EMS In Crisis

medic3974

medic3974

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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.
 
 
I'm on a roll tonight.

medic3974 said:
I`ve had it with this job. It was a career and a profession,.
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When was that? If it was I'd probably still be on a truck.


medic3974 said:
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.
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Why is it the government's responsibility? In a government of the people, for the people, by the people. Doesn't that make it our responsibility and not that of some ambiguous entity?

It was EMS people who told the public to measure effectiveness by the amount of people raised from the dead, the volume of paramedics in the system, and response times.

medic3974 said:
Private EMS folks were looking to get rich so transport everything.
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Every type of agency does. The worst offender i ever worked for was a municiple 3rd service that measured how good of a paramedic you were by how many runs you could do in a day.

medic3974 said:
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..
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That is an over generous estimation.

medic3974 said:
Working 24 hour shifs, sleep depervation, starving to eat because your on the 16th call and the truck got fuel but you didnt...
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True that sucks.

medic3974 said:
Senior Parmedics 5 years in the field because most wont last past that after all the abuse.
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I once heard a joke that the only smart marine was an ex marine. But when medics used to simply switch services to get a new environment to avoid burnout, organizations started not hiring them refering to them as "gypsies" and "not worth the investment" so you could no longer recruit somebody with more than 5 years experience. Meanwhile services (all services are guilty) didn't want to spend the money to offer a career laddrer for people to stay. Again our fault. There was a time a union could have helped, but I think it is past that.

medic3974 said:
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.
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They will get what they are willing to pay for. No less, certainly no more.


medic3974 said:
because paramedic school is 2 years and nobody wants this anymore.
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Do you promise!!!?

Then there wouldn't be 10,000 patch and pulse providers without a clue and the demand will outstrip the supply. Ask any economist what happens then!
 
hmmm

Hmmm,

You know I think it might be worth it to look back at the history of the 911 service. I have to admit that I don't know that much about it at all...but it is a great concept. Unfortunelty,it is being abused...and a lot more than I think a lot of people realize (check out this article http://money.cnn.com/2009/08/24/news/economy/healthcare_911_abuse/index.htm). I think it definitly has gone from a luxury mindset to a call on demand service...think about it really...how fortunate are we to be able to dial three numbers and have other people, who really have no obligation to help us...yet are trained, come and give aid. Unfortunetly the mindset has gone from that to "of course they came...I called them! And they should have been here faster...now...why haven't my fries been brought yet??" <_<

There was a little situation one of our expedition groups had a couple years ago. About 3 days out in the back country...broken ankle...no cell service (and where they were satalite phones were about useless...but they did have a WEMT with them ;) In any case they had to send to people to higher ground to call 911 for an ambulance...they had to call 24 times before they got a dispatcher because they kept being put on hold because all of the lines were busy. Later they were told it was because there were several non-emergencies that had taken up the phone lines...rediculous!!

It seems to me that there should be a better way to educate people on when to and when not to call 911....reminds me of that movie quote:

"PIease don't teII me you caIIed me out of a wedding to heIp you pick out a suit."
"You ran out of a wedding? That's horribIe!"
"You said it was an emergency! Didn't I memo you as to what constitutes an emergency?"
"Yes. Large meteor, severe Ioss of bIood and what's the third one again?"
"Death!"
" And you're not dead."
"No"

But despite all of its greviences...and let's face it no job is perfect...keep in mind that to those who really do have an emergency...you're heroes. I have yet to decide if I will continue my training and possibly work within the urban context as an EMT so speaking as someone who is not currently one...I have to say I respect all of you, and what you do, a lot....hope that wasn't too sappy for you all :D
 
this is why I enjoy volly services.. do a differant thing then regular job, community support. big plus 1 on volly services.
 
medic3974 said:
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.
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Nice of you to visit. Happy to see you reflect many views that people can relate to.

Now...how can we be of assistance?
 
Nobody is holding a gun to your head, your life is your own.
Do with it what you think best.
 
OP seems ambivalent...

Other places aren't as bad, some maybe worse. As long as young single warriors with death keep flinging themselves in, it will continue.
Move. Hone your skills. Get another job. Some games are best not played at all.
 
Veneficus, free market effect doesn't work with EMS.

Too much regulation built in at many levels (legal, civil, governmental at many junctures), cost too high without subsidy for most people.
In fact, EMS is an excellent example on one hand of why civil service and government functions are needed (to carry out stuff no one can or wants to do for private profit), and on the other how and why it fails (operational considerations are political, expectations constantly inflated, and results tainted by inflation and mudslinging.

PS: someone (OP?) said public needs educations as to how to use EMS. Most have no alternative because EMS sucked public health dry years ago, or they think they deserve a cadillac ride and emergency dept care when all they really need is a short wait at a well-run clinic and a ride home because they are sick.
 
what's next?
 
Cynical much? Anyone in EMS for any length of time gets jaded, but if you hate it that much, it's time to move on to something else. When I started feeling this way about the practice of law, I realized that my mental health required an exit strategy, even if it was in the long term.
 
medic3974 said:
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.
Click to expand...

