Just so you get grounded...WHAT you remember, is not what it’s like now.
I know nostalgia tinges things, but I've still got a lot of friends out there, I'm pretty sure the mountains and ocean are still there, most of the forest hasn't burned down, and Knott's, Disney and Universal are still in business. Plus we're bored with Houston and I'm rapidly reaching the point where I'm ready to do more than 'just' EMS.
At least what I'm seeing is that Texas, despite its dazzling variety of places, is essentially the
same model and place, repeated over and over again. County A = County B = St. Whoever EMS = Arbitrary Geographic Place/Feature EMS = Adverb EMS = Adjective EMS. Not just in terms of role, but in terms of how people are treated. Pay, schedules, benefits...it's all the same. 24-hour high-volume operations. Decent pay, but only because a lot of hours. RSI and New Clinical Hotness and transfusions, etc. In general, if you want to do 911 EMS on a 12-hour truck in Texas, you're either at MedStar, Acadian-Pasadena/San Antonio, Lubbock, Amarillo or AMR-Arlington (ewww!). The rest of it is 24s or longer. Eww! And although Rocketmedic of 2014 was impressed by the freedom and scope of what could be done, Rocketmedic 2019 realizes that we're being sent out to do some pretty incredible things with minimal preparation, not a whole lot of training or work to develop or ensure quality, and a whole lot of responsibility, and that's the normal here. Are there good places where this isn't necessarily the case? Yes, but I've spent years there, and it's still the same basic thing. A small group of trusted people, good old boys not meanin' no harm, inside a larger system. It gets exasperating. And I certainly haven't helped myself by flitting from one job to another (three total down here in five years, counting current gig) even though it's been beneficial to me from the standpoint of allowing me to go to school.
I'm not naive. I know everywhere has its own inner cliques, trusted people and mentors, and I know everywhere has its problems. I know I've largely been spared having to ask a nurse for permission to do something Paramedic-y and that I'm largely ignorant of the challenges of working with/for non-transporting, scene-commanding, some-are-more-equal-than-others ALS fire departments that allegedly treat EMS like gurney jockeys. I don't know what a normal American, Hall or AMR day is, aside from a guess it's pretty similar to an EMSA or Cy Creek day. But I see the
good of CA, like the diverse fun experiences that aren't swamp or the not driving into frequent reminders of the Confederacy and the state's increased-as-compared-to-Texas emphasis on worker rights, and the 12-hour shift schedules that allow for paramedicine as a job instead of a lifestyle sound amazing. And compared to the "work 3-4 12-hour shifts then spend 2-3 days at the clear mountain lake, not exhausted", not being able to RSI someone or having to confirm a cardioversion or whatnot is pretty minor.
Also, CA apparently allows people to BLS calls. That alone is incredible. Pretty much my entire time in EMS, everything has been either medic-only or so limited in what could be released to BLS that it was insignificant. Being able to literally assign an entire call to a BLS crew sounds amazing.
