EMS In Crisis

[46Young]

Let me get a degree to make $14/hr. Yep, that makes sense.

Paramedics need more education, and more pay. Restructure how they're educated, and then they should get compensated for that.

The problem is, who is going to advocate for this restructuring? It's in the best interests of EMS admin (fire, private, hosp based and muni third service alike) to keep the EMS applicant supply cheap and plentiful. This is evidenced by the fact that most employers don't even ask where you got your P-card, let alone require a degree or even give preference for one at the entry level position. The EMS employers certainly aren't going to buck up and donate funds for lobbying and such, so that leaves the EMS professionals.

Many on this forum do advocate for higher educational standards in EMS, but what percentage of EMS professionals outside of this forum feel the same? I'm betting not many since quite a few come and go from EMS for various reasons, and have no vested interest in advancing the profession for the long term.

Restructuring education alone won't automatically benefit the profession. You need lobbying and organization. You need a workforce that's not transient to accomplish that.

 

[Shishkabob]

Let me get a degree to make $14/hr. Yep, that makes sense.

Paramedics need more education, and more pay. Restructure how they're educated, and then they should get compensated for that.

Problem is, what comes first?


Who's going to want to spend a lot of money on a degree that they can't recoup easily in their career?

On the same token, who is going to want to pay for a more educated person, when they can get the same thing from less educated?



Texas attempted compensating degreed medics with their "Licensed Paramedic" level. Problem is, LPs typically get no more (or very little) pay than a certified Paramedic, have no further advanced protocols or freedom of choice, and have to pay more to get re certified every 4 years. Only difference between an LP and a certified Paramedic? LPs have golden letters on their medic patch.

 

[mycrofft]

Well, just invent another type of EMT.

Works in California, has since they invented EMT's. Just invent an EMT who can also start IV's. And an EMT who can defibrillate. And an EMT who can prescribe drugs.

 

[CAOX3]

i`ve had it with this job. It was a career and a profession, now it has turned into the largest sanatation company in the usa. Government let it fail by not educating citizens how and when to call 911. Private ems folks were looking to get rich so transport everything. Fire departments attempt to stop the bleeding and take over ems only to find themselves over their head in a system they have no understanding of. Working 24 hour shifs, sleep depervation, starving to eat because your on the 16th call and the truck got fuel but you didnt.senior parmedics 5 years in the field because most wont last past that after all the abuse. Work for a slower service only to be punished monitarly for running fewer calls. Yep the citizens will finaly get what they diserve very soon a red cross first aid trained person because that is all you will find because paramedic school is 2 years and nobody wants this anymore.

Can you say vacation!

 

[mct601]

The problem is, who is going to advocate for this restructuring? It's in the best interests of EMS admin (fire, private, hosp based and muni third service alike) to keep the EMS applicant supply cheap and plentiful. This is evidenced by the fact that most employers don't even ask where you got your P-card, let alone require a degree or even give preference for one at the entry level position. The EMS employers certainly aren't going to buck up and donate funds for lobbying and such, so that leaves the EMS professionals.

Many on this forum do advocate for higher educational standards in EMS, but what percentage of EMS professionals outside of this forum feel the same? I'm betting not many since quite a few come and go from EMS for various reasons, and have no vested interest in advancing the profession for the long term.

Restructuring education alone won't automatically benefit the profession. You need lobbying and organization. You need a workforce that's not transient to accomplish that.

Problem is, what comes first?


Who's going to want to spend a lot of money on a degree that they can't recoup easily in their career?

On the same token, who is going to want to pay for a more educated person, when they can get the same thing from less educated?



Texas attempted compensating degreed medics with their "Licensed Paramedic" level. Problem is, LPs typically get no more (or very little) pay than a certified Paramedic, have no further advanced protocols or freedom of choice, and have to pay more to get re certified every 4 years. Only difference between an LP and a certified Paramedic? LPs have golden letters on their medic patch.

