This may be a hot button topic, but it has bothered me enough to come out of hiding and post about it. I'm really hoping that there are some King Co EMT's and FF's here who can shed light on this.
I am currently an ER technician but am seriously considering going back out into the field. I miss the rigs like crazy, and only took my current job cause everyone was in a hiring freeze when I moved up here in 09. Anyways, the topic of this post is the relationship that FD has with EMS.
Here in King Co., for those unfamiliar, the FD is first on scene and relies on private company EMS for BLS transportation to the hospital. The two companies operating in King County with 911 contracts are AMR and Tri-Med. For as long as I have been around both of them (3yrs now) in the ED, there has been one common thread that is universally accepted...Fire hates EMS and EMS hates Fire.
Granted, there are exceptions with certain crews who have gotten in good with a particular engine company etc etc., but literally daily I always hear one complaining about the other. Fire complains that EMS is worthless and incompetent, and EMS complains the same about Fire. In fact, I have a personal anecdote about how they interact. I was a good Samaritan bystander on a trauma that happened outside of a grocery store. Some crackhead hauled off on a woman with a ceramic coffee mug and beat the heck out of her from the waist up. I was assisting Fire with the workup when EMS (Tri-Med) arrived (as I said before, they are second due). I called out to one of the EMT's for a sling and swath, and the Fire Lt stopped me saying, "This is our patient, they're just transport. We do the patient care. We'll use our gear." I was stunned. I came out of a SoCal EMS operation where FD would refuse to attend social events unless we were invited as well. On this particular call, EMS literally did not say a single word until the patient was on their gurney in the back of the ambulance.
I knew this particular crew from seeing them come to my ED and they were both competent EMT's who provided outstanding patient care. All of my coworkers enjoyed seeing them roll through the door. I asked them about what happened and they said that they were told on hire that if they spoke on scene they could be fired. I know for a fact multiple EMT's that lost their jobs for questioning FD's authority. I also know that several FD's have begun using this particular company for their BLS transport because they were tired of AMR "taking too long on scene after we give them a patient to take to the hospital. Tri-Med doesn't ask questions."
Now let me say this, American Medical Response in King County employs EMT's that are excellent, but they are far more hated by FD than is TriMed. I have experience in EMS operations from SoCal to the mid-west to the northwest, and these EMT's bring us extremely sick patients (ALS turfs to BLS the majority of the time due to low ALS numbers) and provide amazing patient care. I don't know what this AMR operation does, but they seem to get it right. Their reports are thorough, their assessments are nearly always flawless and their patient care is aggressive and bold. When I asked several AMR employees about what they do on scene compared to this other company, they tell me that they run their own full assessment whether FD likes it or not. They also admit that FD either gets livid on scene and cusses them out, or FD will leave the instant AMR shows up. Another source of irritation for FD is that AMR will put their foot down and demand a medic-eval of the pt before they accept them for transport (ALS is usually second due as well).
I will also say this, I have had FD bring patients in (very rarely, but it does happen) and I have had them put a patient on the bed and walk out without giving a report. I have asked them for a report and they have not asked the patient a SAMPLE hx, or even a HAM hx. We get a lot of patients sent to us that have not had a medic eval that clearly need it. We even got a pediatric respiratory distress (that arrested the second Tri-Med sprinted through our door) that FD had refused to call ALS for. I don't mean to bag on FD, but this is a shared opinion of FD among my coworkers and the EMS community. I can't tell you how often I hear, "Thank God AMR is bringing this guy in."
We have several volly's that work in the ED as techs, and they hate EMS, always talking behind their backs, calling them idiots and pains-in-the-@$$.
I know that this is kind of a rant, but honestly it's very discouraging. I absolutely loved my FD brothers, we were a family. Even though we didn't have stations we would always end up at the fire house sharing meals, chores and football games. The only difference between here and there is that in SoCal we were dispatched simultaneously.
Does anyone have any insight as to why this is? Any tips on what my interaction will need to be on scene? Maybe I'm reading too much into things, and yes, this is just MY observations from a view that originated INSIDE the hospital and not out in the field. But so far it's enough to make me dread going back on the rig, I don't want to have to have a showdown every time a patient is transferred to my care. I also want to be considered a viable provider in the King County EMS system. The whole feud makes the first-responder world a bit of a laughingstock in the hospital. Most of the non-responder employees shake their heads. Any enlightenment would be awesome, I'm very interested to know what you guys think!
