?  Are there multiple spots each shift that are filled that way?  One spot per day?  Several per week?  While a great soundbite, and from the labor perspective a great way to make their case, it's really a pretty nebulous comment that needs further explanation.  (and believe me, I'm fully on the side of labor)
> 
> Where I work we also (like almost every department) have mandatory overtime.  At a guess I'd say that over the course of the year 75% or so of the department will get held over on mandatory overtime ONCE.  So, you could also say about my department that it is happening "with regularity as if it were a normal way of running a schedule," and be completely accurate...although the reality is that it is so infrequent on a personal level that it's benign.



Once in a while we get holdovers during the week, but for the medics in busy stations, they're regularly in jeopardy of getting held on Sat. and Sun. Our relief is one for one, then it goes to others in the station, then it goes to the battalion holdover/recall list, then it goes department-wide. We try to avoid holdover by working the evening half preceding our shift, which puts us at 36 hrs when the holdover would occur. We have a 36 hour forced OT cap. Some people do work exchanges to create a 36 hour situation, and others try to get the OT.

The ambulances in busy stations get screwed. The OT spots typically get covered with the slower stations, and the truck/engine spots are typically covered as well. Since it's in-station then in-battalion, people that work there get the shaft, while people in slower stations rarely, if ever, get held over.


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## Chewy20 (Oct 31, 2015)

46Young said:


> Once in a while we get holdovers during the week, but for the medics in busy stations, they're regularly in jeopardy of getting held on Sat. and Sun. Our relief is one for one, then it goes to others in the station, then it goes to the battalion holdover/recall list, then it goes department-wide. We try to avoid holdover by working the evening half preceding our shift, which puts us at 36 hrs when the holdover would occur. We have a 36 hour forced OT cap. Some people do work exchanges to create a 36 hour situation, and others try to get the OT.
> 
> The ambulances in busy stations get screwed. The OT spots typically get covered with the slower stations, and the truck/engine spots are typically covered as well. Since it's in-station then in-battalion, people that work there get the shaft, while people in slower stations rarely, if ever, get held over.



Sounds ten times worse then our way of doing it by being on-call once a month lol. Maybe there should be news articles about yall!


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## 46Young (Oct 31, 2015)

Chewy20 said:


> Sounds ten times worse then our way of doing it by being on-call once a month lol. Maybe there should be news articles about yall!



You're probably right. I could do over 100 or more hours of OT, and they'll still hold me if I have no relief. What I do is take the forced OT at 1.5x comp time, and just take another Sat or Sun off. I used to not do that, but I work so much OT that I have no problem playing hooky to take a day back. The truth is, I'd rather be able to work OT whenever I want to, instead of having the OT strictly controlled, which would lead me to work at some IFT company making less than half of my OT rate doing the dialysis derby, MRI round trips, and IV/monitor/O2 txp's ad nauseum.

I assume that your department doesn't do one for one relief? Meaning that if your relief calls in sick, and they don't have the spot filled, you can leave the unit out of service and go home? Or is it that the vacancy will never occur because there are enough OT tramps looking to pad their income?

Edit: The forced OT was way worse when I worked for Charleston County EMS back in 2007. I basically had no life. From reading articles on A/TCEMS, they make it seem like evryone is forced to work a bazillion hours of forced OT every month. I can take a beating on a busy 24 if I don't have to stay for an additional 12-24 against my will.


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## Chewy20 (Oct 31, 2015)

46Young said:


> You're probably right. I could do over 100 or more hours of OT, and they'll still hold me if I have no relief. What I do is take the forced OT at 1.5x comp time, and just take another Sat or Sun off. I used to not do that, but I work so much OT that I have no problem playing hooky to take a day back. The truth is, I'd rather be able to work OT whenever I want to, instead of having the OT strictly controlled, which would lead me to work at some IFT company making less than half of my OT rate doing the dialysis derby, MRI round trips, and IV/monitor/O2 txp's ad nauseum.
> 
> I assume that your department doesn't do one for one relief? Meaning that if your relief calls in sick, and they don't have the spot filled, you can leave the unit out of service and go home? Or is it that the vacancy will never occur because there are enough OT tramps looking to pad their income?
> 
> Edit: The forced OT was way worse when I worked for Charleston County EMS back in 2007. I basically had no life. From reading articles on A/TCEMS, they make it seem like evryone is forced to work a bazillion hours of forced OT every month. I can take a beating on a busy 24 if I don't have to stay for an additional 12-24 against my will.