You're both right- I'm not saying its easy. I'm not sure how to get there, but I wish we could work towards it. I love EMS but unfortunately this is not my career because of the current state its in. I plan to attempt to get into medical school, or at least a BSN degree because I crave more medical knowledge.

 

[rescue99]

You're both right- I'm not saying its easy. I'm not sure how to get there, but I wish we could work towards it. I love EMS but unfortunately this is not my career because of the current state its in. I plan to attempt to get into medical school, or at least a BSN degree because I crave more medical knowledge.

Anyone can get a degree and still be a Paramedic but one has to want to be a Paramedic to really stick with the job. Some folks love their career and still crave more education. Some love being agood medic and that's enough for them. If the people in EMS want more pay and more respect as professionals they will have to lobby for themselves. PD did it. FD did it. Nurses did it. Even Physicians had to make their profession happen lest they continue to settle for chickens. We cannot simply say we have a higher education degree therefore deserve more. We have to make it happen by organizing and demonstrating a little support and strength, a little solidarity as an organization. I've discovered people in EMS are deathly afraid to organize and have yet to figure out why.

 

[dudemanguy]

The grass is always greener. If youve never done anything except EMS or the medical field, try something else. You might be in for a rude shock or you may find something else you love. I've lasted a couple years at a job that was so wretchedly bad illegal aliens wouldnt even do it, why? Because my situation was such that it was that or try being homeless for a while(also tried that and didnt care for it much).

Point is everyone thinks they got it bad until they see what bad really is.

 

[LanCo EMT]

I'm just gonna put my opinion out there....


EMS is a job in which if you don't truly love the job or at LEAST like it, it's time for you to quit.

 

[TgerFoxMark]

huh. on the training bit... I like a radically different style... you hire in, untrained, and then they train you.
needed to be hired, have a CDL-B. you start as a driver and are taught basic first aid, CPR, O2, and triage
Spend 6 months doing this.
then offer to be trained to EMT I. add in ECG 3 lead at this point.
18months service from that
EMT-II. IV starting, nothing more than NS. Teach to do Oximitry, and take a glucose reading. Psyhcology training, bring in wildland training as well.
24 months
EMT III
Basic Drugs, Pharm. Bring in the real schooling, A&P. 12 lead, Manual Defib, Extracation.
24months.
EMT IV
Advanced Drugs, more like todays Paramedic.
24months.
EMT V Trained higher than Nursing. Some Sugical Skills. Can Suture in the field
24 months.
EMT VI Highest Level.
Trained to ER Doc + Trauma Surgon level. Full interventions, has own medical liscense to practice under if needed. is considered a doctor. can work as a doctor or surgon. Can run a clinic. Full Perscribing abilities.

Yes its a LONG road. that time is needed. we need people who can do more advanced interventions, perscibe meds.

if we could send out a rig with people on it who can complete the entire mess on scene, it would help the ER's, help the pt more, cost less overall.

People will disagree with me. It happens. something more along these lines makes this a true profession.
Keep in mind, i wrote this in 5 min or less. no, not everything is thought through. my spelling and grammar stink.

 

[firecoins]

You can require a Master's degree. Medic will get $14/hr. That is how much the job is valued at. Fixing how well the medics are educated will not get you higher pay.

We aren't firefighters or cops. We lack the hero status. IN NYC, people come out to protest the closing of a firehouse due to a slower response. They protest cop layoffs. These same people have no idea how long it takes to get an ambulance which is something they will more likely need. We do not get their support simply because the general public is unaware. They expect they will get an ambulance quicky but are less involved than with cops or firefighters.

 

[Trayos]

Sad but true, I have to explain what an EMT is to most people I bring it up with.

 

[JPINFV]

Sad but true, I have to explain what an EMT is to most people I bring it up with.

EMT as in the concept of prehospital providers or EMT in contrast to a paramedic?

 

[MrBrown]

Seriously, this attitude is why I don't see clinical EMS progressing past the EMS AAS, or even achieve that level as the minimum. There aren't enough in our field that are willing to make the 2-4 year degree commitment and then have to accept the conditions that you rant about

Then by all means, because the providers are lazy arses, lets not do it!

