Austin Travis County EMS hiring Paramedics and paying them as Basics

[46Young]

ugh, 33 an hour for your most experienced medics, but you only do IFTs? I would kill myself, esp if I was considered the highest level of training at my agency. Unstable IFTs are one thing (STEMI, Strokes, etc, anything where there is a life threat from a very recent illness or injury), but a very stable IFT? where the patient needs a monitor for a procedure tomorrow morning? I couldn't do it, and I know quite a few medics (actually a whole lot) who would die or boredom. Just a personal opinion, your opinion may be different.

And yes, I do know quite a few RNs who do CCTs, and they are often partnered with a paramedic (so they can do ALS 911 calls when not on a CCT). They have similar opinions about CCTs, especially the prescheduled ones.

and why do they pay low wages? because people will work for such low wages. Then again, I'd rather work OT on my schedule than being forced, or a side job, since usually OT pays morenot for nothing.

The CC medics that only do IFT like doing only IFT. Not everyone in the system wants to do NYC 911. The CCM only gets high acuity calls, not NH discharges, routine IVL/monitor/O2, etc. That system gets a fair amount of CC calls, so it's not too bad. They can spend the down time taking classes and such.

As far as FDNY EMS, everyone in NY knows that you work at the hospitals for the money, schedule, and working conditions, and you work FDNY for the benefits. It's good money if you're just off the street or stocking shelves somewhere I suppose. The pay used to actually be worse, believe it or not, before they got uniform status and actually got a new contract. Their top pay is actually closer to the hospitals than what it was before. If you're committed to living in NY for life, and are committed to doing EMS for the long term, then it's the best choice to work for FDNY EMS since you get decent medical, a pension that includes OT in the calculation, and is way more stable than the hospitals, which seem to be falling like dominoes lately.

Of course, a medic can do better financially and also with working conditions out of state, particularly fire based, but most in the business back in NY are maybe vaguely aware of EMS systems elsewhere, but hear that they pay crap. So, the FDNY EMS pay seems to be not too awful for a 110 hr EMT course or a 13 month medic class for those with little ambition in life.

 

[Fish]

I love the saying nobody joins EMS to get rich


I usually hear that from EMTs who make $8 an hour and are trying to convince themselves that they don't mind.

That being said

Austin pays well, their Medics live comfortable life styles and are typically not living paycheck to paycheck. What they are willing to pay an EMT basic with no experience right out of school is the best around.

 

[ThirdCareerMedic]

I agree, it would be quite frustrating. I'd probably end up getting called in to the medical directors office a couple times... :unsure:

So, if you are working as an "overfill" in an EMT position when you are licensed as a paramedic, do you only practice to the level of an EMT, using EMT level protocols, etc.? Or, are you by law/license expected to practice to the level of paramedic regardless of whether your position is that of an EMT or not?
All the responsibility of a paramedic but not the pay?

 

[46Young]

So, if you are working as an "overfill" in an EMT position when you are licensed as a paramedic, do you only practice to the level of an EMT, using EMT level protocols, etc.? Or, are you by law/license expected to practice to the level of paramedic regardless of whether your position is that of an EMT or not?
All the responsibility of a paramedic but not the pay?

Refer to post #77. They're hired into an EMT spot, so their patch says EMT, even though they're credentialed to a higher level by the state.

 

[ThirdCareerMedic]

Refer to post #77. They're hired into an EMT spot, so their patch says EMT, even though they're credentialed to a higher level by the state.

Thanks for that. Just so I am clear, so if one wears a patch saying EMT, then one has no ethical or legal responsibility to provide care at the ALS level in spite of credentialing or licensing at that level?

 

[shfd739]

Thanks for that. Just so I am clear, so if one wears a patch saying EMT, then one has no ethical or legal responsibility to provide care at the ALS level in spite of credentialing or licensing at that level?

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.

Maybe I missed it..Is there a possibility in the future that ATC will hire in current paramedics to function at that level? Or is the only way now to hire in as a paramedic and play as a basic till a paramedic spot opens (a la Boston)?

 

[firecoins]

If your a medic working as an EMT, you have no obligation to provide ALS care and you wont have the equipment available to provide ALS care anyway. Your expected to do the BLS as best can be done.

 

[marshmallow22]

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. I agree that for an EMT I don't think you'll find many places that will pay as high as us working in an all 911 only system with great benefits. As a paramedic there may be better options as far as the pay goes, at least until you promote to a paramedic spot.

 

[shfd739]

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. I agree that for an EMT I don't think you'll find many places that will pay as high as us working in an all 911 only system with great benefits. As a paramedic there may be better options as far as the pay goes, at least until you promote to a paramedic spot.

So for a current paramedic is this the only way in? Or will ATC hire in paramedics in the future to function at that level without the Medic 1 crap?

