How to buff calls in NYC?

[Jim37F]

If you want to run 911 calls, and need "action" so bad, why don't you go get hired on by a 911 provider vs work for free for someone who doesn't get the types of calls you want dispatched?

There sems to be plenty of 911 providers all over the country who would love to compensate you for you spending 100 hours a week or so in their ambulance ...

I think I read that you said pretty much all your local 911 service providers require 6 months experience? The obvious implication is that you don't have that experience. That you are a brand spanking new EMT. When most of us here have worked for IFT only services when first certified/licensed, honestly, you really come out sounding like my last Army roommate, brand new soldier fresh from Basic, less than 6 months in the Army, complaining to me how they wouldn't let him direct commission in to be an officer with his law degree (of course he didn't do any ROTC or anything, he just did some school, talked to a recruiter am signed the dotted line, and then expected a sympathetic ear from me when he didn't get his way handed to him on a silver platter. Sound familiar?)

When I first got my cert, I worked for an IFT only company. 6 months on a BLS unit, you know how many calls that weren't pre-scheduled non emergent transfers? Zero. The only times we turned on the lights were when backing around traffic. The following three months on a Critical Care Transport unit, only 1 emergent call. Heck half the time we only got 1 or 2 calls a shift total.

THEN I finally got hired on by a 911 company. We only got maybe 3 calls a shift, if 2 or more of those were 911 calls (everyone got both IFT and 911) you had a nice busy shift. But guess what? The way that city structured their 911 system, us on the BLS ambulance were NEVER dispatched emergent. The FD medic unit did go code, but if we showed up code when they didn't request us to upgrade would've meant I'd have been looking for a new job...We only transported Code 3 when the medics rode in with us (all BLS transports were strictly code 2 non emergent only). It was easy to go an entire week (3-4 12 hour shifts) without once ever turning on the lights. And because that was one of only 6 ambulance companies in the county with a 911 contract, out of almost 90 companies in the county (probably more) THAT was action packed compared to most everyone else.

So be very very glad you happen to be in pretty much the ONLY area of the country where "buffing" is so much as tolerated.

 

[ERDoc]

Seriously, if you want to run calls that bad before you have the ability to run them, go out to Long Island. There are plenty of vollies that more than busy enough. I can't tell you where to go in Nassau but I could give you a few VACs in Suffolk.

 

[Jim37F]

Also, there's a Recruiter (actually lots of them) with an 11X Airborne Ranger contract just waiting for someone to walk in their door asking for action....

 

[ERDoc]

That is an even better idea.

 

[Akulahawk]

Just gotta love all the different EMS slang/lingo that varies around the USA.

Maybe you want to sit around doing nothing, but I didn't get into EMS to sit on my ***. I need action!

When I got started in EMS approximately 15 years ago, I worked for a little "mom & pop" type ambulance company. We did mostly IFT with the occasional emergency run. Most of the time, I worked 12 hour shifts (tours) and in that time, I'd average 8-9 calls (jobs). Here's the interesting thing: we stressed doing good assessments for each and every patient we contacted. Therefore we got very, very good at doing them. I liked doing the emergency runs simply because that meant that I'd get the opportunity to go to the ED with a patient, present my findings and learn from them what I did right and didn't do so well.

The company I worked for was so well regarded that when 911 calls (jobs) were solicited by the 911 dispatch center, we usually got assigned those calls (jobs). When we'd arrive on scene, we'd very often see a look of relief instead of a look of sheer contempt by the local FD's. They knew that we knew what we were doing. Later, when I got into 911, I'd usually have 15 calls (jobs) in 24 hours. A slow day was when we'd get maybe 8 or fewer. Fewest calls (jobs) I ever had in a 24 hour period was... zero. Most I'd ever had? 21.

Now that I'm working in the ER, today I had just 10 patients in 12 hours. It was a slow day. Do I like busy days? Sure. It makes the day go by a little faster. Here's the thing though. Sure, I get to do a lot of things in the ED and I got to do a lot of things when I was out on the street. I never lost sight of the fact that for me to have a "good day" it usually meant that my patients likely had one of the worst days of their lives. I see them as people and these people have a problem that I can help them work through. Sometimes, for some very practical matters, I do have to sit on my *** because I need data that I must wait for. When it comes to doing various tasks/skills, I'm actually a minimalist. A lot of us are that way. I do only that which is needed instead of lots of things simply because I can. Eventually you'll learn that stuff too.

