Fire or Ambulance District? Which do you prefer?

[VentMonkey]

FF Private at $32,981—$ 51,168 versus medic at $34,164 - $51,272, you're right. I would quibble wit how the top range is roughly the same, though, unless you're promoting your medics somehow (considering that FF private is probably for the true entry level FF)?

No charts or graphs, Ep? Someone's slacking. I kid, I kid.

 

[StCEMT]

(temporary) thread hijack:

Could you give a quick overview of how EMS works within the St. Louis FD?

What's the in-house culture between the fire guys, and single roles?

It seems like they hire almost constantly. I looked at them briefly when I was a new paramedic as well.

I don't know much. I believe they run P/B trucks on 12 hour shifts (I wouldn't want to do 24's with them, but the other place does and gets hit hard too). They keep folks on the pumpers and stuff too to help us out when we get dispatched to a city call. We back them up when things are especially busy and our BLS trucks take the psychs and such calls that would tie up their ALS trucks.

Honestly, I don't know anything about their in house culture between the two, although I do like that it is split. That might be the one way I don't mind fire based EMS. If I would have applied (just didn't have enough time left in MO), I could have given you a better answer. All I know is those folks get worked hard and 1 year with STLFD=many years at other places outside of the city. Kinda a mix between sheer call volume mixed in with the shootings, OD's, MVC's, that are a regular occurrence here.

I would imagine that there is a pretty high turnover rate there. Like I said, it is a busy place so its easy to get burnt out there. Not to mention, you can get paid so much better at surrounding departments that if you can jump ship it'd be worth it.

 

[gotbeerz001]

In an all ALS system, I would venture to guesss this is the ideal approach to being an effective engine paramedic, and hardly see any reason for scrutinizing this method.

I am also willing to bet most of the interactions with the transport paramedics in your area appreciate this, which in turn would produce a smooth well-oiled call, and environment.

Of course, this is all hypothetical.

When I transport, I have some specific fire depts known to hold us at arms length until they finish "their assessment... and CHOOSE to transfer care". While this goes against the cliché of FDs not caring about EMS, from a clinical perspective, I find it frustrating that they delay transport for no real reason.

I work with a couple career fire medics (no transport time) at the FD who also have the same approach that "we (the FD) are the the ones who care about our community and are their best advocates for our patients against the systemic laziness of the transporting medics (who obviously can't land a badass fire job)"... which is BS. I have received a few words from those who say I "don't treat my patients" though in my mind I have ruled out the conditions that concerned me and determined the pt is stable enough to move.

Conversely, I have had some instances where FDs have severely under-treated pts but these are relatively few and far between; maybe I have been lucky or just hold the bar pretty low. I'd say the delay issue detailed above occurs more often than blatant poor care.


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[VentMonkey]

When I transport, I have some specific fire depts known to hold us at arms length until they finish "their assessment... and CHOOSE to transfer care". While this goes against the cliché of FDs not caring about EMS, from a clinical perspective, I find it frustrating that they delay transport for no real reason.

I work with a couple career fire medics (no transport time) at the FD who also have the same approach that "we (the FD) are the the ones who care about our community and are their best advocates for our patients against the systemic laziness of the transporting medics (who obviously can't land a badass fire job)"... which is BS. I have received a few words from those who say I "don't treat my patients" though in my mind I have ruled out the conditions that concerned me and determined the pt is stable enough to move.

Conversely, I have had some instances where FDs have severely under-treated pts but these are relatively few and far between; maybe I have been lucky or just hold the bar pretty low. I'd say the delay issue detailed above occurs more often than blatant poor care.

I had this same mix, and experience in a previous "all ALS" system in my previous, albeit short-lived, paramedic county.

Strangely enough, I got along great with the engine medics similar to yourself, and not so much with the ones whose departments didacted that we were merely there for transport.

Goods, and bads overall just like anywhere, but overall it was an excellent place to gain 5 years of experience in about a year.

A little ego goes a long way (pun intended).