"Does the EMS have a gruge against FFs?"

[Bloom-IUEMT]

LE and EMS require people who are individual decision makers on a regular basis, unlike the fire service where there is less individual decision making. (I have never been or have any inclination towards LE. I speak from the fire and EMS perspective)

As well LE and EMS regularly act as individuals until backup arrives. The Fire service usually has a more massive initial response.
In LE and EMS larger teams are made up of smaller ones. In Fire larger teams are usually divided to smaller ones. (an engine company may form 2 attack lines, a rescue company divide on a search, truck companies dividing for search and ventilation.

In EMS systems where there is no station, there seems to be more integration with the indigenous people. The fire department seems more like a fortress, you go to the emergency, it rarely comes to you.
It seems to me firefighting is also more about an event than an interpersonal experience like LE and EMS.

As examples as a firefighter dispatched to: “house on fire,” “medical first response,” “EMS call.”

As an EMS provider dispatched to: “Chest pain” “sick person,” “rape.”
Some similarities: (all vehicle related) “MVA,” “train wreck,” “plane crash.”
LE and EMS also seem to have short interactions with lots of paperwork. Fire seems to have long interactions with less. Compare an average fire report to an average LE report or PCR.

Police and EMS don’t wear turnout gear, may wear BDUs.

Seems like moot and arbitrary differences to me You work in a station-you don't work in a station- you work as part of a team- you work in a group. I don't think most people would not have difficulty making that kind of transition. The differences that are apparent though are more deep seated: the psychological and philosophical make-up of the people who are attracted to LE as oppose to those to are attracted to EMS. Undoubtedly I am making generalizations and this are definitely overlap between the different types of personalities but the psychological differences in the types of people make combining the two somewhat at odds.

I will say that the conclusions I draw are from a relatively small and homogeneous "sample size:" somewhat small communities in a Midwestern state. So there is the possibility the difference I see is an artifact of my location.

@Aprz I think the idea of LEO, FF and EMS mixed is a good idea for small communities (did I just contradict myself? :wacko. It seems like small communities don't need the three separate departments as it would be expensive and would need too many personnel.

 

[46Young]

Mare, I agree with you, it seems like a lot of people use EMS as a stepping stone to become a FF. I attend two EMT classes, one at Chabot in Hayward and one at SJCC in San Jose (I am not a student in the Chabot class, but the instructors allow me to attend as long as I am not distruptive and I like to give other students input on what I learn differently at SJCC where I am really a student). In both classes, the majority of students want to go into Fire. I dislike that.

Nobody is going to make any comments on the Public Safety Officers that I mentioned on page 2 of this discussion? It's really neat in my opinion and seems to be working out. They are EMTs, FFs, and LEOs all in one!

On a personal level, I don't think it's necessary or useful for Fire to be cert. EMTs, but that's probably because I live in the Bay Area and the arrival of LEOs, FFs, and EMTs have little to no difference, and from what I have witnessed so far, extrication is usually not a problem.

LEOs don't have to hate criminals, love law abiding people, and etc.. just as much as EMTs don't have to love sick people, love pot/crack heads, love gang members that got hurt in a gang fight/shooting, etc.. Bloom, do you think the mindset of LEOs could change if they were taught about EMS in parallel? [edit]We are taught that we are not there to judge, but there to treat like you guys said earlier. I don't know about LEOs, but I think they don't have to judge people there.. they are just there to enforce the law. You either broke the law or you didn't... You need treatment, you get treatment. Duh...[/edit]

I agree with Linuss, I think we do have more in common with LEOs than with FFs (if FFs didn't do any EMS related stuff). His list on the previous page was pretty convincing to me.

As far as the EMS to fire stepping stone thing, I think that depends on the area. I'm from NY, where professional EMS and fire are exclusively single role. FDNY has a seperate EMS, but that's it as far as combo depts. I didn't even know that there was any such thing as a FF/EMT or FF/medic. If you take your EMT, it's to work in EMS.

But here's the thing. Many realize that EMS isn't as sustainable or fufilling as other professions, mostly due to pay, working conditions, and lack of career advancement. So, even if the EMT or medic in NY didn't initially intend for EMS to be a stepping stone, it ends up being just that regardless. Maybe they stay in EMS per diem or something. In other areas, the total package that the FD gives is decidedly more attractive than what EMS offers there (generalization, of course). The young adult will look at EMS and fire and decide that the fire side offers a better future. Since fire based EMS is popular in many areas, the EMT cert is necessary.