Sorry patients, we were too lazy to go to school! Our bad, but you gotta suffer with some warm pulse patch factory medic who couldn't be bothered gettin the edoomukashin.

Biggest fail ever.

 

[emtstudent04]

hahah thats so funny.

 

[medic3974]

Why is it when you put it out their, the whole truth and nothing but the truth, about this job people always come up with you need a vacation or you need a new job. To answer the question's, yes I would love a vaction and yes it is time for me to move on. Not for the reason of being burned out. The reason is EMS as we know it now is broken. You to will become burned out and will be just like me one day. I know right now you want to save the world and you carry all of your eqipment to the patients side and follow all of your company's SOP but one day you will get tired of hearing my stomach hurts at 03:00am with every kid in the house up watching TV. So with that said you will be left with mostly non experience medics with less that five years or a few like me who just keep their head down hoping one day it would change. Wouldn't be nice if someone would come up with a plan to fix it. I'm not sure if it can be fixed. There is a few people getting rich on the backs of EMT's and Paramedics. So, there is alot of folks who are happy not to fix it and keep it the way it is. What kills me is that patient care is not first nor will it ever be.

 

[firecoins]

When was EMS not broken? It was always broken.

 

[TransportJockey]

Education most likely will need to come first. Start mandating that all providers need a minimum of an AAS. It's not that hard to attain. Pay will eventually start increasing as education has already increased then. We are the only 'healthcare' provider that already doesn't require at least that.
And you wonder why hospital staff doesn't take us seriously? Those of us who have worked in hospitals can see exactly why when certain medics walk through the doors with a patient.

 

[medic3974]

I use to like being better than some other paramedics. It use to feel good when I would come in to a call that was going to hell in a hand basket and everyone would feel a sense of relief when I would walk in. I think education is a lot of it. I agree, how will anyone take us seriously when you can get your paramedic certification out of a ceral box. Most students now arent allowed to touch a patient in the O.R. so they have no real intubation experience when they hit the field. Hospitals dont let students do anything in any department unless they know you in the ER and even then the student is not going to get to do much. I remember a time when meical professionals in the hospital respected us enough to at least teach us someting while we were in paramedic school. I also remember a time when Er Dr's would pull you to the side and talk to you like a normal human being and tell you something you did wrong or right. Now they dont care. Dr's sign my trip reports all of the time and never ask what their signing for. Just let me sign and dont bother me. Education cant change everything but it would be a good start.

 

[firetender]

The Root Problem

Our OP exemplifies the root problem of most everything that has been discussed re: EMS in crisis. It is, but not in the way he thinks. It is in crisis because HE is in crisis.

There had never been the continuity of employed crusaders in the profession to effect change for one reason; the turnover rate is sky high due to burnout. Burnout is sky-high due to the fact that NO ONE FACES IT.

Burnout is the poop in the living room that everyone is in denial about.

If there's a chance, as I see it, for EMS to grow as a profession the very first thing that must be put in place is something that allows active medics to MOVE THROUGH the emotional, psychological, moralistic, spiritual and psychic traumas they experience in their work. The people to set that up are medics themselves. Everyone else who's tried to do it has failed because they are not living within those conflicts themselves.

Nursing and other medical professionals have been able to organize because turnover doesn't begin to really accelerate until burnout takes hold, usually after ten or more years in the field; and then, because exposure is doled out in increments, it takes another five or so years before the individuals pull the plug on their careers. And yet, because there is a solid profession there they can actually extend the suffering somewhat comfortably for years more because they're paid well to do it. This is not a good thing for anyone, especially the patient, but Hey! It pays the bills!

With medics, the burnout period is massively accelerated, largely because of the steady exposure to intense and unrelenting trauma. I'm not talking about gory crashes or children dying in your arms, I'm talking de-sensitizing yourself to the human condition by "having" to transport human shells back and forth to the Nursing Home being the essence of the work along with dealing with human beings who now have degenerated into "abusers".

