AMR Hiring SoCal?

Virgil

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In Kern Co. BLS (EMT/ EMT) ambulances run all sorts of 911 calls without any paramedics whatsoever, do handoffs/ receive handoffs from paramedics etc., and utilize their BLS skills daily. Just sayin'...
I commute two hours one way now, into Santa Monica. I don't have a desire to see such commutes for a long time lol. Maybe once I get little more beneath my belt I can head out to northern pastures.
 

RocketMedic

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In Kern Co. BLS (EMT/ EMT) ambulances run all sorts of 911 calls without any paramedics whatsoever, do handoffs/ receive handoffs from paramedics etc., and utilize their BLS skills daily. Just sayin'...
Can medics turf patients to BLS?
 

RocketMedic

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Dude. Kern County is WAY more progressive than 98% of Texas. Why am I not there?


I've realized that RSI doesn't matter in the vast majority of cases. Nor does a bunch of the other esoteric things we keep/do. A lot of what we do do isn't particularly wise or smart or medically-indicated, and I fear that the Texan EMS culture often needlessly derides informed medical consultation in order to follow a protocol or "cowboy" through things.

I'm over it.
 

VentMonkey

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Dude. Kern County is WAY more progressive than 98% of Texas. Why am I not there?
I think we both know that this isn’t true.
A lot of what we do do isn't particularly wise or smart or medically-indicated, and I fear that the Texan EMS culture often needlessly derides informed medical consultation in order to follow a protocol or "cowboy" through things.
This is “heroic” EMS culture in general, not exclusive to Texas.

Because I respect both your opinions on here, and the educational efforts that you’ve made to hone yourself as a professional in an industry that’s got mixed views and signals on what exactly it is that defines such, I’ll say this:

You’ve got to stop selling yourself short...to yourself. Hopping from one job to the next probably isn’t the solution to your search for an “EMS unicorn”. There is no unicorn.

To me, it sounds as if you’ve got a clinicians heart, and an administrators mind. From firsthand experience this can be a pretty hard thing to grapple with.

Truth be told though, if you really want to make changes, you need to decide whether it’s more hands-on clinically, or behind-the-scenes administratively.

You could probably start with the former, and segue into the latter. But again, grinding it out with realistic approaches to whatever agenda that the current administrations you’re under has (wherever it may inevitably be) is, well, inevitable.

TLDR~ you’re going to have to start from the bottom and work your way up somewhere with an open mind. //shrugs// At least your educational background should help the threshold to your promotional aspirations a shorter one.

And just to re-rail the thread: Hall is always hiring.

#LongLiveTheCult.
 

DrParasite

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Dude. Kern County is WAY more progressive than 98% of Texas. Why am I not there?[/qupte]Is that all your looking for? Go to NJ then. Or Delaware. or find another system that is a tiered EMS system
I've realized that RSI doesn't matter in the vast majority of cases. Nor does a bunch of the other esoteric things we keep/do. A lot of what we do do isn't particularly wise or smart or medically-indicated, and I fear that the Texan EMS culture often needlessly derides informed medical consultation in order to follow a protocol or "cowboy" through things.

I'm over it.
I thought all protocols in Texas were solely at the discretion of the medical director? so if your medical director said you could perform a procedure, you can. so if you want to find an agency that lets you RSI, you need to find an medical director that allows you to RSI. Again, no first hand knowledge on how texas works, just what i've read here.
 

RocketMedic

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Indeed, our individual services set our scopes of practice. And sometimes it's great. Other times, they're handing people laryngyscopes and paralytics without appropriate anything. And the chances to use those "skills" are rare.
 

rescue1

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Indeed, our individual services set our scopes of practice. And sometimes it's great. Other times, they're handing people laryngyscopes and paralytics without appropriate anything. And the chances to use those "skills" are rare.
Have you ever thought of going back to school? CRNA, PA, NP, Doctor, etc? If you're looking for significant education and an ability to do cool procedures on a fairly regular basis (and not have to worry about if you're actually helping the patient, like with routine RSI) I just don't think you're going to find it in EMS, except maybe in some flight programs.
 