As far as the PSO's, I've only seen two examples, one from you, and one from Linuss, I think. I don't know of any others. They may exist, but that goes to show that the PSO program isn't popular at this time. Given the poor state of our economy, I'm sure that many local governments have considered having PSO's. The fact that they have declined to do so tells me that it isn't as cost effective as having a seperate PD from other emergency services. Cost effectiveness would be the sole motivating factor to combine services to form PSO's in the first place.

NYPD ESU can extricate. It was amusing to watch ESU and FDNY fight over who can do the cut job.

As far as having LEO's crosstrained for ALS/BLS first response and also for txp, there's one major problem that sticks out in my mind. Where does the majority of our call volume lie? It originates from the lower socioeconomic classes. In these areas, law enforcement is held in poor regard. In NYC PD are assigned to each EMS job, although they don't show unless it's an EDP, shot, trauma, cardiac arrest, or domestic dispute. Police always had multiple jobs holding, and weren't available to back us up. The next time you're doing pt care and an LEO walks into the house, watch how the pt and their family change their demeanor, their body language. "Why are the police here?" is a common question I get. This is borne from suspicion and apprehension towards law enforcement, not the same as "why are there four firefighters on an engine here to help me"?

The thing I've heard time and time again from friends and family on the job as cops is that they hate being lied to, deceived, and disrespected. I've seen it firsthand in how LEO's and corrections officers treat my pts. The Cx pain at Rikers Island is "BS". They make fun of our drunks, and have handled them roughly (may not be a drunk, but a legit medical condition, you know). The pt gets a lengthy, hostile lecture from the cop at the MVA scene as I'm trying to do pt care. I can't see a cop tolerating the amount of abuse that EMS endures on a regular basis without reacting in a manner that adversely affects pt care. Even the mere presence of an LEO would cause a flight or fight response, let alone if the officer engages in an argument or questions the pt in a manner that puts them on the defensive. I've seen cops verbaly abuse my pts by cracking jokes about their condition, telling them to shut up, I'll take you to jail, etc. On many lover's spat calls (domestic dispute call) between life partners, I've witnessed cops behaving poorly. The cops have chuckled, snickered in the presence of the pt and their partner, and have cracked jokes within earshot. They can't seem to be able to keep a straight face, or probably feel that they don't have to. What's the pt going to say to them, anyway?

A good number in EMS get sick and tired of mistreatment from pts throughout the years, and can do nothing about it. Actually they can, as I've witnessed some punishing "pt care", such as punitive IV's, drunk tossing, taping the eyebrows, going over potholes at high speed with a backboarded pt, walking cardiac/respiratory pts, withholding certain treatments from perps, so on and so forth. Now you want a cop to be in charge of pt care, where they already have a lower tolerance of abuse from pts, and can mess with the pts in a physical or psychological manner to "get back", whatever they can do without getting jammed up.

 

[46Young]

Double Post

 

[46Young]

In regards to police officers being spiteful and needing to "get even" or to teach someone a lesson, I don't know if it's ego, being fed up with people BS'ing them and complaining to them constantly, or some combination of that. This isn't the mindset I want in a pt care provider.

In the above posts, this isn't the IAFF talking, it's me, 46Young. This is what I've experienced from experience and direct observation. Your experience and local demographics may differ, but this is what I've found to be the case in my travels.

 

[Shishkabob]

The next time you're doing pt care and an LEO walks into the house, watch how the pt and their family change their demeanor, their body language. "Why are the police here?" is a common question I get. This is borne from suspicion and apprehension towards law enforcement, not the same as "why are there four firefighters on an engine here to help me"?

That can be partially attributed to the fact that PD aren't typically seen as EMS caregivers. I know there are a couple of LE based EMS in the US, around the NW I believe... I'm quite sure the residents of those communities aren't as shocked to see a cop on scene and aren't as apprehensive when they do show up. That's because they are used to it. I bet if fire showed up they'd go "Where's the fire?"

Or go to any of the DPS style areas where they provide all 3, fire/ems/LE, and the residents won't be apprehensive to police presence either.


Plus why can't there be single-role LE EMS, like there is single-role fire EMS? Why does the caregiver have to be a cop, instead of just associated with the police?