Work on developing good, solid patient care skills and learn why you do them and you'll more quickly be able to realize what we're all trying to tell you. You don't need to do any buffing to learn those skills. Do them by approaching each and every call (job) as if it's an emergency and dial things back from there as needed. Eventually you'll run everything using the same pattern and you won't miss anything substantial while doing just the necessary stuff. When you step up to 911, the only real changes will be the lights and siren get used more and the patient acuity may be a little higher most of the time.

You're not there yet. You're brand new, relatively speaking. I'm still a very new nurse and I still have lots to learn about my field... but put me on an ambulance and I'd be right at home whether it's an ALS or BLS ambulance (bus). It's not that I know it all, it's just that my experience base is much wider and deeper than yours... and a whole lot shallower and narrower than many others that post here.

Hence the advice about buffing: Don't.

 

[Chewy20]

Also, there's a Recruiter (actually lots of them) with an 11X Airborne Ranger contract just waiting for someone to walk in their door asking for action....

lol my recruiter would have smacked me upside the head if I said that. Luckily he was 11b himself and didnt spew me the whole, you'll have all the fun in the world if you join my Army BS.

 

[RedAirplane]

I'm not a New York EMT, but I did sleep at a Holiday Inn Express last night.

The whole system of "jumping calls" really confused me; it seemed like something straight from Alice in Wonderland. I wanted to find out more.

I requested some information from the City of New York under the Freedom of Information Act but was met with a less-than-lukewarm response. A letter from the Fire Commissioner's Office would have me believe that the volunteer ambulances magically come into existence only when FDNY needs them, and they vanish into nothingness at other times.

I also managed to get my hands on dispatch protocols for one of the volunteer ambulances. It looks like there is a Memorandum of Understanding in place where although they are not dispatched via 911, they have unit numbers they can call FDNY dispatch to advise that they are on scene of the call and cancel the FDNY unit. The Memorandum also seems to imply that NYPD is more than happy to have their calls for ambulances jumped by the closer volunteer unit and when in the zone of that ambulance service will radio directly sometimes.

It's nuts, and I have my own thoughts on what should be done about it, but it seems that is how it is.

What I am not sure about is whether this practice extends to the private/IFT type ambulances. That is the question I would encourage OP to find out locally.

And while the entire situation is dizzying, if what OP is asking to do is in fact expected/condoned from his type of ambulance service, I am not sure one can blame him for figuring out exactly how to do what is expected but perhaps not spelled out.

Maybe I'm just someone who doesn't know anything, but this is my $0.02.

 

[adamNYC]

Yes im a new EMT but not new to Healthcare. 4 years previous experience as CNA/PCT. I got in EMS because it got boring and I needed outdoor action. I also use to be a NYC bike messenger so I think you can tell im an adrenaline junkie.

Ironically, I did consider Army/Airborne/Ranger before but I have a son and love NYC too much. If I went I should have went when I was in my early 20s.

Redairplane: Exactly what Im saying. Buffing is standard volly practice between the private calls they receive from local neighbors.

Im also considering another volly in a supposedy bad part of Brooklyn that is known for its GSWs traumas and whatnot

As for privates buffing, its not allowed and I dont do it, but ive heard of guys who have and they simply tell our dispatcher they got flagged for the job. Plausible deniability and intentional serendipity is the name of the game they say

 

[Carlos Danger]

EMS is probably not a good place for an "adrenaline junkie"....

 

[Tigger]

Do you know what patients are? Or is your own ego so large that you don't generally see those on your tours?

 

[OnceAnEMT]

Not to snuff out the OP or anything...

Why is "buffing" these "jobs" not prosecuted by PD? Or the OEM of the city even? There is not much volly EMS where I am at, and where there is, it is 911. I for one think it is silly that there is actually government EMS overlapping with volly. There is your problem. Go join a company, get paid, make a difference, be proud of what you do. As you are trying to race to a scene to beat up the reaper, you are also putting others in danger. But then again, you are wanting more patients. Spin that, see how it goes.

Seriously, this is ridiculous. Worse then Fire arguing over which side of the street they are the AHJ on (and restarting the argument when a structure fire drops).