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RocketMedic

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@VentMonkey
I have very little desire to be "more" clinically. Quite frankly, the bandwidth isn't there. I'm a pretty smart dude with a lot of bandwidth and I feel like it's maxed out at times. There's a reason that big things are done in teams. Having one person be responsible for everything under the sun clinically doesn't work in our environment in an unlimited setting without a lot of luck, and luck is a finite resource. With that being said, I really really enjoy the science and practice of education and the process of education, and I really want to lean more towards the educational role than operational or pure-administrative (although my dream job has a decent portion of all three disciplines).

With that in mind, @rescue1 , I'm not terribly enthused about going to more clinical school. I have no desire to be a physician; their job looks horrible. The money can be OK, but I really don't enjoy the repetitive performance of clinical procedures; I really don't even particularly enjoy blood&guts and such (although there is a part of me that does enjoy the challenge posed by a sick/injured patient). I really like working with systems, helping set people up for success. It's a challenge just as great (and rewarding) as clinical medicine, and I am pretty good at it. In fact, looking back at my career so far, most of my discontent is actually coming from dissatisfaction at working conditions and systems to a significant degree, not anything clinical. One of the better jobs I've had (that I left out of a combination of dissatisfaction with how we were treated and need to keep going to school -vs- "junior supervisor" roles that precluded school) encapsulated it perfectly...clinically excellent care, but no leadership support for doing the right thing for patients and crews. A safety nap or declined/delayed non-emergency transfer was not allowed; the expectation was that the supervisor would simply 'get it done'. All the time. Every time. Regardless of who they put at risk, how much risk, or why. Because reputation and dollars and "work ethic" mattered more than safety or health. And that agency is far from unique. It drives away nearly 80% of its workforce every two years, and the pattern doesn't change regardless of who sits in the corner office. And that's the same everywhere.

And although I've been able to find clinically-decent systems pretty easily, I've found that they all have cores of dog poop when it comes to how crews are treated, how the culture is, and how/who is leading them and how they are empowered to help. And that matters. Cypress Creek is one of the more advanced providers in the US in our field, yet their entire culture is one of fear, intimidation and exploitation. They run 30% annual turnover simply because their culture doesn't permit change and their leadership prioritizes 'clinical care' and objective operational measures like cost and times and doesn't consider human factors.

@NomadicMedic , you brought up a point earlier in PMs about chronic dissatisfaction. And I think you're right; it is primarily my unrealistic expectations that have contributed to my nomadic ways and my failure so far to leverage my education and talents beyond where they could be. But I think that you miss an important point- that dissatisfaction is precisely why we need to change things. The way that things are done currently limits EMS to a fractional subset of people desperate, crazy or generous enough to work in current conditions and cultures, and as we're seeing, it's not really enough to even sustain the need for people, much less grow to meet population changes and current/future needs. Those aren't just financial problems, they're cultural problems. I'm 30 years old, making around $80k a year gross with overtime factored in (24/48@ 22.33/hour), with OK benefits...and I don't like my job, because it's not about the money. It's how we're treated. And that's frustrating. The existing systems do not have appropriate work-life balances, do not properly utilize their human capital, and do not produce cultures, climates or practices that ensure a high degree of safety, reliability, value or efficiency. That means that the systems need to change, and people like us are the ones to do it. I stick around this field, with my antenna up, because I think that there are opportunities out there to do exactly that, and that's what I really want to do with my fancy book learning and passion and talents. Help to build a better system, because I've grown up in and been working for and been harmed by bad systems for literally my entire life (minus the Army).

It's not even about the money. Enough to pay bills and live life is all that's really needed. It's about how we're treated by our management, by our coworkers, and maybe a little by the public (but almost all the first one). You could run an exceptional EMS service on a bit less than current budgets, with no capital changes, if you simply lead well.

And to re-rail the thread, I got off of my butt and sent in my California paramedic reciprocity packet, license verifications, and the DOJ background check, and some money, so I can have options. California Dreaming? Definitely. And I don't know if I'll ever use it. But CA is 40 million people and growing, it's nearly post-oil financially, and it's got an environment, culture and vibe that makes it a world-class place to live and visit, and the taxes actually aren't that bad compared to ours here in Texas. And those 40 million people have needs, we work in a short-staffed field that caters to those needs, and there's bound to be opportunities with those 40 million people. It would be a shame to miss something like that for want of a card. Yeah, this thread exposes some problems like AMR Riverside being not excellent. But y'all miss the point...you can at least try for better! Here, dissent is met with termination, and there's no point being dissatisfied, because everywhere is basically the same in every way that matters and the ones that are different are rare, far from home, can't afford you, etc.

