Best state and county to work as a paramedic! ?

@triemal04 yes I believe I work for a good department. One of the biggest if not the biggest 3rd role agency in the country. Boston may be a little bigger volume wise.
 
Chewy20 said:
@triemal04 yes I believe I work for a good department. One of the biggest if not the biggest 3rd role agency in the country. Boston may be a little bigger volume wise.
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I think new Orleans mIght have y'all beat ;)
Actually, never mind...Lol I forgot how small no really is
 
New Orleans is, by many accounts, a high-speed cool-lookin' all-paramedic BLS+ service in the vein of Houston Fire.

Austin/Travis County would be cool if it wasn't for "years as a basic".
 
Chewy20 said:
@triemal04 yes I believe I work for a good department. One of the biggest if not the biggest 3rd role agency in the country. Boston may be a little bigger volume wise.
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Boston runs about 350 calls a day with about 12-14 trucks. Mostly BLS trucks and I believe 3-4 ALS trucks. A lot of employees are medics working as basics waiting for a promotion to Boston's paramedic school. They do have more progressive protocols (RSI) compared to other companies in the state. But good luck on waiting, spoke with a BEMS employee the other day and he was saying people are quitting like crazy. Yeah they get paid more and have a pension but it evens out cause you have to live in the city for 10 years with roommates to survive. On top of the fact of picking up psych and ETOH pt's all day/night. I don't have any bad blood I just wouldn't work there unless I was eighteen and straight out of EMT school. Move out of the city at 28 start saving money starting a family and hope to get promoted. IMHO.

Side note, you know something's wrong when BEMS employees have to had out flyers at the ER to other EMS providers when they are hiring.
 
Rocketmedic...you really didn't understand a word I said. Carry on though, not my concern.
 
I don't think BEMS is a great model for medicine. I think every patient deserves an ALS assessment when needed, adequate pain management and shouldn't need to wait a long time for it.

You can't tell me with a straight face that every hip fracture, dyspnea or "unknown medical" in Boston gets that treatment.
 
Burritomedic1127 said:
Boston runs about 350 calls a day with about 12-14 trucks. Mostly BLS trucks and I believe 3-4 ALS trucks. A lot of employees are medics working as basics waiting for a promotion to Boston's paramedic school. They do have more progressive protocols (RSI) compared to other companies in the state. But good luck on waiting, spoke with a BEMS employee the other day and he was saying people are quitting like crazy. Yeah they get paid more and have a pension but it evens out cause you have to live in the city for 10 years with roommates to survive. On top of the fact of picking up psych and ETOH pt's all day/night. I don't have any bad blood I just wouldn't work there unless I was eighteen and straight out of EMT school. Move out of the city at 28 start saving money starting a family and hope to get promoted. IMHO.

Side note, you know something's wrong when BEMS employees have to had out flyers at the ER to other EMS providers when they are hiring.
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Nevermind we run more calls than that. I can see what youre saying about them though. Used to talk to them when I worked in the area.
 
RocketMedic said:
I don't think BEMS is a great model for medicine. I think every patient deserves an ALS assessment when needed, adequate pain management and shouldn't need to wait a long time for it.

You can't tell me with a straight face that every hip fracture, dyspnea or "unknown medical" in Boston gets that treatment.
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Not a chance. Major traumas, codes, chest pain, or anything "spicy" enough to put on their alerts, I'd assume would get ALS in Boston
 
RocketMedic said:
I don't think BEMS is a great model for medicine. I think every patient deserves an ALS assessment when needed, adequate pain management and shouldn't need to wait a long time for it.

You can't tell me with a straight face that every hip fracture, dyspnea or "unknown medical" in Boston gets that treatment.
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It isn't. If I wanted ALS while working for a private there it was either coming from own company or not at all.

Peak of six ALS trucks during the day, drops to three at night.
 
I don't see that as being a good system, 8r even something to emulate.
 
I know some of their emts pride themselves on having a special project waiver for albuterol and narcan at the BLS level. I've seen them bring in hypotensive pts BLS or diff breathers with albuterol administered BLS. If any ALS medication is given (based on state protocols) that Pt should be ALS. Yeah you can train emts to use albuterol and narcan but what about cardiac wheezes, no response to meds, and the such?
 
