Hazard Pay

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RocketMedic

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So I know it’s a tender moment with the economy shutting down and everything, but here’s a question: at what point does the hazardous pay discussion need to be had, both for EMS and the healthcare industry?

We’ve got massive shortages of critical equipment.

We’re all working, or soon to be, WAY outside of our levels of familiarity, training and safety.
And we’re doing it in the context of a viral, lethal pandemic that is killing healthcare providers disturbingly frequently.

so, when is this discussion OK?
 

mgr22

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I think discussion is always ok. What I'm asking myself is, would hazard pay solve any of the issues you highlighted, make me and my family safer, make anyone else any safer, or even help me feel better about being in EMS at a time like this? Probably not.
 
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RocketMedic

RocketMedic

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It’s not.
Why not though? Why even be paid at all in this time of hardship?

Also wanted to mention that fellow paramedics in California and Oklahoma are reported to be in critical condition, on ECMO, as a consequence of COVID-19 infection. So there’s that.
I’m not saying it needs to be immediate, but I am saying that there definitely appears to be hazards looming that are extraordinary.
 

NomadicMedic

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We teach PPE use in every EMT class. Not just for fun, but because you need to use it to protect yourself.

In my view, it’s incredibly naive for any EMS provider to think they would never come in contact with potentially infectious people or material. And ridiculous to expect that when it happens, demand more money.

Quite simply, taking care of sick people is part of the job.
 

NomadicMedic

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And as for not being paid at all... we are furloughing officestaff and wheelchair van drivers due to lack of work.
 
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RocketMedic

RocketMedic

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We teach PPE use in every EMT class. Not just for fun, but because you need to use it to protect yourself.

In my view, it’s incredibly naive for any EMS provider to think they would never come in contact with potentially infectious people or material. And ridiculous to expect that when it happens, demand more money.

Quite simply, taking care of sick people is part of the job.
But by that same token, PARTICULARLY when the PPE supplies are inadequate and what’s being used is out of its performance envelope, AND in the viral light of an extraordinary pandemic, is that an extraordinary hazard?
 

DesertMedic66

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Also wanted to mention that fellow paramedics in California are reported to be in critical condition, on ECMO, as a consequence of COVID-19 infection.
That is news to the vast majority of California clinicians.
 

ffemt8978

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So I know it’s a tender moment with the economy shutting down and everything, but here’s a question: at what point does the hazardous pay discussion need to be had, both for EMS and the healthcare industry?

We’ve got massive shortages of critical equipment.

We’re all working, or soon to be, WAY outside of our levels of familiarity, training and safety.
And we’re doing it in the context of a viral, lethal pandemic that is killing healthcare providers disturbingly frequently.

so, when is this discussion OK?
It's a fair question, but once you start providing it for one group, other groups are going to feel like they should receive it too (and a lot more groups than you probably realize). Where will the money come from?
 
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RocketMedic

RocketMedic

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No. Do your job.
So are you going to keep doing yours if the lethality rate hits 5%? 10%? If you are told to use a bandana and go without gloves?

Is your position absolute, or relative?
And are you a practicing field provider, or an administrator who plays at Paramedicine?
 

E tank

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Why not though? Why even be paid at all in this time of hardship?

Also wanted to mention that fellow paramedics in California and Oklahoma are reported to be in critical condition, on ECMO, as a consequence of COVID-19 infection. So there’s that.
Who is reporting COVID-19 patients being on ecmo currently?
 
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RocketMedic

RocketMedic

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It's a fair question, but once you start providing it for one group, other groups are going to feel like they should receive it too (and a lot more groups than you probably realize). Where will the money come from?
That is a problem for society. The way I see it though, we’re about to be asking a whole lot of a small group of people and those people are going to be facing some pretty extraordinary and extreme dangers to their health, and the first few paramedics who die for $17 an hour or EMTs who die for $10/hour are going to provoke some serious and significant discussions across EMS. Same for CNAs, RN, etc.

@NomadicMedic might ride the noble steed of ideas and optimism, but me? I’m a mercenary to some extent. There’s gotta be something in it for me if we’re going to do this for a long time without proper training, equipment, etc, or if the risk gets to be more than it is. That calculation is dynamic, especially if social support networks get good enough one could plausibly maintain a standard of living by staying home and welfare-ing it up.
I’ve done some deeply dangerous things for the USA and people before, but if I’d have gotten shot or blown up, there’s care there. Lifetime pension, disability, etc. SGLI, even. Police and firefighters generally have pretty robust personal injury protections. EMS usually doesn’t. And if it becomes a matter of “when”, not “if”, because the NomadicMedics and other leaders of your EMS agency can’t supply you with the things you need to do your job safely:..new hazard introduced. Ergo, hazard pay. It’s not necessarily just hourly pay either though. Housing, fuel, food, child care, pensions, disability, etc, are all on the table.
It is highly stupid to simply assume that willingness to “help someone” under normal circumstances translates to a mandate to go into a potentially-deadly situation on the regular, btw. Maybe a few will. But most of us will recalculate.
 