 

[ExpatMedic0]

sounds like an EMT's dream come true and a paramedics bad dream.

 

[TransportJockey]

I guess ATC just got taken off the list of places I really wanna work... There's still Williamson though

 

[medic417]

I guess ATC just got taken off the list of places I really wanna work... There's still Williamson though

You can definitely find better pay and protocols away from ATC. They are no longer even close to being one of the best.

 

[marshmallow22]

Not sure how long this will go on for, but we are being told that the medical director wants a 60/40 ratio of dual medic vs medic/EMT trucks. Also, in regards to Williamson County, they do a 24 on and 48 off rotating schedule, and their pay starts at 16.30/hr regardless of experience. Just FYI. And opinions may vary, but as far as EMS agencies go, we are still one of the most respected and one of the higher paying departments in the nation (at least for the medics who came in before the current hiring practices).

 

[marshmallow22]

Agencies are not measured to be the best by their protocols or pay. Those things are what is desireable to potential applicants. To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center. There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate. A good paramedic is basically a social worker 90% of the time. You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.

 

[medic417]

Agencies are not measured to be the best by their protocols or pay. Those things are what is desireable to potential applicants. To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center. There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate. A good paramedic is basically a social worker 90% of the time. You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.

But when your patient needs them you sure want to be working for a progressive system where you can do what the patient needs.

I do agree with the social worker statement in fact it is actually closer to 99% than 90%.

 

[Veneficus]

Agencies are not measured to be the best by their protocols or pay. Those things are what is desireable to potential applicants. To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates,

Cardiac arrest survival rate is nowhere near a measure of a good EMS system.

There are far too many confounding factors and you are measuring how well you are bringing people back from the dead.

To say nothing of the fact that bystander CPR is going to be the biggest indicator of success.

About the best you could do to turn this in your favor is community CPR instruction and public access AEDs.

on scene trauma times

This doesn't matter either. Most trauma is ortho in nature. The only life threatening ortho injury is compartment syndrome.

Sprains, strains, and most fractures are time dependant in hours or days.

There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill..

Are you saying that advanced training and skills is not something that attracts and retains quality providers?

A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate. A good paramedic is basically a social worker 90% of the time. You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.

I think this contradicts your earlier statement. If this is a measure of a good paramedic, would not advanced skill training and knowledge, or special education in social issues and alternative transport decisions from the ED be the mark of a good system.

You basically used a 1980s set of measurements of a good system and then went on to give modern examples of a good paramedic.

???

 

[marshmallow22]

The ways to measure a good EMS system ARE the ways in which I stated you do that. Why? Because that is raw data... objective data. Everything else is just opinion and subjective argument. Again, opinions may vary, but what I can tell you is that our stats don't lie. I'm proud of my department and our protocols work just fine for our system. I believe we are still one of the best systems in the country.

 

[RocketMedic]

Agencies are not measured to be the best by their protocols or pay. Those things are what is desireable to potential applicants. To measure an agency by being "the top" or "the best" you need to look at things like cardiac arrest survival rates, door to balloon times in MI's, on scene trauma times, and stroke recognition with proper triaging to a stroke center. There are plenty of agencies that have protocols from here to the moon, but 1) never use 90% of them, and when they do they can't remember the procedure anyway, or perform them incorrectly, and For example, you may have pericardiocentesis, surgical crichs, or even chest tubes in your protocols, but really how many times in your career are you going to be performing those procedures. In fact, intubatations and/or nasal intubations are a lot more rare now than they were 10 years ago, especially with CPAP... and CPAP is a BLS skill. A good paramedic is not measured by the protocols or the skill they are allowed to perform, but rather being able to do a good assessment, a good triage of patient condition, and a patient advocate. A good paramedic is basically a social worker 90% of the time. You can teach a monkey to memorize protocols or do procedures, but you need first be able to recognize when they need to be done.

*Intubation

I agree with the sentiments of your post, but emphasis on statistics is also flawed.

 

[medicsb]

There is a funny thing that happens on EMTLIFE, which is demonstrable in this thread. A service that is relatively transparent, which actually dedicates time to PR, etc. seems to get plenty of bad-mouthing by others. There is always a citation of "better" services outside of whatever one is being talked about, yet rarely are these services ever mentioned, and when they are, I look them up and I am consistently underwhelmed.

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.

 

[Veneficus]

The ways to measure a good EMS system ARE the ways in which I stated you do that. Why? Because that is raw data... objective data. Everything else is just opinion and subjective argument. Again, opinions may vary, but what I can tell you is that our stats don't lie. I'm proud of my department and our protocols work just fine for our system. I believe we are still one of the best systems in the country.

Raw data that means nothing has no value.