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8 hr shifts with the call volume they have might be reasonable. If there are calls pending every time you drop a patient off I might hit my limit ~8 hrs too.
Does everyone on this site want to get into FDNY?
- Thread starter patzyboi
- Start date
8 hr shifts with the call volume they have might be reasonable. If there are calls pending every time you drop a patient off I might hit my limit ~8 hrs too.
firecoins
IFT Puppet
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nothing wrong with an 8 hour tour in NYC. 8 hours is plenty.
DrParasite
The fire extinguisher is not just for show
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as an east coaster, I can say I have absolutely no desire to work for FDNY EMS.
The only reason you should want to work there is if you want to be promoted to the suppression side. Other than that it's a horrible system to work in.
The only reason you should want to work there is if you want to be promoted to the suppression side. Other than that it's a horrible system to work in.
NYMedic828
Forum Deputy Chief
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8 hours trapped in a box with the same person is too long as is...
Stoked
Forum Crew Member
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Try being trapped 12 hours in a car on Wednesday day shift with a partner who attended dispatch's "Taco Tuesday" party the night before (read that any way you want).
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Dude, I did a 16 with this chick yesterday who's really cool. But I found out she doesn't stop talking...for 16 hours straight.
Holy balls.
On days where we're running back to back to back with calls pending constantly I agree with Chaz, I know I hit my burnt out, over it stage right around 8 hours in.
NYMedic828
Forum Deputy Chief
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When I was on the bus, I almost always had a movie to watch on my tablet or music to listen to. If we were between jobs, headphones went right on. You would think headphones signalled "Hey don't bug me unless its important im relaxing."
You know how that goes...
JPat86
Forum Lieutenant
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Being from nyc the big thing ahout going into FDNY is because of the job security, pension, benefits, 401k, Ect. The pay sucks.the hospitals here are struggling and threat to close. A few already have over the past couple of years. The city (FDNY., NYPD, DSNY,) Will never close, and everyone who's in FDNY EMS gets a higher and faster chance of rolling over to fire FDNY. Now that's a job that everyone wants. Why? The pay is great with full benefits, pension and the work week is short.
If you do eight hour shifts, FDNY can mandate you for another eight on the same day. In NYC, you're not allowed to work more than sixteen consecutive hours in a twenty-four hour period. It's easy to just make someone stay on the bus if the relief bangs in sick.
Funny that you mention protocols - just the other day, I was showing my medic partner the REMSCO ALS protocols, how restrictive they were, and how much of the OLMC options we can give on standing orders. I suppose this is due to having numerous agencies doing NYC 911 along with FDNY, and having no control over their hiring standards, and limited influence with QA/QI.
I'd rather do the extra 4-8 hours and have more days off, like two 16's and an eight, two 12's/two 8's, or 16/12/12. These are typical hospital based NYC EMS schedules. The doubles are typically morning/afternoon shifts. You won't typically see someone come in at 2000 and leave at noon, for example. The 12's could start ant any time.
I felt that the system is useful for a new medic, since you're using your protocols a lot. If you want to be an (appropriately) aggressive, forward thinking medic, NYC is too restrictive with having to stick to protocols, and all of the OLMC required contacts. Basically, get a few year's experience seeing a lot of sick patients, then move somewhere else that has more progressive guidelines, but typically has far fewer acutely ill patient contacts.
That's the irony - as a NYC/FDNY medic, you'll see many sick patients that need ALS interventions (meds, airway management, etc), but the protocols and OLMD you work under are markedly restrictive compared to many other places, where most of the patients don't need any significant (but available on standing order) interventions most of the time.
It's going to get worse for the hospitals. Due to the unfunded EMTALA mandates, they have to treat everyone. Reimbursement for the insured under the Affordable Care Act ("Obamacare") will be much less than the privately insured. There's a rule that if a patient is re-admitted in three weeks or less after discharge, there's no reimbursement. How many people in the city wait until the last minute to call 911 because they're tired of going to the hospital all the time for their COPD, CHF, etc?
In my neck of the woods, a large hospital system has mandated 1200 layoffs by 2015, the first 200 by the end of this summer. Per diem and part time nurses will be forced to either go full-time or quit. It gets worse - the banks are refusing to lend credit to hospitals for capital projects unless the hospital maintains an equal amount of capital in reserve as collateral. This will (is costing) jobs, and will certainly retard future plans for economic development of these hospital systems.
Look at the border hospitals in Texas. They're set to go down like dominoes. Illegals keep crossing the border, entering these hospitals, getting expensive surgeries, then disappearing without having to pay (unfunded gov't mandate )to provide these services.
As an aside, I wonder if the "three week re-admission mandate" will generate business for inter-facility EMS, since the 911 receiving hospital may look to "GOMER" them to another hospital, since they aren't getting paid for the re-admission at all. My understanding is that "No beds available" is a valid reason for reimbursement for an ED to ED, or ED to floor transfer. It should be easy to just say that they have no beds available, and the other hospitals can do the same, so that they can still get paid for the patients that need to be re-admitted within the three week window.
RocketMedic
Californian, Lost in Texas
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Its going to be ugly for border hospitals, hell on anyone in the city. Nursing homes are going to explode- what about the Old Lady Falls 3x a week, every week?
I suppose this would be an excellent time to invest in corporations that invest in developing urgent care facilities. Sooner or later, people that have insurance will figure out that they can go to urgent care instead of the ED. The urgent care facilities will do well, the private and non profit hospitals will either go belly up, or convert to private care, or whatever you call the type of hospital that only accepts the affluent. The municipal hospitals will become zoos.