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RocketMedic

RocketMedic

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Who is reporting COVID-19 patients being on ecmo currently?
Trusted acquaintances. HIPAA is making it hard to gather data.
 

NomadicMedic

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Is the CFR going to hit 10%? No. It'll most likely stay right around 3%, where it's been from the very beginning.

I won't work without gloves. Neither should you. That's a very different statement from asking if you should get more money because you venture into harm's way.

My system has appropriate PPE and thanks to strategic stockpiling and allocations from the state, we expect to stay in decent shape.

Are we going to reuse N-95 masks? Yes, following the CDC guidelines. (https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html)

Am I a field paramedic? Yep. Sure am. I am also an administrator with responsibilities to the public, my employees and the board of directors.
Balancing these responsibilities is difficult. If you were actually in a leadership position instead of sniping from the back row, you would understand this.

Our mandate is simple: We will continue to respond to the public in the safest and most expedient way possible. We will continue utillize to guidelines and policies that have been put in place to protect and provide clear expectations for our staff on safety and operations and we will be responsible to the board of directors while managing our fiscal obligations.

I would never expect a provider to go into the field and work with anything less than the recommended PPE. But just because there are sick people and there is risk doesn't automatically indicate "hazard pay" for performing a job that provides adequate protection, education on its use and clear policies that mandate how and when to use it.

Sorry. It's not going to fly with me. Go peddle your papers somewhere else.
 

ffemt8978

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That is a problem for society. The way I see it though, we’re about to be asking a whole lot of a small group of people and those people are going to be facing some pretty extraordinary and extreme dangers to their health, and the first few paramedics who die for $17 an hour or EMTs who die for $10/hour are going to provoke some serious and significant discussions across EMS. Same for CNAs, RN, etc.

@NomadicMedic might ride the noble steed of ideas and optimism, but me? I’m a mercenary to some extent. There’s gotta be something in it for me if we’re going to do this for a long time without proper training, equipment, etc, or if the risk gets to be more than it is. That calculation is dynamic, especially if social support networks get good enough one could plausibly maintain a standard of living by staying home and welfare-ing it up.
I’ve done some deeply dangerous things for the USA and people before, but if I’d have gotten shot or blown up, there’s care there. Lifetime pension, disability, etc. SGLI, even. Police and firefighters generally have pretty robust personal injury protections. EMS usually doesn’t. And if it becomes a matter of “when”, not “if”, because the NomadicMedics and other leaders of your EMS agency can’t supply you with the things you need to do your job safely:..new hazard introduced. Ergo, hazard pay. It’s not necessarily just hourly pay either though. Housing, fuel, food, child care, pensions, disability, etc, are all on the table.
It is highly stupid to simply assume that willingness to “help someone” under normal circumstances translates to a mandate to go into a potentially-deadly situation on the regular, btw. Maybe a few will. But most of us will recalculate.
So you want hazard pay but have decided it is for others to determine where the money for it comes from. Others working in critically necessary professions make less than a medic and sometimes less than an EMT, deal with more people on a daily basis, and do so with less PPE and training (i.e. the employees at your local grocery stores). Are you suggesting they should receive hazard pay too?
 
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RocketMedic

RocketMedic

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Go look at Italy and tell me what happens when your world looks like that. “We expect”...bro, you’re already reusing masks. Pretty soon it’ll be reusing everything, same as we are. And then one or two of your people will get sick, and this discussion will return. And guidelines? In the last week we’ve seen those change from “every encounter toss it” to “maybe a bandana will work” from the CDC. How about you go try that in Wuhan?
Pandemics are extraordinary circumstances and might justify that pay. You’re pretty clearly an absolutist who opposes the very concept and I’m glad I will never work with you if you’re so close minded as to be unable to articulate any reasonable point for hazard pay.
 
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RocketMedic

RocketMedic

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So you want hazard pay but have decided it is for others to determine where the money for it comes from. Others working in critically necessary professions make less than a medic and sometimes less than an EMT, deal with more people on a daily basis, and do so with less PPE and training (i.e. the employees at your local grocery stores). Are you suggesting they should receive hazard pay too?
Yes, they absolutely should. And when they start leaving their jobs in frustration, fear and for reasons of illness, the market will be forced to try to earn them back with higher wages.
Hazard pay for particularly hazardous tasks is a hallmark of the military, which is quite literally a solemn legal obligation voluntarily entered into without knowledge of potential hazards. So @Nomadicmedic’s thing doesn’t really fly...if the Army pays you more for duty in a hazardous zone despite the fact that you can die CONUS, you should be paid more for working during a viral pandemic.
 
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ffemt8978

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Yes, they absolutely should. And when they start leaving their jobs in frustration, fear and for reasons of illness, the market will be forced to try to earn them back with higher wages.
So where do you draw the line at which groups should receive this pay?

And based upon what happened in the markets where minimum wage went up significantly (reduced hours, reduced benefits, reduced employees), earning employees back with higher wages may not work. The same for government bailouts...the money has to come from somewhere, and until that can be determined, the entire concept is a moot point.
 
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