Don't hold back, tell us how you really feel. Just kidding.

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.

Ventmedic has advised of those nursing and other professions collectively becoming educated, taking the position that it's mainly for pt benefit, then organizing and lobbying for all that they have now. That model obviously worked, for them, but doesn't mean that the same model will work for EMS. No guarantee.

Unless employers require degrees as condition of employment and/or significant political organization/lobbying takes place, the outlook for the future of EMS is grim. If things remain unchanged, the way I see it, the fire service will eventually achieve an overwhelming majority (or even complete)control of 911 EMS txp, nurses will do most IFT, with the privates left with simple, non emergent IFT at best. I'm suprised that the nurses haven't attempted to take over EMS IFT at large thus far by exposing the inadequate education of the EMT and paramedic. With their level of education, perhaps the hospitals would be able to bill for IFT at a higher rate using nurses, and needing to have nurses at the minimum due to the inadequacy of the paramedic's education.
 
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46Young said:
Ventmedic has advised of those nursing and other professions collectively becoming educated, taking the position that it's mainly for pt benefit, then organizing and lobbying for all that they have now. That model obviously worked, for them, but doesn't mean that the same model will work for EMS. No guarantee.
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What type of health care education is described by the following system:

Any Tom, ****, or Harry could open up a school.

Almost no standardized education requirements.

Admissions and graduation requirements decided by the schools with high variability from institution to institution.

The ability to observe or participate in patient care ranged from none to a virtual run of the place.

Lab facilities (both clinical skills lab and educational labs) varied from non-existent to high levels.

Instructors were who ever could be found to volunteer time.


Give up?



Medical education in the US circa 1910. Isn't it kinda of scary what medical education consisted of just a relatively short 100 years ago? I've said this before, and will continue to say it. Probably the best way to advance EMS education standards at this point of the game is through a Flexner style report that shames the EMS community to demand higher standards and reform education.
 
JPINFV said:
What type of health care education is described by the following system:

Any Tom, ****, or Harry could open up a school.

Almost no standardized education requirements.

Admissions and graduation requirements decided by the schools with high variability from institution to institution.

The ability to observe or participate in patient care ranged from none to a virtual run of the place.

Lab facilities (both clinical skills lab and educational labs) varied from non-existent to high levels.

Instructors were who ever could be found to volunteer time.


Give up?



Medical education in the US circa 1910. Isn't it kinda of scary what medical education consisted of just a relatively short 100 years ago? I've said this before, and will continue to say it. Probably the best way to advance EMS education standards at this point of the game is through a Flexner style report that shames the EMS community to demand higher standards and reform education.
Click to expand...

Not disagreeing with you. The Flexner style report is a great idea, but would require organization, along with an extensive media and lobbying, of course.

Who's going to do that?

That was what I was getting at with the last post. EMS doesn't have enough like minded people to fight the good fight. The issues of having a poor work environment, poor pay, poor career advancement, and a transient work force are difficult to overcome when the goal is to retain motivated EMS professionals that will be properly educated, and will organize/lobby.
 
8jimi8 said:
what's next?
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Good question. We ran a call this morning that is a perfect example of what EMS is all about. Female patient c/o pink eye. Demanding to be transported to an already over burden ER. She was full of all the usual dramatics. Towel tied around her head to cover her eyes and the slow painful death march to the unit. I know people who have committed find another job and no one is holding a gun to your head, yea, your the ones that get the stairchairs or stretcher and carry them to the truck. So, I am talking to you folks that have been out of school and have been doing this for awhile. Anyway, I mentioned to the patient waiting a couple of hours untill a clininc opens. I explained to her that the ER was busy and she would save herself the cost of a ambulance and ER bill. She told me "thats what my medicaid is for". Oh yes she got transported and will set in triage forever. But, she will sit their for ever patiently. She will suck everything she can out of the system.
 
Sadly I can't see such a report working.


The media is content to look at EMT's and Medics as heroes that save lives. Most EMT'/Ps are content to buy into this and all the myths of EMS. "This is the street. It seperates the men from the boys"

In all likliehood nothing will change. Whackers will stick around, and anyone with any sense will get out.
 
46Young said:
Don't hold back, tell us how you really feel. Just kidding.

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.

Ventmedic has advised of those nursing and other professions collectively becoming educated, taking the position that it's mainly for pt benefit, then organizing and lobbying for all that they have now. That model obviously worked, for them, but doesn't mean that the same model will work for EMS. No guarantee.

Unless employers require degrees as condition of employment and/or significant political organization/lobbying takes place, the outlook for the future of EMS is grim. If things remain unchanged, the way I see it, the fire service will eventually achieve an overwhelming majority (or even complete)control of 911 EMS txp, nurses will do most IFT, with the privates left with simple, non emergent IFT at best. I'm suprised that the nurses haven't attempted to take over EMS IFT at large thus far by exposing the inadequate education of the EMT and paramedic. With their level of education, perhaps the hospitals would be able to bill for IFT at a higher rate using nurses, and needing to have nurses at the minimum due to the inadequacy of the paramedic's education.
Click to expand...



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.
 
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