Austin Travis County EMS hiring Paramedics and paying them as Basics

[gotbeerz001]

Gotshirtz, you're a new California paramedic with a superiority complex becaise you haven't earned the emity of the Internet's legions of wannabes and newbs. Color me impressed by your depth of knowledge.

I am a new CA paramedic.
I am not new to working hard, finding satisfaction in my work while seeking out better opportunities.
I am not new to getting along with coworkers.

That said, it is only a matter of time before I am no longer a "new medic". The other traits seem to allude people for a lifetime.

 

[ExpatMedic0]

This thread had a recent revival. I started this thread in 2012 and my opinion still stands for a variety of reasons. I don't agree with the practice myself. In my opinion it seems to be the opposite of anything "high performance" as your weeding out some of the most knowledgeable and perhaps educated employee's and penalising them as applicants. In theory I suppose this is a heavy handed tactic of training everyone from the ground up the way you want them before there delicate blank canvases are spoiled by the reality and knowledge of the outside world. I believe some tribes in the 3rd world have the same theory and tactic when it comes to the virginity of their women and various other human rights violations. However, before I stray to far off topic, ACTEMS was also in JEMS, EMS World, and local news papers at the time this article was started for major financial problems, system wide administrative failures, and other huge agency woes. As you may remember that is when this idea came into practice.

 

[RocketMedic]

Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine.

If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.

If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.

 

[Tigger]

I like how none of you actually possess the faculties to do more than laugh. It really reinforces just how mediocre this industry and some of this forum's members are- stunted, "novel" BLS-heavy systems with good PR are idolized with little or no justification and critical analysis is written off as the rantings of a bitter hermit.

Chewy20, you're a Kool Aid drinking newbie who thinks your selection for a fairly exclusive service qualifies your opinion over all other ones. You literally do not have any experience of value to people smart enough to look around at the world.
Gotshirtz, you're a new California paramedic with a superiority complex becaise you haven't earned the emity of the Internet's legions of wannabes and newbs. Color me impressed by your depth of knowledge.

Remi, I have no idea who you are, but I really don't care. Yes, for me, finding a unicorn is important. I feel far too many of us settle for what we are told is good and justify it by playing up the good and denying the bad. I don't judge people by their employment decisions, but I do certainly feel that some of us brainwash ourselves into accepting a situation, and I think that's unfortunate.

You would also seem to lack any experience of value when it comes to your previous employers.

Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.

I'm surprised to see that you didn't know that.

 

[RocketMedic]

You would also seem to lack any experience of value when it comes to your previous employers.

Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.

I'm surprised to see that you didn't know that.

So, the primarily-BLS service expanded more? Even if most or all of their ALS treatments were on standing order, they would still be blindingly average.

 

[RocketMedic]

You would also seem to lack any experience of value when it comes to your previous employers.

Additionally you posted the Massachusetts state protocols that services are free to add waivers to. Meaning that what you find in there is not necessarily indicative of what a service can do both in terms of intervention and on-line control.

I'm surprised to see that you didn't know that.

My previous employers had some value, but it wasn't beneficial for me to remain there. Even EMSA was, at best, a good place to learn.

 

[Tigger]

You're wrong!
No, you're wrong!
You're stupid!
No, you're stupid!

Over it.

When are you guys going to learn that you aren't changing hearts and minds here on this forum? Most folks are stuck in the mud (of their choice) with 4 flat tires.

I appreciate the sentiment, however we encourage discussion here. Which is precisely what is occurring here.

I don't think I am changing anyone's mind. But I think it's important that people reading this get both sides of the story.

 

[Tigger]

So, the primarily-BLS service expanded more? Even if most or all of their ALS treatments were on standing order, they would still be blindingly average.

I don't know. I don't work anywhere near there anymore. Just pointing out that it's hard to get a good grasp of what a service provides solely based on the internet.

 

[RocketMedic]

I don't know. I don't work anywhere near there anymore. Just pointing out that it's hard to get a good grasp of what a service provides solely based on the internet.

However, it's entirely possible to make reasonable evaluations based on their deployment model, general protocols and operational concepts.

 

[Carlos Danger]

Remi, I have no idea who you are, but I really don't care. Yes, for me, finding a unicorn is important. I feel far too many of us settle for what we are told is good and justify it by playing up the good and denying the bad. I don't judge people by their employment decisions, but I do certainly feel that some of us brainwash ourselves into accepting a situation, and I think that's unfortunate.

I am a disinterested observer here. For years I worked in some pretty progressive HEMS programs, but EMS is simply a hobby to me now. I couldn't care less what you do with your career or how satisfied or dissatisfied you are.

I'm just telling you, the constant berating of everyone else's career choices is wrong on several levels, and it really makes you come across as an arrogant prick. If you really want to help people find career satisfaction, there are ways to do it. If you just want to be a whiny know-it-all who no one takes seriously because your response is the same to every question, just keep doing what you are doing.

 

[Chewy20]

Smh.