As far as SoCal EMS goes, IDK. I haven't lived there since 2007 and I was a kid. But 99% of this job is the exact same everywhere, and the more I look at deep Texas drug boxes or whatnot, the more I kind of wonder what difference most of it makes and is it really the end of the world if I have to ask a second opinion before I do something rare, potentially-dangerous and potentially unnecessary?
 
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rescue1

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I think you're biggest issue was also my biggest issue with EMS and why I left--being a paramedic is a profession with minimal self-governance. You're a poorly to moderately payed widget, completely interchangeable with any other paramedic at any time. Even being a supervisor is basically just serving as an extension of whatever management wants rather than a position where you can create real change. The issue is that unless you stick around at a specific job for a long long time and get promoted several times to a position where you may be able to change something, you'll never be in a spot to enact systems based change as a paramedic.

I know some people who have gone back to school to get emergency management bachelors/masters degrees and now work on a systems level. One is now in the process of converting a volunteer ambulance system consisting of multiple independent departments into a paid county based EMS department and he's younger than you. Something like this can give you a lot more legitimacy in terms of finding jobs where you have the ability to create change at a larger systems level.

Of course you may get lucky and find a great job where employees are valued and clinical skills are nurtured and all that, but those things can easily be taken away with new ownership/city government/new medical director/whatever. Having some sort of marketable "skill" like an EM degree and management experience can let you have a hand in the change itself, or escape more easily if the worst should happen.

I agree with you that it's likely that the vast majority of differences between EMS protocols have no impact whatsoever on patient outcomes, and having some New Jersey EMS experience, calling base command for simple stuff is hardly a big hardship.
 

RocketMedic

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I think you're biggest issue was also my biggest issue with EMS and why I left--being a paramedic is a profession with minimal self-governance. You're a poorly to moderately payed widget, completely interchangeable with any other paramedic at any time. Even being a supervisor is basically just serving as an extension of whatever management wants rather than a position where you can create real change. The issue is that unless you stick around at a specific job for a long long time and get promoted several times to a position where you may be able to change something, you'll never be in a spot to enact systems based change as a paramedic.

I know some people who have gone back to school to get emergency management bachelors/masters degrees and now work on a systems level. One is now in the process of converting a volunteer ambulance system consisting of multiple independent departments into a paid county based EMS department and he's younger than you. Something like this can give you a lot more legitimacy in terms of finding jobs where you have the ability to create change at a larger systems level.

Of course you may get lucky and find a great job where employees are valued and clinical skills are nurtured and all that, but those things can easily be taken away with new ownership/city government/new medical director/whatever. Having some sort of marketable "skill" like an EM degree and management experience can let you have a hand in the change itself, or escape more easily if the worst should happen.

I agree with you that it's likely that the vast majority of differences between EMS protocols have no impact whatsoever on patient outcomes, and having some New Jersey EMS experience, calling base command for simple stuff is hardly a big hardship.
That’s what I’m really on the lookout for- a change to leapfrog the supervisor/manager pipeline by leveraging that education. I’ve had to pass on a few opportunities while I was finishing my MHA, but now I’m free to go for them.
 

Virgil

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Did my interview for AMR Riverside, they said there is no skills test involved, only what takes place during the FTO period after Orientation. I would've thought there would be one.
 

teufulhund

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Did my interview for AMR Riverside, they said there is no skills test involved, only what takes place during the FTO period after Orientation. I would've thought there would be one.
Ya I’ve heard all they do is a physical test. Basic stuff like lifting the stretcher and such.
 

Virgil

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Ya I’ve heard all they do is a physical test. Basic stuff like lifting the stretcher and such.
Yeah, they said EMT's go through a FTO period where they either get ALS or BLS rated? Something like that. But either way, I'm looking forward to (hopefully) getting a call back.
 

teufulhund

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Yeah, they said EMT's go through a FTO period where they either get ALS or BLS rated? Something like that. But either way, I'm looking forward to (hopefully) getting a call back.
Ya you have like 11 FTO shifts, some ALS some BLS. After all that if you’re good, and the need requires it, you’ll get placed ALS. Good luck man!!
 

Virgil

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Congrats dude! Do you know if you’re working North End or South End?
Not yet, I have orientation soon, and hopefully they'll key me in with what area I'll be working.

Any differences between the two? Call volume, types of calls, etc?
 
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