In regards to police officers being spiteful and needing to "get even" or to teach someone a lesson, I don't know if it's ego, being fed up with people BS'ing them and complaining to them constantly, or some combination of that. This isn't the mindset I want in a pt care provider.

I know many cops. Most are not like that... and the majority only act like that on calls to establish authority. They go home and they are some of the nicest people you meet. When you have to deal with the lowest of the low everyday, and they constantly lie to you, you need to find ways through that.


Plus you can't tell me there aren't FFs and EMTs/Medics who are just as fed up with the crap of society as well.









Why would we force someone to be certified in something they state over and over again they have no interest in? "That's not the kind of caregiver I want" (cough firefighters that dont want to do EMS cough)

 

[atropine]

Well here in Gods county Los Angleles, EMS doesn't have any beef with fire, and if they do only certain opinions matter anyways. All in all I think we have a pretty decent system, and as long as nothing changes for the next 8 years I'll be one happy retired SOB, then things can change all they want.

 

[grich242]

Why would we force someone to be certified in something they state over and over again they have no interest in? "That's not the kind of caregiver I want" (cough firefighters that dont want to do EMS cough)[/QUOTE]

And who are they? In this area most are fire/ems and almost all departments in the area won't even consider you unless you are a paramedic. I chose my career and enjoy both sides of the job. the problem with these arguments is that when it really comes down to it, is that it depends on the area your talking about. sometimes a third service just isn't a sound option where as other areas with a truly busy fire service combining the two is not a good idea either. I know of a few pso departments in this state as well and it isn't all its cracked up to be either. It seems to work better in very small towns where the run volume is relatively low, however in mid to larger cities it gets very expensive to train with all three requirements.

 

[Shishkabob]

Grich... how many FFs do you know state "I just want to fight fires" or "I don't want to do medicine but became a medic because it got me the job"?

I guarantee you've heard it. We've all heard it.


I don't know about you, but I don't want someone being the lead practitioner on me if they have no interest in doing what they are doing. EMT? Sure. Medic where they can give me over 60+ different drugs, and a host of invasive things that can kill me quickly? No way.

 

[fortsmithman]

LE likes hurting people,

The LEO's I work with do not like hurting people. They're good guys and gals. As for compassion I feel compassion for most patients except for example a child molester or someone who has raped a women or beaten an elderly person or others in a home invasion. I would treat those one but as to show any compassion to those wastes of space forget it.

 

[Veneficus]

Seems like moot and arbitrary differences to me You work in a station-you don't work in a station- you work as part of a team- you work in a group. I don't think most people would not have difficulty making that kind of transition.

I think team dynamics is a very important point.

The differences that are apparent though are more deep seated: the psychological and philosophical make-up of the people who are attracted to LE as oppose to those to are attracted to EMS. Undoubtedly I am making generalizations and this are definitely overlap between the different types of personalities but the psychological differences in the types of people make combining the two somewhat at odds.

From my perspective I don't think there is a cultural difference in psych between EMS and LE. Most of the cops I have met are not strict "law and order" rules are absolute, punish the offender types. (infact the ones who are stand out in memory like bad patients)

At the same time not all EMS providers are internalized morals, help the patient, rules of society be damned, out of the box thinkers. One EMS agency I worked at for a very short period prided themselves on following the rules to the letter everytime regardless of circumstances.

There might be a stereotyping of the types of personalities attracted to both. But truthfully, with few exceptions any of the firefighters, police officers, or EMS people I have worked with could have easily performed well in the role of the other.

@Aprz I think the idea of LEO, FF and EMS mixed is a good idea for small communities (did I just contradict myself? :wacko. It seems like small communities don't need the three separate departments as it would be expensive and would need too many personnel.

Or maybe they could regionalize public safety and EMS. Many small communties don't need dedicated fire, police, or EMS agencies at all or so rarely that it could not justify the cost.

A jack of all trades and master of none in these professions is basically a basement saving, ambulance driving, meter maid.

It also must make prosecution difficult. I'll bet a good attorney could get a lot of evidence silenced from not having seperation of medical and LE information. A patient is also more forthcoming with information to healthcare providers than police. Fighting a working structure fire is also physically fatiguing. Especially 2 or 3 in the same day. It just reenforces my idea that these public servants are not doing much of anything they are dedicated to and probably not often enough to do it well.

