Austin Travis County EMS hiring Paramedics and paying them as Basics

[marshmallow22]

Well put medicsb!! And let me just say, out of all of my posts I have never degraded or taken away from any other EMS department. Each department has their pros and cons... just as mine does.

 

[TransportJockey]

Well put medicsb!! And let me just say, out of all of my posts I have never degraded or taken away from any other EMS department. Each department has their pros and cons... just as mine does.

The only agency i have spoken disparagingly about is DC FEMS (yes i feel the acronym is fitting considering how they perform). It has been shown several times what type of system they are.
As for Austin/Travis, i just have a personal issue with being a medic but not being allowed to perform up to my full training and knowledge. I have been gravitating to working for agencies that employ the double medic truck model, and i would love to go back to Texas to do it. It is my personal opinion that i do not like the way they work their system now, and hence i will most likely not consider employment with that agency. I have others, including several with community health or advanced practice and critical care scopes (which interests me much more than an all 911 truck does anyways), that i was considering which will move up in consideration. Including a maroon company in a large metro area in Texas.

 

[marshmallow22]

When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency. We get plenty of apps. and we'll operate just fine without you so that's okay if you don't apply with us. I think you're going to find it won't be as easy as you think it is to get hired with the agency of your choice, but good luck to you anyways.

 

[Fish]

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).

Austin no longer pays for experience

 

[DrParasite]

When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency.

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?

 

[Fish]

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.

One thing is for sure, Austin has a PIO and a large Clinical department. And large budget. Allowing for them to make stats as available as they do.

I would not say "shame on others..." not all departments have the same amount of resources.

 

[TransportJockey]

When we were hiring all paramedics we actually only hired about 10 to 20% of the applicants that were actually successful through the entire testing process. I think you're going to find this to be true with any reputable agency. We get plenty of apps. and we'll operate just fine without you so that's okay if you don't apply with us. I think you're going to find it won't be as easy as you think it is to get hired with the agency of your choice, but good luck to you anyways.

I know for a fact it won't be easy. That's why I am doing as much as possible to stand above people I know I will be applying against. It's why I am finishing a class to prepare me to sit for my FP-C, and why I'm looking at my AAS in EMS, along with a BS-EMS specializing in community paramedicine. Thank you for hte luck, I know I will still need it no matter what. I have no doubt that your agency will do just fine, as I said, it's my personal opinion. And to me, applying for agencies out of NM, that's all that matters.
Either way, stay safe.

 

[marshmallow22]

Historically if you passed the written and skills then you made it through all 3 days of the:excl: process which include the physical agility, a psych written, a psych interview, and a panel interview. Those that made it through the process and did not get hired were not hired for a number of reasons. Some of those include having a poor interview, a poor psych interview, and failing our background process.

 

[medicsb]

One thing is for sure, Austin has a PIO and a large Clinical department. And large budget. Allowing for them to make stats as available as they do.

I would not say "shame on others..." not all departments have the same amount of resources.

Nah. I disagree. Most EMS' have websites. It doesn't take much effort to make a page for "quality" metrics. Any service that does any sort of QA/QI should be able to track certain things from response times to ETI success to STEMIs ID'd to use of CPAP. It may take some effort to gather the data, but the effort is worth it. I remember back when I was first a medic and was helping out with QA/QI, it took me only a couple of hours to compile ETI stats over the past few years since we did electronic charting (man were those bad).

 

[medicsb]

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.

Wut? No where near a good measure? C'mon. We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs. Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system. For something we consider to be so easy to manage, many seem to not do it well. Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems. If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.

It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.

It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.

 

[Fish]

Nah. I disagree. Most EMS' have websites. It doesn't take much effort to make a page for "quality" metrics. Any service that does any sort of QA/QI should be able to track certain things from response times to ETI success to STEMIs ID'd to use of CPAP. It may take some effort to gather the data, but the effort is worth it. I remember back when I was first a medic and was helping out with QA/QI, it took me only a couple of hours to compile ETI stats over the past few years since we did electronic charting (man were those bad).

True, and I would add. Most EMS services already have this data, they have just not got around to placing it online. For whatever reason.

 

[Veneficus]

Wut? No where near a good measure? C'mon. We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs. Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system. For something we consider to be so easy to manage, many seem to not do it well. Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems. If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.

It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.

It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.

Easily measurable yes. But I stand by my statement it is a poor measurement of a system.

I could probably write a book on the utstein criteria and its shortcomings.

So how do you rate EMS systems with poor cardiac arrest survival in populations predisposed to poor outcomes?

Take for example Medic-1 stats, they have a reasonably healthy and educated populous, compared to say greater DC or Philly. What about Detroit? States with high incidence of obesity and comorbidities of it?

Does a low arrest "save" rate reflect poorly on those systems?

How does it compare with what was done by the hospital?