Someone at least tell me where I get those patches he is talking about. Our shirts are only allowed to have the state and the department patches, and the other shirt only has department logo and personal name. I wanna be tacticool so bad.

Let the little ginger hobbit go back to his hole.

If someone has a question PM me, if you want. Now, back to being an ambulance driver.

@Tigger doubt it says anything about BLS being able to use Narcan etc. at our old service...but hey, he knows.

 

[Burritomedic1127]

Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine.

If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.

If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.

So putting 10 stickers on a patient and potentially starting an IV make you a clinician? The best tool any clinician can have is a killer physical assessment, whether basic, medic, RN, PA, whatever role.

The assessment is the bread and butter and everything else after that is to help narrow findings off your assessment.

To say that high volume and short transport BLS providers are just drivers, solidifies to me how unconfident you are as a provider, using cockiness to overcompensate.

Wouldnt normally respond to something like this but being that i work in a high call volume area of one of the states where you dont know your *** from your elbow i had to chime in. Basics with strong assessments can be more helpful that dingleberry paragods who uses the monitors and drop huge IV lines brah.

Strip everything down company, trucks, pay, patches, level, ego, call volume, transport time, tools like monitors etc, all we should be doing is an good solid assessment.

Giving you advice: dont be that guy

 

[RocketMedic]

Burrito, you miss the point entirely.

 

[Burritomedic1127]

No i really dont though. Saying people shouldnt work at places in high call volume/short transport areas because it turns them into just a driver and not a clinician is ridiculous.

 

[Burritomedic1127]

Just saying man is that people dont want to hear someones opinions who hasnt worked in a area with a certain company. Its like a fart with the windows locked, a bunch of hot air. I could say x, y, and z ambulance company are terrible because of yadda yadda yadda but it doesnt hold any weight/validity because I never worked for x, y, and z. Everything else is just gossip, BS, and misinformed opinions. Unless you work or haved worked for the said companies, I wouldnt deter someone from working there and making their own opinions. Just looking out for people

 

[RocketMedic]

No i really dont though. Saying people shouldnt work at places in high call volume/short transport areas because it turns them into just a driver and not a clinician is ridiculous.

That's not what I am saying. I am pointing out that the model they maintain encourages minimal standards amd intervention.

 

[Chewy20]

That's not what I am saying. I am pointing out that the model they maintain encourages minimal standards amd intervention.

I am seriously the biggest idiot in here, because I try and not reply to you. Your last sentence is pretty far fetched though. The standards are pretty high here, and if you are talking about protocols, well then I do not know because I have not worked for another real 911 system. Ever since my first day our Medical Director has said, "You are expected to be a clinician, not a technician." A little cheesy? Sure, but I found it to be true, and I had to study my *** off in pathophysiology to meet his standards, or I would not have received my credentialing after FTO time. Which is a face-to-face interview with one of the MDs about medical. So to call me (or anyone really) a "little basic" makes you the person no one wants to work with. I promise you no one on here would want to work a shift with you (we know you do not care, I feel bad for you coworkers who have no choice though). My knowledge base has increased a ton from the date I started working here, because of here. Do I know everything? Nope, I am not you, so that would be impossible. Also, I do not "get excited" about much in EMS, nevermind narcan bud. Does that mean I will leave EMS? Who knows. About the interventions, if there is an intervention that NEEDS to be performed it is performed, whether it be critical, or for pain management. We have never rushed off scene once unless it called for it. Being new, I have tried to get the patient in the truck, only for my FTO to say, "Do you have at least 3 differentials yet? Is there anything more we can do?" We stay on scene until we no longer have anything more to go off of. So, that's all I will say about that narrow minded comment.

If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count

Lol where do I start here? Do certain people have more titles? Yes, they earned them, they are not noticeable anywhere except for telestaff except for you rank. Patches? We are not allowed to put patches on anything. Our white shirt has the state and department, that's it besides name and badge. Our blue shirt has only department logo and personal name. Does that solve that issue for you? Near living-wage? Like I have said before I live in the city and have plenty of money to do things out of work and go on vacations. Whats wrong with being on a bike, tactical, rescue or a community health team? They tried out for those and earned a spot. They are not just titles, our rescue and tactical always training and tactical is always on calls with SWAT. Rescues come unexpected obviously, but some are deployed to other parts of state due to the severe weather lately. Big rigs? You know everyone here absolutely hates being in our reserve trucks right (the "big rigs"), of course you did. Long hours, we work 48 hours a week. More than likely going to 42s for same pay. Pretty sure that's the norm.

You literally have zero to say about any department. You can have questions and opinions, that's it.

How about this? I come to your department for a ride out, more specifically request one with you. I would love to see what a REAL paramedic does. More importantly I would love to see other peoples opinions of you. Hey who knows, maybe we can get through the day and you will blow my mind with your awesomeness and I will praise you and buy you a beer. Or throw my head through a wall. 50/50. 6 years of experience as a medic you have? It would be my honor.

