Austin Travis County EMS hiring Paramedics and paying them as Basics

[Fox800]

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.

 

[STXmedic]

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?

 

[Fox800]

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.

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.

 

[Fox800]

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]

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.

 

[Fox800]

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?

 

[Fish]

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"

 

[Fox800]

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.

 

[Fish]

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?

 

[mycrofft]

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?<_<

 

[RocketMedic]

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.

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

 

[Fox800]

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.

 

[Fox800]

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.

 

[Fish]

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

 

[Fish]

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/

 

[Fox800]

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.

 

[Fish]

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.

 

[Fox800]

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.

 

[medic417]

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.

 

[Fish]

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