I am currently an ER technician but am seriously considering going back out into the field. I miss the rigs like crazy, and only took my current job cause everyone was in a hiring freeze when I moved up here in 09. Anyways, the topic of this post is the relationship that FD has with EMS.
Here in King Co., for those unfamiliar, the FD is first on scene and relies on private company EMS for BLS transportation to the hospital. The two companies operating in King County with 911 contracts are AMR and Tri-Med. For as long as I have been around both of them (3yrs now) in the ED, there has been one common thread that is universally accepted...Fire hates EMS and EMS hates Fire.
Granted, there are exceptions with certain crews who have gotten in good with a particular engine company etc etc., but literally daily I always hear one complaining about the other. Fire complains that EMS is worthless and incompetent, and EMS complains the same about Fire. In fact, I have a personal anecdote about how they interact. I was a good Samaritan bystander on a trauma that happened outside of a grocery store. Some crackhead hauled off on a woman with a ceramic coffee mug and beat the heck out of her from the waist up. I was assisting Fire with the workup when EMS (Tri-Med) arrived (as I said before, they are second due). I called out to one of the EMT's for a sling and swath, and the Fire Lt stopped me saying, "This is our patient, they're just transport. We do the patient care. We'll use our gear." I was stunned. I came out of a SoCal EMS operation where FD would refuse to attend social events unless we were invited as well. On this particular call, EMS literally did not say a single word until the patient was on their gurney in the back of the ambulance.
I knew this particular crew from seeing them come to my ED and they were both competent EMT's who provided outstanding patient care. All of my coworkers enjoyed seeing them roll through the door. I asked them about what happened and they said that they were told on hire that if they spoke on scene they could be fired. I know for a fact multiple EMT's that lost their jobs for questioning FD's authority. I also know that several FD's have begun using this particular company for their BLS transport because they were tired of AMR "taking too long on scene after we give them a patient to take to the hospital. Tri-Med doesn't ask questions."
Now let me say this, American Medical Response in King County employs EMT's that are excellent, but they are far more hated by FD than is TriMed. I have experience in EMS operations from SoCal to the mid-west to the northwest, and these EMT's bring us extremely sick patients (ALS turfs to BLS the majority of the time due to low ALS numbers) and provide amazing patient care. I don't know what this AMR operation does, but they seem to get it right. Their reports are thorough, their assessments are nearly always flawless and their patient care is aggressive and bold. When I asked several AMR employees about what they do on scene compared to this other company, they tell me that they run their own full assessment whether FD likes it or not. They also admit that FD either gets livid on scene and cusses them out, or FD will leave the instant AMR shows up. Another source of irritation for FD is that AMR will put their foot down and demand a medic-eval of the pt before they accept them for transport (ALS is usually second due as well).
I will also say this, I have had FD bring patients in (very rarely, but it does happen) and I have had them put a patient on the bed and walk out without giving a report. I have asked them for a report and they have not asked the patient a SAMPLE hx, or even a HAM hx. We get a lot of patients sent to us that have not had a medic eval that clearly need it. We even got a pediatric respiratory distress (that arrested the second Tri-Med sprinted through our door) that FD had refused to call ALS for. I don't mean to bag on FD, but this is a shared opinion of FD among my coworkers and the EMS community. I can't tell you how often I hear, "Thank God AMR is bringing this guy in."
We have several volly's that work in the ED as techs, and they hate EMS, always talking behind their backs, calling them idiots and pains-in-the-@$$.
I know that this is kind of a rant, but honestly it's very discouraging. I absolutely loved my FD brothers, we were a family. Even though we didn't have stations we would always end up at the fire house sharing meals, chores and football games. The only difference between here and there is that in SoCal we were dispatched simultaneously.
Does anyone have any insight as to why this is? Any tips on what my interaction will need to be on scene? Maybe I'm reading too much into things, and yes, this is just MY observations from a view that originated INSIDE the hospital and not out in the field. But so far it's enough to make me dread going back on the rig, I don't want to have to have a showdown every time a patient is transferred to my care. I also want to be considered a viable provider in the King County EMS system. The whole feud makes the first-responder world a bit of a laughingstock in the hospital. Most of the non-responder employees shake their heads. Any enlightenment would be awesome, I'm very interested to know what you guys think!