 

[RocketMedic]

I am seriously the biggest idiot in here, because I try and not reply to you. Your last sentence is pretty far fetched though. The standards are pretty high here, and if you are talking about protocols, well then I do not know because I have not worked for another real 911 system. Ever since my first day our Medical Director has said, "You are expected to be a clinician, not a technician." A little cheesy? Sure, but I found it to be true, and I had to study my *** off in pathophysiology to meet his standards, or I would not have received my credentialing after FTO time. Which is a face-to-face interview with one of the MDs about medical. So to call me (or anyone really) a "little basic" makes you the person no one wants to work with. I promise you no one on here would want to work a shift with you (we know you do not care, I feel bad for you coworkers who have no choice though). My knowledge base has increased a ton from the date I started working here, because of here. Do I know everything? Nope, I am not you, so that would be impossible. Also, I do not "get excited" about much in EMS, nevermind narcan bud. Does that mean I will leave EMS? Who knows. About the interventions, if there is an intervention that NEEDS to be performed it is performed, whether it be critical, or for pain management. We have never rushed off scene once unless it called for it. Being new, I have tried to get the patient in the truck, only for my FTO to say, "Do you have at least 3 differentials yet? Is there anything more we can do?" We stay on scene until we no longer have anything more to go off of. So, that's all I will say about that narrow minded comment.



Lol where do I start here? Do certain people have more titles? Yes, they earned them, they are not noticeable anywhere except for telestaff except for you rank. Patches? We are not allowed to put patches on anything. Our white shirt has the state and department, that's it besides name and badge. Our blue shirt has only department logo and personal name. Does that solve that issue for you? Near living-wage? Like I have said before I live in the city and have plenty of money to do things out of work and go on vacations. Whats wrong with being on a bike, tactical, rescue or a community health team? They tried out for those and earned a spot. They are not just titles, our rescue and tactical always training and tactical is always on calls with SWAT. Rescues come unexpected obviously, but some are deployed to other parts of state due to the severe weather lately. Big rigs? You know everyone here absolutely hates being in our reserve trucks right (the "big rigs"), of course you did. Long hours, we work 48 hours a week. More than likely going to 42s for same pay. Pretty sure that's the norm.

You literally have zero to say about any department. You can have questions and opinions, that's it. But since you think everything that comes out of your mouth is a fact makes you a dbag.

The only thing you should be commenting on is how you can not hold a job for longer than 6 months, is it REALLY because you are looking for a "unicorn" service? Or is it because you alienate yourself from he rest of the company because you are "that guy" everyone wants to throat punch.

How about this? I come to your department for a ride out, more specifically request one with you. I would love to see what a REAL paramedic does. More importantly I would love to see other peoples opinions of you. Hey who knows, maybe we can get through the day and you will blow my mind with your awesomeness and I will praise you and buy you a beer. Or throw my head through a wall. 50/50. 6 years of experience as a medic you have? It would be my honor.

Oh, I used to believe that. This time a year ago, I would have said the same thing about EMSA. Then I found out what those buzzwords, metrics and all that jazz really meant and how it was treated, and it resulted in me ping-ponging around until I found a place that is finally better. You're more than welcome to come over for a rideout. We work very similarly to how you describe ATC, and I would enjoy the opportunity to change your mind and show you the world outside Travis County.

Before you get all high-and-mighty though, do yourself a favor and try EMS in some other settings and contexts. Do a few shifts with Acadian or AMR. Explain to QI why it's not unreasonable or outside of protocol to medicate abdominal pain or avoid a spine board, or why you have the company's highest fentanyl administration rate, at 12% of your patients. Work with a good ole' boy EMT-B older than you that thinks it's acceptable to throw tantrums when you shoot down the plan to "take a nap" before you take a transfer. Work with coworkers who literally believe that sickle-cell is fake, that PID isn't a thing, that every trauma needs 14s and diesel alone. Work with an ******* who thinks a child's fear of needles overcomes both parental informed and implied consent and medical need.

As for job-hopping- Go work a little outside of your insulated enclave and tell me why it's bad to jump through mediocre jobs in search of one that doesn't consume you. Go try and work for AMR at 35k a year, or Acadian at 37k, or even Washington County at 38k a year on a fixed 24/48. Go work for Acadian San Antonio and see if it's all you can do. If you enjoy that, feel free to belittle me- but if you want more, than you should probably shut up now.

Yes, I judge ATC by the lens of experience I have had in similar systems. Is it entirely fair or accurate? Probably not, but I feel the fundamentals are accurate. Frankly, Chewy, I look at your system and I see the setup for the exact same thing.

 

[Tigger]

I have removed the comments that have nothing to with the discussion. I like the discussion, I do not like the tone. I am also guilty of snark here, but this is where it stops. Some us could use a lesson in tact now and again.

Also, the report button. It's a thing.

 

[Chimpie]

Thread has been cleaned up again. Keep it on topic (see original post or thread title) or it will be closed permanently and warnings/bans will be issued.