 

[EMSLaw]

That can be partially attributed to the fact that PD aren't typically seen as EMS caregivers. I know there are a couple of LE based EMS in the US, around the NW I believe... I'm quite sure the residents of those communities aren't as shocked to see a cop on scene and aren't as apprehensive when they do show up. That's because they are used to it. I bet if fire showed up they'd go "Where's the fire?"

Or go to any of the DPS style areas where they provide all 3, fire/ems/LE, and the residents won't be apprehensive to police presence either.


Plus why can't there be single-role LE EMS, like there is single-role fire EMS? Why does the caregiver have to be a cop, instead of just associated with the police?

It's not terribly common, but I know of three departments in my county alone where the police are responsible for EMS. In each of those towns, while the police department has responsibility for the EMS service, the actual services are provided by Community Service Officers (or whatever they are called depending on the town) who are dedicated EMTs.

It's really no different than having EMS glommed up into fire, with single role Medics and EMTs. But the same downsides apply - the police department, as an institution, will always choose to spend its money predominantly on police work, leaving the EMS service as a red-headed stepchild.

 

[grich242]

Grich... how many FFs do you know state "I just want to fight fires" or "I don't want to do medicine but became a medic because it got me the job"?

I guarantee you've heard it. We've all heard it.


I don't know about you, but I don't want someone being the lead practitioner on me if they have no interest in doing what they are doing. EMT? Sure. Medic where they can give me over 60+ different drugs, and a host of invasive things that can kill me quickly? No way.

Yes I've heard it however its not quite that simple for instance I work in a suburb of a large city ems is probably 90% of our run volume which is about 10k runs yearly. The fact is that we just dont get the fire volume we did in the old days. So Ems is most of the job and guys know that coming in. If you only want to do fire go to a big city. I guess my point is that the job itself has changed and anyone applying in this area is fully aware of just what that job is. As in our city third service would be difficult to start fighting for budgets etc. being part if the fd its included in our budget and we take it seriously. enough that even our engines are licensed ALS. We recently started a long overdue er bypass for stemi's to go straight to the cath lab etc. just dont paint us all with the same brush stroke. its a big country and there are plenty of progressive departments out there.

 

[Shishkabob]

Yes, I know people go in knowing they will do it. Doesn't excuse it though. It's just the fire service trying to save itself from having its budget cut by saying "We're still needed!" instead of actually providing what's best for their populations: People who practice medicine who care/want to.


Yes, there are firemedics who like to practice medicine, and are only FF's because it pays better. One was my instructor, and another was my preceptor. They exist, and they exist in fair numbers. But why does it have to be the only way to make a decent living is to be fire?

 

[ExpatMedic0]

But why does it have to be the only way to make a decent living is to be fire?

Because its municipal. Private company's can not offer a pension or pay as much.
The best thing for us would be if all EMS was 3rd party municipal agency I.E. Boston EMS. but thats not going to happen across the board over night, at least if your the red headed stepchild of the FD you get a good retirement, much better pay, and better public image.

 

[Veneficus]

I don't think 3rd service municiple EMS is always the solution. While there are many outstanding third service agencies we like to talk about, there are also some extremely poor ones.

(they often list themseves as "high performance") Not because of the medical care but because they have a very high unit utilization and do many calls but very few interventions.

Quality EMS is possible in all manner of service, it is just a question of the values of the organization.

 

[NWParamedic]

Schultz has it exactly right. That damn socialized fire department giving out decent benefits, what a shame.

Non-Unionized privates will always sacrifice worker pay and benefits for their own personal profit gain. Very understandable really. They are in business to make money. They are not going to give it to you. Privates always give only what they have to keep employees. Even their attempt retain employees gets curbed when they have a fresh supply of newbies waiting at the door for a job.

The only non municipal companies worth working for in EMS are the large ambulance services like AMR, who have to put forth a good image and actually following a county contract and the third service not for profits.

 

[46Young]

That can be partially attributed to the fact that PD aren't typically seen as EMS caregivers. I know there are a couple of LE based EMS in the US, around the NW I believe... I'm quite sure the residents of those communities aren't as shocked to see a cop on scene and aren't as apprehensive when they do show up. That's because they are used to it. I bet if fire showed up they'd go "Where's the fire?"

