usafmedic45
Forum Deputy Chief
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Not Maryland.
Best states for EMS?
- Thread starter IRIDEZX6R
- Start date
medic417
The Truth Provider
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Maybe it would be easier to make a list of the 49 worst states for EMS.
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the money is good in excess of over 100k a year, and you only have to work about ten days out of the month and if you work more then you get more $$$$, and where else can you retire with 90 percent of your base pay (at least for now). Yeah you might have to fight fire every now and then, but those who can't whine I guess, anyways just my opinion.
Sounds exactly like my department, minus the :censored::censored::censored::censored:ty cost of living (and only 8 days a month)
firecoins
IFT Puppet
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A state of shock is the best state for EMS.
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I am here: http://maps.google.com/maps?ll=40.754488,-73.898366
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I am here: http://maps.google.com/maps?ll=40.754488,-73.898366
Here you are:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
LOL
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Honestly I have no issue with statewide protocols because they establish a minimum degree of competency for each of level of provider allowing providers to transfer between services a little bit easier.
The Massachusetts protocols are not set in stone either. Those services that think they are capable of providing more education for their providers to expand their scope can apply for waivers from state protocols. I think this is great for stuff like RSI where some places do not have the call volume or geographic necessity to see that their providers actually use the intervention. It's the same for expanding a basics scope. A private IFT service has little reason to have their providers give albuterol nebs or nasal narcan simply because of how unlikely these interventions are to be needed. But basics working a busy urban 911 truck have plenty of use for these skills so those services just get a waiver and provided the necessary initial and continuing education.
A protocol is by definition an established code of procedure. While it may provide a minimum competency level (and I emphasize minimum), it also restricts promotion and growth by its very definition of the procedure. Why waste time on waivers and variances when you could have guidelines instead that allow a provider to utilize an autonomous thought process with a bit of critical thinking?
This is a huge issue with state wide protocols. They allow minimal autonomy and localization of efforts. Should you have a crappy board of MD's writing these state wide protocols (as some states currently do, no names mentioned), then you cannot have any discernable level of QA/QI through your local agency as your Medical director really has no level of oversight within his /her right to practice medicine. He / She has to conform to what others wrote. "No thank you" say's I...................I'll stick with delivering sound quality medicine under a physician who takes an active progressive role in the care of our patient's and community.
NREMTB12
Forum Probie
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Paducah KY, town of about 30,000 and 10,000 in the county have a private service here i work for we are the only service in county and do all IFT, emergency, standyby...etc.. on our way to hit over 14,000+ runs this year.
Shishkabob
Forum Chief
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Honestly, if I had things my way, RNs and Paramedics wouldn't have "protocols", as it'd instead be "Here's your license, you can do what's within your scope whenever you deem necessary, so long as it fits current medical practice" (or 'nursing practice')
No more medics being stuck at agencies still doing stacked shocks because that's what "protocol" states and they haven't updated them in a while. It's silly to think you can trust someone with making decisions, such as RSI, only on duty and under very strict rules, but that they would somehow lose all critical thinking the moment they're off duty or protocols are taken away.
If you can't trust them to do their job or practice their certification well, then why hire / certify them?
In my experience, Texas, compared to most (if not all other states) has the right idea with EMS.... even though there has recently been some representatives that want to do statewide protocols, under the guise of "Every other state is, so why are we different?"
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At least here in Mass, the protocols are updated at the very minimum annually, if not monthly. I'd rather this than every service having its own protocols that lax QA personnel keep forgetting to update. Maybe it's just me, but it sure seems like there are too many crappy providers out there incapable of utilizing critical thinking skills. Until they are gone (read: a mandate for more education), I just don't feel comfortable having everyone being able to work completely free within their scope of practice. Some of the low-acuity/high risk interventions should not be available to every provider, either because they lack the education or the opportunity to ever use them
Shishkabob
Forum Chief
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Then limit the scope per level, don't limit the scope.
Afraid of not enough intubations? Take it away from Intermediates, and don't have 100 Paramedics on each scene.
Afraid of not enough intubations? Take it away from Intermediates, and don't have 100 Paramedics on each scene.
Wake County EMS is one of the best places to work for, from what I've heard, but they don't pay much, like most other departments in the Carolinas, unfortunately. Maybe low 30's/yr for medics to start, IIRC.
I tried that in Charleston, but I found out that the lower cost of living only applied to housing. Everything else was as expensive or more so than in a major metropolitan area. 30 something grand isn't going to get you very far, unless you live with your parents.
I would have done Texas if my wife would have agreed to it.
If you're strictly single role, I'd go with Texas. If you prefer fire based, I'd go with Virginia. Especially after the BRAC re-alignment, money keeps coming into the area due to the close proximity to D.C. We don't have a lot of the financial issues other areas do. Plenty of resources, two OMD's, bi-annual protocol/guideline updates with field input, and all the tools we need to do our job sans RSI, which the flight medics have, along with Fairfax City. The drawback is that we have too many medics, spread out with our all ALS system, which is a combo of double medic training units and medic/EMT rigs, with only four BLS buses.