I agree it is easy data to collect. It is easy to sell to the public. But as far as measure for a system, too many confounding variables.

Edit: I would also point out that areas which have good outcomes using Utstein generally advocate for it and places with poor statistics don't use it at all.

 

[ExpatMedic0]

So as some one else mentioned, ATC is also no longer paying for years of experience?

 

[marshmallow22]

That's correct. It does not matter on your experience anymore. I know that may limit the # of apps of people we get that have experience, but also experience doesn't necessarily mean a good candidate. We also do not want someone with bad habits. With our new recent adoption of civil service voted in by the residents this past election many things may change in regards to our hiring practices in the future.

 

[usalsfyre]

That's correct. It does not matter on your experience anymore. I know that may limit the # of apps of people we get that have experience, but also experience doesn't necessarily mean a good candidate. We also do not want someone with bad habits. With our new recent adoption of civil service voted in by the residents this past election many things may change in regards to our hiring practices in the future.

So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".

 

[46Young]

So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".

I was thinking the same thing. Only employing the inexperienced, which is what is happening by proxy with ATC's current hiring practices, just assures that the new hires only think along company lines, with no forward thinking of their own. Places that only want inexperienced people clearly do not value forward thinkers with different perspectives and ways to improve their service.

Right after I left NS-LIJ CEMS they did the same thing - they only wanted new people that did things the company way and would not question any current practices for the purpose of improving their operations and working conditions. Also, if you've never worked anywhere else, a system could be seriously flawed, but the probie would never know it.

 

[marshmallow22]

We're not only going to hire inexperienced people. We actually have some experienced paramedics that got hired in the medic 1 position with the last hiring process. All are welcome to apply, and we will hire the best candidate for the position. Once again, someone with experience does not always make the best candidate, especially if they're a problem child somewhere else, or have an untrainable attitude.

 

[Veneficus]

So you want the best candidates? Or do you want people who you can get to drink the Kool Aid with out question? Cause I'll be honest, I haven't seen you espouse a change I consider particularly positive. Seems like you want to play the same game as many FDs rather than move forward as a MEDICALLY minded organization. How many practices would chose a newbie attending surgeon over a well credentialed and established one then pay him resident wages so that they didn't get "bad habits".

Well said.

I have even come across places that wanted to hire outsiders specifically for an unbiased outside view of the company.

That is a mark of a highly progressive and respectable employer.

I was thinking the same thing. Only employing the inexperienced, which is what is happening by proxy with ATC's current hiring practices, just assures that the new hires only think along company lines, with no forward thinking of their own. Places that only want inexperienced people clearly do not value forward thinkers with different perspectives and ways to improve their service.

This is becomming more and more common in all industries as I see it.

Those with nothing to fear have nothing to hide.

But when you get promoted by seniority instead of ability, hiring a highly capable, established, and tested candidate is a very scary prospect.

We're not only going to hire inexperienced people. We actually have some experienced paramedics that got hired in the medic 1 position with the last hiring process. All are welcome to apply, and we will hire the best candidate for the position. Once again, someone with experience does not always make the best candidate, especially if they're a problem child somewhere else, or have an untrainable attitude.

I doubt that.

One of my former partners, an extremely capable and singularly gifted medic, applied there many years ago. I was listed as one of her references and ATC called me.

The questions they asked me about her were largely non-professional. When I pointed out their questions had nothing to do with the job and were basically things they were not legally permitted to ask a reference or at an interview, the caller tried to pull the "we're both medics and nobody will ever know, be a friend..." line.

Again I stated I would not answer questions not relevant to the position and her out of work hobbies and "preferences" was the word he used.
He then asked me in the same call, based on my credentials, if I wanted to interview for a postion as well.

I declined.

I don't need anybody calling my former coworkers and friends asking about my "preferences" out of work to see if I am a good candidate for a job.

I will also point out, a "problem child" is a very subjective description. I have been labeled a "problem child" by some of my past employers. For things like "not driving fast enough in the fog" or " not sounding panicked enough on the radio." I was even a "problem child" for pointing out that the billing practices at one agency might actually be medicare fraud. (only a few years after I left they "settled" the matter out of court)

In other agencies, I continue to be acclaimed as an extremely desirable employee.

I guess it is all a matter of your "preferences."

 

[RocketMedic]

Kool-aid Kool-aid!

There's a fantastic Army cadence about just that.

Personally, I think one of the markers of a truly superior employer is when there is no Kool-Aid, simply a desire to work there (along with a gourmet coffeepot).

I'd take coffee over Kool-Aid any day of the week.

 

[NomadicMedic]

Kool-aid Kool-aid!

There's a fantastic Army cadence about just that.

Personally, I think one of the markers of a truly superior employer is when there is no Kool-Aid, simply a desire to work there (along with a gourmet coffeepot).

I'd take coffee over Kool-Aid any day of the week.

We have a Keurig at every station.