Burritomedic1127 said:
I know some of their emts pride themselves on having a special project waiver for albuterol and narcan at the BLS level. I've seen them bring in hypotensive pts BLS or diff breathers with albuterol administered BLS. If any ALS medication is given (based on state protocols) that Pt should be ALS. Yeah you can train emts to use albuterol and narcan but what about cardiac wheezes, no response to meds, and the such?
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Albuterol and narcan are not statewide ALS meds in MA, if that's the state you are talking about. I worked for a private and we carried both on our BLS trucks.
 
Chewy20 said:
Albuterol and narcan are not statewide ALS meds in MA, if that's the state you are talking about. I worked for a private and we carried both on our BLS trucks.
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Yeah I know. Mass companies that are under a special project waiver allow their BLS to carry albuterol and narcan. I don't know it's been awhile but I'm assuming there not teaching albuterol and narcan in EMT class, but they do teach those meds in medic school.
 
Burritomedic1127 said:
Yeah I know. Mass companies that are under a special project waiver allow their BLS to carry albuterol and narcan. I don't know it's been awhile but I'm assuming there not teaching albuterol and narcan in EMT class, but they do teach those meds in medic school.
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Oh I see what youre saying. I do remember being taught those things when I was in EMT school. Not sure if that was the norm or not.
 
Chewy20 said:
STX hates ATC don't listen to him ;)
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I think my gripe with ATC comes from most (not all, you aren't there yet Chewy [emoji6] ) ATC medics I know being exceptionally arrogant and cocky. They think their **** doesn't stink, they're god's gift to paramedicine, their system is the best in the country, and every other system is garbage. Even with that attitude, I have only considered one of them a truly good medic (albeit my standards are set pretty high), and I don't think as a system they do anything special or ground-breaking. The Kool-aid there is exceptionally potent, and undeservedly so.

I don't think they're a bad service by any means. They do some things I'm not a fan of, but I can see how those things would work for others. If every medic there wasn't so damn arrogant, or could at least back it up, I'd probably like ATC much more. It's primarily the attitude I don't like, which comically changes as soon as they leave (and they almost all leave).
 
STXmedic said:
I think my gripe with ATC comes from most (not all, you aren't there yet Chewy [emoji6] ) ATC medics I know being exceptionally arrogant and cocky. They think their **** doesn't stink, they're god's gift to paramedicine, their system is the best in the country, and every other system is garbage. Even with that attitude, I have only considered one of them a truly good medic (albeit my standards are set pretty high), and I don't think as a system they do anything special or ground-breaking. The Kool-aid there is exceptionally potent, and undeservedly so.

I don't think they're a bad service by any means. They do some things I'm not a fan of, but I can see how those things would work for others. If every medic there wasn't so damn arrogant, or could at least back it up, I'd probably like ATC much more. It's primarily the attitude I don't like, which comically changes as soon as they leave (and they almost all leave).
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A lot of them are incredibly cocky, for sure. Then the other half are incredibly jaded and/or burnt out.

My biggest gripe with ATCEMS is that they are a politically governed body that does not make their decisions on what is in the best interest of their medics, but rather, what makes them look good as a whole. They do not stand behind their medics, as reflected with their incredibly limited scope of practice. Not to mention, their hiring process is a load of crap.
 
Chewy20 said:
Oh I see what youre saying. I do remember being taught those things when I was in EMT school. Not sure if that was the norm or not.
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Went to EMT school in NH were basics can use combitubes, albuterol, narcan but thats standard in their state protocols. Not sure in mass though. Not to go too far off topic but there are some things basic should be able to use like glucometers
 
teedubbyaw said:
A lot of them are incredibly cocky, for sure. Then the other half are incredibly jaded and/or burnt out.

My biggest gripe with ATCEMS is that they are a politically governed body that does not make their decisions on what is in the best interest of their medics, but rather, what makes them look good as a whole. They do not stand behind their medics, as reflected with their incredibly limited scope of practice. Not to mention, their hiring process is a load of crap.
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Whats your gripe with the hiring process? Not coming at you, just wondering as I just finished with it a couple months ago.
 
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