teedubbyaw
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As much expendable money that ATCEMS has, they sure could learn to use it differently.
Austin Travis County EMS hiring Paramedics and paying them as Basics
- Thread starter ExpatMedic0
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Answers a lot, thanks!
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.
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?
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.
teedubbyaw
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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.
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.
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.
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.
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
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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.
TransportJockey
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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.
teedubbyaw
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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
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.
TransportJockey
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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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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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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.