Most medics hit one or more of these walls and in the absence of an outlet to process, come to terms with and then move on WHOOSH!! they're gone. I don't know what the stats are for average burn out today, but if you look at them one level deeper you'll see that the first three years have the biggest proportion of turnover.

The "culture" of the medic is still in an infantile Macho stage. I'll betcha a buck most of the medics on this site showing no pity to the OP will be gone within 3 years themselves!

Those who last much longer are essentially gluttons for punishment (and damn good medics) and too drained to have the energy to organize; especially since the biggest proportion of the people who they have to organize are not ready to dedicate themselves to the field by doing such things as getting educated. This "wait and see" attitude limits growth.

It's a numbers game and we ain't got the numbers to effect change. We don't have a profession because FNG's come in, get burned out fast and there is always the need to have warm bodies in the ambulance. It's relatively easy to get new blood because there are so many wanna be FNG's who are hooked on the "idea" of Johnny and Roy and about the third time the reality really slaps them in the face; Bye Bye!

The systems depend on this turnover to be cost-effective. They're not employing professionals, they're filtering through wanna-bes, the smallest majority of whom stick to it, really become medics and then, they'd just as soon that THEY leave because, well they gotta give them a raise every year!

It's quite the vicious circle, isn't it?

 

[46Young]

Our OP exemplifies the root problem of most everything that has been discussed re: EMS in crisis. It is, but not in the way he thinks. It is in crisis because HE is in crisis.

There had never been the continuity of employed crusaders in the profession to effect change for one reason; the turnover rate is sky high due to burnout. Burnout is sky-high due to the fact that NO ONE FACES IT.

Burnout is the poop in the living room that everyone is in denial about.

If there's a chance, as I see it, for EMS to grow as a profession the very first thing that must be put in place is something that allows active medics to MOVE THROUGH the emotional, psychological, moralistic, spiritual and psychic traumas they experience in their work. The people to set that up are medics themselves. Everyone else who's tried to do it has failed because they are not living within those conflicts themselves.

Nursing and other medical professionals have been able to organize because turnover doesn't begin to really accelerate until burnout takes hold, usually after ten or more years in the field; and then, because exposure is doled out in increments, it takes another five or so years before the individuals pull the plug on their careers. And yet, because there is a solid profession there they can actually extend the suffering somewhat comfortably for years more because they're paid well to do it. This is not a good thing for anyone, especially the patient, but Hey! It pays the bills!

With medics, the burnout period is massively accelerated, largely because of the steady exposure to intense and unrelenting trauma. I'm not talking about gory crashes or children dying in your arms, I'm talking de-sensitizing yourself to the human condition by "having" to transport human shells back and forth to the Nursing Home being the essence of the work along with dealing with human beings who now have degenerated into "abusers".

Most medics hit one or more of these walls and in the absence of an outlet to process, come to terms with and then move on WHOOSH!! they're gone. I don't know what the stats are for average burn out today, but if you look at them one level deeper you'll see that the first three years have the biggest proportion of turnover.

The "culture" of the medic is still in an infantile Macho stage. I'll betcha a buck most of the medics on this site showing no pity to the OP will be gone within 3 years themselves!

Those who last much longer are essentially gluttons for punishment (and damn good medics) and too drained to have the energy to organize; especially since the biggest proportion of the people who they have to organize are not ready to dedicate themselves to the field by doing such things as getting educated. This "wait and see" attitude limits growth.

It's a numbers game and we ain't got the numbers to effect change. We don't have a profession because FNG's come in, get burned out fast and there is always the need to have warm bodies in the ambulance. It's relatively easy to get new blood because there are so many wanna be FNG's who are hooked on the "idea" of Johnny and Roy and about the third time the reality really slaps them in the face; Bye Bye!

The systems depend on this turnover to be cost-effective. They're not employing professionals, they're filtering through wanna-bes, the smallest majority of whom stick to it, really become medics and then, they'd just as soon that THEY leave because, well they gotta give them a raise every year!

It's quite the vicious circle, isn't it?

That sounds about right. Sad and frustrating indeed.