Or go to any of the DPS style areas where they provide all 3, fire/ems/LE, and the residents won't be apprehensive to police presence either.


Plus why can't there be single-role LE EMS, like there is single-role fire EMS? Why does the caregiver have to be a cop, instead of just associated with the police?





I know many cops. Most are not like that... and the majority only act like that on calls to establish authority. They go home and they are some of the nicest people you meet. When you have to deal with the lowest of the low everyday, and they constantly lie to you, you need to find ways through that.


Plus you can't tell me there aren't FFs and EMTs/Medics who are just as fed up with the crap of society as well.









Why would we force someone to be certified in something they state over and over again they have no interest in? "That's not the kind of caregiver I want" (cough firefighters that dont want to do EMS cough)

Like I've said, it depends on what area you come from. If you're protecting an area that's middle to upper class, the police will be held in high regard, and they will have a more positive interaction with the public. Where I live, I'm happy to see a cop car patrolling the neighborhood. In the ghetto, they hate the cop's guts. In NYC, cops are taught not to stand under windowsills, as some residents will drop flowerpots, bricks, and various other things on their heads.

Sure, FF's, FF/EMT's and single role EMS can get fed up with the crap of society, not unlike law enforcement. In the case of EMS, getting fed up means that they'll look to leave, or stay and perform their job poorly in the form of poor pt care, or neglect of duties. The FF and FF/EMT can be subject to the same, but it's not nearly as common due to better working conditions and pay/benefits.

The only single role LE/EMS that I know of is the Nassau County PD in NY. Their uniforms are designed to look obviously different from the cops. They ride by themselves in the bus. A cop meets the medic onscene in their cruiser, which effectively makes it a BLS first response vehicle (the cop is trained to EMT). The problem is, the cop needs to be driven back to their cruiser after the call, much like a fly car medic. If a second medic is needed, another bus shows up, and that medic needs to be brought back as well. Not the most cost effective or efficient system, by far. With an ALS engine, they can pick up the medic at the hospital, and can stay inservice as a three person crew regardless for suppression calls.

As far as FF's not wanting to do EMS, enough depts have EMS now that it's accepted and well known as being as much of a FF's job as suppression. If that is unacceptable for the aspiring FF, then they have the option of applying to a city FD that does not do EMS, such as FDNY, Charleston SC, N Charleston, Charlotte NC, etc.

 

[46Young]

Grich... how many FFs do you know state "I just want to fight fires" or "I don't want to do medicine but became a medic because it got me the job"?

I guarantee you've heard it. We've all heard it.


I don't know about you, but I don't want someone being the lead practitioner on me if they have no interest in doing what they are doing. EMT? Sure. Medic where they can give me over 60+ different drugs, and a host of invasive things that can kill me quickly? No way.

I believe that the interest or lack thereof regarding EMS depends on the region. Lately, we've been getting medics here that have worked elsewhere for several years prior in single role EMS. I did the same. If anything, if you were a medic first, doing it through a fire based system will allow a longer career with less stress and financial strain than in a non fire based system, generally speaking. The best third service depts don't hire often, so the fire service is really the only option to have the best career possible regarding compensation and career advancement, while still doing the same job, 911 ALS txp. In addition, we've had a very competitive process for a limited number of spots in the dept sponsered medic school, given through a degree program. I know that a good attitude in the fire service towards EMS isn't the same elsewhere, that's why I say it's area dependent.

 

[46Young]

Schultz has it exactly right. That damn socialized fire department giving out decent benefits, what a shame.

Non-Unionized privates will always sacrifice worker pay and benefits for their own personal profit gain. Very understandable really. They are in business to make money. They are not going to give it to you. Privates always give only what they have to keep employees. Even their attempt retain employees gets curbed when they have a fresh supply of newbies waiting at the door for a job.

The only non municipal companies worth working for in EMS are the large ambulance services like AMR, who have to put forth a good image and actually following a county contract and the third service not for profits.

One major problem with choosing to make private EMS your career and to retire doing so, is that there's always the risk of losing the 911 contract to other privates, muni EMS, or a fire based EMS dept. I'd hate to be with a company for ten years or more, have a family and a mortgage, have the regional division of the company lose the contract, and have to either move far away or be unemployed.

 

[fortsmithman]

I have no grudge personally against the fire service.