If you want to not have to worry about salary and retirement, I'd look in Northern VA and in MD near D.C.
Alexandria Fire and EMS are single role EMS with FD benefits, with a 24/48/24/96 schedule, definitely worth taking a look. You can get 3000 sf homes an hour and a half away (you're only working two days out of every eight) for well under 300k.
If you want to not have to worry about salary and retirement, I'd look in Northern VA and in MD near D.C.
Alexandria Fire and EMS are single role EMS with FD benefits, with a 24/48/24/96 schedule, definitely worth taking a look. You can get 3000 sf homes an hour and a half away (you're only working two days out of every eight) for well under 300k.
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Any idea how busy Alexandria EMS is? I've been looking for single-role EMS in DC Metro area.
Chief Complaint
Forum Captain
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Im a Nothern VA guy and i agree with most of your post. If you get on with one of the 5 main counties life will be pretty good. The problem is actually landing the job. Its VERY difficult to get a paid gig around here, especially if you are a white male.
There is no gaurantee that every county will be putting a recruit class through each year either, so there is a ton of waiting involved in the application process. Its pretty common for all of the counties to be on a hiring freeze.
And when they do open up for hiring, it is extremely competetive. Even being a medic (I/P) will only get you so far. Prince William County just had over 700 people sit for their written exam, Chief says that he will be looking to fill 15-20 spots.
NoVa is a great place to work, its just very hard to get a job.
Not sure about exact call volume, but i understand that they stay pretty busy over there. Word on the street is that Alexandria is in the process of merging fire and EMS in the near future. Im sure something like that would take forever to implement and i have no idea if its actually true or not, but thats what people are saying. Just something to think about.
There was a scare a while back about wanting to merge fire and EMS. I can't say for sure, but I think that passed. IIRC, you need to pass the CPAT (we do Alex's CPAT's in Chantilly), but they hired a couple of medic classes recently, and they didn't have to go to the fire academy.
The pay is listed in the 40's, but it's really in the 50's when you include everything, from what I've been told.
It's a busy system, you're running most of the day, the nights are hit or miss, but you only have to work two days out of eight. They have a 12 hour rig that covers units that go OOS for CEU's. No need to pursue con-ed off duty, unless you like to do extra, which is always a good idea. There are mandatory holdovers, though. As far as burn out, all of these systems are combined systems, so you've got extra bodies to carry your equipment and also carry your patients much of the time, so that definitely helps. I've done the six floor walkups for the 300 lb diff breather with just me and my partner back in NY. It's much better for the EMS crew this way, it saves your body and helps with stress, although having extra hands onscene can paradoxically extend scene times if you don't know the crews, and they don't know how you like things to go.
I haven't seen any animosity between EMS and fire, so co-habitating should be amicable.
You'll run into my county from time to time if you're on M205 or M208. You can also run in to Arlington.
In general, the budgets in our area have rebounded in a positive fashion. Business is coming into the area, and the BRAC re-alignment definitely helps. We're getting a lot of development in Tyson's in FXCO ourselves. All our neighboring counties have re-implemented COLA's, and we expect step increases to resume next year. They've been frozen since 2009, as well as COLA's. We're now going back to running back to back recruit schools, which are a combo of medic and EMT. From the 127th to the 130th, it was just medics. My old partner from NYC EMS just graduated the 131st. Fairfax only hires EMT-P's, degree preferred, but we're giving incumbents the EMT-I through NOVA CC with a pre-requisite of Human Biology 150 and HLT 250 Pharmacology. Other counties have been hiring as well. In fact, Loudon, Alex, and Arlington gave better COLA's than we received. Things look to be turning around.
Just apply everywhere, and don't forget Montgomery and Howard Counties in MD.
Edit: That 700:20 ratio is for basic FF's. Your chances as a medic are much greater. Also realize that out of those 700, many will fail the CPAT right off the bat (38 out of 40 for one of ours), others will fail the Poly, some will even manage to fail the written exam! They also have to get through the psych exam. As a medic, you should do much better than the average cat.
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Chief Complaint
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Im going through the process with PWC as well as Fairfax right now, not very far into either though. Passed the CPAT for Fairfax last week and ill be taking it for PWC this weekend. ALS candidates who pass the CPAT will be able to take the polygraph the following day for PWC. I was amazed at the number of people who couldnt pass the CPAT. There were people that showed up to take it who were very fat and out of shape and obviously didnt prepare at all.
I dont have high hopes for Fairfax but it will be good to have my information in their system for future recruitment. I will be taking their written exam on Thursday, any idea whats on it? The PWC written was easy, im hoping that Fairfax uses a similar test.
Montgomery and Howard counties arent accepting applications right now but ill be checking in with them often.
Having my medic definitely helps, but im a white guy, thats going to work against me for sure. Such a shame.