If someone calls in sick before their shift you cannot leave the truck unmanned. You simply wait until someone comes in. Either someone on the OCP list will be called in or someone will pick it up on their on will. OCP people have 2 hours to be at the station from the time they are called in. You start receiving your OT pay from the moment you get the call. Think it's like 3 bucks an hour when just on call. No one here likes the OCP list. But to say we work a ton of forced overtime is untrue (maybe that's just my exp. but I've only been here a little over a year so I figure id be the one forced to work that mysterious forced OT, but I don't). From what you have said and what other departments do. It seems like we have it quite easy. Now IF we were made to stay an extra 12-24 hours after a shift. I would not be working here. 

Since being here the longest I've been held over was about two hours, due to a last minute cardiac arrest.


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## triemal04 (Nov 1, 2015)

46Young said:


> Once in a while we get holdovers during the week, but for the medics in busy stations, they're regularly in jeopardy of getting held on Sat. and Sun. Our relief is one for one, then it goes to others in the station, then it goes to the battalion holdover/recall list, then it goes department-wide. We try to avoid holdover by working the evening half preceding our shift, which puts us at 36 hrs when the holdover would occur. We have a 36 hour forced OT cap. Some people do work exchanges to create a 36 hour situation, and others try to get the OT.
> 
> The ambulances in busy stations get screwed. The OT spots typically get covered with the slower stations, and the truck/engine spots are typically covered as well. Since it's in-station then in-battalion, people that work there get the shaft, while people in slower stations rarely, if ever, get held over.


Damn...you definitely have it far worse than I do.  While OT is certainly abundant here, mandatory OT, though it does happen, isn't.  If I'm understanding how you guys fill vacancies, ie the guys in the station first followed by ones in the battalion...double damn.  Honestly, THAT sounds completely unworkable and a breeding ground for creating rivalries/dislike for slower stations.


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## 46Young (Mar 14, 2016)

So, did ATCEMS go to 12-hour shifts yet?


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## Chewy20 (Mar 14, 2016)

You're either on straight 12s (42 hour work week) or 24/48 (48 hour week) with a payback week once a month. 

Will all be going to a 42 work week in August. Same 12s. Then 24/72. There will always be 24s here.


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## TXmed (May 7, 2016)

People from ft.worth medstar and Arlington EMS used to say that too, and neither of them do 24's now. I worked for Arlington when they did their switch and I do have to say things got alot better when they switched to all 12's


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## Chewy20 (May 7, 2016)

TXmed said:


> People from ft.worth medstar and Arlington EMS used to say that too, and neither of them do 24's now. I worked for Arlington when they did their switch and I do have to say things got alot better when they switched to all 12's



We have county trucks that average 2-3 calls in 24 hours and some that have like 10 calls a month lol. Some of the city 24s are the same way but have about 5-8 calls daily. They won't be going anywhere.

But unless you have about 1-2 years tenure as a medic 1 or about 8-10 years as a medic 2, you will be on 12s


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## TXmed (May 7, 2016)

haha doesnt sound like yall are understaffed at all then


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## Chewy20 (May 7, 2016)

TXmed said:


> haha doesnt sound like yall are understaffed at all then



Need more medic 2s but I don't believe there is a big shortage. Another medic 2 academy is starting in the next couple months.


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## TXmed (May 7, 2016)

Medic 2 academy? I thought y'all didn't hire people in for medic 2? Or is that how y'all do upgrades ?


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## Chewy20 (May 7, 2016)

TXmed said:


> Medic 2 academy? I thought y'all didn't hire people in for medic 2? Or is that how y'all do upgrades ?



Internal academy for medic 1s.


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