 

[NPO]

This is the most ridiculous thing I've ever heard. Listen to the feedback. This is a bad idea. It's probably illegal (it is in CA), especially if responding lights and sirens to a scene. I know an EMT who had his license revoked for this EXACT thing.

So then I got to thinking. If you didn't "buff" calls, would your ambulance just sit there? Probably. So why does your agency exist? It's not covering an uncovered area, because you are trying to beat the REAL ambulance there, and most of the time you can't, so it doesn't sound undeserved either.

So that leaves the question of why is it so important for you to race to calls, which are not yours, to get patients.

For billing. Someone is profiting from this, at your expense. Who ever owns your agency could not secure any 911 contracts legitimately so you have to steal calls. Which is also illegal.

So far I count 3 serious illegal offenses, not counting the behind closed doors nonsense I'm sure we don't see.

Listen to us. Get out while you can, or go work for a legitimate transfer only service if that's all you can get.

And I thought Los Angeles was bad. At least there you get a real ambulance when you call 911, even if it does have a firefighters in medics' clothing.

 

[Chewy20]

If I went I should have went when I was in my early 20s.

Wait, you're not 17?

 

[Carlos Danger]

EMS is probably not a good place for an "adrenaline junkie"....

Just to clarify my earlier post.....

EMS is very stimulating and exciting at first, for everyone. But as anyone whose been in EMS for a minute or two knows, that quickly fades and it can become very mundane and routine 99% of the time.

The reason that's a problem is because it means getting into EMS for the excitement is very much the wrong reason. I think a big part of the reason there are so many disillusioned, burned out, miserable people in EMS is because they were sold something false about EMS. It isn't at all the "racing the reaper" stuff that they had envisioned it being. Rather, it's boredom, routine, and sometimes very stressful. It's very rarely fulfilling, if what you need to be fulfilled is stimulation.

And the reason that's a problem is that bored, stressed out, unfulfilled people have a hard time being good at what EMS really requires: selflessness, compassion, understanding. Knowing the medicine and being good at the skills is important, of course, but what the job requires 90% of the time is something very different than what most of us thought going into it.

 

[ffemt8978]

Hey, easy there.



No, you need to stop and come back when you are mature enough. Once you see your pts as people and not as awesome calls to gloat about, then you will be ready for EMS, until then, please stop.

^^^^ THIS ^^^^

 

[adamNYC]

"Listen to us. Get out while you can, or go work for a legitimate transfer only service if that's all you can get"

As per my signature I do specify I do txp work for a private. Privates don't buff so I look forward to the occasional emergencies at docs offices, SNFs, & assisted living facilities. Not to mention hoping I get flagged down for a job, which happened quite a few times.

Remi: Very well said. That was drilled into us in class and after four FDNY EMS ridealongs I did not see any arrests, traumas, or MVAs.

Grimes: Vollys have a rich history in NYC EMS history. It started when city ambulances had slow response times so the local volly would get there faster. Goto any of their sites and you'll read about their history. There are some 40 or so volunteer ambulance organizations in NYC:

http://www.nycremsco.org/newsflash1.aspx

This particular volly gets alot of news coverage

 

[Tigger]

History. Not a good reason to do much of anything.

 

[adamNYC]

No lie I've been getting frustrated at the whole buffing thing myself. Just did a 4-hr volly tour with no calls. If all the vollies would rally together and demand to be part of 911 I would be all about that. Until then I am doing what I can to experience what I want to experience via:

- Joining a busier volly that is in service more often and gets more calls
- Doing ridelaongs with FDNY EMS more often, even if I'm the *****-*** observer helping to carry bags.
- Aggressively job hunting 911 hospitals in approximately 2 months when my 6mos experience is down.
- Taking the FDNY EMS civil service test this year and hopefully start academy next year.

Not a bad plan.

 

[Chewy20]

Yeah, you keep doing you. FDNY EMS will love you...Think its time to stop feeding him peoples.

 

[ERDoc]

Take it from someone who grew up in the same system you are in. You will learn far more about real medicine and caring for pts on your paid bus than you ever will as a volley. Read the discharge summaries on every pt you transport. Go home and read about the pathology. Make a note of a disease one of your SNF pts has that you don't know much about and read about it. Become a provider not a technician. You will never learn anything from running 911 calls other than how to drive fast and dangerous.